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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 10267 Introduced in House (IH)]

<DOC>

118th CONGRESS
  2d Session
                               H. R. 10267

   To improve the provision of care and services under the Veterans 
 Community Care Program of the Department of Veterans Affairs, and for 
                            other purposes.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                            December 3, 2024

Mr. Bost (for himself and Mr. Bilirakis) introduced the following bill; 
        which was referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL

 
   To improve the provision of care and services under the Veterans 
 Community Care Program of the Department of Veterans Affairs, and for 
                            other purposes.

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Complete the 
Mission Act of 2024''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
        TITLE I--IMPROVEMENT OF VETERANS COMMUNITY CARE PROGRAM

Sec. 101. Codification of requirements for eligibility standards for 
                            access to community care from Department of 
                            Veterans Affairs.
Sec. 102. Requirement that Secretary notify veterans of eligibility for 
                            care under Veterans Community Care Program.
Sec. 103. Consideration under Veterans Community Care Program of 
                            veteran preference for care and need for 
                            caregiver or attendant.
Sec. 104. Notification of denial of request for care under Veterans 
                            Community Care Program.
Sec. 105. Discussion of telehealth options under Veterans Community 
                            Care Program.
Sec. 106. Use of value-based reimbursement models under Veterans 
                            Community Care Program.
Sec. 107. Extension of deadline for submittal of claims by health care 
                            entities and providers under prompt payment 
                            standard.
                  TITLE II--OTHER HEALTH CARE MATTERS

Sec. 201. Plan on establishment of interactive, online self-service 
                            module for care.
Sec. 202. Publication of wait times for care at medical centers of 
                            Department of Veterans Affairs.
Sec. 203. Modification of requirements for Center for Innovation for 
                            Care and Payment of the Department of 
                            Veterans Affairs and requirement for pilot 
                            program.
Sec. 204. Standardized process to determine eligibility of covered 
                            veterans for participation in certain 
                            mental health treatment programs.
Sec. 205. Reports.

        TITLE I--IMPROVEMENT OF VETERANS COMMUNITY CARE PROGRAM

SEC. 101. CODIFICATION OF REQUIREMENTS FOR ELIGIBILITY STANDARDS FOR 
              ACCESS TO COMMUNITY CARE FROM DEPARTMENT OF VETERANS 
              AFFAIRS.

