[118th Congress Public Law 210]
[From the U.S. Government Publishing Office]
[[Page 2705]]
SENATOR ELIZABETH DOLE 21ST CENTURY VETERANS HEALTHCARE AND BENEFITS
IMPROVEMENT ACT
[[Page 138 STAT. 2706]]
Public Law 118-210
118th Congress
An Act
To amend title 38, United States Code, to improve certain programs of
the Department of Veterans Affairs for home and community based services
for veterans, and for other purposes. <<NOTE: Jan. 2, 2025 - [S.
141]>>
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled, <<NOTE: Senator
Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement
Act.>>
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) <<NOTE: 38 USC 101 note.>> Short Title.--This Act may be cited
as the ``Senator Elizabeth Dole 21st Century Veterans Healthcare and
Benefits Improvement Act''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--HEALTH CARE MATTERS
Subtitle A--Veterans Community Care Program Matters
Sec. 101. Implementation of provision of care under Veterans Community
Care Program upon determination of eligibility by veteran and
veteran's referring clinician.
Sec. 102. Outreach regarding care and services under Veterans Community
Care Program.
Sec. 103. Annual review and report on waivers of certain payment rates
under Veterans Community Care Program.
Sec. 104. Modification of requirements for standards for quality of care
from Department of Veterans Affairs.
Sec. 105. Pilot program to improve administration of care under Veterans
Community Care Program.
Sec. 106. Pilot program on consolidating approval process of Department
of Veterans Affairs for covered dental care.
Sec. 107. Strategic plan on value-based health care system for Veterans
Health Administration; pilot program.
Sec. 108. Plan on adoption of certain health information standards for
Department of Veterans Affairs and certain health care
providers.
Sec. 109. Report on use of value-based reimbursement models under
Veterans Community Care Program.
Sec. 110. Inspector General assessment of implementation of Veterans
Community Care Program.
Sec. 111. Comptroller General report on dentistry under Veterans
Community Care Program.
Subtitle B--Matters Relating to Nursing Home and Other Long Term Care
and Family Caregivers
Sec. 120. Increase of expenditure cap for noninstitutional care
alternatives to nursing home care.
Sec. 121. Coordination with Program of All-Inclusive Care for the
Elderly.
Sec. 122. Authority for Secretary of Veterans Affairs to award grants or
contracts to entities to improve provision of mental health
support to family caregivers of veterans.
Sec. 123. Home- and community-based services: programs.
Sec. 124. Coordination with assistance and support services for
caregivers.
[[Page 138 STAT. 2707]]
Sec. 125. Improvements to program of comprehensive assistance for family
caregivers.
Sec. 126. Improvements relating to Homemaker and Home Health Aide
program.
Sec. 127. Pilot program to furnish assisted living services to certain
veterans.
Sec. 128. Provision of medicine, equipment, and supplies available to
Department of Veterans Affairs to State homes.
Sec. 129. Recognition of organizations and individuals to assist
veterans, family members, and caregivers navigating programs
and services of Veterans Health Administration.
Sec. 130. Reviews and other improvements relating to home- and
community-based services.
Sec. 131. GAO report on mental health support for caregivers.
Sec. 132. Development of centralized website for program information.
Sec. 133. Definitions.
Subtitle C--Medical Treatment and Other Matters
Sec. 140. Quarterly report on referrals for non-Department of Veterans
Affairs health care.
Sec. 141. Elimination of certain requirements for certain Department of
Veterans Affairs Assistant Under Secretaries.
Sec. 142. Modification of pay limitation for physicians, podiatrists,
optometrists, and dentists of Department of Veterans Affairs.
Sec. 143. Reimbursement of ambulance cost for care for certain rural
veterans.
Sec. 144. Pilot program to furnish dental care from the Department of
Veterans Affairs to certain veterans diagnosed with ischemic
heart disease.
Sec. 145. Documentation of preferences of veterans for scheduling of
appointments for health care under laws administered by
Secretary of Veterans Affairs.
Sec. 146. Staffing model and performance metrics for certain employees
of the Department of Veterans Affairs.
Sec. 147. Online health education portal for veterans enrolled in
patient enrollment system of Department of Veterans Affairs.
Sec. 148. Limitation on detail of directors of medical centers of
Department of Veterans Affairs to different positions.
Sec. 149. National Veteran Suicide Prevention Annual Report.
Sec. 150. Report on physical infrastructure required by medical
facilities of Department of Veterans Affairs to provide
dental care services.
Sec. 151. Comptroller General report on certain oral health care
programs under laws administered by Secretary of Veterans
Affairs.
Sec. 152. Review of workflows associated with processing referrals
between facilities of the Veterans Health Administration.
Sec. 153. Plan for timely scheduling of appointments at medical
facilities of Department of Veterans Affairs.
Sec. 154. Authorization of appropriations to support initiatives for
mobile mammography services for veterans.
TITLE II--ECONOMIC OPPORTUNITY MATTERS
Subtitle A--Educational Assistance
Sec. 201. Temporary expansion of eligibility for Marine Gunnery Sergeant
John David Fry Scholarship.
Sec. 202. Removal of expiration on entitlement to Marine Gunnery
Sergeant John David Fry Scholarship for surviving spouses.
Sec. 203. Sole liability for transferred educational assistance by an
individual who fails to complete a service agreement.
Sec. 204. Notice to educational institutions of risk-based surveys.
Sec. 205. Relationship of participation by an educational institution in
certain Federal student financial aid programs to approval of
such institution for purposes of Department of Veterans
Affairs educational assistance programs.
Sec. 206. Expansion of Department of Veterans Affairs oversight of
certain educational institutions.
Sec. 207. Requirement that educational institutions approved for
purposes of Department of Veterans Affairs educational
assistance programs provide digital official transcripts.
Sec. 208. Payment of full monthly housing stipend for veterans enrolled
in final semester using educational assistance under Post-9/
11 Educational Assistance Program.
Sec. 209. Modification of rules for approval of commercial driver
education programs for purposes of educational assistance
programs of the Department of Veterans Affairs.
[[Page 138 STAT. 2708]]
Sec. 210. Provision of certificates of eligibility and award letters
using electronic means.
Sec. 211. Retroactive effective date of law regarding charge to
entitlement to educational assistance for individuals who do
not transfer credits from certain closed or disapproved
programs of education.
Sec. 212. Department of Veterans Affairs high technology program.
Sec. 213. Notice of changes to Department of Veterans Affairs policies
and guidance affecting the educational assistance programs of
the Department.
Sec. 214. Payment of VA educational assistance via electronic fund
transfer to a foreign institution of higher education.
Sec. 215. Improving transparency and accountability of educational
institutions for purposes of veterans educational assistance.
Subtitle B--Employment and Training
Sec. 221. Improvements to reemployment rights of members of the Armed
Forces.
Sec. 222. Review of investigations manual of Veterans' Employment and
Training Service.
Sec. 223. Warrior Training Advancement Course.
Subtitle C--Home Loans
Sec. 231. Improvements to program for direct housing loans made to
Native American veterans by the Secretary of Veterans
Affairs.
Sec. 232. Native community development financial institution relending
program.
TITLE III--DISABILITY AND MEMORIAL AFFAIRS MATTERS
Sec. 301. Burial allowance for certain veterans who die at home while in
receipt of hospice care furnished by Department of Veterans
Affairs.
Sec. 302. Authority for Secretary of Veterans Affairs to award grants to
States and Indian Tribes to improve outreach to veterans.
Sec. 303. Definition of surviving spouse.
Sec. 304. Ensuring only licensed health care professionals perform
medical disability examinations under certain Department of
Veterans Affairs pilot program.
Sec. 305. Provision of information regarding an agent or attorney to a
licensed health care professional who performs a medical
disability examination under certain Department of Veterans
Affairs pilot program.
Sec. 306. Modernization of Department of Veterans Affairs disability
benefit questionnaires.
Sec. 307. Department of Veterans Affairs automatic processing of certain
claims for temporary disability ratings.
TITLE IV--HOMELESSNESS MATTERS
Sec. 401. Short title.
Sec. 402. Per diem payments provided by the Secretary of Veterans
Affairs for services furnished to homeless veterans.
Sec. 403. Authorization for Secretary of Veterans Affairs to use certain
funds for improved flexibility in assistance to homeless
veterans.
Sec. 404. Access to Department of Veterans Affairs telehealth services.
TITLE V--OVERSIGHT AND INVESTIGATIONS MATTERS
Sec. 501. Department of Veterans Affairs employee training regarding
Office of Inspector General.
Sec. 502. Annual review of security at covered facilities of the
Department of Veterans Affairs.
Sec. 503. Modification of certain housing loan fees.
TITLE I--HEALTH CARE MATTERS
Subtitle A--Veterans Community Care Program Matters
<<NOTE: 38 USC 1703 note.>> SEC. 101. IMPLEMENTATION OF PROVISION
OF CARE UNDER VETERANS COMMUNITY CARE
PROGRAM UPON DETERMINATION OF ELIGIBILITY
BY VETERAN AND VETERAN'S REFERRING
CLINICIAN.
(a) In General.--During the period specified in subsection (c), the
Secretary of Veterans Affairs shall implement section
[[Page 138 STAT. 2709]]
1703(d)(1)(E) of title 38, United States Code, in compliance with the
implementing regulations for such section under section 17.4010(a)(5) of
title 38, Code of Federal Regulations, such that the determination of
eligibility for care is final and shall be made by the veteran and the
veteran's referring clinician.
(b) Correction of Errors.--A covered veteran and the referring
clinician of such veteran may correct any errors made with respect to a
determination described in subsection (a).
(c) <<NOTE: Effective date.>> Period Specified.--The period
specified in this subsection is the two-year period beginning on the
date that is 90 days after the date of the enactment of this Act.
(d) <<NOTE: Time period.>> Report.--Not later than one year and not
later than two years after the commencement of the period specified by
subsection (c), the Secretary of Veterans Affairs shall submit to
Congress a report on the care provided under section 1703(d)(1)(E) of
title 38, United States Code, during the one-year period preceding the
date of the report, including--
(1) the number of instances of care provided;
(2) the type of care provided; and
(3) the cost of such care.
(e) Rule of Construction.--Nothing in this section shall be
construed to limit the Secretary's authority to prescribe, amend, or
rescind regulations under section 1703 of title 38, United States Code.
(f) Covered Veteran Defined.--In this section, the term ``covered
veteran'' has the meaning given that term in section 1703(b) of title
38, United States Code.
SEC. 102. OUTREACH REGARDING CARE AND SERVICES UNDER VETERANS
COMMUNITY CARE PROGRAM.
(a) Requirement.--Section 1703 of title 38, United States Code, is
amended--
(1) by redesignating subsection (o) as subsection (p); and
(2) by inserting after subsection (n) the following new
subsection (o):
``(o) Outreach Regarding Availability of Care and Services.--(1) The
Secretary shall conduct outreach to inform veterans of the following:
``(A) The conditions for care or services under subsections
(d) and (e).
``(B) How to request such care or services.
``(C) How to appeal a denial of a request for such care or
services using the clinical appeals process of the Veterans
Health Administration.
``(2) <<NOTE: Time period. Notification.>> Upon enrollment of a
veteran in the system of annual patient enrollment established and
operated under section 1705 of this title, and not less frequently than
every two years thereafter, the Secretary shall inform the veteran of
information described in paragraph (1).
``(3) The Secretary shall ensure that information described in
paragraph (1) is--
``(A) <<NOTE: Public information.>> publicly displayed in
each medical facility of the Department;
``(B) <<NOTE: Web posting.>> prominently displayed on a
website of the Department; and
``(C) included in other outreach campaigns and activities
conducted by the Secretary.''.
[[Page 138 STAT. 2710]]
(b) Solid Start Program.--Section 6320(a)(2)(A) of title 38, United
States Code, is amended by inserting ``, including how to enroll in the
system of annual patient enrollment established and operated under
section 1705 of this title and the ability to seek care and services
under sections 1703 and 1710 of this title'' before the semicolon.
(c) Comptroller General Report on Outreach.--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 on the
efforts of the Secretary of Veterans Affairs to ensure that veterans are
informed of the conditions for eligibility for care and services under
section 1703 of title 38, United States Code, including such efforts to
conduct outreach pursuant to subsection (o) of such section (as added by
subsection (a)).
SEC. 103. ANNUAL REVIEW AND REPORT ON WAIVERS OF CERTAIN PAYMENT
RATES UNDER VETERANS COMMUNITY CARE
PROGRAM.
(a) In General.--Section 1703 of title 38, United States Code, is
further amended--
(1) by redesignating subsection (p) as subsection (q); and
(2) by inserting after subsection (o) the following new
subsection (p):
``(p) Annual Review and Report on Waivers of Payment Rates.--(1) On
an annual basis, the Secretary shall--
``(A) conduct a review of waivers of payment rates under
subsection (i) for Third Party Administrators to identify
whether such waivers help to alleviate community-specific
challenges, including scarcity of medical services associated
with access to health care; and
``(B) submit to Congress a report on the results of such
review.
``(2) <<NOTE: Statements.>> Each report under paragraph (1)(B)
shall include, with respect to the period covered by the report--
``(A) a statement, disaggregated by region, of the total
number of waivers described in subparagraph (A) of such
paragraph requested by Third Party Administrators;
``(B) a statement of the total number of such waivers that
were--
``(i) granted by the Secretary;
``(ii) denied by the Secretary; or
``(iii) withdrawn by a Third Party Administrator;
``(C) a description of the process for the review required
under paragraph (1);
``(D) a statement, disaggregated by region, of the average
time to process such waivers;
``(E) <<NOTE: Assessment.>> an assessment, disaggregated by
region, of the extent to which such waivers that were granted by
the Secretary improved access to health care for covered
veterans; and
``(F) a description of trends, if any, identified by the
Secretary with respect to such waivers.
``(3) <<NOTE: Definition.>> In this subsection, the term `Third
Party Administrator' has the meaning given such term in section 1703B of
this title.''.
(b) <<NOTE: 38 USC 1703 note.>> Deadline.--The Secretary shall
submit the first report required under subsection (p) of section 1703 of
such title (as added by subsection (a)) not later than 180 days after
the date of the enactment of this Act.
[[Page 138 STAT. 2711]]
SEC. 104. MODIFICATION OF REQUIREMENTS FOR STANDARDS FOR QUALITY
OF CARE FROM DEPARTMENT OF VETERANS
AFFAIRS.
(a) In General.--Section 1703C of title 38, United States Code, is
amended--
(1) in subsection (a)--
(A) in paragraph (2)--
(i) by striking ``In establishing'' and
inserting ``(A) In establishing''; and
(ii) by adding at the end the following new
subparagraph:
``(B) <<NOTE: Data.>> The Secretary shall ensure that the
standards for quality established under paragraph (1) are
comparable to industry standards to ensure there is adequate
data transference between care furnished by the Department and
care furnished by a non-Department provider.'';
(B) in paragraph (3)(B), by adding at the end the
following new clause:
``(v) Outcomes relating to patient quality of
life.'';
(C) in paragraph (4)--
(i) by striking ``and the Centers for Medicare
& Medicaid Services'' and inserting ``the Centers
for Medicare & Medicaid Services, and the Indian
Health Service''; and
(ii) by striking ``and other nongovernmental
entities'' and inserting ``and other non-
governmental entities including Third Party
Administrators''; and
(D) by striking paragraph (5) and inserting the
following new paragraphs:
``(5) <<NOTE: Data.>> When collecting, considering, and applying
data related to patient care for purposes of establishing standards for
quality under paragraph (1), the Secretary shall ensure no metric is
being over or under analyzed.
``(6) <<NOTE: Data.>> In establishing standards for quality under
paragraph (1), the Secretary shall--
``(A) utilize the most up-to-date practices for extracting
and analyzing relevant data;
``(B) utilize all relevant data available to the Secretary;
``(C) ensure the most efficient use of time and resources
related to the use of data scientists employed by the
Department; and
``(D) collaborate, as appropriate, with entities specified
in paragraph (4).
``(7)(A) <<NOTE: Time period. Updates.>> Not less frequently than
once every five years, the Secretary shall update the standards for
quality established under paragraph (1) pursuant to the requirements for
the establishment of such standards under this subsection.
``(B) <<NOTE: Reports.>> Not later than 30 days after any date on
which the Secretary updates, pursuant to subparagraph (A), the standards
for quality under paragraph (1), the Secretary shall submit to the
appropriate committees of Congress a report on such updated standards
for quality.''; and
(2) in subsection (b)--
(A) in paragraph (1)--
(i) by striking ``Not later than 1 year after
the date on which the Secretary establishes
standards for
[[Page 138 STAT. 2712]]
quality under subsection (a)'' and inserting ``Not
less frequently than once every three years''; and
(ii) by inserting ``pursuant to standards for
quality under subsection (a)'' after ``medical
facilities of the Department''; and
(B) in paragraph (2), by inserting ``or updates''
after ``establishes''.
(b) <<NOTE: 38 USC 1703C note.>> Deadline for Update.--The
Secretary, pursuant to paragraph (7) of section 1703C(a) of title 38,
United States Code (as added by subsection (a)), shall make the first
update to the standards for quality established under paragraph (1) of
such section not later than the date that is five years after the date
on which the Secretary submits the report under paragraph (2) of
subsection (d).
(c) Report.--Not later than one year after the date of the enactment
of this Act, the Secretary of Veterans Affairs shall submit to the
appropriate committees of Congress a report on how the Secretary--
(1) has consulted with entities specified in paragraph (4)
of section 1703C(a) of title 38, United States Code, before the
date of the enactment of this Act in establishing standards for
quality under such section;
(2) has continued to consult with those entities on and
after such date of enactment; and
(3) intends to leverage data sciences to improve standards
for quality care furnished by the Department of Veterans
Affairs.
(d) <<NOTE: 38 USC 1703C note.>> Updates to Quality Care Metrics.--
(1) Initial report.--Not later than one year after the date
of the enactment of this Act, the Secretary of Veterans Affairs
shall submit to the appropriate committees of Congress a report
on how the Secretary plans to implement the amendments made by
subsections (a).
(2) Deadline; summary report.--Not later than two years
after the date of the enactment of this Act, the Secretary
shall--
(A) implement the amendments made by subsection (a),
including by updating the standards for quality
established under section 1703C of title 38, United
States Code; and
(B) submit to the appropriate committees of Congress
a report detailing the standards for quality updated
pursuant to such amendments.
(e) Audit of Quality Care Metrics.--
(1) <<NOTE: Deadline. Contracts.>> In general.--Not later
than 180 days after the date of the enactment of this Act, the
Secretary of Veterans Affairs shall enter into one or more
contracts with a non-Department entity described in paragraph
(2) to conduct an audit on the quality of care from the
Department of Veterans Affairs, including through non-Department
health care providers pursuant to section 1703 of title 38
United States Code.
(2) Non-department entity described.--A non-Department
entity described in this paragraph is an entity that--
(A) specializes in analyzing large-scale
organizational data collection and analysis efforts,
especially with respect to the health care sector; and
[[Page 138 STAT. 2713]]
(B) has experience and proven outcomes in optimizing
the accuracy and comprehensiveness of data collection
and analysis related to the quality of health care
services.
(3) <<NOTE: Assessments.>> Elements.--The audit required
under paragraph (1) shall include the following:
(A) An assessment of the methodology used by the
Department to collect and assess data on the quality of
care furnished by the Department, including any
vulnerabilities in such methodology.
(B) An assessment of the accuracy and reliability of
the data sources used by the Department to compile data
on the quality of care furnished by the Department.
(C) The extent to which the standards the Department
uses to assess the quality of care furnished by the
Department are--
(i) comparable with industry standards;
(ii) easily accessible to, and understood by--
(I) veterans;
(II) employees of the Department;
and
(III) other individuals, as the
private sector entity considers
appropriate.
(D) <<NOTE: Recommenda- tions.>> Any
recommendations of such private sector entity with
respect to improvements that the Secretary could
administer to more accurately capture the quality of
care furnished by the Department.
(4) Reports on audit.--
(A) Report on findings and recommendations.--Not
later than 60 days after any date on which a private
sector entity described in paragraph (2) completes an
audit under paragraph (1), such private sector entity
shall submit to the Secretary, the Committee on
Veterans' Affairs of the Senate, and the Committee on
Veterans' Affairs of the House of Representatives a
report that includes--
(i) the findings of such audit; and
(ii) recommendations of such private sector
entity with respect to such audit.
(B) Report on planned improvements.--Not later than
60 days after any date on which the Secretary receives a
report under subparagraph (A), the Secretary shall
submit to the Committee on Veterans' Affairs of the
Senate and the Committee on Veterans' Affairs of the
House of Representatives a report on how the Secretary
plans to improve the standards for quality of care of
the Department.
(f) <<NOTE: 38 USC 1703C note.>> Appropriate Committees of Congress
Defined.--In this section, the term ``appropriate committees of
Congress'' has the meaning given such term in section 1703C of title 38,
United States Code.
SEC. 105. <<NOTE: 38 USC 1703 note.>> PILOT PROGRAM TO IMPROVE
ADMINISTRATION OF CARE UNDER VETERANS
COMMUNITY CARE PROGRAM.
(a) <<NOTE: Plan.>> Establishment.--Pursuant to section 1703E of
title 38, United States Code, the Secretary of Veterans Affairs, acting
through the Center for Innovation for Care and Payment established under
such section, shall carry out a pilot program to seek to develop and
implement a plan--
[[Page 138 STAT. 2714]]
(1) to provide monetary and non-monetary incentives to a
covered health care provider--
(A) <<NOTE: Assessment.>> to allow the Secretary to
see the scheduling system of the provider, to assess the
availability of, and to assist in scheduling
appointments for, veterans under the Veterans Community
Care Program under section 1703 of such title, including
through synchronous, asynchronous, and asynchronous
assisted digital scheduling;
(B) to complete continuing professional educational
training available through the VHA TRAIN program (or any
successor program or initiative) regarding veteran
cultural competency, the opioid safety initiative (or
any successor program or initiative), and other subjects
determined appropriate by the Secretary;
(C) to improve methods of accounting for non-
Department training that is equivalent or substantially
similar to the continuing professional educational
training described in subparagraph (B);
(D) to improve the rate of the timely return to the
Secretary of medical record documentation for care or
services provided under the Veterans Community Care
Program;
(E) to improve the timeliness and quality of the
delivery of care and services to veterans under such
program; and
(F) to achieve other objectives determined
appropriate by the Secretary; and
(2) to decrease the rate of no-show appointments under such
program.
(b) Report.--Not later than one year after the date of the
establishment of the pilot program under this section, and annually
thereafter during the term of the pilot program, the Secretary of
Veterans Affairs shall submit to the Committees on Veterans' Affairs of
the House of Representatives and the Senate a report on the pilot
program that includes, with respect to the period covered by the
report--
(1) <<NOTE: Assessment.>> an assessment of the extent to
which--
(A) the system of the Department of Veterans Affairs
for scheduling appointments for veterans under the
Veterans Community Care Program has improved;
(B) the rate of timely return to the Secretary of
medical record documentation described in subparagraph
(D) of subsection (a)(1) has improved;
(C) the timeliness and quality of the delivery of
care and services described in subparagraph (E) of such
subsection has improved; and
(D) the frequency of no-show appointments described
in paragraph (2) of such subsection decreased;
(2) <<NOTE: List.>> a list of the continuing professional
educational training courses under subparagraph (B) of such
subsection available to covered health care providers;
(3) the rate of participation in such continuing
professional education training courses; and
(4) any other matter the Secretary determines appropriate.
(c) Definitions.--In this section:
(1) The term ``covered health care provider'' means a health
care provider--
[[Page 138 STAT. 2715]]
(A) described in subsection (c) of section 1703 of
title 38, United States Code, that furnishes care or
services under the Veterans Community Care Program
pursuant to a contract or agreement with a Third Party
Administrator; or
(B) that otherwise furnishes care or services
outside of Department facilities pursuant to a contract
or agreement with the Secretary of Veterans Affairs.
(2) The term ``opioid safety initiative'' means the
programs, processes, and guidelines of the Veterans Health
Administration of the Department of Veterans Affairs relating to
the management of opioid therapy and chronic pain.
(3) The term ``Third Party Administrator'' means an entity
that manages a network of health care providers and performs
administrative services related to such network under section
1703 of such title.
(4) The term ``VHA TRAIN program'' means the free program of
the Veterans Health Administration that offers veteran-specific
continuing medical education courses.
SEC. 106. <<NOTE: 38 USC 1703 note.>> PILOT PROGRAM ON
CONSOLIDATING APPROVAL PROCESS OF
DEPARTMENT OF VETERANS AFFAIRS FOR COVERED
DENTAL CARE.
(a) <<NOTE: Deadline.>> In General.--Not later than 180 days after
the date of the enactment of this Act, the Secretary of Veterans
Affairs, acting through the Center for Innovation for Care and Payment
established under section 1703E of title 38, United States Code, shall
carry out a pilot program under which the Secretary shall hire--
(1) general dentists at medical facilities of the Department
of Veterans Affairs to manage approval by the Department of
treatment plans requested by dental providers in providing
covered dental care; and
(2) dental specialists at Veterans Integrated Service
Networks of the Department to manage approval by the Department
of treatment plans for specialty dental care requested by dental
providers in providing covered dental care.
(b) Locations.--The Secretary shall carry out the pilot program in
not fewer than two Veterans Integrated Service Networks of the
Department.
(c) Reports.--
(1) Initial report.--Not later than one year after the date
of the commencement of such pilot program, the Secretary shall
submit to the Committees on Veterans' Affairs of the Senate and
the House of Representatives a report on the pilot program, that
includes--
(A) an identification of the Veterans Integrated
Service Networks participating in such pilot program;
(B) a description of the implementation of such
pilot program;
(C) an identification of any barriers or challenges
to implementing such pilot program;
(D) <<NOTE: Assessment.>> an assessment of the
efficacy of hiring general dentists and dental
specialists pursuant to such pilot program;
(E) aggregated feedback with respect to such pilot
program from dentists of the Department in Veterans
[[Page 138 STAT. 2716]]
Integrated Service Networks participating in such pilot
program; and
(F) aggregated feedback from dental providers
providing covered dental care within such Veterans
Integrated Service Networks regarding any changes in the
timeliness of treatment plan approvals by the
Department.
(2) Final report.--Not later than 90 days before the date of
the completion of such pilot program, the Secretary shall submit
to the Committees on Veterans' Affairs of the Senate and the
House of Representatives a report on the pilot program that--
(A) includes, with respect to the period covered by
the report, each element of the report required under
paragraph (1) described in subparagraphs (A) through (F)
of such paragraph;
(B) <<NOTE: Recommenda- tions.>> includes
recommendations of the Secretary on whether the pilot
program should be--
(i) extended;
(ii) expanded; or
(iii) adopted throughout the Department; and
(C) indicates whether the Secretary requests action
by Congress to make the pilot program permanent.
(d) Sunset.--The authority to carry out the pilot program under this
section shall terminate on the date that is two years after the date of
the enactment of this Act.
(e) Covered Dental Care Defined.--In this section, the term
``covered dental care'' means dental care provided--
(1) under section 1703 of title 38, United States Code; or
(2) pursuant to a Veterans Care Agreement under section
1703A of such title.
SEC. 107. <<NOTE: 38 USC 1701 note.>> STRATEGIC PLAN ON VALUE-
BASED HEALTH CARE SYSTEM FOR VETERANS
HEALTH ADMINISTRATION; PILOT PROGRAM.
(a) Establishment of Working Group.--
(1) <<NOTE: Deadline.>> In general.--Not later than one year
after the date of the enactment of this Act, the Secretary of
Veterans Affairs shall--
(A) establish a working group on value-based care;
and
(B) submit to the Committees on Veterans' Affairs of
the House of Representatives and the Senate the
strategic plan developed by the working group pursuant
to subsection (b).
(2) Membership.--
(A) Required members.--The working group shall
include, at a minimum, the following members:
(i) The Under Secretary for Health of the
Department of Veterans Affairs.
(ii) The Director of the Office of Mental
Health and Suicide Prevention of the Department of
Veterans Affairs (or any successor office).
(iii) The Director of the Office of Integrated
Veteran Care of the Department (or any successor
office).
(iv) The Director of the Office of Rural
Health of the Department (or any successor
office).
[[Page 138 STAT. 2717]]
(v) The Director of the Office of Connected
Care of the Department (or any successor office).
(vi) The Assistant Secretary for the Office of
Information Technology (or any successor office).
(vii) The Chief Officer of the Office of
Healthcare Innovation and Learning of the Office
of Discovery, Education, and Affiliate Networks of
the Veterans Health Administration (or any
successor office).
(viii) An individual designated by the
Secretary from the Center for Innovation for Care
and Payment of the Department under section 1703E
of title 38, United States Code.
(ix) An individual designated by the
Administrator of the Centers for Medicare &
Medicaid Services from the Center for Medicare and
Medicaid Innovation.
(x) An individual designated by the Secretary
of Health and Human Services from the Federal
Office of Rural Health Policy of the Health
Resources and Services Administration.
(xi) The Chief of Human Capital Management for
the Veterans Health Administration.
(xii) An individual designated by the
Secretary of Defense that is a representative of
the Defense Health Agency.
