118TH CONGRESS 

2D SESSION S. 141 

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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 
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1 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

2 (a) SHORT TITLE.—This Act may be cited as the 

3 ‘‘Senator Elizabeth Dole 21st Century Veterans 

4 Healthcare and Benefits Improvement Act’’. 

5 (b) TABLE OF CONTENTS.—The table of contents for 

6 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. 
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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 communitybased 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. 
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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. 
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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. 

1 TITLE I—HEALTH CARE 

2 MATTERS 

3 Subtitle A—Veterans Community 

4 Care Program Matters 

5 SEC. 101. IMPLEMENTATION OF PROVISION OF CARE 

6 UNDER VETERANS COMMUNITY CARE PRO7 GRAM UPON DETERMINATION OF ELIGI8 BILITY BY VETERAN AND VETERAN’S REFER9 RING CLINICIAN. 

10 (a) IN GENERAL.—During the period specified in 

11 subsection (c), the Secretary of Veterans Affairs shall im12 plement section 1703(d)(1)(E) of title 38, United States 

13 Code, in compliance with the implementing regulations for 
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1 such section under section 17.4010(a)(5) of title 38, Code 

2 of Federal Regulations, such that the determination of eli3 gibility for care is final and shall be made by the veteran 

4 and the veteran’s referring clinician. 

5 (b) CORRECTION OF ERRORS.—A covered veteran 

6 and the referring clinician of such veteran may correct any 

7 errors made with respect to a determination described in 

8 subsection (a). 

9 (c) PERIOD SPECIFIED.—The period specified in this 

10 subsection is the two-year period beginning on the date 

11 that is 90 days after the date of the enactment of this 

12 Act. 

13 (d) REPORT.—Not later than one year and not later 

14 than two years after the commencement of the period 

15 specified by subsection (c), the Secretary of Veterans Af16 fairs shall submit to Congress a report on the care pro17 vided under section 1703(d)(1)(E) of title 38, United 

18 States Code, during the one-year period preceding the date 

19 of the report, including— 

20 (1) the number of instances of care provided; 

21 (2) the type of care provided; and 

22 (3) the cost of such care. 

23 (e) RULE OF CONSTRUCTION.—Nothing in this sec24 tion shall be construed to limit the Secretary’s authority 
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1 to prescribe, amend, or rescind regulations under section 

2 1703 of title 38, United States Code. 

3 (f) COVERED VETERAN DEFINED.—In this section, 

4 the term ‘‘covered veteran’’ has the meaning given that 

5 term in section 1703(b) of title 38, United States Code. 

6 SEC. 102. OUTREACH REGARDING CARE AND SERVICES 

7 UNDER VETERANS COMMUNITY CARE PRO8 GRAM. 

9 (a) REQUIREMENT.—Section 1703 of title 38, United 

10 States Code, is amended— 

11 (1) by redesignating subsection (o) as sub12 section (p); and 

13 (2) by inserting after subsection (n) the fol14 lowing new subsection (o): 

15 ‘‘(o) OUTREACH REGARDING AVAILABILITY OF CARE

16 AND SERVICES.—(1) The Secretary shall conduct out17 reach to inform veterans of the following: 

18 ‘‘(A) The conditions for care or services under 

19 subsections (d) and (e). 

20 ‘‘(B) How to request such care or services. 

21 ‘‘(C) How to appeal a denial of a request for 

22 such care or services using the clinical appeals proc23 ess of the Veterans Health Administration. 

24 ‘‘(2) Upon enrollment of a veteran in the system of 

25 annual patient enrollment established and operated under 
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1 section 1705 of this title, and not less frequently than 

2 every two years thereafter, the Secretary shall inform the 

3 veteran of information described in paragraph (1). 

4 ‘‘(3) The Secretary shall ensure that information de5 scribed in paragraph (1) is— 

6 ‘‘(A) publicly displayed in each medical facility 

7 of the Department; 

8 ‘‘(B) prominently displayed on a website of the 

9 Department; and 

10 ‘‘(C) included in other outreach campaigns and 

11 activities conducted by the Secretary.’’. 

12 (b) SOLID START PROGRAM.—Section 6320(a)(2)(A) 

13 of title 38, United States Code, is amended by inserting 

14 ‘‘, including how to enroll in the system of annual patient 

15 enrollment established and operated under section 1705 

16 of this title and the ability to seek care and services under 

17 sections 1703 and 1710 of this title’’ before the semicolon. 

18 (c) COMPTROLLER GENERAL REPORT ON OUT19 REACH.—Not later than two years after the date of the 

20 enactment of this Act, the Comptroller General of the 

21 United States shall submit to Congress a report on the 

22 efforts of the Secretary of Veterans Affairs to ensure that 

23 veterans are informed of the conditions for eligibility for 

24 care and services under section 1703 of title 38, United 

25 States Code, including such efforts to conduct outreach 
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1 pursuant to subsection (o) of such section (as added by 

2 subsection (a)). 

3 SEC. 103. ANNUAL REVIEW AND REPORT ON WAIVERS OF 

4 CERTAIN PAYMENT RATES UNDER VETERANS 

5 COMMUNITY CARE PROGRAM. 

6 (a) IN GENERAL.—Section 1703 of title 38, United 

7 States Code, is further amended— 

8 (1) by redesignating subsection (p) as sub9 section (q); and 

10 (2) by inserting after subsection (o) the fol11 lowing new subsection (p): 

12 ‘‘(p) ANNUAL REVIEW AND REPORT ON WAIVERS OF

13 PAYMENT RATES.—(1) On an annual basis, the Secretary 

14 shall— 

15 ‘‘(A) conduct a review of waivers of payment 

16 rates under subsection (i) for Third Party Adminis17 trators to identify whether such waivers help to al18 leviate community-specific challenges, including scar19 city of medical services associated with access to 

20 health care; and 

21 ‘‘(B) submit to Congress a report on the results 

22 of such review. 

23 ‘‘(2) Each report under paragraph (1)(B) shall in24 clude, with respect to the period covered by the report— 
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1 ‘‘(A) a statement, disaggregated by region, of 

2 the total number of waivers described in subpara3 graph (A) of such paragraph requested by Third 

4 Party Administrators; 

5 ‘‘(B) a statement of the total number of such 

6 waivers that were— 

7 ‘‘(i) granted by the Secretary; 

8 ‘‘(ii) denied by the Secretary; or 

9 ‘‘(iii) withdrawn by a Third Party Admin10 istrator; 

11 ‘‘(C) a description of the process for the review 

12 required under paragraph (1); 

13 ‘‘(D) a statement, disaggregated by region, of 

14 the average time to process such waivers; 

15 ‘‘(E) an assessment, disaggregated by region, of 

16 the extent to which such waivers that were granted 

17 by the Secretary improved access to health care for 

18 covered veterans; and 

19 ‘‘(F) a description of trends, if any, identified 

20 by the Secretary with respect to such waivers. 

21 ‘‘(3) In this subsection, the term ‘Third Party Ad22 ministrator’ has the meaning given such term in section 

23 1703B of this title.’’. 

24 (b) DEADLINE.—The Secretary shall submit the first 

25 report required under subsection (p) of section 1703 of 
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1 such title (as added by subsection (a)) not later than 180 

2 days after the date of the enactment of this Act. 

3 SEC. 104. MODIFICATION OF REQUIREMENTS FOR STAND4 ARDS FOR QUALITY OF CARE FROM DEPART5 MENT OF VETERANS AFFAIRS. 

6 (a) IN GENERAL.—Section 1703C of title 38, United 

7 States Code, is amended— 

8 (1) in subsection (a)— 

9 (A) in paragraph (2)— 

10 (i) by striking ‘‘In establishing’’ and 

11 inserting ‘‘(A) In establishing’’; and 

12 (ii) by adding at the end the following 

13 new subparagraph: 

14 ‘‘(B) The Secretary shall ensure that the stand15 ards for quality established under paragraph (1) are 

16 comparable to industry standards to ensure there is 

17 adequate data transference between care furnished 

18 by the Department and care furnished by a non-De19 partment provider.’’; 

20 (B) in paragraph (3)(B), by adding at the 

21 end the following new clause: 

22 ‘‘(v) Outcomes relating to patient 

23 quality of life.’’; 

24 (C) in paragraph (4)— 
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1 (i) by striking ‘‘and the Centers for 

2 Medicare & Medicaid Services’’ and insert3 ing ‘‘the Centers for Medicare & Medicaid 

4 Services, and the Indian Health Service’’; 

5 and 

6 (ii) by striking ‘‘and other nongovern7 mental entities’’ and inserting ‘‘and other 

8 non-governmental entities including Third 

9 Party Administrators’’; and 

10 (D) by striking paragraph (5) and insert11 ing the following new paragraphs: 

12 ‘‘(5) When collecting, considering, and applying data 

13 related to patient care for purposes of establishing stand14 ards for quality under paragraph (1), the Secretary shall 

15 ensure no metric is being over or under analyzed. 

16 ‘‘(6) In establishing standards for quality under para17 graph (1), the Secretary shall— 

18 ‘‘(A) utilize the most up-to-date practices for 

19 extracting and analyzing relevant data; 

20 ‘‘(B) utilize all relevant data available to the 

21 Secretary; 

22 ‘‘(C) ensure the most efficient use of time and 

23 resources related to the use of data scientists em24 ployed by the Department; and 
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1 ‘‘(D) collaborate, as appropriate, with entities 

2 specified in paragraph (4). 

3 ‘‘(7)(A) Not less frequently than once every five 

4 years, the Secretary shall update the standards for quality 

5 established under paragraph (1) pursuant to the require6 ments for the establishment of such standards under this 

7 subsection. 

8 ‘‘(B) Not later than 30 days after any date on which 

9 the Secretary updates, pursuant to subparagraph (A), the 

10 standards for quality under paragraph (1), the Secretary 

11 shall submit to the appropriate committees of Congress 

12 a report on such updated standards for quality.’’; and 

13 (2) in subsection (b)— 

14 (A) in paragraph (1)— 

15 (i) by striking ‘‘Not later than 1 year 

16 after the date on which the Secretary es17 tablishes standards for quality under sub18 section (a)’’ and inserting ‘‘Not less fre19 quently than once every three years’’; and 

20 (ii) by inserting ‘‘pursuant to stand21 ards for quality under subsection (a)’’ 

22 after ‘‘medical facilities of the Depart23 ment’’; and 

24 (B) in paragraph (2), by inserting ‘‘or up25 dates’’ after ‘‘establishes’’. 
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1 (b) DEADLINE FOR UPDATE.—The Secretary, pursu2 ant to paragraph (7) of section 1703C(a) of title 38, 

3 United States Code (as added by subsection (a)), shall 

4 make the first update to the standards for quality estab5 lished under paragraph (1) of such section not later than 

6 the date that is five years after the date on which the Sec7 retary submits the report under paragraph (2) of sub8 section (d). 

9 (c) REPORT.—Not later than one year after the date 

10 of the enactment of this Act, the Secretary of Veterans 

11 Affairs shall submit to the appropriate committees of Con12 gress a report on how the Secretary— 

13 (1) has consulted with entities specified in para14 graph (4) of section 1703C(a) of title 38, United 

15 States Code, before the date of the enactment of this 

16 Act in establishing standards for quality under such 

17 section; 

18 (2) has continued to consult with those entities 

19 on and after such date of enactment; and 

20 (3) intends to leverage data sciences to improve 

21 standards for quality care furnished by the Depart22 ment of Veterans Affairs. 

23 (d) UPDATES TO QUALITY CARE METRICS.— 

24 (1) INITIAL REPORT.—Not later than one year 

25 after the date of the enactment of this Act, the Sec-
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1 retary of Veterans Affairs shall submit to the appro2 priate committees of Congress a report on how the 

3 Secretary plans to implement the amendments made 

4 by subsections (a). 

5 (2) DEADLINE; SUMMARY REPORT.—Not later 

6 than two years after the date of the enactment of 

7 this Act, the Secretary shall— 

8 (A) implement the amendments made by 

9 subsection (a), including by updating the stand10 ards for quality established under section 

11 1703C of title 38, United States Code; and 

12 (B) submit to the appropriate committees 

13 of Congress a report detailing the standards for 

14 quality updated pursuant to such amendments. 

15 (e) AUDIT OF QUALITY CARE METRICS.— 

16 (1) IN GENERAL.—Not later than 180 days 

17 after the date of the enactment of this Act, the Sec18 retary of Veterans Affairs shall enter into one or 

19 more contracts with a non-Department entity de20 scribed in paragraph (2) to conduct an audit on the 

21 quality of care from the Department of Veterans Af22 fairs, including through non-Department health care 

23 providers pursuant to section 1703 of title 38 

24 United States Code. 
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1 (2) NON-DEPARTMENT ENTITY DESCRIBED.—A 

2 non-Department entity described in this paragraph 

3 is an entity that— 

4 (A) specializes in analyzing large-scale or5 ganizational data collection and analysis efforts, 

6 especially with respect to the health care sector; 

7 and 

8 (B) has experience and proven outcomes in 

9 optimizing the accuracy and comprehensiveness 

10 of data collection and analysis related to the 

11 quality of health care services. 

12 (3) ELEMENTS.—The audit required under 

13 paragraph (1) shall include the following: 

14 (A) An assessment of the methodology 

15 used by the Department to collect and assess 

16 data on the quality of care furnished by the De17 partment, including any vulnerabilities in such 

18 methodology. 

19 (B) An assessment of the accuracy and re20 liability of the data sources used by the Depart21 ment to compile data on the quality of care fur22 nished by the Department. 

23 (C) The extent to which the standards the 

24 Department uses to assess the quality of care 

25 furnished by the Department are— 
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1 (i) comparable with industry stand2 ards; 

3 (ii) easily accessible to, and under4 stood by— 

5 (I) veterans; 

6 (II) employees of the Depart7 ment; and 

8 (III) other individuals, as the pri9 vate sector entity considers appro10 priate. 

11 (D) Any recommendations of such private 

12 sector entity with respect to improvements that 

13 the Secretary could administer to more accu14 rately capture the quality of care furnished by 

15 the Department. 

16 (4) REPORTS ON AUDIT.— 

17 (A) REPORT ON FINDINGS AND REC18 OMMENDATIONS.—Not later than 60 days after 

19 any date on which a private sector entity de20 scribed in paragraph (2) completes an audit 

21 under paragraph (1), such private sector entity 

22 shall submit to the Secretary, the Committee on 

23 Veterans’ Affairs of the Senate, and the Com24 mittee on Veterans’ Affairs of the House of 

25 Representatives a report that includes— 
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1 (i) the findings of such audit; and 

2 (ii) recommendations of such private 

3 sector entity with respect to such audit. 

4 (B) REPORT ON PLANNED IMPROVE5 MENTS.—Not later than 60 days after any date 

6 on which the Secretary receives a report under 

7 subparagraph (A), the Secretary shall submit to 

8 the Committee on Veterans’ Affairs of the Sen9 ate and the Committee on Veterans’ Affairs of 

10 the House of Representatives a report on how 

11 the Secretary plans to improve the standards 

12 for quality of care of the Department. 

13 (f) APPROPRIATE COMMITTEES OF CONGRESS DE14 FINED.—In this section, the term ‘‘appropriate commit15 tees of Congress’’ has the meaning given such term in sec16 tion 1703C of title 38, United States Code. 

17 SEC. 105. PILOT PROGRAM TO IMPROVE ADMINISTRATION 

18 OF CARE UNDER VETERANS COMMUNITY 

19 CARE PROGRAM. 

20 (a) ESTABLISHMENT.—Pursuant to section 1703E of 

21 title 38, United States Code, the Secretary of Veterans 

22 Affairs, acting through the Center for Innovation for Care 

23 and Payment established under such section, shall carry 

24 out a pilot program to seek to develop and implement a 

25 plan— 
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1 (1) to provide monetary and non-monetary in2 centives to a covered health care provider— 

3 (A) to allow the Secretary to see the sched4 uling system of the provider, to assess the avail5 ability of, and to assist in scheduling appoint6 ments for, veterans under the Veterans Com7 munity Care Program under section 1703 of 

8 such title, including through synchronous, asyn9 chronous, and asynchronous assisted digital 

10 scheduling; 

11 (B) to complete continuing professional 

12 educational training available through the VHA 

13 TRAIN program (or any successor program or 

14 initiative) regarding veteran cultural com15 petency, the opioid safety initiative (or any suc16 cessor program or initiative), and other subjects 

17 determined appropriate by the Secretary; 

18 (C) to improve methods of accounting for 

19 non-Department training that is equivalent or 

20 substantially similar to the continuing profes21 sional educational training described in sub22 paragraph (B); 

23 (D) to improve the rate of the timely re24 turn to the Secretary of medical record docu-
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1 mentation for care or services provided under 

2 the Veterans Community Care Program; 

3 (E) to improve the timeliness and quality 

4 of the delivery of care and services to veterans 

5 under such program; and 

6 (F) to achieve other objectives determined 

7 appropriate by the Secretary; and 

8 (2) to decrease the rate of no-show appoint9 ments under such program. 

10 (b) REPORT.—Not later than one year after the date 

11 of the establishment of the pilot program under this sec12 tion, and annually thereafter during the term of the pilot 

13 program, the Secretary of Veterans Affairs shall submit 

14 to the Committees on Veterans’ Affairs of the House of 

15 Representatives and the Senate a report on the pilot pro16 gram that includes, with respect to the period covered by 

17 the report— 

18 (1) an assessment of the extent to which— 

19 (A) the system of the Department of Vet20 erans Affairs for scheduling appointments for 

21 veterans under the Veterans Community Care 

22 Program has improved; 

23 (B) the rate of timely return to the Sec24 retary of medical record documentation de-
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1 scribed in subparagraph (D) of subsection 

2 (a)(1) has improved; 

3 (C) the timeliness and quality of the deliv4 ery of care and services described in subpara5 graph (E) of such subsection has improved; and 

6 (D) the frequency of no-show appointments 

7 described in paragraph (2) of such subsection 

8 decreased; 

9 (2) a list of the continuing professional edu10 cational training courses under subparagraph (B) of 

11 such subsection available to covered health care pro12 viders; 

13 (3) the rate of participation in such continuing 

14 professional education training courses; and 

15 (4) any other matter the Secretary determines 

16 appropriate. 

17 (c) DEFINITIONS.—In this section: 

18 (1) The term ‘‘covered health care provider’’ 

19 means a health care provider— 

20 (A) described in subsection (c) of section 

21 1703 of title 38, United States Code, that fur22 nishes care or services under the Veterans Com23 munity Care Program pursuant to a contract or 

24 agreement with a Third Party Administrator; 

25 or 
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1 (B) that otherwise furnishes care or serv2 ices outside of Department facilities pursuant 

3 to a contract or agreement with the Secretary 

4 of Veterans Affairs. 

5 (2) The term ‘‘opioid safety initiative’’ means 

6 the programs, processes, and guidelines of the Vet7 erans Health Administration of the Department of 

8 Veterans Affairs relating to the management of 

9 opioid therapy and chronic pain. 

10 (3) The term ‘‘Third Party Administrator’’ 

11 means an entity that manages a network of health 

12 care providers and performs administrative services 

13 related to such network under section 1703 of such 

14 title. 

15 (4) The term ‘‘VHA TRAIN program’’ means 

16 the free program of the Veterans Health Adminis17 tration that offers veteran-specific continuing med18 ical education courses. 

19 SEC. 106. PILOT PROGRAM ON CONSOLIDATING APPROVAL 

20 PROCESS OF DEPARTMENT OF VETERANS AF21 FAIRS FOR COVERED DENTAL CARE. 

22 (a) IN GENERAL.—Not later than 180 days after the 

23 date of the enactment of this Act, the Secretary of Vet24 erans Affairs, acting through the Center for Innovation 

25 for Care and Payment established under section 1703E 
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1 of title 38, United States Code, shall carry out a pilot pro2 gram under which the Secretary shall hire— 

3 (1) general dentists at medical facilities of the 

4 Department of Veterans Affairs to manage approval 

5 by the Department of treatment plans requested by 

6 dental providers in providing covered dental care; 

7 and 

8 (2) dental specialists at Veterans Integrated 

9 Service Networks of the Department to manage ap10 proval by the Department of treatment plans for 

11 specialty dental care requested by dental providers 

12 in providing covered dental care. 

13 (b) LOCATIONS.—The Secretary shall carry out the 

14 pilot program in not fewer than two Veterans Integrated 

15 Service Networks of the Department. 

16 (c) REPORTS.— 

17 (1) INITIAL REPORT.—Not later than one year 

18 after the date of the commencement of such pilot 

19 program, the Secretary shall submit to the Commit20 tees on Veterans’ Affairs of the Senate and the 

21 House of Representatives a report on the pilot pro22 gram, that includes— 

23 (A) an identification of the Veterans Inte24 grated Service Networks participating in such 

25 pilot program; 
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1 (B) a description of the implementation of 

2 such pilot program; 

3 (C) an identification of any barriers or 

4 challenges to implementing such pilot program; 

5 (D) an assessment of the efficacy of hiring 

6 general dentists and dental specialists pursuant 

7 to such pilot program; 

8 (E) aggregated feedback with respect to 

9 such pilot program from dentists of the Depart10 ment in Veterans Integrated Service Networks 

11 participating in such pilot program; and 

12 (F) aggregated feedback from dental pro13 viders providing covered dental care within such 

14 Veterans Integrated Service Networks regard15 ing any changes in the timeliness of treatment 

16 plan approvals by the Department. 

17 (2) FINAL REPORT.—Not later than 90 days 

18 before the date of the completion of such pilot pro19 gram, the Secretary shall submit to the Committees 

20 on Veterans’ Affairs of the Senate and the House of 

21 Representatives a report on the pilot program that— 

22 (A) includes, with respect to the period 

23 covered by the report, each element of the re24 port required under paragraph (1) described in 
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1 subparagraphs (A) through (F) of such para2 graph; 

3 (B) includes recommendations of the Sec4 retary on whether the pilot program should 

5 be— 

6 (i) extended; 

7 (ii) expanded; or 

8 (iii) adopted throughout the Depart9 ment; and 

10 (C) indicates whether the Secretary re11 quests action by Congress to make the pilot 

12 program permanent. 

13 (d) SUNSET.—The authority to carry out the pilot 

14 program under this section shall terminate on the date 

15 that is two years after the date of the enactment of this 

16 Act. 

17 (e) COVERED DENTAL CARE DEFINED.—In this sec18 tion, the term ‘‘covered dental care’’ means dental care 

19 provided— 

20 (1) under section 1703 of title 38, United 

21 States Code; or 

22 (2) pursuant to a Veterans Care Agreement 

23 under section 1703A of such title. 
26 

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1 SEC. 107. STRATEGIC PLAN ON VALUE-BASED HEALTH 

2 CARE SYSTEM FOR VETERANS HEALTH AD3 MINISTRATION; PILOT PROGRAM. 

4 (a) ESTABLISHMENT OF WORKING GROUP.— 

5 (1) IN GENERAL.—Not later than one year 

6 after the date of the enactment of this Act, the Sec7 retary of Veterans Affairs shall— 

8 (A) establish a working group on value9 based care; and 

10 (B) submit to the Committees on Veterans’ 

11 Affairs of the House of Representatives and the 

12 Senate the strategic plan developed by the 

13 working group pursuant to subsection (b). 

14 (2) MEMBERSHIP.— 

15 (A) REQUIRED MEMBERS.—The working 

16 group shall include, at a minimum, the fol17 lowing members: 

18 (i) The Under Secretary for Health of 

19 the Department of Veterans Affairs. 

20 (ii) The Director of the Office of Men21 tal Health and Suicide Prevention of the 

22 Department of Veterans Affairs (or any 

23 successor office). 

24 (iii) The Director of the Office of In25 tegrated Veteran Care of the Department 

26 (or any successor office). 
27 

†S 141 ES

1 (iv) The Director of the Office of 

2 Rural Health of the Department (or any 

3 successor office). 

4 (v) The Director of the Office of Con5 nected Care of the Department (or any 

6 successor office). 

7 (vi) The Assistant Secretary for the 

8 Office of Information Technology (or any 

9 successor office). 

10 (vii) The Chief Officer of the Office of 

11 Healthcare Innovation and Learning of the 

12 Office of Discovery, Education, and Affil13 iate Networks of the Veterans Health Ad14 ministration (or any successor office). 

15 (viii) An individual designated by the 

16 Secretary from the Center for Innovation 

17 for Care and Payment of the Department 

18 under section 1703E of title 38, United 

19 States Code. 

20 (ix) An individual designated by the 

21 Administrator of the Centers for Medicare 

22 & Medicaid Services from the Center for 

23 Medicare and Medicaid Innovation. 

24 (x) An individual designated by the 

25 Secretary of Health and Human Services 
28 

†S 141 ES

1 from the Federal Office of Rural Health 

2 Policy of the Health Resources and Serv3 ices Administration. 

4 (xi) The Chief of Human Capital 

5 Management for the Veterans Health Ad6 ministration. 

7 (xii) An individual designated by the 

8 Secretary of Defense that is a representa9 tive of the Defense Health Agency. 

10 (xiii) An individual selected by the 

11 Secretary of Veterans Affairs from the spe12 cial medical advisory group established 

13 under section 7312 of title 38, United 

14 States Code. 

15 (B) OPTIONAL MEMBERS.—The Secretary 

16 of Veterans Affairs may appoint any of the fol17 lowing individuals as members of the working 

18 group: 

19 (i) An individual representing the 

20 Health and Medicine Division of the Na21 tional Academies of Sciences, Engineering, 

22 and Medicine. 

23 (ii) Three individuals representing a 

24 private health care system that has made 

25 the transition to value-based care. 
29 

†S 141 ES

1 (iii) Three individuals representing an 

2 organization recognized by the Secretary of 

3 Veterans Affairs under section 5902 of 

4 title 38, United States Code. 

5 (3) PUBLIC AVAILABILITY.—All meetings delib6 erations, and products of the working group shall be 

7 made publicly available throughout the duration of 

8 the working group, including to individuals rep9 resenting organizations recognized by the Secretary 

10 of Veterans Affairs under section 5902 of title 38, 

11 United States Code. 

12 (4) EXEMPTION FROM FACA.—Chapter 10 of 

13 title 5, United States Code, shall not apply to the 

14 working group established under paragraph (1). 

15 (b) DEVELOPMENT OF STRATEGIC PLAN.—The 

16 working group shall develop a strategic plan to implement 

17 value-based care into the Veterans Health Administration 

18 that includes the following: 

19 (1) An identification of the state of the Vet20 erans Health Administration as of the date of the 

21 enactment of this Act, including an assessment of 

22 the current model of health care delivery used by the 

23 Veterans Health Administration in medical facilities 

24 of the Department of Veterans Affairs. 
30 

†S 141 ES

1 (2) An assessment of the capacity needs of the 

2 Veterans Health Administration during the five-year 

3 period beginning on the date of the enactment of 

4 this Act. 

5 (3) An analysis of the leadership of the Vet6 erans Health Administration, including an assess7 ment of leadership acumen and ability to implement 

8 a clear, shared vision and effective change manage9 ment and care coordination. 

10 (4) An identification of goals for the future of 

11 the Veterans Health Administration. 

12 (5) An identification and classification of the 

13 current capabilities, capacity, and gaps in access and 

14 quality of the health care system of the Department 

15 of Veterans Affairs. 

16 (6) An analysis of value-based care models, in17 cluding— 

18 (A) a selection of potential models that 

19 would best work for the Veterans Health Ad20 ministration; 

21 (B) the capacity and capabilities of each 

22 such model; and 

23 (C) a thorough justification of the selection 

24 of each selected model, including a summary of 
31 

†S 141 ES

1 the ability of such model to improve the metrics 

2 described under paragraph (9). 

3 (7) A definition of what quality means with re4 spect to— 

5 (A) access to health care under the laws 

6 administered by the Secretary of Veterans Af7 fairs; and 

8 (B) delivery of such health care. 

9 (8) A definition of what value means with re10 spect to care furnished by the Veterans Health Ad11 ministration, 

12 (9) A system for measuring value within the 

13 Veterans Health Administration that includes 

14 metrics for— 

15 (A) outcomes; 

16 (B) safety; 

17 (C) service; 

18 (D) access; 

19 (E) productivity; 

20 (F) capacity; and 

21 (G) total cost of patient care. 

22 (10) With respect to the system described in 

23 subparagraph (H), an analysis of variable value with 

24 respect to patient outcomes across different health 

25 care types and specialties. 
32 

†S 141 ES

1 (11) An assessment of— 

2 (A) previous or ongoing assessments of the 

3 current information technology infrastructure of 

4 the Veterans Health Administration, includ5 ing— 

6 (i) such assessments conducted pursu7 ant to the Electronic Health Record Mod8 ernization program of the Department of 

9 Veterans Affairs; and 

10 (ii) any other ongoing information 

11 technology modernization programs of such 

12 Department and any unimplemented rel13 evant recommendations from such assess14 ments; 

15 (B) the information technology infrastruc16 ture of the Veterans Health Administration in 

17 effect as of the date of the enactment of this 

18 Act; 

19 (C) the value-driven framework of the De20 partment, in effect as of the date of the enact21 ment of this Act, for evaluating health care in22 novations, and how improvements in such 

23 framework could be used to encourage innova24 tion; and 
33 

†S 141 ES

1 (D) workforce challenges and needs of the 

2 Veterans Health Administration based on— 

3 (i) reviews of workforce assessment 

4 data available as of the date of the enact5 ment of this Act; and 

6 (ii) the findings of— 

7 (I) the report required by section 

8 301(d) of the Veterans Access, 

9 Choice, and Accountability Act of 

10 2014 (Public Law 113–146); 

11 (II) the reports required by sec12 tion 505 of the John S. McCain III, 

13 Daniel K. Akaka and Samuel R. 

14 Johnson VA Maintaining Internal 

15 Systems and Strengthening Inte16 grated Outside Networks Act of 2018 

17 (Public Law 115–182); 

18 (III) the report required by sec19 tion 301 of the VA Choice and Qual20 ity Employment Act of 2017 (Public 

21 Law 115–46); and 

22 (IV) any comprehensive health 

23 care inspection conducted by the In24 spector General of the Department of 
34 

†S 141 ES

1 Veterans Affairs as of the date of the 

2 enactment of this Act. 

3 (12) Any recommendations of the working 

4 group with respect to improving the information 

5 technology infrastructure described in clause (i) of 

6 subparagraph (J). 

7 (13) An analysis of how the value-driven frame8 work described in clause (iii) of such subparagraph 

9 could be used to improve the model of care delivery 

10 by the Department. 

11 (14) A description of how a value-based care 

12 system would apply to primary care, inpatient and 

13 outpatient mental health care, and inpatient and 

14 outpatient substance use treatment, spinal cord in15 jury disorder care, and polytrauma care furnished by 

16 the Veterans Health Administration. 

17 (15) With respect to legislative or administra18 tive action necessary to incorporate value-based care 

19 models into the Veterans Health Administration, a 

20 description of the estimated timelines, effect on 

21 workforce, and costs. 

22 (c) PILOT PROGRAM.— 

23 (1) IN GENERAL.—Not later than 180 days 

24 after the submission of the strategic plan pursuant 

25 to subsection (b), the Secretary of Veterans Affairs, 
35 

†S 141 ES

1 acting through the Center for Innovation for Care 

2 and Payment established under section 1703E of 

3 title 38, United States Code, shall commence a 

4 three-year pilot program under which the Secretary 

5 shall implement the elements of such strategic plan 

6 relating to the delivery, by the Veterans Health Ad7 ministration, of primary care, inpatient and out8 patient mental health treatment, inpatient and out9 patient substance abuse treatment, spinal cord in10 jury disorder care, and polytrauma care. 

11 (2) LOCATIONS.—The Secretary shall carry out 

12 such pilot program in four Veterans Integrated 

13 Service Networks that are geographically dispersed 

14 and shall include the following: 

15 (A) A Veterans Integrated Service Net16 work that predominately serves veterans in 

17 rural and highly rural areas. 

18 (B) A Veterans Integrated Service Net19 work that predominately serves veterans in 

20 urban areas. 

21 (C) A Veterans Integrated Service Net22 work that has a high rate of suicide among vet23 erans. 
36 

†S 141 ES

1 (D) A Veterans Integrated Service Net2 work that has a high rate of substance use dis3 order among veterans. 

4 (E) A Veterans Integrated Service Net5 work that has access or productivity challenges. 

6 (3) REPORTS TO CONGRESS.— 

7 (A) ANNUAL REPORT.—Not later than one 

8 year after the commencement of the pilot pro9 gram, and annually thereafter during the dura10 tion of the pilot program, the Secretary shall 

11 submit to Congress a report on the pilot pro12 gram. 

13 (B) FINAL REPORT.—Not later than 90 

14 days before the conclusion of the pilot program, 

15 the Secretary shall submit to Congress a final 

16 report on the pilot program that includes— 

17 (i) lessons learned during the adminis18 tration of such pilot program; and 

19 (ii) specific health outcomes in veteran 

20 patient care compared to the Veterans 

21 Health Administration system of care in 

22 effect as of the date of the enactment of 

23 this Act. 
37 

†S 141 ES

1 SEC. 108. PLAN ON ADOPTION OF CERTAIN HEALTH INFOR2 MATION STANDARDS FOR DEPARTMENT OF 

3 VETERANS AFFAIRS AND CERTAIN HEALTH 

4 CARE PROVIDERS. 

5 (a) PLAN FOR CERTAIN HEALTH INFORMATION

6 STANDARDS.— 

7 (1) IN GENERAL.—The Secretary of Veterans 

8 Affairs, in consultation with the Secretary of Health 

9 and Human Services, the Administrator of the Cen10 ters for Medicare & Medicaid Services, and the Na11 tional Coordinator for Health Information Tech12 nology of the Department of Health and Human 

13 Services, shall create and implement a plan to adopt, 

14 as rapidly and to the most comprehensive extent fea15 sible, national health information interoperability 

16 standards for the Department of Veterans Affairs 

17 and community care providers with respect to— 

18 (A) coordination of— 

19 (i) care; and 

20 (ii) benefits; 

21 (B) patient identity matching; 

22 (C) measurement and reporting of quality; 

23 (D) population health; and 

24 (E) public health. 
38 

†S 141 ES

1 (2) CONSIDERATION.—In developing the plan 

2 under paragraph (1), the Secretary of Veterans Af3 fairs shall consider challenges faced by— 

4 (A) small community care providers; and 

5 (B) community care providers located in 

6 rural areas. 

