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[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[S. 425 Reported in Senate (RS)]

<DOC>

                                                       Calendar No. 716
114th CONGRESS
  2d Session
                                 S. 425

                          [Report No. 114-395]

   To amend title 38, United States Code, to provide for a five-year 
   extension to the homeless veterans reintegration programs and to 
  provide clarification regarding eligibility for services under such 
                               programs.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                           February 10, 2015

  Mr. Boozman (for himself, Mr. Tester, Mr. Inhofe, and Mr. Schumer) 
introduced the following bill; which was read twice and referred to the 
                     Committee on Veterans' Affairs

                            December 7, 2016

  Reported by Mr. Isakson, with an amendment and an amendment to the 
                                 title
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 A BILL

 
   To amend title 38, United States Code, to provide for a five-year 
   extension to the homeless veterans reintegration programs and to 
  provide clarification regarding eligibility for services under such 
                               programs.

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

<DELETED>SECTION 1. SHORT TITLE.</DELETED>

<DELETED>    This Act may be cited as the ``Homeless Veterans' 
Reintegration Programs Reauthorization Act of 2015''.</DELETED>

<DELETED>SEC. 2. REAUTHORIZATION OF DEPARTMENT OF VETERANS AFFAIRS 
              HOMELESS VETERANS REINTEGRATION PROGRAMS.</DELETED>

<DELETED>    (a) Five-Year Extension of Homeless Veterans Reintegration 
Programs.--Section 2021(e)(F) of title 38, United States Code, is 
amended by striking ``2015'' and inserting ``2020''.</DELETED>
<DELETED>    (b) Five-Year Extension of Homeless Women Veterans and 
Homeless Veterans With Children Reintegration Grant Program.--Section 
2021A(f)(1) of such title is amended by striking ``2015'' and inserting 
``2020''.</DELETED>
<DELETED>    (c) Clarification of Eligibility for Services Under 
Homeless Veterans Reintegration Programs.--Section 2021(a) of such 
title is amended by striking ``reintegration of homeless veterans into 
the labor force.'' and inserting the following: ``reintegration into 
the labor force of--''</DELETED>
        <DELETED>    ``(1) homeless veterans;</DELETED>
        <DELETED>    ``(2) veterans participating in the Department of 
        Veterans Affairs supported housing program for which rental 
        assistance is provided pursuant to section 8(o)(19) of the 
        United States Housing Act of 1937 (42 U.S.C. 
        1437f(o)(19));</DELETED>
        <DELETED>    ``(3) Indians who are veterans and receiving 
        assistance under the Native American Housing Assistance and 
        Self Determination Act of 1996 (25 U.S.C. 4101 et seq.); 
        and</DELETED>
        <DELETED>    ``(4) veterans who are transitioning from being 
        incarcerated.''.</DELETED>

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Veterans Homeless 
Programs, Caregiver Services, and Other Improvements Act of 2015''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.

                           TITLE I--BENEFITS

Sec. 101. Expedited payment of survivors benefits.
Sec. 102. Increase in special pension for Medal of Honor recipients.

                      TITLE II--EDUCATION MATTERS

Sec. 201. Restoration of entitlement to Post-9/11 Educational 
                            Assistance for veterans affected by 
                            closures of educational institutions.
Sec. 202. Modification and improvement of transfer of unused Post-9/11 
                            Educational Assistance to family members.
Sec. 203. Codification and improvement of election process for Post-9/
                            11 Educational Assistance.
Sec. 204. Centralized reporting of veteran enrollment by certain 
                            groups, districts, and consortiums of 
                            educational institutions.
Sec. 205. Improved role of State approving agencies in administration 
                            of veterans educational benefits.
Sec. 206. Modification of criteria used to approve courses for purposes 
                            of veterans educational benefits.
Sec. 207. Surveys for compliance of educational institutions and 
                            training establishments with requirements 
                            relating to administration of veterans 
                            educational benefits.
Sec. 208. Modification of requirements for approval for purposes of 
                            educational assistance provided by 
                            Department of Veterans Affairs of programs 
                            designed to prepare individuals for 
                            licensure or certification.
Sec. 209. Expansion of Yellow Ribbon G.I. Education Enhancement 
                            Program.
Sec. 210. Consideration of certain time spent receiving medical care 
                            from Secretary of Defense as active duty 
                            for purposes of eligibility for Post-9/11 
                            Educational Assistance.