    (a) Eligibility Access Standards.--Section 1703B of title 38, 
United States Code, is amended--
            (1) by striking subsections (a) through (e) and inserting 
        the following:
    ``(a) Eligibility Standards for Access to Community Care.--(1) A 
covered veteran shall be eligible to elect to receive non-Department 
hospital care, medical services, or extended care services, excluding 
nursing home care, through the Veterans Community Care Program under 
section 1703 of this title pursuant to subsection (d)(1)(D) of such 
section using the following eligibility access standards:
            ``(A) With respect to primary care, mental health care, or 
        extended care services, excluding nursing home care, if the 
        Department cannot schedule an in-person appointment for the 
        covered veteran with a health care provider of the Department 
        who can provide the needed service--
                    ``(i) within 30 minutes average driving time (or 
                such shorter average driving time as the Secretary may 
                prescribe) from the residence of the veteran unless a 
                longer average driving time has been agreed to by the 
                veteran in consultation with a health care provider of 
                the veteran; and
                    ``(ii) within 20 days (or such shorter period as 
                the Secretary may prescribe) of the date of request for 
                such an appointment unless a later date has been agreed 
                to by the veteran in consultation with a health care 
                provider of the veteran.
            ``(B) With respect to specialty care, if the Department 
        cannot schedule an in-person appointment for the covered 
        veteran with a health care provider of the Department who can 
        provide the needed service--
                    ``(i) within 60 minutes average driving time (or 
                such shorter average driving time as the Secretary may 
                prescribe) from the residence of the veteran unless a 
                longer average driving time has been agreed to by the 
                veteran in consultation with a health care provider of 
                the veteran; and
                    ``(ii) within 28 days (or such shorter period as 
                the Secretary may prescribe) of the date of request for 
                such an appointment unless a later date has been agreed 
                to by the veteran in consultation with a health care 
                provider of the veteran.
    ``(2) For the purposes of determining the eligibility of a covered 
veteran for care or services under paragraph (1), the Secretary shall 
not take into consideration the availability of telehealth appointments 
from the Department when determining whether the Department is able to 
furnish such care or services in a manner that complies with the 
eligibility access standards under such paragraph.
    ``(3) In the case of a covered veteran who has had an appointment 
with a health care provider of the Department canceled by the 
Department for a reason other than the request of the veteran, in 
calculating a wait time for a subsequent appointment under paragraph 
(1), the Secretary shall calculate such wait time from the date of the 
request for the original, canceled appointment.
    ``(4) If a veteran agrees to a longer average drive time or a later 
date under subparagraph (A) or (B) of paragraph (1), the Secretary 
shall document the agreement to such longer average drive time or later 
date in the electronic health record of the veteran and provide the 
veteran a copy of such documentation. Such copy may be provided 
electronically.
    ``(b) Application.--The Secretary shall ensure that the eligibility 
access standards established under subsection (a) apply--
            ``(1) to all care and services within the medical benefits 
        package of the Department to which a covered veteran is 
        eligible under section 1703 of this title, excluding nursing 
        home care; and
            ``(2) to all covered veterans, regardless of whether a 
        veteran is a new or established patient.
    ``(c) Periodic Review of Access Standards.--Not later than three 
years after the date of the enactment of the Complete the Mission Act 
of 2024, and not less frequently than once every three years 
thereafter, the Secretary shall--
            ``(1) conduct a review of the eligibility access standards 
        under subsection (a) in consultation with--
                    ``(A) such Federal entities as the Secretary 
                considers appropriate, including the Department of 
                Defense, the Department of Health and Human Services, 
                and the Centers for Medicare & Medicaid Services;
                    ``(B) entities and individuals in the private 
                sector, including--
                            ``(i) veteran patients;
                            ``(ii) veterans service organizations; and
                            ``(iii) health care providers participating 
                        in the Veterans Community Care Program under 
                        section 1703 of this title; and
                    ``(C) other entities that are not part of the 
                Federal Government; and
            ``(2) submit to the appropriate committees of Congress a 
        report on--
                    ``(A) the findings of the Secretary with respect to 
                the review conducted under paragraph (1); and
                    ``(B) such recommendations as the Secretary may 
                have with respect to the eligibility access standards 
                under subsection (a).'';
            (2) by striking subsection (g);
            (3) by redesignating subsections (f), (h), and (i) as 
        subsections (d), (e), and (f), respectively;
            (4) in subsection (d), as redesignated by paragraph (3)--
                    (A) by striking ``established'' each place it 
                appears; and
                    (B) in paragraph (1), by striking ``(1) Subject 
                to'' and inserting ``Compliance by Community Care 
                Providers With Access Standards.--(1) Subject to'';
            (5) in subsection (e), as so redesignated--
                    (A) in paragraph (1)--
                            (i) by striking ``(1) Consistent with'' and 
                        inserting ``Determination Regarding 
                        Eligibility.--(1) Consistent with''; and
                            (ii) by striking ``designated access 
                        standards established under this section'' and 
                        inserting ``eligibility access standards under 
                        subsection (a)''; and
                    (B) in paragraph (2)(B), by striking ``designated 
                access standards established under this section'' and 
                inserting ``eligibility access standards under 
                subsection (a)''; and
            (6) in subsection (f), as redesignated by paragraph (2)--
                    (A) in the matter preceding paragraph (1), by 
                striking ``In this section'' and inserting 
                ``Definitions.--In this section''; and
                    (B) in paragraph (2)--
                            (i) by striking ``covered veterans'' and 
                        inserting ``covered veteran''; and
                            (ii) by striking ``veterans described'' and 
                        inserting ``a veteran described''.
    (b) Conforming Amendments.--Section 1703(d) of such title is 
amended--
            (1) in paragraph (1)(D), by striking ``designated access 
        standards developed by the Secretary under section 1703B of 
        this title'' and inserting ``eligibility access standards under 
        section 1703B(a) of this title''; and
            (2) in paragraph (3), by striking ``designated access 
        standards developed by the Secretary under section 1703B of 
        this title'' and inserting ``eligibility access standards under 
        section 1703B(a) of this title''.

