```

[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 141 Enrolled Bill (ENR)]

        S.141

                     One Hundred Eighteenth Congress

                                 of the

                        United States of America

                          AT THE SECOND SESSION

         Begun and held at the City of Washington on Wednesday,
         the third day of January, two thousand and twenty four

                                 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.

    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 ``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.
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.
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

    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 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) 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) 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) 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) publicly displayed in each medical facility of the 
    Department;
        ``(B) prominently displayed on a website of the Department; and
        ``(C) included in other outreach campaigns and activities 
    conducted by the Secretary.''.
    (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) 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) 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) In this subsection, the term `Third Party Administrator' has 
the meaning given such term in section 1703B of this title.''.
    (b) 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.
    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) 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) 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) 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) 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) 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 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) 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) 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) 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
            (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) 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) 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) 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. PILOT PROGRAM TO IMPROVE ADMINISTRATION OF CARE UNDER 
      VETERANS COMMUNITY CARE PROGRAM.
    (a) 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--
        (1) to provide monetary and non-monetary incentives to a 
    covered health care provider--
            (A) 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) 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) 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--
            (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. PILOT PROGRAM ON CONSOLIDATING APPROVAL PROCESS OF 
      DEPARTMENT OF VETERANS AFFAIRS FOR COVERED DENTAL CARE.
    (a) 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) 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 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) 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. STRATEGIC PLAN ON VALUE-BASED HEALTH CARE SYSTEM FOR 
      VETERANS HEALTH ADMINISTRATION; PILOT PROGRAM.
    (a) Establishment of Working Group.--
        (1) 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).
                (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) 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) 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.
        (2) 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) 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) 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) 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) 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) 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) 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 in such framework 
        could be used to encourage innovation; and
            (D) workforce challenges and needs of the Veterans Health 
        Administration based on--
                (i) 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) Any recommendations of the working group with respect to 
    improving the information technology infrastructure described in 
    clause (i) of subparagraph (J).
        (13) 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) 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.
            (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. 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) 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--
            (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) 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) 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) recommendations of the Secretary with respect to 
            development of health information interoperability 
            standards;
                (iv) 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--
                (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) 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) 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. INSPECTOR GENERAL ASSESSMENT OF IMPLEMENTATION OF 
      VETERANS COMMUNITY CARE PROGRAM.
    (a) 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;
        (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) 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) by adding at the end the following new paragraph:
    ``(2)(A) 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 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) 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) 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, 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. 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) 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.
    ``(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) 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) 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 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) 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) 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) 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. 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'. 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.
    ``(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) 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.
    ``(f) 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) 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).
        ``(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) 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) 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--

                    (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) 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) 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.''.
        (2) 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 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) 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 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) 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) The Secretary shall ensure that all data included in a report 
under subparagraph (A)--
        ``(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. IMPROVEMENTS RELATING TO HOMEMAKER AND HOME HEALTH AIDE 
      PROGRAM.
    (a) Pilot Program for Communities With Shortage of Home Health 
Aides.--
        (1) 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) 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.
        (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) a statement of the results of such pilot program; and
            (B) 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) 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) 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. PILOT PROGRAM TO FURNISH ASSISTED LIVING SERVICES TO 
      CERTAIN VETERANS.
    (a) 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.--
        (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) 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
            (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 
    oversight of the pilot program, or any other barriers or 
    challenges;
        (6) 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) 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) 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--
            (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. 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. RECOGNITION OF ORGANIZATIONS AND INDIVIDUALS TO ASSIST 
      VETERANS, FAMILY MEMBERS, AND CAREGIVERS NAVIGATING PROGRAMS AND 
      SERVICES OF VETERANS HEALTH ADMINISTRATION.
    (a) 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) 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. REVIEWS AND OTHER IMPROVEMENTS RELATING TO HOME- AND 
      COMMUNITY-BASED SERVICES.
    (a) Office of Geriatric and Extended Care.--
        (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.--
        (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) 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.
            (B) 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) 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.
        (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. DEVELOPMENT OF CENTRALIZED WEBSITE FOR PROGRAM 
      INFORMATION.
    (a) 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) 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. 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).
        (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, 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. 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) 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
        ``(2) any other period of time that the Secretary determines 
    necessary.''.
    (b) 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) 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;
                ``(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) 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) 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) 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--
            ``(i) 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) 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) 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 is amended in the heading by inserting 
        ``Optometrists,'' after ``PODIATRISTS,''.
            (B) Table of sections.--The table of sections for such 
        chapter is amended by striking the item relating to subchapter 
        III and inserting the following:

 ``subchapter iii--pay for physicians and other health-care personnel''.