                  TITLE III--HOMELESS VETERANS MATTERS

Sec. 301. Expansion of definition of homeless veteran for purposes of 
                            benefits under the laws administered by the 
                            Secretary of Veterans Affairs.
Sec. 302. Increased per diem payments for transitional housing 
                            assistance that becomes permanent housing 
                            for homeless veterans.
Sec. 303. Expansion of Department of Veterans Affairs authority to 
                            provide dental care to homeless veterans.
Sec. 304. Clarification of eligibility for services under homeless 
                            veterans reintegration programs.
Sec. 305. Program to improve retention of housing by formerly homeless 
                            veterans and veterans at risk of becoming 
                            homeless.
Sec. 306. Pilot program on provision of intensive case management 
                            interventions to homeless veterans who 
                            receive the most health care from the 
                            Department of Veterans Affairs.
Sec. 307. Establishment of National Center on Homelessness Among 
                            Veterans.
Sec. 308. Partnerships with public and private entities to provide 
                            legal services to homeless veterans and 
                            veterans at risk of homelessness.
Sec. 309. Administrative improvements to grant and per diem programs of 
                            Department of Veterans Affairs.
Sec. 310. Repeal of requirement for annual reports on assistance to 
                            homeless veterans.
Sec. 311. Comptroller General of the United States study on homeless 
                            veterans programs of Department of Veterans 
                            Affairs.
Sec. 312. Requirement for Department of Veterans Affairs to assess 
                            comprehensive service programs for homeless 
                            veterans.
Sec. 313. Report on outreach relating to increasing the amount of 
                            housing available to veterans.

                     TITLE IV--HEALTH CARE MATTERS

Sec. 401. Short title.

     Subtitle A--Employment of Directors and Health Care Providers

Sec. 411. Extension of period for increase in graduate medical 
                            education residency positions at medical 
                            facilities of the Department of Veterans 
                            Affairs.
Sec. 412. Modification of hours of employment for physicians and 
                            physician assistants employed by the 
                            Department of Veterans Affairs.
Sec. 413. Requirement that physician assistants employed by the 
                            Department of Veterans Affairs receive 
                            competitive pay.
Sec. 414. Establishment of positions of Directors of Veterans 
                            Integrated Service Networks in Office of 
                            Under Secretary for Health of Department of 
                            Veterans Affairs and modification of 
                            qualifications for Medical Directors.
Sec. 415. Pay for Medical Directors and Directors of Veterans 
                            Integrated Service Networks.
Sec. 416. Additional requirements for hiring of health care providers 
                            by Department of Veterans Affairs.
Sec. 417. Provision of information on health care providers of 
                            Department of Veterans Affairs to State 
                            medical boards.
Sec. 418. Report on compliance by Department of Veterans Affairs with 
                            reviews of health care providers leaving 
                            the Department or transferring to other 
                            facilities.

             Subtitle B--Opioid Therapy and Pain Management

Sec. 421. Guidelines on management of opioid therapy by Department of 
                            Veterans Affairs and Department of Defense 
                            and implementation of such guidelines by 
                            Department of Veterans Affairs.
Sec. 422. Improvement of opioid safety measures by Department of 
                            Veterans Affairs.
Sec. 423. Enhancement of joint working group on pain management of the 
                            Department of Veterans Affairs and the 
                            Department of Defense.
Sec. 424. Establishment of pain management boards of Department of 
                            Veterans Affairs.
Sec. 425. Review, investigation, and report on use of opioids in 
                            treatment by Department of Veterans 
                            Affairs.