SEC. 102. REQUIREMENT THAT SECRETARY NOTIFY VETERANS OF ELIGIBILITY FOR 
              CARE UNDER VETERANS COMMUNITY CARE PROGRAM.

    Section 1703(a) of title 38, United States Code, is amended by 
adding at the end the following new paragraph:
    ``(5)(A) The Secretary shall notify each covered veteran in writing 
of the eligibility of such veteran for care or services under this 
section as soon as possible, but not later than two business days, 
after the date on which a veteran eligible for such care or services 
under this section seeks care or services.
    ``(B) With respect to each covered veteran eligible for care or 
services under subsection (d), the Secretary shall provide such veteran 
periodic reminders, as the Secretary determines appropriate, of their 
ongoing eligibility under such subsection.
    ``(C) Any notification or reminder under this paragraph may be 
provided electronically.''.

SEC. 103. CONSIDERATION UNDER VETERANS COMMUNITY CARE PROGRAM OF 
              VETERAN PREFERENCE FOR CARE AND NEED FOR CAREGIVER OR 
              ATTENDANT.

    Section 1703(d)(2) of title 38, United States Code, is amended by 
adding at the end the following new subparagraphs:
            ``(F) The preference of the covered veteran for where, 
        when, and how to seek hospital care, medical services, or 
        extended care services.
            ``(G) Whether the covered veteran requests or requires the 
        assistance of a caregiver or attendant when seeking hospital 
        care, medical services, or extended care services.''.

SEC. 104. NOTIFICATION OF DENIAL OF REQUEST FOR CARE UNDER VETERANS 
              COMMUNITY CARE PROGRAM.

    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) Notification of Denial of Request for Care and How To 
Appeal.--(1) If a request by a veteran for care or services under this 
section is denied, the Secretary shall notify the veteran in writing as 
soon as possible, but not later than two business days, after the 
denial is made--
            ``(A) of the reason for the denial; and
            ``(B) with instructions on how to appeal such denial using 
        the clinical appeals process of the Veterans Health 
        Administration.
    ``(2) If a denial under paragraph (1) is due to not meeting the 
eligibility access standards under section 1703B(a) of this title, 
notice under such paragraph shall include an explanation for why the 
Secretary does not consider the veteran to have met such standards.
    ``(3) Any notification under this subsection may be provided 
electronically.''.

SEC. 105. DISCUSSION OF TELEHEALTH OPTIONS UNDER VETERANS COMMUNITY 
              CARE PROGRAM.

    Section 1703 of title 38, United States Code, as amended by section 
104, is further amended--
            (1) by redesignating subsection (p) as subsection (q); and
            (2) by inserting after subsection (o) the following new 
        subsection (p):
    ``(p) Discussion of Options for Telehealth.--When discussing 
options for care or services for a covered veteran under this section, 
the Secretary shall ensure that the veteran is informed of the ability 
of the veteran to seek care or services via telehealth, either through 
a medical facility of the Department or under this section, if 
telehealth--
            ``(1) is available to the veteran;
            ``(2) is appropriate for the type of care or services the 
        veteran is seeking, as determined by the Secretary; and
            ``(3) is acceptable to the veteran.''.

SEC. 106. USE OF VALUE-BASED REIMBURSEMENT MODELS UNDER VETERANS 
              COMMUNITY CARE PROGRAM.