(xiii) An individual selected by the Secretary
of Veterans Affairs from the special medical
advisory group established under section 7312 of
title 38, United States Code.
(B) <<NOTE: Appointments.>> Optional members.--The
Secretary of Veterans Affairs may appoint any of the
following individuals as members of the working group:
(i) An individual representing the Health and
Medicine Division of the National Academies of
Sciences, Engineering, and Medicine.
(ii) Three individuals representing a private
health care system that has made the transition to
value-based care.
(iii) Three individuals representing an
organization recognized by the Secretary of
Veterans Affairs under section 5902 of title 38,
United States Code.
(3) Public availability.--All meetings deliberations, and
products of the working group shall be made publicly available
throughout the duration of the working group, including to
individuals representing organizations recognized by the
Secretary of Veterans Affairs under section 5902 of title 38,
United States Code.
(4) Exemption from faca.--Chapter 10 of title 5, United
States Code, shall not apply to the working group established
under paragraph (1).
(b) Development of Strategic Plan.--The working group shall develop
a strategic plan to implement value-based care into the Veterans Health
Administration that includes the following:
(1) <<NOTE: Assessment.>> An identification of the state of
the Veterans Health Administration as of the date of the
enactment of this Act, including an assessment of the current
model of health care delivery used by the Veterans Health
Administration in medical facilities of the Department of
Veterans Affairs.
[[Page 138 STAT. 2718]]
(2) <<NOTE: Assessment. Time period. Effective date.>> An
assessment of the capacity needs of the Veterans Health
Administration during the five-year period beginning on the date
of the enactment of this Act.
(3) <<NOTE: Analysis. Assessment.>> An analysis of the
leadership of the Veterans Health Administration, including an
assessment of leadership acumen and ability to implement a
clear, shared vision and effective change management and care
coordination.
(4) An identification of goals for the future of the
Veterans Health Administration.
(5) An identification and classification of the current
capabilities, capacity, and gaps in access and quality of the
health care system of the Department of Veterans Affairs.
(6) <<NOTE: Analysis.>> An analysis of value-based care
models, including--
(A) a selection of potential models that would best
work for the Veterans Health Administration;
(B) the capacity and capabilities of each such
model; and
(C) <<NOTE: Summary.>> a thorough justification of
the selection of each selected model, including a
summary of the ability of such model to improve the
metrics described under paragraph (9).
(7) A definition of what quality means with respect to--
(A) access to health care under the laws
administered by the Secretary of Veterans Affairs; and
(B) delivery of such health care.
(8) A definition of what value means with respect to care
furnished by the Veterans Health Administration,
(9) A system for measuring value within the Veterans Health
Administration that includes metrics for--
(A) outcomes;
(B) safety;
(C) service;
(D) access;
(E) productivity;
(F) capacity; and
(G) total cost of patient care.
(10) <<NOTE: Analysis.>> With respect to the system
described in subparagraph (H), an analysis of variable value
with respect to patient outcomes across different health care
types and specialties.
(11) <<NOTE: Assessment.>> An assessment of--
(A) previous or ongoing assessments of the current
information technology infrastructure of the Veterans
Health Administration, including--
(i) such assessments conducted pursuant to the
Electronic Health Record Modernization program of
the Department of Veterans Affairs; and
(ii) any other ongoing information technology
modernization programs of such Department and any
unimplemented relevant recommendations from such
assessments;
(B) the information technology infrastructure of the
Veterans Health Administration in effect as of the date
of the enactment of this Act;
(C) <<NOTE: Evaluation.>> the value-driven framework
of the Department, in effect as of the date of the
enactment of this Act, for evaluating health care
innovations, and how improvements
[[Page 138 STAT. 2719]]
in such framework could be used to encourage innovation;
and
(D) workforce challenges and needs of the Veterans
Health Administration based on--
(i) <<NOTE: Reviews.>> reviews of workforce
assessment data available as of the date of the
enactment of this Act; and
(ii) the findings of--
(I) the report required by section
301(d) of the Veterans Access, Choice,
and Accountability Act of 2014 (Public
Law 113-146);
(II) the reports required by section
505 of the John S. McCain III, Daniel K.
Akaka and Samuel R. Johnson VA
Maintaining Internal Systems and
Strengthening Integrated Outside
Networks Act of 2018 (Public Law 115-
182);
(III) the report required by section
301 of the VA Choice and Quality
Employment Act of 2017 (Public Law 115-
46); and
(IV) any comprehensive health care
inspection conducted by the Inspector
General of the Department of Veterans
Affairs as of the date of the enactment
of this Act.
(12) <<NOTE: Recommenda- tions.>> Any recommendations of the
working group with respect to improving the information
technology infrastructure described in clause (i) of
subparagraph (J).
(13) <<NOTE: Analysis.>> An analysis of how the value-driven
framework described in clause (iii) of such subparagraph could
be used to improve the model of care delivery by the Department.
(14) A description of how a value-based care system would
apply to primary care, inpatient and outpatient mental health
care, and inpatient and outpatient substance use treatment,
spinal cord injury disorder care, and polytrauma care furnished
by the Veterans Health Administration.
(15) With respect to legislative or administrative action
necessary to incorporate value-based care models into the
Veterans Health Administration, a description of the estimated
timelines, effect on workforce, and costs.
(c) Pilot Program.--
(1) <<NOTE: Deadline. Time period.>> In general.--Not later
than 180 days after the submission of the strategic plan
pursuant to subsection (b), the Secretary of Veterans Affairs,
acting through the Center for Innovation for Care and Payment
established under section 1703E of title 38, United States Code,
shall commence a three-year pilot program under which the
Secretary shall implement the elements of such strategic plan
relating to the delivery, by the Veterans Health Administration,
of primary care, inpatient and outpatient mental health
treatment, inpatient and outpatient substance abuse treatment,
spinal cord injury disorder care, and polytrauma care.
(2) Locations.--The Secretary shall carry out such pilot
program in four Veterans Integrated Service Networks that are
geographically dispersed and shall include the following:
(A) A Veterans Integrated Service Network that
predominately serves veterans in rural and highly rural
areas.
(B) A Veterans Integrated Service Network that
predominately serves veterans in urban areas.
[[Page 138 STAT. 2720]]
(C) A Veterans Integrated Service Network that has a
high rate of suicide among veterans.
(D) A Veterans Integrated Service Network that has a
high rate of substance use disorder among veterans.
(E) A Veterans Integrated Service Network that has
access or productivity challenges.
(3) Reports to congress.--
(A) Annual report.--Not later than one year after
the commencement of the pilot program, and annually
thereafter during the duration of the pilot program, the
Secretary shall submit to Congress a report on the pilot
program.
(B) Final report.--Not later than 90 days before the
conclusion of the pilot program, the Secretary shall
submit to Congress a final report on the pilot program
that includes--
(i) lessons learned during the administration
of such pilot program; and
(ii) specific health outcomes in veteran
patient care compared to the Veterans Health
Administration system of care in effect as of the
date of the enactment of this Act.
SEC. 108. <<NOTE: 38 USC note prec. 5701.>> PLAN ON ADOPTION OF
CERTAIN HEALTH INFORMATION STANDARDS FOR
DEPARTMENT OF VETERANS AFFAIRS AND CERTAIN
HEALTH CARE PROVIDERS.
(a) Plan for Certain Health Information Standards.--
(1) In general.--The Secretary of Veterans Affairs, in
consultation with the Secretary of Health and Human Services,
the Administrator of the Centers for Medicare & Medicaid
Services, and the National Coordinator for Health Information
Technology of the Department of Health and Human Services, shall
create and implement a plan to adopt, as rapidly and to the most
comprehensive extent feasible, national health information
interoperability standards for the Department of Veterans
Affairs and community care providers with respect to--
(A) coordination of--
(i) care; and
(ii) benefits;
(B) patient identity matching;
(C) measurement and reporting of quality;
(D) population health; and
(E) public health.
(2) Consideration.--In developing the plan under paragraph
(1), the Secretary of Veterans Affairs shall consider challenges
faced by--
(A) small community care providers; and
(B) community care providers located in rural areas.
(b) Plan on Electronic Health Record Exchange.--
(1) <<NOTE: Deadline.>> In general.--Not later than one year
after the date of enactment of this Act, the Secretary shall
submit to the Committees on Veterans' Affairs of the Senate and
the House of Representatives a plan to provide, at no cost, to
community care providers of the Department, through Third Party
Administrators, a capability to facilitate the electronic direct
exchange, between such providers and the Department, of--
[[Page 138 STAT. 2721]]
(A) the health records of veterans; and
(B) documents relating to health care of veterans,
clinical notes, and any other information the Secretary
determines necessary.
(2) Prioritization.--In developing the plan required under
paragraph (1), the Secretary shall prioritize providing the
capability described in such paragraph to community care
providers that--
(A) provide care under the laws administered by the
Secretary to--
(i) a lower volume of veterans; and
(ii) veterans who are located in rural areas;
and
(B) are unable or unwilling to exchange the records
and documents described in subparagraphs (A) and (B) of
such paragraph with the Department through standards-
based or direct exchange mechanisms in effect as of the
date of the enactment of this Act.
(c) Reports on Plan for Interoperability Standards.--
(1) Initial report.--Not later than one year after the date
of the enactment of this Act, the Secretary of Veterans Affairs
shall submit to the Committees on Veterans' Affairs of the
Senate and the House of Representatives--
(A) the plan required by subsection (a); and
(B) a report that includes--
(i) <<NOTE: Analysis.>> an analysis of gaps,
if any, between the use, by the Department and
other agencies, health information exchanges, and
technology companies, of national health
information interoperability standards and the
potential, or optimal, use of such national health
information interoperability standards;
(ii) <<NOTE: Analysis.>> an analysis and
description of the participation by the
Department, community care providers, and other
relevant entities in the Trusted Exchange
Framework and Common Agreement program of the
Department of Health and Human Services as of the
date of the enactment of this Act;
(iii) <<NOTE: Recommenda-
tions.>> recommendations of the Secretary with
respect to development of health information
interoperability standards;
(iv) <<NOTE: Timelines.>> timelines or
schedules to implement the plan required by
subsection (a); and
(v) an identification of any legislative
authorities or resources the Secretary requires to
implement such plan.
(2) Recurring report requirement.--
(A) In general.--Not later than 18 months after the
date of the enactment of this Act, and every 180 days
thereafter for four years, the Secretary of Veterans
Affairs shall submit to Committees on Veterans' Affairs
of the Senate and the House of Representatives a report
on the status of implementation of the plan required
under subsection (a).
(B) Elements of subsequent reports.--Each report
under subparagraph (A) submitted after the date on which
the first report required by such subparagraph is
submitted shall include a description of any revisions
to--
[[Page 138 STAT. 2722]]
(i) the plan required by subsection (a) made
during the period covered by the report; and
(ii) the analysis, recommendations, timelines,
and legislative authorities reported pursuant to
paragraph (1).
(d) Definitions.--In this section:
(1) The term ``community care provider'' means a non-
Department health care provider providing care (including dental
care)--
(A) under section 1703 of title 38, United States
Code;
(B) pursuant to a Veterans Care Agreement under
section 1703A of such title; or
(C) under any other law administered by the
Secretary of Veterans Affairs.
(2) The term ``Third Party Administrator'' means an entity
that manages a provider network and performs administrative
services related to such network under section 1703 of title 38,
United States Code.
SEC. 109. REPORT ON USE OF VALUE-BASED REIMBURSEMENT MODELS UNDER
VETERANS COMMUNITY CARE PROGRAM.
(a) Report on Value-based Reimbursement Models.--Not later than one
year after the date of the enactment of this Act, the Secretary of
Veterans Affairs, in consultation with the Center for Innovation for
Care and Payment of the Department of Veterans Affairs under section
1703E of title 38 United States Code, the Office of Integrated Veteran
Care of the Department, or successor office, and Third Party
Administrators, shall submit to the Committees on Veterans' Affairs of
the House of Representatives and the Senate a report containing--
(1) <<NOTE: Assessment.>> an assessment of the efforts of
the Department pursuant to section 1703(i)(5) of such title, to
incorporate value-based reimbursement models under the Veterans
Community Care Program to promote the provision of high-quality
care to veterans; and
(2) <<NOTE: Recommenda- tions.>> such recommendations for
legislative or administrative action as the Secretary considers
appropriate regarding the use of value-based reimbursement
models throughout the Veterans Community Care Program under
section 1703 of such title.
(b) Rule of Construction.--This section shall not be construed to be
a pilot program subject to the requirements of section 1703E of title
38, United States Code.
(c) Third Party Administrator Defined.--In this section, the term
``Third Party Administrator'' means an entity that manages a provider
network and performs administrative services related to such network
under section 1703 of title 38, United States Code.
SEC. 110. <<NOTE: 38 USC 1703 note.>> INSPECTOR GENERAL
ASSESSMENT OF IMPLEMENTATION OF VETERANS
COMMUNITY CARE PROGRAM.
(a) <<NOTE: Deadline. Time period.>> In General.--Not later than 18
months after the date of the enactment of this Act, and periodically
thereafter, the Inspector General shall assess the performance of the
Department of Veterans Affairs in--
(1) appropriately identifying veterans eligible for care and
services under section 1703 of title 38, United States Code;
[[Page 138 STAT. 2723]]
(2) informing veterans of their eligibility for such care
and services; and
(3) delivering such care and services in a timely manner.
(b) Briefing on Assessments.--Upon the submission of the assessment
required by subsection (a), the Inspector General of the Department of
Veterans Affairs shall provide to the Committees on Veterans Affairs of
the House of Representatives and the Senate a briefing on the results of
such assessment.
SEC. 111. COMPTROLLER GENERAL REPORT ON DENTISTRY UNDER VETERANS
COMMUNITY CARE PROGRAM.
(a) <<NOTE: Review.>> In General.--Not later than one year after
the date of the enactment of this Act, the Comptroller General of the
United States shall submit to the Committees on Veterans' Affairs of the
Senate and the House of Representatives a report on dental care
furnished by the Secretary of Veterans Affairs under the Veterans
Community Care Program under section 1703 of title 38, United States
Code, that includes a review of--
(1) the impact current reimbursement rates provided by the
Department of Veterans Affairs to dental providers under such
program have on--
(A) the availability of dental care for veterans;
and
(B) the ability of Third Party Administrators to
meet their contractual obligations for network adequacy;
(2) the satisfaction of dental providers providing dental
care under such program with the processes of the Department for
approving dental care under such program; and
(3) the current processes of the Department for approving
emergent dental care under such program.
(b) Third Party Administrator Defined.--In this section, the term
``Third Party Administrator'' means an entity that manages a provider
network and performs administrative services related to such network
under section 1703 of title 38, United States Code.
Subtitle B--Matters Relating to Nursing Home and Other Long Term Care
and Family Caregivers
SEC. 120. INCREASE OF EXPENDITURE CAP FOR NONINSTITUTIONAL CARE
ALTERNATIVES TO NURSING HOME CARE.
(a) Increase of Expenditure Cap.--Section 1720C(d) of title 38,
United States Code, is amended--
(1) by striking ``The total cost'' and inserting ``(1)
Except as provided in paragraph (2), the total cost'';
(2) by striking ``65 percent'' and inserting ``100
percent''; and
(3) <<NOTE: Determination.>> by adding at the end the
following new paragraph:
``(2)(A) <<NOTE: Regulations.>> The total cost of providing
services or in-kind assistance in the case of any veteran described in
subparagraph (B) for any fiscal year under the program may exceed 100
percent of the cost that would otherwise have been incurred as specified
in paragraph (1) if the Secretary determines, based on a consideration
of clinical need, geographic market factors, and such other matters as
the
[[Page 138 STAT. 2724]]
Secretary may prescribe through regulation, that such higher total cost
is in the best interest of the veteran.
``(B) A veteran described in this subparagraph is a veteran with
amyotrophic lateral sclerosis, a spinal cord injury, or a condition the
Secretary determines to be similar to such conditions.''.
(b) <<NOTE: Effective date. 38 USC 1720C note.>> Applicability.--The
amendments made by subsection (a) shall apply with respect to fiscal
years beginning on or after the date of the enactment of this Act.
SEC. 121. COORDINATION WITH PROGRAM OF ALL-INCLUSIVE CARE FOR THE
ELDERLY.
Section 1720C of title 38, United States Code, as amended by section
120, is further amended by adding at the end the following new
subsection:
``(f) <<NOTE: Contracts.>> In furnishing services to a veteran
under the program conducted pursuant to subsection (a), if a medical
center of the Department through which such program is administered is
located in a geographic area in which services are available to the
veteran under a PACE program (as such term is defined in sections
1894(a)(2) and 1934(a)(2) of the Social Security Act (42 U.S.C.
1395eee(a)(2); 1396u-4(a)(2))), the Secretary shall seek to enter into
an agreement with the PACE program operating in that area for the
furnishing of such services.''.
SEC. 122. AUTHORITY FOR SECRETARY OF VETERANS AFFAIRS TO AWARD
GRANTS OR CONTRACTS TO ENTITIES TO IMPROVE
PROVISION OF MENTAL HEALTH SUPPORT TO
FAMILY CAREGIVERS OF VETERANS.
Subchapter II of chapter 17 of title 38, <<NOTE: 38 USC prec.
1701.>> United States Code, is amended by adding at the end the
following new section (and conforming the table of sections at the
beginning of such chapter accordingly):
``Sec. 1720K. <<NOTE: 38 USC 1720K.>> Grants or contracts to
provide mental health support to family
caregivers of veterans
``(a) Authority.--The Secretary may award grants or contracts to
carry out, coordinate, improve, or otherwise enhance mental health
counseling, treatment, or support to the family caregivers of veterans
participating in the family caregiver program.
``(b) Application.--(1) To be eligible for a grant or contract under
this section, an entity shall submit to the Secretary an application
therefor at such time, in such manner, and containing such information
as the Secretary may require.
``(2) <<NOTE: Plans.>> Each application submitted under paragraph
(1) shall include the following:
``(A) A detailed plan for the use of the grant or contract.
``(B) A description of the programs or efforts through which
the entity will meet the outcome measures developed by the
Secretary under subsection (f).
``(C) A description of how the entity will distribute grant
or contract amounts equitably among areas with varying levels of
urbanization.
``(D) A plan for how the grant or contract will be used to
meet the unique needs of veterans residing in rural areas,
Native American, Native Hawaiian, or Alaska Native veterans,
elderly veterans, women veterans, and veterans from other
underserved communities.
[[Page 138 STAT. 2725]]
``(c) Distribution.--The Secretary shall seek to ensure that grants
and contracts awarded under this section are equitably distributed among
entities located in States with varying levels of urbanization.
``(d) Priority.--The Secretary shall prioritize awarding grants or
contracts under this section that will serve the following areas:
``(1) Areas with high rates of veterans enrolled in the
family caregiver program.
``(2) Areas with high rates of--
``(A) suicide among veterans; or
``(B) referrals to the Veterans Crisis Line.
``(e) Required Activities.--Any grant or contract awarded under this
section shall be used--
``(1) to expand existing programs, activities, and services;
``(2) to establish new or additional programs, activities,
and services; or
``(3) for travel and transportation to facilitate carrying
out paragraph (1) or (2).
``(f) Outcome Measures.--(1) The Secretary shall develop and provide
to each entity that receives a grant or contract under this section
written guidance on the following:
``(A) Outcome measures.
``(B) Policies of the Department.
``(2) In developing outcome measures under paragraph (1), the
Secretary shall consider the following goals:
``(A) Increasing the utilization of mental health services
among family caregivers of veterans participating in the family
caregiver program.
``(B) Reducing barriers to mental health services among
family caregivers of veterans participating in such program.
``(g) Tracking Requirements.--(1) The Secretary shall establish
appropriate tracking requirements with respect to the entities receiving
a grant or contract under this section.
``(2) <<NOTE: Reports.>> Not less frequently than annually, the
Secretary shall submit to Congress a report on such tracking
requirements.
``(h) Performance Review.--The Secretary shall--
``(1) review the performance of each entity that receives a
grant or contract under this section; and
``(2) <<NOTE: Public information.>> make information
regarding such performance publicly available.
``(i) Remediation Plan.--(1) In the case of an entity that receives
a grant or contract under this section and does not meet the outcome
measures developed by the Secretary under subsection (f), the Secretary
shall require the entity to submit to the Secretary a remediation plan
under which the entity shall describe how and when it plans to meet such
outcome measures.
``(2) The Secretary may not award a subsequent grant or contract
under this section to an entity described in paragraph (1) unless the
Secretary approves the remediation plan submitted by the entity under
such paragraph.
``(j) Maximum Amount.--The amount of a grant or contract awarded
under this section may not exceed 10 percent of amounts made available
for grants or contracts under this section for the fiscal year in which
the grant or contract is awarded.
``(k) Supplement, Not Supplant.--Any grant or contract awarded under
this section shall be used to supplement and not
[[Page 138 STAT. 2726]]
supplant funding that is otherwise available through the Department to
provide mental health support among family caregivers of veterans
participating in the family caregiver program.
``(l) <<NOTE: Notice.>> Outreach to Family Caregivers.--The
Secretary shall include, in the outreach materials regularly provided to
a family caregiver who participates in the family caregiver program,
notice of mental health support provided by recipients of grants or
contracts under this section that are located in the relevant Veterans
Integrated Service Network.
``(m) Funding.--(1) Amounts for the activities of the Department
under this section shall be budgeted and appropriated through a separate
appropriation account.
``(2) In the budget justification materials submitted to Congress in
support of the budget of the Department for any fiscal year (as
submitted with the budget of the President under section 1105(a) of
title 31), the Secretary shall include a separate statement of the
amount requested to be appropriated for that fiscal year for the account
specified in paragraph (1).
``(n) <<NOTE: Time periods.>> Authorization of Appropriations.--
There is authorized to be appropriated to the Secretary, for each of
fiscal years 2025 and 2026, $10,000,000 to carry out this section.
``(o) Definitions.--In this section:
``(1) The terms `caregiver' and `family caregiver' have the
meanings given those terms in section 1720G of this title.
``(2) The term `family caregiver program' means the program
of comprehensive assistance for family caregivers under section
1720G of this title.
``(3) The term `Veterans Crisis Line' means the toll-free
hotline for veterans established under section 1720F of this
title.''.
SEC. 123. HOME- AND COMMUNITY-BASED SERVICES: PROGRAMS.
(a) <<NOTE: 38 USC prec. 1701.>> Programs.--Such subchapter is
further amended by inserting after section 1720K (as added by section
122) the following new section (and conforming the table of sections at
the beginning of such chapter accordingly):
``Sec. 1720L. <<NOTE: 38 USC 1720L.>> Home- and community-based
services: programs
``(a) In General.--In furnishing noninstitutional alternatives to
nursing home care pursuant to the authority of section 1720C of this
title (or any other authority under this chapter or other provision of
law administered by the Secretary of Veterans Affairs), the Secretary
shall carry out each of the programs specified in this section in
accordance with such relevant authorities except as otherwise provided
in this section.
``(b) Veteran-Directed Care Program.--(1) The Secretary of Veterans
Affairs, in collaboration with the Secretary of Health and Human
Services, shall carry out a program to be known as the `Veteran-Directed
Care program'. <<NOTE: Contracts.>> Under such program, the Secretary
of Veterans Affairs may enter into agreements with the providers
described in paragraph (2) to provide to eligible veterans funds, to the
extent practicable, to obtain such in-home care services and related
items that support clinical need and improve quality of life, as may be
determined appropriate by the Secretary of Veterans Affairs and selected
by the veteran, including through the veteran hiring individuals to
provide such services and items or directly purchasing such services and
items.
[[Page 138 STAT. 2727]]
``(2) The providers described in this paragraph are the following:
``(A) An Aging and Disability Resource Center, an area
agency on aging, or a State agency.
``(B) A center for independent living.
``(C) An Indian tribe or tribal organization receiving
assistance under title VI of the Older Americans Act of 1965 (42
U.S.C. 3057 et seq.).
``(D) Any other entity that the Secretary, in consultation
with the Secretary of Health and Human Services, determines
appropriate.
``(3) In carrying out the Veteran-Directed Care program, the
Secretary of Veterans Affairs shall--
``(A) administer such program through each medical center of
the Department of Veterans Affairs;
``(B) seek to ensure the availability of such program in
American Samoa, Guam, the Commonwealth of the Northern Mariana
Islands, the Commonwealth of Puerto Rico, the Virgin Islands of
the United States, and any other territory or possession of the
United States, to the extent practicable; and
``(C) seek to ensure the availability of such program for
eligible veterans who are Native American veterans receiving
care and services furnished by the Indian Health Service, a
tribal health program, an Urban Indian organization, or (in the
case of a Native Hawaiian veteran) a Native Hawaiian health care
system, to the extent practicable.
``(4) If a veteran participating in the Veteran-Directed Care
program is hospitalized, the veteran may continue to use funds under the
program during a period of hospitalization in the same manner that the
veteran would be authorized to use such funds under the program if the
veteran were not hospitalized.
``(c) <<NOTE: Contracts.>> Homemaker and Home Health Aide Program.--
(1) The Secretary shall carry out a program to be known as the
`Homemaker and Home Health Aide program' under which the Secretary may
enter into agreements with home health agencies to provide to eligible
veterans such home health aide services as may be determined appropriate
by the Secretary.
``(2) In carrying out the Homemaker and Home Health Aide program,
the Secretary shall--
``(A) administer such program in the locations specified in
subparagraph (A) of subsection (b)(3);
``(B) seek to ensure the availability of such program in the
locations specified in subparagraph (B) of subsection (b)(3);
and
``(C) seek to ensure the availability of such program for
the veteran populations specified in subparagraph (C) of
subsection (b)(3).
``(d) Home-Based Primary Care Program.--The Secretary shall carry
out a program to be known as the `Home-Based Primary Care program' under
which the Secretary may furnish to eligible veterans in-home health
care, the provision of which is overseen by a provider of the
Department.
``(e) Purchased Skilled Home Care Program.--The Secretary shall
carry out a program to be known as the `Purchased Skilled Home Care
program' under which the Secretary may furnish to eligible veterans such
in-home care services as may be determined appropriate and selected by
the Secretary for the veteran.
[[Page 138 STAT. 2728]]
``(f) <<NOTE: Time period.>> Caregiver Support.--(1) With respect to
a resident eligible caregiver of a veteran participating in a program
under this section, the Secretary shall--
``(A) if the veteran meets the requirements of a covered
veteran under section 1720G(b) of this title, provide to such
caregiver the option of enrolling in the program of general
caregiver support services under such section;
``(B) provide to such caregiver covered respite care of not
less than 30 days annually; and
``(C) conduct on an annual basis (and, to the extent
practicable, in connection with in-person services provided
under the program in which the veteran is participating), a
wellness contact of such caregiver.
``(2) <<NOTE: Determination.>> Covered respite care provided to a
resident eligible caregiver of a veteran under paragraph (1) may exceed
30 days annually if such extension is requested by the resident eligible
caregiver or veteran and determined medically appropriate by the
Secretary.
``(g) Rule of Construction.--Nothing in this section shall be
construed to limit the authority of the Secretary to carry out programs
providing home- and community-based services under any other provision
of law.
``(h) Definitions.--In this section:
``(1) The terms `Aging and Disability Resource Center',
`area agency on aging', and `State agency' have the meanings
given those terms in section 102 of the Older Americans Act of
1965 (42 U.S.C. 3002).
``(2) The terms `caregiver' and `family caregiver', with
respect to a veteran, have the meanings given those terms,
respectively, under subsection (e) of section 1720G of this
title with respect to an eligible veteran under subsection (a)
of such section or a covered veteran under subsection (b) of
such section, as the case may be.
``(3) The term `center for independent living' has the
meaning given that term in section 702 of the Rehabilitation Act
of 1973 (29 U.S.C. 796a).
``(4) The term `covered respite care' has the meaning given
such term in section 1720G(d) of this title.
``(5) The term `eligible veteran' means any veteran--
``(A) for whom the Secretary determines
participation in a specific program under this section
is medically necessary to promote, preserve, or restore
the health of the veteran; and
``(B) who absent such participation would be at
increased risk for hospitalization, placement in a
nursing home, or emergency room care.
``(6) The term `home health aide' means an individual
employed by a home health agency to provide in-home care
services.
``(7) The term `in-home care service' means any service,
including a personal care service, provided to enable the
recipient of such service to live at home.
``(8) The terms `Indian tribe' and `tribal organization'
have the meanings given those terms in section 4 of the Indian
Self-Determination and Education Assistance Act (25 U.S.C.
5304).
[[Page 138 STAT. 2729]]
``(9) The terms `Native American' and `Native American
veteran' have the meanings given those terms in section 3765 of
this title.
``(10) The terms `Native Hawaiian' and `Native Hawaiian
health care system' have the meanings given those terms in
section 12 of the Native Hawaiian Health Care Improvement Act
(42 U.S.C. 11711).
``(11) The terms `tribal health programs' and `Urban Indian
organizations' have the meanings given those terms in section 4
of the Indian Health Care Improvement Act (25 U.S.C. 1603).