                      Subtitle C--Patient Advocacy

Sec. 431. Establishment of Office of Patient Advocacy of the Department 
                            of Veterans Affairs.
Sec. 432. Community meetings on improving care from Department of 
                            Veterans Affairs.
Sec. 433. Improvement of awareness of patient advocacy program and 
                            patient bill of rights of Department of 
                            Veterans Affairs.
Sec. 434. Comptroller General Report on Patient Advocacy Program of 
                            Department of Veterans Affairs.

            Subtitle D--Complementary and Integrative Health

Sec. 441. Expansion of research and education on and delivery of 
                            complementary and integrative health to 
                            veterans.
Sec. 442. Pilot program on integration of complementary and integrative 
                            health within Department of Veterans 
                            Affairs medical centers.

                     Subtitle E--Family Caregivers

Sec. 451. Expansion of family caregiver program of Department of 
                            Veterans Affairs.
Sec. 452. Implementation of information technology system of Department 
                            of Veterans Affairs to assess and improve 
                            the family caregiver program.
Sec. 453. Modifications to annual evaluation report on caregiver 
                            program of Department of Veterans Affairs.
Sec. 454. Advisory committee on caregiver policy.
Sec. 455. Comprehensive study on seriously injured veterans and their 
                            caregivers.

                   Subtitle F--Health Care Agreements

Sec. 461. Authorization of agreements between the Department of 
                            Veterans Affairs and non-Department 
                            extended care providers.
Sec. 462. Modification of authority to enter into agreements with State 
                            homes to provide nursing home care.

                         TITLE V--OTHER MATTERS

Sec. 501. Extension of temporary increase in number of judges on United 
                            States Court of Appeals for Veterans 
                            Claims.
Sec. 502. Repeal inapplicability of modification of basic allowance for 
                            housing to benefits under laws administered 
                            by Secretary of Veterans Affairs.
Sec. 503. Department of Veterans Affairs program of internal audits.
Sec. 504. Improvement of training for managers.

                           TITLE I--BENEFITS

SEC. 101. EXPEDITED PAYMENT OF SURVIVORS BENEFITS.

    (a) In General.--Section 5101(a)(1) of title 38, United States 
Code, is amended--
            (1) by striking ``A specific'' and inserting ``(A) Except 
        as provided in subparagraph (B), a specific''; and
            (2) by adding at the end the following new subparagraph:
    ``(B)(i) The Secretary may pay benefits under chapters 13 and 15 
and sections 2302, 2307, and 5121 of this title to a survivor of a 
veteran who has not filed a formal claim if the Secretary determines 
that the record contains sufficient evidence to establish the 
entitlement of the survivor to such benefits.
    ``(ii) For purposes of this subparagraph and section 5110 of this 
title, the date on which the Secretary is notified of the death of the 
veteran shall be treated as the date of the receipt of the survivor's 
application for benefits described in clause (i).''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply with respect to claims for benefits based on a death occurring on 
or after the date of the enactment of this Act.

SEC. 102. INCREASE IN SPECIAL PENSION FOR MEDAL OF HONOR RECIPIENTS.

    (a) In General.--Section 1562(a) of title 38, United States Code, 
is amended by striking ``$1,000'' and inserting ``$3,000''.
    (b) Effective Date.--
            (1) In general.--The amendment made by subsection (a) shall 
        take effect on the date that is--
                    (A) except as provided in subparagraph (B), one 
                year after the date of the enactment of this Act; and
                    (B) in the case that the date that is one year 
                after the date of the enactment of this Act is not the 
                first day of a month, the first day of the first month 
                beginning after the date that is one year after the 
                date of the enactment of this Act.
            (2) Delay of annual cost of living adjustment.--
                    (A) In general.--The Secretary shall not make an 
                increase pursuant to section 1562(e) of such title 
                effective December 1, 2016, if the amendment made by 
                subsection (a) takes effect before such date.
                    (B) Resumption.--In the case that the Secretary, 
                pursuant to subparagraph (A), does not make an increase 
                pursuant to section 1562(e) of such title effective 
                December 1, 2016, the Secretary shall resume making 
                increases pursuant to such section with the first such 
                increase effective December 1, 2017.