    (a) In General.--Section 1703(i)(5) of title 38, United States 
Code, is amended by striking ``may'' and inserting ``shall''.
    (b) Negotiation of Terms.--The Secretary of Veterans Affairs shall 
negotiate with Third Party Administrators to establish the use of 
value-based reimbursement models under the Veterans Community Care 
Program under section 1703 of title 38, United States Code, pursuant to 
the amendment made by subsection (a).
    (c) Report on Value-Based Reimbursement Models.--Not later than one 
year after negotiating under subsection (b) terms to establish the use 
of value-based reimbursement models under the Veterans Community Care 
Program under section 1703 of title 38, United States Code, the 
Secretary, 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, and the Office of Integrated Veteran Care 
of the Department, or successor office, shall submit to the Committee 
on Veterans' Affairs of the Senate and the Committee on Veterans' 
Affairs of the House of Representatives a report containing--
            (1) an assessment of the efforts of the Department pursuant 
        to section 1703(i)(5) of such title, as amended by subsection 
        (a), to incorporate value-based reimbursement models to promote 
        the provision of high-quality care to veterans; and
            (2) such recommendations for legislative or administrative 
        action as the Secretary considers appropriate to increase the 
        use of value-based reimbursement models throughout the Veterans 
        Community Care Program under section 1703 of such title.
    (d) 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.
    (e) 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. 107. EXTENSION OF DEADLINE FOR SUBMITTAL OF CLAIMS BY HEALTH CARE 
              ENTITIES AND PROVIDERS UNDER PROMPT PAYMENT STANDARD.

    Section 1703D(b) of title 38, United States Code, is amended by 
striking ``180 days'' and inserting ``one year''.

                  TITLE II--OTHER HEALTH CARE MATTERS

SEC. 201. PLAN ON ESTABLISHMENT OF INTERACTIVE, ONLINE SELF-SERVICE 
              MODULE FOR CARE.

    (a) In General.--The Secretary of Veterans Affairs, working with 
Third Party Administrators and acting through the Center for Innovation 
for Care and Payment of the Department of Veterans Affairs under 
section 1703E of title 38, United States Code, shall develop and 
implement a plan to establish an interactive, online self-service 
module--
            (1) to allow veterans to request appointments, track 
        referrals for health care under the laws administered by the 
        Secretary, whether at a facility of the Department or through a 
        non-Department provider, and receive appointment reminders;
            (2) to allow veterans to appeal and track decisions 
        relating to--
                    (A) denials of requests for care or services under 
                section 1703 of title 38, United States Code; or
                    (B) denials of requests for care or services at 
                facilities of the Department, including under section 
                1710 of such title; and
            (3) to implement such other matters as determined 
        appropriate by the Secretary in consultation with Third Party 
        Administrators.
    (b) Submittal of Plan.--
            (1) Initial plan.--Not later than 180 days after the date 
        of the enactment of this Act, the Secretary shall submit to the 
        Committee on Veterans' Affairs of the Senate and the Committee 
        on Veterans' Affairs of the House of Representatives the plan 
        developed under subsection (a).
            (2) Quarterly update.--Not less frequently than quarterly 
        following the submittal of the plan under paragraph (1) and for 
        two years 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 
        containing any updates on the implementation of such plan.
    (c) 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.
    (d) 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. 202. PUBLICATION OF WAIT TIMES FOR CARE AT MEDICAL CENTERS OF 
              DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--Subchapter I of chapter 17 of title 38, United 
States Code, is amended by inserting after section 1703F the following 
new section:
``Sec. 1703G. Publication of wait times for care at medical centers
    ``(a) In General.--The Secretary shall publish on a publicly 
available internet website of the Department the average wait time for 
a veteran to schedule an appointment at each medical center of the 
Department for the receipt of primary care, specialty care, and mental 
health care measured from the date of request for the appointment to 
the date on which the care was provided.
    ``(b) Update.--The Secretary shall update the wait times published 
under subsection (a) not less frequently than monthly.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such subchapter is amended by inserting after the item relating to 
section 1703F the following new item:

``1703G. Publication of wait times for care at medical centers.''.

SEC. 203. MODIFICATION OF REQUIREMENTS FOR CENTER FOR INNOVATION FOR 
              CARE AND PAYMENT OF THE DEPARTMENT OF VETERANS AFFAIRS 
              AND REQUIREMENT FOR PILOT PROGRAM.