``(12) The term `resident eligible caregiver' means an
individual who--
``(A) is a caregiver, or a family caregiver, of a
veteran and resides with that veteran; and
``(B) has not entered into a contract, agreement, or
other arrangement for such individual to act as a
caregiver for that veteran unless such individual is a
family member of the veteran or is furnishing caregiver
services through a medical foster home.''.
(b) <<NOTE: 38 USC 1720L note.>> Deadline for Improved
Administration.--The Secretary of Veterans Affairs shall ensure that the
Veteran-Directed Care program and the Homemaker and Home Health Aide
program are administered through each medical center of the Department
of Veterans Affairs in accordance with section 1720L of title 38, United
States Code (as added by subsection (a)), by not later than two years
after the date of the enactment of this Act.
(c) <<NOTE: 38 USC 1720L note.>> Administration of Veteran-Directed
Care Program.--
(1) Procedures.--
(A) The Secretary shall establish procedures to--
(i) identify the staffing needs for the
Veteran-Directed Care program of the Department of
Veterans Affairs under such section (as added by
subsection (a)); and
(ii) define the roles and responsibilities for
personnel of the Department responsible for the
administration of such program, including such
personnel employed at the national, Veterans
Integrated Service Network, or medical facility
level.
(B) The responsibilities described in clause (ii) of
subparagraph (A) shall include responsibilities for
engagement with--
(i) veterans participating in such program;
(ii) veterans interested in participating in
such program; and
(iii) providers described in section
1720L(b)(2) (as added by subsection (a)).
(2) Staffing model; report.--Not later than two years after
enactment of this Act, the Secretary of Veterans Affairs shall--
(A) establish a staffing model for the
administration of such program at each medical facility
of the Department of Veterans Affairs; and
(B) submit to the Committees on Veterans' Affairs of
the House of Representatives and the Senate a report
containing the following:
(i) A description of--
[[Page 138 STAT. 2730]]
(I) the staffing model described in
subparagraph (A); and
(II) the rationale for such staffing
model.
(ii) An identification of the ratio of staff
required to administer such program to the number
of veterans served by such program, disaggregated
by each medical facility of the Department of
Veterans Affairs.
(iii) A description of budgetary resources or
other support, if any, required to accommodate an
increase in staffing at medical facilities of the
Department of Veterans Affairs pursuant to the
requirements of the staffing model described in
subparagraph (A).
(iv) Such other matters as the Secretary of
Veterans Affairs determines appropriate.
SEC. 124. COORDINATION WITH ASSISTANCE AND SUPPORT SERVICES FOR
CAREGIVERS.
(a) Coordination With Program of Comprehensive Assistance for Family
Caregivers.--
(1) Coordination.--Section 1720G(a) of title 38, United
States Code, is amended by adding at the end the following new
paragraph:
``(14)(A) In the case of a veteran or caregiver who seeks services
under this subsection and is denied such services, or a veteran or the
family caregiver of a veteran who is discharged from the program under
this subsection, the Secretary shall--
``(i) if the veteran meets the requirements of a covered
veteran under subsection (b), provide to such caregiver the
option of enrolling in the program of general caregiver support
services under such subsection;
``(ii) <<NOTE: Assessment.>> assess the veteran or caregiver
for participation in any other available program of the
Department for home- and community-based services (including the
programs specified in section 1720L of this title) for which the
veteran or caregiver may be eligible and, with respect to the
veteran, store (and make accessible to the veteran) the results
of such assessment in the electronic medical record of the
veteran; and
``(iii) <<NOTE: Notification.>> provide to the veteran or
caregiver written information on any such program identified
pursuant to the assessment under clause (ii), including
information about facilities, eligibility requirements, and
relevant contact information for each such program.
``(B) The Secretary shall, to the extent practicable, provide to a
veteran or family caregiver the option of obtaining clinically
appropriate services under any other available program of the Department
for home- and community-based services (including the programs specified
in section 1720L of this title) for which the veteran or family
caregiver may be eligible prior to discharging the veteran or family
caregiver from the program under this subsection.
``(C) For each veteran or family caregiver who is discharged from
the program under this subsection, a caregiver support coordinator shall
provide for a smooth and personalized transition from such program to an
appropriate program of the Department for home- and community-based
services (including the programs specified in section 1720L of this
title), including by integrating caregiver support across programs.''.
[[Page 138 STAT. 2731]]
(2) <<NOTE: Effective date. Time period. 38 USC 1720G
note.>> Applicability.--The amendments made by paragraph (1)
shall apply with respect to denials and discharges occurring on
or after the date that is 180 days after the date of the
enactment of this Act.
(3) Technical and conforming amendments.--Section 1720G(d)
of such title <<NOTE: 38 USC 1720G.>> is amended--
(A) by striking ``or a covered veteran'' each place
it appears and inserting ``, a veteran denied or
discharged as specified in paragraph (14) of such
subsection, or a covered veteran''; and
(B) by striking ``under subsection (a), means'' each
place it appears and inserting ``under subsection (a) or
a veteran denied or discharged as specified in paragraph
(14) of such subsection, means''.
(b) Conformity of Respite Care Across Programs.--Section 1720G of
title 38, United States Code, as amended by subsection (a)(3), is
further amended--
(1) in subsection (a)(3)--
(A) by amending subparagraph (A)(ii)(III) to read as
follows:
``(III) covered respite care of not less than 30
days annually;''; and
(B) by striking subparagraph (B) and redesignating
subparagraphs (C) and (D) as subparagraphs (B) through
(C), respectively; and
(2) by amending subsection (b)(3)(A)(iii) to read as
follows:
``(iii) Covered respite care of not less than 30 days
annually.''; and
(3) in subsection (d)--
(A) by redesignating paragraphs (2) through (4) as
paragraphs (3) through (5), respectively; and
(B) by inserting after paragraph (1) the following
new paragraph:
``(2) <<NOTE: Definition. Time period.>> The term `covered
respite care' means, with respect to a caregiver of a veteran,
respite care under section 1720B of this title that--
``(A) is medically and age appropriate for the
veteran (including 24-hour per day care of the veteran
commensurate with the care provided by the caregiver);
and
``(B) includes in-home care.''.
(c) Review Relating to Caregiver Contact.--The Secretary shall
conduct a review of the capacity of the Department to establish a
streamlined system for contacting all caregivers enrolled in the program
of general caregiver support services under section 1720G(b) of title
38, United States Code, to provide to such caregivers program updates
and alerts relating to emerging services for which such caregivers or
the veterans for which they provide care may be eligible.
SEC. 125. IMPROVEMENTS TO PROGRAM OF COMPREHENSIVE ASSISTANCE FOR
FAMILY CAREGIVERS.
Section 1720G(a) of title 38, United States Code, as amended by
section 124, is further amended--
(1) in paragraph (12)--
(A) in subparagraph (A), by inserting ``, which
shall include all criteria used to determine eligibility
for such assistance and, in the case of a completed
evaluation, how
[[Page 138 STAT. 2732]]
such criteria were used to evaluate information provided
in assessments to determine such eligibility'' before
the period at the end; and
(B) in subparagraph (C)(i), by striking ``who
submits'' and all that follows through the end of the
clause and inserting the following: ``who--
``(I) submits an application for the program
established under paragraph (1); or
``(II) is being reassessed for eligibility to
continue in such program.''; and
(2) by adding at the end the following new paragraph:
``(15)(A) <<NOTE: Time periods. Reports.>> Not less frequently than
annually, the Secretary shall submit to the Committees on Veterans'
Affairs of the Senate and the House of Representatives a comprehensive
report on the program required by paragraph (1) that includes, with
respect to the one-year period preceding the date of the submission of
such report, the following:
``(i) The number of applications received for such program.
``(ii) The number, disaggregated by race, sex, and era and
branch of service in the Armed Forces of the applicant, of--
``(I) approvals of such applications; and
``(II) denials of such applications.
``(iii) The number of reassessments conducted for such
program.
``(iv) An identification of each decision made with respect
to a reassessment conducted for such program, disaggregated by
decisions resulting in--
``(I) disenrollment, including removal, discharge,
or voluntary withdrawal;
``(II) tier reduction; and
``(III) tier continuation.
``(v) The number of appeals of decisions made with respect
to such program, disaggregated by type of appeal.
``(vi) With respect to each appeal described in clause (v),
the decision rendered, if any.
``(vii) A description of all tools used in assessments
conducted for such program, including an explanation of how and
by whom such tools are administered.
``(viii) A description of procedures used under such program
for reviewing and integrating clinical records from health care
providers that includes an explanation of how such records are
used in determinations of eligibility for such program.
``(ix) A description of procedures available under such
program for health care providers to communicate medical
opinions to the teams conducting assessments to determine
eligibility for such program, including health care providers in
the private sector and health care providers specified in
subsection (c) of section 1703 of this title.
``(x) A description of information technology systems and
processes used under such program to upload and integrate all
clinical records from all non-Department providers, including
providers in the private sector and providers under the Veterans
Community Care Program established under such section.
``(B) <<NOTE: Data.>> The Secretary shall ensure that all data
included in a report under subparagraph (A)--
[[Page 138 STAT. 2733]]
``(i) relating to a decision made under the program required
by paragraph (1), are disaggregated by the specific reason for
the decision;
``(ii) relating to a veteran, include comprehensive
demographic information of the veteran, including the time
period of the injuries, if any, of the veteran and the Veterans
Integrated Service Network in which the veteran is located; and
``(iii) with respect to eligibility determinations relating
to a serious injury of a veteran, specify--
``(I) how many such determinations relate to the
ability of the veteran to perform activities of daily
living; and
``(II) how many such determinations relate to the
need of a veteran for supervision and protection.
``(C) The Secretary shall provide the data under paragraph (B)
pursuant to Federal laws and in a manner that is wholly consistent with
applicable Federal privacy and confidentiality laws, including the
Privacy Act (5 U.S.C. 552a), the Health Insurance Portability and
Accountability Act (Public Law 104-191; 42 U.S.C. 201 note) and
regulations (title 45, Code of Federal Regulations, parts 160 and 164,
or successor regulations), and sections 5701, 5705, and 7332 of this
title to ensure that the provided data, or some portion of the data,
will not undermine the anonymity of a veteran.''.
SEC. 126. <<NOTE: 38 USC 1720L note.>> IMPROVEMENTS RELATING TO
HOMEMAKER AND HOME HEALTH AIDE PROGRAM.
(a) Pilot Program for Communities With Shortage of Home Health
Aides.--
(1) <<NOTE: Deadline. Time period.>> Program.--Beginning not
later than 18 months after the date of the enactment of this
Act, the Secretary shall carry out a three-year pilot program
under which the Secretary shall provide homemaker and home
health aide services to veterans who reside in communities with
a shortage of home health aides.
(2) <<NOTE: Determination.>> Locations.--The Secretary shall
select not fewer than five geographic locations in which the
Secretary determines there is a shortage of home health aides at
which to carry out the pilot program under paragraph (1).
(3) Nursing assistants.--
(A) In general.--In carrying out the pilot program
under paragraph (1), the Secretary may hire nursing
assistants as new employees of the Department of
Veterans Affairs, or reassign nursing assistants who are
existing employees of the Department, to provide to
veterans in-home care services (including basic tasks
authorized by the State certification of the nursing
assistant) under the pilot program, in lieu of or in
addition to the provision of such services through non-
Department home health aides.
(B) Relationship to home-based primary care
program.--Nursing assistants hired or reassigned under
subparagraph (A) may provide services to a veteran under
the pilot program under paragraph (1) while serving as
part of a health care team for the veteran under the
Home-Based Primary Care program.
[[Page 138 STAT. 2734]]
(4) Report to congress.--Not later than one year before the
date of the termination of the pilot program under paragraph
(1), the Secretary shall submit to the Committees on Veterans'
Affairs of the House of Representatives and the Senate a report
that includes--
(A) <<NOTE: Statement.>> a statement of the results
of such pilot program; and
(B) <<NOTE: Assessment.>> an assessment of the
feasibility and advisability of--
(i) extending such pilot program; or
(ii) making such pilot program a permanent
program of the Department of Veterans Affairs.
(b) <<NOTE: Time period.>> Report on Use of Funds.--Not later than
one year after the date of the enactment of this Act, the Secretary of
Veterans Affairs shall submit to the Committees on Veterans' Affairs of
the House of Representatives and the Senate a report containing, with
respect to the period beginning in fiscal year 2012 and ending in fiscal
year 2024, the following:
(1) An identification of the amount of funds that were
included in a budget of the Department of Veterans Affairs
during such period for the provision of in-home care to veterans
under the Homemaker and Home Health Aide program but were not
expended for such provision, disaggregated by medical center of
the Department for which such unexpended funds were budgeted (if
such disaggregation is possible).
(2) To the extent practicable, an identification of the
number of veterans for whom, during such period, the hours
during which a home health aide was authorized to provide
services to the veteran under the Homemaker and Home Health Aide
program were reduced for a reason other than a change in the
health care needs of the veteran, and a detailed description of
the reasons why any such reductions may have occurred.
(c) <<NOTE: Deadline. Process.>> Updated Guidance on Program.--Not
later than one year after the date of the enactment of this Act, the
Secretary shall issue updated guidance for the Homemaker and Home Health
Aide program. Such updated guidance shall include the following:
(1) A process for the transition of veterans from the
Homemaker and Home Health Aide program to other covered
programs.
(2) A requirement for the directors of the medical
facilities of the Department to complete such process whenever a
veteran with care needs has been denied services from home
health agencies under the Homemaker and Home Health Aide program
as a result of the clinical needs or behavioral issues of the
veteran.
SEC. 127. <<NOTE: 38 USC 1710B note.>> PILOT PROGRAM TO FURNISH
ASSISTED LIVING SERVICES TO CERTAIN
VETERANS.
(a) <<NOTE: Deadline. Assessments.>> Establishment.--Beginning not
later than two years after the date of the enactment of this Act, the
Secretary of Veterans Affairs shall carry out a pilot program to
assess--
(1) the effectiveness of providing assisted living services
to eligible veterans, at the election of such veterans; and
(2) the satisfaction with the pilot program of veterans
participating in such pilot program.
(b) Program Locations.--
[[Page 138 STAT. 2735]]
(1) Veterans integrated service networks.--The Secretary
shall select two Veterans Integrated Service Networks of the
Department of Veterans Affairs at which to carry out the pilot
program under subsection (a).
(2) Facilities.--
(A) In general.--Within the Veterans Integrated
Service Networks selected under paragraph (1), the
Secretary shall select facilities at which to carry out
the pilot program under subsection (a)(1).
(B) Selection criteria.--In selecting facilities
under subparagraph (A) at which to carry out the pilot
program under subsection (a)(1), the Secretary shall
ensure that--
(i) the locations of such facilities are in
geographically diverse areas;
(ii) not fewer than one such facility serves
veterans in rural or highly rural areas (as
determined through the use of the Rural-Urban
Commuting Areas coding system of the Department of
Agriculture);
(iii) not fewer than one such facility is
located in each Veterans Integrated Service
Network selected under paragraph (1); and
(iv) not fewer than one such facility is a
State home.
(c) Program Participants.--Not more than 60 eligible veterans may
participate in the pilot program under subsection (a)(1) in each
Veterans Integrated Service Network selected under subsection (b)(1).
(d) Provision of Assisted Living Services.--
(1) Agreements.--In carrying out the pilot program under
subsection (a)(1), the Secretary may enter into agreements for
the provision of assisted living services on behalf of eligible
veterans with--
(A) a provider participating under a State plan or
waiver under title XIX of the Social Security Act (42
U.S.C. 1396 et seq.); or
(B) a State home recognized and certified under
subpart B of part 51 of title 38, Code of Federal
Regulations, or successor regulations.
(2) <<NOTE: Determination.>> Standards.--The Secretary may
not place, transfer, or admit a veteran to any facility for
assisted living services under the pilot program under
subsection (a)(1) unless the Secretary determines that--
(A) the facility meets the standards for community
residential care established under sections 17.61
through 17.72 of title 38, Code of Federal Regulations,
or successor regulations, and any additional standards
of care as the Secretary may specify; or
(B) in the case of a facility that is a State home,
the State home meets such standards of care as the
Secretary may specify.
(3) Inspection.--The Secretary shall inspect facilities at
which veterans are placed under the pilot program under
subsection (a)(1)--
(A) with respect to a facility that is a State home,
not less frequently than annually and in the same manner
as the Secretary conducts inspection of State homes
under section 1742 of title 38, United States Code; and
[[Page 138 STAT. 2736]]
(B) with respect to any other facility, not less
frequently than annually and in the same manner as the
Secretary conducts inspection of facilities under
section 1730 of such title.
(4) Payment to certain facilities.--
(A) State homes.--In the case of a facility
participating in the pilot program under subsection
(a)(1) that is a State home, the Secretary shall pay to
the State home a per diem for each veteran participating
in the pilot program at a rate agreed to by the
Secretary and the State home.
(B) Community assisted living facilities.--In the
case of a facility participating in the pilot program
under subsection (a)(1) that is a community assisted
living facility, the Secretary shall--
(i) pay to the facility an amount that is less
than the average rate paid by the Department for
placement in a community nursing home in the same
Veterans Integrated Service Network; and
(ii) re-evaluate payment rates annually to
account for current economic conditions and
current costs of assisted living services.
(e) Continuity of Care.--Upon the termination of the pilot program
under subsection (a)(1), the Secretary shall--
(1) provide to all veterans participating in the pilot
program at the time of such termination the option to continue
to receive assisted living services at the site they were
assigned to under the pilot program, at the expense of the
Department; and
(2) for such veterans who do not opt to continue to receive
such services--
(A) ensure such veterans do not experience lapses in
care; and
(B) provide such veterans with information on, and
furnish such veterans with, other extended care services
based on their preferences and best medical interest.
(f) Determination of Quality.--The Secretary shall determine a
method for assessment of quality of care provided to veterans
participating in the pilot program under subsection (a)(1) and shall
communicate that method to providers of services under the pilot
program.
(g) Annual Report.--Not later than one year after the initiation of
the pilot program under subsection (a)(1), and annually thereafter for
the duration of such pilot program, the Secretary shall submit to the
Committees on Veterans' Affairs of the House of Representatives and the
Senate a report on the pilot program that includes--
(1) an identification of Veterans Integrated Services
Networks and facilities of the Department participating in the
pilot program and assisted living facilities and State homes at
which veterans are placed under the pilot program;
(2) the number of participants in the pilot program,
disaggregated by facility;
(3) general demographic information of participants in the
pilot program, including average age, sex, and race or
ethnicity;
(4) disability status of participants in the pilot program;
(5) an identification of any barriers or challenges to
furnishing care to veterans under the pilot program, conducting
[[Page 138 STAT. 2737]]
oversight of the pilot program, or any other barriers or
challenges;
(6) <<NOTE: Costs. Cost analysis.>> the cost of care at each
assisted living facility and State home participating in the
pilot program, including an analysis of any cost savings by the
Department when comparing that cost to the cost of nursing home
care;
(7) aggregated feedback from participants in the pilot
program, including from veteran resident surveys and interviews;
and
(8) such other matters the Secretary considers appropriate.
(h) Final Report.--Not later than one year after the pilot program
terminates under subsection (j), the Secretary shall submit to the
Committees on Veterans' Affairs of the House of Representatives and the
Senate a report on the pilot program that--
(1) includes the matters required under paragraphs (1)
through (8) of subsection (g);
(2) <<NOTE: Recommenda- tions.>> includes recommendations on
whether the model studied in the pilot program should be
continued or adopted throughout the Department; and
(3) indicates whether the Secretary requests action by
Congress to make the pilot program permanent.
(i) Inspector General Report.--
(1) In general.--Not later than three years after the
initiation of the pilot program under subsection (a)(1), the
Inspector General of the Department of Veterans Affairs shall
submit to the Secretary of Veterans Affairs and the Committees
on Veterans' Affairs of House of Representatives and the Senate
a report on the pilot program.
(2) <<NOTE: Assessment.>> Elements.--The report required by
paragraph (1) shall include an assessment of--
(A) the quality of care provided to veterans at
facilities participating in the pilot program, measured
pursuant to the method determined under subsection (f);
(B) the oversight of such facilities, as conducted
by the Department, the Centers for Medicare & Medicaid
Services, State agencies, and other relevant entities;
and
(C) such other matters as the Inspector General
considers appropriate.
(3) Plan required.--Not later than 90 days after the
submission of the report under paragraph (1), the Secretary
shall submit to the Committees on Veterans' Affairs of the House
of Representatives and the Senate a plan to address the
deficiencies identified in the report, if any.
(j) Termination.--
(1) In general.--Subject to paragraph (2), the pilot program
under subsection (a)(1) shall terminate on September 30, 2028.
(2) Extension.--The Secretary may extend the duration of the
pilot program for an additional two-year period if the
Secretary, based on the results of the reports submitted under
subsection (g), determines such an extension is appropriate.
(k) Definitions.--In this section:
(1) The term ``assisted living services'' means services of
a facility in providing room, board, and personal care for and
supervision of residents for their health, safety, and welfare.
(2) The term ``eligible veteran'' means a veteran who is--
[[Page 138 STAT. 2738]]
(A) receiving nursing home care paid for by the
Department of Veterans Affairs, eligible to receive such
care pursuant to section 1710A of title 38, United
States Code, or requires a higher level of care than the
domiciliary care provided by the Department of Veterans
Affairs, but does not meet the requirements for nursing
home level care provided by the Department pursuant to
such section; and
(B) eligible for assisted living services, as
determined by the Secretary or meets such additional
criteria for eligibility for the pilot program under
subsection (a)(1) as the Secretary may establish.
(3) The term ``State home'' has the meaning given that term
in section 101 of title 38, United States Code.
SEC. 128. <<NOTE: 38 USC 1741 note.>> PROVISION OF MEDICINE,
EQUIPMENT, AND SUPPLIES AVAILABLE TO
DEPARTMENT OF VETERANS AFFAIRS TO STATE
HOMES.
(a) Provision Authorized.--The Secretary of Veterans Affairs may
provide to State homes medicine, personal protective equipment, medical
supplies, and any other equipment, supplies, and assistance available to
the Department of Veterans Affairs.
(b) Definition.--In this section:
(1) The term ``personal protective equipment'' means any
protective equipment required to prevent the wearer from
contracting an infectious disease, including gloves, N-95
respirator masks, gowns, goggles, face shields, or other
equipment required for safety.
(2) The term ``State home'' has the meaning given such term
in section 101 of title 38, United States Code.
SEC. 129. <<NOTE: 38 USC 1720G note.>> RECOGNITION OF
ORGANIZATIONS AND INDIVIDUALS TO ASSIST
VETERANS, FAMILY MEMBERS, AND CAREGIVERS
NAVIGATING PROGRAMS AND SERVICES OF
VETERANS HEALTH ADMINISTRATION.
(a) <<NOTE: Deadline. Process.>> In General.--Not later than one
year after the date of the enactment of this Act, the Secretary of
Veterans Affairs shall establish a process through which the Department
of Veterans Affairs may recognize organizations and individuals to
assist a veteran, a family member of a veteran, or a caregiver of a
veteran (as defined in section 1720G(d) of title 38, United States Code)
in navigating the programs and services of the Veterans Health
Administration.
(b) <<NOTE: Recommenda- tions.>> Solicitation of Feedback.--The
Secretary shall solicit feedback and recommendations in the creation of
the process under subsection (a) from such organizations as the
Secretary may consider relevant.
(c) Limitation.--The Secretary may not recognize an organization or
individual pursuant to the process established under subsection (a)
unless the organization or individual has certified to the Secretary
that no fee or compensation of any nature will be charged to any
individual for services rendered in providing assistance pursuant to
such subsection.
SEC. 130. <<NOTE: 38 USC 1720L note.>> REVIEWS AND OTHER
IMPROVEMENTS RELATING TO HOME- AND
COMMUNITY-BASED SERVICES.
(a) Office of Geriatric and Extended Care.--
[[Page 138 STAT. 2739]]
(1) Review of programs.--The Under Secretary for Health of
the Department of Veterans Affairs shall conduct a review of
each program administered through the Office of Geriatric and
Extended Care of the Department and the Caregiver Support
Program Office of the Department, or any successor offices, to--
(A) eliminate service gaps at the medical center
level; and
(B) ensure--
(i) the clinical needs of veterans are met;
(ii) consistency in program management;
(iii) the availability of, and the access by
veterans to, home- and community-based services,
including for veterans living in rural areas; and
(iv) proper coordination between covered
programs.
(2) Assessment of staffing needs.--The Secretary of Veterans
Affairs shall conduct an assessment of the staffing needs of the
Office of Geriatric and Extended Care of the Department and the
Caregiver Support Program Office of the Department, or any
successor offices.
(3) Goals for geographic alignment of care.--
(A) Establishment of goals.--The Director of the
Office of Geriatric and Extended Care, or successor
office, shall establish quantitative goals to enable
aging or disabled veterans who are not located near
medical centers of the Department to access extended
care services (including by improving access to home-
and community-based services for such veterans).
(B) Implementation timeline.--Each goal established
under subparagraph (A) shall include a timeline for the
implementation of the goal at each medical center of the
Department.
(4) Goals for in-home specialty care.--The Director of the
Office of Geriatric and Extended Care, or successor office,
shall establish quantitative goals to address the specialty care
needs of veterans through in-home care, including by ensuring
the education of home health aides and caregivers of veterans in
the following areas:
(A) Dementia care.
(B) Care for spinal cord injuries and diseases.
(C) Ventilator care.
(D) Other speciality care areas as determined by the
Secretary.
(5) Input on goals.--To the extent practicable, the head of
the Caregiver Support Program Office, or successor office, shall
provide to the Director of the Office of Geriatric and Extended
Care, or successor office, input with respect to the
establishment of the goals under paragraphs (3) and (4).
(6) Report to congress.--Not later than one year after the
date of the enactment of this Act, the Secretary shall submit to
the Committees on Veterans' Affairs of the House of
Representatives and the Senate a report containing the findings
of the review under paragraph (1), the results of the assessment
under paragraph (2), and the goals established under paragraphs
(3) and (4).
(b) Review of Incentives and Efforts Relating to Home- and
Community-based Services.--
[[Page 138 STAT. 2740]]
(1) Review.--The Secretary of Veterans Affairs shall conduct
a review of the following:
(A) The financial and organizational incentives or
disincentives for the directors of medical centers of
the Department to establish or expand covered programs
at such medical centers.
(B) Any incentives or disincentives for such
directors to provide to veterans home- and community-
based services in lieu of institutional care.
(C) The efforts taken by the Secretary to enhance
spending of the Department for extended care by
balancing spending between institutional care and home-
and community-based services consistent with the demand
for such services.
(D) The plan of the Under Secretary for Health of
the Department to accelerate efforts to enhance spending
as specified in subparagraph (C), to match the progress
of similar efforts taken by the Administrator of the
Centers for Medicare & Medicaid Services with respect to
spending of the Centers for Medicare & Medicaid Services
for extended care.
(2) Report to congress.--Not later than one year after the
date of the enactment of this Act, the Secretary shall submit to
the Committees on Veterans' Affairs of the House of
Representatives and the Senate a report on the findings of the
review under paragraph (1).
(c) <<NOTE: Deadline.>> Review of Respite Care Services.--Not later
than two years after the date of the enactment of this Act, the
Secretary of Veterans Affairs shall conduct a review of the use,
availability, cost, and effectiveness, of the respite care services
furnished by the Secretary under chapter 17 of title 38, United States
Code, including--
(1) the frequency at which the Department of Veterans
Affairs is unable to meet demand for such services;
(2) a detailed description of--
(A) the reasons the Department of Veterans Affairs
is unable to meet the demand for such services; and
(B) any actions, or planned actions, of the
Secretary of Veterans Affairs to ensure such demand is
met.
(d) Collaboration to Improve Home- and Community-based Services.--
(1) Recommendations.--
(A) Development.--The Secretary of Veterans Affairs
shall develop recommendations as follows:
(i) With respect to home- and community-based
services for veterans, the Secretary of Veterans
Affairs shall develop recommendations regarding
new services (in addition to those furnished as of
the date of enactment of this Act) in
collaboration with the Secretary of Health and
Human Services.
(ii) With respect to the national shortage of
home health aides, the Secretary of Veterans
Affairs shall develop recommendations regarding
methods to address such shortage in collaboration
with the Secretary of Health and Human Services
and the Secretary of Labor.
[[Page 138 STAT. 2741]]
(B) <<NOTE: Reports. Determination.>> Submission to
congress.--The Secretary of Veterans Affairs shall
submit to the Committees on Veterans' Affairs of the
House of Representatives and the Senate a report
containing the recommendations developed under
subparagraph (A) and an identification of any changes in
existing law or new statutory authority necessary to
implement the recommendations, as determined by the
Secretary.
(C) Consultation with secretary of labor.--In
carrying out this paragraph, the Secretary of Veterans
Affairs shall consult with the Secretary of Labor.
(2) Feedback and recommendations on caregiver support.--
(A) Feedback and recommendations.--The Secretary of
Veterans Affairs shall solicit from the entities
described in subparagraph (B) feedback and
recommendations regarding opportunities for the
Secretary to enhance home- and community-based services
for veterans and the caregivers of veterans, including
through the potential provision by the entity of care
and respite services to veterans and caregivers who may
not be eligible for any program under section 1720G of
title 38, United States Code, or section 1720L of such
title (as added by section 123), but have a need for
assistance.