7 (b) PLAN ON ELECTRONIC HEALTH RECORD EX8 CHANGE.— 

9 (1) IN GENERAL.—Not later than one year 

10 after the date of enactment of this Act, the Sec11 retary shall submit to the Committees on Veterans’ 

12 Affairs of the Senate and the House of Representa13 tives a plan to provide, at no cost, to community 

14 care providers of the Department, through Third 

15 Party Administrators, a capability to facilitate the 

16 electronic direct exchange, between such providers 

17 and the Department, of— 

18 (A) the health records of veterans; and 

19 (B) documents relating to health care of 

20 veterans, clinical notes, and any other informa21 tion the Secretary determines necessary. 

22 (2) PRIORITIZATION.—In developing the plan 

23 required under paragraph (1), the Secretary shall 

24 prioritize providing the capability described in such 

25 paragraph to community care providers that— 
39 

†S 141 ES

1 (A) provide care under the laws adminis2 tered by the Secretary to— 

3 (i) a lower volume of veterans; and 

4 (ii) veterans who are located in rural 

5 areas; and 

6 (B) are unable or unwilling to exchange 

7 the records and documents described in sub8 paragraphs (A) and (B) of such paragraph with 

9 the Department through standards-based or di10 rect exchange mechanisms in effect as of the 

11 date of the enactment of this Act. 

12 (c) REPORTS ON PLAN FOR INTEROPERABILITY

13 STANDARDS.— 

14 (1) INITIAL REPORT.—Not later than one year 

15 after the date of the enactment of this Act, the Sec16 retary of Veterans Affairs shall submit to the Com17 mittees on Veterans’ Affairs of the Senate and the 

18 House of Representatives— 

19 (A) the plan required by subsection (a); 

20 and 

21 (B) a report that includes— 

22 (i) an analysis of gaps, if any, be23 tween the use, by the Department and 

24 other agencies, health information ex25 changes, and technology companies, of na-
40 

†S 141 ES

1 tional health information interoperability 

2 standards and the potential, or optimal, 

3 use of such national health information 

4 interoperability standards; 

5 (ii) an analysis and description of the 

6 participation by the Department, commu7 nity care providers, and other relevant en8 tities in the Trusted Exchange Framework 

9 and Common Agreement program of the 

10 Department of Health and Human Serv11 ices as of the date of the enactment of this 

12 Act; 

13 (iii) recommendations of the Secretary 

14 with respect to development of health in15 formation interoperability standards; 

16 (iv) timelines or schedules to imple17 ment the plan required by subsection (a); 

18 and 

19 (v) an identification of any legislative 

20 authorities or resources the Secretary re21 quires to implement such plan. 

22 (2) RECURRING REPORT REQUIREMENT.— 

23 (A) IN GENERAL.—Not later than 18 

24 months after the date of the enactment of this 

25 Act, and every 180 days thereafter for four 
41 

†S 141 ES

1 years, the Secretary of Veterans Affairs shall 

2 submit to Committees on Veterans’ Affairs of 

3 the Senate and the House of Representatives a 

4 report on the status of implementation of the 

5 plan required under subsection (a). 

6 (B) ELEMENTS OF SUBSEQUENT RE7 PORTS.—Each report under subparagraph (A) 

8 submitted after the date on which the first re9 port required by such subparagraph is sub10 mitted shall include a description of any revi11 sions to— 

12 (i) the plan required by subsection (a) 

13 made during the period covered by the re14 port; and 

15 (ii) the analysis, recommendations, 

16 timelines, and legislative authorities re17 ported pursuant to paragraph (1). 

18 (d) DEFINITIONS.—In this section: 

19 (1) The term ‘‘community care provider’’ means 

20 a non-Department health care provider providing 

21 care (including dental care)— 

22 (A) under section 1703 of title 38, United 

23 States Code; 

24 (B) pursuant to a Veterans Care Agree25 ment under section 1703A of such title; or 
42 

†S 141 ES

1 (C) under any other law administered by 

2 the Secretary of Veterans Affairs. 

3 (2) The term ‘‘Third Party Administrator’’ 

4 means an entity that manages a provider network 

5 and performs administrative services related to such 

6 network under section 1703 of title 38, United 

7 States Code. 

8 SEC. 109. REPORT ON USE OF VALUE-BASED REIMBURSE9 MENT MODELS UNDER VETERANS COMMU10 NITY CARE PROGRAM. 

11 (a) REPORT ON VALUE-BASED REIMBURSEMENT

12 MODELS.—Not later than one year after the date of the 

13 enactment of this Act, the Secretary of Veterans Affairs, 

14 in consultation with the Center for Innovation for Care 

15 and Payment of the Department of Veterans Affairs under 

16 section 1703E of title 38 United States Code, the Office 

17 of Integrated Veteran Care of the Department, or suc18 cessor office, and Third Party Administrators, shall sub19 mit to the Committees on Veterans’ Affairs of the House 

20 of Representatives and the Senate a report containing— 

21 (1) an assessment of the efforts of the Depart22 ment pursuant to section 1703(i)(5) of such title, to 

23 incorporate value-based reimbursement models under 

24 the Veterans Community Care Program to promote 

25 the provision of high-quality care to veterans; and 
43 

†S 141 ES

1 (2) such recommendations for legislative or ad2 ministrative action as the Secretary considers appro3 priate regarding the use of value-based reimburse4 ment models throughout the Veterans Community 

5 Care Program under section 1703 of such title. 

6 (b) RULE OF CONSTRUCTION.—This section shall not 

7 be construed to be a pilot program subject to the require8 ments of section 1703E of title 38, United States Code. 

9 (c) THIRD PARTY ADMINISTRATOR DEFINED.—In 

10 this section, the term ‘‘Third Party Administrator’’ means 

11 an entity that manages a provider network and performs 

12 administrative services related to such network under sec13 tion 1703 of title 38, United States Code. 

14 SEC. 110. INSPECTOR GENERAL ASSESSMENT OF IMPLE15 MENTATION OF VETERANS COMMUNITY 

16 CARE PROGRAM. 

17 (a) IN GENERAL.—Not later than 18 months after 

18 the date of the enactment of this Act, and periodically 

19 thereafter, the Inspector General shall assess the perform20 ance of the Department of Veterans Affairs in— 

21 (1) appropriately identifying veterans eligible 

22 for care and services under section 1703 of title 38, 

23 United States Code; 

24 (2) informing veterans of their eligibility for 

25 such care and services; and 
44 

†S 141 ES

1 (3) delivering such care and services in a timely 

2 manner. 

3 (b) BRIEFING ON ASSESSMENTS.—Upon the submis4 sion of the assessment required by subsection (a), the In5 spector General of the Department of Veterans Affairs 

6 shall provide to the Committees on Veterans Affairs of the 

7 House of Representatives and the Senate a briefing on the 

8 results of such assessment. 

9 SEC. 111. COMPTROLLER GENERAL REPORT ON DENTISTRY 

10 UNDER VETERANS COMMUNITY CARE PRO11 GRAM. 

12 (a) IN GENERAL.—Not later than one year after the 

13 date of the enactment of this Act, the Comptroller General 

14 of the United States shall submit to the Committees on 

15 Veterans’ Affairs of the Senate and the House of Rep16 resentatives a report on dental care furnished by the Sec17 retary of Veterans Affairs under the Veterans Community 

18 Care Program under section 1703 of title 38, United 

19 States Code, that includes a review of— 

20 (1) the impact current reimbursement rates 

21 provided by the Department of Veterans Affairs to 

22 dental providers under such program have on— 

23 (A) the availability of dental care for vet24 erans; and 
45 

†S 141 ES

1 (B) the ability of Third Party Administra2 tors to meet their contractual obligations for 

3 network adequacy; 

4 (2) the satisfaction of dental providers pro5 viding dental care under such program with the 

6 processes of the Department for approving dental 

7 care under such program; and 

8 (3) the current processes of the Department for 

9 approving emergent dental care under such program. 

10 (b) THIRD PARTY ADMINISTRATOR DEFINED.—In 

11 this section, the term ‘‘Third Party Administrator’’ means 

12 an entity that manages a provider network and performs 

13 administrative services related to such network under sec14 tion 1703 of title 38, United States Code. 

15 Subtitle B—Matters Relating to 

16 Nursing Home and Other Long 

17 Term Care and Family Care18 givers 

19 SEC. 120. INCREASE OF EXPENDITURE CAP FOR NON20 INSTITUTIONAL CARE ALTERNATIVES TO 

21 NURSING HOME CARE. 

22 (a) INCREASE OF EXPENDITURE CAP.—Section 

23 1720C(d) of title 38, United States Code, is amended— 
46 

†S 141 ES

1 (1) by striking ‘‘The total cost’’ and inserting 

2 ‘‘(1) Except as provided in paragraph (2), the total 

3 cost’’; 

4 (2) by striking ‘‘65 percent’’ and inserting ‘‘100 

5 percent’’; and 

6 (3) by adding at the end the following new 

7 paragraph: 

8 ‘‘(2)(A) The total cost of providing services or in-kind 

9 assistance in the case of any veteran described in subpara10 graph (B) for any fiscal year under the program may ex11 ceed 100 percent of the cost that would otherwise have 

12 been incurred as specified in paragraph (1) if the Sec13 retary determines, based on a consideration of clinical 

14 need, geographic market factors, and such other matters 

15 as the Secretary may prescribe through regulation, that 

16 such higher total cost is in the best interest of the veteran. 

17 ‘‘(B) A veteran described in this subparagraph is a 

18 veteran with amyotrophic lateral sclerosis, a spinal cord 

19 injury, or a condition the Secretary determines to be simi20 lar to such conditions.’’. 

21 (b) APPLICABILITY.—The amendments made by sub22 section (a) shall apply with respect to fiscal years begin23 ning on or after the date of the enactment of this Act. 
47 

†S 141 ES

1 SEC. 121. COORDINATION WITH PROGRAM OF ALL-INCLU2 SIVE CARE FOR THE ELDERLY. 

3 Section 1720C of title 38, United States Code, as 

4 amended by section 120, is further amended by adding 

5 at the end the following new subsection: 

6 ‘‘(f) In furnishing services to a veteran under the pro7 gram conducted pursuant to subsection (a), if a medical 

8 center of the Department through which such program is 

9 administered is located in a geographic area in which serv10 ices are available to the veteran under a PACE program 

11 (as such term is defined in sections 1894(a)(2) and 

12 1934(a)(2) of the Social Security Act (42 U.S.C. 

13 1395eee(a)(2); 1396u–4(a)(2))), the Secretary shall seek 

14 to enter into an agreement with the PACE program oper15 ating in that area for the furnishing of such services.’’. 

16 SEC. 122. AUTHORITY FOR SECRETARY OF VETERANS AF17 FAIRS TO AWARD GRANTS OR CONTRACTS TO 

18 ENTITIES TO IMPROVE PROVISION OF MEN19 TAL HEALTH SUPPORT TO FAMILY CARE20 GIVERS OF VETERANS. 

21 Subchapter II of chapter 17 of title 38, United States 

22 Code, is amended by adding at the end the following new 

23 section (and conforming the table of sections at the begin24 ning of such chapter accordingly): 
48 

†S 141 ES

1 ‘‘§ 1720K. Grants or contracts to provide mental 

2 health support to family caregivers of 

3 veterans 

4 ‘‘(a) AUTHORITY.—The Secretary may award grants 

5 or contracts to carry out, coordinate, improve, or other6 wise enhance mental health counseling, treatment, or sup7 port to the family caregivers of veterans participating in 

8 the family caregiver program. 

9 ‘‘(b) APPLICATION.—(1) To be eligible for a grant or 

10 contract under this section, an entity shall submit to the 

11 Secretary an application therefor at such time, in such 

12 manner, and containing such information as the Secretary 

13 may require. 

14 ‘‘(2) Each application submitted under paragraph (1) 

15 shall include the following: 

16 ‘‘(A) A detailed plan for the use of the grant 

17 or contract. 

18 ‘‘(B) A description of the programs or efforts 

19 through which the entity will meet the outcome 

20 measures developed by the Secretary under sub21 section (f). 

22 ‘‘(C) A description of how the entity will dis23 tribute grant or contract amounts equitably among 

24 areas with varying levels of urbanization. 

25 ‘‘(D) A plan for how the grant or contract will 

26 be used to meet the unique needs of veterans resid-
49 

†S 141 ES

1 ing in rural areas, Native American, Native Hawai2 ian, or Alaska Native veterans, elderly veterans, 

3 women veterans, and veterans from other under4 served communities. 

5 ‘‘(c) DISTRIBUTION.—The Secretary shall seek to en6 sure that grants and contracts awarded under this section 

7 are equitably distributed among entities located in States 

8 with varying levels of urbanization. 

9 ‘‘(d) PRIORITY.—The Secretary shall prioritize 

10 awarding grants or contracts under this section that will 

11 serve the following areas: 

12 ‘‘(1) Areas with high rates of veterans enrolled 

13 in the family caregiver program. 

14 ‘‘(2) Areas with high rates of— 

15 ‘‘(A) suicide among veterans; or 

16 ‘‘(B) referrals to the Veterans Crisis Line. 

17 ‘‘(e) REQUIRED ACTIVITIES.—Any grant or contract 

18 awarded under this section shall be used— 

19 ‘‘(1) to expand existing programs, activities, 

20 and services; 

21 ‘‘(2) to establish new or additional programs, 

22 activities, and services; or 

23 ‘‘(3) for travel and transportation to facilitate 

24 carrying out paragraph (1) or (2). 
50 

†S 141 ES

1 ‘‘(f) OUTCOME MEASURES.—(1) The Secretary shall 

2 develop and provide to each entity that receives a grant 

3 or contract under this section written guidance on the fol4 lowing: 

5 ‘‘(A) Outcome measures. 

6 ‘‘(B) Policies of the Department. 

7 ‘‘(2) In developing outcome measures under para8 graph (1), the Secretary shall consider the following goals: 

9 ‘‘(A) Increasing the utilization of mental health 

10 services among family caregivers of veterans partici11 pating in the family caregiver program. 

12 ‘‘(B) Reducing barriers to mental health serv13 ices among family caregivers of veterans partici14 pating in such program. 

15 ‘‘(g) TRACKING REQUIREMENTS.—(1) The Secretary 

16 shall establish appropriate tracking requirements with re17 spect to the entities receiving a grant or contract under 

18 this section. 

19 ‘‘(2) Not less frequently than annually, the Secretary 

20 shall submit to Congress a report on such tracking re21 quirements. 

22 ‘‘(h) PERFORMANCE REVIEW.—The Secretary 

23 shall— 

24 ‘‘(1) review the performance of each entity that 

25 receives a grant or contract under this section; and 
51 

†S 141 ES

1 ‘‘(2) make information regarding such perform2 ance publicly available. 

3 ‘‘(i) REMEDIATION PLAN.—(1) In the case of an enti4 ty that receives a grant or contract under this section and 

5 does not meet the outcome measures developed by the Sec6 retary under subsection (f), the Secretary shall require the 

7 entity to submit to the Secretary a remediation plan under 

8 which the entity shall describe how and when it plans to 

9 meet such outcome measures. 

10 ‘‘(2) The Secretary may not award a subsequent 

11 grant or contract under this section to an entity described 

12 in paragraph (1) unless the Secretary approves the reme13 diation plan submitted by the entity under such para14 graph. 

15 ‘‘(j) MAXIMUM AMOUNT.—The amount of a grant or 

16 contract awarded under this section may not exceed 10 

17 percent of amounts made available for grants or contracts 

18 under this section for the fiscal year in which the grant 

19 or contract is awarded. 

20 ‘‘(k) SUPPLEMENT, NOT SUPPLANT.—Any grant or 

21 contract awarded under this section shall be used to sup22 plement and not supplant funding that is otherwise avail23 able through the Department to provide mental health 

24 support among family caregivers of veterans participating 

25 in the family caregiver program. 
52 

†S 141 ES

1 ‘‘(l) OUTREACH TO FAMILY CAREGIVERS.—The Sec2 retary shall include, in the outreach materials regularly 

3 provided to a family caregiver who participates in the fam4 ily caregiver program, notice of mental health support pro5 vided by recipients of grants or contracts under this sec6 tion that are located in the relevant Veterans Integrated 

7 Service Network. 

8 ‘‘(m) FUNDING.—(1) Amounts for the activities of 

9 the Department under this section shall be budgeted and 

10 appropriated through a separate appropriation account. 

11 ‘‘(2) In the budget justification materials submitted 

12 to Congress in support of the budget of the Department 

13 for any fiscal year (as submitted with the budget of the 

14 President under section 1105(a) of title 31), the Secretary 

15 shall include a separate statement of the amount re16 quested to be appropriated for that fiscal year for the ac17 count specified in paragraph (1). 

18 ‘‘(n) AUTHORIZATION OF APPROPRIATIONS.—There 

19 is authorized to be appropriated to the Secretary, for each 

20 of fiscal years 2025 and 2026, $10,000,000 to carry out 

21 this section. 

22 ‘‘(o) DEFINITIONS.—In this section: 

23 ‘‘(1) The terms ‘caregiver’ and ‘family care24 giver’ have the meanings given those terms in sec25 tion 1720G of this title. 
53 

†S 141 ES

1 ‘‘(2) The term ‘family caregiver program’ 

2 means the program of comprehensive assistance for 

3 family caregivers under section 1720G of this title. 

4 ‘‘(3) The term ‘Veterans Crisis Line’ means the 

5 toll-free hotline for veterans established under sec6 tion 1720F of this title.’’. 

7 SEC. 123. HOME- AND COMMUNITY-BASED SERVICES: PRO8 GRAMS. 

9 (a) PROGRAMS.—Such subchapter is further amend10 ed by inserting after section 1720K (as added by section 

11 122) the following new section (and conforming the table 

12 of sections at the beginning of such chapter accordingly): 

13 ‘‘§ 1720L. Home- and community-based services: pro14 grams 

15 ‘‘(a) IN GENERAL.—In furnishing noninstitutional al16 ternatives to nursing home care pursuant to the authority 

17 of section 1720C of this title (or any other authority under 

18 this chapter or other provision of law administered by the 

19 Secretary of Veterans Affairs), the Secretary shall carry 

20 out each of the programs specified in this section in ac21 cordance with such relevant authorities except as other22 wise provided in this section. 

23 ‘‘(b) VETERAN-DIRECTED CARE PROGRAM.—(1) The 

24 Secretary of Veterans Affairs, in collaboration with the 

25 Secretary of Health and Human Services, shall carry out 
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1 a program to be known as the ‘Veteran-Directed Care pro2 gram’. Under such program, the Secretary of Veterans Af3 fairs may enter into agreements with the providers de4 scribed in paragraph (2) to provide to eligible veterans 

5 funds, to the extent practicable, to obtain such in-home 

6 care services and related items that support clinical need 

7 and improve quality of life, as may be determined appro8 priate by the Secretary of Veterans Affairs and selected 

9 by the veteran, including through the veteran hiring indi10 viduals to provide such services and items or directly pur11 chasing such services and items. 

12 ‘‘(2) The providers described in this paragraph are 

13 the following: 

14 ‘‘(A) An Aging and Disability Resource Center, 

15 an area agency on aging, or a State agency. 

16 ‘‘(B) A center for independent living. 

17 ‘‘(C) An Indian tribe or tribal organization re18 ceiving assistance under title VI of the Older Ameri19 cans Act of 1965 (42 U.S.C. 3057 et seq.). 

20 ‘‘(D) Any other entity that the Secretary, in 

21 consultation with the Secretary of Health and 

22 Human Services, determines appropriate. 

23 ‘‘(3) In carrying out the Veteran-Directed Care pro24 gram, the Secretary of Veterans Affairs shall— 
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1 ‘‘(A) administer such program through each 

2 medical center of the Department of Veterans Af3 fairs; 

4 ‘‘(B) seek to ensure the availability of such pro5 gram in American Samoa, Guam, the Common6 wealth of the Northern Mariana Islands, the Com7 monwealth of Puerto Rico, the Virgin Islands of the 

8 United States, and any other territory or possession 

9 of the United States, to the extent practicable; and 

10 ‘‘(C) seek to ensure the availability of such pro11 gram for eligible veterans who are Native American 

12 veterans receiving care and services furnished by the 

13 Indian Health Service, a tribal health program, an 

14 Urban Indian organization, or (in the case of a Na15 tive Hawaiian veteran) a Native Hawaiian health 

16 care system, to the extent practicable. 

17 ‘‘(4) If a veteran participating in the Veteran-Di18 rected Care program is hospitalized, the veteran may con19 tinue to use funds under the program during a period of 

20 hospitalization in the same manner that the veteran would 

21 be authorized to use such funds under the program if the 

22 veteran were not hospitalized. 

23 ‘‘(c) HOMEMAKER AND HOME HEALTH AIDE PRO24 GRAM.—(1) The Secretary shall carry out a program to 

25 be known as the ‘Homemaker and Home Health Aide pro-
56 

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1 gram’ under which the Secretary may enter into agree2 ments with home health agencies to provide to eligible vet3 erans such home health aide services as may be deter4 mined appropriate by the Secretary. 

5 ‘‘(2) In carrying out the Homemaker and Home 

6 Health Aide program, the Secretary shall— 

7 ‘‘(A) administer such program in the locations 

8 specified in subparagraph (A) of subsection (b)(3); 

9 ‘‘(B) seek to ensure the availability of such pro10 gram in the locations specified in subparagraph (B) 

11 of subsection (b)(3); and 

12 ‘‘(C) seek to ensure the availability of such pro13 gram for the veteran populations specified in sub14 paragraph (C) of subsection (b)(3). 

15 ‘‘(d) HOME-BASED PRIMARY CARE PROGRAM.—The 

16 Secretary shall carry out a program to be known as the 

17 ‘Home-Based Primary Care program’ under which the 

18 Secretary may furnish to eligible veterans in-home health 

19 care, the provision of which is overseen by a provider of 

20 the Department. 

21 ‘‘(e) PURCHASED SKILLED HOME CARE PROGRAM.— 

22 The Secretary shall carry out a program to be known as 

23 the ‘Purchased Skilled Home Care program’ under which 

24 the Secretary may furnish to eligible veterans such in- 
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1 home care services as may be determined appropriate and 

2 selected by the Secretary for the veteran. 

3 ‘‘(f) CAREGIVER SUPPORT.—(1) With respect to a 

4 resident eligible caregiver of a veteran participating in a 

5 program under this section, the Secretary shall— 

6 ‘‘(A) if the veteran meets the requirements of 

7 a covered veteran under section 1720G(b) of this 

8 title, provide to such caregiver the option of enroll9 ing in the program of general caregiver support serv10 ices under such section; 

11 ‘‘(B) provide to such caregiver covered respite 

12 care of not less than 30 days annually; and 

13 ‘‘(C) conduct on an annual basis (and, to the 

14 extent practicable, in connection with in-person serv15 ices provided under the program in which the vet16 eran is participating), a wellness contact of such 

17 caregiver. 

18 ‘‘(2) Covered respite care provided to a resident eligi19 ble caregiver of a veteran under paragraph (1) may exceed 

20 30 days annually if such extension is requested by the resi21 dent eligible caregiver or veteran and determined medi22 cally appropriate by the Secretary. 

23 ‘‘(g) RULE OF CONSTRUCTION.—Nothing in this sec24 tion shall be construed to limit the authority of the Sec-
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1 retary to carry out programs providing home- and commu2 nity-based services under any other provision of law. 

3 ‘‘(h) DEFINITIONS.—In this section: 

4 ‘‘(1) The terms ‘Aging and Disability Resource 

5 Center’, ‘area agency on aging’, and ‘State agency’ 

6 have the meanings given those terms in section 102 

7 of the Older Americans Act of 1965 (42 U.S.C. 

8 3002). 

9 ‘‘(2) The terms ‘caregiver’ and ‘family care10 giver’, with respect to a veteran, have the meanings 

11 given those terms, respectively, under subsection (e) 

12 of section 1720G of this title with respect to an eli13 gible veteran under subsection (a) of such section or 

14 a covered veteran under subsection (b) of such sec15 tion, as the case may be. 

16 ‘‘(3) The term ‘center for independent living’ 

17 has the meaning given that term in section 702 of 

18 the Rehabilitation Act of 1973 (29 U.S.C. 796a). 

19 ‘‘(4) The term ‘covered respite care’ has the 

20 meaning given such term in section 1720G(d) of this 

21 title. 

22 ‘‘(5) The term ‘eligible veteran’ means any vet23 eran— 

24 ‘‘(A) for whom the Secretary determines 

25 participation in a specific program under this 
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1 section is medically necessary to promote, pre2 serve, or restore the health of the veteran; and 

3 ‘‘(B) who absent such participation would 

4 be at increased risk for hospitalization, place5 ment in a nursing home, or emergency room 

6 care. 

7 ‘‘(6) The term ‘home health aide’ means an in8 dividual employed by a home health agency to pro9 vide in-home care services. 

10 ‘‘(7) The term ‘in-home care service’ means any 

11 service, including a personal care service, provided to 

12 enable the recipient of such service to live at home. 

13 ‘‘(8) The terms ‘Indian tribe’ and ‘tribal organi14 zation’ have the meanings given those terms in sec15 tion 4 of the Indian Self-Determination and Edu16 cation Assistance Act (25 U.S.C. 5304). 

17 ‘‘(9) The terms ‘Native American’ and ‘Native 

18 American veteran’ have the meanings given those 

19 terms in section 3765 of this title. 

20 ‘‘(10) The terms ‘Native Hawaiian’ and ‘Native 

21 Hawaiian health care system’ have the meanings 

22 given those terms in section 12 of the Native Hawai23 ian Health Care Improvement Act (42 U.S.C. 

24 11711). 
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1 ‘‘(11) The terms ‘tribal health programs’ and 

2 ‘Urban Indian organizations’ have the meanings 

3 given those terms in section 4 of the Indian Health 

4 Care Improvement Act (25 U.S.C. 1603). 

5 ‘‘(12) The term ‘resident eligible caregiver’ 

6 means an individual who— 

7 ‘‘(A) is a caregiver, or a family caregiver, 

8 of a veteran and resides with that veteran; and 

9 ‘‘(B) has not entered into a contract, 

10 agreement, or other arrangement for such indi11 vidual to act as a caregiver for that veteran un12 less such individual is a family member of the 

13 veteran or is furnishing caregiver services 

14 through a medical foster home.’’. 

15 (b) DEADLINE FOR IMPROVED ADMINISTRATION.— 

16 The Secretary of Veterans Affairs shall ensure that the 

17 Veteran-Directed Care program and the Homemaker and 

18 Home Health Aide program are administered through 

19 each medical center of the Department of Veterans Affairs 

20 in accordance with section 1720L of title 38, United 

21 States Code (as added by subsection (a)), by not later 

22 than two years after the date of the enactment of this Act. 

23 (c) ADMINISTRATION OF VETERAN-DIRECTED CARE

24 PROGRAM.— 

25 (1) PROCEDURES.— 
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1 (A) The Secretary shall establish proce2 dures to— 

3 (i) identify the staffing needs for the 

4 Veteran-Directed Care program of the De5 partment of Veterans Affairs under such 

6 section (as added by subsection (a)); and 

7 (ii) define the roles and responsibil8 ities for personnel of the Department re9 sponsible for the administration of such 

10 program, including such personnel em11 ployed at the national, Veterans Integrated 

12 Service Network, or medical facility level. 

13 (B) The responsibilities described in clause 

14 (ii) of subparagraph (A) shall include respon15 sibilities for engagement with— 

16 (i) veterans participating in such pro17 gram; 

18 (ii) veterans interested in partici19 pating in such program; and 

20 (iii) providers described in section 

21 1720L(b)(2) (as added by subsection (a)). 

22 (2) STAFFING MODEL; REPORT.—Not later 

23 than two years after enactment of this Act, the Sec24 retary of Veterans Affairs shall— 
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1 (A) establish a staffing model for the ad2 ministration of such program at each medical 

3 facility of the Department of Veterans Affairs; 

4 and 

5 (B) submit to the Committees on Veterans’ 

6 Affairs of the House of Representatives and the 

7 Senate a report containing the following: 

8 (i) A description of— 

9 (I) the staffing model described 

10 in subparagraph (A); and 

11 (II) the rationale for such staff12 ing model. 

13 (ii) An identification of the ratio of 

14 staff required to administer such program 

15 to the number of veterans served by such 

16 program, disaggregated by each medical 

17 facility of the Department of Veterans Af18 fairs. 

19 (iii) A description of budgetary re20 sources or other support, if any, required 

21 to accommodate an increase in staffing at 

22 medical facilities of the Department of 

23 Veterans Affairs pursuant to the require24 ments of the staffing model described in 

25 subparagraph (A). 
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1 (iv) Such other matters as the Sec2 retary of Veterans Affairs determines ap3 propriate. 

4 SEC. 124. COORDINATION WITH ASSISTANCE AND SUPPORT 

5 SERVICES FOR CAREGIVERS. 

6 (a) COORDINATION WITH PROGRAM OF COMPREHEN7 SIVE ASSISTANCE FOR FAMILY CAREGIVERS.— 

8 (1) COORDINATION.—Section 1720G(a) of title 

9 38, United States Code, is amended by adding at 

10 the end the following new paragraph: 

11 ‘‘(14)(A) In the case of a veteran or caregiver who 

12 seeks services under this subsection and is denied such 

13 services, or a veteran or the family caregiver of a veteran 

14 who is discharged from the program under this subsection, 

15 the Secretary shall— 

16 ‘‘(i) if the veteran meets the requirements of a 

17 covered veteran under subsection (b), provide to 

18 such caregiver the option of enrolling in the program 

19 of general caregiver support services under such sub20 section; 

21 ‘‘(ii) assess the veteran or caregiver for partici22 pation in any other available program of the Depart23 ment for home- and community-based services (in24 cluding the programs specified in section 1720L of 

25 this title) for which the veteran or caregiver may be 
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1 eligible and, with respect to the veteran, store (and 

2 make accessible to the veteran) the results of such 

3 assessment in the electronic medical record of the 

4 veteran; and 

5 ‘‘(iii) provide to the veteran or caregiver written 

6 information on any such program identified pursu7 ant to the assessment under clause (ii), including in8 formation about facilities, eligibility requirements, 

9 and relevant contact information for each such pro10 gram. 

11 ‘‘(B) The Secretary shall, to the extent practicable, 

12 provide to a veteran or family caregiver the option of ob13 taining clinically appropriate services under any other 

14 available program of the Department for home- and com15 munity-based services (including the programs specified in 

16 section 1720L of this title) for which the veteran or family 

17 caregiver may be eligible prior to discharging the veteran 

18 or family caregiver from the program under this sub19 section. 

20 ‘‘(C) For each veteran or family caregiver who is dis21 charged from the program under this subsection, a care22 giver support coordinator shall provide for a smooth and 

23 personalized transition from such program to an appro24 priate program of the Department for home- and commu25 nity-based services (including the programs specified in 
65 

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1 section 1720L of this title), including by integrating care2 giver support across programs.’’. 

3 (2) APPLICABILITY.—The amendments made 

4 by paragraph (1) shall apply with respect to denials 

5 and discharges occurring on or after the date that 

6 is 180 days after the date of the enactment of this 

7 Act. 

8 (3) TECHNICAL AND CONFORMING AMEND9 MENTS.—Section 1720G(d) of such title is amend10 ed— 

11 (A) by striking ‘‘or a covered veteran’’ 

12 each place it appears and inserting ‘‘, a veteran 

13 denied or discharged as specified in paragraph 

14 (14) of such subsection, or a covered veteran’’; 

15 and 

16 (B) by striking ‘‘under subsection (a), 

17 means’’ each place it appears and inserting 

18 ‘‘under subsection (a) or a veteran denied or 

19 discharged as specified in paragraph (14) of 

20 such subsection, means’’. 

21 (b) CONFORMITY OF RESPITE CARE ACROSS PRO22 GRAMS.—Section 1720G of title 38, United States Code, 

23 as amended by subsection (a)(3), is further amended— 

24 (1) in subsection (a)(3)— 
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1 (A) by amending subparagraph (A)(ii)(III) 

2 to read as follows: 

3 ‘‘(III) covered respite care of not less than 

4 30 days annually;’’; and 

5 (B) by striking subparagraph (B) and re6 designating subparagraphs (C) and (D) as sub7 paragraphs (B) through (C), respectively; and 

8 (2) by amending subsection (b)(3)(A)(iii) to 

9 read as follows: 

10 ‘‘(iii) Covered respite care of not less than 30 

11 days annually.’’; and 

12 (3) in subsection (d)— 

13 (A) by redesignating paragraphs (2) 

14 through (4) as paragraphs (3) through (5), re15 spectively; and 

16 (B) by inserting after paragraph (1) the 

17 following new paragraph: 

18 ‘‘(2) The term ‘covered respite care’ means, 

19 with respect to a caregiver of a veteran, respite care 

20 under section 1720B of this title that— 

21 ‘‘(A) is medically and age appropriate for 

22 the veteran (including 24-hour per day care of 

23 the veteran commensurate with the care pro24 vided by the caregiver); and 

25 ‘‘(B) includes in-home care.’’. 
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1 (c) REVIEW RELATING TO CAREGIVER CONTACT.— 

2 The Secretary shall conduct a review of the capacity of 

3 the Department to establish a streamlined system for con4 tacting all caregivers enrolled in the program of general 

5 caregiver support services under section 1720G(b) of title 

6 38, United States Code, to provide to such caregivers pro7 gram updates and alerts relating to emerging services for 

8 which such caregivers or the veterans for which they pro9 vide care may be eligible. 