    (a) In General.--Section 1703E of title 38, United States Code, is 
amended--
            (1) in subsection (a)--
                    (A) in paragraph (1), by striking ``within the 
                Department'' and inserting ``within the Office of the 
                Secretary'';
                    (B) in paragraph (2), by striking ``may'' and 
                inserting ``shall''; and
                    (C) in paragraph (3)--
                            (i) in subparagraph (A), by striking ``; 
                        and'' and inserting a semicolon;
                            (ii) in subparagraph (B), by striking the 
                        period at the end and inserting ``; or''; and
                            (iii) by adding at the end the following 
                        new subparagraph:
            ``(C) increase productivity, efficiency, and modernization 
        throughout the Department.'';
            (2) by striking subsection (d) and inserting the following 
        new subsection (d):
    ``(d) Budgetary Line Item.--The Secretary shall include in the 
budget justification materials submitted to Congress in support of the 
budget of the Department of Veterans Affairs for a fiscal year (as 
submitted with the budget of the President under section 1105(a) of 
title 31) specific identification, as a budgetary line item, of the 
amounts required to carry out this section.'';
            (3) in subsection (f)--
                    (A) in paragraph (1), by striking ``in subchapters 
                I, II, and III of this chapter'' and inserting ``of 
                this title, of title 38, Code of Federal Regulations, 
                and of any handbooks, directives, or policy documents 
                of the Department''; and
                    (B) in paragraph (2), in the matter preceding 
                subparagraph (A), by striking ``waiving any authority'' 
                and inserting ``waiving any provision of this title'';
            (4) in subsection (g)(1), by inserting ``fewer than three 
        or'' before ``more than 10'';
            (5) in subsection (i)--
                    (A) in paragraph (1), by striking ``the Under 
                Secretary for Health and the Special Medical Advisory 
                Group established pursuant to section 7312 of this 
                title'' and inserting ``the Under Secretary for Health, 
                the Special Medical Advisory Group established pursuant 
                to section 7312 of this title, the Office of Integrated 
                Veteran Care (or successor office), the Office of 
                Finance (or successor office), the Veteran Experience 
                Office (or successor office), the Office of Enterprise 
                Integration (or successor office), and the Office of 
                Information and Technology (or successor office)''; and
                    (B) in paragraph (2), by striking ``representatives 
                of relevant Federal agencies, and clinical and 
                analytical experts with expertise in medicine and 
                health care management'' and inserting 
                ``representatives of relevant Federal agencies, 
                nonprofit organizations, and other public and private 
                sector entities, including those with clinical and 
                analytical experts with expertise in medicine and 
                health care management''; and
            (6) by adding at the end the following new subsection:
    ``(k) Report on Activities of Center for Innovation for Care and 
Payment.--Not less frequently than annually, the Secretary shall submit 
to Congress a report that contains, for the one-year period preceding 
the date of the report--
            ``(1) a full accounting of the activities, staff, budget, 
        and other resources and efforts of the Center; and
            ``(2) an assessment of the outcomes of the efforts of the 
        Center.''.
    (b) Comptroller General Report.--Not later than 18 months after the 
date of the enactment of this Act, the Comptroller General of the 
United States shall submit to Congress a report--
            (1) on the efforts of the Center for Innovation for Care 
        and Payment of the Department of Veterans Affairs in fulfilling 
        the objectives and requirements under section 1703E of title 
        38, United States Code, as amended by subsection (a); and
            (2) containing such recommendations as the Comptroller 
        General considers appropriate.
    (c) Pilot Program.--
            (1) In general.--Not later than one year after the date of 
        the enactment of this Act, the Center for Innovation for Care 
        and Payment of the Department of Veterans Affairs under section 