(B) Covered entities.--The entities described in
this subparagraph are veterans service organizations and
nonprofit organizations with a focus on caregiver
support or long term care (as determined by the
Secretary).
(3) Collaboration for certain veterans.--The Secretary of
Veterans Affairs shall collaborate with the Director of the
Indian Health Service and representatives from tribal health
programs and Urban Indian organizations to ensure the
availability of home- and community-based services for--
(A) Native American veterans, including Native
American veterans receiving health care and medical
services under multiple health care systems; and
(B) Native Hawaiian veterans, including Native
Hawaiian veterans receiving health care and medical
services under the Native Hawaiian health care system.
SEC. 131. GAO REPORT ON MENTAL HEALTH SUPPORT FOR CAREGIVERS.
(a) Report Required.--Not later than one year after the date of the
enactment of this Act, the Comptroller General of the United States
shall submit to the Committee on Veterans' Affairs of the Senate and the
Committee on Veterans' Affairs of the House of Representatives a report
on the provision of mental health support to caregivers of veterans.
(b) <<NOTE: Assessments.>> Contents.--The report submitted under
subsection (a) shall include the following:
(1) An assessment of the need for mental health support
among caregivers participating in the caregiver programs.
(2) An assessment of options for mental health support in
facilities of the Department of Veterans Affairs and in the
community for caregivers participating in the caregiver
programs.
[[Page 138 STAT. 2742]]
(3) An assessment of the availability and accessibility of
mental health support in facilities of the Department and in the
community for caregivers participating in the caregiver
programs.
(4) An assessment of the awareness among caregivers of the
availability of mental health support in facilities of the
Department and in the community for caregivers participating in
the caregiver programs.
(5) An assessment of barriers to mental health support in
facilities of the Department and in the community for caregivers
participating in the caregiver programs.
(c) Definitions.--In this section:
(1) The term ``caregiver'' has the meaning given that term
in section 1720G of title 38, United States Code.
(2) The term ``caregiver programs'' means--
(A) the program of comprehensive assistance for
family caregivers under subsection (a) of section 1720G
of title 38, United States Code; and
(B) the program of support services for caregivers
under subsection (b) of such section.
SEC. 132. <<NOTE: 38 USC 1720L note.>> DEVELOPMENT OF CENTRALIZED
WEBSITE FOR PROGRAM INFORMATION.
(a) <<NOTE: Public information.>> Centralized Website.--The
Secretary shall develop and maintain a centralized and publically
accessible internet website of the Department as a clearinghouse for
information and resources relating to covered programs.
(b) Contents.--The website under subsection (a) shall contain the
following:
(1) A description of each covered program.
(2) An informational assessment tool that--
(A) explains the administrative eligibility, if
applicable, of a veteran, or a caregiver of a veteran,
for any covered program; and
(B) provides information, as a result of such
explanation, on any covered program for which the
veteran or caregiver (as the case may be) may be
eligible.
(3) <<NOTE: List.>> A list of required procedures for the
directors of the medical facilities of the Department to follow
in determining the eligibility and suitability of veterans for
participation in a covered program, including procedures
applicable to instances in which the resource constraints of a
facility (or of a community in which a facility is located) may
result in the inability to address the health needs of a veteran
under a covered program in a timely manner.
(c) Updates.--The Secretary shall ensure the website under
subsection (a) is updated on a periodic basis.
SEC. 133. <<NOTE: 38 USC 1720L note.>> DEFINITIONS.
In this subtitle:
(1) The terms ``caregiver'' and ``family caregiver'' have
the meanings given those terms under section 1720L(h) of title
38, United States Code (as added by section 123).
(2) The term ``covered program''--
(A) means any program of the Department of Veterans
Affairs for home- and community-based services; and
(B) includes the programs specified in section 1720L
of title 38, United States Code (as added by section
123).
[[Page 138 STAT. 2743]]
(3) The term ``home- and community-based services''--
(A) means the services referred to in section
1701(6)(E) of title 38, United States Code; and
(B) includes services furnished under a program
specified in section 1720L of such title (as added by
section 123).
(4) The terms ``Home-Based Primary Care program'',
``Homemaker and Home Health Aide program'', and ``Veteran-
Directed Care program'' mean the programs of the Department of
Veterans Affairs specified in subsection (d), (c), and (b) of
such section 1720L, respectively.
(5) The terms ``home health aide'', ``Native American'',
``Native American veteran'', ``tribal health programs'', and
``Urban Indian organizations'' have the meanings given those
terms in subsection (h) of such section 1720L.
(6) The term ``veterans service organization'' means any
organization recognized by the Secretary under section 5902 of
such title.
Subtitle C--Medical Treatment and Other Matters
SEC. 140. QUARTERLY REPORT ON REFERRALS FOR NON-DEPARTMENT OF
VETERANS AFFAIRS HEALTH CARE.
(a) In General.--Subchapter I of chapter 17 of title 38, United
States Code, <<NOTE: 38 USC prec. 1701.>> is amended by inserting after
section 1703F the following new section (and amending the table of
sections at the beginning of such chapter accordingly):
``Sec. 1703G. <<NOTE: 38 USC 1703G.>> Quarterly report on
referrals for non-Department health care
``The Secretary shall submit to the Committees on Veterans' Affairs
of the Senate and the House of Representatives a quarterly report
containing, with respect to referrals for non-Department health care
originating from a medical facility of the Department during the quarter
preceding the date of the submission of the report, a measurement of,
for each such medical facility--
``(1) <<NOTE: Time periods.>> the period of time between--
``(A) the date on which a clinician employed by the
Department determines that a veteran requires care, or a
veteran presents to the Department requesting care, and
the date on which the referral for care is sent to a
non-Department health care provider;
``(B) the date on which such referral is sent to a
non-Department health care provider and the date on
which such non-Department health care provider accepts
such referral;
``(C) the date on which such non-Department health
care provider accepts such referral and the date on
which such referral is completed;
``(D) the date on which such referral is completed
and the date on which an appointment with a non-
Department health care provider is made; and
``(E) the date on which such an appointment is made
and the date on which such appointment occurs; and
[[Page 138 STAT. 2744]]
``(2) any other period of time that the Secretary determines
necessary.''.
(b) <<NOTE: 38 USC 1703G note.>> Effective Date.--The first report
under section 1703G, as added by this section, shall be due not later
than 180 days after the date of the enactment of this section.
SEC. 141. ELIMINATION OF CERTAIN REQUIREMENTS FOR CERTAIN
DEPARTMENT OF VETERANS AFFAIRS ASSISTANT
UNDER SECRETARIES.
Section 7306 of title 38, United States Code, is amended--
(1) by striking subsection (b);
(2) by redesignating subsections (c) through (g) as
subsections (b) through (f), respectively; and
(3) in subsection (c) (as so redesignated), by striking
``subsection (e)'' and inserting ``subsection (d)''.
SEC. 142. MODIFICATION OF PAY LIMITATION FOR PHYSICIANS,
PODIATRISTS, OPTOMETRISTS, AND DENTISTS OF
DEPARTMENT OF VETERANS AFFAIRS.
(a) Pay.--
(1) In general.--Section 7431 of title 38, United States
Code, is amended--
(A) by inserting ``optometrists,'' after
``podiatrists,'' each place it appears;
(B) by inserting ``optometrist'' after
``podiatrist,'' each place it appears;
(C) in subsection (c)--
(i) in paragraph (5), by adding at the end the
following new sentence: ``Such a notice shall
include a statement of whether the market pay will
increase, decrease, or remain unchanged following
such evaluation.''; and
(ii) by adding at the end the following new
paragraphs:
``(7) The Secretary shall ensure that each physician,
podiatrist, optometrist, and dentist in the Veterans Health
Administration is--
``(A) advised, on an annual basis, of the criteria
described in subparagraph (F) of paragraph (4);
``(B) evaluated in accordance with such criteria;
and
``(C) compensated in accordance with--
``(i) applicable assignment and pay levels,
subject to relevant pay limitations; and
``(ii) the extent to which such criteria are
met.
``(8) <<NOTE: Reports. Lists.>> Not later than 120 days
after the end of each fiscal year, the Secretary shall submit to
the Committees on Veterans' Affairs of the Senate and the House
of Representatives a report that includes the following:
``(A) A list of each facility and specialty that
conducted an evaluation of pay during the period covered
by the report.
``(B) For each evaluation described in subparagraph
(A)--
``(i) a list of occupations for which pay was
evaluated, disaggregated by medical specialty,
number of authorized full-time employees, and
onsite full-time employees as of the date of the
evaluation;
``(ii) the date such evaluation was completed;
[[Page 138 STAT. 2745]]
``(iii) whether a market pay adjustment was
made following the evaluation per each occupation
and specialty evaluated;
``(iv) whether applicable employees were
notified of such evaluation;
``(v) whether local labor partners were
notified of such evaluation; and
``(vi) in the case of an evaluation that
resulted in an adjustment of pay--
``(I) the date such adjustment--
``(aa) was implemented; and
``(bb) became effective; and
``(II) the percentage of employees
of each occupation and specialty for
which pay was adjusted pursuant to such
evaluation.
``(C) <<NOTE: Time period.>> A list of facilities of
the Department that have not conducted an evaluation of
market pay, pursuant to paragraph (5), during the 18-
month-period that precedes the date of the submission of
such report.''; and
(D) in subsection (e), by adding at the end the
following new paragraphs:
``(5) Notwithstanding any compensation or pay limitations
under this title or title 5, the Secretary may authorize the
Under Secretary for Health to pay physicians, podiatrists,
optometrists, and dentists--
``(A) awards authorized under this title;
``(B) advance payments, recruitment or relocation
bonuses, and retention allowances authorized under
section 7410(a) of this title or as otherwise provided
by law;
``(C) incentives or bonuses under section 706 of
this title or as otherwise provided by law; and
``(D) earnings from fee-basis appointments under
section 7405(a)(2) of this title.
``(6)(A) <<NOTE: Waiver authority.>> The Secretary may
waive any pay limitation described in this section (including
tier limitations) that the Secretary determines necessary for
the recruitment or retention of critical health care personnel
whom the Secretary determines would provide direct patient care.
``(B) Priority for such waivers shall be given for
positions, locations, and care provided through agreements that
are costly to the Department.
``(C) The Chief Human Capital Officer of the Department, the
Chief Financial Officer of the Department, and the Office of the
General Counsel of the Department shall review any waiver issued
under subparagraph (A).
``(D) During the period the authority under subparagraph (A)
is effective, the Secretary may not issue more than 300 waivers
under such subparagraph.
``(E) The Secretary may prescribe requirements, limitations,
and other considerations for waivers under such subparagraph.
``(F) <<NOTE: Reports.>> Not later than 180 days after the
date of the enactment of the Senator Elizabeth Dole 21st Century
Veterans Healthcare and Benefits Improvement Act, and annually
thereafter, the Secretary shall submit to the Committees on
Veterans' Affairs of the Senate and the House of Representatives
a report that includes--
[[Page 138 STAT. 2746]]
``(i) <<NOTE: Updates.>> any updates to the
requirements, limitations, and considerations prescribed
under subparagraph (B) during the period covered by the
report;
``(ii) a description of the findings of each review,
if any, conducted pursuant to subparagraph (C);
``(iii) a description of each waiver under
subparagraph (A) in effect as of the date of the
submission of the report, including the--
``(I) duty location, position, specialty,
market and performance considerations for the
waiver; and
``(II) impact, if any, of the waiver on care
furnished by the Department pursuant to an
agreement regarding the geographic area; and
``(iv) <<NOTE: List.>> a list of any separation
actions during the period covered by the report with
respect to a position for which a waiver under
subparagraph (A) is in effect.
``(G) <<NOTE: Termination.>> The authority of the Secretary
under subparagraph (A) shall terminate on the last day of the
third full fiscal year following the date of the enactment of
the Senator Elizabeth Dole 21st Century Veterans Healthcare and
Benefits Improvement Act.''.
(2) Report on waiver authority.--Not later than 180 days
after the date of the enactment of this Act, the Secretary of
Veterans Affairs shall submit to the Committees on Veterans'
Affairs of the Senate and the House of Representatives a report
that includes a description of the requirements, limitations,
and other considerations prescribed under section 7431(b)(6)(D)
of title 38, United States Code, as added by paragraph (1).
(3) Conforming amendments.--
(A) Pay of under secretary for health.--Section
7432(b)(1) of such title is amended by inserting ``,
podiatrist, optometrist,'' after ``physician''.
(B) Administrative matters.--Section 7433 of such
title is amended by inserting ``optometrists,'' after
``physicians,'' each place it appears.
(C) Competitive pay.--Section 7451(a)(2)(C) of such
title is amended by inserting ``optometrist,'' after
``physician,''.
(4) Clerical amendments.--
(A) Subchapter heading.--Subchapter III of chapter
74 of such title <<NOTE: 38 USC prec. 7431.>> is amended
in the heading by inserting ``Optometrists,'' after
``PODIATRISTS,''.
(B) Table of sections.--The table of sections for
such chapter is <<NOTE: 38 USC prec. 7401.>> amended by
striking the item relating to subchapter III and
inserting the following:
``subchapter iii--pay for physicians and other health-care personnel''.
(5) <<NOTE: Effective date. Time period. 38 USC 7431
note.>> Applicability dates.--The amendments made by this
subsection shall apply to any pay period of the Department of
Veterans Affairs beginning on or after the date that is 180 days
after the date of the enactment of this Act.
(b) Modification and Clarification of Pay Grade for Optometrists.--
Section 7404 of title 38, United States Code, is amended--
(1) in subsection (a)(2)(A), by striking ``podiatrists, and
dentists'' and inserting ``podiatrists, optometrists, and
dentists''; and
[[Page 138 STAT. 2747]]
(2) in subsection (b)--
(A) by striking ``podiatrist (dpm), and dentist''
and inserting ``podiatrist (dpm), optometrist (od), and
dentist'';
(B) by striking ``clinical chiropractor and
optometrist schedule,'' and inserting ``clinical
chiropractor schedule''; and
(C) by inserting ``optometrist grade'' after
``Podiatrist grade''.
(c) <<NOTE: 38 USC 7431 note.>> Retroactive Authority for
Compensation.--
(1) In general.--The Secretary of Veterans Affairs may pay
retroactive compensation to a covered employee in an amount that
equals the amount of compensation that was authorized to be paid
to such covered employee during the period specified in
paragraph (2), but was deferred and paid to such employee in the
calendar year following the calender year in which such
compensation was authorized because the payment such
compensation would have exceeded an applicable cap on annual
compensation.
(2) Period specified.--The period specified in this
paragraph is the period beginning on January 8, 2006, and ending
on December 31, 2017.
(3) Exclusion.--Compensation authorized under this
subsection shall not be included in the calculation of any
aggregate limit on compensation for a covered employee for the
year in which it is paid.
(4) Charging of compensation.--Compensation authorized under
this subsection shall be charged to the appropriate medical care
appropriation account of the Department of Veterans Affairs for
the fiscal year in which the work was performed except as
follows:
(A) In the case of an account that has closed
pursuant to section 1552 of title 31, United States
Code, the compensation shall be charged to a current
appropriation account in accordance with section 1553 of
such title.
(B) In the case of an expired account that has not
closed, if charging the compensation to the expired
account would cause such account to have a negative
unliquidated or unexpended balance, the compensation may
be charged to a current appropriation account available
for the same purpose.
(5) Definitions.--In this subsection:
(A) The term ``compensation'' means any pay,
including salary, awards, and incentives.
(B) The term ``covered employee'' means a physician,
podiatrist, or dentist subject to market pay under
section 7431 of title 38, United States Code.
SEC. 143. <<NOTE: 38 USC 1728 note.>> REIMBURSEMENT OF AMBULANCE
COST FOR CARE FOR CERTAIN RURAL VETERANS.
(a) <<NOTE: Payment.>> In General.--The Secretary of Veterans
Affairs shall pay, or reimburse a covered veteran for, the cost of
transporting the veteran by ambulance, including air ambulance, from a
covered location to a provider of the Department of Veterans Affairs, a
non-Department provider, or the nearest hospital that can meet the needs
of the veteran (including a hospital that compacts with the Indian
Health Service) for covered care.
[[Page 138 STAT. 2748]]
(b) Amount Covered.--The maximum cumulative amount covered under
this section for a covered veteran is $46,000.
(c) Sunset.--This section shall cease to be effective on September
30, 2026.
(d) Definitions.--In this section:
(1) The term ``covered care'' means care for a veteran
eligible for care provided by the Department of Veterans Affairs
under title 38, United States Code, or any other law
administered by the Secretary of Veterans Affairs, even if the
care associated with the transport described in subsection (a)
is not authorized by the Department.
(2) The term ``covered location'' means a location that is--
(A) in a State that is 100 miles or more from the
nearest medical center of the Department of Veterans
Affairs; and
(B) in an area rated as a 10 or higher under the
rural-urban commuting areas coding system of the
Department of Agriculture.
(3) The term ``covered veteran'' means a veteran who--
(A) has a service-connected disability rated by the
Secretary as between 0 and 30 percent disabling;
(B) is not eligible for payments or reimbursements
for beneficiary travel or other transportation under the
laws administered by the Secretary of Veterans Affairs,
other than under this section; and
(C) is not entitled to care or services under a non-
Department of Veterans Affairs health-plan contract.
(4) The term ``health-plan contract'' has the meaning given
that term in section 1725 of title 38, United States Code.
(5) The term ``service-connected'' has the meaning given
that term in section 101 of such title.
SEC. 144. <<NOTE: 38 USC 1712 note.>> PILOT PROGRAM TO FURNISH
DENTAL CARE FROM THE DEPARTMENT OF
VETERANS AFFAIRS TO CERTAIN VETERANS
DIAGNOSED WITH ISCHEMIC HEART DISEASE.
(a) <<NOTE: Deadline.>> In General.--Beginning not later than one
year after the date of the enactment of this Act, the Secretary of
Veterans Affairs shall carry out a two-year pilot program (in this
section referred to as the ``pilot program'') under which the Secretary
shall furnish covered care to covered veterans through means that
include the use of community care.
(b) Locations.--
(1) In general.--The Secretary shall select not more than
four States in which to carry out the pilot program.
(2) <<NOTE: Determinations.>> Selection criteria.--In
selecting States under paragraph (1), the Secretary shall
prioritize States in which--
(A) the Department of Veterans Affairs serves a high
proportion, as determined by the Secretary, of veterans
residing in rural or highly rural areas (as determined
through the use of the Rural-Urban Commuting Areas
coding system of the Department of Agriculture);
(B) dental clinics operated by the Department of
Veterans Affairs currently utilize teledentistry;
(C) the Department of Veterans Affairs does not
currently operate a dental clinic; or
[[Page 138 STAT. 2749]]
(D) the Secretary determines a large percentage of
veterans enrolled in the system of annual patient
enrollment of the Department of Veterans Affairs
established and operated under paragraphs (1) or (2) of
section 1705(a) of title 38, United States Code, visit
emergency rooms for dental emergencies at high rates.
(c) Participation Limitation.--Participation in a pilot program
established pursuant to this section shall be limited to a covered
veteran who receives health care in a facility of the Department located
in a State selected under subsection (b).
(d) Use of Certain Methods to Provide Care.--
(1) Mobile dental clinics.--In carrying out the pilot
program, the Secretary shall test the efficacy of mobile dental
clinics to service rural areas that do not have a population
base to warrant a full-time clinic but where there are covered
veterans in need of dental care.
(2) Home-based dental care.--In carrying out the pilot
program, the Secretary shall test the efficacy of portable
dental care units to service rural veterans in their homes, as
the Secretary considers medically appropriate.
(e) Administration.--
(1) Community care network review.--
(A) In general.--Before commencing the pilot
program, the Secretary shall work with third party
administrators to conduct a review of dental providers
who are part of the community care network of the
Department in each State selected under subsection
(b)(1) to ensure--
(i) dental providers who are no longer
accepting patients from the Department--
(I) are not still listed as
providers accepting referrals from the
Department; and
(II) are not sent referrals from the
Department; and
(ii) dental providers participating in each
such network are capable of receiving an influx of
patients from the Department under the pilot
program.
(B) <<NOTE: Determination.>> Expansion of network.--
If, pursuant to a review under subparagraph (A), the
Secretary determines the community care network in a
State selected under subsection (b)(1) is not capable of
receiving an influx of patients under the pilot program,
the Secretary shall coordinate with the Third Party
Administrator for such State to ensure the dental
provider network of such community care network is
sufficiently expanded before the initiation of the pilot
program.
(2) Notice to covered veterans.--In carrying out the pilot
program, the Secretary shall inform all covered veterans in
States selected under subsection (b)(1) of the covered care
available under the pilot program.
(3) <<NOTE: Time period. Determination.>> Loss of
eligibility.--Any veteran participating in the pilot program who
ceases to be a covered veteran shall be removed from the pilot
program on the date that is 90 days after the Secretary
determines the participant is no longer a covered veteran.
(4) Continuity of care.--
[[Page 138 STAT. 2750]]
(A) In general.--Upon the termination of the pilot
program, the Secretary shall provide to all veterans
participating in the pilot program at the time of such
termination--
(i) information on how to enroll in the dental
insurance plan of the Department of Veterans
Affairs under section 1712C of title 38, United
States Code;
(ii) if appropriate, information on the
VETSmile program of the Department of Veterans
Affairs, or any successor program; and
(iii) contact information for dental providers
in the surrounding community who provide low- or
no-cost dental care and whom the Secretary has
confirmed are available to take on new patients.
(B) Continuation of treatment plan.--Any veteran
participating in the pilot program may continue to
receive services under the pilot program after the
termination of the pilot program to complete a treatment
plan commenced under the pilot program, as determined
necessary by the Secretary.
(f) Reports.--
(1) Annual report.--Not later than one year after the
commencement of the pilot program, and annually thereafter for
the duration of the pilot program, the Secretary of Veterans
Affairs shall submit to the Committees on Veterans' Affairs of
the House of Representatives and the Senate a report on the
pilot program that includes--
(A) an identification of the States participating in
the pilot program;
(B) a description of the implementation and
operation of the pilot program;
(C) the number of participants in the pilot program,
disaggregated by--
(i) State; and
(ii) disability rating;
(D) an identification of any barriers or challenges
to implementing the pilot program;
(E) aggregated feedback from participants in the
pilot program, including from interviews and surveys;
(F) the average annual cost of providing covered
care to a participant in the pilot program,
disaggregated by--
(i) State;
(ii) disability rating; and
(iii) whether the care was provided through
the community care network or through a provider
of the Department;
(G) <<NOTE: Analysis.>> an analysis of the
communication and collaboration of the Department with
Third Party Administrators and community care dental
providers, disaggregated by State;
(H) <<NOTE: Analysis.>> an analysis of any cost
savings by the Department with respect to the treatment
of ischemic heart disease;
(I) <<NOTE: Assessment.>> an assessment of the
impact of the pilot program on appointments for care,
prescriptions, hospitalizations, emergency room visits,
wellness, employability, satisfaction, and perceived
quality of life of covered veterans related to their
diagnosis of ischemic heart disease;
[[Page 138 STAT. 2751]]
(J) <<NOTE: Analysis. Assessment.>> an analysis and
assessment of the efficacy of mobile clinics and
portable dental care units, to the extent such
modalities are used, to service the needs of covered
veterans under the pilot program;
(K) <<NOTE: Analysis. Assessment.>> an analysis and
assessment of the usage of teledentistry to service the
needs of covered veterans under the pilot program, to
include a cost benefit analysis of such services; and
(L) such other matters as the Secretary considers
appropriate.
(2) Final report.--Not later than 90 days before the
completion of the pilot program, the Secretary shall submit to
the Committees on Veterans' Affairs of the House of
Representatives and the Senate a report on the pilot program
that--
(A) includes the matters required under paragraph
(1);
(B) <<NOTE: Recommenda- tions.>> includes
recommendations on whether the pilot program should be
continued, expanded, or adopted throughout the
Department; and
(C) indicates whether the Secretary requests action
by Congress to make the pilot program permanent.
(g) Impact on Community Care.--Participants in the pilot program
shall be able to access covered care in the community under section 1703
of title 38, United States Code.
(h) Definitions.--In this section:
(1) The term ``covered care'' means dental care that is
consistent with the dental services and treatment furnished by
the Secretary of Veterans Affairs to veterans pursuant to
section 1712(a)(1)(G) of title 38, United States Code.
(2) The term ``covered veteran'' means a veteran who--
(A) is enrolled in the system of annual patient
enrollment of the Department established and operated
under paragraphs (1) or (2) of section 1705(a) of title
38, United States Code;
(B) is not eligible for dental services and
treatment and related dental appliances under the laws
administered by the Secretary as of the date of the
enactment of this Act; and
(C) has a diagnosis of ischemic heart disease.
(3) The term ``Third Party Administrator'' has the meaning
given such term in section 1703F of such title.
SEC. 145. <<NOTE: 38 USC 1701 note.>> DOCUMENTATION OF PREFERENCES
OF VETERANS FOR SCHEDULING OF APPOINTMENTS
FOR HEALTH CARE UNDER LAWS ADMINISTERED BY
SECRETARY OF VETERANS AFFAIRS.
(a) <<NOTE: Deadline.>> In General.--Not later than one year after
the date of the enactment of this Act, the Secretary of Veterans Affairs
shall develop a mechanism to solicit information regarding the
preference of veterans enrolled in the system of annual patient
enrollment of the Department of Veterans Affairs established and
operated under section 1705(a) of title 38, United States Code, for
scheduling of appointments for health care and related services under
the laws administered by the Secretary, including through non-Department
providers.
[[Page 138 STAT. 2752]]
(b) Documentation of Preference.--Preferences provided voluntarily
by a veteran pursuant to subsection (a) shall be documented on My
HealtheVet or another system designated by the Secretary that allows the
veteran to view and change such preferences at any time.
(c) Inclusion in Preference.--Preferences solicited under subsection
(a) shall include the following:
(1) How and when the veteran prefers to be contacted about
an appointment for health care.
(2) Whether the veteran prefers to schedule appointments
without the assistance of the Department, if able.
(3) Whether the veteran prefers to select a provider without
the assistance of the Department, if able.
(4) Whether the veteran prefers appointments to be scheduled
during certain days or times.
(d) Use of Preference.--The Secretary shall make the preferences
provided under subsection (a) easily accessible to medical support
assistants and other staff of the Department, or non-Department staff,
as the Secretary determines appropriate, who assist in the appointment
scheduling process.
(e) Deployment of Mechanism.--
(1) In general.--Beginning after the date on which the
Secretary develops the mechanism required under subsection (a),
the Secretary shall--
(A) test the mechanism in not fewer than three
geographically diverse Veterans Integrated Service
Networks; and
(B) gather feedback about the effectiveness of such
mechanism from veterans, medical support assistants,
staff and other stakeholders as the Secretary determines
appropriate.
(2) Limitation.--The Secretary may not implement such
mechanism across the Veterans Health Administration of the
Department before the Secretary addresses the feedback described
in paragraph (1)(B).
SEC. 146. <<NOTE: 38 USC 1701 note.>> STAFFING MODEL AND
PERFORMANCE METRICS FOR CERTAIN EMPLOYEES
OF THE DEPARTMENT OF VETERANS AFFAIRS.
(a) Staffing Model.--
(1) <<NOTE: Deadline.>> In general.--Not later than one year
after the date of the enactment of this Act, the Secretary of
Veterans Affairs shall--
(A) develop, validate, and implement a staffing
model for the Office of Integrated Veteran Care of the
Department of Veterans Affairs, or successor office,
Veterans Integrated Services Networks, and medical
centers of the Department that includes appropriate
target staffing levels nationally, regionally, and
locally to ensure timely access to care and effectively
oversee the provision of care by the Department, whether
at a facility of the Department or through a non-
Department provider; and
(B) <<NOTE: Briefing.>> provide to Congress a
briefing on such staffing model, which shall include--
(i) the metrics and measures used by the
Secretary in developing such staffing model;
[[Page 138 STAT. 2753]]
(ii) <<NOTE: Analysis.>> an analysis of how
such staffing model compares to the staffing
models of other relevant Government-owned and
private sector health care systems; and
(iii) <<NOTE: Estimate.>> an estimate of the
portion of the roles in such staffing model that
will be filled by contracted staff at any given
time.
(2) Report on implementation of staffing model.--Not later
than one year after the date on which the Secretary implements
the staffing model required under paragraph (1), the Secretary
shall submit to Congress and the Comptroller General of the
United States a report containing--
(A) <<NOTE: Update.>> an update on such
implementation; and
(B) information on the outcomes yielded by such
staffing model in terms of improved access to care for
veterans and improved compliance with relevant laws,
regulations, policy directives, and guidance governing
access to care.
(b) Performance Metrics.--
(1) <<NOTE: Deadline. Implementation plan.>> In general.--
Not later than one year after the date of the enactment of this
Act, the Secretary shall develop and implement a plan, with an
appropriate tracking system, to incorporate appropriate
standardized performance metrics and oversight measures within
the performance appraisal systems for employees of the
Department specified in paragraph (2).