                      TITLE II--EDUCATION MATTERS

SEC. 201. RESTORATION OF ENTITLEMENT TO POST-9/11 EDUCATIONAL 
              ASSISTANCE FOR VETERANS AFFECTED BY CLOSURES OF 
              EDUCATIONAL INSTITUTIONS.

    (a) Educational Assistance.--
            (1) In general.--Section 3312 of title 38, United States 
        Code, is amended by adding at the end the following new 
        subsection:
    ``(d) Discontinuation of Education Due to Closure of Educational 
Institution.--
            ``(1) In general.--Any payment of educational assistance 
        described in paragraph (2) shall not--
                    ``(A) be charged against any entitlement to 
                educational assistance of the individual concerned 
                under this chapter; or
                    ``(B) be counted against the aggregate period for 
                which section 3695 of this title limits the 
                individual's receipt of educational assistance under 
                this chapter.
            ``(2) Description of payment of educational assistance.--
        Subject to paragraph (3), the payment of educational assistance 
        described in this paragraph is the payment of such assistance 
        to an individual for pursuit of a course or courses under this 
        chapter if the Secretary finds that the individual--
                    ``(A) was forced to discontinue such course pursuit 
                as a result of a permanent closure of an educational 
                institution; and
                    ``(B) did not receive credit, or lost training 
                time, toward completion of the program of education 
                being pursued at the time of such closure.
            ``(3) Period for which payment not charged.--The period for 
        which, by reason of this subsection, educational assistance is 
        not charged against entitlement or counted toward the 
        applicable aggregate period under section 3695 of this title 
        shall not exceed the aggregate of--
                    ``(A) the portion of the period of enrollment in 
                the course or courses from which the individual failed 
                to receive credit or with respect to which the 
                individual lost training time, as determined under 
                paragraph (2)(B), and
                    ``(B) the period by which a monthly stipend is 
                extended under section 3680(a)(2)(B) of this title.''.
            (2) Applicability.--Subsection (d) of such section, as 
        added by paragraph (1), shall apply with respect to courses and 
        programs of education discontinued as described in paragraph 
        (2) of such subsection in fiscal year 2015 or any fiscal year 
        thereafter.
    (b) Monthly Housing Stipend.--
            (1) In general.--Section 3680(a) of such title is amended--
                    (A) by striking the matter after paragraph (3)(B);
                    (B) in paragraph (3), by redesignating 
                subparagraphs (A) and (B) as clauses (i) and (ii), 
                respectively;
                    (C) by redesignating paragraphs (1) through (3) as 
                subparagraphs (A) through (C), respectively;
                    (D) in the matter before subparagraph (A), as 
                redesignated, in the first sentence, by striking 
                ``Payment of'' and inserting ``(1) Except as provided 
                in paragraph (2), payment of''; and
                    (E) by adding at the end the following new 
                paragraph (2):
    ``(2) Notwithstanding paragraph (1), the Secretary may, pursuant to 
such regulations as the Secretary shall prescribe, continue to pay 
allowances to eligible veterans and eligible persons enrolled in 
courses set forth in paragraph (1)(A)--
            ``(A) during periods when schools are temporarily closed 
        under an established policy based on an Executive order of the 
        President or due to an emergency situation, except that the 
        total number of weeks for which allowances may continue to be 
        so payable in any 12-month period may not exceed four weeks; or
            ``(B) solely for the purpose of awarding a monthly housing 
        stipend described in section 3313 of this title, during periods 
        following a permanent school closure, except that payment of 
        such a stipend may only be continued until the earlier of--
                    ``(i) the date of the end of the term, quarter, or 
                semester during which the school closure occurred; and
                    ``(ii) the date that is 4 months after the date of 
                the school closure.''.
            (2) Conforming amendment.--Paragraph (1)(C)(ii) of such 
        section, as redesignated, is amended by striking ``described in 
        subclause (A) of this clause'' and inserting ``described in 
        clause (i)''.

SEC. 202. MODIFICATION AND IMPROVEMENT OF TRANSFER OF UNUSED POST-9/11 
              EDUCATIONAL ASSISTANCE TO FAMILY MEMBERS.