10 SEC. 125. IMPROVEMENTS TO PROGRAM OF COMPREHEN11 SIVE ASSISTANCE FOR FAMILY CAREGIVERS. 

12 Section 1720G(a) of title 38, United States Code, as 

13 amended by section 124, is further amended— 

14 (1) in paragraph (12)— 

15 (A) in subparagraph (A), by inserting ‘‘, 

16 which shall include all criteria used to deter17 mine eligibility for such assistance and, in the 

18 case of a completed evaluation, how such cri19 teria were used to evaluate information pro20 vided in assessments to determine such eligi21 bility’’ before the period at the end; and 

22 (B) in subparagraph (C)(i), by striking 

23 ‘‘who submits’’ and all that follows through the 

24 end of the clause and inserting the following: 

25 ‘‘who— 
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1 ‘‘(I) submits an application for the pro2 gram established under paragraph (1); or 

3 ‘‘(II) is being reassessed for eligibility to 

4 continue in such program.’’; and 

5 (2) by adding at the end the following new 

6 paragraph: 

7 ‘‘(15)(A) Not less frequently than annually, the Sec8 retary shall submit to the Committees on Veterans’ Affairs 

9 of the Senate and the House of Representatives a com10 prehensive report on the program required by paragraph 

11 (1) that includes, with respect to the one-year period pre12 ceding the date of the submission of such report, the fol13 lowing: 

14 ‘‘(i) The number of applications received for 

15 such program. 

16 ‘‘(ii) The number, disaggregated by race, sex, 

17 and era and branch of service in the Armed Forces 

18 of the applicant, of— 

19 ‘‘(I) approvals of such applications; and 

20 ‘‘(II) denials of such applications. 

21 ‘‘(iii) The number of reassessments conducted 

22 for such program. 

23 ‘‘(iv) An identification of each decision made 

24 with respect to a reassessment conducted for such 

25 program, disaggregated by decisions resulting in— 
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1 ‘‘(I) disenrollment, including removal, dis2 charge, or voluntary withdrawal; 

3 ‘‘(II) tier reduction; and 

4 ‘‘(III) tier continuation. 

5 ‘‘(v) The number of appeals of decisions made 

6 with respect to such program, disaggregated by type 

7 of appeal. 

8 ‘‘(vi) With respect to each appeal described in 

9 clause (v), the decision rendered, if any. 

10 ‘‘(vii) A description of all tools used in assess11 ments conducted for such program, including an ex12 planation of how and by whom such tools are admin13 istered. 

14 ‘‘(viii) A description of procedures used under 

15 such program for reviewing and integrating clinical 

16 records from health care providers that includes an 

17 explanation of how such records are used in deter18 minations of eligibility for such program. 

19 ‘‘(ix) A description of procedures available 

20 under such program for health care providers to 

21 communicate medical opinions to the teams con22 ducting assessments to determine eligibility for such 

23 program, including health care providers in the pri24 vate sector and health care providers specified in 

25 subsection (c) of section 1703 of this title. 
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1 ‘‘(x) A description of information technology 

2 systems and processes used under such program to 

3 upload and integrate all clinical records from all 

4 non-Department providers, including providers in 

5 the private sector and providers under the Veterans 

6 Community Care Program established under such 

7 section. 

8 ‘‘(B) The Secretary shall ensure that all data in9 cluded in a report under subparagraph (A)— 

10 ‘‘(i) relating to a decision made under the pro11 gram required by paragraph (1), are disaggregated 

12 by the specific reason for the decision; 

13 ‘‘(ii) relating to a veteran, include comprehen14 sive demographic information of the veteran, includ15 ing the time period of the injuries, if any, of the vet16 eran and the Veterans Integrated Service Network 

17 in which the veteran is located; and 

18 ‘‘(iii) with respect to eligibility determinations 

19 relating to a serious injury of a veteran, specify— 

20 ‘‘(I) how many such determinations relate 

21 to the ability of the veteran to perform activi22 ties of daily living; and 

23 ‘‘(II) how many such determinations relate 

24 to the need of a veteran for supervision and 

25 protection. 
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1 ‘‘(C) The Secretary shall provide the data under 

2 paragraph (B) pursuant to Federal laws and in a manner 

3 that is wholly consistent with applicable Federal privacy 

4 and confidentiality laws, including the Privacy Act (5 

5 U.S.C. 552a), the Health Insurance Portability and Ac6 countability Act (Public Law 104–191; 42 U.S.C. 201 

7 note) and regulations (title 45, Code of Federal Regula8 tions, parts 160 and 164, or successor regulations), and 

9 sections 5701, 5705, and 7332 of this title to ensure that 

10 the provided data, or some portion of the data, will not 

11 undermine the anonymity of a veteran.’’. 

12 SEC. 126. IMPROVEMENTS RELATING TO HOMEMAKER AND 

13 HOME HEALTH AIDE PROGRAM. 

14 (a) PILOT PROGRAM FOR COMMUNITIES WITH

15 SHORTAGE OF HOME HEALTH AIDES.— 

16 (1) PROGRAM.—Beginning not later than 18 

17 months after the date of the enactment of this Act, 

18 the Secretary shall carry out a three-year pilot pro19 gram under which the Secretary shall provide home20 maker and home health aide services to veterans 

21 who reside in communities with a shortage of home 

22 health aides. 

23 (2) LOCATIONS.—The Secretary shall select not 

24 fewer than five geographic locations in which the 

25 Secretary determines there is a shortage of home 
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1 health aides at which to carry out the pilot program 

2 under paragraph (1). 

3 (3) NURSING ASSISTANTS.— 

4 (A) IN GENERAL.—In carrying out the 

5 pilot program under paragraph (1), the Sec6 retary may hire nursing assistants as new em7 ployees of the Department of Veterans Affairs, 

8 or reassign nursing assistants who are existing 

9 employees of the Department, to provide to vet10 erans in-home care services (including basic 

11 tasks authorized by the State certification of 

12 the nursing assistant) under the pilot program, 

13 in lieu of or in addition to the provision of such 

14 services through non-Department home health 

15 aides. 

16 (B) RELATIONSHIP TO HOME-BASED PRI17 MARY CARE PROGRAM.—Nursing assistants 

18 hired or reassigned under subparagraph (A) 

19 may provide services to a veteran under the 

20 pilot program under paragraph (1) while serv21 ing as part of a health care team for the vet22 eran under the Home-Based Primary Care pro23 gram. 

24 (4) REPORT TO CONGRESS.—Not later than one 

25 year before the date of the termination of the pilot 
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1 program under paragraph (1), the Secretary shall 

2 submit to the Committees on Veterans’ Affairs of 

3 the House of Representatives and the Senate a re4 port that includes— 

5 (A) a statement of the results of such pilot 

6 program; and 

7 (B) an assessment of the feasibility and 

8 advisability of— 

9 (i) extending such pilot program; or 

10 (ii) making such pilot program a per11 manent program of the Department of 

12 Veterans Affairs. 

13 (b) REPORT ON USE OF FUNDS.—Not later than one 

14 year after the date of the enactment of this Act, the Sec15 retary of Veterans Affairs shall submit to the Committees 

16 on Veterans’ Affairs of the House of Representatives and 

17 the Senate a report containing, with respect to the period 

18 beginning in fiscal year 2012 and ending in fiscal year 

19 2024, the following: 

20 (1) An identification of the amount of funds 

21 that were included in a budget of the Department of 

22 Veterans Affairs during such period for the provision 

23 of in-home care to veterans under the Homemaker 

24 and Home Health Aide program but were not ex25 pended for such provision, disaggregated by medical 
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1 center of the Department for which such unex2 pended funds were budgeted (if such disaggregation 

3 is possible). 

4 (2) To the extent practicable, an identification 

5 of the number of veterans for whom, during such pe6 riod, the hours during which a home health aide was 

7 authorized to provide services to the veteran under 

8 the Homemaker and Home Health Aide program 

9 were reduced for a reason other than a change in 

10 the health care needs of the veteran, and a detailed 

11 description of the reasons why any such reductions 

12 may have occurred. 

13 (c) UPDATED GUIDANCE ON PROGRAM.—Not later 

14 than one year after the date of the enactment of this Act, 

15 the Secretary shall issue updated guidance for the Home16 maker and Home Health Aide program. Such updated 

17 guidance shall include the following: 

18 (1) A process for the transition of veterans 

19 from the Homemaker and Home Health Aide pro20 gram to other covered programs. 

21 (2) A requirement for the directors of the med22 ical facilities of the Department to complete such 

23 process whenever a veteran with care needs has been 

24 denied services from home health agencies under the 

25 Homemaker and Home Health Aide program as a 
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1 result of the clinical needs or behavioral issues of the 

2 veteran. 

3 SEC. 127. PILOT PROGRAM TO FURNISH ASSISTED LIVING 

4 SERVICES TO CERTAIN VETERANS. 

5 (a) ESTABLISHMENT.—Beginning not later than two 

6 years after the date of the enactment of this Act, the Sec7 retary of Veterans Affairs shall carry out a pilot program 

8 to assess— 

9 (1) the effectiveness of providing assisted living 

10 services to eligible veterans, at the election of such 

11 veterans; and 

12 (2) the satisfaction with the pilot program of 

13 veterans participating in such pilot program. 

14 (b) PROGRAM LOCATIONS.— 

15 (1) VETERANS INTEGRATED SERVICE NET16 WORKS.—The Secretary shall select two Veterans 

17 Integrated Service Networks of the Department of 

18 Veterans Affairs at which to carry out the pilot pro19 gram under subsection (a). 

20 (2) FACILITIES.— 

21 (A) IN GENERAL.—Within the Veterans 

22 Integrated Service Networks selected under 

23 paragraph (1), the Secretary shall select facili24 ties at which to carry out the pilot program 

25 under subsection (a)(1). 
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1 (B) SELECTION CRITERIA.—In selecting 

2 facilities under subparagraph (A) at which to 

3 carry out the pilot program under subsection 

4 (a)(1), the Secretary shall ensure that— 

5 (i) the locations of such facilities are 

6 in geographically diverse areas; 

7 (ii) not fewer than one such facility 

8 serves veterans in rural or highly rural 

9 areas (as determined through the use of 

10 the Rural-Urban Commuting Areas coding 

11 system of the Department of Agriculture); 

12 (iii) not fewer than one such facility is 

13 located in each Veterans Integrated Service 

14 Network selected under paragraph (1); and 

15 (iv) not fewer than one such facility is 

16 a State home. 

17 (c) PROGRAM PARTICIPANTS.—Not more than 60 eli18 gible veterans may participate in the pilot program under 

19 subsection (a)(1) in each Veterans Integrated Service Net20 work selected under subsection (b)(1). 

21 (d) PROVISION OF ASSISTED LIVING SERVICES.— 

22 (1) AGREEMENTS.—In carrying out the pilot 

23 program under subsection (a)(1), the Secretary may 

24 enter into agreements for the provision of assisted 

25 living services on behalf of eligible veterans with— 
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1 (A) a provider participating under a State 

2 plan or waiver under title XIX of the Social Se3 curity Act (42 U.S.C. 1396 et seq.); or 

4 (B) a State home recognized and certified 

5 under subpart B of part 51 of title 38, Code of 

6 Federal Regulations, or successor regulations. 

7 (2) STANDARDS.—The Secretary may not place, 

8 transfer, or admit a veteran to any facility for as9 sisted living services under the pilot program under 

10 subsection (a)(1) unless the Secretary determines 

11 that— 

12 (A) the facility meets the standards for 

13 community residential care established under 

14 sections 17.61 through 17.72 of title 38, Code 

15 of Federal Regulations, or successor regula16 tions, and any additional standards of care as 

17 the Secretary may specify; or 

18 (B) in the case of a facility that is a State 

19 home, the State home meets such standards of 

20 care as the Secretary may specify. 

21 (3) INSPECTION.—The Secretary shall inspect 

22 facilities at which veterans are placed under the pilot 

23 program under subsection (a)(1)— 

24 (A) with respect to a facility that is a 

25 State home, not less frequently than annually 
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1 and in the same manner as the Secretary con2 ducts inspection of State homes under section 

3 1742 of title 38, United States Code; and 

4 (B) with respect to any other facility, not 

5 less frequently than annually and in the same 

6 manner as the Secretary conducts inspection of 

7 facilities under section 1730 of such title. 

8 (4) PAYMENT TO CERTAIN FACILITIES.— 

9 (A) STATE HOMES.—In the case of a facil10 ity participating in the pilot program under 

11 subsection (a)(1) that is a State home, the Sec12 retary shall pay to the State home a per diem 

13 for each veteran participating in the pilot pro14 gram at a rate agreed to by the Secretary and 

15 the State home. 

16 (B) COMMUNITY ASSISTED LIVING FACILI17 TIES.—In the case of a facility participating in 

18 the pilot program under subsection (a)(1) that 

19 is a community assisted living facility, the Sec20 retary shall— 

21 (i) pay to the facility an amount that 

22 is less than the average rate paid by the 

23 Department for placement in a community 

24 nursing home in the same Veterans Inte25 grated Service Network; and 
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1 (ii) re-evaluate payment rates annu2 ally to account for current economic condi3 tions and current costs of assisted living 

4 services. 

5 (e) CONTINUITY OF CARE.—Upon the termination of 

6 the pilot program under subsection (a)(1), the Secretary 

7 shall— 

8 (1) provide to all veterans participating in the 

9 pilot program at the time of such termination the 

10 option to continue to receive assisted living services 

11 at the site they were assigned to under the pilot pro12 gram, at the expense of the Department; and 

13 (2) for such veterans who do not opt to con14 tinue to receive such services— 

15 (A) ensure such veterans do not experience 

16 lapses in care; and 

17 (B) provide such veterans with information 

18 on, and furnish such veterans with, other ex19 tended care services based on their preferences 

20 and best medical interest. 

21 (f) DETERMINATION OF QUALITY.—The Secretary 

22 shall determine a method for assessment of quality of care 

23 provided to veterans participating in the pilot program 

24 under subsection (a)(1) and shall communicate that meth25 od to providers of services under the pilot program. 
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1 (g) ANNUAL REPORT.—Not later than one year after 

2 the initiation of the pilot program under subsection (a)(1), 

3 and annually thereafter for the duration of such pilot pro4 gram, the Secretary shall submit to the Committees on 

5 Veterans’ Affairs of the House of Representatives and the 

6 Senate a report on the pilot program that includes— 

7 (1) an identification of Veterans Integrated 

8 Services Networks and facilities of the Department 

9 participating in the pilot program and assisted living 

10 facilities and State homes at which veterans are 

11 placed under the pilot program; 

12 (2) the number of participants in the pilot pro13 gram, disaggregated by facility; 

14 (3) general demographic information of partici15 pants in the pilot program, including average age, 

16 sex, and race or ethnicity; 

17 (4) disability status of participants in the pilot 

18 program; 

19 (5) an identification of any barriers or chal20 lenges to furnishing care to veterans under the pilot 

21 program, conducting oversight of the pilot program, 

22 or any other barriers or challenges; 

23 (6) the cost of care at each assisted living facil24 ity and State home participating in the pilot pro25 gram, including an analysis of any cost savings by 
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1 the Department when comparing that cost to the 

2 cost of nursing home care; 

3 (7) aggregated feedback from participants in 

4 the pilot program, including from veteran resident 

5 surveys and interviews; and 

6 (8) such other matters the Secretary considers 

7 appropriate. 

8 (h) FINAL REPORT.—Not later than one year after 

9 the pilot program terminates under subsection (j), the 

10 Secretary shall submit to the Committees on Veterans’ Af11 fairs of the House of Representatives and the Senate a 

12 report on the pilot program that— 

13 (1) includes the matters required under para14 graphs (1) through (8) of subsection (g); 

15 (2) includes recommendations on whether the 

16 model studied in the pilot program should be contin17 ued or adopted throughout the Department; and 

18 (3) indicates whether the Secretary requests ac19 tion by Congress to make the pilot program perma20 nent. 

21 (i) INSPECTOR GENERAL REPORT.— 

22 (1) IN GENERAL.—Not later than three years 

23 after the initiation of the pilot program under sub24 section (a)(1), the Inspector General of the Depart25 ment of Veterans Affairs shall submit to the Sec-
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1 retary of Veterans Affairs and the Committees on 

2 Veterans’ Affairs of House of Representatives and 

3 the Senate a report on the pilot program. 

4 (2) ELEMENTS.—The report required by para5 graph (1) shall include an assessment of— 

6 (A) the quality of care provided to veterans 

7 at facilities participating in the pilot program, 

8 measured pursuant to the method determined 

9 under subsection (f); 

10 (B) the oversight of such facilities, as con11 ducted by the Department, the Centers for 

12 Medicare & Medicaid Services, State agencies, 

13 and other relevant entities; and 

14 (C) such other matters as the Inspector 

15 General considers appropriate. 

16 (3) PLAN REQUIRED.—Not later than 90 days 

17 after the submission of the report under paragraph 

18 (1), the Secretary shall submit to the Committees on 

19 Veterans’ Affairs of the House of Representatives 

20 and the Senate a plan to address the deficiencies 

21 identified in the report, if any. 

22 (j) TERMINATION.— 

23 (1) IN GENERAL.—Subject to paragraph (2), 

24 the pilot program under subsection (a)(1) shall ter25 minate on September 30, 2028. 
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1 (2) EXTENSION.—The Secretary may extend 

2 the duration of the pilot program for an additional 

3 two-year period if the Secretary, based on the results 

4 of the reports submitted under subsection (g), deter5 mines such an extension is appropriate. 

6 (k) DEFINITIONS.—In this section: 

7 (1) The term ‘‘assisted living services’’ means 

8 services of a facility in providing room, board, and 

9 personal care for and supervision of residents for 

10 their health, safety, and welfare. 

11 (2) The term ‘‘eligible veteran’’ means a vet12 eran who is— 

13 (A) receiving nursing home care paid for 

14 by the Department of Veterans Affairs, eligible 

15 to receive such care pursuant to section 1710A 

16 of title 38, United States Code, or requires a 

17 higher level of care than the domiciliary care 

18 provided by the Department of Veterans Af19 fairs, but does not meet the requirements for 

20 nursing home level care provided by the Depart21 ment pursuant to such section; and 

22 (B) eligible for assisted living services, as 

23 determined by the Secretary or meets such ad24 ditional criteria for eligibility for the pilot pro-
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1 gram under subsection (a)(1) as the Secretary 

2 may establish. 

3 (3) The term ‘‘State home’’ has the meaning 

4 given that term in section 101 of title 38, United 

5 States Code. 

6 SEC. 128. PROVISION OF MEDICINE, EQUIPMENT, AND SUP7 PLIES AVAILABLE TO DEPARTMENT OF VET8 ERANS AFFAIRS TO STATE HOMES. 

9 (a) PROVISION AUTHORIZED.—The Secretary of Vet10 erans Affairs may provide to State homes medicine, per11 sonal protective equipment, medical supplies, and any 

12 other equipment, supplies, and assistance available to the 

13 Department of Veterans Affairs. 

14 (b) DEFINITION.—In this section: 

15 (1) The term ‘‘personal protective equipment’’ 

16 means any protective equipment required to prevent 

17 the wearer from contracting an infectious disease, 

18 including gloves, N–95 respirator masks, gowns, 

19 goggles, face shields, or other equipment required 

20 for safety. 

21 (2) The term ‘‘State home’’ has the meaning 

22 given such term in section 101 of title 38, United 

23 States Code. 
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1 SEC. 129. RECOGNITION OF ORGANIZATIONS AND INDIVID2 UALS TO ASSIST VETERANS, FAMILY MEM3 BERS, AND CAREGIVERS NAVIGATING PRO4 GRAMS AND SERVICES OF VETERANS 

5 HEALTH ADMINISTRATION. 

6 (a) IN GENERAL.—Not later than one year after the 

7 date of the enactment of this Act, the Secretary of Vet8 erans Affairs shall establish a process through which the 

9 Department of Veterans Affairs may recognize organiza10 tions and individuals to assist a veteran, a family member 

11 of a veteran, or a caregiver of a veteran (as defined in 

12 section 1720G(d) of title 38, United States Code) in navi13 gating the programs and services of the Veterans Health 

14 Administration. 

15 (b) SOLICITATION OF FEEDBACK.—The Secretary 

16 shall solicit feedback and recommendations in the creation 

17 of the process under subsection (a) from such organiza18 tions as the Secretary may consider relevant. 

19 (c) LIMITATION.—The Secretary may not recognize 

20 an organization or individual pursuant to the process es21 tablished under subsection (a) unless the organization or 

22 individual has certified to the Secretary that no fee or 

23 compensation of any nature will be charged to any indi24 vidual for services rendered in providing assistance pursu25 ant to such subsection. 
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1 SEC. 130. REVIEWS AND OTHER IMPROVEMENTS RELATING 

2 TO HOME- AND COMMUNITY-BASED SERV3 ICES. 

4 (a) OFFICE OF GERIATRIC AND EXTENDED CARE.— 

5 (1) REVIEW OF PROGRAMS.—The Under Sec6 retary for Health of the Department of Veterans Af7 fairs shall conduct a review of each program admin8 istered through the Office of Geriatric and Extended 

9 Care of the Department and the Caregiver Support 

10 Program Office of the Department, or any successor 

11 offices, to— 

12 (A) eliminate service gaps at the medical 

13 center level; and 

14 (B) ensure— 

15 (i) the clinical needs of veterans are 

16 met; 

17 (ii) consistency in program manage18 ment; 

19 (iii) the availability of, and the access 

20 by veterans to, home- and community21 based services, including for veterans living 

22 in rural areas; and 

23 (iv) proper coordination between cov24 ered programs. 

25 (2) ASSESSMENT OF STAFFING NEEDS.—The 

26 Secretary of Veterans Affairs shall conduct an as-
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1 sessment of the staffing needs of the Office of Geri2 atric and Extended Care of the Department and the 

3 Caregiver Support Program Office of the Depart4 ment, or any successor offices. 

5 (3) GOALS FOR GEOGRAPHIC ALIGNMENT OF

6 CARE.— 

7 (A) ESTABLISHMENT OF GOALS.—The Di8 rector of the Office of Geriatric and Extended 

9 Care, or successor office, shall establish quan10 titative goals to enable aging or disabled vet11 erans who are not located near medical centers 

12 of the Department to access extended care serv13 ices (including by improving access to home14 and community-based services for such vet15 erans). 

16 (B) IMPLEMENTATION TIMELINE.—Each 

17 goal established under subparagraph (A) shall 

18 include a timeline for the implementation of the 

19 goal at each medical center of the Department. 

20 (4) GOALS FOR IN-HOME SPECIALTY CARE.— 

21 The Director of the Office of Geriatric and Extended 

22 Care, or successor office, shall establish quantitative 

23 goals to address the specialty care needs of veterans 

24 through in-home care, including by ensuring the 
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1 education of home health aides and caregivers of vet2 erans in the following areas: 

3 (A) Dementia care. 

4 (B) Care for spinal cord injuries and dis5 eases. 

6 (C) Ventilator care. 

7 (D) Other speciality care areas as deter8 mined by the Secretary. 

9 (5) INPUT ON GOALS.—To the extent prac10 ticable, the head of the Caregiver Support Program 

11 Office, or successor office, shall provide to the Direc12 tor of the Office of Geriatric and Extended Care, or 

13 successor office, input with respect to the establish14 ment of the goals under paragraphs (3) and (4). 

15 (6) REPORT TO CONGRESS.—Not later than one 

16 year after the date of the enactment of this Act, the 

17 Secretary shall submit to the Committees on Vet18 erans’ Affairs of the House of Representatives and 

19 the Senate a report containing the findings of the 

20 review under paragraph (1), the results of the as21 sessment under paragraph (2), and the goals estab22 lished under paragraphs (3) and (4). 

23 (b) REVIEW OF INCENTIVES AND EFFORTS RELAT24 ING TO HOME- AND COMMUNITY-BASED SERVICES.— 
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1 (1) REVIEW.—The Secretary of Veterans Af2 fairs shall conduct a review of the following: 

3 (A) The financial and organizational incen4 tives or disincentives for the directors of med5 ical centers of the Department to establish or 

6 expand covered programs at such medical cen7 ters. 

8 (B) Any incentives or disincentives for 

9 such directors to provide to veterans home- and 

10 community-based services in lieu of institutional 

11 care. 

12 (C) The efforts taken by the Secretary to 

13 enhance spending of the Department for ex14 tended care by balancing spending between in15 stitutional care and home- and community16 based services consistent with the demand for 

17 such services. 

18 (D) The plan of the Under Secretary for 

19 Health of the Department to accelerate efforts 

20 to enhance spending as specified in subpara21 graph (C), to match the progress of similar ef22 forts taken by the Administrator of the Centers 

23 for Medicare & Medicaid Services with respect 

24 to spending of the Centers for Medicare & Med25 icaid Services for extended care. 
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1 (2) REPORT TO CONGRESS.—Not later than one 

2 year after the date of the enactment of this Act, the 

3 Secretary shall submit to the Committees on Vet4 erans’ Affairs of the House of Representatives and 

5 the Senate a report on the findings of the review 

6 under paragraph (1). 

7 (c) REVIEW OF RESPITE CARE SERVICES.—Not later 

8 than two years after the date of the enactment of this Act, 

9 the Secretary of Veterans Affairs shall conduct a review 

10 of the use, availability, cost, and effectiveness, of the res11 pite care services furnished by the Secretary under chapter 

12 17 of title 38, United States Code, including— 

13 (1) the frequency at which the Department of 

14 Veterans Affairs is unable to meet demand for such 

15 services; 

16 (2) a detailed description of— 

17 (A) the reasons the Department of Vet18 erans Affairs is unable to meet the demand for 

19 such services; and 

20 (B) any actions, or planned actions, of the 

21 Secretary of Veterans Affairs to ensure such 

22 demand is met. 

23 (d) COLLABORATION TO IMPROVE HOME- AND COM24 MUNITY-BASED SERVICES.— 

25 (1) RECOMMENDATIONS.— 
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1 (A) DEVELOPMENT.—The Secretary of 

2 Veterans Affairs shall develop recommendations 

3 as follows: 

4 (i) With respect to home- and commu5 nity-based services for veterans, the Sec6 retary of Veterans Affairs shall develop 

7 recommendations regarding new services 

8 (in addition to those furnished as of the 

9 date of enactment of this Act) in collabora10 tion with the Secretary of Health and 

11 Human Services. 

12 (ii) With respect to the national short13 age of home health aides, the Secretary of 

14 Veterans Affairs shall develop rec15 ommendations regarding methods to ad16 dress such shortage in collaboration with 

17 the Secretary of Health and Human Serv18 ices and the Secretary of Labor. 

19 (B) SUBMISSION TO CONGRESS.—The Sec20 retary of Veterans Affairs shall submit to the 

21 Committees on Veterans’ Affairs of the House 

22 of Representatives and the Senate a report con23 taining the recommendations developed under 

24 subparagraph (A) and an identification of any 

25 changes in existing law or new statutory au-
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1 thority necessary to implement the rec2 ommendations, as determined by the Secretary. 

3 (C) CONSULTATION WITH SECRETARY OF

4 LABOR.—In carrying out this paragraph, the 

5 Secretary of Veterans Affairs shall consult with 

6 the Secretary of Labor. 

7 (2) FEEDBACK AND RECOMMENDATIONS ON

8 CAREGIVER SUPPORT.— 

9 (A) FEEDBACK AND RECOMMENDA10 TIONS.—The Secretary of Veterans Affairs shall 

11 solicit from the entities described in subpara12 graph (B) feedback and recommendations re13 garding opportunities for the Secretary to en14 hance home- and community-based services for 

15 veterans and the caregivers of veterans, includ16 ing through the potential provision by the entity 

17 of care and respite services to veterans and 

18 caregivers who may not be eligible for any pro19 gram under section 1720G of title 38, United 

20 States Code, or section 1720L of such title (as 

21 added by section 123), but have a need for as22 sistance. 

23 (B) COVERED ENTITIES.—The entities de24 scribed in this subparagraph are veterans serv25 ice organizations and nonprofit organizations 
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1 with a focus on caregiver support or long term 

2 care (as determined by the Secretary). 

3 (3) COLLABORATION FOR CERTAIN VET4 ERANS.—The Secretary of Veterans Affairs shall col5 laborate with the Director of the Indian Health 

6 Service and representatives from tribal health pro7 grams and Urban Indian organizations to ensure the 

8 availability of home- and community-based services 

9 for— 

10 (A) Native American veterans, including 

11 Native American veterans receiving health care 

12 and medical services under multiple health care 

13 systems; and 

14 (B) Native Hawaiian veterans, including 

15 Native Hawaiian veterans receiving health care 

16 and medical services under the Native Hawaiian 

17 health care system. 

18 SEC. 131. GAO REPORT ON MENTAL HEALTH SUPPORT FOR 

19 CAREGIVERS. 

20 (a) REPORT REQUIRED.—Not later than one year 

21 after the date of the enactment of this Act, the Comp22 troller General of the United States shall submit to the 

23 Committee on Veterans’ Affairs of the Senate and the 

24 Committee on Veterans’ Affairs of the House of Rep-
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1 resentatives a report on the provision of mental health 

2 support to caregivers of veterans. 

3 (b) CONTENTS.—The report submitted under sub4 section (a) shall include the following: 

5 (1) An assessment of the need for mental 

6 health support among caregivers participating in the 

7 caregiver programs. 

8 (2) An assessment of options for mental health 

9 support in facilities of the Department of Veterans 

10 Affairs and in the community for caregivers partici11 pating in the caregiver programs. 

12 (3) An assessment of the availability and acces13 sibility of mental health support in facilities of the 

14 Department and in the community for caregivers 

15 participating in the caregiver programs. 

16 (4) An assessment of the awareness among 

17 caregivers of the availability of mental health sup18 port in facilities of the Department and in the com19 munity for caregivers participating in the caregiver 

20 programs. 

21 (5) An assessment of barriers to mental health 

22 support in facilities of the Department and in the 

23 community for caregivers participating in the care24 giver programs. 

25 (c) DEFINITIONS.—In this section: 
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1 (1) The term ‘‘caregiver’’ has the meaning 

2 given that term in section 1720G of title 38, United 

3 States Code. 

4 (2) The term ‘‘caregiver programs’’ means— 

5 (A) the program of comprehensive assist6 ance for family caregivers under subsection (a) 

7 of section 1720G of title 38, United States 

8 Code; and 

9 (B) the program of support services for 

10 caregivers under subsection (b) of such section. 

11 SEC. 132. DEVELOPMENT OF CENTRALIZED WEBSITE FOR 

12 PROGRAM INFORMATION. 

13 (a) CENTRALIZED WEBSITE.—The Secretary shall 

14 develop and maintain a centralized and publically acces15 sible internet website of the Department as a clearing16 house for information and resources relating to covered 

17 programs. 

18 (b) CONTENTS.—The website under subsection (a) 

19 shall contain the following: 

20 (1) A description of each covered program. 

21 (2) An informational assessment tool that— 

22 (A) explains the administrative eligibility, 

23 if applicable, of a veteran, or a caregiver of a 

24 veteran, for any covered program; and 
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1 (B) provides information, as a result of 

2 such explanation, on any covered program for 

3 which the veteran or caregiver (as the case may 

4 be) may be eligible. 

5 (3) A list of required procedures for the direc6 tors of the medical facilities of the Department to 

7 follow in determining the eligibility and suitability of 

8 veterans for participation in a covered program, in9 cluding procedures applicable to instances in which 

10 the resource constraints of a facility (or of a commu11 nity in which a facility is located) may result in the 

12 inability to address the health needs of a veteran 

13 under a covered program in a timely manner. 

14 (c) UPDATES.—The Secretary shall ensure the 

15 website under subsection (a) is updated on a periodic 

16 basis. 

17 SEC. 133. DEFINITIONS. 

18 In this subtitle: 

19 (1) The terms ‘‘caregiver’’ and ‘‘family care20 giver’’ have the meanings given those terms under 

21 section 1720L(h) of title 38, United States Code (as 

22 added by section 123). 

23 (2) The term ‘‘covered program’’— 
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1 (A) means any program of the Department 

2 of Veterans Affairs for home- and community3 based services; and 

4 (B) includes the programs specified in sec5 tion 1720L of title 38, United States Code (as 

6 added by section 123). 

7 (3) The term ‘‘home- and community-based 

8 services’’— 

9 (A) means the services referred to in sec10 tion 1701(6)(E) of title 38, United States Code; 

11 and 

12 (B) includes services furnished under a 

13 program specified in section 1720L of such title 

14 (as added by section 123). 

15 (4) The terms ‘‘Home-Based Primary Care pro16 gram’’, ‘‘Homemaker and Home Health Aide pro17 gram’’, and ‘‘Veteran-Directed Care program’’ mean 

18 the programs of the Department of Veterans Affairs 

19 specified in subsection (d), (c), and (b) of such sec20 tion 1720L, respectively. 

21 (5) The terms ‘‘home health aide’’, ‘‘Native 

22 American’’, ‘‘Native American veteran’’, ‘‘tribal 

23 health programs’’, and ‘‘Urban Indian organiza24 tions’’ have the meanings given those terms in sub25 section (h) of such section 1720L. 
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1 (6) The term ‘‘veterans service organization’’ 

2 means any organization recognized by the Secretary 

3 under section 5902 of such title. 