(2) Employees of the department specified.--Employees of the
Department specified in this paragraph are employees who are
responsible for ensuring timely access to care from the
Department, compliance with relevant statutes and regulations
relating to the provision of care, including section 1703 of
title 38, United States Code, and overseeing the provision of
care, whether at a facility of the Department or through a non-
Department provider, including employees within the Office of
Integrated Veteran Care of the Department, or successor office,
employees of a Veterans Integrated Service Network, and
employees of a medical center of the Department.
(3) Report on implementation of performance metrics.--Not
later than one year after implementing the performance metrics
required under paragraph (1), the Secretary shall submit to
Congress and the Comptroller General of the United States a
report containing--
(A) <<NOTE: Update.>> an update on such
implementation; and
(B) information on the outcomes yielded by such
performance metrics in terms of improved access to care
for veterans and improved compliance with relevant laws,
policy directives, and guidance governing access to
care.
(c) GAO Report.--Not later than two years after the later of the
date on which the Comptroller General receives the report under
subsection (a)(2) or the report under subsection (b)(3), the Comptroller
General shall submit to Congress a report that includes--
(1) <<NOTE: Assessment.>> an assessment of the performance
of the Office of Integrated Veteran Care of the Department, or
successor office, in improving access to care for veterans in
facilities of the Department and pursuant to section 1703 of
title 38, United States Code; and
[[Page 138 STAT. 2754]]
(2) <<NOTE: Recommenda- tions.>> such recommendations as the
Comptroller General considers appropriate with respect to
improving access to the care described in paragraph (1) for
veterans.
SEC. 147. <<NOTE: Deadline. 38 USC 1701 note.>> ONLINE HEALTH
EDUCATION PORTAL FOR VETERANS ENROLLED IN
PATIENT ENROLLMENT SYSTEM OF DEPARTMENT OF
VETERANS AFFAIRS.
Not later than one year after the date of the enactment of this Act,
the Secretary of Veterans Affairs shall establish, on an Internet
website of the Department, a health education portal that includes
interactive educational modules to ensure veterans enrolled in the
patient enrollment system of the Department of Veterans Affairs
established and operated under section 1705(a) of title 38, United
States Code, understand the basic health care eligibilities and
entitlements of veterans under the laws administered by the Secretary,
including under the Veterans Community Care Program under section 1703
of such title.
SEC. 148. <<NOTE: Deadlines. 38 USC 7401 note.>> LIMITATION ON
DETAIL OF DIRECTORS OF MEDICAL CENTERS OF
DEPARTMENT OF VETERANS AFFAIRS TO
DIFFERENT POSITIONS.
(a) Notification.--
(1) In general.--Not later than 90 days after detailing a
director of a medical center of the Department of Veterans
Affairs to a different position within the Department, the
Secretary of Veterans Affairs shall notify the Committee on
Veterans' Affairs of the Senate and the Committee on Veterans'
Affairs of the House of Representatives of such detail.
(2) Matters to be included.--The notification required by
paragraph (1) shall include, with respect to a director of a
medical center who is detailed to a different position within
the Department, the following information:
(A) The location at which the director is detailed.
(B) The position title of the detail.
(C) The estimated time the director is expected to
be absent from their duties at the medical center.
(D) Such other information as the Secretary may
determine appropriate.
(b) Appointment of Acting Director.--Not later than 120 days after
detailing a director of a medical center of the Department to a
different position within the Department, the Secretary shall appoint an
individual as acting director of such medical center with all of the
authority and responsibilities of the detailed director.
(c) <<NOTE: Time period.>> Update on Detail.--Not later than 120
days after detailing a director of a medical center of the Department to
a different position within the Department, and not less frequently than
every 30 days thereafter while the detail is in effect or while the
director position at the medical center is vacant, the Secretary shall
submit to the Committee on Veterans' Affairs of the Senate and the
Committee on Veterans' Affairs of the House of Representatives an update
regarding the status of the detail.
(d) Return to Position or Reassignment.--
(1) In general.--Except as provided in paragraph (2), not
later than 180 days after detailing a director of a medical
center of the Department to a different position within the
Department, for a reason other than an ongoing investigation or
administrative action with respect to the director, the
Secretary shall--
[[Page 138 STAT. 2755]]
(A) return the individual to the position as
director of the medical center; or
(B) reassign the individual from the position as
director of the medical center and begin the process of
hiring a new director for such position.
(2) Waiver.--
(A) <<NOTE: Time period.>> In general.--The
Secretary may waive the requirement under paragraph (1)
with respect to an individual for successive 90-day
increments for a total period of not more than 540 days
from the original date the individual was detailed away
from their position as director of a medical center.
(B) Notification.--Not later than 30 days after
exercising a waiver under subparagraph (A), the
Secretary shall notify Congress of the waiver and
provide to Congress information as to why the waiver is
necessary.
SEC. 149. <<NOTE: 38 USC 1709B note.>> NATIONAL VETERAN SUICIDE
PREVENTION ANNUAL REPORT.
(a) National Veteran Suicide Prevention Annual Report.--
(1) <<NOTE: Public information. Web posting.>> In general.--
Not later than 18 months after the date of the enactment of this
Act, and not later than September 30 of each year thereafter,
the Secretary of Veterans Affairs shall submit to the
appropriate congressional committees and publish on a publicly
available website of the Department of Veterans Affairs a report
to be known as the ``National Veteran Suicide Prevention Annual
Report''.
(2) Extension.--
(A) In general.--If the Secretary requires an
extension of the deadline for a report under subsection
(a), the Secretary shall submit to the appropriate
congressional committees a written request for such an
extension.
(B) Elements.--Each written request under paragraph
(1) for an extension for a report shall include the
following:
(i) The rationale for the delay in the
submission of the report.
(ii) An explanation of the need for an
extension.
(iii) A proposed amended date for the
submission and publication of the report.
(3) Briefing.--With respect to each report required under
paragraph (1), the Secretary shall, before the date on which the
Secretary submits such report, provide to the appropriate
congressional committees a briefing on such report.
(4) Elements.--
(A) In general.--Each report required under
paragraph (1) shall include--
(i) the findings of the national analysis of
veteran suicide rates for the latest year for
which data is available;
(ii) an identification of trends, if any,
demonstrated by such data; and
(iii) a comparison of such data to data on
veteran suicide rates during preceding years.
(B) Additional elements.--Each report under
paragraph (1) shall include, for the year covered by the
report, the following:
[[Page 138 STAT. 2756]]
(i) Suicide rates of veterans disaggregated by
age, gender, and race or ethnicity.
(ii) Trends in suicide rates of veterans
compared to engagement of those veterans with
health care from the Veterans Health
Administration, including an examination of trends
in suicide rates or deaths among--
(I) veterans who have recently
received health care from the Veterans
Health Administration as compared to
veterans who have never received health
care from the Veterans Health
Administration;
(II) veterans who are enrolled in
the patient enrollment system of the
Department of Veterans Affairs under
section 1705(a) of title 38, United
States Code, as compared to veterans who
have never enrolled in such system;
(III) veterans who have recently
used services from a Vet Center as
compared to veterans who have never used
such services;
(IV) to the extent practicable,
veterans who have a diagnosis of
substance use disorder; and
(V) other groups of veterans
relating to engagement with health care
from the Veterans Health Administration,
as the Secretary considers practicable.
(iii) To the extent practicable, trends in
suicide rates of veterans compared to engagement
of those veterans with benefits from the Veterans
Benefits Administration, including an examination
of trends in suicide rates or deaths among--
(I) veterans who are currently
using, have previously used, or have
never used educational assistance under
the laws administered by the Secretary;
(II) veterans who are currently
receiving, have previously received, or
have never received services or
assistance under chapter 31 of title 38,
United States Code;
(III) with respect to compensation
under chapter 11 of such title--
(aa) veterans who were
recipients of such compensation
as compared to veterans who
never applied for such
compensation prior to death;
(bb) veterans who had a
claim denied for such
compensation prior to death;
(cc) veterans who had a
pending claim for such
compensation at time of death;
and
(dd) veterans who had an
entitlement for such
compensation reduced prior to
death;
(IV) veterans who are currently
receiving or have never received pension
under chapter 15 of title 38, United
States Code;
(V) veterans who are currently
using, have recently used, or have never
used programs or services provided by
the Homeless Programs Office
[[Page 138 STAT. 2757]]
of the Department, including an
examination of trends in suicide rates
or deaths among veterans who made
contact with such office but were denied
or deemed ineligible for any such
program or service;
(VI) with respect to housing loans
guaranteed by the Secretary under
chapter 37 of title 38, United States
Code, veterans who are current
recipients of, were recent recipients
of, or have never received such a loan;
(VII) veterans owing debts to the
Department;
(VIII) veterans who were involved in
a veterans treatment court program,
whether they graduated successfully or
not; and
(IX) veterans who were successfully
contacted, unsuccessfully contacted, or
never contacted by the Department
through the Solid Start program under
section 6320 of title 38, United States
Code.
(C) Strategy and recommendations.--
(i) Initial report.--The initial report under
paragraph (1) shall include a strategy and
recommendations developed by the Secretary of
Veterans Affairs, in collaboration with the
Director of the Centers for Disease Control and
Prevention, for--
(I) <<NOTE: Data.>> improving data
collection at the State and local levels
to accurately capture suicide deaths of
veterans;
(II) improving the timeliness,
efficacy, and standardization of data
reporting on suicide deaths of veterans
at the Federal level, including by the
Centers for Disease Control and
Prevention and the Department of
Veterans Affairs;
(III) <<NOTE: Analysis.>> improving
the timeliness of identification and
analysis of suicide deaths of veterans
by Federal agencies, including the
Centers for Disease Control and
Prevention, and the Department of
Veterans Affairs; and
(IV) any other necessary process
improvements for improving the
timeliness, efficacy, and
standardization of reporting of data
relating to suicide deaths of veterans,
particularly with respect to the annual
report under this section.
(ii) <<NOTE: Updates.>> Subsequent reports.--
Each report after the initial report under
paragraph (1) shall include updates on actions
taken to meet the strategy and recommendations
developed under subparagraph (A).
(5) Definitions.--In this subsection:
(A) The term ``appropriate congressional
committees'' means the Committees on Veterans' Affairs
of the Senate and the House of Representatives.
(B) The term ``Vet Center'' means a center for
readjustment counseling and related mental health
services for veterans under section 1712A of title 38,
United States Code.
(b) Independent Assessment of National Veteran Suicide Prevention
Annual Report.--
[[Page 138 STAT. 2758]]
(1) <<NOTE: Contracts.>> In general.--Not later than 90 days
after the date of the enactment of this Act, the Secretary of
Veterans Affairs shall enter into one or more contracts with a
private sector entity described in paragraph (5) to conduct an
independent assessment of the National Veteran Suicide
Prevention Annual Report required under subsection (a).
(2) Frequency.--The private sector entity or entities
carrying out the assessment required under paragraph (1) shall
complete such assessment not later than 240 days after entering
into the contract described in such subsection and not less
frequently than every five years thereafter.
(3) <<NOTE: Analyses.>> Elements.--Each assessment required
under paragraph (1) shall analyze the following:
(A) The methodology used by the Department to track,
analyze, categorize, and report suicide deaths and
suicide rates among veterans.
(B) Whether data sources used by the Department to
compile data on suicide deaths and suicide rates among
veterans are accurately reflecting such data.
(C) Vulnerabilities in the methodology used by the
Department that could lead to inaccurate counting of
suicide deaths and suicide rates among veterans.
(D) The ability of the Department to cross reference
suicide deaths and suicide rates among veterans with
trends in usage of programs of the Veterans Health
Administration or the Veterans Benefits Administration
or other programs that could serve as widespread
protective factors against suicide.
(E) Improvements that could be made to ensure the
National Veteran Suicide Prevention Annual Report
required under subsection (a) is accurate and
comprehensive and provides insights for making
improvements to the suicide prevention efforts of the
Department.
(4) Report on assessment.--
(A) Report on findings and recommendations.--Not
later than 60 days after completing an assessment
required by paragraph (1), the private sector entity or
entities carrying out the assessment shall submit to the
Secretary of Veterans Affairs and the Committees on
Veterans' Affairs of the Senate and the House of
Representatives a report on the findings and
recommendations of the private sector entity or entities
with respect to such assessment.
(B) Report on planned improvements.--Not later than
60 days after receiving a report under paragraph (1)
with respect to an assessment required by paragraph (1),
the Secretary shall submit to the Committees on
Veterans' Affairs of the Senate and the House of
Representatives a report on how the Department plans to
improve the National Veteran Suicide Prevention Annual
Report required under subsection (a) based on such
assessment.
(5) Private sector entity described.--A private sector
entity described in this paragraph is a private entity that--
(A) specializes in analyzing large-scale
organizational data collection and analysis efforts,
especially with respect to the health care sector; and
[[Page 138 STAT. 2759]]
(B) has experience and proven outcomes in optimizing
the accuracy and comprehensiveness of data collection
and analysis related to suicide.
(c) Report on Additional Benefits and Services From Department of
Veterans Affairs to Prevent Veteran Suicide.--
(1) In general.-- <<NOTE: Web posting. Public
information. Recommenda- tions.>> Not later than three years
after the date of the enactment of this Act, the Secretary of
Veterans Affairs shall submit to the Committees on Veterans'
Affairs of the Senate and the House of Representatives and
publish on a publicly available website of the Department of
Veterans Affairs a report that analyzes which benefits and
services under the laws administered by such Secretary,
including such benefits and services furnished by the Veterans
Benefits Administration, have the greatest impact on the
prevention of suicide among veterans, including recommendations
for potential expansion of services and benefits to reduce the
number of veteran suicides.
(2) <<NOTE: Analysis.>> Assessment of solid start program.--
The report required by paragraph (1) shall include an analysis
of the effectiveness of the Solid Start program under section
6320 of title 38, United States Code, on prevention of suicide
among veterans.
(d) Toolkit for State and Local Coroners and Medical Examiners on
Best Practices for Identifying and Reporting on Suicide Deaths of
Veterans.--
(1) In general.--The Secretary of Veterans Affairs, in
collaboration with the Director of the Centers for Disease
Control and Prevention, shall develop a toolkit for State and
local coroners and medical examiners that contains best
practices for--
(A) accurately identifying and reporting suicide
deaths of veterans, including how to identify veteran
status; and
(B) reporting such deaths to the Centers for Disease
Control and Prevention and other applicable entities.
(2) <<NOTE: Deadline. Public information. Web
posting.>> Availability.--Not later than two years after the
date of the enactment of this Act, the Secretary shall make the
toolkit developed under paragraph (1) available on a publicly
available website of the Department of Veterans Affairs.
(3) Outreach.--The Secretary, in collaboration with the
Director of the Centers for Disease Control and Prevention,
shall conduct outreach to appropriate State and local agencies
to promote the availability and use of the toolkit developed
under paragraph (1).
SEC. 150. REPORT ON PHYSICAL INFRASTRUCTURE REQUIRED BY MEDICAL
FACILITIES OF DEPARTMENT OF VETERANS
AFFAIRS TO PROVIDE DENTAL CARE SERVICES.
Not later than one year after the date of the enactment of this Act,
the Secretary of Veterans Affairs shall submit to the Committees on
Veterans' Affairs of the Senate and the House of Representatives a
report, for each medical center or other relevant health care facility
of the Department of Veterans Affairs, that includes--
(1) an identification of the physical infrastructure,
including new facilities, renovations, remodels, leases, or
other infrastructure, such medical center or health care
facility requires to
[[Page 138 STAT. 2760]]
provide dental care services to veterans eligible for such
services under the laws administered by the Secretary; and
(2) <<NOTE: Analysis.>> an analysis of the physical
infrastructure such medical center or health care facility would
require if a greater number of veterans became eligible for such
dental care services pursuant to a modification of the laws
administered by the Secretary.
SEC. 151. COMPTROLLER GENERAL REPORT ON CERTAIN ORAL HEALTH CARE
PROGRAMS UNDER LAWS ADMINISTERED BY
SECRETARY OF VETERANS AFFAIRS.
(a) <<NOTE: Assessment.>> In General.--Not later than one year after
the date of the enactment of this Act, the Comptroller General of the
United States shall submit to the Committees on Veterans' Affairs of the
Senate and the House of Representatives a report on the status of the
oral health care programs of the Department of Veterans Affairs, that
includes an assessment of--
(1) any issues with information technology programs,
including Dental Record Manager Plus, that affect dental care
staff of the Department;
(2) the implementation of the dental insurance plan of the
Department under section 1712C of title 38, United States Code;
(3) the implementation and expansion of the VETSmile program
of the Department;
(4) barriers preventing the Department from expanding dental
care eligibility to all veterans with ischemic heart disease,
including such barriers relating to physical infrastructure,
workforce, and cost of such dental care;
(5) barriers preventing dental clinics of the Department, if
any, from adopting teledentistry;
(6) the demographic makeup of veterans eligible for dental
care paid for by the Department as of the commencement of the
pilot program under section 144 of this Act, including
information on--
(A) age;
(B) gender;
(C) race or ethnicity, disaggregated by--
(i) membership in an Indian Tribe; and
(ii) the major race groups used in the
decennial census;
(D) employment status; and
(E) location of residence, disaggregated by rural,
highly rural, and urban locations; and
(7) changes to such demographic makeup if any, that would
result from an expansion of eligibility for dental care under
the laws administered by the Secretary to all veterans with
ischemic heart disease including changes to demographics
specified in paragraph (6).
(b) Third Party Administrator Defined.--In this section, the term
``Third Party Administrator'' means an entity that manages a provider
network and performs administrative services related to such network
under section 1703 of title 38, United States Code.
[[Page 138 STAT. 2761]]
SEC. 152. REVIEW OF WORKFLOWS ASSOCIATED WITH PROCESSING REFERRALS
BETWEEN FACILITIES OF THE VETERANS HEALTH
ADMINISTRATION.
(a) In General.--The Secretary of Veterans Affairs shall conduct a
review of the workflows directly associated with processing referrals of
patients between facilities of the Veterans Health Administration of the
Department of Veterans Affairs to identify specific delays or
bottlenecks in such referrals.
(b) Elements of Review.--The review required under subsection (a)
shall include a review of--
(1) <<NOTE: Guidance.>> the interfacility consult management
guidance of the Veterans Health Administration that assists
facilities described in subsection (a) in constructing a
workflow for consults between such facilities; and
(2) the roles and responsibilities of the individuals
involved in the consult management process in managing such
consults, including the role of the referral coordination team.
(c) Report.--Not later than 180 days after the date of the enactment
of this Act, the Secretary shall submit to Congress a report on the
results of the review required under subsection (a).
SEC. 153. PLAN FOR TIMELY SCHEDULING OF APPOINTMENTS AT MEDICAL
FACILITIES OF DEPARTMENT OF VETERANS
AFFAIRS.
(a) Plan Required.--To improve responsiveness in the provision of
hospital care and medical services at medical facilities of the
Department of Veterans Affairs, the Secretary of Veterans Affairs shall
develop a plan to--
(1) ensure that whenever a covered veteran contacts the
Department by telephone to request the scheduling of an
appointment for care or services for the covered veteran at such
a facility, the scheduling for the appointment occurs during
that telephone call (regardless of the prospective date of the
appointment being scheduled); and
(2) provide timely and, where applicable, same-day
scheduling for an appointment described in paragraph (1).
(b) Report.--Not later than one year after the date of the enactment
of this Act, the Secretary shall submit to the Committees on Veterans'
Affairs of the House of Representatives and the Senate a report on the
plan under subsection (a).
(c) Covered Veteran Defined.--In this section, the term ``covered
veteran'' means a veteran who is enrolled in the system of patient
enrollment of the Department under section 1705(a) of title 38, United
States Code.
SEC. 154. AUTHORIZATION OF APPROPRIATIONS TO SUPPORT INITIATIVES
FOR MOBILE MAMMOGRAPHY SERVICES FOR
VETERANS.
There is authorized to be appropriated to the Secretary of Veterans
Affairs $5,000,000 for fiscal year 2025 for the Office of Women's Health
of the Department of Veterans Affairs under section 7310 of title 38,
United States Code, to be used by the Secretary to expand access of
women veterans to--
(1) mobile mammography initiatives;
(2) advanced mammography equipment; and
(3) outreach activities to publicize those initiatives and
equipment.
[[Page 138 STAT. 2762]]
TITLE II--ECONOMIC OPPORTUNITY MATTERS
Subtitle A--Educational Assistance
SEC. 201. <<NOTE: 38 USC 3311 note.>> TEMPORARY EXPANSION OF
ELIGIBILITY FOR MARINE GUNNERY SERGEANT
JOHN DAVID FRY SCHOLARSHIP.
(a) In General.--The Secretary of Veterans Affairs shall treat an
individual described in subsection (b) as a covered individual described
in section 3311(b) of title 38, United States Code.
(b) Covered Individual Described.--An individual described in this
subsection is an individual who is the child or spouse of a person--
(1) <<NOTE: Time period.>> who dies from a service-connected
disability during the 120-day period immediately following the
day on which the person was discharged or released from duty as
a member of the Armed Forces (without regard to whether such
duty was active duty); and
(2)(A) who received an honorable discharge; or
(B) whose service in the Armed Forces is characterized by
the Secretary concerned as honorable service.
(c) Applicability.--This section shall apply with respect to--
(1) deaths that occur before, on, or after the date of the
enactment of this Act; and
(2) <<NOTE: Time period.>> a quarter, semester, or term, as
applicable, commencing--
(A) on or after August 1, 2025; and
(B) before October 1, 2027.
SEC. 202. REMOVAL OF EXPIRATION ON ENTITLEMENT TO MARINE GUNNERY
SERGEANT JOHN DAVID FRY SCHOLARSHIP FOR
SURVIVING SPOUSES.
Section 3311(f) of title 38, United States Code, is amended--
(1) by striking paragraph (2);
(2) by redesignating paragraphs (3) through (5) as
paragraphs (2) through (4), respectively;
(3) in paragraph (2), as redesignated by paragraph (2) of
this section, by striking ``in paragraph (4)'' and inserting
``in paragraph (3)''; and
(4) in paragraph (3)(A), as redesignated by paragraph (2) of
this section, by striking ``under paragraph (3)'' and inserting
``under paragraph (2)''.
SEC. 203. SOLE LIABILITY FOR TRANSFERRED EDUCATIONAL ASSISTANCE BY
AN INDIVIDUAL WHO FAILS TO COMPLETE A
SERVICE AGREEMENT.
Subsection (i) of section 3319 of title 38, United States Code, is
amended--
(1) in paragraph (1)--
(A) by striking ``In the event'' and inserting
``Subject to paragraph (2), in the event''; and
(B) by inserting ``of this title'' after ``section
3685'';
(2) in subparagraph (A) of paragraph (2)--
(A) in the heading, by striking ``In general'' and
inserting ``Sole liability''; and
[[Page 138 STAT. 2763]]
(B) by striking ``under paragraph (1)'' and
inserting ``for which the individual shall be solely
liable to the United States for the amount of the
overpayment for purposes of section 3685 of this
title''; and
(3) in subparagraph (B) of paragraph (2)--
(A) in the matter preceding clause (i), by striking
``Subparagraph (A) shall not apply'' and inserting
``Neither the individual nor the dependent shall be
liable to the United States for the amount of the
overpayment for purposes of section 3685 of this
title''; and
(B) in clause (ii), by inserting ``of this title''
after ``section 3311(c)(4)''.
SEC. 204. NOTICE TO EDUCATIONAL INSTITUTIONS OF RISK-BASED
SURVEYS.
Section 3673A(d) of title 38, United States Code, is amended by
striking ``one business day'' and inserting ``two business days''.
SEC. 205. RELATIONSHIP OF PARTICIPATION BY AN EDUCATIONAL
INSTITUTION IN CERTAIN FEDERAL STUDENT
FINANCIAL AID PROGRAMS TO APPROVAL OF SUCH
INSTITUTION FOR PURPOSES OF DEPARTMENT OF
VETERANS AFFAIRS EDUCATIONAL ASSISTANCE
PROGRAMS.
Paragraph (4) of section 3675(b) of title 38, United States Code, is
amended to read as follows:
``(4) The educational institution--
``(A) is approved and participates in a program
under title IV of the Higher Education Act of 1965 (20
U.S.C. 1070 et seq.); or
``(B) <<NOTE: Waiver. Notice. Determination.>> does
not participate in such a program and the Secretary has
waived the requirement under this paragraph with respect
to the educational institution, and submits to the
Committee on Veterans' Affairs of the Senate and the
Committee on Veterans' Affairs of the House of
Representatives notice of such waiver, because the
Secretary determines that the educational institution--
``(i) elects not to participate in such a
program;
``(ii) cannot participate in such a program;
or
``(iii) <<NOTE: Time period.>> is in the
process of making a good-faith effort to submit an
initial application for approval to participate in
such a program, except that a waiver under this
clause may not be provided for a period of longer
than 36 months.''.
SEC. 206. EXPANSION OF DEPARTMENT OF VETERANS AFFAIRS OVERSIGHT OF
CERTAIN EDUCATIONAL INSTITUTIONS.
(a) Additional Requirement for Approval.--Section 3675(b) of title
38, United States Code, as amended by section 205, is further amended by
adding at the end the following new paragraph:
``(5) <<NOTE: Deadline. Notification.>> The educational
institution agrees to, not later than 30 days after any date on
which such educational institution becomes subject to an action
or event described in section 3673(e)(3) of this title, submit
to the State approving agency, or the Secretary when acting in
the role of a State approving agency, a notification of such
action or event in such form and containing such information as
the Secretary determines appropriate.''.
[[Page 138 STAT. 2764]]
(b) Additional Requirement for Approval of Nonaccredited Courses.--
(1) In general.-- <<NOTE: 38 USC 3676.>> Section 3676(c) of
such title is amended--
(A) by redesignating paragraphs (14) through (16) as
paragraphs (15) through (17), respectively; and
(B) by inserting after paragraph (13) the following
new paragraph:
``(14) <<NOTE: Deadline. Notification.>> The institution
agrees to, not later than 30 days after any date on which such
institution becomes subject to an action or event described in
section 3673(e)(3) of this title, submit to the State approving
agency, or the Secretary when acting in the role of a State
approving agency, a notification of such action or event in such
form and containing such information as the Secretary determines
appropriate.''.
(2) Conforming amendments.--Such title is further amended--
(A) in section 3672(b)(2)(C), by striking
``paragraph (14) or (15)'' and inserting ``paragraph
(15) or (16)'';
(B) in section 3675(b)(3), by striking ``(14), (15),
and (16)'' and inserting ``(15), (16), and (17)'';
(C) in section 3679(d), by striking ``described in
paragraph (14) or (15)'' and inserting ``described in
paragraph (15) or (16)''; and
(D) in section 3680A(a)(4)(C)(iii), by striking
``section 3676(c)(14) and (15)'' and inserting ``section
3676(c)(15) and (16)''.
(c) Additional Grounds for Suspension of Approval.--Section
3679(f)(1) of such title is amended by adding at the end the following
new subparagraph:
``(I) Comply with the notification requirements under
sections 3675(b)(5) and 3676(c)(14) of this title, when
applicable.''.
(d) <<NOTE: 38 USC 3673A note.>> Deadline for Risk-based Surveys
Database.--The Secretary of Veterans Affairs shall establish the
database required under section 3673A(c) of title 38, United States
Code, by not later than 180 days after the date of the enactment of this
Act.
SEC. 207. REQUIREMENT THAT EDUCATIONAL INSTITUTIONS APPROVED FOR
PURPOSES OF DEPARTMENT OF VETERANS AFFAIRS
EDUCATIONAL ASSISTANCE PROGRAMS PROVIDE
DIGITAL OFFICIAL TRANSCRIPTS.
(a) Requirement.--Section 3675(b) of title 38, United States Code,
as amended by sections 205 and 206, is further amended by adding at the
end the following new paragraph:
``(6) The educational institution makes available to each
eligible person or veteran a copy of the person or veteran's
official transcript in a digital format.''.
(b) Conforming Amendments.--
(1) Approval of courses.--Section 3672(b)(2)(A) of such
title is amended by striking ``(b)(1) and (b)(2)'' and inserting
``paragraphs (1), (2), and (6) of section 3675(b)''.
(2) Approval of nonaccredited courses.--Section 3676(c) of
such title is amended--
(A) by redesignating paragraph (17) as paragraph
(18); and
(B) by inserting after paragraph (16) the following
new paragraph (17):
[[Page 138 STAT. 2765]]
``(17) In the case of a course that leads to a standard
college degree, the educational institution satisfies the
requirements of section 3675(b)(6) of this title.''.
(3) Conforming amendments.-- <<NOTE: 38 USC 3675.>> Section
3675(b)(3) of such title is amended by striking ``(15), (16),
and (17)'' and inserting ``(15), (16), and (18)''.
(c) <<NOTE: 38 USC 3672 note.>> Effective Date.--The amendments made
by this section shall take effect on August 1, 2025, and apply with
respect to a quarter, semester, or term, as applicable, commencing on or
after such date.
SEC. 208. PAYMENT OF FULL MONTHLY HOUSING STIPEND FOR VETERANS
ENROLLED IN FINAL SEMESTER USING
EDUCATIONAL ASSISTANCE UNDER POST-9/11
EDUCATIONAL ASSISTANCE PROGRAM.