        1703E of title 38, United States Code, shall establish a three-
        year pilot program in not fewer than five locations to allow 
        veterans enrolled in the system of annual patient enrollment of 
        the Department established and operated under section 1705(a) 
        of such title to access outpatient mental health and substance 
        use services through health care providers specified under 
        section 1703(c) of such title without referral or pre-
        authorization.
            (2) Priority.--In selecting sites for the pilot program 
        under paragraph (1), the Secretary shall prioritize sites in 
        the following areas:
                    (A) Areas with varying degrees of urbanization, 
                including urban, rural, and highly rural areas.
                    (B) Areas with high rates of suicide among 
                veterans.
                    (C) Areas with high rates of overdose deaths among 
                veterans.
                    (D) Areas with high rates of calls to the Veterans 
                Crisis Line.
                    (E) Areas with long wait times for mental health 
                and substance use services at facilities of the 
                Department.
                    (F) Areas with outpatient mental health and 
                substance use programs that utilize a value-based care 
                model, to the extent practicable.
            (3) Elements.--The Secretary, in implementing the pilot 
        program under paragraph (1), shall ensure the Department has a 
        care coordination system in place that includes--
                    (A) knowledge sharing, including the timely 
                exchange of medical documentation;
                    (B) assistance with transitions of care, including 
                the potential need for inpatient or residential 
                psychiatric services, substance use detoxification 
                services, post-detoxification step-down services, and 
                residential rehabilitation programs;
                    (C) continuous assessment of patient needs and 
                goals; and
                    (D) creating personalized, proactive care plans.
            (4) Oversight and outcomes.--The Secretary shall develop 
        appropriate metrics and measures--
                    (A) to track and oversee sites at which the pilot 
                program under paragraph (1) is carried out;
                    (B) to monitor patient safety and outcomes under 
                the pilot program; and
                    (C) to assess and mitigate any barriers to 
                extending the pilot program across the entire Veterans 
                Health Administration.
            (5) Annual report.--
                    (A) In general.--Not later than one year after the 
                commencement of the pilot program under paragraph (1), 
                and not less frequently than annually thereafter during 
                the duration of the pilot program, the Secretary shall 
                submit to the Committee on Veterans' Affairs of the 
                Senate and Committee on Veterans' Affairs of the House 
                of Representatives a report on the pilot program, which 
                shall include the following:
                            (i) The number of unique veterans who 
                        participated in the pilot program.
                            (ii) The number of health care providers 
                        who participated in the pilot program.
                            (iii) An assessment of the effectiveness of 
                        the pilot program in increasing access to, and 
                        improving outcomes for, mental health and 
                        substance use treatment services.
                            (iv) The cost of the pilot program.
                            (v) Such other matters as the Secretary 
                        considers appropriate.
                    (B) Final report.--The Secretary shall include in 
                the final report submitted under subparagraph (A), in 
                addition to the requirements under such subparagraph, 
                the assessment by the Secretary of the feasibility and 
                advisability of extending the pilot program across the 
                entire Veterans Health Administration, including a 
                plan, timeline, and required resources for such an 
                extension.
            (6) Veterans crisis line defined.--In this subsection, the 
        term ``Veterans Crisis Line'' means the toll-free hotline for 
        veterans established under section 1720F(h) of title 38, United 
        States Code.