4 Subtitle C—Medical Treatment and 

5 Other Matters 

6 SEC. 140. QUARTERLY REPORT ON REFERRALS FOR NON7 DEPARTMENT OF VETERANS AFFAIRS 

8 HEALTH CARE. 

9 (a) IN GENERAL.—Subchapter I of chapter 17 of title 

10 38, United States Code, is amended by inserting after sec11 tion 1703F the following new section (and amending the 

12 table of sections at the beginning of such chapter accord13 ingly): 

14 ‘‘§ 1703G. Quarterly report on referrals for non-De15 partment health care 

16 ‘‘The Secretary shall submit to the Committees on 

17 Veterans’ Affairs of the Senate and the House of Rep18 resentatives a quarterly report containing, with respect to 

19 referrals for non-Department health care originating from 

20 a medical facility of the Department during the quarter 

21 preceding the date of the submission of the report, a meas22 urement of, for each such medical facility— 

23 ‘‘(1) the period of time between— 

24 ‘‘(A) the date on which a clinician em25 ployed by the Department determines that a 
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1 veteran requires care, or a veteran presents to 

2 the Department requesting care, and the date 

3 on which the referral for care is sent to a non4 Department health care provider; 

5 ‘‘(B) the date on which such referral is 

6 sent to a non-Department health care provider 

7 and the date on which such non-Department 

8 health care provider accepts such referral; 

9 ‘‘(C) the date on which such non-Depart10 ment health care provider accepts such referral 

11 and the date on which such referral is com12 pleted; 

13 ‘‘(D) the date on which such referral is 

14 completed and the date on which an appoint15 ment with a non-Department health care pro16 vider is made; and 

17 ‘‘(E) the date on which such an appoint18 ment is made and the date on which such ap19 pointment occurs; and 

20 ‘‘(2) any other period of time that the Secretary 

21 determines necessary.’’. 

22 (b) EFFECTIVE DATE.—The first report under sec23 tion 1703G, as added by this section, shall be due not later 

24 than 180 days after the date of the enactment of this sec25 tion. 
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1 SEC. 141. ELIMINATION OF CERTAIN REQUIREMENTS FOR 

2 CERTAIN DEPARTMENT OF VETERANS AF3 FAIRS ASSISTANT UNDER SECRETARIES. 

4 Section 7306 of title 38, United States Code, is 

5 amended— 

6 (1) by striking subsection (b); 

7 (2) by redesignating subsections (c) through (g) 

8 as subsections (b) through (f), respectively; and 

9 (3) in subsection (c) (as so redesignated), by 

10 striking ‘‘subsection (e)’’ and inserting ‘‘subsection 

11 (d)’’. 

12 SEC. 142. MODIFICATION OF PAY LIMITATION FOR PHYSI13 CIANS, PODIATRISTS, OPTOMETRISTS, AND 

14 DENTISTS OF DEPARTMENT OF VETERANS 

15 AFFAIRS. 

16 (a) PAY.— 

17 (1) IN GENERAL.—Section 7431 of title 38, 

18 United States Code, is amended— 

19 (A) by inserting ‘‘optometrists,’’ after ‘‘po20 diatrists,’’ each place it appears; 

21 (B) by inserting ‘‘optometrist’’ after ‘‘podi22 atrist,’’ each place it appears; 

23 (C) in subsection (c)— 

24 (i) in paragraph (5), by adding at the 

25 end the following new sentence: ‘‘Such a 

26 notice shall include a statement of whether 
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1 the market pay will increase, decrease, or 

2 remain unchanged following such evalua3 tion.’’; and 

4 (ii) by adding at the end the following 

5 new paragraphs: 

6 ‘‘(7) The Secretary shall ensure that each phy7 sician, podiatrist, optometrist, and dentist in the 

8 Veterans Health Administration is— 

9 ‘‘(A) advised, on an annual basis, of the 

10 criteria described in subparagraph (F) of para11 graph (4); 

12 ‘‘(B) evaluated in accordance with such 

13 criteria; and 

14 ‘‘(C) compensated in accordance with— 

15 ‘‘(i) applicable assignment and pay 

16 levels, subject to relevant pay limitations; 

17 and 

18 ‘‘(ii) the extent to which such criteria 

19 are met. 

20 ‘‘(8) Not later than 120 days after the end of 

21 each fiscal year, the Secretary shall submit to the 

22 Committees on Veterans’ Affairs of the Senate and 

23 the House of Representatives a report that includes 

24 the following: 
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1 ‘‘(A) A list of each facility and specialty 

2 that conducted an evaluation of pay during the 

3 period covered by the report. 

4 ‘‘(B) For each evaluation described in sub5 paragraph (A)— 

6 ‘‘(i) a list of occupations for which 

7 pay was evaluated, disaggregated by med8 ical specialty, number of authorized full9 time employees, and onsite full-time em10 ployees as of the date of the evaluation; 

11 ‘‘(ii) the date such evaluation was 

12 completed; 

13 ‘‘(iii) whether a market pay adjust14 ment was made following the evaluation 

15 per each occupation and specialty evalu16 ated; 

17 ‘‘(iv) whether applicable employees 

18 were notified of such evaluation; 

19 ‘‘(v) whether local labor partners were 

20 notified of such evaluation; and 

21 ‘‘(vi) in the case of an evaluation that 

22 resulted in an adjustment of pay— 

23 ‘‘(I) the date such adjustment— 

24 ‘‘(aa) was implemented; and 

25 ‘‘(bb) became effective; and 
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1 ‘‘(II) the percentage of employees 

2 of each occupation and specialty for 

3 which pay was adjusted pursuant to 

4 such evaluation. 

5 ‘‘(C) A list of facilities of the Department 

6 that have not conducted an evaluation of mar7 ket pay, pursuant to paragraph (5), during the 

8 18-month-period that precedes the date of the 

9 submission of such report.’’; and 

10 (D) in subsection (e), by adding at the end 

11 the following new paragraphs: 

12 ‘‘(5) Notwithstanding any compensation or pay 

13 limitations under this title or title 5, the Secretary 

14 may authorize the Under Secretary for Health to 

15 pay physicians, podiatrists, optometrists, and den16 tists— 

17 ‘‘(A) awards authorized under this title; 

18 ‘‘(B) advance payments, recruitment or re19 location bonuses, and retention allowances au20 thorized under section 7410(a) of this title or 

21 as otherwise provided by law; 

22 ‘‘(C) incentives or bonuses under section 

23 706 of this title or as otherwise provided by 

24 law; and 
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1 ‘‘(D) earnings from fee-basis appointments 

2 under section 7405(a)(2) of this title. 

3 ‘‘(6)(A) The Secretary may waive any pay limi4 tation described in this section (including tier limita5 tions) that the Secretary determines necessary for 

6 the recruitment or retention of critical health care 

7 personnel whom the Secretary determines would pro8 vide direct patient care. 

9 ‘‘(B) Priority for such waivers shall be given for 

10 positions, locations, and care provided through 

11 agreements that are costly to the Department. 

12 ‘‘(C) The Chief Human Capital Officer of the 

13 Department, the Chief Financial Officer of the De14 partment, and the Office of the General Counsel of 

15 the Department shall review any waiver issued under 

16 subparagraph (A). 

17 ‘‘(D) During the period the authority under 

18 subparagraph (A) is effective, the Secretary may not 

19 issue more than 300 waivers under such subpara20 graph. 

21 ‘‘(E) The Secretary may prescribe require22 ments, limitations, and other considerations for 

23 waivers under such subparagraph. 

24 ‘‘(F) Not later than 180 days after the date of 

25 the enactment of the Senator Elizabeth Dole 21st 
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1 Century Veterans Healthcare and Benefits Improve2 ment Act, and annually thereafter, the Secretary 

3 shall submit to the Committees on Veterans’ Affairs 

4 of the Senate and the House of Representatives a 

5 report that includes— 

6 ‘‘(i) any updates to the requirements, limi7 tations, and considerations prescribed under 

8 subparagraph (B) during the period covered by 

9 the report; 

10 ‘‘(ii) a description of the findings of each 

11 review, if any, conducted pursuant to subpara12 graph (C); 

13 ‘‘(iii) a description of each waiver under 

14 subparagraph (A) in effect as of the date of the 

15 submission of the report, including the— 

16 ‘‘(I) duty location, position, specialty, 

17 market and performance considerations for 

18 the waiver; and 

19 ‘‘(II) impact, if any, of the waiver on 

20 care furnished by the Department pursu21 ant to an agreement regarding the geo22 graphic area; and 

23 ‘‘(iv) a list of any separation actions dur24 ing the period covered by the report with re-
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1 spect to a position for which a waiver under 

2 subparagraph (A) is in effect. 

3 ‘‘(G) The authority of the Secretary under sub4 paragraph (A) shall terminate on the last day of the 

5 third full fiscal year following the date of the enact6 ment of the Senator Elizabeth Dole 21st Century 

7 Veterans Healthcare and Benefits Improvement 

8 Act.’’. 

9 (2) REPORT ON WAIVER AUTHORITY.—Not 

10 later than 180 days after the date of the enactment 

11 of this Act, the Secretary of Veterans Affairs shall 

12 submit to the Committees on Veterans’ Affairs of 

13 the Senate and the House of Representatives a re14 port that includes a description of the requirements, 

15 limitations, and other considerations prescribed 

16 under section 7431(b)(6)(D) of title 38, United 

17 States Code, as added by paragraph (1). 

18 (3) CONFORMING AMENDMENTS.— 

19 (A) PAY OF UNDER SECRETARY FOR

20 HEALTH.—Section 7432(b)(1) of such title is 

21 amended by inserting ‘‘, podiatrist, optom22 etrist,’’ after ‘‘physician’’. 

23 (B) ADMINISTRATIVE MATTERS.—Section 

24 7433 of such title is amended by inserting ‘‘op-
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1 tometrists,’’ after ‘‘physicians,’’ each place it 

2 appears. 

3 (C) COMPETITIVE PAY.—Section 

4 7451(a)(2)(C) of such title is amended by in5 serting ‘‘optometrist,’’ after ‘‘physician,’’. 

6 (4) CLERICAL AMENDMENTS.— 

7 (A) SUBCHAPTER HEADING.—Subchapter 

8 III of chapter 74 of such title is amended in the 

9 heading by inserting ‘‘Optometrists,’’ after 

10 ‘‘PODIATRISTS,’’. 

11 (B) TABLE OF SECTIONS.—The table of 

12 sections for such chapter is amended by strik13 ing the item relating to subchapter III and in14 serting the following: 

‘‘SUBCHAPTER III—PAY FOR PHYSICIANS AND OTHER HEALTH-CARE

PERSONNEL’’. 

15 (5) APPLICABILITY DATES.—The amendments 

16 made by this subsection shall apply to any pay pe17 riod of the Department of Veterans Affairs begin18 ning on or after the date that is 180 days after the 

19 date of the enactment of this Act. 

20 (b) MODIFICATION AND CLARIFICATION OF PAY

21 GRADE FOR OPTOMETRISTS.—Section 7404 of title 38, 

22 United States Code, is amended— 
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1 (1) in subsection (a)(2)(A), by striking ‘‘podia2 trists, and dentists’’ and inserting ‘‘podiatrists, op3 tometrists, and dentists’’; and 

4 (2) in subsection (b)— 

5 (A) by striking ‘‘podiatrist (dpm), and den6 tist’’ and inserting ‘‘podiatrist (dpm), optom7 etrist (od), and dentist’’; 

8 (B) by striking ‘‘clinical chiropractor and 

9 optometrist schedule,’’ and inserting ‘‘clinical 

10 chiropractor schedule’’; and 

11 (C) by inserting ‘‘optometrist grade’’ after 

12 ‘‘Podiatrist grade’’. 

13 (c) RETROACTIVE AUTHORITY FOR COMPENSA14 TION.— 

15 (1) IN GENERAL.—The Secretary of Veterans 

16 Affairs may pay retroactive compensation to a cov17 ered employee in an amount that equals the amount 

18 of compensation that was authorized to be paid to 

19 such covered employee during the period specified in 

20 paragraph (2), but was deferred and paid to such 

21 employee in the calendar year following the calender 

22 year in which such compensation was authorized be23 cause the payment such compensation would have 

24 exceeded an applicable cap on annual compensation. 
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1 (2) PERIOD SPECIFIED.—The period specified 

2 in this paragraph is the period beginning on Janu3 ary 8, 2006, and ending on December 31, 2017. 

4 (3) EXCLUSION.—Compensation authorized 

5 under this subsection shall not be included in the 

6 calculation of any aggregate limit on compensation 

7 for a covered employee for the year in which it is 

8 paid. 

9 (4) CHARGING OF COMPENSATION.—Compensa10 tion authorized under this subsection shall be 

11 charged to the appropriate medical care appropria12 tion account of the Department of Veterans Affairs 

13 for the fiscal year in which the work was performed 

14 except as follows: 

15 (A) In the case of an account that has 

16 closed pursuant to section 1552 of title 31, 

17 United States Code, the compensation shall be 

18 charged to a current appropriation account in 

19 accordance with section 1553 of such title. 

20 (B) In the case of an expired account that 

21 has not closed, if charging the compensation to 

22 the expired account would cause such account 

23 to have a negative unliquidated or unexpended 

24 balance, the compensation may be charged to a 
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1 current appropriation account available for the 

2 same purpose. 

3 (5) DEFINITIONS.—In this subsection: 

4 (A) The term ‘‘compensation’’ means any 

5 pay, including salary, awards, and incentives. 

6 (B) The term ‘‘covered employee’’ means a 

7 physician, podiatrist, or dentist subject to mar8 ket pay under section 7431 of title 38, United 

9 States Code. 

10 SEC. 143. REIMBURSEMENT OF AMBULANCE COST FOR 

11 CARE FOR CERTAIN RURAL VETERANS. 

12 (a) IN GENERAL.—The Secretary of Veterans Affairs 

13 shall pay, or reimburse a covered veteran for, the cost of 

14 transporting the veteran by ambulance, including air am15 bulance, from a covered location to a provider of the De16 partment of Veterans Affairs, a non-Department provider, 

17 or the nearest hospital that can meet the needs of the vet18 eran (including a hospital that compacts with the Indian 

19 Health Service) for covered care. 

20 (b) AMOUNT COVERED.—The maximum cumulative 

21 amount covered under this section for a covered veteran 

22 is $46,000. 

23 (c) SUNSET.—This section shall cease to be effective 

24 on September 30, 2026. 

25 (d) DEFINITIONS.—In this section: 
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1 (1) The term ‘‘covered care’’ means care for a 

2 veteran eligible for care provided by the Department 

3 of Veterans Affairs under title 38, United States 

4 Code, or any other law administered by the Sec5 retary of Veterans Affairs, even if the care associ6 ated with the transport described in subsection (a) 

7 is not authorized by the Department. 

8 (2) The term ‘‘covered location’’ means a loca9 tion that is— 

10 (A) in a State that is 100 miles or more 

11 from the nearest medical center of the Depart12 ment of Veterans Affairs; and 

13 (B) in an area rated as a 10 or higher 

14 under the rural-urban commuting areas coding 

15 system of the Department of Agriculture. 

16 (3) The term ‘‘covered veteran’’ means a vet17 eran who— 

18 (A) has a service-connected disability rated 

19 by the Secretary as between 0 and 30 percent 

20 disabling; 

21 (B) is not eligible for payments or reim22 bursements for beneficiary travel or other 

23 transportation under the laws administered by 

24 the Secretary of Veterans Affairs, other than 

25 under this section; and 
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1 (C) is not entitled to care or services under 

2 a non-Department of Veterans Affairs health3 plan contract. 

4 (4) The term ‘‘health-plan contract’’ has the 

5 meaning given that term in section 1725 of title 38, 

6 United States Code. 

7 (5) The term ‘‘service-connected’’ has the 

8 meaning given that term in section 101 of such title. 

9 SEC. 144. PILOT PROGRAM TO FURNISH DENTAL CARE 

10 FROM THE DEPARTMENT OF VETERANS AF11 FAIRS TO CERTAIN VETERANS DIAGNOSED 

12 WITH ISCHEMIC HEART DISEASE. 

13 (a) IN GENERAL.—Beginning not later than one year 

14 after the date of the enactment of this Act, the Secretary 

15 of Veterans Affairs shall carry out a two-year pilot pro16 gram (in this section referred to as the ‘‘pilot program’’) 

17 under which the Secretary shall furnish covered care to 

18 covered veterans through means that include the use of 

19 community care. 

20 (b) LOCATIONS.— 

21 (1) IN GENERAL.—The Secretary shall select 

22 not more than four States in which to carry out the 

23 pilot program. 
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1 (2) SELECTION CRITERIA.—In selecting States 

2 under paragraph (1), the Secretary shall prioritize 

3 States in which— 

4 (A) the Department of Veterans Affairs 

5 serves a high proportion, as determined by the 

6 Secretary, of veterans residing in rural or high7 ly rural areas (as determined through the use 

8 of the Rural-Urban Commuting Areas coding 

9 system of the Department of Agriculture); 

10 (B) dental clinics operated by the Depart11 ment of Veterans Affairs currently utilize tele12 dentistry; 

13 (C) the Department of Veterans Affairs 

14 does not currently operate a dental clinic; or 

15 (D) the Secretary determines a large per16 centage of veterans enrolled in the system of 

17 annual patient enrollment of the Department of 

18 Veterans Affairs established and operated under 

19 paragraphs (1) or (2) of section 1705(a) of title 

20 38, United States Code, visit emergency rooms 

21 for dental emergencies at high rates. 

22 (c) PARTICIPATION LIMITATION.—Participation in a 

23 pilot program established pursuant to this section shall be 

24 limited to a covered veteran who receives health care in 
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1 a facility of the Department located in a State selected 

2 under subsection (b). 

3 (d) USE OF CERTAIN METHODS TO PROVIDE

4 CARE.— 

5 (1) MOBILE DENTAL CLINICS.—In carrying out 

6 the pilot program, the Secretary shall test the effi7 cacy of mobile dental clinics to service rural areas 

8 that do not have a population base to warrant a full9 time clinic but where there are covered veterans in 

10 need of dental care. 

11 (2) HOME-BASED DENTAL CARE.—In carrying 

12 out the pilot program, the Secretary shall test the 

13 efficacy of portable dental care units to service rural 

14 veterans in their homes, as the Secretary considers 

15 medically appropriate. 

16 (e) ADMINISTRATION.— 

17 (1) COMMUNITY CARE NETWORK REVIEW.— 

18 (A) IN GENERAL.—Before commencing the 

19 pilot program, the Secretary shall work with 

20 third party administrators to conduct a review 

21 of dental providers who are part of the commu22 nity care network of the Department in each 

23 State selected under subsection (b)(1) to en24 sure— 
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1 (i) dental providers who are no longer 

2 accepting patients from the Department— 

3 (I) are not still listed as pro4 viders accepting referrals from the 

5 Department; and 

6 (II) are not sent referrals from 

7 the Department; and 

8 (ii) dental providers participating in 

9 each such network are capable of receiving 

10 an influx of patients from the Department 

11 under the pilot program. 

12 (B) EXPANSION OF NETWORK.—If, pursu13 ant to a review under subparagraph (A), the 

14 Secretary determines the community care net15 work in a State selected under subsection (b)(1) 

16 is not capable of receiving an influx of patients 

17 under the pilot program, the Secretary shall co18 ordinate with the Third Party Administrator 

19 for such State to ensure the dental provider 

20 network of such community care network is suf21 ficiently expanded before the initiation of the 

22 pilot program. 

23 (2) NOTICE TO COVERED VETERANS.—In car24 rying out the pilot program, the Secretary shall in25 form all covered veterans in States selected under 
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1 subsection (b)(1) of the covered care available under 

2 the pilot program. 

3 (3) LOSS OF ELIGIBILITY.—Any veteran par4 ticipating in the pilot program who ceases to be a 

5 covered veteran shall be removed from the pilot pro6 gram on the date that is 90 days after the Secretary 

7 determines the participant is no longer a covered 

8 veteran. 

9 (4) CONTINUITY OF CARE.— 

10 (A) IN GENERAL.—Upon the termination 

11 of the pilot program, the Secretary shall provide 

12 to all veterans participating in the pilot pro13 gram at the time of such termination— 

14 (i) information on how to enroll in the 

15 dental insurance plan of the Department of 

16 Veterans Affairs under section 1712C of 

17 title 38, United States Code; 

18 (ii) if appropriate, information on the 

19 VETSmile program of the Department of 

20 Veterans Affairs, or any successor pro21 gram; and 

22 (iii) contact information for dental 

23 providers in the surrounding community 

24 who provide low- or no-cost dental care 
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1 and whom the Secretary has confirmed are 

2 available to take on new patients. 

3 (B) CONTINUATION OF TREATMENT

4 PLAN.—Any veteran participating in the pilot 

5 program may continue to receive services under 

6 the pilot program after the termination of the 

7 pilot program to complete a treatment plan 

8 commenced under the pilot program, as deter9 mined necessary by the Secretary. 

10 (f) REPORTS.— 

11 (1) ANNUAL REPORT.—Not later than one year 

12 after the commencement of the pilot program, and 

13 annually thereafter for the duration of the pilot pro14 gram, the Secretary of Veterans Affairs shall submit 

15 to the Committees on Veterans’ Affairs of the House 

16 of Representatives and the Senate a report on the 

17 pilot program that includes— 

18 (A) an identification of the States partici19 pating in the pilot program; 

20 (B) a description of the implementation 

21 and operation of the pilot program; 

22 (C) the number of participants in the pilot 

23 program, disaggregated by— 

24 (i) State; and 

25 (ii) disability rating; 
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1 (D) an identification of any barriers or 

2 challenges to implementing the pilot program; 

3 (E) aggregated feedback from participants 

4 in the pilot program, including from interviews 

5 and surveys; 

6 (F) the average annual cost of providing 

7 covered care to a participant in the pilot pro8 gram, disaggregated by— 

9 (i) State; 

10 (ii) disability rating; and 

11 (iii) whether the care was provided 

12 through the community care network or 

13 through a provider of the Department; 

14 (G) an analysis of the communication and 

15 collaboration of the Department with Third 

16 Party Administrators and community care den17 tal providers, disaggregated by State; 

18 (H) an analysis of any cost savings by the 

19 Department with respect to the treatment of 

20 ischemic heart disease; 

21 (I) an assessment of the impact of the 

22 pilot program on appointments for care, pre23 scriptions, hospitalizations, emergency room vis24 its, wellness, employability, satisfaction, and 

25 perceived quality of life of covered veterans re-
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1 lated to their diagnosis of ischemic heart dis2 ease; 

3 (J) an analysis and assessment of the effi4 cacy of mobile clinics and portable dental care 

5 units, to the extent such modalities are used, to 

6 service the needs of covered veterans under the 

7 pilot program; 

8 (K) an analysis and assessment of the 

9 usage of teledentistry to service the needs of 

10 covered veterans under the pilot program, to in11 clude a cost benefit analysis of such services; 

12 and 

13 (L) such other matters as the Secretary 

14 considers appropriate. 

15 (2) FINAL REPORT.—Not later than 90 days 

16 before the completion of the pilot program, the Sec17 retary shall submit to the Committees on Veterans’ 

18 Affairs of the House of Representatives and the Sen19 ate a report on the pilot program that— 

20 (A) includes the matters required under 

21 paragraph (1); 

22 (B) includes recommendations on whether 

23 the pilot program should be continued, ex24 panded, or adopted throughout the Department; 

25 and 
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1 (C) indicates whether the Secretary re2 quests action by Congress to make the pilot 

3 program permanent. 

4 (g) IMPACT ON COMMUNITY CARE.—Participants in 

5 the pilot program shall be able to access covered care in 

6 the community under section 1703 of title 38, United 

7 States Code. 

8 (h) DEFINITIONS.—In this section: 

9 (1) The term ‘‘covered care’’ means dental care 

10 that is consistent with the dental services and treat11 ment furnished by the Secretary of Veterans Affairs 

12 to veterans pursuant to section 1712(a)(1)(G) of 

13 title 38, United States Code. 

14 (2) The term ‘‘covered veteran’’ means a vet15 eran who— 

16 (A) is enrolled in the system of annual pa17 tient enrollment of the Department established 

18 and operated under paragraphs (1) or (2) of 

19 section 1705(a) of title 38, United States Code; 

20 (B) is not eligible for dental services and 

21 treatment and related dental appliances under 

22 the laws administered by the Secretary as of 

23 the date of the enactment of this Act; and 

24 (C) has a diagnosis of ischemic heart dis25 ease. 
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1 (3) The term ‘‘Third Party Administrator’’ has 

2 the meaning given such term in section 1703F of 

3 such title. 

4 SEC. 145. DOCUMENTATION OF PREFERENCES OF VET5 ERANS FOR SCHEDULING OF APPOINTMENTS 

6 FOR HEALTH CARE UNDER LAWS ADMINIS7 TERED BY SECRETARY OF VETERANS AF8 FAIRS. 

9 (a) IN GENERAL.—Not later than one year after the 

10 date of the enactment of this Act, the Secretary of Vet11 erans Affairs shall develop a mechanism to solicit informa12 tion regarding the preference of veterans enrolled in the 

13 system of annual patient enrollment of the Department 

14 of Veterans Affairs established and operated under section 

15 1705(a) of title 38, United States Code, for scheduling 

16 of appointments for health care and related services under 

17 the laws administered by the Secretary, including through 

18 non-Department providers. 

19 (b) DOCUMENTATION OF PREFERENCE.—Pref20 erences provided voluntarily by a veteran pursuant to sub21 section (a) shall be documented on My HealtheVet or an22 other system designated by the Secretary that allows the 

23 veteran to view and change such preferences at any time. 

24 (c) INCLUSION IN PREFERENCE.—Preferences solic25 ited under subsection (a) shall include the following: 
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1 (1) How and when the veteran prefers to be 

2 contacted about an appointment for health care. 

3 (2) Whether the veteran prefers to schedule ap4 pointments without the assistance of the Depart5 ment, if able. 

6 (3) Whether the veteran prefers to select a pro7 vider without the assistance of the Department, if 

8 able. 

9 (4) Whether the veteran prefers appointments 

10 to be scheduled during certain days or times. 

11 (d) USE OF PREFERENCE.—The Secretary shall 

12 make the preferences provided under subsection (a) easily 

13 accessible to medical support assistants and other staff of 

14 the Department, or non-Department staff, as the Sec15 retary determines appropriate, who assist in the appoint16 ment scheduling process. 

17 (e) DEPLOYMENT OF MECHANISM.— 

18 (1) IN GENERAL.—Beginning after the date on 

19 which the Secretary develops the mechanism re20 quired under subsection (a), the Secretary shall— 

21 (A) test the mechanism in not fewer than 

22 three geographically diverse Veterans Inte23 grated Service Networks; and 

24 (B) gather feedback about the effectiveness 

25 of such mechanism from veterans, medical sup-
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1 port assistants, staff and other stakeholders as 

2 the Secretary determines appropriate. 

3 (2) LIMITATION.—The Secretary may not im4 plement such mechanism across the Veterans Health 

5 Administration of the Department before the Sec6 retary addresses the feedback described in para7 graph (1)(B). 

8 SEC. 146. STAFFING MODEL AND PERFORMANCE METRICS 

9 FOR CERTAIN EMPLOYEES OF THE DEPART10 MENT OF VETERANS AFFAIRS. 

11 (a) STAFFING MODEL.— 

12 (1) IN GENERAL.—Not later than one year 

13 after the date of the enactment of this Act, the Sec14 retary of Veterans Affairs shall— 

15 (A) develop, validate, and implement a 

16 staffing model for the Office of Integrated Vet17 eran Care of the Department of Veterans Af18 fairs, or successor office, Veterans Integrated 

19 Services Networks, and medical centers of the 

20 Department that includes appropriate target 

21 staffing levels nationally, regionally, and locally 

22 to ensure timely access to care and effectively 

23 oversee the provision of care by the Depart24 ment, whether at a facility of the Department 

25 or through a non-Department provider; and 
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1 (B) provide to Congress a briefing on such 

2 staffing model, which shall include— 

3 (i) the metrics and measures used by 

4 the Secretary in developing such staffing 

5 model; 

6 (ii) an analysis of how such staffing 

7 model compares to the staffing models of 

8 other relevant Government-owned and pri9 vate sector health care systems; and 

10 (iii) an estimate of the portion of the 

11 roles in such staffing model that will be 

12 filled by contracted staff at any given time. 

13 (2) REPORT ON IMPLEMENTATION OF STAFF14 ING MODEL.—Not later than one year after the date 

15 on which the Secretary implements the staffing 

16 model required under paragraph (1), the Secretary 

17 shall submit to Congress and the Comptroller Gen18 eral of the United States a report containing— 

19 (A) an update on such implementation; 

20 and 

21 (B) information on the outcomes yielded 

22 by such staffing model in terms of improved ac23 cess to care for veterans and improved compli24 ance with relevant laws, regulations, policy di25 rectives, and guidance governing access to care. 
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1 (b) PERFORMANCE METRICS.— 

2 (1) IN GENERAL.—Not later than one year 

3 after the date of the enactment of this Act, the Sec4 retary shall develop and implement a plan, with an 

5 appropriate tracking system, to incorporate appro6 priate standardized performance metrics and over7 sight measures within the performance appraisal 

8 systems for employees of the Department specified 

9 in paragraph (2). 

10 (2) EMPLOYEES OF THE DEPARTMENT SPECI11 FIED.—Employees of the Department specified in 

12 this paragraph are employees who are responsible 

13 for ensuring timely access to care from the Depart14 ment, compliance with relevant statutes and regula15 tions relating to the provision of care, including sec16 tion 1703 of title 38, United States Code, and over17 seeing the provision of care, whether at a facility of 

18 the Department or through a non-Department pro19 vider, including employees within the Office of Inte20 grated Veteran Care of the Department, or suc21 cessor office, employees of a Veterans Integrated 

22 Service Network, and employees of a medical center 

23 of the Department. 

24 (3) REPORT ON IMPLEMENTATION OF PER25 FORMANCE METRICS.—Not later than one year after 
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1 implementing the performance metrics required 

2 under paragraph (1), the Secretary shall submit to 

3 Congress and the Comptroller General of the United 

4 States a report containing— 

5 (A) an update on such implementation; 

6 and 

7 (B) information on the outcomes yielded 

8 by such performance metrics in terms of im9 proved access to care for veterans and improved 

10 compliance with relevant laws, policy directives, 

11 and guidance governing access to care. 

12 (c) GAO REPORT.—Not later than two years after 

13 the later of the date on which the Comptroller General 

14 receives the report under subsection (a)(2) or the report 

15 under subsection (b)(3), the Comptroller General shall 

16 submit to Congress a report that includes— 

17 (1) an assessment of the performance of the Of18 fice of Integrated Veteran Care of the Department, 

19 or successor office, in improving access to care for 

20 veterans in facilities of the Department and pursu21 ant to section 1703 of title 38, United States Code; 

22 and 

23 (2) such recommendations as the Comptroller 

24 General considers appropriate with respect to im-
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1 proving access to the care described in paragraph 

2 (1) for veterans. 

3 SEC. 147. ONLINE HEALTH EDUCATION PORTAL FOR VET4 ERANS ENROLLED IN PATIENT ENROLLMENT 

5 SYSTEM OF DEPARTMENT OF VETERANS AF6 FAIRS. 

7 Not later than one year after the date of the enact8 ment of this Act, the Secretary of Veterans Affairs shall 

9 establish, on an Internet website of the Department, a 

10 health education portal that includes interactive edu11 cational modules to ensure veterans enrolled in the patient 

12 enrollment system of the Department of Veterans Affairs 

13 established and operated under section 1705(a) of title 38, 

14 United States Code, understand the basic health care eli15 gibilities and entitlements of veterans under the laws ad16 ministered by the Secretary, including under the Veterans 

17 Community Care Program under section 1703 of such 

18 title. 

19 SEC. 148. LIMITATION ON DETAIL OF DIRECTORS OF MED20 ICAL CENTERS OF DEPARTMENT OF VET21 ERANS AFFAIRS TO DIFFERENT POSITIONS. 

22 (a) NOTIFICATION.— 

23 (1) IN GENERAL.—Not later than 90 days after 

24 detailing a director of a medical center of the De25 partment of Veterans Affairs to a different position 
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1 within the Department, the Secretary of Veterans 

2 Affairs shall notify the Committee on Veterans’ Af3 fairs of the Senate and the Committee on Veterans’ 

4 Affairs of the House of Representatives of such de5 tail. 

6 (2) MATTERS TO BE INCLUDED.—The notifica7 tion required by paragraph (1) shall include, with re8 spect to a director of a medical center who is de9 tailed to a different position within the Department, 

10 the following information: 

11 (A) The location at which the director is 

12 detailed. 

13 (B) The position title of the detail. 

14 (C) The estimated time the director is ex15 pected to be absent from their duties at the 

16 medical center. 

17 (D) Such other information as the Sec18 retary may determine appropriate. 

19 (b) APPOINTMENT OF ACTING DIRECTOR.—Not later 

20 than 120 days after detailing a director of a medical cen21 ter of the Department to a different position within the 

22 Department, the Secretary shall appoint an individual as 

23 acting director of such medical center with all of the au24 thority and responsibilities of the detailed director. 
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1 (c) UPDATE ON DETAIL.—Not later than 120 days 

2 after detailing a director of a medical center of the De3 partment to a different position within the Department, 

4 and not less frequently than every 30 days thereafter while 

5 the detail is in effect or while the director position at the 

6 medical center is vacant, the Secretary shall submit to the 

7 Committee on Veterans’ Affairs of the Senate and the 

8 Committee on Veterans’ Affairs of the House of Rep9 resentatives an update regarding the status of the detail. 

10 (d) RETURN TO POSITION OR REASSIGNMENT.— 

11 (1) IN GENERAL.—Except as provided in para12 graph (2), not later than 180 days after detailing a 

13 director of a medical center of the Department to a 

14 different position within the Department, for a rea15 son other than an ongoing investigation or adminis16 trative action with respect to the director, the Sec17 retary shall— 

18 (A) return the individual to the position as 

19 director of the medical center; or 

20 (B) reassign the individual from the posi21 tion as director of the medical center and begin 

22 the process of hiring a new director for such po23 sition. 

24 (2) WAIVER.— 
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1 (A) IN GENERAL.—The Secretary may 

2 waive the requirement under paragraph (1) 

3 with respect to an individual for successive 90- 

4 day increments for a total period of not more 

5 than 540 days from the original date the indi6 vidual was detailed away from their position as 

7 director of a medical center. 