(a) Housing Allowance.--Section 3680(a)(3) of title 38, United
States Code, is amended--
(1) by redesignating subparagraphs (A) and (B) as clauses
(i) and (ii), respectively (and by redesignating each
subordinate provision and the margins thereof accordingly);
(2) by striking ``Notwithstanding paragraph (1)'' and
inserting ``(A) Notwithstanding paragraph (1)'';
(3) by striking ``, including a monthly housing stipend
described in section 3313(c) of this title,''; and
(4) by adding at the end the following new subparagraph (B):
``(B) For purposes of providing a monthly housing stipend described
in section 3313(c) to an eligible veteran or eligible person for whom
the Secretary is providing educational assistance under chapter 33 of
this title during a period that is the last semester, term, or academic
period pursuant to subparagraph (A), the Secretary shall treat the
veteran or person as pursuing a program of education on a full-time
basis.''.
(b) <<NOTE: Effective date. 38 USC 3680 note.>> Application.--The
amendments made by subsection (a) shall take effect on the date of the
enactment of this Act and apply with respect to a quarter, semester, or
term, as applicable, commencing on or after January 1, 2025.
SEC. 209. MODIFICATION OF RULES FOR APPROVAL OF COMMERCIAL DRIVER
EDUCATION PROGRAMS FOR PURPOSES OF
EDUCATIONAL ASSISTANCE PROGRAMS OF THE
DEPARTMENT OF VETERANS AFFAIRS.
(a) In General.--Subsection (a)(4) of section 2 of the Veteran
Improvement Commercial Driver License Act of 2023 (Public Law 118-95) is
amended, in the matter to be inserted as the new paragraph (2) of
section 3680A(e) of title 38, United States Code--
(1) in subparagraph (A)--
(A) in the matter preceding clause (i), by striking
``the commercial driver education program offered at the
branch by the educational institution--'' and inserting
and em dash; and
(B) by striking clauses (i) and (ii) and inserting
the following:
``(i) the commercial driver education program offered at the
branch by the educational institution is approved for purposes
of this chapter by a State approving agency (or the Secretary
when acting in the role of a State approving agency); and
[[Page 138 STAT. 2766]]
``(ii)(I) such branch is located in a State in which such
educational institution offers such commercial driver education
program at another branch of such educational institution; or
``(II) such branch--
``(aa) has been operating for at least one
year; and
``(bb) offers such commercial driver education
program, using the same curriculum as another
branch of such educational institution.''; and
(2) by adding at the end the following new subparagraph:
``(D) <<NOTE: Notification. Deadline.>> The Secretary shall submit
to the Committees on Veterans' Affairs of the Senate and House of
Representatives a notification not later than 30 days after the
Secretary grants an exemption under subparagraph (A). Such notification
shall identify the educational institution, and the branch thereof,
granted such exemption.''.
(b) Implementation.-- <<NOTE: 38 USC 3680A note.>> Section 2(b) of
such Act is amended--
(1) in paragraph (2), by striking ``180 days'' and inserting
``365 days''; and
(2) by adding at the end the following new paragraphs:
``(3) <<NOTE: Consultation. 38 USC 3680A
note.>> Regulations.--In prescribing any regulation to carry out
the amendments made by subsection (a), the Secretary of Veterans
Affairs shall consult with State approving agencies designated
under section 3671 of such title.
``(4) <<NOTE: Deadline.>> GAO study.--Not later than 365
days after the applicability date under paragraph (2), the
Comptroller General of the United States shall--
``(A) conduct a study to--
``(i) <<NOTE: Determination.>> determine the
effects of the amendments made by subsection (a);
and
``(ii) the feasibility and advisability of
similarly amending the rules for approval of
programs of education for other vocational
programs of education; and
``(B) <<NOTE: Reports.>> submit to the Committees on
Veterans' Affairs of the Senate and House of
Representatives a report on the findings of the
Comptroller General with respect to such study.''.
(c) <<NOTE: 38 USC 3680A note.>> Effective Date.--The amendments
made by this section shall take effect as if included in such Act on the
date of the enactment of such Act.
SEC. 210. PROVISION OF CERTIFICATES OF ELIGIBILITY AND AWARD
LETTERS USING ELECTRONIC MEANS.
(a) In General.--Chapter 36 of title 38, <<NOTE: 38 USC prec.
3601.>> United States Code, is amended by inserting after section 3698
the following new section (and conforming the table of sections at the
beginning of such chapter accordingly):
``Sec. 3698A. <<NOTE: 38 USC 3698A.>> Provision of certificates of
eligibility and award letters using electronic
means
``(a) Requirement.--Except as provided by subsection (b), the
Secretary shall provide to an individual the following documents using
electronic means:
``(1) A certificate of eligibility for the entitlement of
the individual to covered educational assistance.
[[Page 138 STAT. 2767]]
``(2) An award letter regarding the authorization of the
individual to receive covered educational assistance.
``(b) Election to Opt Out.--An individual may elect to receive the
documents specified in subsection (a) by mail rather than through
electronic means under subsection (a). An individual may revoke such an
election at any time, by means prescribed by the Secretary.
``(c) <<NOTE: Definition.>> Covered Educational Assistance.--In this
section, the term `covered educational assistance' means educational
assistance under chapter 30, 33, or 35 of this title, or section 3699C
of this title.''.
(b) Clerical Amendment.--The table of sections at the beginning of
such chapter <<NOTE: 38 USC prec. 3601.>> is amended by inserting after
the item relating to section 3698 the following new item:
``3698A. Provision of certificates of eligibility and award letters
using electronic means.''.
SEC. 211. RETROACTIVE EFFECTIVE DATE OF LAW REGARDING CHARGE TO
ENTITLEMENT TO EDUCATIONAL ASSISTANCE FOR
INDIVIDUALS WHO DO NOT TRANSFER CREDITS
FROM CERTAIN CLOSED OR DISAPPROVED
PROGRAMS OF EDUCATION.
Section 3699(c)(2) of title 38, United States Code, is amended by
striking subparagraph (C) and inserting the following new subparagraph
(C):
``(C) <<NOTE: Applicability. Time period.>> This paragraph,
including clauses (ii) and (iii) of subparagraph (A), shall apply with
respect to the closure or discontinuation of a course or program of
education, as described in subsection (b)(1), that occurs during the
period beginning on August 1, 2021, and ending on September 30, 2025.''.
SEC. 212. DEPARTMENT OF VETERANS AFFAIRS HIGH TECHNOLOGY PROGRAM.
(a) High Technology Program.--
(1) In general.--Chapter 36 of title 38, United States Code,
as amended by section 210, is amended by adding at the end the
following new section:
``Sec. 3699C. <<NOTE: 38 USC 3699C.>> High technology program
``(a) <<NOTE: Determination.>> Establishment.--(1) The Secretary
shall carry out a program under which the Secretary provides covered
individuals with the opportunity to enroll in high technology programs
of education that the Secretary determines provide training or skills
sought by employers in a relevant field or industry.
``(2) Not more than 4,000 covered individuals may participate in the
program under this section in any fiscal year.
``(b) Amount of Assistance.--(1) The Secretary shall provide, to
each covered individual who pursues a high technology program of
education under this section, educational assistance in amounts equal to
the amounts provided under section 3313(c)(1) of this title, including,
except as provided in paragraph (3), with respect to the housing stipend
described in that section and in accordance with the treatment of
programs that are distance learning and programs that are less than
half-time.
``(2) Under paragraph (1), the Secretary shall provide such amounts
of educational assistance to a covered individual for each of the
following:
``(A) A high technology program of education.
[[Page 138 STAT. 2768]]
``(B) A second such program if--
``(i) <<NOTE: Time period.>> the second such program
begins at least 18 months after the covered individual
graduates from the first such program; and
``(ii) the covered individual uses educational
assistance under chapter 33 of this title to pursue the
second such program.
``(3) No covered individual may receive a housing stipend under this
subsection for any month if such individual is in receipt of a housing
stipend under chapter 33 of this title for that month.
``(c) Contracts.--(1) For purposes of carrying out subsection (a),
the Secretary shall seek to enter into contracts with any number of
qualified providers of high technology programs of education for the
provision of such programs to covered individuals. Each such contract
shall provide for the conditions under which the Secretary may terminate
the contract with the provider and the procedures for providing for the
graduation of students who were enrolled in a program provided by such
provider in the case of such a termination.
``(2) A contract under this subsection shall provide that the
Secretary shall pay to a provider--
``(A) upon the enrollment of a covered individual in the
program, 25 percent of the cost of the tuition and other fees
for the program of education for the individual;
``(B) upon graduation of the individual from the program, 25
percent of such cost; and
``(C) 50 percent of such cost upon--
``(i) <<NOTE: Time period.>> the successful
employment of the covered individual for a period--
``(I) of 180 days in the field of study of the
program; and
``(II) that begins not later than 180 days
following graduation of the covered individual
from the program;
``(ii) the employment of the individual by the
provider for a period of one year; or
``(iii) the enrollment of the individual in a
program of education to continue education in such field
of study.
``(3) For purposes of this section, a provider of a high technology
program of education is qualified if--
``(A) <<NOTE: Determination.>> the provider employs
instructors whom the Secretary determines are experts in their
respective fields in accordance with paragraph (5);
``(B) the provider has successfully provided the high
technology program for at least one year;
``(C) the provider does not charge tuition and fees to a
covered individual who receives assistance under this section to
pursue such program that are higher than the tuition and fees
charged by such provider to another individual; and
``(D) the provider meets the approval criteria developed by
the Secretary under paragraph (4).
``(4)(A) <<NOTE: Criteria.>> The Secretary shall prescribe criteria
for approving providers of a high technology program of education under
this section.
``(B) In developing such criteria, the Secretary may consult with
State approving agencies.
``(C) Such criteria are not required to meet the requirements of
section 3672 of this title.
[[Page 138 STAT. 2769]]
``(D) Such criteria shall include the job placement rate, in the
field of study of a program of education, of covered individuals who
complete such program of education.
``(5) <<NOTE: Determination.>> The Secretary shall determine whether
instructors are experts under paragraph (3)(A) based on evidence
furnished to the Secretary by the provider regarding the ability of the
instructors to--
``(A) identify professions in need of new employees to hire,
tailor the programs to meet market needs, and identify the
employers likely to hire graduates;
``(B) effectively teach the skills offered to covered
individuals;
``(C) provide relevant industry experience in the fields of
programs offered to incoming covered individuals; and
``(D) demonstrate relevant industry experience in such
fields of programs.
``(6) In entering into contracts under this subsection, the
Secretary shall give preference to a provider of a high technology
program of education--
``(A) <<NOTE: Time period.>> from which at least 70 percent
of graduates find full-time employment in the field of study of
the program during the 180-day period beginning on the date the
student graduates from the program; or
``(B) that offers tuition reimbursement for any student who
graduates from such a program and does not find employment
described in subparagraph (A).
``(d) Effect on Other Entitlement.--(1) If a covered individual
enrolled in a high technology program of education under this section
has remaining entitlement to educational assistance under chapter 30,
32, 33, 34, or 35 of this title, such entitlement shall be charged at
the rate of one month of such entitlement for each month of educational
assistance provided under this section.
``(2) If a covered individual enrolled in a high technology program
of education under this section does not have remaining entitlement to
educational assistance under chapter 30, 32, 33, 34, or 35 of this
title, any educational assistance provided to such individual under this
section shall be provided in addition to the entitlement that the
individual has used.
``(3) The Secretary may not consider enrollment in a high technology
program of education under this section to be assistance under a
provision of law referred to in section 3695 of this title.
``(4)(A) <<NOTE: Notice.>> An application for enrollment in a high
technology program of education under this section shall include notice
of the requirements relating to use of entitlement under paragraphs (1)
and (2), including--
``(i) in the case of the enrollment of an individual
referred to under paragraph (1), the amount of entitlement that
is typically charged for such enrollment;
``(ii) an identification of any methods that may be
available for minimizing the amount of entitlement required for
such enrollment; and
``(iii) an element requiring applicants to acknowledge
receipt of the notice under this subparagraph.
``(B) <<NOTE: Award letter.>> If the Secretary approves the
enrollment of a covered individual in a high technology program of
education under this section, the Secretary shall deliver electronically
to the individual
[[Page 138 STAT. 2770]]
an award letter that provides notice of such approval and includes
specific information describing how paragraphs (1) and (2) will be
applied to the individual if the individual chooses to enroll in the
program.
``(e) <<NOTE: Determinations. Time period.>> Requirements for
Educational Institutions.--(1) The Secretary shall not approve the
enrollment of any covered individual, not already enrolled, in any high
technology programs of education under this section for any period
during which the Secretary finds that more than 85 percent of the
students enrolled in the program are having all or part of their
tuition, fees, or other charges paid to or for them by the educational
institution or by the Department of Veterans Affairs under this title or
under chapter 1606 or 1607 of title 10, except with respect to tuition,
fees, or other charges that are paid under a payment plan at an
educational institution that the Secretary determines has a history of
offering payment plans that are completed not later than 180 days after
the end of the applicable term, quarter, or semester.
``(2) <<NOTE: Waiver.>> The Secretary may waive a requirement of
paragraph (1) if the Secretary determines, pursuant to regulations which
the Secretary shall prescribe, such waiver to be in the interest of the
covered individual and the Federal Government. <<NOTE: Reports.>> Not
later than 30 days after the Secretary waives such a requirement, the
Secretary shall submit to the Committees on Veterans' Affairs of the
Senate and House of Representatives a report regarding such waiver.
``(3)(A)(i) <<NOTE: Review process.>> The Secretary shall establish
and maintain a process by which an educational institution may request a
review of a determination that the educational institution does not meet
the requirements of paragraph (1).
``(ii) The Secretary may consult with a State approving agency
regarding such process or such a review.
``(iii) <<NOTE: Reports.>> Not later than 180 days after the
Secretary establishes or revises a process under this subparagraph, the
Secretary shall submit to the Committees on Veterans' Affairs of the
Senate and House of Representatives a report regarding such process.
``(B) An educational institution that requests a review under
subparagraph (A)--
``(i) <<NOTE: Deadline.>> shall request the review not later
than 30 days after the start of the term, quarter, or semester
for which the determination described in subparagraph (A)
applies; and
``(ii) may include any information that the educational
institution believes the Department should have taken into
account when making the determination, including with respect to
any mitigating circumstances.
``(f) Annual Reports.--Not later than one year after the date of the
enactment of this section, and annually thereafter until the termination
date specified in subsection (i), the Secretary shall submit to the
Committees on Veterans' Affairs of the Senate and House of
Representatives a report on the operation of program under this section
during the year covered by the report. Each such report shall include
each of the following:
``(1) The number of covered individuals enrolled in the
program, disaggregated by type of educational institution,
during the year covered by the report.
[[Page 138 STAT. 2771]]
``(2) The number of covered individuals who completed a high
technology program of education under the program during the
year covered by the report.
``(3) <<NOTE: Time period.>> The average employment rate of
covered individuals who completed such a program of education
during such year, as of 180 days after the date of completion.
``(4) The average length of time between the completion of
such a program of education and employment.
``(5) The total number of covered individuals who completed
a program of education under the program and who, as of the date
of the submission of the report, are employed in a position
related to technology.
``(6) <<NOTE: Determination.>> The average salary of a
covered individual who completed a program of education under
the program and who is employed in a position related to
technology, in various geographic areas determined by the
Secretary.
``(7) The average salary of all individuals employed in
positions related to technology in the geographic areas
determined under subparagraph (F), and the difference, if any,
between such average salary and the average salary of a covered
individual who completed a program of education under the
program and who is employed in a position related to technology.
``(8) The number of covered individuals who completed a
program of education under the program and who subsequently
enrolled in a second program of education under the program.
``(g) Collection of Information; Consultation.--(1) The Secretary
shall develop practices to use to collect information about covered
individuals and providers of high technology programs of education.
``(2) For the purpose of carrying out program under this section,
the Secretary may consult with providers of high technology programs of
education and may establish an advisory group made up of representatives
of such providers, private employers in the technology field, and other
relevant groups or entities, as the Secretary determines necessary.
``(h) Definitions.--In this section:
``(1) <<NOTE: Determinations.>> The term `covered
individual' means any of the following:
``(A) A veteran whom the Secretary determines--
``(i) served an aggregate of at least 36
months on active duty in the Armed Forces
(including service on active duty in entry level
and skill training) and was discharged or released
therefrom under conditions other than
dishonorable; and
``(ii) has not attained the age of 62.
``(B) <<NOTE: Time period.>> A member of the Armed
Forces that the Secretary determines will become a
veteran described in subparagraph (A) fewer than 180
days after the date of such determination.
``(2) The term `high technology program of education' means
a program of education--
``(A) offered by a public or private educational
institution;
``(B) if offered by an institution of higher
learning, that is provided directly by such institution
rather than by an entity other than such institution
under a contract or other agreement;
[[Page 138 STAT. 2772]]
``(C) that does not lead to a degree;
``(D) that has a term of not less than six and not
more than 28 weeks; and
``(E) that provides instruction in computer
programming, computer software, media application, data
processing, or information sciences.
``(i) Termination.--The Secretary may not provide educational
assistance under this section for a high technology program of education
that begins after September 30, 2027.''.
(2) Clerical amendment.--The table of sections at the
beginning of such chapter <<NOTE: 38 USC prec. 3601.>> is
amended by inserting after the item relating to section 3699B
the following new item:
``3699C. High technology program.''.
(b) Effect on High Technology Pilot Program.--Section 116 of the
Harry W. Colmery Veterans Educational Assistance Act of 2017 (Public Law
115-48; 38 U.S.C. 3001 note) is amended--
(1) by amending subsection (d) to read as follows:
``(d) Housing Stipend.--
``(1) <<NOTE: Payment.>> In general.--Except as provided
under paragraph (2), the Secretary shall pay to each eligible
veteran (not including an individual described in the second
sentence of subsection (b)) who is enrolled in a high technology
program of education under the pilot program on a full-time or
part-time basis a monthly housing stipend equal to the product--
``(A) of--
``(i) in the case of a veteran pursuing
resident training, the monthly amount of the basic
allowance for housing payable under section 403 of
title 37, United States Code, for a member with
dependents in pay grade E-5 residing in the
military housing area that encompasses all or the
majority portion of the ZIP code area in which is
located the campus of the institution where the
individual physically participates in a majority
of classes; or
``(ii) in the case of a veteran pursuing a
program of education through distance learning, a
monthly amount equal to 50 percent of the national
average of the monthly amount of the basic
allowance for housing payable under section 403 of
title 37, United States Code, for a member with
dependents in pay grade E-5, multiplied by
``(B) the lesser of--
``(i) 1.0; or
``(ii) the number of course hours borne by the
individual in pursuit of the program of education
involved, divided by the minimum number of course
hours required for full-time pursuit of such
program of education, rounded to the nearest
multiple of 10.
``(2) Bar to dual eligibility.--No covered individual may
receive a housing stipend under this subsection for any month if
such individual is in receipt of a housing stipend under chapter
33 of title 38, United States Code, for that month.'';
(2) in subsection (g), by striking paragraph (6); and
(3) by striking subsection (h) and inserting the following
new subsection (h):
[[Page 138 STAT. 2773]]
``(h) Termination.--The Secretary may not, under this section, pay a
provider for a high technology program of education that begins after
September 30, 2024.''.
(c) Approval of Certain High Technology Programs.--Section 3680A of
title 38, United States Code, is amended--
(1) in subsection (a), by striking paragraph (4) and
inserting the following:
``(4) Any independent study program except--
``(A) an independent study program (including such a
program taken over open circuit television) that--
``(i) is accredited by an accrediting agency
or association recognized by the Secretary of
Education under subpart 2 of part H of title IV of
the Higher Education Act of 1965 (20 U.S.C.
1099b);
``(ii) leads to--
``(I) a standard college degree;
``(II) a certificate that reflects
educational attainment offered by an
institution of higher learning; or
``(III) a certificate that reflects
graduation from a course of study
offered by--
``(aa) an area career and
technical education school (as
defined in subparagraphs (C) and
(D) of section 3(3) of the Carl
D. Perkins Career and Technical
Education Act of 2006 (20 U.S.C.
2302(3))) that provides
education at the postsecondary
level; or
``(bb) a postsecondary
vocational institution (as
defined in section 102(c) of the
Higher Education Act of 1965 (20
U.S.C. 1002(c))) that provides
education at the postsecondary
level; and
``(iii) in the case of a program described in
clause (ii)(III)--
``(I) provides training aligned with
the requirements of employers in the
State or local area where the program is
located, which may include in-demand
industry sectors or occupations;
``(II) provides a student, upon
graduation from the program, with a
recognized postsecondary credential that
is recognized by employers in the
relevant industry, which may include a
credential recognized by industry or
sector partnerships in the State or
local area where the industry is
located; and
``(III) meets such content and
instructional standards as may be
required to comply with the criteria
under section 3676(c)(14) and (15) of
this title; or
``(B) an online high technology program of education
(as defined in subsection (h)(2) of section 3699C of
this title)--
``(i) the provider of which has entered into a
contract with the Secretary under subsection (c)
of such section;
[[Page 138 STAT. 2774]]
``(ii) <<NOTE: Time period.>> that has been
provided to covered individuals (as defined in
subsection (h)(1) of such section) under such
contract for a period of at least five years;
``(iii) <<NOTE: Determination.>> regarding
which the Secretary has determined that the
average employment rate of covered individuals who
graduated from such program of education is 65
percent or higher for the year preceding such
determination; and
``(iv) that satisfies the requirements of
subsection (e) of such section.''; and
(2) in subsection (d), by adding at the end the following:
``(8) Paragraph (1) shall not apply to the enrollment of a veteran
in an online high technology program described in subsection
(a)(4)(B).''.
SEC. 213. NOTICE OF CHANGES TO DEPARTMENT OF VETERANS AFFAIRS
POLICIES AND GUIDANCE AFFECTING THE
EDUCATIONAL ASSISTANCE PROGRAMS OF THE
DEPARTMENT.
(a) In General.--Subchapter III of chapter 36 of title 38, United
States Code, as amended by sections 210 and 212, is further amended by
adding at the end the following new section:
``Sec. 3699D. <<NOTE: 38 USC 3699D.>> Notice of changes to
policies and guidance relating to educational
assistance programs
``In the case of any change to any policy or guidance provided by
the Secretary that relates to any educational assistance program of the
Department, the Secretary may not implement the change before the date
that is 90 days after the date on which the Secretary makes available to
students, educational institutions, and the Committees on Veterans'
Affairs of the Senate and House of Representatives notice of, and
justification for, the change.''.
(b) Clerical Amendment.--The table of sections at the beginning of
such chapter is <<NOTE: 38 USC prec. 3601.>> amended by inserting after
the item relating to section 3699B the following new item:
``3699D. Notice of changes to policies and guidance relating to
educational assistance programs.''.
SEC. 214. <<NOTE: Deadline. Update. 38 USC 3680 note.>> PAYMENT OF
VA EDUCATIONAL ASSISTANCE VIA ELECTRONIC
FUND TRANSFER TO A FOREIGN INSTITUTION OF
HIGHER EDUCATION.
Not later than 90 days after the date of the enactment of this Act,
the Secretary of Veterans Affairs shall update the payment system of the
Department of Veterans Affairs to allow for electronic fund transfer of
educational assistance, administered by the Secretary, to a foreign
institution of higher education that--
(1) provides an approved course of education to an eligible
recipient of such assistance; and
(2) does not have--
(A) an employer identification number; or
(B) an account with a domestic bank.
SEC. 215. <<NOTE: 38 USC 3698 note.>> IMPROVING TRANSPARENCY AND
ACCOUNTABILITY OF EDUCATIONAL INSTITUTIONS
FOR PURPOSES OF VETERANS EDUCATIONAL
ASSISTANCE.
(a) Requirement Relating to G.I. Bill Comparison Tool.--
(1) Requirement to maintain tool.--The Secretary of Veterans
Affairs shall maintain the G.I. Bill Comparison Tool that was
established pursuant to Executive Order 13607 (77
[[Page 138 STAT. 2775]]
Fed. Reg. 25861; relating to establishing principles of
excellence for educational institutions serving service members,
veterans, spouses, and other family members) and in effect on
the day before the date of enactment of this Act, or a successor
tool, to provide relevant and timely information about programs
of education approved under chapter 36 of title 38, United
States Code, and the educational institutions that offer such
programs.
(2) <<NOTE: Time period.>> Data retention.--The Secretary
shall ensure that historical data that is reported via the tool
maintained under paragraph (1) remains easily and prominently
accessible on the benefits.va.gov website, or a successor
website, for a period of not less than six years from the date
of initial publication.
(b) Providing Timely and Relevant Education Information to Veterans,
Members of the Armed Forces, and Other Individuals.--
(1) <<NOTE: Deadline.>> In general.--Not later than one year
after the date of the enactment of this Act, the Secretary of
Veterans Affairs, in consultation with the Secretary of
Education, the Secretary of the Treasury, and the heads of other
relevant Federal agencies, shall make such changes to the tool
maintained under subsection (a) as the Secretary of Veterans
Affairs determines appropriate to ensure that such tool is an
effective and efficient method for providing information
pursuant to section 3698(b)(5) of title 38, United States Code.
(2) <<NOTE: Deadline.>> Memorandum of understanding
required.--Not later than two years after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall
seek to enter into a memorandum of understanding with the
Secretary of Education and the heads other relevant Federal
agencies, as the Secretary of Veterans Affairs determines
appropriate, to obtain information on outcomes with respect to
individuals who are entitled to educational assistance under the
laws administered by the Secretary of Veterans Affairs and who
are attending educational institutions. Such memorandum of
understanding may include data sharing or computer matching
agreements.
(3) Modification of scope of comprehensive policy on
providing education information.--Section 3698 of title 38,
United States Code, is amended--
(A) in subsection (a), by striking ``veterans and
members of the Armed Forces'' and inserting
``individuals entitled to educational assistance under
laws administered by the Secretary of Veterans
Affairs''; and
(B) in subsection (b)(5)--
(i) by striking ``veterans and members of the
Armed Forces'' and inserting ``individuals
described in subsection (a)''; and
(ii) by striking ``the veteran or member'' and
inserting ``the individual''.
(4) G.I. bill comparison tool required disclosures.--
Paragraph (1) of subsection (c) of such section is amended--
(A) by striking subparagraph (B) and inserting the
following:
``(B) for each individual described in subsection (a)
seeking information provided under subsection (b)(5), the name
of each Federal student aid program, and a description of each
such
[[Page 138 STAT. 2776]]
program, from which the individual may receive educational
assistance; and'';
(B) in subparagraph (C)--
(i) in clause (i), by inserting ``and a
definition of each type of institution'' before
the semicolon;
(ii) in clause (iv), by inserting ``and if so,
which programs'' before the semicolon;
(iii) by striking clause (v) and inserting the
following:
``(v) the average annual cost and the total cost to
earn an associate's degree and a bachelor's degree, with
available cost information on any other degree or
credential the institution awards;'';
(iv) in clause (vi), by inserting before the
semicolon the following: ``disaggregated by--
``(I) the type of beneficiary of educational
assistance;
``(II) individuals who received a credential
and individuals who did not; and
``(III) individuals using educational
assistance under laws administered by the
Secretary and individuals who are not;'';
(v) in clause (xiv), by striking ``and'' at
the end;
(vi) in clause (xv), by striking the period at
the end and inserting a semicolon; and
(vii) by adding at the end the following new
clauses:
``(xvi) the number of veterans or members who
completed covered education at the institution leading
to--
``(I) a degree, disaggregated by type of
program, including--
``(aa) an associate degree;
``(bb) a bachelor's degree; and
``(cc) a postbaccalaureate degree;
and
``(II) a certificate or professional license,
disaggregated by type of certificate or
professional license;
``(xvii) programs available and the average time for
completion of each program;
``(xviii) employment rate and median income of
graduates of the institution in general two and five
years after graduation, disaggregated by--
``(I) specific program; and
``(II) individuals using educational
assistance under laws administered by the
Secretary and individuals who are not; and
``(xix) the number of individuals using educational
assistance under laws administered by the Secretary who
are enrolled in the both the institution and specific
program per year.''.
(5) Clarity and anonymity of information provided.--
Paragraph (2) of such subsection is amended--
(A) by inserting ``(A)'' before ``To the extent'';
and
(B) by adding at the end the following new
subparagraph:
[[Page 138 STAT. 2777]]
``(B) The Secretary shall ensure that information provided pursuant
to subsection (b)(5) is provided in a manner that is easy for, and
accessible to, individuals described in subsection (a).
``(C) In providing information pursuant to subsection (b)(5), the
Secretary shall maintain the anonymity of individuals described in
subsection (a) and, to the extent that a portion of any data would
undermine such anonymity, ensure that such data is not made available
pursuant to such subsection.''.