SEC. 204. STANDARDIZED PROCESS TO DETERMINE ELIGIBILITY OF COVERED 
              VETERANS FOR PARTICIPATION IN CERTAIN MENTAL HEALTH 
              TREATMENT PROGRAMS.

    (a) Standardized Screening Process.--Not later than one year after 
the date of the enactment of this Act, the Secretary of Veterans 
Affairs shall establish a standardized screening process to determine, 
based on clinical need, whether a covered veteran satisfies criteria 
for priority or routine admission to a covered treatment program.
    (b) Eligibility Criteria.--
            (1) In general.--Under the standardized screening process 
        required by subsection (a), a covered veteran shall be eligible 
        for priority admission to a covered treatment program if the 
        covered veteran meets criteria that include, but are not 
        limited to, the following:
                    (A) Symptoms that--
                            (i) significantly affect activities of 
                        daily life; and
                            (ii) increase the risk of such veteran for 
                        adverse outcomes.
                    (B) An unsafe living situation.
                    (C) A high-risk flag for suicide.
                    (D) A determination of being a high risk for 
                suicide.
                    (E) Risk factors for overdose.
                    (F) Non-responsive, relapsed, or unable to find 
                recovery from one other course of treatment, such as 
                outpatient or intensive outpatient treatment.
                    (G) Other such criteria as the Secretary determines 
                appropriate.
            (2) Consideration.--In making a determination under 
        paragraph (1), the Secretary shall consider any referral of a 
        health care provider of a covered veteran for such covered 
        veteran to be admitted to a covered treatment program.
    (c) Time for Screening and Admission.--Under the standardized 
screening process required by subsection (a), the Secretary shall 
ensure a covered veteran--
            (1) is screened not later than 48 hours after the date on 
        which the covered veteran, or a relevant health care provider, 
        makes a request for the covered veteran to be admitted to a 
        covered treatment program; and
            (2) determined eligible for priority admission to a covered 
        treatment program is admitted to such covered treatment program 
        not later than 48 hours after the date of such determination.
    (d) Access Standards for Routine Admission.--The Secretary shall 
include the standardized screening process under this section in the 
wait time access standards for eligibility for mental health care under 
section 1703(d) of such title established by the Secretary under 
section 1703B of such title.
    (e) Conditions Under Which Care Shall Be Furnished Through Non-
Department Providers.--If the Secretary determines a covered veteran to 
be eligible for either priority or routine admission to a covered 
treatment program pursuant to the standardized screening process 
required by subsection (a), and the Secretary is unable to admit such 
covered veteran to a clinically necessary covered treatment program at 
a facility of the Department of Veterans Affairs within 30 minutes 
average driving time (or such shorter period as the Secretary may 
prescribe) of the veteran's residence; and within 20 days (or such 
shorter period as the Secretary may prescribe) of the date of request 
for veterans eligible for routine admission, or within 48 hours (or 
such shorter period as the Secretary may prescribe) for veterans deemed 
eligible for priority admission unless a later date has been agreed to 
by the veteran in consultation with their Department health care 
provider.
    (f) Definitions.--In this section:
            (1) The term ``covered treatment program''--
                    (A) means a mental health residential 
                rehabilitation treatment program of the Department of 
                Veterans Affairs;
                    (B) a program of the Department for residential 
                care for mental health and substance abuse disorders;
                    (C) includes--
                            (i) the programs designated as of the date 
                        of the enactment of this section as domiciliary 
                        residential rehabilitation treatment programs; 
                        and
                            (ii) any programs designated as domiciliary 
                        residential rehabilitation treatment programs 
                        on or after such date of enactment; and
                    (D) does not include Compensated Work Therapy 
                Transition Residence programs of the Department.
            (2) The term ``covered veteran'' means a veteran described 
        in section 1703(b) of title 38, United States Code.

SEC. 205. REPORTS.

    (a) Report on Improvements to Clinical Appeals Process.--Not later 
than one year after the date of the enactment of this Act, and not less 
frequently than once every three years thereafter, the Secretary of 
Veterans Affairs, in consultation with veterans service organizations, 
veterans, caregivers of veterans, employees of the Department of 
Veterans Affairs, and other stakeholders as determined by the 
Secretary, shall submit to the Committee on Veterans' Affairs of the 
Senate and Committee on Veterans' Affairs of the House of 
Representatives a report containing recommendations for legislative or 
administrative action to improve the clinical appeals process of the 
Department with respect to timeliness, transparency, objectivity, 
consistency, and fairness.
    (b) Report on Required Care and Services Under Community Care 
Program.--Not later than one year after the date of the enactment of 
this Act, and not less frequently than annually thereafter, the 
Secretary shall submit to the Committee on Veterans' Affairs of the 
Senate and Committee on Veterans' Affairs of the House of 
Representatives a report that contains, for the one-year period 
preceding the date of the report, the following:
            (1) The number of veterans eligible for care or services 
        under section 1703 of title 38, United States Code, and the 
        reasons for such eligibility, including multiple such reasons 
        for veterans eligible under more than one eligibility criteria.
            (2) The number of veterans who opt to seek care or services 
        under such section.
            (3) The number of veterans who do not opt to seek care or 
        services under such section.
            (4) An assessment of the timeliness of referrals for care 
        or services under such section.
            (5) The number of times a veteran did not show for an 
        appointment for care or services under such section.
            (6) The number of requests for an appeal of a denial of 
        care or services under such section using the clinical appeals 
        process of the Veterans Health Administration.
            (7) The timeliness of each such appeal.
            (8) The outcome of each such appeal.
    (c) Veterans Service Organization Defined.--In this section, the 
term ``veterans service organization'' means any organization 
recognized by the Secretary under section 5902 of title 38, United 
States Code.
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