        (5) 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
        (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) 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. REIMBURSEMENT OF AMBULANCE COST FOR CARE FOR CERTAIN 
      RURAL VETERANS.
    (a) 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.
    (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. PILOT PROGRAM TO FURNISH DENTAL CARE FROM THE DEPARTMENT 
      OF VETERANS AFFAIRS TO CERTAIN VETERANS DIAGNOSED WITH ISCHEMIC 
      HEART DISEASE.
    (a) 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) 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
            (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) 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) 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.--
            (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) an analysis of the communication and collaboration of 
        the Department with Third Party Administrators and community 
        care dental providers, disaggregated by State;
            (H) an analysis of any cost savings by the Department with 
        respect to the treatment of ischemic heart disease;
            (I) 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;
            (J) 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) 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) 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. DOCUMENTATION OF PREFERENCES OF VETERANS FOR SCHEDULING 
      OF APPOINTMENTS FOR HEALTH CARE UNDER LAWS ADMINISTERED BY 
      SECRETARY OF VETERANS AFFAIRS.
    (a) In General.--Not later than one year after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall 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.
    (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. STAFFING MODEL AND PERFORMANCE METRICS FOR CERTAIN 
      EMPLOYEES OF THE DEPARTMENT OF VETERANS AFFAIRS.
    (a) Staffing Model.--
        (1) 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) 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;
                (ii) 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) 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) 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) 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) 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) 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
        (2) such recommendations as the Comptroller General considers 
    appropriate with respect to improving access to the care described 
    in paragraph (1) for veterans.
    SEC. 147. 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. 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) 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--
            (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) 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. NATIONAL VETERAN SUICIDE PREVENTION ANNUAL REPORT.
    (a) National Veteran Suicide Prevention Annual Report.--
        (1) 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:
                (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 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) 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) 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) 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.--
        (1) 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) 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
            (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.--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) 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) 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 provide dental care services to veterans eligible for 
    such services under the laws administered by the Secretary; and
        (2) 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) 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.
    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) 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.

                 TITLE II--ECONOMIC OPPORTUNITY MATTERS
                   Subtitle A--Educational Assistance

    SEC. 201. 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) 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) 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
            (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) 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) 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) 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.''.
    (b) Additional Requirement for Approval of Nonaccredited Courses.--
        (1) In general.--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) 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) 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):
        ``(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.--Section 3675(b)(3) of such title is 
    amended by striking ``(15), (16), and (17)'' and inserting ``(15), 
    (16), and (18)''.
    (c) 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) 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
        ``(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) 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.--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) 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) 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) 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) 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) 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, 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. 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.
        ``(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) 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 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) 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. High technology program
    ``(a) 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.
        ``(B) A second such program if--
            ``(i) 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) 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) 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) 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.
    ``(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) 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) 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) 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) 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 
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) 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) 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. 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) 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) 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) 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.
        ``(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) 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) 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) 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) 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;
            ``(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 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) 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):
    ``(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;
                ``(ii) 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) 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. 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 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. 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. 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 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) 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) 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) 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 
    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:
    ``(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) 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) 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
            (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) 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) 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.--
        (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) 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) 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) 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 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) 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) 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;
                (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) 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) 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) 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) 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--
            (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.

                         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) 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) 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
        ``(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) 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).
                ``(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:
    ``(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) 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).''.
    (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. 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) 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.
    ``(e) 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 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. 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) on or after the date that is 180 days after the date of the 
    enactment of this Act; and
        (2) before October 1, 2026.
    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. 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) 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 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) 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) 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) 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);
        ``(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 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) 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 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) 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) 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.
    SEC. 306. MODERNIZATION OF DEPARTMENT OF VETERANS AFFAIRS 
      DISABILITY BENEFIT QUESTIONNAIRES.
    (a) 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) 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) 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.
    SEC. 307. DEPARTMENT OF VETERANS AFFAIRS AUTOMATIC PROCESSING OF 
      CERTAIN CLAIMS FOR TEMPORARY DISABILITY RATINGS.
    (a) 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--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) 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:
    ``(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) 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) 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) 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) 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) A plan and timeline for implementation of the method 
        included under subparagraph (A).
            (C) An estimate of increased costs or savings per year 
        under the plan.
            (D) An overview of the different grants that will be 
        available once the plan is implemented.
    SEC. 403. AUTHORIZATION FOR SECRETARY OF VETERANS AFFAIRS TO USE 
      CERTAIN FUNDS FOR IMPROVED FLEXIBILITY IN ASSISTANCE TO HOMELESS 
      VETERANS.
    (a) 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) 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) 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
        (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. 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 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. 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 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) 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) 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).
        (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) 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) 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) 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;
        (2) 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) 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.
    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''.

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.
```