(c) Improvements for Student Feedback.--
(1) In general.--Subsection (b)(2) of such section is
amended--
(A) by amending subparagraph (A) to read as follows:
``(A) provides institutions of higher learning--
``(i) <<NOTE: Deadline. Review.>> up to 30
days to review and respond to feedback from
individuals described in subsection (a) and
address issues regarding the feedback before the
feedback is published; and
``(ii) if an institution of higher learning
contests the accuracy of the feedback, the
opportunity to challenge the inclusion of such
data with an official appointed by the
Secretary;'';
(B) in subparagraph (B), by striking ``and'' at the
end;
(C) in subparagraph (C), by striking ``that conforms
with criteria for relevancy that the Secretary shall
determine.'' and inserting ``, and responses from
institutions of higher learning to such feedback, that
conform with criteria for relevancy that the Secretary
shall determine;''; and
(D) by adding at the end the following new
subparagraphs:
``(D) for each institution of higher learning that
is approved under this chapter, retains, maintains, and
publishes all of such feedback for not less than six
years; and
``(E) is easily accessible to individuals described
in subsection (a) and to the general public.''.
(2) Accessibility from g.i. bill comparison tool.--The
Secretary shall ensure that--
(A) the feedback tracked and published under
subsection (b)(2) of such section, as amended by
paragraph (1), is prominently displayed in the tool
maintained under subsection (a) of this section; and
(B) when such tool displays information for an
institution of higher learning, the applicable feedback
is also displayed for such institution of higher
learning.
(d) Training for Provision of Education Counseling Services.--
(1) <<NOTE: Deadline.>> In general.--Not less than one year
after the date of the enactment of this Act, the Secretary shall
ensure that personnel employed by the Department of Veteran
Affairs, or a contractor of the Department, to provide education
benefits counseling, vocational or transition assistance, or
similar functions, including employees or contractors of the
Department who provide such counseling or assistance as part of
the Transition Assistance Program, are trained on how--
(A) to use properly the tool maintained under
subsection (a); and
[[Page 138 STAT. 2778]]
(B) to provide appropriate educational counseling
services to individuals described in section 3698(a) of
such title, as amended by subsection (b)(3)(A).
(2) Transition assistance program defined.--In this
subsection, the term ``Transition Assistance Program'' means the
program of counseling, information, and services under section
1142 of title 10, United States Code.
Subtitle B--Employment and Training
SEC. 221. IMPROVEMENTS TO REEMPLOYMENT RIGHTS OF MEMBERS OF THE
ARMED FORCES.
(a) USERRA Purposes.--Section 4301(a)(1) of title 38, United States
Code, is amended by striking ``encourage noncareer service in the
uniformed services'' and inserting ``encourage service in the uniformed
services''.
(b) Prohibition of Retaliation.--Subsection (b) of section 4311 of
title 38, United States Code, is amended by inserting ``or other
retaliatory action'' after ``employment action''.
(c) Expansion of Injunctive Relief.--Subsection (e) of section 4323
of such title is amended--
(1) by striking ``The court shall use'' and inserting ``(1)
The court shall use''; and
(2) by adding at the end the following new paragraphs:
``(2) A person bringing an action to enforce a provision of this
chapter pursuant to subsection (a) shall be entitled to an injunction
under paragraph (1) if such person demonstrates--
``(A) a violation--
``(i) of the provisions of this chapter; or
``(ii) of the provisions of this chapter is
threatened or is imminent;
``(B) the harm to the person outweighs the injury to the
employer;
``(C) a likelihood of success on the merits of such action;
and
``(D) awarding such relief is in the public interest.
``(3) The court may not deny a motion for injunctive relief on the
basis that a party bringing an action to enforce a provision of this
chapter may be awarded wages unearned due to an unlawful termination or
denial of employment at the conclusion of such action.''.
(d) <<NOTE: Courts.>> Damages Against a State or Private Employer.--
Section 4323 of such title is further amended, in paragraph (1) of
subsection (d), by striking subparagraph (C) and inserting the following
new subparagraphs:
``(C) The court may require the employer to pay the person
the amount referred to in subparagraph (B) and interest on such
amount, calculated at a rate of 3 percent per year.
``(D) <<NOTE: Determination.>> The court may require the
employer to pay the person the greater of $50,000 or the amount
equal to the amounts referred to in subparagraphs (B) and (C) as
liquidated damages, if the court determines that the employer
knowingly failed to comply with the provisions of this
chapter.''.
(e) Mandatory Attorney Fees Award in Successful Actions for
Reemployment.--
[[Page 138 STAT. 2779]]
(1) MSPB actions.--Paragraph (4) of subsection (c) of
section 4324 of such title is amended--
(A) by striking ``may, in its discretion,'' and
inserting ``shall''; and
(B) by adding at the end the following new sentence:
``The Board may, in its discretion, award reasonable
attorney fees in a case settled before the issuance of
an order if the person can demonstrate that significant
attorney fees were incurred and that justice requires
such an award.''.
(2) Federal circuit actions.--Subsection (d) of such section
is amended by adding at the end the following new paragraph:
``(3) In such Federal Circuit proceeding, the court shall award such
person reasonable attorney fees, expert witness fees, and other
litigation expenses if such person--
``(A) prevails in such Federal Circuit proceeding; and
``(B) is not represented by the Special Counsel in such
Federal Circuit proceeding.''.
(3) Actions against a state or private employer.--Paragraph
(2) of section 4323(h) of such title is amended--
(A) by striking ``subsection (a)(2)'' and inserting
``subsection (a)(3)''; and
(B) by striking ``the court may award any such
person who prevails in such action or proceeding
reasonable attorney fees'' and inserting ``the court
shall award any such person who prevails in such action
or proceeding reasonable attorney fees''.
(f) GAO Review and Report on USERRA.--
(1) Review.--The Comptroller General of the United States
shall review the methods through which the Secretary of Labor,
acting through the Veterans' Employment and Training Service,
processes actions for relief under chapter 43 of title 38,
United States Code.
(2) Elements.--Not later than one year after the date of the
enactment of this Act, the Comptroller General shall submit to
the Committees on Veterans' Affairs of the House of
Representatives and the Senate a report that includes--
(A) the findings of the review required under
paragraph (1);
(B) an identification of the number of actions for
relief under chapter 43 of title 38, United States Code,
initiated during the period covered by the report,
disaggregated by size of employer and geographic region;
(C) <<NOTE: Determination.>> an identification of
the number of such actions for relief that were
erroneously dismissed, as determined by the Comptroller
General;
(D) an identification of the number of such actions
for relief that were referred to the Department of
Justice; and
(E) <<NOTE: Assessment.>> an assessment of trends,
if any, in such actions for relief initiated during such
period.
(g) GAO Review of Protections for Members of the Uniformed Services
by Federal Intelligence Agencies.--
(1) <<NOTE: Reports.>> In general.--Not later than one year
after the date of the enactment of this Act, the Comptroller
General of the United States shall submit to the appropriate
congressional
[[Page 138 STAT. 2780]]
committees a report on the processes and procedures adopted and
used by the intelligence community to provide the protections
for members of the uniformed services otherwise established
under chapter 43 of title 38, United States Code.
(2) Definitions.--In this subsection:
(A) The term ``appropriate congressional
committees'' means the Committees on Veterans' Affairs
of the House of Representatives and Senate, the
Permanent Select Committee on Intelligence of the House
of Representatives, and the Select Committee on
Intelligence of the Senate.
(B) The term ``intelligence community'' has the
meaning given such term in section 3(4) of the National
Security Act of 1947 (50 U.S.C. 3003(4)).
SEC. 222. REVIEW OF INVESTIGATIONS MANUAL OF VETERANS' EMPLOYMENT
AND TRAINING SERVICE.
(a) <<NOTE: Deadline. Time periods.>> In General.--Not later than
one year after the date of the enactment of this Act, and once every two
years thereafter for the period of five years beginning on such date,
the Secretary of Labor, shall review the manual of the Department of
Labor titled ``Veterans' Employment and Training Service Investigations
Manual: USERRA, VEOA, and VP'' (or a successor manual) and make such
revisions to such manual as the Secretary determines appropriate.
(b) Report.--Not later than 90 days after any date on which the
Secretary completes a review required under subsection (a), the
Secretary shall submit to the Committees on Veterans' Affairs of the
House of Representatives and the Senate--
(1) a report that includes a description of any revision to
such manual made pursuant to such review; and
(2) a copy of the entire such manual which--
(A) shall be provided to the Chairman and Ranking
Member of each such committee; and
(B) may contain a separate addendum for portions of
the manual that contain law enforcement sensitive
materials.
SEC. 223. WARRIOR TRAINING ADVANCEMENT COURSE.
(a) <<NOTE: 38 USC 4214 note.>> Reports Required.--
(1) Initial report.--Not later than six months after the
date of the enactment of this Act, the Secretary of Veterans
Affairs shall submit to the Committees on Veterans' Affairs of
the Senate and House of Representatives a report on WARTAC.
(2) Annual report.--One year after the submission of the
report required under paragraph (1) and annually thereafter, the
Secretary shall submit to such Committees a report that contains
the elements under paragraphs (1) and (3) of subsection (b) with
regards to the preceding year.
(3) Elements.--Except as provided in subsection (a)(2), the
reports under this subsection shall include the following
elements:
(A) Best practices.--With regards to best practices
of WARTAC--
(i) how many covered members have applied to
participate in WARTAC;
(ii) how many covered members have
participated in WARTAC;
[[Page 138 STAT. 2781]]
(iii) how the Secretary provides training to
covered members during TAP;
(iv) how many covered members have completed
WARTAC; and
(v) any other information the Secretary
determines appropriate.
(B) <<NOTE: Determinations.>> Cost savings.--With
regards to cost savings of WARTAC--
(i) how much money the Secretary determines
WARTAC saves the United States each fiscal year;
(ii) how much money the Secretary determines
WARTAC has saved the United States since its
establishment; and
(iii) the determination of the Secretary
whether other Federal agencies may save money by
establishing a program similar to WARTAC.
(C) Hiring.--With regards to hiring covered members
who complete WARTAC--
(i) how the Secretary identifies positions in
the Department of Veterans Affairs for which such
covered members may qualify;
(ii) the grades of such positions on the
General Schedule under section 5332 of title 5,
United States Code; and
(iii) how many such covered members the
Secretary has hired to such positions.
(4) <<NOTE: Deadline. Records.>> Distribution.--Not later
than 30 days after submitting the report under paragraph (1),
the Secretary of Veterans Affairs shall transmit a copy of such
report to the head of each Federal agency.
(5) Definitions.--In this subsection:
(A) The term ``covered member'' means members of the
Armed Forces participating in TAP.
(B) The term ``TAP'' means the Transition Assistance
Program under sections 1142 and 1144 of title 10, United
States Code.
(C) The term ``WARTAC'' means the Warrior Training
Advancement Course of the Veterans Benefit
Administration, in which the Secretary provides training
to covered members so such covered members may qualify
for certain employment in the Veterans Benefit
Administration.
(b) <<NOTE: Guidelines.>> Best Practices for Other Departments.--The
Assistant Secretary of Labor for Veterans' Employment and Training
shall, in consultation with the Secretary of Veterans Affairs, establish
guidelines containing best practices for departments and agencies of the
Federal Government that carry out programs to employ veterans who are
transitioning from service in the Armed Forces. Such guidelines shall
include the findings of the initial report required under subsection
(a)(1).
(c) <<NOTE: 43 USC 1457 note.>> Pilot Program.--
(1) Establishment.--The Secretary of the Interior shall, in
consultation with the Secretary of Labor and the Secretary of
Veterans Affairs, establish a pilot program to proactively
inform veterans of available employment positions that relate to
the conservation and resource management activities of the
Department of the Interior.
(2) Positions.--The Secretary of the Interior shall--
[[Page 138 STAT. 2782]]
(A) identify vacant positions in the Department of
the Interior that are appropriate to fill using the
pilot program; and
(B) to the maximum extent practicable, provide
assistance to veterans in selecting one or more vacant
positions to apply to, for which that veteran may be
best qualified.
(3) Reports.--
(A) Implementation report.--Not later than one year
after the date on which the pilot program under
paragraph (1) commences, the Secretary of the Interior,
the Secretary of Veterans Affairs, and the Secretary of
Labor shall jointly provide to the appropriate
congressional committees a report on the implementation
of the pilot program.
(B) Final report.--Not later than 30 days after the
date on which the pilot program under paragraph (1)
terminates under paragraph (4), the Secretary of the
Interior, the Secretary of Veterans Affairs, and the
Secretary of Labor shall jointly submit to the
appropriate congressional committees a report on the
pilot program that includes the following:
(i) The number of veterans who applied to
participate in the pilot program.
(ii) The number of such veterans employed
under the pilot program.
(iii) The number of veterans identified in
clause (ii) who transitioned to full-time
positions with the Federal Government after
participating in the pilot program.
(iv) Any other information the Secretary of
the Interior, the Secretary of Veterans Affairs,
and the Secretary of Labor determine appropriate
with respect to measuring the effectiveness of the
pilot program.
(4) Termination.--The authority to carry out the pilot
program under this subsection shall terminate on the date that
is two years after the date on which the pilot program
commences.
(5) Appropriate congressional committees defined.--In this
subsection, the term ``appropriate congressional committees''
means--
(A) the Committee on Veterans' Affairs and the
Committee on Energy and Natural Resources of the Senate;
and
(B) the Committee on Veterans' Affairs and the
Committee on Natural Resources of the House of
Representatives.
(d) Outdoor Recreation Program Attendance.--The Secretary of the
Interior and the Secretary of Agriculture are encouraged to work with
the Secretary of Defense and the Secretary of Veterans Affairs to ensure
members of the Armed Forces and veterans have access to outdoor
recreation and outdoor-related volunteer and wellness programs as part
of the basic services provided to such members and veterans.
[[Page 138 STAT. 2783]]
Subtitle C--Home Loans
SEC. 231. IMPROVEMENTS TO PROGRAM FOR DIRECT HOUSING LOANS MADE TO
NATIVE AMERICAN VETERANS BY THE SECRETARY
OF VETERANS AFFAIRS.
(a) General Authorities and Requirements.--
(1) Direct housing loans to native american veterans.--
Section 3762(a) of title 38, United States Code, is amended to
read as follows:
``(a) The Secretary may make a direct housing loan to a Native
American veteran under this subchapter if the Secretary ensures the
following:
``(1) That each Native American veteran to whom the
Secretary makes a direct housing loan under this subchapter--
``(A) holds, possesses, or purchases using the
proceeds of the loan a meaningful interest in a lot or
dwelling (or both) that is located on trust land; and
``(B) will purchase, construct, or improve (as the
case may be) a dwelling on the lot using the proceeds of
the loan.
``(2) That each such Native American veteran will convey to
the Secretary by an appropriate instrument the interest referred
to in paragraph (1)(A) as security for a direct housing loan
under this subchapter.
``(3) That the Secretary, including the Secretary's
employees or agents, may enter upon the trust land for the
purposes of carrying out such actions as the Secretary
determines are necessary, including--
``(A) <<NOTE: Evaluation.>> to evaluate the
advisability of the loan;
``(B) to monitor any purchase, construction, or
improvements carried out using the proceeds of the loan;
and
``(C) to manage any servicing or post-foreclosure
activities, including acquisition, property inspections,
and property management.
``(4) <<NOTE: Standards. Procedures.>> That there are
established standards and procedures that apply to the
foreclosure of the interest conveyed by a Native American
veteran pursuant to paragraph (2), including--
``(A) procedures for foreclosing the interest; and
``(B) procedures for the resale of the lot or
dwelling (or both) purchased, constructed, or improved
using the proceeds of the loan.
``(5) That the loan is made in a responsible and prudent
manner, subject to standards and procedures as are necessary for
the reasonable protection of the financial interests of the
United States.''.
(2) Memorandums of understanding, agreements, and
determinations.--Section 3762(b) of such title is amended to
read as follows:
``(b)(1) To carry out the purpose of subsection (a), the Secretary
may--
``(A) enter into a memorandum of understanding with a tribal
organization, other entity, or individual;
``(B) rely on agreements or determinations of other Federal
agencies to guarantee, insure, or make loans on trust land; and
[[Page 138 STAT. 2784]]
``(C) enter into other agreements or take such other actions
as the Secretary determines necessary.
``(2) If the Secretary determines that the requirements under
subsection (a) are not being enforced by a tribal organization, other
entity, or individual that is a party to any memorandum of
understanding, agreement, or determination described in paragraph (1),
the Secretary may cease making new direct housing loans to Native
American veterans under this subchapter within the area of the authority
of the tribal organization, other entity, or individual (as the case may
be).''.
(b) Direct Loans to Native American Veterans To Refinance Existing
Mortgage Loans.--Section 3762(h) of such title is amended to read as
follows:
``(h) The Secretary may make direct loans to Native American
veterans in order to enable such veterans to refinance existing mortgage
loans for any of the following purposes:
``(1) To refinance an existing loan made under this section,
if the loan--
``(A) meets the requirements set forth in
subparagraphs (B), (C), and (E) of paragraph (1) of
section 3710(e) of this title;
``(B) will bear an interest rate at least one
percentage point less than the interest rate borne by
the loan being refinanced; and
``(C) <<NOTE: Compliance.>> complies with paragraphs
(2) and (3) of section 3710(e) of this title, except
that for the purposes of this subsection the reference
to subsection (a)(8) of section 3710 of this title in
such paragraphs (2) and (3) shall be deemed to be a
reference to this subsection.
``(2) To refinance an existing mortgage loan not made under
this section on a dwelling owned and occupied by the veteran as
the veteran's home, if all of the following requirements are
met:
``(A) The loan will be secured by the same dwelling
as was the loan being refinanced.
``(B) The loan will provide the veteran with a net
tangible benefit.
``(C) The nature and condition of the property is
such as to be suitable for dwelling purposes.
``(D) The amount of the loan does not exceed either
of the following:
``(i) 100 percent of the reasonable value of
the dwelling, with such reasonable value
determined under the procedures established by the
Secretary under subsection (d)(2).
``(ii) An amount equal to the sum of the
balance of the loan being refinanced and such
closing costs (including any discount points) as
may be authorized by the Secretary to be included
in the loan.
``(E) Notwithstanding subparagraph (D), if a loan is
made for both the purpose of this paragraph and to make
energy efficiency improvements, the loan must not exceed
either of the following:
``(i) 100 percent of the reasonable value of
the dwelling as improved for energy efficiency,
with such reasonable value determined under the
procedures established by the Secretary under
subsection (d)(2).
[[Page 138 STAT. 2785]]
``(ii) The amount referred to under
subparagraph (D)(ii), plus the applicable amount
specified under section 3710(d)(2) of this title.
``(F) The loan meets all other requirements the
Secretary may establish under this subchapter.
``(G) The existing mortgage being refinanced is a
first lien on the property and secured of record.
``(3) To refinance an existing mortgage loan to repair,
alter, or improve a dwelling owned by the veteran and occupied
by the veteran as the veteran's home, if all of the following
requirements are met:
``(A) The loan will be secured by the same dwelling
as was the loan being refinanced.
``(B) The nature and condition of the property is
such as to be suitable for dwelling purposes, and the
repair, alteration, or improvement substantially
protects or improves the basic livability or utility of
such property.
``(C) The amount of the loan, including the costs of
repairs, alterations, and improvements, does not exceed
either of the following:
``(i) 100 percent of the reasonable value of
the dwelling as repaired, altered, or improved,
with such reasonable value determined under the
procedures established by the Secretary under
subsection (d)(2).
``(ii) An amount equal to the sum of--
``(I) the balance of the loan being
refinanced;
``(II) the actual cost of repairs,
alterations, or improvements; and
``(III) such closing costs
(including any discount points) as may
be authorized by the Secretary to be
included in the loan.
``(D) The loan meets all other requirements the
Secretary may establish under this subchapter.
``(E) The existing mortgage loan being refinanced is
a first lien on the property and secured of record.''.
(c) Expansion of Outreach Program on Availability of Direct Housing
Loans for Native American Veterans.--Section 3762(i)(2) of such title is
amended by adding at the end the following new subparagraph:
``(G) Pursuant to subsection (g)(4), assisting Native
American veterans in qualifying for mortgage financing by--
``(i) partnering with local service providers, such
as tribal organizations, tribally designated housing
entities, Native community development financial
institutions, and nonprofit organizations, for
conducting outreach, homebuyer education, housing
counseling, and post-purchase education; and
``(ii) providing other technical assistance as
needed.
``(H) Attending conferences and conventions conducted by the
network of Native community development financial institutions
and other Native American homeownership organizations to provide
information and training to Native community development
financial institutions about the availability of the relending
program under section 3762A of this title.''.
(d) Adequate Personnel.--Section 3762 of such title is amended by
adding at the end the following new subsection:
[[Page 138 STAT. 2786]]
``(k) The Secretary shall assign a sufficient number of personnel of
the Department dedicated to carrying out the authority of the Secretary
under this subchapter, including construction and valuation specialists
to assist with issues unique to new construction and renovations on
trust land.''.
(e) Definitions.--Section 3765 of such title is amended--
(1) in paragraph (1)--
(A) by amending subparagraph (C) to read as follows:
``(C) is located in the State of Alaska within a
region established under section 7(a) of the Alaska
Native Claims Settlement Act (43 U.S.C. 1606(a));'';
(B) in subparagraph (D), by striking the period at
the end and inserting a semicolon; and
(C) by adding at the end the following new
subparagraphs:
``(E) is defined by the Secretary of the Interior
and recognized by the United States as land over which
an Indian Tribe has governmental dominion; or
``(F) <<NOTE: Determination.>> is on any land that
the Secretary determines is provided to Native American
veterans because of their status as Native Americans.'';
and
(2) by adding at the end the following new paragraphs:
``(6) The term `community development financial institution'
has the meaning given that term in section 103 of the Community
Development Banking and Financial Institutions Act of 1994 (12
U.S.C. 4702).
``(7) The term `Indian Tribe' means any Indian tribe, band,
nation, or other organized group or community, including any
Alaska Native village or regional or village corporation as
defined in or established pursuant to the Alaska Native Claims
Settlement Act (43 U.S.C. 1601 et seq.), which is recognized as
eligible for the special programs and services provided by the
United States to Indians because of their status as Indians.
``(8) The term `Native community development financial
institution' means any entity--
``(A) that has been certified as a community
development financial institution by the Secretary of
the Treasury;
``(B) that is not less than 51 percent owned or
controlled by Native Americans; and
``(C) for which not less than 51 percent of the
activities of the entity serve Native Americans.
``(9) The term `net tangible benefit' shall have such
meaning as the Secretary determines appropriate, but shall
include the refinance of an interim construction loan.
``(10) The term `other technical assistance' means services
to assist a Native American veteran to navigate the steps
necessary for securing a mortgage loan on trust land, including
pre-development activities related to utilities, identifying
appropriate residential construction services, and obtaining
lease clearances and title status reports from the applicable
tribal organization or the Bureau of Indian Affairs.
``(11) The term `tribally designated housing entity' has the
meaning given that term in section 4 of the Native American
Housing Assistance and Self-Determination Act of 1996 (25 U.S.C.
4103).''.
[[Page 138 STAT. 2787]]
(f) Interest Rate Reduction Financing Loan.--Section 3729(b)(4)(F)
of such title is amended by striking ``3762(h)'' and inserting
``3762(h)(1)''.
(g) Regulations.--Section 3761 of such title is amended by adding at
the end the following new subsection:
``(c) The Secretary shall prescribe such regulations as may be
necessary to carry out this subchapter.''.
SEC. 232. NATIVE COMMUNITY DEVELOPMENT FINANCIAL INSTITUTION
RELENDING PROGRAM.
(a) In General.--Subchapter V of chapter 37 of title 38, United
States Code, is amended by inserting after section 3762 the following
new section:
``Sec. 3762A. <<NOTE: 38 USC 3762A.>> Native community development
financial institution relending program
``(a) Purpose.--The Secretary may make a loan to a Native community
development financial institution for the purpose of allowing the
institution to relend loan amounts to qualified Native American
veterans, subject to the requirements of this section.
``(b) Standards.--(1) The Secretary shall establish standards to be
used in evaluating whether to make a loan to a Native community
development financial institution under this section.
``(2) In establishing standards under paragraph (1), the Secretary
shall ensure that a Native community development financial institution--
``(A) is able to originate and service loans for single-
family homes;
``(B) is able to operate the relending program in a manner
consistent with the mission of the Department to serve veterans;
and
``(C) uses loan amounts received under this section only for
the purpose of relending, as described in subsection (c), to
Native American veterans.
``(c) Relending Requirements.--(1) A Native community development
financial institution that receives a loan under this section shall use
the loan amounts to make loans to Native American veterans residing on
trust land.
``(2) A loan to a Native American veteran made by a Native community
development financial institution under paragraph (1) shall--
``(A) be limited either to the purpose of purchase,
construction, or improvement of a dwelling located on trust land
or to the refinance of an existing mortgage loan for a dwelling
on trust land, consistent with the requirements of section
3762(h) of this title; and
``(B) <<NOTE: Compliance.>> comply with such terms and
conditions as the Secretary determines are necessary to protect
against predatory lending, including the interest rate charged
on a loan to a Native American veteran.
``(d) Repayment.--A loan made to a Native community development
financial institution under this section shall--
``(1) be payable to the Secretary upon such terms and
conditions as are prescribed in regulations pursuant to this
subchapter; and
``(2) bear interest at a rate of one percent.
[[Page 138 STAT. 2788]]
``(e) <<NOTE: Notice.>> Oversight.--Subject to notice and
opportunity for a hearing, whenever the Secretary finds with respect to
loans made under subsection (a) or (c) that any Native community
development financial institution has failed to maintain adequate loan
accounting records, to demonstrate proper ability to service loans
adequately, or to exercise proper credit judgment, or that such Native
community development financial institution has willfully or negligently
engaged in practices otherwise detrimental to the interest of veterans
or of the Government, the Secretary may take such actions as the
Secretary determines necessary to protect veterans or the Government,
such as requiring immediate repayment of any loans made under subsection
(a) and the assignment to the Secretary of loans made under subsection
(c).
``(f) Sunset.--The Secretary may not make a loan under this section
after September 30, 2027.''.
(b) Clerical Amendment.--The table of sections at the beginning of
chapter 37 of such <<NOTE: 38 USC prec. 3701.>> title is amended by
inserting after the item relating to section 3762 the following new
item:
``3762A. Native community development financial institution relending
program.''.
(c) Native American Veteran Housing Loan Program Account.--Section
3763 of such title is amended by adding at the end the following new
subsection:
``(c) Of amounts available in the Account, the Secretary may use for
loans made under section 3762A of this title--
``(1) in fiscal year 2025, not more than $5,000,000; and
``(2) in any fiscal year after fiscal year 2025, an amount
determined necessary by the Secretary to meet the demand for
such loans.''.
TITLE III--DISABILITY AND MEMORIAL AFFAIRS MATTERS
SEC. 301. <<NOTE: 38 USC 2303 note.>> BURIAL ALLOWANCE FOR CERTAIN
VETERANS WHO DIE AT HOME WHILE IN RECEIPT
OF HOSPICE CARE FURNISHED BY DEPARTMENT OF
VETERANS AFFAIRS.
(a) In General.--The Secretary of Veterans Affairs shall treat a
veteran described in subsection (b) as a veteran described in
subparagraph (A) of section 2303(a)(2) of title 38, United States Code.
(b) Veteran Described.--A veteran described in this subsection is a
veteran who dies in a home or other setting at which the deceased
veteran was, at the time of death, receiving hospice care pursuant to
section 1717(a) of such title if such care was directly preceded by the
Secretary furnishing to the veteran hospital care or nursing home care
described in clause (ii) of such subparagraph.
(c) Effective Date; Applicability.--This section shall apply with
respect to deaths that occur--
(1) <<NOTE: Time period.>> on or after the date that is 180
days after the date of the enactment of this Act; and
(2) before October 1, 2026.
[[Page 138 STAT. 2789]]
SEC. 302. AUTHORITY FOR SECRETARY OF VETERANS AFFAIRS TO AWARD
GRANTS TO STATES AND INDIAN TRIBES TO
IMPROVE OUTREACH TO VETERANS.
(a) In General.--Chapter 63 of title 38, United States Code, is
amended--
(1) by redesignating sections 6307 and 6308 as sections 6308
and 6309, respectively; and
(2) by inserting after section 6306 the following new
section 6307:
``Sec. 6307. <<NOTE: 38 USC 6307.>> Grants to States and Indian
Tribes to improve outreach to veterans
``(a) Purpose.--It is the purpose of this section to provide for
assistance by the Secretary to States and Indian Tribes to carry out
programs that improve covered outreach and assistance to veterans and
the spouses, children, and parents of veterans, to ensure that such
individuals are fully informed about, and assisted in applying for, any
veterans and veterans-related benefits and programs (including veterans
programs of a State or Indian Tribe) for which they may be eligible and
facilitate opportunities for such individuals to receive competent,
qualified services in the preparation, presentation and prosecution of
veterans benefits claims.
``(b) Authority.--The Secretary may award grants to States and
Indian Tribes--
``(1) to carry out, coordinate, improve, or otherwise
enhance--
``(A) covered outreach activities; or
``(B) activities to assist in the development and
submittal of claims for veterans and veterans-related
benefits; or
``(2) to increase the number of county or Tribal veterans
service officers serving in the State by hiring new, additional
such officers.