    (a) Eligibility Requirements.--Subsection (b)(1) of section 3319 of 
title 38, United States Code, is amended--
            (1) by striking ``six years'' and inserting ``ten years''; 
        and
            (2) by striking ``four more years'' and inserting ``two 
        more years''.
    (b) Commencement of Use.--Subsection (g)(1)(A) of such section is 
amended by striking ``six years'' and inserting ``ten years''.
    (c) Rate of Payment.--Subsection (h)(3)(B) of such section is 
amended by inserting before the period at the end the following: ``, 
except that the amount of the monthly stipend described in subsection 
(c)(1)(B) or (g)(3)(A)(ii) of section 3313, as the case may be, shall 
be payable in an amount equal to 50 percent of the amount of such 
stipend that would otherwise be payable under this chapter to the 
individual making the transfer''.
    (d) Technical Correction.--Such section is further amended by 
striking ``armed forces'' each place it appears and inserting ``Armed 
Forces''.
    (e) Applicability.--The amendments made by subsections (a) through 
(c) shall apply with respect to an election to transfer entitlement 
under section 3319 of title 38, United States Code, that is made on or 
after the date that is 180 days after the date of the enactment of this 
Act.

SEC. 203. CODIFICATION AND IMPROVEMENT OF ELECTION PROCESS FOR POST-9/
              11 EDUCATIONAL ASSISTANCE.