8 (B) NOTIFICATION.—Not later than 30 

9 days after exercising a waiver under subpara10 graph (A), the Secretary shall notify Congress 

11 of the waiver and provide to Congress informa12 tion as to why the waiver is necessary. 

13 SEC. 149. NATIONAL VETERAN SUICIDE PREVENTION AN14 NUAL REPORT. 

15 (a) NATIONAL VETERAN SUICIDE PREVENTION AN16 NUAL REPORT.— 

17 (1) IN GENERAL.—Not later than 18 months 

18 after the date of the enactment of this Act, and not 

19 later than September 30 of each year thereafter, the 

20 Secretary of Veterans Affairs shall submit to the ap21 propriate congressional committees and publish on a 

22 publicly available website of the Department of Vet23 erans Affairs a report to be known as the ‘‘National 

24 Veteran Suicide Prevention Annual Report’’. 

25 (2) EXTENSION.— 
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1 (A) IN GENERAL.—If the Secretary re2 quires an extension of the deadline for a report 

3 under subsection (a), the Secretary shall submit 

4 to the appropriate congressional committees a 

5 written request for such an extension. 

6 (B) ELEMENTS.—Each written request 

7 under paragraph (1) for an extension for a re8 port shall include the following: 

9 (i) The rationale for the delay in the 

10 submission of the report. 

11 (ii) An explanation of the need for an 

12 extension. 

13 (iii) A proposed amended date for the 

14 submission and publication of the report. 

15 (3) BRIEFING.—With respect to each report re16 quired under paragraph (1), the Secretary shall, be17 fore the date on which the Secretary submits such 

18 report, provide to the appropriate congressional com19 mittees a briefing on such report. 

20 (4) ELEMENTS.— 

21 (A) IN GENERAL.—Each report required 

22 under paragraph (1) shall include— 

23 (i) the findings of the national anal24 ysis of veteran suicide rates for the latest 

25 year for which data is available; 
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1 (ii) an identification of trends, if any, 

2 demonstrated by such data; and 

3 (iii) a comparison of such data to data 

4 on veteran suicide rates during preceding 

5 years. 

6 (B) ADDITIONAL ELEMENTS.—Each report 

7 under paragraph (1) shall include, for the year 

8 covered by the report, the following: 

9 (i) Suicide rates of veterans 

10 disaggregated by age, gender, and race or 

11 ethnicity. 

12 (ii) Trends in suicide rates of veterans 

13 compared to engagement of those veterans 

14 with health care from the Veterans Health 

15 Administration, including an examination 

16 of trends in suicide rates or deaths 

17 among— 

18 (I) veterans who have recently re19 ceived health care from the Veterans 

20 Health Administration as compared to 

21 veterans who have never received 

22 health care from the Veterans Health 

23 Administration; 

24 (II) veterans who are enrolled in 

25 the patient enrollment system of the 
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1 Department of Veterans Affairs under 

2 section 1705(a) of title 38, United 

3 States Code, as compared to veterans 

4 who have never enrolled in such sys5 tem; 

6 (III) veterans who have recently 

7 used services from a Vet Center as 

8 compared to veterans who have never 

9 used such services; 

10 (IV) to the extent practicable, 

11 veterans who have a diagnosis of sub12 stance use disorder; and 

13 (V) other groups of veterans re14 lating to engagement with health care 

15 from the Veterans Health Administra16 tion, as the Secretary considers prac17 ticable. 

18 (iii) To the extent practicable, trends 

19 in suicide rates of veterans compared to 

20 engagement of those veterans with benefits 

21 from the Veterans Benefits Administra22 tion, including an examination of trends in 

23 suicide rates or deaths among— 

24 (I) veterans who are currently 

25 using, have previously used, or have 
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1 never used educational assistance 

2 under the laws administered by the 

3 Secretary; 

4 (II) veterans who are currently 

5 receiving, have previously received, or 

6 have never received services or assist7 ance under chapter 31 of title 38, 

8 United States Code; 

9 (III) with respect to compensa10 tion under chapter 11 of such title— 

11 (aa) veterans who were re12 cipients of such compensation as 

13 compared to veterans who never 

14 applied for such compensation 

15 prior to death; 

16 (bb) veterans who had a 

17 claim denied for such compensa18 tion prior to death; 

19 (cc) veterans who had a 

20 pending claim for such com21 pensation at time of death; and 

22 (dd) veterans who had an 

23 entitlement for such compensa24 tion reduced prior to death; 
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1 (IV) veterans who are currently 

2 receiving or have never received pen3 sion under chapter 15 of title 38, 

4 United States Code; 

5 (V) veterans who are currently 

6 using, have recently used, or have 

7 never used programs or services pro8 vided by the Homeless Programs Of9 fice of the Department, including an 

10 examination of trends in suicide rates 

11 or deaths among veterans who made 

12 contact with such office but were de13 nied or deemed ineligible for any such 

14 program or service; 

15 (VI) with respect to housing 

16 loans guaranteed by the Secretary 

17 under chapter 37 of title 38, United 

18 States Code, veterans who are current 

19 recipients of, were recent recipients of, 

20 or have never received such a loan; 

21 (VII) veterans owing debts to the 

22 Department; 

23 (VIII) veterans who were in24 volved in a veterans treatment court 
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1 program, whether they graduated suc2 cessfully or not; and 

3 (IX) veterans who were success4 fully contacted, unsuccessfully con5 tacted, or never contacted by the De6 partment through the Solid Start pro7 gram under section 6320 of title 38, 

8 United States Code. 

9 (C) STRATEGY AND RECOMMENDATIONS.— 

10 (i) INITIAL REPORT.—The initial re11 port under paragraph (1) shall include a 

12 strategy and recommendations developed 

13 by the Secretary of Veterans Affairs, in 

14 collaboration with the Director of the Cen15 ters for Disease Control and Prevention, 

16 for— 

17 (I) improving data collection at 

18 the State and local levels to accurately 

19 capture suicide deaths of veterans; 

20 (II) improving the timeliness, ef21 ficacy, and standardization of data re22 porting on suicide deaths of veterans 

23 at the Federal level, including by the 

24 Centers for Disease Control and Pre-
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1 vention and the Department of Vet2 erans Affairs; 

3 (III) improving the timeliness of 

4 identification and analysis of suicide 

5 deaths of veterans by Federal agen6 cies, including the Centers for Disease 

7 Control and Prevention, and the De8 partment of Veterans Affairs; and 

9 (IV) any other necessary process 

10 improvements for improving the time11 liness, efficacy, and standardization of 

12 reporting of data relating to suicide 

13 deaths of veterans, particularly with 

14 respect to the annual report under 

15 this section. 

16 (ii) SUBSEQUENT REPORTS.—Each 

17 report after the initial report under para18 graph (1) shall include updates on actions 

19 taken to meet the strategy and rec20 ommendations developed under subpara21 graph (A). 

22 (5) DEFINITIONS.—In this subsection: 

23 (A) The term ‘‘appropriate congressional 

24 committees’’ means the Committees on Vet-
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1 erans’ Affairs of the Senate and the House of 

2 Representatives. 

3 (B) The term ‘‘Vet Center’’ means a cen4 ter for readjustment counseling and related 

5 mental health services for veterans under sec6 tion 1712A of title 38, United States Code. 

7 (b) INDEPENDENT ASSESSMENT OF NATIONAL VET8 ERAN SUICIDE PREVENTION ANNUAL REPORT.— 

9 (1) IN GENERAL.—Not later than 90 days after 

10 the date of the enactment of this Act, the Secretary 

11 of Veterans Affairs shall enter into one or more con12 tracts with a private sector entity described in para13 graph (5) to conduct an independent assessment of 

14 the National Veteran Suicide Prevention Annual Re15 port required under subsection (a). 

16 (2) FREQUENCY.—The private sector entity or 

17 entities carrying out the assessment required under 

18 paragraph (1) shall complete such assessment not 

19 later than 240 days after entering into the contract 

20 described in such subsection and not less frequently 

21 than every five years thereafter. 

22 (3) ELEMENTS.—Each assessment required 

23 under paragraph (1) shall analyze the following: 

24 (A) The methodology used by the Depart25 ment to track, analyze, categorize, and report 
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1 suicide deaths and suicide rates among vet2 erans. 

3 (B) Whether data sources used by the De4 partment to compile data on suicide deaths and 

5 suicide rates among veterans are accurately re6 flecting such data. 

7 (C) Vulnerabilities in the methodology used 

8 by the Department that could lead to inac9 curate counting of suicide deaths and suicide 

10 rates among veterans. 

11 (D) The ability of the Department to cross 

12 reference suicide deaths and suicide rates 

13 among veterans with trends in usage of pro14 grams of the Veterans Health Administration 

15 or the Veterans Benefits Administration or 

16 other programs that could serve as widespread 

17 protective factors against suicide. 

18 (E) Improvements that could be made to 

19 ensure the National Veteran Suicide Prevention 

20 Annual Report required under subsection (a) is 

21 accurate and comprehensive and provides in22 sights for making improvements to the suicide 

23 prevention efforts of the Department. 

24 (4) REPORT ON ASSESSMENT.— 
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1 (A) REPORT ON FINDINGS AND REC2 OMMENDATIONS.—Not later than 60 days after 

3 completing an assessment required by para4 graph (1), the private sector entity or entities 

5 carrying out the assessment shall submit to the 

6 Secretary of Veterans Affairs and the Commit7 tees on Veterans’ Affairs of the Senate and the 

8 House of Representatives a report on the find9 ings and recommendations of the private sector 

10 entity or entities with respect to such assess11 ment. 

12 (B) REPORT ON PLANNED IMPROVE13 MENTS.—Not later than 60 days after receiving 

14 a report under paragraph (1) with respect to an 

15 assessment required by paragraph (1), the Sec16 retary shall submit to the Committees on Vet17 erans’ Affairs of the Senate and the House of 

18 Representatives a report on how the Depart19 ment plans to improve the National Veteran 

20 Suicide Prevention Annual Report required 

21 under subsection (a) based on such assessment. 

22 (5) PRIVATE SECTOR ENTITY DESCRIBED.—A 

23 private sector entity described in this paragraph is 

24 a private entity that— 
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1 (A) specializes in analyzing large-scale or2 ganizational data collection and analysis efforts, 

3 especially with respect to the health care sector; 

4 and 

5 (B) has experience and proven outcomes in 

6 optimizing the accuracy and comprehensiveness 

7 of data collection and analysis related to sui8 cide. 

9 (c) REPORT ON ADDITIONAL BENEFITS AND SERV10 ICES FROM DEPARTMENT OF VETERANS AFFAIRS TO

11 PREVENT VETERAN SUICIDE.— 

12 (1) IN GENERAL.—Not later than three years 

13 after the date of the enactment of this Act, the Sec14 retary of Veterans Affairs shall submit to the Com15 mittees on Veterans’ Affairs of the Senate and the 

16 House of Representatives and publish on a publicly 

17 available website of the Department of Veterans Af18 fairs a report that analyzes which benefits and serv19 ices under the laws administered by such Secretary, 

20 including such benefits and services furnished by the 

21 Veterans Benefits Administration, have the greatest 

22 impact on the prevention of suicide among veterans, 

23 including recommendations for potential expansion 

24 of services and benefits to reduce the number of vet25 eran suicides. 
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1 (2) ASSESSMENT OF SOLID START PROGRAM.— 

2 The report required by paragraph (1) shall include 

3 an analysis of the effectiveness of the Solid Start 

4 program under section 6320 of title 38, United 

5 States Code, on prevention of suicide among vet6 erans. 

7 (d) TOOLKIT FOR STATE AND LOCAL CORONERS AND

8 MEDICAL EXAMINERS ON BEST PRACTICES FOR IDENTI9 FYING AND REPORTING ON SUICIDE DEATHS OF VET10 ERANS.— 

11 (1) IN GENERAL.—The Secretary of Veterans 

12 Affairs, in collaboration with the Director of the 

13 Centers for Disease Control and Prevention, shall 

14 develop a toolkit for State and local coroners and 

15 medical examiners that contains best practices for— 

16 (A) accurately identifying and reporting 

17 suicide deaths of veterans, including how to 

18 identify veteran status; and 

19 (B) reporting such deaths to the Centers 

20 for Disease Control and Prevention and other 

21 applicable entities. 

22 (2) AVAILABILITY.—Not later than two years 

23 after the date of the enactment of this Act, the Sec24 retary shall make the toolkit developed under para-
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1 graph (1) available on a publicly available website of 

2 the Department of Veterans Affairs. 

3 (3) OUTREACH.—The Secretary, in collabora4 tion with the Director of the Centers for Disease 

5 Control and Prevention, shall conduct outreach to 

6 appropriate State and local agencies to promote the 

7 availability and use of the toolkit developed under 

8 paragraph (1). 

9 SEC. 150. REPORT ON PHYSICAL INFRASTRUCTURE RE10 QUIRED BY MEDICAL FACILITIES OF DEPART11 MENT OF VETERANS AFFAIRS TO PROVIDE 

12 DENTAL CARE SERVICES. 

13 Not later than one year after the date of the enact14 ment of this Act, the Secretary of Veterans Affairs shall 

15 submit to the Committees on Veterans’ Affairs of the Sen16 ate and the House of Representatives a report, for each 

17 medical center or other relevant health care facility of the 

18 Department of Veterans Affairs, that includes— 

19 (1) an identification of the physical infrastruc20 ture, including new facilities, renovations, remodels, 

21 leases, or other infrastructure, such medical center 

22 or health care facility requires to provide dental care 

23 services to veterans eligible for such services under 

24 the laws administered by the Secretary; and 
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1 (2) an analysis of the physical infrastructure 

2 such medical center or health care facility would re3 quire if a greater number of veterans became eligible 

4 for such dental care services pursuant to a modifica5 tion of the laws administered by the Secretary. 

6 SEC. 151. COMPTROLLER GENERAL REPORT ON CERTAIN 

7 ORAL HEALTH CARE PROGRAMS UNDER 

8 LAWS ADMINISTERED BY SECRETARY OF 

9 VETERANS AFFAIRS. 

10 (a) IN GENERAL.—Not later than one year after the 

11 date of the enactment of this Act, the Comptroller General 

12 of the United States shall submit to the Committees on 

13 Veterans’ Affairs of the Senate and the House of Rep14 resentatives a report on the status of the oral health care 

15 programs of the Department of Veterans Affairs, that in16 cludes an assessment of— 

17 (1) any issues with information technology pro18 grams, including Dental Record Manager Plus, that 

19 affect dental care staff of the Department; 

20 (2) the implementation of the dental insurance 

21 plan of the Department under section 1712C of title 

22 38, United States Code; 

23 (3) the implementation and expansion of the 

24 VETSmile program of the Department; 
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1 (4) barriers preventing the Department from 

2 expanding dental care eligibility to all veterans with 

3 ischemic heart disease, including such barriers relat4 ing to physical infrastructure, workforce, and cost of 

5 such dental care; 

6 (5) barriers preventing dental clinics of the De7 partment, if any, from adopting teledentistry; 

8 (6) the demographic makeup of veterans eligible 

9 for dental care paid for by the Department as of the 

10 commencement of the pilot program under section 

11 144 of this Act, including information on— 

12 (A) age; 

13 (B) gender; 

14 (C) race or ethnicity, disaggregated by— 

15 (i) membership in an Indian Tribe; 

16 and 

17 (ii) the major race groups used in the 

18 decennial census; 

19 (D) employment status; and 

20 (E) location of residence, disaggregated by 

21 rural, highly rural, and urban locations; and 

22 (7) changes to such demographic makeup if 

23 any, that would result from an expansion of eligi24 bility for dental care under the laws administered by 

25 the Secretary to all veterans with ischemic heart dis-
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1 ease including changes to demographics specified in 

2 paragraph (6). 

3 (b) THIRD PARTY ADMINISTRATOR DEFINED.—In 

4 this section, the term ‘‘Third Party Administrator’’ means 

5 an entity that manages a provider network and performs 

6 administrative services related to such network under sec7 tion 1703 of title 38, United States Code. 

8 SEC. 152. REVIEW OF WORKFLOWS ASSOCIATED WITH 

9 PROCESSING REFERRALS BETWEEN FACILI10 TIES OF THE VETERANS HEALTH ADMINIS11 TRATION. 

12 (a) IN GENERAL.—The Secretary of Veterans Affairs 

13 shall conduct a review of the workflows directly associated 

14 with processing referrals of patients between facilities of 

15 the Veterans Health Administration of the Department of 

16 Veterans Affairs to identify specific delays or bottlenecks 

17 in such referrals. 

18 (b) ELEMENTS OF REVIEW.—The review required 

19 under subsection (a) shall include a review of— 

20 (1) the interfacility consult management guid21 ance of the Veterans Health Administration that as22 sists facilities described in subsection (a) in con23 structing a workflow for consults between such fa24 cilities; and 
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1 (2) the roles and responsibilities of the individ2 uals involved in the consult management process in 

3 managing such consults, including the role of the re4 ferral coordination team. 

5 (c) REPORT.—Not later than 180 days after the date 

6 of the enactment of this Act, the Secretary shall submit 

7 to Congress a report on the results of the review required 

8 under subsection (a). 

9 SEC. 153. PLAN FOR TIMELY SCHEDULING OF APPOINT10 MENTS AT MEDICAL FACILITIES OF DEPART11 MENT OF VETERANS AFFAIRS. 

12 (a) PLAN REQUIRED.—To improve responsiveness in 

13 the provision of hospital care and medical services at med14 ical facilities of the Department of Veterans Affairs, the 

15 Secretary of Veterans Affairs shall develop a plan to— 

16 (1) ensure that whenever a covered veteran con17 tacts the Department by telephone to request the 

18 scheduling of an appointment for care or services for 

19 the covered veteran at such a facility, the scheduling 

20 for the appointment occurs during that telephone 

21 call (regardless of the prospective date of the ap22 pointment being scheduled); and 

23 (2) provide timely and, where applicable, same24 day scheduling for an appointment described in 

25 paragraph (1). 
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1 (b) REPORT.—Not later than one year after the date 

2 of the enactment of this Act, the Secretary shall submit 

3 to the Committees on Veterans’ Affairs of the House of 

4 Representatives and the Senate a report on the plan under 

5 subsection (a). 

6 (c) COVERED VETERAN DEFINED.—In this section, 

7 the term ‘‘covered veteran’’ means a veteran who is en8 rolled in the system of patient enrollment of the Depart9 ment under section 1705(a) of title 38, United States 

10 Code. 

11 SEC. 154. AUTHORIZATION OF APPROPRIATIONS TO SUP12 PORT INITIATIVES FOR MOBILE MAMMOG13 RAPHY SERVICES FOR VETERANS. 

14 There is authorized to be appropriated to the Sec15 retary of Veterans Affairs $5,000,000 for fiscal year 2025 

16 for the Office of Women’s Health of the Department of 

17 Veterans Affairs under section 7310 of title 38, United 

18 States Code, to be used by the Secretary to expand access 

19 of women veterans to— 

20 (1) mobile mammography initiatives; 

21 (2) advanced mammography equipment; and 

22 (3) outreach activities to publicize those initia23 tives and equipment. 
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1 TITLE II—ECONOMIC 

2 OPPORTUNITY MATTERS 

3 Subtitle A—Educational Assistance 

4 SEC. 201. TEMPORARY EXPANSION OF ELIGIBILITY FOR MA5 RINE GUNNERY SERGEANT JOHN DAVID FRY 

6 SCHOLARSHIP. 

7 (a) IN GENERAL.—The Secretary of Veterans Affairs 

8 shall treat an individual described in subsection (b) as a 

9 covered individual described in section 3311(b) of title 38, 

10 United States Code. 

11 (b) COVERED INDIVIDUAL DESCRIBED.—An indi12 vidual described in this subsection is an individual who 

13 is the child or spouse of a person— 

14 (1) who dies from a service-connected disability 

15 during the 120-day period immediately following the 

16 day on which the person was discharged or released 

17 from duty as a member of the Armed Forces (with18 out regard to whether such duty was active duty); 

19 and 

20 (2)(A) who received an honorable discharge; or 

21 (B) whose service in the Armed Forces is char22 acterized by the Secretary concerned as honorable 

23 service. 

24 (c) APPLICABILITY.—This section shall apply with re25 spect to— 
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1 (1) deaths that occur before, on, or after the 

2 date of the enactment of this Act; and 

3 (2) a quarter, semester, or term, as applicable, 

4 commencing— 

5 (A) on or after August 1, 2025; and 

6 (B) before October 1, 2027. 

7 SEC. 202. REMOVAL OF EXPIRATION ON ENTITLEMENT TO 

8 MARINE GUNNERY SERGEANT JOHN DAVID 

9 FRY SCHOLARSHIP FOR SURVIVING SPOUSES. 

10 Section 3311(f) of title 38, United States Code, is 

11 amended— 

12 (1) by striking paragraph (2); 

13 (2) by redesignating paragraphs (3) through 

14 (5) as paragraphs (2) through (4), respectively; 

15 (3) in paragraph (2), as redesignated by para16 graph (2) of this section, by striking ‘‘in paragraph 

17 (4)’’ and inserting ‘‘in paragraph (3)’’; and 

18 (4) in paragraph (3)(A), as redesignated by 

19 paragraph (2) of this section, by striking ‘‘under 

20 paragraph (3)’’ and inserting ‘‘under paragraph 

21 (2)’’. 
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1 SEC. 203. SOLE LIABILITY FOR TRANSFERRED EDU2 CATIONAL ASSISTANCE BY AN INDIVIDUAL 

3 WHO FAILS TO COMPLETE A SERVICE AGREE4 MENT. 

5 Subsection (i) of section 3319 of title 38, United 

6 States Code, is amended— 

7 (1) in paragraph (1)— 

8 (A) by striking ‘‘In the event’’ and insert9 ing ‘‘Subject to paragraph (2), in the event’’; 

10 and 

11 (B) by inserting ‘‘of this title’’ after ‘‘sec12 tion 3685’’; 

13 (2) in subparagraph (A) of paragraph (2)— 

14 (A) in the heading, by striking ‘‘IN GEN15 ERAL’’ and inserting ‘‘SOLE LIABILITY’’; and 

16 (B) by striking ‘‘under paragraph (1)’’ and 

17 inserting ‘‘for which the individual shall be sole18 ly liable to the United States for the amount of 

19 the overpayment for purposes of section 3685 

20 of this title’’; and 

21 (3) in subparagraph (B) of paragraph (2)— 

22 (A) in the matter preceding clause (i), by 

23 striking ‘‘Subparagraph (A) shall not apply’’ 

24 and inserting ‘‘Neither the individual nor the 

25 dependent shall be liable to the United States 
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1 for the amount of the overpayment for purposes 

2 of section 3685 of this title’’; and 

3 (B) in clause (ii), by inserting ‘‘of this 

4 title’’ after ‘‘section 3311(c)(4)’’. 

5 SEC. 204. NOTICE TO EDUCATIONAL INSTITUTIONS OF 

6 RISK-BASED SURVEYS. 

7 Section 3673A(d) of title 38, United States Code, is 

8 amended by striking ‘‘one business day’’ and inserting 

9 ‘‘two business days’’. 

10 SEC. 205. RELATIONSHIP OF PARTICIPATION BY AN EDU11 CATIONAL INSTITUTION IN CERTAIN FED12 ERAL STUDENT FINANCIAL AID PROGRAMS 

13 TO APPROVAL OF SUCH INSTITUTION FOR 

14 PURPOSES OF DEPARTMENT OF VETERANS 

15 AFFAIRS EDUCATIONAL ASSISTANCE PRO16 GRAMS. 

17 Paragraph (4) of section 3675(b) of title 38, United 

18 States Code, is amended to read as follows: 

19 ‘‘(4) The educational institution— 

20 ‘‘(A) is approved and participates in a pro21 gram under title IV of the Higher Education 

22 Act of 1965 (20 U.S.C. 1070 et seq.); or 

23 ‘‘(B) does not participate in such a pro24 gram and the Secretary has waived the require25 ment under this paragraph with respect to the 
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1 educational institution, and submits to the 

2 Committee on Veterans’ Affairs of the Senate 

3 and the Committee on Veterans’ Affairs of the 

4 House of Representatives notice of such waiver, 

5 because the Secretary determines that the edu6 cational institution— 

7 ‘‘(i) elects not to participate in such a 

8 program; 

9 ‘‘(ii) cannot participate in such a pro10 gram; or 

11 ‘‘(iii) is in the process of making a 

12 good-faith effort to submit an initial appli13 cation for approval to participate in such a 

14 program, except that a waiver under this 

15 clause may not be provided for a period of 

16 longer than 36 months.’’. 

17 SEC. 206. EXPANSION OF DEPARTMENT OF VETERANS AF18 FAIRS OVERSIGHT OF CERTAIN EDU19 CATIONAL INSTITUTIONS. 

20 (a) ADDITIONAL REQUIREMENT FOR APPROVAL.— 

21 Section 3675(b) of title 38, United States Code, as amend22 ed by section 205, is further amended by adding at the 

23 end the following new paragraph: 

24 ‘‘(5) The educational institution agrees to, not 

25 later than 30 days after any date on which such 
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1 educational institution becomes subject to an action 

2 or event described in section 3673(e)(3) of this title, 

3 submit to the State approving agency, or the Sec4 retary when acting in the role of a State approving 

5 agency, a notification of such action or event in such 

6 form and containing such information as the Sec7 retary determines appropriate.’’. 

8 (b) ADDITIONAL REQUIREMENT FOR APPROVAL OF

9 NONACCREDITED COURSES.— 

10 (1) IN GENERAL.—Section 3676(c) of such title 

11 is amended— 

12 (A) by redesignating paragraphs (14) 

13 through (16) as paragraphs (15) through (17), 

14 respectively; and 

15 (B) by inserting after paragraph (13) the 

16 following new paragraph: 

17 ‘‘(14) The institution agrees to, not later than 

18 30 days after any date on which such institution be19 comes subject to an action or event described in sec20 tion 3673(e)(3) of this title, submit to the State ap21 proving agency, or the Secretary when acting in the 

22 role of a State approving agency, a notification of 

23 such action or event in such form and containing 

24 such information as the Secretary determines appro25 priate.’’. 
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1 (2) CONFORMING AMENDMENTS.—Such title is 

2 further amended— 

3 (A) in section 3672(b)(2)(C), by striking 

4 ‘‘paragraph (14) or (15)’’ and inserting ‘‘para5 graph (15) or (16)’’; 

6 (B) in section 3675(b)(3), by striking 

7 ‘‘(14), (15), and (16)’’ and inserting ‘‘(15), 

8 (16), and (17)’’; 

9 (C) in section 3679(d), by striking ‘‘de10 scribed in paragraph (14) or (15)’’ and insert11 ing ‘‘described in paragraph (15) or (16)’’; and 

12 (D) in section 3680A(a)(4)(C)(iii), by 

13 striking ‘‘section 3676(c)(14) and (15)’’ and in14 serting ‘‘section 3676(c)(15) and (16)’’. 

15 (c) ADDITIONAL GROUNDS FOR SUSPENSION OF AP16 PROVAL.—Section 3679(f)(1) of such title is amended by 

17 adding at the end the following new subparagraph: 

18 ‘‘(I) Comply with the notification requirements 

19 under sections 3675(b)(5) and 3676(c)(14) of this 

20 title, when applicable.’’. 

21 (d) DEADLINE FOR RISK-BASED SURVEYS DATA22 BASE.—The Secretary of Veterans Affairs shall establish 

23 the database required under section 3673A(c) of title 38, 

24 United States Code, by not later than 180 days after the 

25 date of the enactment of this Act. 
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1 SEC. 207. REQUIREMENT THAT EDUCATIONAL INSTITU2 TIONS APPROVED FOR PURPOSES OF DE3 PARTMENT OF VETERANS AFFAIRS EDU4 CATIONAL ASSISTANCE PROGRAMS PROVIDE 

5 DIGITAL OFFICIAL TRANSCRIPTS. 

6 (a) REQUIREMENT.—Section 3675(b) of title 38, 

7 United States Code, as amended by sections 205 and 206, 

8 is further amended by adding at the end the following new 

9 paragraph: 

10 ‘‘(6) The educational institution makes avail11 able to each eligible person or veteran a copy of the 

12 person or veteran’s official transcript in a digital 

13 format.’’. 

14 (b) CONFORMING AMENDMENTS.— 

15 (1) APPROVAL OF COURSES.—Section 

16 3672(b)(2)(A) of such title is amended by striking 

17 ‘‘(b)(1) and (b)(2)’’ and inserting ‘‘paragraphs (1), 

18 (2), and (6) of section 3675(b)’’. 

19 (2) APPROVAL OF NONACCREDITED COURSES.— 

20 Section 3676(c) of such title is amended— 

21 (A) by redesignating paragraph (17) as 

22 paragraph (18); and 

23 (B) by inserting after paragraph (16) the 

24 following new paragraph (17): 

25 ‘‘(17) In the case of a course that leads to a 

26 standard college degree, the educational institution 
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1 satisfies the requirements of section 3675(b)(6) of 

2 this title.’’. 

3 (3) CONFORMING AMENDMENTS.—Section 

4 3675(b)(3) of such title is amended by striking 

5 ‘‘(15), (16), and (17)’’ and inserting ‘‘(15), (16), 

6 and (18)’’. 

7 (c) EFFECTIVE DATE.—The amendments made by 

8 this section shall take effect on August 1, 2025, and apply 

9 with respect to a quarter, semester, or term, as applicable, 

10 commencing on or after such date. 

11 SEC. 208. PAYMENT OF FULL MONTHLY HOUSING STIPEND 

12 FOR VETERANS ENROLLED IN FINAL SEMES13 TER USING EDUCATIONAL ASSISTANCE 

14 UNDER POST-9/11 EDUCATIONAL ASSISTANCE 

15 PROGRAM. 

16 (a) HOUSING ALLOWANCE.—Section 3680(a)(3) of 

17 title 38, United States Code, is amended— 

18 (1) by redesignating subparagraphs (A) and 

19 (B) as clauses (i) and (ii), respectively (and by re20 designating each subordinate provision and the mar21 gins thereof accordingly); 

22 (2) by striking ‘‘Notwithstanding paragraph 

23 (1)’’ and inserting ‘‘(A) Notwithstanding paragraph 

24 (1)’’; 
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1 (3) by striking ‘‘, including a monthly housing 

2 stipend described in section 3313(c) of this title,’’; 

3 and 

4 (4) by adding at the end the following new sub5 paragraph (B): 

6 ‘‘(B) For purposes of providing a monthly housing 

7 stipend described in section 3313(c) to an eligible veteran 

8 or eligible person for whom the Secretary is providing edu9 cational assistance under chapter 33 of this title during 

10 a period that is the last semester, term, or academic period 

11 pursuant to subparagraph (A), the Secretary shall treat 

12 the veteran or person as pursuing a program of education 

13 on a full-time basis.’’. 

14 (b) APPLICATION.—The amendments made by sub15 section (a) shall take effect on the date of the enactment 

16 of this Act and apply with respect to a quarter, semester, 

17 or term, as applicable, commencing on or after January 

18 1, 2025. 

19 SEC. 209. MODIFICATION OF RULES FOR APPROVAL OF 

20 COMMERCIAL DRIVER EDUCATION PRO21 GRAMS FOR PURPOSES OF EDUCATIONAL AS22 SISTANCE PROGRAMS OF THE DEPARTMENT 

23 OF VETERANS AFFAIRS. 

24 (a) IN GENERAL.—Subsection (a)(4) of section 2 of 

25 the Veteran Improvement Commercial Driver License Act 
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1 of 2023 (Public Law 118–95) is amended, in the matter 

2 to be inserted as the new paragraph (2) of section 

3 3680A(e) of title 38, United States Code— 

4 (1) in subparagraph (A)— 

5 (A) in the matter preceding clause (i), by 

6 striking ‘‘the commercial driver education pro7 gram offered at the branch by the educational 

8 institution—’’ and inserting and em dash; and 

9 (B) by striking clauses (i) and (ii) and in10 serting the following: 

11 ‘‘(i) the commercial driver education program 

12 offered at the branch by the educational institution 

13 is approved for purposes of this chapter by a State 

14 approving agency (or the Secretary when acting in 

15 the role of a State approving agency); and 

16 ‘‘(ii)(I) such branch is located in a State in 

17 which such educational institution offers such com18 mercial driver education program at another branch 

19 of such educational institution; or 

20 ‘‘(II) such branch— 

21 ‘‘(aa) has been operating for at least 

22 one year; and 

23 ‘‘(bb) offers such commercial driver 

24 education program, using the same cur-
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1 riculum as another branch of such edu2 cational institution.’’; and 

3 (2) by adding at the end the following new sub4 paragraph: 

5 ‘‘(D) The Secretary shall submit to the Committees 

6 on Veterans’ Affairs of the Senate and House of Rep7 resentatives a notification not later than 30 days after the 

8 Secretary grants an exemption under subparagraph (A). 

9 Such notification shall identify the educational institution, 

10 and the branch thereof, granted such exemption.’’. 

11 (b) IMPLEMENTATION.—Section 2(b) of such Act is 

12 amended— 

13 (1) in paragraph (2), by striking ‘‘180 days’’ 

14 and inserting ‘‘365 days’’; and 

15 (2) by adding at the end the following new 

16 paragraphs: 

17 ‘‘(3) REGULATIONS.—In prescribing any regu18 lation to carry out the amendments made by sub19 section (a), the Secretary of Veterans Affairs shall 

20 consult with State approving agencies designated 

21 under section 3671 of such title. 

22 ‘‘(4) GAO STUDY.—Not later than 365 days 

23 after the applicability date under paragraph (2), the 

24 Comptroller General of the United States shall— 

25 ‘‘(A) conduct a study to— 
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1 ‘‘(i) determine the effects of the 

2 amendments made by subsection (a); and 

3 ‘‘(ii) the feasibility and advisability of 

4 similarly amending the rules for approval 

5 of programs of education for other voca6 tional programs of education; and 

7 ‘‘(B) submit to the Committees on Vet8 erans’ Affairs of the Senate and House of Rep9 resentatives a report on the findings of the 

10 Comptroller General with respect to such 

11 study.’’. 