``(c) Application.--(1) To be eligible for a grant under this
section, a State or Indian Tribe shall submit to the Secretary an
application therefor at such time, in such manner, and containing such
information as the Secretary may require.
``(2) <<NOTE: Plans.>> Each application submitted under paragraph
(1) shall include the following:
``(A) A detailed plan for the use of the grant.
``(B) A description of the programs through which the State
or Indian Tribe will meet the outcome measures developed by the
Secretary under subsection (j).
``(C) A description of how the State or Indian Tribe will
distribute grant amounts equitably among counties or Tribal
lands with varying levels of urbanization.
``(D) A plan for how the grant will be used to meet the
unique needs of American Indian veterans, Alaska Native
veterans, or Native Hawaiian veterans, elderly veterans, and
veterans from other underserved communities.
``(d) Distribution.--The Secretary shall seek to ensure that grants
awarded under this section are equitably distributed among States and
Indian Tribes with varying levels of urbanization.
``(e) Set-aside.--Of the amounts authorized to be appropriated or
otherwise made available for grants under this section for any
[[Page 138 STAT. 2790]]
fiscal year, the Secretary shall ensure that not less than five percent
is used to make grants to Indian Tribes.
``(f) Priority.--The Secretary shall prioritize awarding grants
under this section that will serve the following areas:
``(1) Areas with a critical shortage of county or Tribal
veterans service officers.
``(2) Areas with high rates of--
``(A) suicide among veterans; or
``(B) referrals to the Veterans Crisis Line.
``(g) Use of County or Tribal Veterans Service Officers.--A State or
Indian Tribe that receives a grant under this section to carry out an
activity described in subsection (b)(1) shall carry out the activity
through--
``(1) a county or Tribal veterans service officer of the
State; or
``(2) if the State or Indian Tribe does not have a county or
Tribal veterans service officer, or if the county or Tribal
veterans service officers of the State or Indian Tribe cover
only a portion of that State or Indian Tribe, an appropriate
entity of a State, local, or Tribal government, as determined by
the Secretary.
``(h) Required Activities.--Any grant awarded under this section
shall be used--
``(1) to expand existing programs, activities, and services;
``(2) to hire new, additional county or Tribal veterans
service officers; or
``(3) for travel and transportation to facilitate carrying
out paragraph (1) or (2).
``(i) Authorized Activities.--A grant under this section may be used
to provide education and training, including on-the-job training, for
State, county, local, and Tribal government employees who provide (or
when trained will provide) covered outreach services in order for those
employees to obtain accreditation in accordance with procedures approved
by the Secretary.
``(j) <<NOTE: Guidance.>> Outcome Measures.--(1) The Secretary shall
develop and provide to each State or Indian Tribe that receives a grant
under this section written guidance on the following:
``(A) Outcome measures.
``(B) Policies of the Department.
``(2) In developing outcome measures under paragraph (1), the
Secretary shall consider the following goals:
``(A) Increasing the use of veterans and veterans-related
benefits, particularly among vulnerable populations.
``(B) Increasing the number of county and Tribal veterans
service officers recognized by the Secretary for the
representation of veterans under chapter 59 of this title.
``(k) <<NOTE: Time period.>> Tracking Requirements.--(1) With
respect to each grant awarded under this section, the Secretary shall
track the use of veterans and veterans-related benefits among the
population served by the grant, including the average period of time
between the date on which a veteran applies for such a benefit and the
date on which the veteran receives the benefit, disaggregated by type of
benefit.
``(2) <<NOTE: Time period. Reports.>> Not less frequently than
annually during the life of the grant program established under this
section, the Secretary shall submit to Congress a report on--
``(A) the information tracked under paragraph (1);
[[Page 138 STAT. 2791]]
``(B) how the grants awarded under this section serve the
unique needs of American Indian veterans, Alaska Native
veterans, or Native Hawaiian veterans, elderly veterans, and
veterans from other underserved communities; and
``(C) other information provided by States and Indian Tribes
pursuant to the grant reporting requirements.
``(l) Performance Review.--The Secretary shall--
``(1) review the performance of each State or Indian Tribe
that receives a grant under this section; and
``(2) make information regarding such performance publicly
available.
``(m) Remediation Plan.--(1) In the case of a State or Indian Tribe
that receives a grant under this section and does not meet the outcome
measures developed by the Secretary under subsection (j), the Secretary
shall require the State or Indian Tribe to submit a remediation plan
under which the State shall describe how and when it plans to meet such
outcome measures.
``(2) The Secretary may not award a subsequent grant under this
section to a State or Indian Tribe described in paragraph (1) unless the
Secretary approves the remediation plan submitted by the State or Indian
Tribe.
``(n) Definitions.--In this section:
``(1) The term `county or Tribal veterans service officer'
includes a local equivalent veterans service officer.
``(2) The term `covered outreach' means outreach with
respect to--
``(A) benefits administered by the Under Secretary
for Benefits; or
``(B) similar benefits administered by a State or
Indian Tribe.
``(3) The term `Indian Tribe' has the meaning given such
term in section 4 of the Indian Self-Determination and Education
Assistance Act (25 U.S.C. 5304).
``(4) The term `State' includes the District of Columbia,
the Commonwealth of Puerto Rico, the Commonwealth of the
Northern Mariana Islands, and any territory or possession of the
United States.
``(5) The term `Veterans Crisis Line' means the toll-free
hotline for veterans established under section 1720F(h) of this
title.''.
(b) Clerical Amendment.--The table of sections at the beginning of
chapter 63 of such title <<NOTE: 38 USC prec. 6301.>> is amended by
striking the items relating to sections 6307 and 6308 and inserting the
following new items:
``6307. Grants to States and Indian Tribes to improve outreach to
veterans.
``6308. Outreach for eligible dependents.
``6309. Biennial report to Congress.''.
(c) <<NOTE: Time periods.>> Authorization of Appropriations.--There
is authorized to be appropriated to the Secretary of Veterans Affairs
for each of fiscal years 2026 and 2027, $10,000,000 to carry out section
6307 of title 38, United States Code, as added by subsection (a).
SEC. 303. DEFINITION OF SURVIVING SPOUSE.
Paragraph (3) of section 101 of title 38, United States Code, is
amended to read as follows:
``(3) The term `surviving spouse' means (except for purposes
of chapter 19 of this title) a person who was the spouse of
[[Page 138 STAT. 2792]]
a veteran at the time of the veteran's death, and who lived with
the veteran continuously from the date of marriage to the date
of the veteran's death (except where there was a separation
which was due to the misconduct of, or procured by, the veteran
without the fault of the spouse) and who has not remarried.''.
SEC. 304. ENSURING ONLY LICENSED HEALTH CARE PROFESSIONALS PERFORM
MEDICAL DISABILITY EXAMINATIONS UNDER
CERTAIN DEPARTMENT OF VETERANS AFFAIRS
PILOT PROGRAM.
(a) Prohibition on Use of Certain Health Care Professionals.--
Section 504(c)(1) of the Veterans' Benefits Improvements Act of 1996
(Public Law 104-275; 38 U.S.C. 5101 note) is amended by inserting
``only'' before ``a health care professional''.
(b) <<NOTE: 38 USC 5101 note.>> Remedies.--The Secretary of Veterans
Affairs shall take such actions as the Secretary considers appropriate
to ensure compliance with section 504(c) of the Veterans' Benefits
Improvements Act of 1996 (Public Law 104-275; 38 U.S.C. 5101 note), as
amended by subsection (a).
(c) Annual Report.--Not later than one year after the date of the
enactment of this Act and not less frequently than once each year
thereafter, the Secretary shall submit to the Committee on Veterans'
Affairs of the Senate and the Committee on Veterans' Affairs of the
House of Representatives a report on--
(1) the conduct of the pilot program established under
section 504 of the Veterans' Benefits Improvements Act of 1996
(Public Law 104-275; 38 U.S.C. 5101 note); and
(2) the actions of the Secretary under subsection (b).
(d) Technical Corrections.--Section 504 of the Veterans' Benefits
Improvements Act of 1996 (Public Law 104-275; 38 U.S.C. 5101 note) is
amended, in the section heading, by striking ``physicians'' and
inserting ``health care professionals''.
SEC. 305. PROVISION OF INFORMATION REGARDING AN AGENT OR ATTORNEY
TO A LICENSED HEALTH CARE PROFESSIONAL WHO
PERFORMS A MEDICAL DISABILITY EXAMINATION
UNDER CERTAIN DEPARTMENT OF VETERANS
AFFAIRS PILOT PROGRAM.
(a) In General.--Section 504 of the Veterans' Benefits Improvements
Act of 1996 (Public Law 104-275; 38 U.S.C. 5101 note), as amended by
section 304, is further amended by adding at the end the following new
subsection:
``(f) Certain Information Provided to Health Care Professional.--The
Secretary shall provide to a health care professional who performs an
examination under subsection (a), or a contractor performing a contract
under such subsection, the contact information of any agent or attorney
recognized by the Secretary under chapter 59 of title 38, United States
Code, with regards to a claim for benefits that gives rise to such
examination.''.
(b) <<NOTE: 38 USC 5101 note.>> Applicability.--The amendment made
by this section shall apply to an examination described in subsection
(a) of such section that is performed on or after the date of the
enactment of this Act.
[[Page 138 STAT. 2793]]
SEC. 306. <<NOTE: 38 USC 5101 note.>> MODERNIZATION OF DEPARTMENT
OF VETERANS AFFAIRS DISABILITY BENEFIT
QUESTIONNAIRES.
(a) <<NOTE: Deadlines.>> Requirement for Transmission of Certain
Information in Machine-readable Format.--
(1) Requirement.--Not later than 180 days after enactment of
this Act, the Secretary of Veterans Affairs shall require all
disability benefit questionnaire data collected in the course of
medical disability examinations made by covered non-Department
providers to be transmitted to the Department in a machine-
readable format.
(2) Issuance of standards.--Not later than 90 days after the
date of the enactment of this Act, the Secretary shall issue
standards for the transmission of disability benefit
questionnaire data in a machine-readable format as required
under paragraph (1).
(3) Updates.--In making updates to disability benefit
questionnaires after the date specified in paragraph (1), the
Secretary shall--
(A) ensure that the updates are made in a manner
that allows for the data collected under the
questionnaires to be in a machine-readable format as of
the date on which the update goes into effect; and
(B) <<NOTE: Notification.>> not later than 30 days
before an update goes into effect, notify the covered
non-Department providers (or the contractor performing a
contract under section 504 of the Veterans Benefits
Improvement Act of 1996 (Public Law 104-275; 38 U.S.C.
5101 note)) described in such paragraph of such updates.
(b) Plan for Information Technology System Modification.--Not later
than 180 days after the date of the enactment of this Act, the Secretary
shall submit to the Committees on Veterans' Affairs of the Senate and
House of Representatives a plan to modify the information technology
systems and processes of the Department to enable a non-Department
health care professional, assigned to or selected by a claimant, to
transmit to the Department, in a machine-readable format, disability
benefit questionnaire data, including complete disability benefit
questionnaires rather than partial questionnaires or elements of medical
evidence.
(c) <<NOTE: Web posting.>> Public Availability of Information.--The
Secretary shall make publicly available on the internet website of the
Department referred to in section 5101(d) of title 38, United States
Code--
(1) a description of the standards issued under subsection
(a)(2); and
(2) the plan required under subsection (b).
(d) Definitions.--In this section:
(1) The term ``claimant'' has the meaning given such term in
section 5100 of title 38, United States Code.
(2) The term ``covered non-Department provider'' means a
health care provider who--
(A) is not an employee of the Department of Veterans
Affairs; and
(B) pursuant to a contract under section 504 of the
Veterans Benefits Improvement Act of 1996 (Public Law
104-275; 38 U.S.C. 5101 note), as amended by sections
304 and 305, examines a claimant for a medical
disability.
[[Page 138 STAT. 2794]]
SEC. 307. <<NOTE: 38 USC 1156 note.>> DEPARTMENT OF VETERANS
AFFAIRS AUTOMATIC PROCESSING OF CERTAIN
CLAIMS FOR TEMPORARY DISABILITY RATINGS.
(a) <<NOTE: Deadline.>> In General.--Not later than one year after
the date of the enactment of this Act, the Secretary of Veterans Affairs
shall modify the information technology systems of the Department of
Veterans Affairs to use automation technology for claims for temporary
disability ratings for veterans described in section 1156(a)(1)(C) of
title 38, United States Code.
(b) Additional Requirements.--In carrying out subsection (a), the
Secretary shall ensure that--
(1) medical evidence is obtained from the corporate data
warehouse of the Department or other sources of data, the
Secretary determines appropriate;
(2) employees of the Department continue to determine
whether a veteran is entitled to a temporary disability rating
under section 1156(a)(1)(C) of title 38, United States Code; and
(3) claims may be processed manually if the evidence of
record is not sufficient to decide the claim or if the medical
evidence is provided in a format that is not compatible with the
system developed under subsection (a).
TITLE IV <<NOTE: Housing our Military Veterans Effectively Act of
2024. 38 USC 101 note.>> --HOMELESSNESS MATTERS
SEC. 401. SHORT TITLE.
This title may be cited as the ``Housing our Military Veterans
Effectively Act of 2024'' or the ``HOME Act of 2024''.
SEC. 402. PER DIEM PAYMENTS PROVIDED BY THE SECRETARY OF VETERANS
AFFAIRS FOR SERVICES FURNISHED TO HOMELESS
VETERANS.
(a) In General.--Section 2012 of title 38, United States Code, is
amended--
(1) in subsection (a)--
(A) in paragraph (2)(B)--
(i) in clause (i)(II)(aa)(BB), by striking
``115 percent'' and inserting ``115 percent (or,
during the period beginning on the date of the
enactment of the Housing our Military Veterans
Effectively Act of 2024 and ending on September
30, 2027, 133 percent)''; and
(ii) by adding at the end the following:
``(iii) <<NOTE: Time period. Waiver. Notification.>> For each of
fiscal years 2025 through 2027, the Secretary may waive the maximum rate
for per diem payments under clause (i)(II)(aa)(BB) or (ii) and, subject
to the availability of appropriations, provide such payments at a rate
that does not exceed 200 percent of the rate authorized for State homes
for domiciliary care under subsection (a)(1)(A) of section 1741 of this
title, as the Secretary may increase from time to time under subsection
(c) of that section, if the Secretary notifies Congress of such waiver.
``(iv) The Secretary may not, pursuant to clause (iii), waive the
maximum rate described in such clause for more than 50 percent of all
grant recipients and eligible entities for a fiscal year.''; and
(B) by adding at the end the following new
paragraph:
[[Page 138 STAT. 2795]]
``(4) The Secretary may not provide more than 12,000 per diem
payments under this section for a fiscal year.''; and
(2) by adding at the end the following new subsection:
``(f) <<NOTE: Time period. Data.>> Reports Required.--Not later than
90 days after the date of the enactment of the HOME Act of 2024, and not
less frequently than twice each year thereafter, the Secretary shall
submit to the Committee on Veterans' Affairs of the Senate and the
Committee on Veterans' Affairs of the House of Representatives a report
on the rate for per diem payments under this section that includes, for
each Veterans Integrated Service Network of the Department, the
following data:
``(1) The average rate for such a payment.
``(2) <<NOTE: List.>> A list of locations where the rate for
such a payment is within 10 percent of the maximum rate for such
a payment authorized under this section.
``(3) The average length of stay by a veteran participating
in a program described in section 2012(a) of this title.''.
(b) <<NOTE: Guidance. 38 USC 2012 note.>> Regulatory Authority.--The
Secretary of Veterans Affairs may carry out the amendments made by
subsection (a) through interim guidance in advance of the issuance of
regulations for such purpose.
(c) Strategic Plan.--
(1) <<NOTE: Deadline.>> In general.--Not later than
September 30, 2025, the Secretary of Veterans Affairs shall
submit to the Committee on Veterans' Affairs of the Senate and
the Committee on Veterans' Affairs of the House of
Representatives a strategic plan for the provision of grants and
per diem payments for services furnished to homeless veterans
under sections 2011 and 2012 of title 38, United States Code.
(2) Elements.--The plan required by paragraph (1) shall
include the following:
(A) A method for administering grant funding
equitably without using the rate authorized for State
homes for domiciliary care under subsection (a)(1)(A) of
section 1741 of title 38, United States Code, as the
Secretary may increase from time to time under
subsection (c) of that section, that takes into
account--
(i) the wide variety of services furnished by
grant recipients and eligible entities under
sections 2011 and 2012 of title 38, United States
Code;
(ii) varying costs of living across different
geographic locations;
(iii) varying availability of affordable
housing in different geographic locations;
(iv) circumstances of housing insecurity in
rural and Tribal communities;
(v) veterans with significant medical care
needs; and
(vi) the changing dynamic of the veteran
population nationwide.
(B) <<NOTE: Timeline.>> A plan and timeline for
implementation of the method included under subparagraph
(A).
(C) <<NOTE: Cost estimate.>> An estimate of
increased costs or savings per year under the plan.
(D) <<NOTE: Overview.>> An overview of the different
grants that will be available once the plan is
implemented.
[[Page 138 STAT. 2796]]
SEC. 403. <<NOTE: 38 USC 2001 note.>> AUTHORIZATION FOR SECRETARY
OF VETERANS AFFAIRS TO USE CERTAIN FUNDS
FOR IMPROVED FLEXIBILITY IN ASSISTANCE TO
HOMELESS VETERANS.
(a) <<NOTE: Time period.>> Use of Funds.--During the period
beginning on the date of the enactment of this Act and ending on the
termination date specified in subsection (d), the Secretary of Veterans
Affairs may provide to a covered veteran, as the Secretary determines
necessary--
(1) food, shelter, clothing, blankets, and hygiene items
required for the safety and survival of the veteran;
(2) transportation required to support the stability and
health of the veteran for appointments with service providers,
the conduct of housing and employment searches, and the
obtainment of food and supplies; and
(3) tablets, smartphones, disposable phones and other
technology, and related service plans required to support the
stability and health of the veteran through the maintenance of
contact with service providers, prospective landlords, and
family members.
(b) Homeless Veterans on Department of Veterans Affairs Land.--
(1) In general.--The Secretary may collaborate, to the
extent practicable, with one or more organizations to manage the
use of land of the Department of Veterans Affairs for homeless
veterans for living and sleeping.
(2) Forms of collaboration.--Collaboration under paragraph
(1) may include the provision by either the Secretary or the
head of the organization concerned of food services and security
for property, buildings, and other facilities owned or
controlled by the Department of Veterans Affairs.
(c) Report Required.--Not later than six months after the date of
the enactment of this Act, and annually thereafter until the date
specified in subsection (d), the Secretary shall submit to Congress a
report that includes, with respect to the period covered by such
report--
(1) <<NOTE: Statement.>> a statement, disaggregated by each
medical center of the Department of Veterans Affairs, of the
amount of funds under this section--
(A) each such medical center requested from the
Secretary; and
(B) to which the Secretary provided each such
medical center;
(2) <<NOTE: Data.>> data, disaggregated by each such medical
center, relating to how each such medical center used amounts
provided by the Secretary under this section;
(3) the number of covered veterans to which the Secretary
provided assistance under this section;
(4) the total amount of assistance the Secretary provided to
covered veterans pursuant to subsection (a)(3) for
communications equipment, broken down by the type of equipment
provided;
(5) the total amount of assistance the Secretary provided
covered veterans pursuant to subsection (a)(2) for ridesharing;
(6) the number of covered veterans who received such
assistance; and
[[Page 138 STAT. 2797]]
(7) a description, for each rideshare used by a covered
veteran with such assistance, of the reasons such covered
veteran used such rideshare.
(8) the number of covered veterans who lived or slept on
Department land;
(9) the amount of funds used to make available Department
land for covered veterans to live and sleep;
(10) the number of Department employees whose primary
responsibilities involved providing services for covered
veterans living or sleeping on Department land;
(11) the average length of time a covered veteran lived or
slept on Department land, and
(12) the period of time the Secretary expects Department
land will be made available for covered veterans to live and
sleep.
(d) Termination Date.--The termination date specified in this
subsection is September 30, 2027.
(e) Definitions.--In this section, the term ``covered veteran''
means--
(1) a homeless veteran, as such term is defined in section
2002 of title 38, United States Code; and
(2) a veteran participating in the program carried out under
section 8(o)(19) of the United States Housing Act of 1937 (42
U.S.C. 1437f(o)(19)).
SEC. 404. ACCESS TO DEPARTMENT OF VETERANS AFFAIRS TELEHEALTH
SERVICES.
(a) In General.--Subtitle VII of chapter 20 of title 38, United
States Code is amended by adding at the end the following new section:
``Sec. 2069. <<NOTE: 38 USC 2069.>> Access to telehealth services
``To the extent practicable, the Secretary shall ensure that
veterans participating in or receiving services from a program under
this chapter have access to telehealth services to which such veterans
are eligible under the laws administered by the Secretary, including by
ensuring that telehealth capabilities are available to--
``(1) such veterans;
``(2) case managers of the Department of programs for
homeless veterans authorized under this chapter; and
``(3) community-based service providers for homeless
veterans receiving funds from the Department through grants or
contracts.''.
(b) Clerical Amendment.--The table of sections at the beginning of
chapter 20 of title 38, United States <<NOTE: 38 USC prec. 2001.>> Code,
is amended by adding at the end the following new item:
``2069. Access to telehealth services.''.
TITLE V--OVERSIGHT AND INVESTIGATIONS MATTERS
SEC. 501. <<NOTE: 38 USC 312 note.>> DEPARTMENT OF VETERANS
AFFAIRS EMPLOYEE TRAINING REGARDING OFFICE
OF INSPECTOR GENERAL.
(a) Training.--The Secretary of Veterans Affairs shall require each
employee of the Department of Veterans Affairs who begins
[[Page 138 STAT. 2798]]
employment with the Department on or after the date of the enactment of
this Act to receive training that the Inspector General of the
Department shall develop on the reporting of wrongdoing to, responding
to requests from, and the duty of cooperating with the Office of
Inspector General of the Department.
(b) <<NOTE: Deadline.>> Timing of Training.--In carrying out
subsection (a), the Secretary shall require each employee of the
Department covered under such subsection to undergo the training
required by such subsection not later than one year after the date on
which the employee begins employment with the Department.
(c) Elements.--Training developed and required under subsection (a)
shall include the following:
(1) Definition of the role, responsibilities, and legal
authority of the Inspector General of the Department and the
duties of employees of the Department for engaging with the
Office of Inspector General.
(2) Identification of Federal whistleblower protection
rights, including the right to report fraud, waste, abuse, and
other wrongdoing to Congress.
(3) Identification of the circumstances and mechanisms for
reporting fraud, waste, abuse, and other wrongdoing to the
Inspector General, including making confidential complaints to
the Inspector General.
(4) Identification of the prohibitions and remedies that
help to protect employees of the Department from retaliation
when reporting wrongdoing to the Inspector General.
(5) Recognition of opportunities to engage with staff of the
Office of Inspector General to improve programs, operations, and
services of the Department.
(6) <<NOTE: Notification. Subpoena.>> Notification of the
authority of the Inspector General to subpoena the attendance
and testimony of witnesses, including former employees of the
Department, as necessary to carry out the duties of the Office
of Inspector General under section 312 of title 38, United
States Code.
(d) Design and Update.--The Inspector General of the Department
shall design, and update as the Inspector General considers appropriate,
the training developed and required by subsection (a).
(e) System.--The Secretary shall provide, via the talent management
system of the Department, or successor system, the training developed
and required under subsection (a).
(f) Relation to Certain Training.--The Secretary shall ensure that
training developed and required under subsection (a) is separate and
distinct from training provided under section 733 of title 38, United
States Code.
(g) Notice to Employees.--The Secretary shall ensure that the
Inspector General is afforded the opportunity, not less frequently than
twice each year and more frequently if the Inspector General considers
appropriate under extraordinary circumstances, to use the electronic
mail system of the Department to notify all authorized users of such
system of the following:
(1) The roles and responsibilities of the employees of the
Department when engaging with the Office of Inspector General.
(2) The availability of training provided under subsection
(a).
(3) How to access training provided under subsection (a).
[[Page 138 STAT. 2799]]
(4) Information about how to contact the Office of Inspector
General, including a link to any website-based reporting form of
the Office.
SEC. 502. ANNUAL REVIEW OF SECURITY AT COVERED FACILITIES OF THE
DEPARTMENT OF VETERANS AFFAIRS.
(a) <<NOTE: Deadline. Time periods.>> Annual Survey.--Not later than
one year after the date of the enactment of this Act, and annually
thereafter for each of the following five fiscal years, the Secretary of
Veterans Affairs, in coordination with the Director of the Office of
Security and Law Enforcement of the Department of Veterans Affairs,
shall conduct a survey of the covered employees at each covered facility
to collect information regarding security. Each annual survey shall
include questions about--
(1) the type and frequency of criminal activity experienced
at the covered facility during the fiscal year which most
recently concluded including whether or not the criminal
activity was related to residents at the facility or campus such
as those in a residential rehabilitation treatment program or
enhanced-use lease facility;
(2) the number of vacancies and number of days vacant for
Department police officers at the covered facility at the time
of the survey delineated by recruitment status and stage;
(3) the availability and adequacy of covered equipment;
(4) the availability and adequacy of resources, classes, or
other time set aside for training Department police officers who
work at each covered facility about any skill or tactic related
to law enforcement, including the proper use of force, firearms
qualifications and training, procedures for responding to an
active threat, and any other training required for Department
police officers;
(5) any security weakness at covered facilities;
(6) the relationship between the covered facility (including
the Department police officers who work at the covered facility)
and local, state, and federal law enforcement agencies including
what agreements or memorandums of understanding exist between
each covered facility and external law enforcement agencies;
(7) efforts by the personnel of the covered facility to
address and reduce criminal activity at, or in close proximity
to, the covered facility; and
(8) <<NOTE: Recommenda- tions.>> recommendations for the
Secretary to better address and reduce criminal activity at, or
in close proximity to, covered facilities so as to improve the
safety of veterans, employees, visitors, other authorized
personnel, and the surrounding community.
(b) <<NOTE: Time periods.>> Report.--Not later than 30 days after
the end of the next full Fiscal Year after the enactment of this Act and
for each of the following five fiscal years, the Secretary shall submit
to each of the Committees on Veterans' Affairs of the Senate and the
House of Representatives a report regarding the results of the surveys
conducted under subsection (a) during the previous fiscal year. The
report shall include--
(1) the results of the annual survey described under
subsection (a) for the year covered by the report;
[[Page 138 STAT. 2800]]
(2) <<NOTE: Analysis. Action plan.>> an analysis, made in
coordination with the Director of the Office of Security and Law
Enforcement of such Department, each director and police chief
of a Veterans Integrated Service Network, and the directors and
police chiefs of the medical centers within the Veterans
Integrated Service Network of the results of the triannual
security inspections conducted in prior fiscal year, to include
a plan of action that describes how the Secretary plans to
address any security weakness identified in the results of the
triannual security inspections and includes clearly-stated goals
with measurable benchmarks for each goal and deadlines for each
benchmark; and
(3) <<NOTE: List.>> a list of all vacant positions for
police chief or deputy police chief at each covered facility
during the prior fiscal year, the number of individuals who
filled those positions over the two years prior to the date of
the survey, the number of days the positions were vacant without
someone serving in an acting capacity, and the number of days
the positions were filled by individuals serving in an acting
capacity.
(c) Definitions.--In this section:
(1) The term ``covered equipment'' means any item issued by
the Secretary of Veterans Affairs to a Department police officer
(including firearms, weapons detecting technology, ballistic
vests, body-worn cameras, and radios) for use in the provision
of services under section 902 of title 38, United States Code.
(2) The term ``covered employee'' means an employee of the
Department of Veterans Affairs who is employed and responsible
for security operations at a covered facility including a
covered facility's police chief, facility emergency management
leader, facility director, or person carrying out the
responsibilities of one of these positions in an acting
capacity.
(3) The term ``covered facility'' means any facility of the
Department of Veterans Affairs where Department police officers
have jurisdiction.
(4) The term ``Department police officer'' is used as such
term as used in section 902 of title 38, United States Code.
(5) The term ``security weakness'' means a deficiency in the
facilities, staffing, or covered equipment at a covered facility
that a covered employee of the covered facility determines
presents a risk to the safety of visitors or staff, including an
unsecured door, inoperable security camera, unsecured police
operations room, a lack of security presence at an entrance to
the covered facility, and a lack of security presence in an area
of the covered facility or the grounds of the covered facility
that the director of the covered facility determines requires an
increased security presence.
[[Page 138 STAT. 2801]]
SEC. 503. MODIFICATION OF CERTAIN HOUSING LOAN FEES.
The loan fee table in section 3729(b)(2) of title 38, United States
Code, is amended by striking ``November 29, 2031'' each place it appears
and inserting ``June 9, 2034''.
Approved January 2, 2025.
LEGISLATIVE HISTORY--S. 141 (H.R. 542):
---------------------------------------------------------------------------
HOUSE REPORTS: No. 118-284 (Comm. on Veterans' Affairs) accompanying
H.R. 542.
CONGRESSIONAL RECORD, Vol. 170 (2024):
Dec. 12, considered and passed Senate.
Dec. 16, considered and passed House.
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