12 (c) EFFECTIVE DATE.—The amendments made by 

13 this section shall take effect as if included in such Act 

14 on the date of the enactment of such Act. 

15 SEC. 210. PROVISION OF CERTIFICATES OF ELIGIBILITY 

16 AND AWARD LETTERS USING ELECTRONIC 

17 MEANS. 

18 (a) IN GENERAL.—Chapter 36 of title 38, United 

19 States Code, is amended by inserting after section 3698 

20 the following new section (and conforming the table of sec21 tions at the beginning of such chapter accordingly): 
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1 ‘‘§ 3698A. Provision of certificates of eligibility and 

2 award letters using electronic means 

3 ‘‘(a) REQUIREMENT.—Except as provided by sub4 section (b), the Secretary shall provide to an individual 

5 the following documents using electronic means: 

6 ‘‘(1) A certificate of eligibility for the entitle7 ment of the individual to covered educational assist8 ance. 

9 ‘‘(2) An award letter regarding the authoriza10 tion of the individual to receive covered educational 

11 assistance. 

12 ‘‘(b) ELECTION TO OPT OUT.—An individual may 

13 elect to receive the documents specified in subsection (a) 

14 by mail rather than through electronic means under sub15 section (a). An individual may revoke such an election at 

16 any time, by means prescribed by the Secretary. 

17 ‘‘(c) COVERED EDUCATIONAL ASSISTANCE.—In this 

18 section, the term ‘covered educational assistance’ means 

19 educational assistance under chapter 30, 33, or 35 of this 

20 title, or section 3699C of this title.’’. 

21 (b) CLERICAL AMENDMENT.—The table of sections 

22 at the beginning of such chapter is amended by inserting 

23 after the item relating to section 3698 the following new 

24 item: 

‘‘3698A. Provision of certificates of eligibility and award letters using electronic 

means.’’. 
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1 SEC. 211. RETROACTIVE EFFECTIVE DATE OF LAW RE2 GARDING CHARGE TO ENTITLEMENT TO EDU3 CATIONAL ASSISTANCE FOR INDIVIDUALS 

4 WHO DO NOT TRANSFER CREDITS FROM CER5 TAIN CLOSED OR DISAPPROVED PROGRAMS 

6 OF EDUCATION. 

7 Section 3699(c)(2) of title 38, United States Code, 

8 is amended by striking subparagraph (C) and inserting 

9 the following new subparagraph (C): 

10 ‘‘(C) This paragraph, including clauses (ii) and (iii) 

11 of subparagraph (A), shall apply with respect to the clo12 sure or discontinuation of a course or program of edu13 cation, as described in subsection (b)(1), that occurs dur14 ing the period beginning on August 1, 2021, and ending 

15 on September 30, 2025.’’. 

16 SEC. 212. DEPARTMENT OF VETERANS AFFAIRS HIGH 

17 TECHNOLOGY PROGRAM. 

18 (a) HIGH TECHNOLOGY PROGRAM.— 

19 (1) IN GENERAL.—Chapter 36 of title 38, 

20 United States Code, as amended by section 210, is 

21 amended by adding at the end the following new sec22 tion: 

23 ‘‘§ 3699C. High technology program 

24 ‘‘(a) ESTABLISHMENT.—(1) The Secretary shall 

25 carry out a program under which the Secretary provides 

26 covered individuals with the opportunity to enroll in high 
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1 technology programs of education that the Secretary de2 termines provide training or skills sought by employers in 

3 a relevant field or industry. 

4 ‘‘(2) Not more than 4,000 covered individuals may 

5 participate in the program under this section in any fiscal 

6 year. 

7 ‘‘(b) AMOUNT OF ASSISTANCE.—(1) The Secretary 

8 shall provide, to each covered individual who pursues a 

9 high technology program of education under this section, 

10 educational assistance in amounts equal to the amounts 

11 provided under section 3313(c)(1) of this title, including, 

12 except as provided in paragraph (3), with respect to the 

13 housing stipend described in that section and in accord14 ance with the treatment of programs that are distance 

15 learning and programs that are less than half-time. 

16 ‘‘(2) Under paragraph (1), the Secretary shall pro17 vide such amounts of educational assistance to a covered 

18 individual for each of the following: 

19 ‘‘(A) A high technology program of education. 

20 ‘‘(B) A second such program if— 

21 ‘‘(i) the second such program begins at 

22 least 18 months after the covered individual 

23 graduates from the first such program; and 
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1 ‘‘(ii) the covered individual uses edu2 cational assistance under chapter 33 of this 

3 title to pursue the second such program. 

4 ‘‘(3) No covered individual may receive a housing sti5 pend under this subsection for any month if such indi6 vidual is in receipt of a housing stipend under chapter 33 

7 of this title for that month. 

8 ‘‘(c) CONTRACTS.—(1) For purposes of carrying out 

9 subsection (a), the Secretary shall seek to enter into con10 tracts with any number of qualified providers of high tech11 nology programs of education for the provision of such 

12 programs to covered individuals. Each such contract shall 

13 provide for the conditions under which the Secretary may 

14 terminate the contract with the provider and the proce15 dures for providing for the graduation of students who 

16 were enrolled in a program provided by such provider in 

17 the case of such a termination. 

18 ‘‘(2) A contract under this subsection shall provide 

19 that the Secretary shall pay to a provider— 

20 ‘‘(A) upon the enrollment of a covered indi21 vidual in the program, 25 percent of the cost of the 

22 tuition and other fees for the program of education 

23 for the individual; 

24 ‘‘(B) upon graduation of the individual from 

25 the program, 25 percent of such cost; and 
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1 ‘‘(C) 50 percent of such cost upon— 

2 ‘‘(i) the successful employment of the cov3 ered individual for a period— 

4 ‘‘(I) of 180 days in the field of study 

5 of the program; and 

6 ‘‘(II) that begins not later than 180 

7 days following graduation of the covered 

8 individual from the program; 

9 ‘‘(ii) the employment of the individual by 

10 the provider for a period of one year; or 

11 ‘‘(iii) the enrollment of the individual in a 

12 program of education to continue education in 

13 such field of study. 

14 ‘‘(3) For purposes of this section, a provider of a high 

15 technology program of education is qualified if— 

16 ‘‘(A) the provider employs instructors whom the 

17 Secretary determines are experts in their respective 

18 fields in accordance with paragraph (5); 

19 ‘‘(B) the provider has successfully provided the 

20 high technology program for at least one year; 

21 ‘‘(C) the provider does not charge tuition and 

22 fees to a covered individual who receives assistance 

23 under this section to pursue such program that are 

24 higher than the tuition and fees charged by such 

25 provider to another individual; and 
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1 ‘‘(D) the provider meets the approval criteria 

2 developed by the Secretary under paragraph (4). 

3 ‘‘(4)(A) The Secretary shall prescribe criteria for ap4 proving providers of a high technology program of edu5 cation under this section. 

6 ‘‘(B) In developing such criteria, the Secretary may 

7 consult with State approving agencies. 

8 ‘‘(C) Such criteria are not required to meet the re9 quirements of section 3672 of this title. 

10 ‘‘(D) Such criteria shall include the job placement 

11 rate, in the field of study of a program of education, of 

12 covered individuals who complete such program of edu13 cation. 

14 ‘‘(5) The Secretary shall determine whether instruc15 tors are experts under paragraph (3)(A) based on evidence 

16 furnished to the Secretary by the provider regarding the 

17 ability of the instructors to— 

18 ‘‘(A) identify professions in need of new em19 ployees to hire, tailor the programs to meet market 

20 needs, and identify the employers likely to hire grad21 uates; 

22 ‘‘(B) effectively teach the skills offered to cov23 ered individuals; 
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1 ‘‘(C) provide relevant industry experience in the 

2 fields of programs offered to incoming covered indi3 viduals; and 

4 ‘‘(D) demonstrate relevant industry experience 

5 in such fields of programs. 

6 ‘‘(6) In entering into contracts under this subsection, 

7 the Secretary shall give preference to a provider of a high 

8 technology program of education— 

9 ‘‘(A) from which at least 70 percent of grad10 uates find full-time employment in the field of study 

11 of the program during the 180-day period beginning 

12 on the date the student graduates from the program; 

13 or 

14 ‘‘(B) that offers tuition reimbursement for any 

15 student who graduates from such a program and 

16 does not find employment described in subparagraph 

17 (A). 

18 ‘‘(d) EFFECT ON OTHER ENTITLEMENT.—(1) If a 

19 covered individual enrolled in a high technology program 

20 of education under this section has remaining entitlement 

21 to educational assistance under chapter 30, 32, 33, 34, 

22 or 35 of this title, such entitlement shall be charged at 

23 the rate of one month of such entitlement for each month 

24 of educational assistance provided under this section. 
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1 ‘‘(2) If a covered individual enrolled in a high tech2 nology program of education under this section does not 

3 have remaining entitlement to educational assistance 

4 under chapter 30, 32, 33, 34, or 35 of this title, any edu5 cational assistance provided to such individual under this 

6 section shall be provided in addition to the entitlement 

7 that the individual has used. 

8 ‘‘(3) The Secretary may not consider enrollment in 

9 a high technology program of education under this section 

10 to be assistance under a provision of law referred to in 

11 section 3695 of this title. 

12 ‘‘(4)(A) An application for enrollment in a high tech13 nology program of education under this section shall in14 clude notice of the requirements relating to use of entitle15 ment under paragraphs (1) and (2), including— 

16 ‘‘(i) in the case of the enrollment of an indi17 vidual referred to under paragraph (1), the amount 

18 of entitlement that is typically charged for such en19 rollment; 

20 ‘‘(ii) an identification of any methods that may 

21 be available for minimizing the amount of entitle22 ment required for such enrollment; and 

23 ‘‘(iii) an element requiring applicants to ac24 knowledge receipt of the notice under this subpara25 graph. 
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1 ‘‘(B) If the Secretary approves the enrollment of a 

2 covered individual in a high technology program of edu3 cation under this section, the Secretary shall deliver elec4 tronically to the individual an award letter that provides 

5 notice of such approval and includes specific information 

6 describing how paragraphs (1) and (2) will be applied to 

7 the individual if the individual chooses to enroll in the pro8 gram. 

9 ‘‘(e) REQUIREMENTS FOR EDUCATIONAL INSTITU10 TIONS.—(1) The Secretary shall not approve the enroll11 ment of any covered individual, not already enrolled, in 

12 any high technology programs of education under this sec13 tion for any period during which the Secretary finds that 

14 more than 85 percent of the students enrolled in the pro15 gram are having all or part of their tuition, fees, or other 

16 charges paid to or for them by the educational institution 

17 or by the Department of Veterans Affairs under this title 

18 or under chapter 1606 or 1607 of title 10, except with 

19 respect to tuition, fees, or other charges that are paid 

20 under a payment plan at an educational institution that 

21 the Secretary determines has a history of offering pay22 ment plans that are completed not later than 180 days 

23 after the end of the applicable term, quarter, or semester. 

24 ‘‘(2) The Secretary may waive a requirement of para25 graph (1) if the Secretary determines, pursuant to regula-
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1 tions which the Secretary shall prescribe, such waiver to 

2 be in the interest of the covered individual and the Federal 

3 Government. Not later than 30 days after the Secretary 

4 waives such a requirement, the Secretary shall submit to 

5 the Committees on Veterans’ Affairs of the Senate and 

6 House of Representatives a report regarding such waiver. 

7 ‘‘(3)(A)(i) The Secretary shall establish and maintain 

8 a process by which an educational institution may request 

9 a review of a determination that the educational institu10 tion does not meet the requirements of paragraph (1). 

11 ‘‘(ii) The Secretary may consult with a State approv12 ing agency regarding such process or such a review. 

13 ‘‘(iii) Not later than 180 days after the Secretary es14 tablishes or revises a process under this subparagraph, the 

15 Secretary shall submit to the Committees on Veterans’ Af16 fairs of the Senate and House of Representatives a report 

17 regarding such process. 

18 ‘‘(B) An educational institution that requests a re19 view under subparagraph (A)— 

20 ‘‘(i) shall request the review not later than 30 

21 days after the start of the term, quarter, or semester 

22 for which the determination described in subpara23 graph (A) applies; and 

24 ‘‘(ii) may include any information that the edu25 cational institution believes the Department should 
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1 have taken into account when making the deter2 mination, including with respect to any mitigating 

3 circumstances. 

4 ‘‘(f) ANNUAL REPORTS.—Not later than one year 

5 after the date of the enactment of this section, and annu6 ally thereafter until the termination date specified in sub7 section (i), the Secretary shall submit to the Committees 

8 on Veterans’ Affairs of the Senate and House of Rep9 resentatives a report on the operation of program under 

10 this section during the year covered by the report. Each 

11 such report shall include each of the following: 

12 ‘‘(1) The number of covered individuals enrolled 

13 in the program, disaggregated by type of educational 

14 institution, during the year covered by the report. 

15 ‘‘(2) The number of covered individuals who 

16 completed a high technology program of education 

17 under the program during the year covered by the 

18 report. 

19 ‘‘(3) The average employment rate of covered 

20 individuals who completed such a program of edu21 cation during such year, as of 180 days after the 

22 date of completion. 

23 ‘‘(4) The average length of time between the 

24 completion of such a program of education and em25 ployment. 
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1 ‘‘(5) The total number of covered individuals 

2 who completed a program of education under the 

3 program and who, as of the date of the submission 

4 of the report, are employed in a position related to 

5 technology. 

6 ‘‘(6) The average salary of a covered individual 

7 who completed a program of education under the 

8 program and who is employed in a position related 

9 to technology, in various geographic areas deter10 mined by the Secretary. 

11 ‘‘(7) The average salary of all individuals em12 ployed in positions related to technology in the geo13 graphic areas determined under subparagraph (F), 

14 and the difference, if any, between such average sal15 ary and the average salary of a covered individual 

16 who completed a program of education under the 

17 program and who is employed in a position related 

18 to technology. 

19 ‘‘(8) The number of covered individuals who 

20 completed a program of education under the pro21 gram and who subsequently enrolled in a second 

22 program of education under the program. 

23 ‘‘(g) COLLECTION OF INFORMATION; CONSULTA24 TION.—(1) The Secretary shall develop practices to use 
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1 to collect information about covered individuals and pro2 viders of high technology programs of education. 

3 ‘‘(2) For the purpose of carrying out program under 

4 this section, the Secretary may consult with providers of 

5 high technology programs of education and may establish 

6 an advisory group made up of representatives of such pro7 viders, private employers in the technology field, and other 

8 relevant groups or entities, as the Secretary determines 

9 necessary. 

10 ‘‘(h) DEFINITIONS.—In this section: 

11 ‘‘(1) The term ‘covered individual’ means any of 

12 the following: 

13 ‘‘(A) A veteran whom the Secretary deter14 mines— 

15 ‘‘(i) served an aggregate of at least 36 

16 months on active duty in the Armed 

17 Forces (including service on active duty in 

18 entry level and skill training) and was dis19 charged or released therefrom under condi20 tions other than dishonorable; and 

21 ‘‘(ii) has not attained the age of 62. 

22 ‘‘(B) A member of the Armed Forces that 

23 the Secretary determines will become a veteran 

24 described in subparagraph (A) fewer than 180 

25 days after the date of such determination. 
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1 ‘‘(2) The term ‘high technology program of edu2 cation’ means a program of education— 

3 ‘‘(A) offered by a public or private edu4 cational institution; 

5 ‘‘(B) if offered by an institution of higher 

6 learning, that is provided directly by such insti7 tution rather than by an entity other than such 

8 institution under a contract or other agreement; 

9 ‘‘(C) that does not lead to a degree; 

10 ‘‘(D) that has a term of not less than six 

11 and not more than 28 weeks; and 

12 ‘‘(E) that provides instruction in computer 

13 programming, computer software, media appli14 cation, data processing, or information sciences. 

15 ‘‘(i) TERMINATION.—The Secretary may not provide 

16 educational assistance under this section for a high tech17 nology program of education that begins after September 

18 30, 2027.’’. 

19 (2) CLERICAL AMENDMENT.—The table of sec20 tions at the beginning of such chapter is amended 

21 by inserting after the item relating to section 3699B 

22 the following new item: 

‘‘3699C. High technology program.’’. 

23 (b) EFFECT ON HIGH TECHNOLOGY PILOT PRO24 GRAM.—Section 116 of the Harry W. Colmery Veterans 
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1 Educational Assistance Act of 2017 (Public Law 115–48; 

2 38 U.S.C. 3001 note) is amended— 

3 (1) by amending subsection (d) to read as fol4 lows: 

5 ‘‘(d) HOUSING STIPEND.— 

6 ‘‘(1) IN GENERAL.—Except as provided under 

7 paragraph (2), the Secretary shall pay to each eligi8 ble veteran (not including an individual described in 

9 the second sentence of subsection (b)) who is en10 rolled in a high technology program of education 

11 under the pilot program on a full-time or part-time 

12 basis a monthly housing stipend equal to the prod13 uct— 

14 ‘‘(A) of— 

15 ‘‘(i) in the case of a veteran pursuing 

16 resident training, the monthly amount of 

17 the basic allowance for housing payable 

18 under section 403 of title 37, United 

19 States Code, for a member with depend20 ents in pay grade E–5 residing in the mili21 tary housing area that encompasses all or 

22 the majority portion of the ZIP code area 

23 in which is located the campus of the insti24 tution where the individual physically par25 ticipates in a majority of classes; or 
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1 ‘‘(ii) in the case of a veteran pursuing 

2 a program of education through distance 

3 learning, a monthly amount equal to 50 

4 percent of the national average of the 

5 monthly amount of the basic allowance for 

6 housing payable under section 403 of title 

7 37, United States Code, for a member with 

8 dependents in pay grade E–5, multiplied 

9 by 

10 ‘‘(B) the lesser of— 

11 ‘‘(i) 1.0; or 

12 ‘‘(ii) the number of course hours 

13 borne by the individual in pursuit of the 

14 program of education involved, divided by 

15 the minimum number of course hours re16 quired for full-time pursuit of such pro17 gram of education, rounded to the nearest 

18 multiple of 10. 

19 ‘‘(2) BAR TO DUAL ELIGIBILITY.—No covered 

20 individual may receive a housing stipend under this 

21 subsection for any month if such individual is in re22 ceipt of a housing stipend under chapter 33 of title 

23 38, United States Code, for that month.’’; 

24 (2) in subsection (g), by striking paragraph (6); 

25 and 
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1 (3) by striking subsection (h) and inserting the 

2 following new subsection (h): 

3 ‘‘(h) TERMINATION.—The Secretary may not, under 

4 this section, pay a provider for a high technology program 

5 of education that begins after September 30, 2024.’’. 

6 (c) APPROVAL OF CERTAIN HIGH TECHNOLOGY PRO7 GRAMS.—Section 3680A of title 38, United States Code, 

8 is amended— 

9 (1) in subsection (a), by striking paragraph (4) 

10 and inserting the following: 

11 ‘‘(4) Any independent study program except— 

12 ‘‘(A) an independent study program (in13 cluding such a program taken over open circuit 

14 television) that— 

15 ‘‘(i) is accredited by an accrediting 

16 agency or association recognized by the 

17 Secretary of Education under subpart 2 of 

18 part H of title IV of the Higher Education 

19 Act of 1965 (20 U.S.C. 1099b); 

20 ‘‘(ii) leads to— 

21 ‘‘(I) a standard college degree; 

22 ‘‘(II) a certificate that reflects 

23 educational attainment offered by an 

24 institution of higher learning; or 
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1 ‘‘(III) a certificate that reflects 

2 graduation from a course of study of3 fered by— 

4 ‘‘(aa) an area career and 

5 technical education school (as de6 fined in subparagraphs (C) and 

7 (D) of section 3(3) of the Carl D. 

8 Perkins Career and Technical 

9 Education Act of 2006 (20 

10 U.S.C. 2302(3))) that provides 

11 education at the postsecondary 

12 level; or 

13 ‘‘(bb) a postsecondary voca14 tional institution (as defined in 

15 section 102(c) of the Higher 

16 Education Act of 1965 (20 

17 U.S.C. 1002(c))) that provides 

18 education at the postsecondary 

19 level; and 

20 ‘‘(iii) in the case of a program de21 scribed in clause (ii)(III)— 

22 ‘‘(I) provides training aligned 

23 with the requirements of employers in 

24 the State or local area where the pro25 gram is located, which may include in- 
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1 demand industry sectors or occupa2 tions; 

3 ‘‘(II) provides a student, upon 

4 graduation from the program, with a 

5 recognized postsecondary credential 

6 that is recognized by employers in the 

7 relevant industry, which may include 

8 a credential recognized by industry or 

9 sector partnerships in the State or 

10 local area where the industry is lo11 cated; and 

12 ‘‘(III) meets such content and in13 structional standards as may be re14 quired to comply with the criteria 

15 under section 3676(c)(14) and (15) of 

16 this title; or 

17 ‘‘(B) an online high technology program of 

18 education (as defined in subsection (h)(2) of 

19 section 3699C of this title)— 

20 ‘‘(i) the provider of which has entered 

21 into a contract with the Secretary under 

22 subsection (c) of such section; 

23 ‘‘(ii) that has been provided to covered 

24 individuals (as defined in subsection (h)(1) 
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1 of such section) under such contract for a 

2 period of at least five years; 

3 ‘‘(iii) regarding which the Secretary 

4 has determined that the average employ5 ment rate of covered individuals who grad6 uated from such program of education is 

7 65 percent or higher for the year preceding 

8 such determination; and 

9 ‘‘(iv) that satisfies the requirements of 

10 subsection (e) of such section.’’; and 

11 (2) in subsection (d), by adding at the end the 

12 following: 

13 ‘‘(8) Paragraph (1) shall not apply to the enrollment 

14 of a veteran in an online high technology program de15 scribed in subsection (a)(4)(B).’’. 

16 SEC. 213. NOTICE OF CHANGES TO DEPARTMENT OF VET17 ERANS AFFAIRS POLICIES AND GUIDANCE 

18 AFFECTING THE EDUCATIONAL ASSISTANCE 

19 PROGRAMS OF THE DEPARTMENT. 

20 (a) IN GENERAL.—Subchapter III of chapter 36 of 

21 title 38, United States Code, as amended by sections 210 

22 and 212, is further amended by adding at the end the 

23 following new section: 
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1 ‘‘§ 3699D. Notice of changes to policies and guidance 

2 relating to educational assistance pro3 grams 

4 ‘‘In the case of any change to any policy or guidance 

5 provided by the Secretary that relates to any educational 

6 assistance program of the Department, the Secretary may 

7 not implement the change before the date that is 90 days 

8 after the date on which the Secretary makes available to 

9 students, educational institutions, and the Committees on 

10 Veterans’ Affairs of the Senate and House of Representa11 tives notice of, and justification for, the change.’’. 

12 (b) CLERICAL AMENDMENT.—The table of sections 

13 at the beginning of such chapter is amended by inserting 

14 after the item relating to section 3699B the following new 

15 item: 

‘‘3699D. Notice of changes to policies and guidance relating to educational assistance programs.’’. 

16 SEC. 214. PAYMENT OF VA EDUCATIONAL ASSISTANCE VIA 

17 ELECTRONIC FUND TRANSFER TO A FOREIGN 

18 INSTITUTION OF HIGHER EDUCATION. 

19 Not later than 90 days after the date of the enact20 ment of this Act, the Secretary of Veterans Affairs shall 

21 update the payment system of the Department of Veterans 

22 Affairs to allow for electronic fund transfer of educational 

23 assistance, administered by the Secretary, to a foreign in24 stitution of higher education that— 
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1 (1) provides an approved course of education to 

2 an eligible recipient of such assistance; and 

3 (2) does not have— 

4 (A) an employer identification number; or 

5 (B) an account with a domestic bank. 

6 SEC. 215. IMPROVING TRANSPARENCY AND ACCOUNT7 ABILITY OF EDUCATIONAL INSTITUTIONS 

8 FOR PURPOSES OF VETERANS EDUCATIONAL 

9 ASSISTANCE. 

10 (a) REQUIREMENT RELATING TO G.I. BILL COM11 PARISON TOOL.— 

12 (1) REQUIREMENT TO MAINTAIN TOOL.—The 

13 Secretary of Veterans Affairs shall maintain the G.I. 

14 Bill Comparison Tool that was established pursuant 

15 to Executive Order 13607 (77 Fed. Reg. 25861; re16 lating to establishing principles of excellence for edu17 cational institutions serving service members, vet18 erans, spouses, and other family members) and in 

19 effect on the day before the date of enactment of 

20 this Act, or a successor tool, to provide relevant and 

21 timely information about programs of education ap22 proved under chapter 36 of title 38, United States 

23 Code, and the educational institutions that offer 

24 such programs. 
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1 (2) DATA RETENTION.—The Secretary shall en2 sure that historical data that is reported via the tool 

3 maintained under paragraph (1) remains easily and 

4 prominently accessible on the benefits.va.gov website, 

5 or a successor website, for a period of not less than 

6 six years from the date of initial publication. 

7 (b) PROVIDING TIMELY AND RELEVANT EDUCATION

8 INFORMATION TO VETERANS, MEMBERS OF THE ARMED

9 FORCES, AND OTHER INDIVIDUALS.— 

10 (1) IN GENERAL.—Not later than one year 

11 after the date of the enactment of this Act, the Sec12 retary of Veterans Affairs, in consultation with the 

13 Secretary of Education, the Secretary of the Treas14 ury, and the heads of other relevant Federal agen15 cies, shall make such changes to the tool maintained 

16 under subsection (a) as the Secretary of Veterans 

17 Affairs determines appropriate to ensure that such 

18 tool is an effective and efficient method for providing 

19 information pursuant to section 3698(b)(5) of title 

20 38, United States Code. 

21 (2) MEMORANDUM OF UNDERSTANDING RE22 QUIRED.—Not later than two years after the date of 

23 the enactment of this Act, the Secretary of Veterans 

24 Affairs shall seek to enter into a memorandum of 

25 understanding with the Secretary of Education and 
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1 the heads other relevant Federal agencies, as the 

2 Secretary of Veterans Affairs determines appro3 priate, to obtain information on outcomes with re4 spect to individuals who are entitled to educational 

5 assistance under the laws administered by the Sec6 retary of Veterans Affairs and who are attending 

7 educational institutions. Such memorandum of un8 derstanding may include data sharing or computer 

9 matching agreements. 

10 (3) MODIFICATION OF SCOPE OF COMPREHEN11 SIVE POLICY ON PROVIDING EDUCATION INFORMA12 TION.—Section 3698 of title 38, United States Code, 

13 is amended— 

14 (A) in subsection (a), by striking ‘‘veterans 

15 and members of the Armed Forces’’ and insert16 ing ‘‘individuals entitled to educational assist17 ance under laws administered by the Secretary 

18 of Veterans Affairs’’; and 

19 (B) in subsection (b)(5)— 

20 (i) by striking ‘‘veterans and members 

21 of the Armed Forces’’ and inserting ‘‘indi22 viduals described in subsection (a)’’; and 

23 (ii) by striking ‘‘the veteran or mem24 ber’’ and inserting ‘‘the individual’’. 
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1 (4) G.I. BILL COMPARISON TOOL REQUIRED

2 DISCLOSURES.—Paragraph (1) of subsection (c) of 

3 such section is amended— 

4 (A) by striking subparagraph (B) and in5 serting the following: 

6 ‘‘(B) for each individual described in subsection 

7 (a) seeking information provided under subsection 

8 (b)(5), the name of each Federal student aid pro9 gram, and a description of each such program, from 

10 which the individual may receive educational assist11 ance; and’’; 

12 (B) in subparagraph (C)— 

13 (i) in clause (i), by inserting ‘‘and a 

14 definition of each type of institution’’ be15 fore the semicolon; 

16 (ii) in clause (iv), by inserting ‘‘and if 

17 so, which programs’’ before the semicolon; 

18 (iii) by striking clause (v) and insert19 ing the following: 

20 ‘‘(v) the average annual cost and the total 

21 cost to earn an associate’s degree and a bach22 elor’s degree, with available cost information on 

23 any other degree or credential the institution 

24 awards;’’; 
187 

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1 (iv) in clause (vi), by inserting before 

2 the semicolon the following: ‘‘disaggregated 

3 by— 

4 ‘‘(I) the type of beneficiary of edu5 cational assistance; 

6 ‘‘(II) individuals who received a cre7 dential and individuals who did not; and 

8 ‘‘(III) individuals using educational 

9 assistance under laws administered by the 

10 Secretary and individuals who are not;’’; 

11 (v) in clause (xiv), by striking ‘‘and’’ 

12 at the end; 

13 (vi) in clause (xv), by striking the pe14 riod at the end and inserting a semicolon; 

15 and 

16 (vii) by adding at the end the fol17 lowing new clauses: 

18 ‘‘(xvi) the number of veterans or members 

19 who completed covered education at the institu20 tion leading to— 

21 ‘‘(I) a degree, disaggregated by type 

22 of program, including— 

23 ‘‘(aa) an associate degree; 

24 ‘‘(bb) a bachelor’s degree; and 
188 

†S 141 ES

1 ‘‘(cc) a postbaccalaureate degree; 

2 and 

3 ‘‘(II) a certificate or professional li4 cense, disaggregated by type of certificate 

5 or professional license; 

6 ‘‘(xvii) programs available and the average 

7 time for completion of each program; 

8 ‘‘(xviii) employment rate and median in9 come of graduates of the institution in general 

10 two and five years after graduation, 

11 disaggregated by— 

12 ‘‘(I) specific program; and 

13 ‘‘(II) individuals using educational as14 sistance under laws administered by the 

15 Secretary and individuals who are not; and 

16 ‘‘(xix) the number of individuals using edu17 cational assistance under laws administered by 

18 the Secretary who are enrolled in the both the 

19 institution and specific program per year.’’. 

20 (5) CLARITY AND ANONYMITY OF INFORMATION

21 PROVIDED.—Paragraph (2) of such subsection is 

22 amended— 

23 (A) by inserting ‘‘(A)’’ before ‘‘To the ex24 tent’’; and 
189 

†S 141 ES

1 (B) by adding at the end the following new 

2 subparagraph: 

3 ‘‘(B) The Secretary shall ensure that information 

4 provided pursuant to subsection (b)(5) is provided in a 

5 manner that is easy for, and accessible to, individuals de6 scribed in subsection (a). 

7 ‘‘(C) In providing information pursuant to subsection 

8 (b)(5), the Secretary shall maintain the anonymity of indi9 viduals described in subsection (a) and, to the extent that 

10 a portion of any data would undermine such anonymity, 

11 ensure that such data is not made available pursuant to 

12 such subsection.’’. 

13 (c) IMPROVEMENTS FOR STUDENT FEEDBACK.— 

14 (1) IN GENERAL.—Subsection (b)(2) of such 

15 section is amended— 

16 (A) by amending subparagraph (A) to read 

17 as follows: 

18 ‘‘(A) provides institutions of higher learn19 ing— 

20 ‘‘(i) up to 30 days to review and re21 spond to feedback from individuals de22 scribed in subsection (a) and address 

23 issues regarding the feedback before the 

24 feedback is published; and 
190 

†S 141 ES

1 ‘‘(ii) if an institution of higher learn2 ing contests the accuracy of the feedback, 

3 the opportunity to challenge the inclusion 

4 of such data with an official appointed by 

5 the Secretary;’’; 

6 (B) in subparagraph (B), by striking 

7 ‘‘and’’ at the end; 

8 (C) in subparagraph (C), by striking ‘‘that 

9 conforms with criteria for relevancy that the 

10 Secretary shall determine.’’ and inserting ‘‘, 

11 and responses from institutions of higher learn12 ing to such feedback, that conform with criteria 

13 for relevancy that the Secretary shall deter14 mine;’’; and 

15 (D) by adding at the end the following new 

16 subparagraphs: 

17 ‘‘(D) for each institution of higher learning 

18 that is approved under this chapter, retains, 

19 maintains, and publishes all of such feedback 

20 for not less than six years; and 

21 ‘‘(E) is easily accessible to individuals de22 scribed in subsection (a) and to the general 

23 public.’’. 

24 (2) ACCESSIBILITY FROM G.I. BILL COMPARISON

25 TOOL.—The Secretary shall ensure that— 
191 

†S 141 ES

1 (A) the feedback tracked and published 

2 under subsection (b)(2) of such section, as 

3 amended by paragraph (1), is prominently dis4 played in the tool maintained under subsection 

5 (a) of this section; and 

6 (B) when such tool displays information 

7 for an institution of higher learning, the appli8 cable feedback is also displayed for such institu9 tion of higher learning. 

10 (d) TRAINING FOR PROVISION OF EDUCATION COUN11 SELING SERVICES.— 

12 (1) IN GENERAL.—Not less than one year after 

13 the date of the enactment of this Act, the Secretary 

14 shall ensure that personnel employed by the Depart15 ment of Veteran Affairs, or a contractor of the De16 partment, to provide education benefits counseling, 

17 vocational or transition assistance, or similar func18 tions, including employees or contractors of the De19 partment who provide such counseling or assistance 

20 as part of the Transition Assistance Program, are 

21 trained on how— 

22 (A) to use properly the tool maintained 

23 under subsection (a); and 

24 (B) to provide appropriate educational 

25 counseling services to individuals described in 
192 

†S 141 ES

1 section 3698(a) of such title, as amended by 

2 subsection (b)(3)(A). 

3 (2) TRANSITION ASSISTANCE PROGRAM DE4 FINED.—In this subsection, the term ‘‘Transition 

5 Assistance Program’’ means the program of coun6 seling, information, and services under section 1142 

7 of title 10, United States Code. 

8 Subtitle B—Employment and 

9 Training 

10 SEC. 221. IMPROVEMENTS TO REEMPLOYMENT RIGHTS OF 

11 MEMBERS OF THE ARMED FORCES. 

12 (a) USERRA PURPOSES.—Section 4301(a)(1) of 

13 title 38, United States Code, is amended by striking ‘‘en14 courage noncareer service in the uniformed services’’ and 

15 inserting ‘‘encourage service in the uniformed services’’. 

16 (b) PROHIBITION OF RETALIATION.—Subsection (b) 

17 of section 4311 of title 38, United States Code, is amend18 ed by inserting ‘‘or other retaliatory action’’ after ‘‘em19 ployment action’’. 

20 (c) EXPANSION OF INJUNCTIVE RELIEF.—Sub21 section (e) of section 4323 of such title is amended— 

22 (1) by striking ‘‘The court shall use’’ and in23 serting ‘‘(1) The court shall use’’; and 

24 (2) by adding at the end the following new 

25 paragraphs: 
193 

†S 141 ES

1 ‘‘(2) A person bringing an action to enforce a provi2 sion of this chapter pursuant to subsection (a) shall be 

3 entitled to an injunction under paragraph (1) if such per4 son demonstrates— 

5 ‘‘(A) a violation— 

6 ‘‘(i) of the provisions of this chapter; or 

7 ‘‘(ii) of the provisions of this chapter is 

8 threatened or is imminent; 

9 ‘‘(B) the harm to the person outweighs the in10 jury to the employer; 

11 ‘‘(C) a likelihood of success on the merits of 

12 such action; and 

13 ‘‘(D) awarding such relief is in the public inter14 est. 

15 ‘‘(3) The court may not deny a motion for injunctive 

16 relief on the basis that a party bringing an action to en17 force a provision of this chapter may be awarded wages 

18 unearned due to an unlawful termination or denial of em19 ployment at the conclusion of such action.’’. 

20 (d) DAMAGES AGAINST A STATE OR PRIVATE EM21 PLOYER.—Section 4323 of such title is further amended, 

22 in paragraph (1) of subsection (d), by striking subpara23 graph (C) and inserting the following new subparagraphs: 

24 ‘‘(C) The court may require the employer to 

25 pay the person the amount referred to in subpara-
194 

†S 141 ES

1 graph (B) and interest on such amount, calculated 

2 at a rate of 3 percent per year. 

3 ‘‘(D) The court may require the employer to 

4 pay the person the greater of $50,000 or the amount 

5 equal to the amounts referred to in subparagraphs 

6 (B) and (C) as liquidated damages, if the court de7 termines that the employer knowingly failed to com8 ply with the provisions of this chapter.’’. 

9 (e) MANDATORY ATTORNEY FEES AWARD IN SUC10 CESSFUL ACTIONS FOR REEMPLOYMENT.— 

11 (1) MSPB ACTIONS.—Paragraph (4) of sub12 section (c) of section 4324 of such title is amend13 ed— 

14 (A) by striking ‘‘may, in its discretion,’’ 

15 and inserting ‘‘shall’’; and 

16 (B) by adding at the end the following new 

17 sentence: ‘‘The Board may, in its discretion, 

18 award reasonable attorney fees in a case settled 

19 before the issuance of an order if the person 

20 can demonstrate that significant attorney fees 

21 were incurred and that justice requires such an 

22 award.’’. 

23 (2) FEDERAL CIRCUIT ACTIONS.—Subsection 

24 (d) of such section is amended by adding at the end 

25 the following new paragraph: 
195 

†S 141 ES

1 ‘‘(3) In such Federal Circuit proceeding, the court 

2 shall award such person reasonable attorney fees, expert 

3 witness fees, and other litigation expenses if such person— 

4 ‘‘(A) prevails in such Federal Circuit pro5 ceeding; and 

6 ‘‘(B) is not represented by the Special Counsel 

7 in such Federal Circuit proceeding.’’. 

8 (3) ACTIONS AGAINST A STATE OR PRIVATE EM9 PLOYER.—Paragraph (2) of section 4323(h) of such 

10 title is amended— 

11 (A) by striking ‘‘subsection (a)(2)’’ and in12 serting ‘‘subsection (a)(3)’’; and 

13 (B) by striking ‘‘the court may award any 

14 such person who prevails in such action or pro15 ceeding reasonable attorney fees’’ and inserting 

16 ‘‘the court shall award any such person who 

17 prevails in such action or proceeding reasonable 

18 attorney fees’’. 

19 (f) GAO REVIEW AND REPORT ON USERRA.— 

20 (1) REVIEW.—The Comptroller General of the 

21 United States shall review the methods through 

22 which the Secretary of Labor, acting through the 

23 Veterans’ Employment and Training Service, proc24 esses actions for relief under chapter 43 of title 38, 

25 United States Code. 
196 

†S 141 ES

1 (2) ELEMENTS.—Not later than one year after 

2 the date of the enactment of this Act, the Comp3 troller General shall submit to the Committees on 

4 Veterans’ Affairs of the House of Representatives 

5 and the Senate a report that includes— 

6 (A) the findings of the review required 

7 under paragraph (1); 

8 (B) an identification of the number of ac9 tions for relief under chapter 43 of title 38, 

10 United States Code, initiated during the period 

11 covered by the report, disaggregated by size of 

12 employer and geographic region; 

13 (C) an identification of the number of such 

14 actions for relief that were erroneously dis15 missed, as determined by the Comptroller Gen16 eral; 

17 (D) an identification of the number of such 

18 actions for relief that were referred to the De19 partment of Justice; and 

20 (E) an assessment of trends, if any, in 

21 such actions for relief initiated during such pe22 riod. 

23 (g) GAO REVIEW OF PROTECTIONS FOR MEMBERS

24 OF THE UNIFORMED SERVICES BY FEDERAL INTEL25 LIGENCE AGENCIES.— 
197 

†S 141 ES

1 (1) IN GENERAL.—Not later than one year 

2 after the date of the enactment of this Act, the 

3 Comptroller General of the United States shall sub4 mit to the appropriate congressional committees a 

5 report on the processes and procedures adopted and 

6 used by the intelligence community to provide the 

7 protections for members of the uniformed services 

8 otherwise established under chapter 43 of title 38, 

9 United States Code. 

10 (2) DEFINITIONS.—In this subsection: 

11 (A) The term ‘‘appropriate congressional 

12 committees’’ means the Committees on Vet13 erans’ Affairs of the House of Representatives 

14 and Senate, the Permanent Select Committee 

15 on Intelligence of the House of Representatives, 

16 and the Select Committee on Intelligence of the 

17 Senate. 

18 (B) The term ‘‘intelligence community’’ 

19 has the meaning given such term in section 

20 3(4) of the National Security Act of 1947 (50 

21 U.S.C. 3003(4)). 
198 

†S 141 ES

1 SEC. 222. REVIEW OF INVESTIGATIONS MANUAL OF VET2 ERANS’ EMPLOYMENT AND TRAINING SERV3 ICE. 

4 (a) IN GENERAL.—Not later than one year after the 

5 date of the enactment of this Act, and once every two 

6 years thereafter for the period of five years beginning on 

7 such date, the Secretary of Labor, shall review the manual 

8 of the Department of Labor titled ‘‘Veterans’ Employment 

9 and Training Service Investigations Manual: USERRA, 

10 VEOA, and VP’’ (or a successor manual) and make such 

11 revisions to such manual as the Secretary determines ap12 propriate. 

13 (b) REPORT.—Not later than 90 days after any date 

14 on which the Secretary completes a review required under 

15 subsection (a), the Secretary shall submit to the Commit16 tees on Veterans’ Affairs of the House of Representatives 

17 and the Senate— 

18 (1) a report that includes a description of any 

19 revision to such manual made pursuant to such re20 view; and 

21 (2) a copy of the entire such manual which— 

22 (A) shall be provided to the Chairman and 

23 Ranking Member of each such committee; and 

24 (B) may contain a separate addendum for 

25 portions of the manual that contain law en26 forcement sensitive materials. 
199 

†S 141 ES

1 SEC. 223. WARRIOR TRAINING ADVANCEMENT COURSE. 

2 (a) REPORTS REQUIRED.— 

3 (1) INITIAL REPORT.—Not later than six 

4 months after the date of the enactment of this Act, 

5 the Secretary of Veterans Affairs shall submit to the 

6 Committees on Veterans’ Affairs of the Senate and 

7 House of Representatives a report on WARTAC. 

8 (2) ANNUAL REPORT.—One year after the sub9 mission of the report required under paragraph (1) 

10 and annually thereafter, the Secretary shall submit 

11 to such Committees a report that contains the ele12 ments under paragraphs (1) and (3) of subsection 

13 (b) with regards to the preceding year. 

14 (3) ELEMENTS.—Except as provided in sub15 section (a)(2), the reports under this subsection 

16 shall include the following elements: 

17 (A) BEST PRACTICES.—With regards to 

18 best practices of WARTAC— 

19 (i) how many covered members have 

20 applied to participate in WARTAC; 

21 (ii) how many covered members have 

22 participated in WARTAC; 

23 (iii) how the Secretary provides train24 ing to covered members during TAP; 

25 (iv) how many covered members have 

26 completed WARTAC; and 
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1 (v) any other information the Sec2 retary determines appropriate. 

3 (B) COST SAVINGS.—With regards to cost 

4 savings of WARTAC— 

5 (i) how much money the Secretary de6 termines WARTAC saves the United 

7 States each fiscal year; 

8 (ii) how much money the Secretary 

9 determines WARTAC has saved the 

10 United States since its establishment; and 

11 (iii) the determination of the Sec12 retary whether other Federal agencies may 

13 save money by establishing a program 

14 similar to WARTAC. 

15 (C) HIRING.—With regards to hiring cov16 ered members who complete WARTAC— 

17 (i) how the Secretary identifies posi18 tions in the Department of Veterans Af19 fairs for which such covered members may 

20 qualify; 

21 (ii) the grades of such positions on 

22 the General Schedule under section 5332 

23 of title 5, United States Code; and 

24 (iii) how many such covered members 

25 the Secretary has hired to such positions. 
201 

†S 141 ES

1 (4) DISTRIBUTION.—Not later than 30 days 

2 after submitting the report under paragraph (1), the 

3 Secretary of Veterans Affairs shall transmit a copy 

4 of such report to the head of each Federal agency. 

5 (5) DEFINITIONS.—In this subsection: 

6 (A) The term ‘‘covered member’’ means 

7 members of the Armed Forces participating in 

8 TAP. 

9 (B) The term ‘‘TAP’’ means the Transi10 tion Assistance Program under sections 1142 

11 and 1144 of title 10, United States Code. 

12 (C) The term ‘‘WARTAC’’ means the 

13 Warrior Training Advancement Course of the 

14 Veterans Benefit Administration, in which the 

15 Secretary provides training to covered members 

16 so such covered members may qualify for cer17 tain employment in the Veterans Benefit Ad18 ministration. 

19 (b) BEST PRACTICES FOR OTHER DEPARTMENTS.— 

20 The Assistant Secretary of Labor for Veterans’ Employ21 ment and Training shall, in consultation with the Sec22 retary of Veterans Affairs, establish guidelines containing 

23 best practices for departments and agencies of the Federal 

24 Government that carry out programs to employ veterans 

25 who are transitioning from service in the Armed Forces. 
202 

†S 141 ES

1 Such guidelines shall include the findings of the initial re2 port required under subsection (a)(1). 

3 (c) PILOT PROGRAM.— 

4 (1) ESTABLISHMENT.—The Secretary of the In5 terior shall, in consultation with the Secretary of 

6 Labor and the Secretary of Veterans Affairs, estab7 lish a pilot program to proactively inform veterans 

8 of available employment positions that relate to the 

9 conservation and resource management activities of 

10 the Department of the Interior. 

11 (2) POSITIONS.—The Secretary of the Interior 

12 shall— 

13 (A) identify vacant positions in the De14 partment of the Interior that are appropriate to 

15 fill using the pilot program; and 

16 (B) to the maximum extent practicable, 

17 provide assistance to veterans in selecting one 

18 or more vacant positions to apply to, for which 

19 that veteran may be best qualified. 

20 (3) REPORTS.— 

21 (A) IMPLEMENTATION REPORT.—Not later 

22 than one year after the date on which the pilot 

23 program under paragraph (1) commences, the 

24 Secretary of the Interior, the Secretary of Vet25 erans Affairs, and the Secretary of Labor shall 
203 

†S 141 ES

1 jointly provide to the appropriate congressional 

2 committees a report on the implementation of 

3 the pilot program. 

4 (B) FINAL REPORT.—Not later than 30 

5 days after the date on which the pilot program 

6 under paragraph (1) terminates under para7 graph (4), the Secretary of the Interior, the 

8 Secretary of Veterans Affairs, and the Sec9 retary of Labor shall jointly submit to the ap10 propriate congressional committees a report on 

11 the pilot program that includes the following: 

12 (i) The number of veterans who ap13 plied to participate in the pilot program. 

14 (ii) The number of such veterans em15 ployed under the pilot program. 

16 (iii) The number of veterans identified 

17 in clause (ii) who transitioned to full-time 

18 positions with the Federal Government 

19 after participating in the pilot program. 

20 (iv) Any other information the Sec21 retary of the Interior, the Secretary of Vet22 erans Affairs, and the Secretary of Labor 

23 determine appropriate with respect to 

24 measuring the effectiveness of the pilot 

25 program. 
204 

†S 141 ES

1 (4) TERMINATION.—The authority to carry out 

2 the pilot program under this subsection shall termi3 nate on the date that is two years after the date on 

4 which the pilot program commences. 

5 (5) APPROPRIATE CONGRESSIONAL COMMIT6 TEES DEFINED.—In this subsection, the term ‘‘ap7 propriate congressional committees’’ means— 

8 (A) the Committee on Veterans’ Affairs 

9 and the Committee on Energy and Natural Re10 sources of the Senate; and 

11 (B) the Committee on Veterans’ Affairs 

12 and the Committee on Natural Resources of the 

13 House of Representatives. 

14 (d) OUTDOOR RECREATION PROGRAM ATTEND15 ANCE.—The Secretary of the Interior and the Secretary 

16 of Agriculture are encouraged to work with the Secretary 

17 of Defense and the Secretary of Veterans Affairs to ensure 

18 members of the Armed Forces and veterans have access 

19 to outdoor recreation and outdoor-related volunteer and 

20 wellness programs as part of the basic services provided 

21 to such members and veterans. 
205 

†S 141 ES

1 Subtitle C—Home Loans 

2 SEC. 231. IMPROVEMENTS TO PROGRAM FOR DIRECT 

3 HOUSING LOANS MADE TO NATIVE AMER4 ICAN VETERANS BY THE SECRETARY OF VET5 ERANS AFFAIRS. 

6 (a) GENERAL AUTHORITIES AND REQUIREMENTS.— 

7 (1) DIRECT HOUSING LOANS TO NATIVE AMER8 ICAN VETERANS.—Section 3762(a) of title 38, 

9 United States Code, is amended to read as follows: 

10 ‘‘(a) The Secretary may make a direct housing loan 

11 to a Native American veteran under this subchapter if the 

12 Secretary ensures the following: 

13 ‘‘(1) That each Native American veteran to 

14 whom the Secretary makes a direct housing loan 

15 under this subchapter— 

16 ‘‘(A) holds, possesses, or purchases using 

17 the proceeds of the loan a meaningful interest 

18 in a lot or dwelling (or both) that is located on 

19 trust land; and 

20 ‘‘(B) will purchase, construct, or improve 

21 (as the case may be) a dwelling on the lot using 

22 the proceeds of the loan. 

23 ‘‘(2) That each such Native American veteran 

24 will convey to the Secretary by an appropriate in25 strument the interest referred to in paragraph 
206 

†S 141 ES

1 (1)(A) as security for a direct housing loan under 

2 this subchapter. 

3 ‘‘(3) That the Secretary, including the Sec4 retary’s employees or agents, may enter upon the 

5 trust land for the purposes of carrying out such ac6 tions as the Secretary determines are necessary, in7 cluding— 

8 ‘‘(A) to evaluate the advisability of the 

9 loan; 

10 ‘‘(B) to monitor any purchase, construc11 tion, or improvements carried out using the 

12 proceeds of the loan; and 

13 ‘‘(C) to manage any servicing or post-fore14 closure activities, including acquisition, property 

15 inspections, and property management. 

16 ‘‘(4) That there are established standards and 

17 procedures that apply to the foreclosure of the inter18 est conveyed by a Native American veteran pursuant 

19 to paragraph (2), including— 

20 ‘‘(A) procedures for foreclosing the inter21 est; and 

22 ‘‘(B) procedures for the resale of the lot or 

23 dwelling (or both) purchased, constructed, or 

24 improved using the proceeds of the loan. 
207 

†S 141 ES

1 ‘‘(5) That the loan is made in a responsible and 

2 prudent manner, subject to standards and proce3 dures as are necessary for the reasonable protection 

4 of the financial interests of the United States.’’. 

5 (2) MEMORANDUMS OF UNDERSTANDING, 

6 AGREEMENTS, AND DETERMINATIONS.—Section 

7 3762(b) of such title is amended to read as follows: 

8 ‘‘(b)(1) To carry out the purpose of subsection (a), 

9 the Secretary may— 

10 ‘‘(A) enter into a memorandum of under11 standing with a tribal organization, other entity, or 

12 individual; 

13 ‘‘(B) rely on agreements or determinations of 

14 other Federal agencies to guarantee, insure, or make 

15 loans on trust land; and 

16 ‘‘(C) enter into other agreements or take such 

17 other actions as the Secretary determines necessary. 

18 ‘‘(2) If the Secretary determines that the require19 ments under subsection (a) are not being enforced by a 

20 tribal organization, other entity, or individual that is a 

21 party to any memorandum of understanding, agreement, 

22 or determination described in paragraph (1), the Secretary 

23 may cease making new direct housing loans to Native 

24 American veterans under this subchapter within the area 
208 

†S 141 ES

1 of the authority of the tribal organization, other entity, 

2 or individual (as the case may be).’’. 

3 (b) DIRECT LOANS TO NATIVE AMERICAN VETERANS

4 TO REFINANCE EXISTING MORTGAGE LOANS.—Section 

5 3762(h) of such title is amended to read as follows: 

6 ‘‘(h) The Secretary may make direct loans to Native 

7 American veterans in order to enable such veterans to refi8 nance existing mortgage loans for any of the following 

9 purposes: 

10 ‘‘(1) To refinance an existing loan made under 

11 this section, if the loan— 

12 ‘‘(A) meets the requirements set forth in 

13 subparagraphs (B), (C), and (E) of paragraph 

14 (1) of section 3710(e) of this title; 

15 ‘‘(B) will bear an interest rate at least one 

16 percentage point less than the interest rate 

17 borne by the loan being refinanced; and 

18 ‘‘(C) complies with paragraphs (2) and (3) 

19 of section 3710(e) of this title, except that for 

20 the purposes of this subsection the reference to 

21 subsection (a)(8) of section 3710 of this title in 

22 such paragraphs (2) and (3) shall be deemed to 

23 be a reference to this subsection. 

24 ‘‘(2) To refinance an existing mortgage loan not 

25 made under this section on a dwelling owned and oc-
209 

†S 141 ES

1 cupied by the veteran as the veteran’s home, if all 

2 of the following requirements are met: 

3 ‘‘(A) The loan will be secured by the same 

4 dwelling as was the loan being refinanced. 

5 ‘‘(B) The loan will provide the veteran with 

6 a net tangible benefit. 

7 ‘‘(C) The nature and condition of the prop8 erty is such as to be suitable for dwelling pur9 poses. 

10 ‘‘(D) The amount of the loan does not ex11 ceed either of the following: 

12 ‘‘(i) 100 percent of the reasonable 

13 value of the dwelling, with such reasonable 

14 value determined under the procedures es15 tablished by the Secretary under sub16 section (d)(2). 

17 ‘‘(ii) An amount equal to the sum of 

18 the balance of the loan being refinanced 

19 and such closing costs (including any dis20 count points) as may be authorized by the 

21 Secretary to be included in the loan. 

22 ‘‘(E) Notwithstanding subparagraph (D), 

23 if a loan is made for both the purpose of this 

24 paragraph and to make energy efficiency im-
210 

†S 141 ES

1 provements, the loan must not exceed either of 

2 the following: 

3 ‘‘(i) 100 percent of the reasonable 

4 value of the dwelling as improved for en5 ergy efficiency, with such reasonable value 

6 determined under the procedures estab7 lished by the Secretary under subsection 

8 (d)(2). 

9 ‘‘(ii) The amount referred to under 

10 subparagraph (D)(ii), plus the applicable 

11 amount specified under section 3710(d)(2) 

12 of this title. 

13 ‘‘(F) The loan meets all other require14 ments the Secretary may establish under this 

15 subchapter. 

16 ‘‘(G) The existing mortgage being refi17 nanced is a first lien on the property and se18 cured of record. 

19 ‘‘(3) To refinance an existing mortgage loan to 

20 repair, alter, or improve a dwelling owned by the 

21 veteran and occupied by the veteran as the veteran’s 

22 home, if all of the following requirements are met: 

23 ‘‘(A) The loan will be secured by the same 

24 dwelling as was the loan being refinanced. 
211 

†S 141 ES

1 ‘‘(B) The nature and condition of the 

2 property is such as to be suitable for dwelling 

3 purposes, and the repair, alteration, or improve4 ment substantially protects or improves the 

5 basic livability or utility of such property. 

6 ‘‘(C) The amount of the loan, including the 

7 costs of repairs, alterations, and improvements, 

8 does not exceed either of the following: 

9 ‘‘(i) 100 percent of the reasonable 

10 value of the dwelling as repaired, altered, 

11 or improved, with such reasonable value 

12 determined under the procedures estab13 lished by the Secretary under subsection 

14 (d)(2). 

15 ‘‘(ii) An amount equal to the sum 

16 of— 

17 ‘‘(I) the balance of the loan being 

18 refinanced; 

19 ‘‘(II) the actual cost of repairs, 

20 alterations, or improvements; and 

21 ‘‘(III) such closing costs (includ22 ing any discount points) as may be 

23 authorized by the Secretary to be in24 cluded in the loan. 
212 

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1 ‘‘(D) The loan meets all other require2 ments the Secretary may establish under this 

3 subchapter. 

4 ‘‘(E) The existing mortgage loan being re5 financed is a first lien on the property and se6 cured of record.’’. 

7 (c) EXPANSION OF OUTREACH PROGRAM ON AVAIL8 ABILITY OF DIRECT HOUSING LOANS FOR NATIVE AMER9 ICAN VETERANS.—Section 3762(i)(2) of such title is 

10 amended by adding at the end the following new subpara11 graph: 

12 ‘‘(G) Pursuant to subsection (g)(4), assisting 

13 Native American veterans in qualifying for mortgage 

14 financing by— 

15 ‘‘(i) partnering with local service providers, 

16 such as tribal organizations, tribally designated 

17 housing entities, Native community development 

18 financial institutions, and nonprofit organiza19 tions, for conducting outreach, homebuyer edu20 cation, housing counseling, and post-purchase 

21 education; and 

22 ‘‘(ii) providing other technical assistance as 

23 needed. 

24 ‘‘(H) Attending conferences and conventions 

25 conducted by the network of Native community de-
213 

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1 velopment financial institutions and other Native 

2 American homeownership organizations to provide 

3 information and training to Native community devel4 opment financial institutions about the availability of 

5 the relending program under section 3762A of this 

6 title.’’. 

7 (d) ADEQUATE PERSONNEL.—Section 3762 of such 

8 title is amended by adding at the end the following new 

9 subsection: 

10 ‘‘(k) The Secretary shall assign a sufficient number 

11 of personnel of the Department dedicated to carrying out 

12 the authority of the Secretary under this subchapter, in13 cluding construction and valuation specialists to assist 

14 with issues unique to new construction and renovations 

15 on trust land.’’. 

16 (e) DEFINITIONS.—Section 3765 of such title is 

17 amended— 

18 (1) in paragraph (1)— 

19 (A) by amending subparagraph (C) to read 

20 as follows: 

21 ‘‘(C) is located in the State of Alaska with22 in a region established under section 7(a) of the 

23 Alaska Native Claims Settlement Act (43 

24 U.S.C. 1606(a));’’; 
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1 (B) in subparagraph (D), by striking the 

2 period at the end and inserting a semicolon; 

3 and 

4 (C) by adding at the end the following new 

5 subparagraphs: 

6 ‘‘(E) is defined by the Secretary of the In7 terior and recognized by the United States as 

8 land over which an Indian Tribe has govern9 mental dominion; or 

10 ‘‘(F) is on any land that the Secretary de11 termines is provided to Native American vet12 erans because of their status as Native Ameri13 cans.’’; and 

14 (2) by adding at the end the following new 

15 paragraphs: 

16 ‘‘(6) The term ‘community development finan17 cial institution’ has the meaning given that term in 

18 section 103 of the Community Development Banking 

19 and Financial Institutions Act of 1994 (12 U.S.C. 

20 4702). 

21 ‘‘(7) The term ‘Indian Tribe’ means any Indian 

22 tribe, band, nation, or other organized group or com23 munity, including any Alaska Native village or re24 gional or village corporation as defined in or estab25 lished pursuant to the Alaska Native Claims Settle-
215 

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1 ment Act (43 U.S.C. 1601 et seq.), which is recog2 nized as eligible for the special programs and serv3 ices provided by the United States to Indians be4 cause of their status as Indians. 

5 ‘‘(8) The term ‘Native community development 

6 financial institution’ means any entity— 

7 ‘‘(A) that has been certified as a commu8 nity development financial institution by the 

9 Secretary of the Treasury; 

10 ‘‘(B) that is not less than 51 percent 

11 owned or controlled by Native Americans; and 

12 ‘‘(C) for which not less than 51 percent of 

13 the activities of the entity serve Native Ameri14 cans. 

15 ‘‘(9) The term ‘net tangible benefit’ shall have 

16 such meaning as the Secretary determines appro17 priate, but shall include the refinance of an interim 

18 construction loan. 

19 ‘‘(10) The term ‘other technical assistance’ 

20 means services to assist a Native American veteran 

21 to navigate the steps necessary for securing a mort22 gage loan on trust land, including pre-development 

23 activities related to utilities, identifying appropriate 

24 residential construction services, and obtaining lease 

25 clearances and title status reports from the applica-
216 

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1 ble tribal organization or the Bureau of Indian Af2 fairs. 

3 ‘‘(11) The term ‘tribally designated housing en4 tity’ has the meaning given that term in section 4 

5 of the Native American Housing Assistance and 

6 Self-Determination Act of 1996 (25 U.S.C. 4103).’’. 

7 (f) INTEREST RATE REDUCTION FINANCING

8 LOAN.—Section 3729(b)(4)(F) of such title is amended 

9 by striking ‘‘3762(h)’’ and inserting ‘‘3762(h)(1)’’. 

10 (g) REGULATIONS.—Section 3761 of such title is 

11 amended by adding at the end the following new sub12 section: 

13 ‘‘(c) The Secretary shall prescribe such regulations 

14 as may be necessary to carry out this subchapter.’’. 

15 SEC. 232. NATIVE COMMUNITY DEVELOPMENT FINANCIAL 

16 INSTITUTION RELENDING PROGRAM. 

17 (a) IN GENERAL.—Subchapter V of chapter 37 of 

18 title 38, United States Code, is amended by inserting after 

19 section 3762 the following new section: 

20 ‘‘§ 3762A. Native community development financial 

21 institution relending program 

22 ‘‘(a) PURPOSE.—The Secretary may make a loan to 

23 a Native community development financial institution for 

24 the purpose of allowing the institution to relend loan 
217 

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1 amounts to qualified Native American veterans, subject to 

2 the requirements of this section. 

3 ‘‘(b) STANDARDS.—(1) The Secretary shall establish 

4 standards to be used in evaluating whether to make a loan 

5 to a Native community development financial institution 

6 under this section. 

7 ‘‘(2) In establishing standards under paragraph (1), 

8 the Secretary shall ensure that a Native community devel9 opment financial institution— 

10 ‘‘(A) is able to originate and service loans for 

11 single-family homes; 

12 ‘‘(B) is able to operate the relending program 

13 in a manner consistent with the mission of the De14 partment to serve veterans; and 

15 ‘‘(C) uses loan amounts received under this sec16 tion only for the purpose of relending, as described 

17 in subsection (c), to Native American veterans. 

18 ‘‘(c) RELENDING REQUIREMENTS.—(1) A Native 

19 community development financial institution that receives 

20 a loan under this section shall use the loan amounts to 

21 make loans to Native American veterans residing on trust 

22 land. 

23 ‘‘(2) A loan to a Native American veteran made by 

24 a Native community development financial institution 

25 under paragraph (1) shall— 
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1 ‘‘(A) be limited either to the purpose of pur2 chase, construction, or improvement of a dwelling lo3 cated on trust land or to the refinance of an existing 

4 mortgage loan for a dwelling on trust land, con5 sistent with the requirements of section 3762(h) of 

6 this title; and 

7 ‘‘(B) comply with such terms and conditions as 

8 the Secretary determines are necessary to protect 

9 against predatory lending, including the interest rate 

10 charged on a loan to a Native American veteran. 

11 ‘‘(d) REPAYMENT.—A loan made to a Native commu12 nity development financial institution under this section 

13 shall— 

14 ‘‘(1) be payable to the Secretary upon such 

15 terms and conditions as are prescribed in regulations 

16 pursuant to this subchapter; and 

17 ‘‘(2) bear interest at a rate of one percent. 

18 ‘‘(e) OVERSIGHT.—Subject to notice and opportunity 

19 for a hearing, whenever the Secretary finds with respect 

20 to loans made under subsection (a) or (c) that any Native 

21 community development financial institution has failed to 

22 maintain adequate loan accounting records, to dem23 onstrate proper ability to service loans adequately, or to 

24 exercise proper credit judgment, or that such Native com25 munity development financial institution has willfully or 
219 

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1 negligently engaged in practices otherwise detrimental to 

2 the interest of veterans or of the Government, the Sec3 retary may take such actions as the Secretary determines 

4 necessary to protect veterans or the Government, such as 

5 requiring immediate repayment of any loans made under 

6 subsection (a) and the assignment to the Secretary of 

7 loans made under subsection (c). 

8 ‘‘(f) SUNSET.—The Secretary may not make a loan 

9 under this section after September 30, 2027.’’. 

10 (b) CLERICAL AMENDMENT.—The table of sections 

11 at the beginning of chapter 37 of such title is amended 

12 by inserting after the item relating to section 3762 the 

13 following new item: 

‘‘3762A. Native community development financial institution relending program.’’. 

14 (c) NATIVE AMERICAN VETERAN HOUSING LOAN

15 PROGRAM ACCOUNT.—Section 3763 of such title is 

16 amended by adding at the end the following new sub17 section: 

18 ‘‘(c) Of amounts available in the Account, the Sec19 retary may use for loans made under section 3762A of 

20 this title— 

21 ‘‘(1) in fiscal year 2025, not more than 

22 $5,000,000; and 
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1 ‘‘(2) in any fiscal year after fiscal year 2025, 

2 an amount determined necessary by the Secretary to 

3 meet the demand for such loans.’’. 

4 TITLE III—DISABILITY AND 

5 MEMORIAL AFFAIRS MATTERS 

6 SEC. 301. BURIAL ALLOWANCE FOR CERTAIN VETERANS 

7 WHO DIE AT HOME WHILE IN RECEIPT OF 

8 HOSPICE CARE FURNISHED BY DEPARTMENT 

9 OF VETERANS AFFAIRS. 

10 (a) IN GENERAL.—The Secretary of Veterans Affairs 

11 shall treat a veteran described in subsection (b) as a vet12 eran described in subparagraph (A) of section 2303(a)(2) 

13 of title 38, United States Code. 

14 (b) VETERAN DESCRIBED.—A veteran described in 

15 this subsection is a veteran who dies in a home or other 

16 setting at which the deceased veteran was, at the time of 

17 death, receiving hospice care pursuant to section 1717(a) 

18 of such title if such care was directly preceded by the Sec19 retary furnishing to the veteran hospital care or nursing 

20 home care described in clause (ii) of such subparagraph. 

21 (c) EFFECTIVE DATE; APPLICABILITY.—This section 

22 shall apply with respect to deaths that occur— 

23 (1) on or after the date that is 180 days after 

24 the date of the enactment of this Act; and 

25 (2) before October 1, 2026. 
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1 SEC. 302. AUTHORITY FOR SECRETARY OF VETERANS AF2 FAIRS TO AWARD GRANTS TO STATES AND IN3 DIAN TRIBES TO IMPROVE OUTREACH TO 

4 VETERANS. 

5 (a) IN GENERAL.—Chapter 63 of title 38, United 

6 States Code, is amended— 

7 (1) by redesignating sections 6307 and 6308 as 

8 sections 6308 and 6309, respectively; and 

9 (2) by inserting after section 6306 the following 

10 new section 6307: 

11 ‘‘§ 6307. Grants to States and Indian Tribes to im12 prove outreach to veterans 

13 ‘‘(a) PURPOSE.—It is the purpose of this section to 

14 provide for assistance by the Secretary to States and In15 dian Tribes to carry out programs that improve covered 

16 outreach and assistance to veterans and the spouses, chil17 dren, and parents of veterans, to ensure that such individ18 uals are fully informed about, and assisted in applying for, 

19 any veterans and veterans-related benefits and programs 

20 (including veterans programs of a State or Indian Tribe) 

21 for which they may be eligible and facilitate opportunities 

22 for such individuals to receive competent, qualified serv23 ices in the preparation, presentation and prosecution of 

24 veterans benefits claims. 

25 ‘‘(b) AUTHORITY.—The Secretary may award grants 

26 to States and Indian Tribes— 
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1 ‘‘(1) to carry out, coordinate, improve, or other2 wise enhance— 

3 ‘‘(A) covered outreach activities; or 

4 ‘‘(B) activities to assist in the development 

5 and submittal of claims for veterans and vet6 erans-related benefits; or 

7 ‘‘(2) to increase the number of county or Tribal 

8 veterans service officers serving in the State by hir9 ing new, additional such officers. 

10 ‘‘(c) APPLICATION.—(1) To be eligible for a grant 

11 under this section, a State or Indian Tribe shall submit 

12 to the Secretary an application therefor at such time, in 

13 such manner, and containing such information as the Sec14 retary may require. 

15 ‘‘(2) Each application submitted under paragraph (1) 

16 shall include the following: 

17 ‘‘(A) A detailed plan for the use of the grant. 

18 ‘‘(B) A description of the programs through 

19 which the State or Indian Tribe will meet the out20 come measures developed by the Secretary under 

21 subsection (j). 

22 ‘‘(C) A description of how the State or Indian 

23 Tribe will distribute grant amounts equitably among 

24 counties or Tribal lands with varying levels of urban25 ization. 
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1 ‘‘(D) A plan for how the grant will be used to 

2 meet the unique needs of American Indian veterans, 

3 Alaska Native veterans, or Native Hawaiian vet4 erans, elderly veterans, and veterans from other un5 derserved communities. 

6 ‘‘(d) DISTRIBUTION.—The Secretary shall seek to en7 sure that grants awarded under this section are equitably 

8 distributed among States and Indian Tribes with varying 

9 levels of urbanization. 

10 ‘‘(e) SET-ASIDE.—Of the amounts authorized to be 

11 appropriated or otherwise made available for grants under 

12 this section for any fiscal year, the Secretary shall ensure 

13 that not less than five percent is used to make grants to 

14 Indian Tribes. 

15 ‘‘(f) PRIORITY.—The Secretary shall prioritize 

16 awarding grants under this section that will serve the fol17 lowing areas: 

18 ‘‘(1) Areas with a critical shortage of county or 

19 Tribal veterans service officers. 

20 ‘‘(2) Areas with high rates of— 

21 ‘‘(A) suicide among veterans; or 

22 ‘‘(B) referrals to the Veterans Crisis Line. 

23 ‘‘(g) USE OF COUNTY OR TRIBAL VETERANS SERV24 ICE OFFICERS.—A State or Indian Tribe that receives a 
224 

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1 grant under this section to carry out an activity described 

2 in subsection (b)(1) shall carry out the activity through— 

3 ‘‘(1) a county or Tribal veterans service officer 

4 of the State; or 

5 ‘‘(2) if the State or Indian Tribe does not have 

6 a county or Tribal veterans service officer, or if the 

7 county or Tribal veterans service officers of the 

8 State or Indian Tribe cover only a portion of that 

9 State or Indian Tribe, an appropriate entity of a 

10 State, local, or Tribal government, as determined by 

11 the Secretary. 

12 ‘‘(h) REQUIRED ACTIVITIES.—Any grant awarded 

13 under this section shall be used— 

14 ‘‘(1) to expand existing programs, activities, 

15 and services; 

16 ‘‘(2) to hire new, additional county or Tribal 

17 veterans service officers; or 

18 ‘‘(3) for travel and transportation to facilitate 

19 carrying out paragraph (1) or (2). 

20 ‘‘(i) AUTHORIZED ACTIVITIES.—A grant under this 

21 section may be used to provide education and training, in22 cluding on-the-job training, for State, county, local, and 

23 Tribal government employees who provide (or when 

24 trained will provide) covered outreach services in order for 
225 

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1 those employees to obtain accreditation in accordance with 

2 procedures approved by the Secretary. 

3 ‘‘(j) OUTCOME MEASURES.—(1) The Secretary shall 

4 develop and provide to each State or Indian Tribe that 

5 receives a grant under this section written guidance on 

6 the following: 

7 ‘‘(A) Outcome measures. 

8 ‘‘(B) Policies of the Department. 

9 ‘‘(2) In developing outcome measures under para10 graph (1), the Secretary shall consider the following goals: 

11 ‘‘(A) Increasing the use of veterans and vet12 erans-related benefits, particularly among vulnerable 

13 populations. 

14 ‘‘(B) Increasing the number of county and 

15 Tribal veterans service officers recognized by the 

16 Secretary for the representation of veterans under 

17 chapter 59 of this title. 

18 ‘‘(k) TRACKING REQUIREMENTS.—(1) With respect 

19 to each grant awarded under this section, the Secretary 

20 shall track the use of veterans and veterans-related bene21 fits among the population served by the grant, including 

22 the average period of time between the date on which a 

23 veteran applies for such a benefit and the date on which 

24 the veteran receives the benefit, disaggregated by type of 

25 benefit. 
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1 ‘‘(2) Not less frequently than annually during the life 

2 of the grant program established under this section, the 

3 Secretary shall submit to Congress a report on— 

4 ‘‘(A) the information tracked under paragraph 

5 (1); 

6 ‘‘(B) how the grants awarded under this section 

7 serve the unique needs of American Indian veterans, 

8 Alaska Native veterans, or Native Hawaiian vet9 erans, elderly veterans, and veterans from other un10 derserved communities; and 

11 ‘‘(C) other information provided by States and 

12 Indian Tribes pursuant to the grant reporting re13 quirements. 

14 ‘‘(l) PERFORMANCE REVIEW.—The Secretary shall— 

15 ‘‘(1) review the performance of each State or 

16 Indian Tribe that receives a grant under this sec17 tion; and 

18 ‘‘(2) make information regarding such perform19 ance publicly available. 

20 ‘‘(m) REMEDIATION PLAN.—(1) In the case of a 

21 State or Indian Tribe that receives a grant under this sec22 tion and does not meet the outcome measures developed 

23 by the Secretary under subsection (j), the Secretary shall 

24 require the State or Indian Tribe to submit a remediation 
227 

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1 plan under which the State shall describe how and when 

2 it plans to meet such outcome measures. 

3 ‘‘(2) The Secretary may not award a subsequent 

4 grant under this section to a State or Indian Tribe de5 scribed in paragraph (1) unless the Secretary approves the 

6 remediation plan submitted by the State or Indian Tribe. 

7 ‘‘(n) DEFINITIONS.—In this section: 

8 ‘‘(1) The term ‘county or Tribal veterans serv9 ice officer’ includes a local equivalent veterans serv10 ice officer. 

11 ‘‘(2) The term ‘covered outreach’ means out12 reach with respect to— 

13 ‘‘(A) benefits administered by the Under 

14 Secretary for Benefits; or 

15 ‘‘(B) similar benefits administered by a 

16 State or Indian Tribe. 

17 ‘‘(3) The term ‘Indian Tribe’ has the meaning 

18 given such term in section 4 of the Indian Self-De19 termination and Education Assistance Act (25 

20 U.S.C. 5304). 

21 ‘‘(4) The term ‘State’ includes the District of 

22 Columbia, the Commonwealth of Puerto Rico, the 

23 Commonwealth of the Northern Mariana Islands, 

24 and any territory or possession of the United States. 
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1 ‘‘(5) The term ‘Veterans Crisis Line’ means the 

2 toll-free hotline for veterans established under sec3 tion 1720F(h) of this title.’’. 

4 (b) CLERICAL AMENDMENT.—The table of sections 

5 at the beginning of chapter 63 of such title is amended 

6 by striking the items relating to sections 6307 and 6308 

7 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.’’. 

8 (c) AUTHORIZATION OF APPROPRIATIONS.—There is 

9 authorized to be appropriated to the Secretary of Veterans 

10 Affairs for each of fiscal years 2026 and 2027, 

11 $10,000,000 to carry out section 6307 of title 38, United 

12 States Code, as added by subsection (a). 

13 SEC. 303. DEFINITION OF SURVIVING SPOUSE. 

14 Paragraph (3) of section 101 of title 38, United 

15 States Code, is amended to read as follows: 

16 ‘‘(3) The term ‘surviving spouse’ means (except 

17 for purposes of chapter 19 of this title) a person 

18 who was the spouse of a veteran at the time of the 

19 veteran’s death, and who lived with the veteran con20 tinuously from the date of marriage to the date of 

21 the veteran’s death (except where there was a sepa22 ration which was due to the misconduct of, or pro23 cured by, the veteran without the fault of the 

24 spouse) and who has not remarried.’’. 
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1 SEC. 304. ENSURING ONLY LICENSED HEALTH CARE PRO2 FESSIONALS PERFORM MEDICAL DISABILITY 

3 EXAMINATIONS UNDER CERTAIN DEPART4 MENT OF VETERANS AFFAIRS PILOT PRO5 GRAM. 

6 (a) PROHIBITION ON USE OF CERTAIN HEALTH

7 CARE PROFESSIONALS.—Section 504(c)(1) of the Vet8 erans’ Benefits Improvements Act of 1996 (Public Law 

9 104–275; 38 U.S.C. 5101 note) is amended by inserting 

10 ‘‘only’’ before ‘‘a health care professional’’. 

11 (b) REMEDIES.—The Secretary of Veterans Affairs 

12 shall take such actions as the Secretary considers appro13 priate to ensure compliance with section 504(c) of the Vet14 erans’ Benefits Improvements Act of 1996 (Public Law 

15 104–275; 38 U.S.C. 5101 note), as amended by subsection 

16 (a). 

17 (c) ANNUAL REPORT.—Not later than one year after 

18 the date of the enactment of this Act and not less fre19 quently than once each year thereafter, the Secretary shall 

20 submit to the Committee on Veterans’ Affairs of the Sen21 ate and the Committee on Veterans’ Affairs of the House 

22 of Representatives a report on— 

23 (1) the conduct of the pilot program established 

24 under section 504 of the Veterans’ Benefits Im25 provements Act of 1996 (Public Law 104–275; 38 

26 U.S.C. 5101 note); and 
230 

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1 (2) the actions of the Secretary under sub2 section (b). 

3 (d) TECHNICAL CORRECTIONS.—Section 504 of the 

4 Veterans’ Benefits Improvements Act of 1996 (Public 

5 Law 104–275; 38 U.S.C. 5101 note) is amended, in the 

6 section heading, by striking ‘‘PHYSICIANS’’ and inserting 

7 ‘‘HEALTH CARE PROFESSIONALS’’. 

8 SEC. 305. PROVISION OF INFORMATION REGARDING AN 

9 AGENT OR ATTORNEY TO A LICENSED 

10 HEALTH CARE PROFESSIONAL WHO PER11 FORMS A MEDICAL DISABILITY EXAMINATION 

12 UNDER CERTAIN DEPARTMENT OF VET13 ERANS AFFAIRS PILOT PROGRAM. 

14 (a) IN GENERAL.—Section 504 of the Veterans’ Ben15 efits Improvements Act of 1996 (Public Law 104–275; 38 

16 U.S.C. 5101 note), as amended by section 304, is further 

17 amended by adding at the end the following new sub18 section: 

19 ‘‘(f) CERTAIN INFORMATION PROVIDED TO HEALTH

20 CARE PROFESSIONAL.—The Secretary shall provide to a 

21 health care professional who performs an examination 

22 under subsection (a), or a contractor performing a con23 tract under such subsection, the contact information of 

24 any agent or attorney recognized by the Secretary under 

25 chapter 59 of title 38, United States Code, with regards 
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1 to a claim for benefits that gives rise to such examina2 tion.’’. 

3 (b) APPLICABILITY.—The amendment made by this 

4 section shall apply to an examination described in sub5 section (a) of such section that is performed on or after 

6 the date of the enactment of this Act. 

7 SEC. 306. MODERNIZATION OF DEPARTMENT OF VETERANS 

8 AFFAIRS DISABILITY BENEFIT QUESTION9 NAIRES. 

10 (a) REQUIREMENT FOR TRANSMISSION OF CERTAIN

11 INFORMATION IN MACHINE-READABLE FORMAT.— 

12 (1) REQUIREMENT.—Not later than 180 days 

13 after enactment of this Act, the Secretary of Vet14 erans Affairs shall require all disability benefit ques15 tionnaire data collected in the course of medical dis16 ability examinations made by covered non-Depart17 ment providers to be transmitted to the Department 

18 in a machine-readable format. 

19 (2) ISSUANCE OF STANDARDS.—Not later than 

20 90 days after the date of the enactment of this Act, 

21 the Secretary shall issue standards for the trans22 mission of disability benefit questionnaire data in a 

23 machine-readable format as required under para24 graph (1). 
232 

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1 (3) UPDATES.—In making updates to disability 

2 benefit questionnaires after the date specified in 

3 paragraph (1), the Secretary shall— 

4 (A) ensure that the updates are made in a 

5 manner that allows for the data collected under 

6 the questionnaires to be in a machine-readable 

7 format as of the date on which the update goes 

8 into effect; and 

9 (B) not later than 30 days before an up10 date goes into effect, notify the covered non-De11 partment providers (or the contractor per12 forming a contract under section 504 of the 

13 Veterans Benefits Improvement Act of 1996 

14 (Public Law 104–275; 38 U.S.C. 5101 note)) 

15 described in such paragraph of such updates. 

16 (b) PLAN FOR INFORMATION TECHNOLOGY SYSTEM

17 MODIFICATION.—Not later than 180 days after the date 

18 of the enactment of this Act, the Secretary shall submit 

19 to the Committees on Veterans’ Affairs of the Senate and 

20 House of Representatives a plan to modify the information 

21 technology systems and processes of the Department to 

22 enable a non-Department health care professional, as23 signed to or selected by a claimant, to transmit to the De24 partment, in a machine-readable format, disability benefit 

25 questionnaire data, including complete disability benefit 
233 

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1 questionnaires rather than partial questionnaires or ele2 ments of medical evidence. 

3 (c) PUBLIC AVAILABILITY OF INFORMATION.—The 

4 Secretary shall make publicly available on the internet 

5 website of the Department referred to in section 5101(d) 

6 of title 38, United States Code— 

7 (1) a description of the standards issued under 

8 subsection (a)(2); and 

9 (2) the plan required under subsection (b). 

10 (d) DEFINITIONS.—In this section: 

11 (1) The term ‘‘claimant’’ has the meaning given 

12 such term in section 5100 of title 38, United States 

13 Code. 

14 (2) The term ‘‘covered non-Department pro15 vider’’ means a health care provider who— 

16 (A) is not an employee of the Department 

17 of Veterans Affairs; and 

18 (B) pursuant to a contract under section 

19 504 of the Veterans Benefits Improvement Act 

20 of 1996 (Public Law 104–275; 38 U.S.C. 5101 

21 note), as amended by sections 304 and 305, ex22 amines a claimant for a medical disability. 
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1 SEC. 307. DEPARTMENT OF VETERANS AFFAIRS AUTO2 MATIC PROCESSING OF CERTAIN CLAIMS 

3 FOR TEMPORARY DISABILITY RATINGS. 

4 (a) IN GENERAL.—Not later than one year after the 

5 date of the enactment of this Act, the Secretary of Vet6 erans Affairs shall modify the information technology sys7 tems of the Department of Veterans Affairs to use auto8 mation technology for claims for temporary disability rat9 ings for veterans described in section 1156(a)(1)(C) of 

10 title 38, United States Code. 

11 (b) ADDITIONAL REQUIREMENTS.—In carrying out 

12 subsection (a), the Secretary shall ensure that— 

13 (1) medical evidence is obtained from the cor14 porate data warehouse of the Department or other 

15 sources of data, the Secretary determines appro16 priate; 

17 (2) employees of the Department continue to 

18 determine whether a veteran is entitled to a tem19 porary disability rating under section 1156(a)(1)(C) 

20 of title 38, United States Code; and 

21 (3) claims may be processed manually if the 

22 evidence of record is not sufficient to decide the 

23 claim or if the medical evidence is provided in a for24 mat that is not compatible with the system devel25 oped under subsection (a). 
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1 TITLE IV—HOMELESSNESS 

2 MATTERS 

3 SEC. 401. SHORT TITLE. 

4 This title may be cited as the ‘‘Housing our Military 

5 Veterans Effectively Act of 2024’’ or the ‘‘HOME Act of 

6 2024’’. 

7 SEC. 402. PER DIEM PAYMENTS PROVIDED BY THE SEC8 RETARY OF VETERANS AFFAIRS FOR SERV9 ICES FURNISHED TO HOMELESS VETERANS. 

10 (a) IN GENERAL.—Section 2012 of title 38, United 

11 States Code, is amended— 

12 (1) in subsection (a)— 

13 (A) in paragraph (2)(B)— 

14 (i) in clause (i)(II)(aa)(BB), by strik15 ing ‘‘115 percent’’ and inserting ‘‘115 per16 cent (or, during the period beginning on 

17 the date of the enactment of the Housing 

18 our Military Veterans Effectively Act of 

19 2024 and ending on September 30, 2027, 

20 133 percent)’’; and 

21 (ii) by adding at the end the fol22 lowing: 

23 ‘‘(iii) For each of fiscal years 2025 through 2027, 

24 the Secretary may waive the maximum rate for per diem 

25 payments under clause (i)(II)(aa)(BB) or (ii) and, subject 
236 

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1 to the availability of appropriations, provide such pay2 ments at a rate that does not exceed 200 percent of the 

3 rate authorized for State homes for domiciliary care under 

4 subsection (a)(1)(A) of section 1741 of this title, as the 

5 Secretary may increase from time to time under sub6 section (c) of that section, if the Secretary notifies Con7 gress of such waiver. 

8 ‘‘(iv) The Secretary may not, pursuant to clause (iii), 

9 waive the maximum rate described in such clause for more 

10 than 50 percent of all grant recipients and eligible entities 

11 for a fiscal year.’’; and 

12 (B) by adding at the end the following new 

13 paragraph: 

14 ‘‘(4) The Secretary may not provide more than 

15 12,000 per diem payments under this section for a fiscal 

16 year.’’; and 

17 (2) by adding at the end the following new sub18 section: 

19 ‘‘(f) REPORTS REQUIRED.—Not later than 90 days 

20 after the date of the enactment of the HOME Act of 2024, 

21 and not less frequently than twice each year thereafter, 

22 the Secretary shall submit to the Committee on Veterans’ 

23 Affairs of the Senate and the Committee on Veterans’ Af24 fairs of the House of Representatives a report on the rate 

25 for per diem payments under this section that includes, 
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1 for each Veterans Integrated Service Network of the De2 partment, the following data: 

3 ‘‘(1) The average rate for such a payment. 

4 ‘‘(2) A list of locations where the rate for such 

5 a payment is within 10 percent of the maximum rate 

6 for such a payment authorized under this section. 

7 ‘‘(3) The average length of stay by a veteran 

8 participating in a program described in section 

9 2012(a) of this title.’’. 

10 (b) REGULATORY AUTHORITY.—The Secretary of 

11 Veterans Affairs may carry out the amendments made by 

12 subsection (a) through interim guidance in advance of the 

13 issuance of regulations for such purpose. 

14 (c) STRATEGIC PLAN.— 

15 (1) IN GENERAL.—Not later than September 

16 30, 2025, the Secretary of Veterans Affairs shall 

17 submit to the Committee on Veterans’ Affairs of the 

18 Senate and the Committee on Veterans’ Affairs of 

19 the House of Representatives a strategic plan for the 

20 provision of grants and per diem payments for serv21 ices furnished to homeless veterans under sections 

22 2011 and 2012 of title 38, United States Code. 

23 (2) ELEMENTS.—The plan required by para24 graph (1) shall include the following: 
238 

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1 (A) A method for administering grant 

2 funding equitably without using the rate au3 thorized for State homes for domiciliary care 

4 under subsection (a)(1)(A) of section 1741 of 

5 title 38, United States Code, as the Secretary 

6 may increase from time to time under sub7 section (c) of that section, that takes into ac8 count— 

9 (i) the wide variety of services fur10 nished by grant recipients and eligible enti11 ties under sections 2011 and 2012 of title 

12 38, United States Code; 

13 (ii) varying costs of living across dif14 ferent geographic locations; 

15 (iii) varying availability of affordable 

16 housing in different geographic locations; 

17 (iv) circumstances of housing insecu18 rity in rural and Tribal communities; 

19 (v) veterans with significant medical 

20 care needs; and 

21 (vi) the changing dynamic of the vet22 eran population nationwide. 

23 (B) A plan and timeline for implementa24 tion of the method included under subpara25 graph (A). 
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1 (C) An estimate of increased costs or sav2 ings per year under the plan. 

3 (D) An overview of the different grants 

4 that will be available once the plan is imple5 mented. 

6 SEC. 403. AUTHORIZATION FOR SECRETARY OF VETERANS 

7 AFFAIRS TO USE CERTAIN FUNDS FOR IM8 PROVED FLEXIBILITY IN ASSISTANCE TO 

9 HOMELESS VETERANS. 

10 (a) USE OF FUNDS.—During the period beginning on 

11 the date of the enactment of this Act and ending on the 

12 termination date specified in subsection (d), the Secretary 

13 of Veterans Affairs may provide to a covered veteran, as 

14 the Secretary determines necessary— 

15 (1) food, shelter, clothing, blankets, and hy16 giene items required for the safety and survival of 

17 the veteran; 

18 (2) transportation required to support the sta19 bility and health of the veteran for appointments 

20 with service providers, the conduct of housing and 

21 employment searches, and the obtainment of food 

22 and supplies; and 

23 (3) tablets, smartphones, disposable phones and 

24 other technology, and related service plans required 

25 to support the stability and health of the veteran 
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1 through the maintenance of contact with service pro2 viders, prospective landlords, and family members. 

3 (b) HOMELESS VETERANS ON DEPARTMENT OF VET4 ERANS AFFAIRS LAND.— 

5 (1) IN GENERAL.—The Secretary may collabo6 rate, to the extent practicable, with one or more or7 ganizations to manage the use of land of the Depart8 ment of Veterans Affairs for homeless veterans for 

9 living and sleeping. 

10 (2) FORMS OF COLLABORATION.—Collaboration 

11 under paragraph (1) may include the provision by ei12 ther the Secretary or the head of the organization 

13 concerned of food services and security for property, 

14 buildings, and other facilities owned or controlled by 

15 the Department of Veterans Affairs. 

16 (c) REPORT REQUIRED.—Not later than six months 

17 after the date of the enactment of this Act, and annually 

18 thereafter until the date specified in subsection (d), the 

19 Secretary shall submit to Congress a report that includes, 

20 with respect to the period covered by such report— 

21 (1) a statement, disaggregated by each medical 

22 center of the Department of Veterans Affairs, of the 

23 amount of funds under this section— 

24 (A) each such medical center requested 

25 from the Secretary; and 
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1 (B) to which the Secretary provided each 

2 such medical center; 

3 (2) data, disaggregated by each such medical 

4 center, relating to how each such medical center 

5 used amounts provided by the Secretary under this 

6 section; 

7 (3) the number of covered veterans to which the 

8 Secretary provided assistance under this section; 

9 (4) the total amount of assistance the Secretary 

10 provided to covered veterans pursuant to subsection 

11 (a)(3) for communications equipment, broken down 

12 by the type of equipment provided; 

13 (5) the total amount of assistance the Secretary 

14 provided covered veterans pursuant to subsection 

15 (a)(2) for ridesharing; 

16 (6) the number of covered veterans who re17 ceived such assistance; and 

18 (7) a description, for each rideshare used by a 

19 covered veteran with such assistance, of the reasons 

20 such covered veteran used such rideshare. 

21 (8) the number of covered veterans who lived or 

22 slept on Department land; 

23 (9) the amount of funds used to make available 

24 Department land for covered veterans to live and 

25 sleep; 
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1 (10) the number of Department employees 

2 whose primary responsibilities involved providing 

3 services for covered veterans living or sleeping on 

4 Department land; 

5 (11) the average length of time a covered vet6 eran lived or slept on Department land, and 

7 (12) the period of time the Secretary expects 

8 Department land will be made available for covered 

9 veterans to live and sleep. 

10 (d) TERMINATION DATE.—The termination date 

11 specified in this subsection is September 30, 2027. 

12 (e) DEFINITIONS.—In this section, the term ‘‘covered 

13 veteran’’ means— 

14 (1) a homeless veteran, as such term is defined 

15 in section 2002 of title 38, United States Code; and 

16 (2) a veteran participating in the program car17 ried out under section 8(o)(19) of the United States 

18 Housing Act of 1937 (42 U.S.C. 1437f(o)(19)). 

19 SEC. 404. ACCESS TO DEPARTMENT OF VETERANS AFFAIRS 

20 TELEHEALTH SERVICES. 

21 (a) IN GENERAL.—Subtitle VII of chapter 20 of title 

22 38, United States Code is amended by adding at the end 

23 the following new section: 
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1 ‘‘§ 2069. Access to telehealth services 

2 ‘‘To the extent practicable, the Secretary shall ensure 

3 that veterans participating in or receiving services from 

4 a program under this chapter have access to telehealth 

5 services to which such veterans are eligible under the laws 

6 administered by the Secretary, including by ensuring that 

7 telehealth capabilities are available to— 

8 ‘‘(1) such veterans; 

9 ‘‘(2) case managers of the Department of pro10 grams for homeless veterans authorized under this 

11 chapter; and 

12 ‘‘(3) community-based service providers for 

13 homeless veterans receiving funds from the Depart14 ment through grants or contracts.’’. 

15 (b) CLERICAL AMENDMENT.—The table of sections 

16 at the beginning of chapter 20 of title 38, United States 

17 Code, is amended by adding at the end the following new 

18 item: 

‘‘2069. Access to telehealth services.’’. 

19 TITLE V—OVERSIGHT AND 

20 INVESTIGATIONS MATTERS 

21 SEC. 501. DEPARTMENT OF VETERANS AFFAIRS EMPLOYEE 

22 TRAINING REGARDING OFFICE OF INSPEC23 TOR GENERAL. 

24 (a) TRAINING.—The Secretary of Veterans Affairs 

25 shall require each employee of the Department of Veterans 
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1 Affairs who begins employment with the Department on 

2 or after the date of the enactment of this Act to receive 

3 training that the Inspector General of the Department 

4 shall develop on the reporting of wrongdoing to, respond5 ing to requests from, and the duty of cooperating with 

6 the Office of Inspector General of the Department. 

7 (b) TIMING OF TRAINING.—In carrying out sub8 section (a), the Secretary shall require each employee of 

9 the Department covered under such subsection to undergo 

10 the training required by such subsection not later than 

11 one year after the date on which the employee begins em12 ployment with the Department. 

13 (c) ELEMENTS.—Training developed and required 

14 under subsection (a) shall include the following: 

15 (1) Definition of the role, responsibilities, and 

16 legal authority of the Inspector General of the De17 partment and the duties of employees of the Depart18 ment for engaging with the Office of Inspector Gen19 eral. 

20 (2) Identification of Federal whistleblower pro21 tection rights, including the right to report fraud, 

22 waste, abuse, and other wrongdoing to Congress. 

23 (3) Identification of the circumstances and 

24 mechanisms for reporting fraud, waste, abuse, and 

25 other wrongdoing to the Inspector General, including 
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1 making confidential complaints to the Inspector 

2 General. 

3 (4) Identification of the prohibitions and rem4 edies that help to protect employees of the Depart5 ment from retaliation when reporting wrongdoing to 

6 the Inspector General. 

7 (5) Recognition of opportunities to engage with 

8 staff of the Office of Inspector General to improve 

9 programs, operations, and services of the Depart10 ment. 

11 (6) Notification of the authority of the Inspec12 tor General to subpoena the attendance and testi13 mony of witnesses, including former employees of 

14 the Department, as necessary to carry out the duties 

15 of the Office of Inspector General under section 312 

16 of title 38, United States Code. 

17 (d) DESIGN AND UPDATE.—The Inspector General of 

18 the Department shall design, and update as the Inspector 

19 General considers appropriate, the training developed and 

20 required by subsection (a). 

21 (e) SYSTEM.—The Secretary shall provide, via the 

22 talent management system of the Department, or suc23 cessor system, the training developed and required under 

24 subsection (a). 
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1 (f) RELATION TO CERTAIN TRAINING.—The Sec2 retary shall ensure that training developed and required 

3 under subsection (a) is separate and distinct from training 

4 provided under section 733 of title 38, United States 

5 Code. 

6 (g) NOTICE TO EMPLOYEES.—The Secretary shall 

7 ensure that the Inspector General is afforded the oppor8 tunity, not less frequently than twice each year and more 

9 frequently if the Inspector General considers appropriate 

10 under extraordinary circumstances, to use the electronic 

11 mail system of the Department to notify all authorized 

12 users of such system of the following: 

13 (1) The roles and responsibilities of the employ14 ees of the Department when engaging with the Of15 fice of Inspector General. 

16 (2) The availability of training provided under 

17 subsection (a). 

18 (3) How to access training provided under sub19 section (a). 

20 (4) Information about how to contact the Office 

21 of Inspector General, including a link to any 

22 website-based reporting form of the Office. 
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1 SEC. 502. ANNUAL REVIEW OF SECURITY AT COVERED FA2 CILITIES OF THE DEPARTMENT OF VET3 ERANS AFFAIRS. 

4 (a) ANNUAL SURVEY.—Not later than one year after 

5 the date of the enactment of this Act, and annually there6 after for each of the following five fiscal years, the Sec7 retary of Veterans Affairs, in coordination with the Direc8 tor of the Office of Security and Law Enforcement of the 

9 Department of Veterans Affairs, shall conduct a survey 

10 of the covered employees at each covered facility to collect 

11 information regarding security. Each annual survey shall 

12 include questions about— 

13 (1) the type and frequency of criminal activity 

14 experienced at the covered facility during the fiscal 

15 year which most recently concluded including wheth16 er or not the criminal activity was related to resi17 dents at the facility or campus such as those in a 

18 residential rehabilitation treatment program or en19 hanced-use lease facility; 

20 (2) the number of vacancies and number of 

21 days vacant for Department police officers at the 

22 covered facility at the time of the survey delineated 

23 by recruitment status and stage; 

24 (3) the availability and adequacy of covered 

25 equipment; 
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1 (4) the availability and adequacy of resources, 

2 classes, or other time set aside for training Depart3 ment police officers who work at each covered facil4 ity about any skill or tactic related to law enforce5 ment, including the proper use of force, firearms 

6 qualifications and training, procedures for respond7 ing to an active threat, and any other training re8 quired for Department police officers; 

9 (5) any security weakness at covered facilities; 

10 (6) the relationship between the covered facility 

11 (including the Department police officers who work 

12 at the covered facility) and local, state, and federal 

13 law enforcement agencies including what agreements 

14 or memorandums of understanding exist between 

15 each covered facility and external law enforcement 

16 agencies; 

17 (7) efforts by the personnel of the covered facil18 ity to address and reduce criminal activity at, or in 

19 close proximity to, the covered facility; and 

20 (8) recommendations for the Secretary to better 

21 address and reduce criminal activity at, or in close 

22 proximity to, covered facilities so as to improve the 

23 safety of veterans, employees, visitors, other author24 ized personnel, and the surrounding community. 
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1 (b) REPORT.—Not later than 30 days after the end 

2 of the next full Fiscal Year after the enactment of this 

3 Act and for each of the following five fiscal years, the Sec4 retary shall submit to each of the Committees on Vet5 erans’ Affairs of the Senate and the House of Representa6 tives a report regarding the results of the surveys con7 ducted under subsection (a) during the previous fiscal 

8 year. The report shall include— 

9 (1) the results of the annual survey described 

10 under subsection (a) for the year covered by the re11 port; 

12 (2) an analysis, made in coordination with the 

13 Director of the Office of Security and Law Enforce14 ment of such Department, each director and police 

15 chief of a Veterans Integrated Service Network, and 

16 the directors and police chiefs of the medical centers 

17 within the Veterans Integrated Service Network of 

18 the results of the triannual security inspections con19 ducted in prior fiscal year, to include a plan of ac20 tion that describes how the Secretary plans to ad21 dress any security weakness identified in the results 

22 of the triannual security inspections and includes 

23 clearly-stated goals with measurable benchmarks for 

24 each goal and deadlines for each benchmark; and 
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1 (3) a list of all vacant positions for police chief 

2 or deputy police chief at each covered facility during 

3 the prior fiscal year, the number of individuals who 

4 filled those positions over the two years prior to the 

5 date of the survey, the number of days the positions 

6 were vacant without someone serving in an acting 

7 capacity, and the number of days the positions were 

8 filled by individuals serving in an acting capacity. 

9 (c) DEFINITIONS.—In this section: 

10 (1) The term ‘‘covered equipment’’ means any 

11 item issued by the Secretary of Veterans Affairs to 

12 a Department police officer (including firearms, 

13 weapons detecting technology, ballistic vests, body14 worn cameras, and radios) for use in the provision 

15 of services under section 902 of title 38, United 

16 States Code. 

17 (2) The term ‘‘covered employee’’ means an em18 ployee of the Department of Veterans Affairs who is 

19 employed and responsible for security operations at 

20 a covered facility including a covered facility’s police 

21 chief, facility emergency management leader, facility 

22 director, or person carrying out the responsibilities 

23 of one of these positions in an acting capacity. 
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1 (3) The term ‘‘covered facility’’ means any fa2 cility of the Department of Veterans Affairs where 

3 Department police officers have jurisdiction. 

4 (4) The term ‘‘Department police officer’’ is 

5 used as such term as used in section 902 of title 38, 

6 United States Code. 

7 (5) The term ‘‘security weakness’’ means a defi8 ciency in the facilities, staffing, or covered equip9 ment at a covered facility that a covered employee 

10 of the covered facility determines presents a risk to 

11 the safety of visitors or staff, including an unsecured 

12 door, inoperable security camera, unsecured police 

13 operations room, a lack of security presence at an 

14 entrance to the covered facility, and a lack of secu15 rity presence in an area of the covered facility or the 

16 grounds of the covered facility that the director of 

17 the covered facility determines requires an increased 

18 security presence. 

19 SEC. 503. MODIFICATION OF CERTAIN HOUSING LOAN 

20 FEES. 

21 The loan fee table in section 3729(b)(2) of title 38, 

22 United States Code, is amended by striking ‘‘November 
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1 29, 2031’’ each place it appears and inserting ‘‘June 9, 

2 2034’’. 

Passed the Senate December 12, 2024. 

Attest: 

Secretary. 

118TH CONGRESS 

2D SESSION S. 141 

AN ACT 

To amend title 38, United States Code, to improve 

for veterans, and for other purposes. Affairs for home and community based services certain programs of the Department of Veterans