    (a) In General.--Subchapter III of chapter 33 of title 38, United 
States Code, is amended by adding at the end the following new section:
``Sec. 3326. Election to receive educational assistance
    ``(a) Individuals Eligible to Elect Participation in Post-9/11 
Educational Assistance.--An individual may elect to receive educational 
assistance under this chapter if such individual--
            ``(1) as of August 1, 2009--
                    ``(A) is entitled to basic educational assistance 
                under chapter 30 of this title and has used, but 
                retains unused, entitlement under that chapter;
                    ``(B) is entitled to educational assistance under 
                chapter 107, 1606, or 1607 of title 10 and has used, 
                but retains unused, entitlement under the applicable 
                chapter;
                    ``(C) is entitled to basic educational assistance 
                under chapter 30 of this title but has not used any 
                entitlement under that chapter;
                    ``(D) is entitled to educational assistance under 
                chapter 107, 1606, or 1607 of title 10 but has not used 
                any entitlement under such chapter;
                    ``(E) is a member of the Armed Forces who is 
                eligible for receipt of basic educational assistance 
                under chapter 30 of this title and is making 
                contributions toward such assistance under section 
                3011(b) or 3012(c) of this title; or
                    ``(F) is a member of the Armed Forces who is not 
                entitled to basic educational assistance under chapter 
                30 of this title by reason of an election under section 
                3011(c)(1) or 3012(d)(1) of this title; and
            ``(2) as of the date of the individual's election under 
        this paragraph, meets the requirements for entitlement to 
        educational assistance under this chapter.
    ``(b) Cessation of Contributions Toward GI Bill.--Effective as of 
the first month beginning on or after the date of an election under 
subsection (a) of an individual described by paragraph (1)(E) of that 
subsection, the obligation of the individual to make contributions 
under section 3011(b) or 3012(c) of this title, as applicable, shall 
cease, and the requirements of such section shall be deemed to be no 
longer applicable to the individual.
    ``(c) Revocation of Remaining Transferred Entitlement.--
            ``(1) Election to revoke.--If, on the date an individual 
        described in paragraph (1)(A) or (1)(C) of subsection (a) makes 
        an election under that subsection, a transfer of the 
        entitlement of the individual to basic educational assistance 
        under section 3020 of this title is in effect and a number of 
        months of the entitlement so transferred remain unutilized, the 
        individual may elect to revoke all or a portion of the 
        entitlement so transferred that remains unutilized.
            ``(2) Availability of revoked entitlement.--Any entitlement 
        revoked by an individual under this paragraph shall no longer 
        be available to the dependent to whom transferred, but shall be 
        available to the individual instead for educational assistance 
        under chapter 33 of this title in accordance with the 
        provisions of this section.
            ``(3) Availability of unrevoked entitlement.--Any 
        entitlement described in paragraph (1) that is not revoked by 
        an individual in accordance with that paragraph shall remain 
        available to the dependent or dependents concerned in 
        accordance with the current transfer of such entitlement under 
        section 3020 of this title.
    ``(d) Post-9/11 Educational Assistance.--
            ``(1) In general.--Subject to paragraph (2) and except as 
        provided in subsection (e), an individual making an election 
        under subsection (a) shall be entitled to educational 
        assistance under this chapter in accordance with the provisions 
        of this chapter, instead of basic educational assistance under 
        chapter 30 of this title, or educational assistance under 
        chapter 107, 1606, or 1607 of title 10, as applicable.
            ``(2) Limitation on entitlement for certain individuals.--
        In the case of an individual making an election under 
        subsection (a) who is described by paragraph (1)(A) of that 
        subsection, the number of months of entitlement of the 
        individual to educational assistance under this chapter shall 
        be the number of months equal to--
                    ``(A) the number of months of unused entitlement of 
                the individual under chapter 30 of this title, as of 
                the date of the election, plus
                    ``(B) the number of months, if any, of entitlement 
                revoked by the individual under subsection (c)(1).
    ``(e) Continuing Entitlement to Educational Assistance Not 
Available Under 9/11 Assistance Program.--
            ``(1) In general.--In the event educational assistance to 
        which an individual making an election under subsection (a) 
        would be entitled under chapter 30 of this title, or chapter 
        107, 1606, or 1607 of title 10, as applicable, is not 
        authorized to be available to the individual under the 
        provisions of this chapter the individual shall remain entitled 
        to such educational assistance in accordance with the 
        provisions of the applicable chapter.
            ``(2) Charge for use of entitlement.--The utilization by an 
        individual of entitlement under paragraph (1) shall be 
        chargeable against the entitlement of the individual to 
        educational assistance under this chapter at the rate of one 
        month of entitlement under this chapter for each month of 
        entitlement utilized by the individual under paragraph (1) (as 
        determined as if such entitlement were utilized under the 
        provisions of chapter 30 of this title, or chapter 107, 1606, 
        or 1607 of title 10, as applicable).
    ``(f) Additional Post-9/11 Assistance for Members Having Made 
Contributions Toward GI Bill.--
            ``(1) Additional assistance.--In the case of an individual 
        making an election under subsection (a) who is described by 
        subparagraph (A), (C), or (E) of paragraph (1) of that 
        subsection, the amount of educational assistance payable to the 
        individual under this chapter as a monthly stipend payable 
        under paragraph (1)(B) of section 3313(c) of this title, or 
        under paragraphs (2) through (7) of that section (as 
        applicable), shall be the amount otherwise payable as a monthly 
        stipend under the applicable paragraph increased by the amount 
        equal to--
                    ``(A) the total amount of contributions toward 
                basic educational assistance made by the individual 
                under section 3011(b) or 3012(c) of this title, as of 
                the date of the election, multiplied by
                    ``(B) the fraction--
                            ``(i) the numerator of which is--
                                    ``(I) the number of months of 
                                entitlement to basic educational 
                                assistance under chapter 30 of this 
                                title remaining to the individual at 
                                the time of the election; plus
                                    ``(II) the number of months, if 
                                any, of entitlement under chapter 30 
                                revoked by the individual under 
                                subsection (c)(1); and
                            ``(ii) the denominator of which is 36 
                        months.
            ``(2) Months of remaining entitlement for certain 
        individuals.--In the case of an individual covered by paragraph 
        (1) who is described by subsection (a)(1)(E), the number of 
        months of entitlement to basic educational assistance remaining 
        to the individual for purposes of paragraph (1)(B)(i)(II) shall 
        be 36 months.
            ``(3) Timing of payment.--The amount payable with respect 
        to an individual under paragraph (1) shall be paid to the 
        individual together with the last payment of the monthly 
        stipend payable to the individual under paragraph (1)(B) of 
        section 3313(c) of this title, or under paragraphs (2) through 
        (7) of that section (as applicable), before the exhaustion of 
        the individual's entitlement to educational assistance under 
        this chapter.
    ``(g) Continuing Entitlement to Additional Assistance for Critical 
Skills or Speciality and Additional Service.--An individual making an 
election under subsection (a)(1) who, at the time of the election, is 
entitled to increased educational assistance under section 3015(d) of 
this title, or section 16131(i) of title 10, or supplemental 
educational assistance under subchapter III of chapter 30 of this 
title, shall remain entitled to such increased educational assistance 
or supplemental educational assistance in the utilization of 
entitlement to educational assistance under this chapter, in an amount 
equal to the quarter, semester, or term, as applicable, equivalent of 
the monthly amount of such increased educational assistance or 
supplemental educational assistance payable with respect to the 
individual at the time of the election.
    ``(h) Alternative Election by Secretary.--
            ``(1) In general.--In the case of an individual who, on or 
        after January 1, 2016, submits to the Secretary an election 
        under this section that the Secretary determines is clearly 
        against the interests of the individual, or who fails to make 
        an election under this section, the Secretary may make an 
        alternative election on behalf of the individual that the 
        Secretary determines is in the best interests of the 
        individual.
            ``(2) Notice.--If the Secretary makes an election on behalf 
        of an individual under this subsection, the Secretary shall 
        notify the individual by not later than seven days after making 
        such election and shall provide the individual with a 30-day 
        period, beginning on the date of the individual's receipt of 
        such notice, during which the individual may modify or revoke 
        the election made by the Secretary on the individual's behalf. 
        The Secretary shall include, as part of such notice, a clear 
        statement of why the alternative election made by the Secretary 
        is in the best interests of the individual as compared to the 
        election submitted by the individual. The Secretary shall 
        provide the notice required under this paragraph by electronic 
        means whenever possible.
    ``(i) Irrevocability of Elections.--An election under subsection 
(a) or (c)(1) is irrevocable.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by adding at the end the following new item:

``3326. Election to receive educational assistance.''.
    (c) Conforming Repeal.--Subsection (c) of section 5003 of the Post-
9/11 Veterans Educational Assistance Act of 2008 (Public Law 110-252; 
38 U.S.C. 3301 note) is hereby repealed.

SEC. 204. CENTRALIZED REPORTING OF VETERAN ENROLLMENT BY CERTAIN 
              GROUPS, DISTRICTS, AND CONSORTIUMS OF EDUCATIONAL 
              INSTITUTIONS.

    (a) In General.--Section 3684(a) of title 38, United States Code, 
is amended--
            (1) in paragraph (1), by inserting ``32, 33,'' after 
        ``31,''; and
            (2) by adding at the end the following new paragraph:
    ``(4) For purposes of this subsection, the term `educational 
institution' may include a group, district, or consortium of separately 
accredited educational institutions located in the same State that are 
organized in a manner that facilitates the centralized reporting of the 
enrollments in such group, district, or consortium of institutions.''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply with respect to reports submitted on or after the date of the 
enactment of this Act.

SEC. 205. IMPROVED ROLE OF STATE APPROVING AGENCIES IN ADMINISTRATION 
              OF VETERANS EDUCATIONAL BENEFITS.

    (a) Approval of Certain Courses.--Section 3672(b)(2)(A) of title 
38, United States Code, is amended by striking ``the following'' and 
all that follows through the colon and inserting the following: ``a 
program of education is deemed to be approved for purposes of this 
chapter if a State approving agency determines that the program is one 
of the following programs:''.
    (b) Approval of Other Courses.--Section 3675 of such title 
amended--
            (1) in subsection (a)(1)--
                    (A) by striking ``The Secretary or a State 
                approving agency'' and inserting ``A State approving 
                agency, or the Secretary when acting in the role of a 
                State approving agency,''; and
                    (B) by striking ``offered by proprietary for-profit 
                educational institutions'' and inserting ``not covered 
                by section 3672 of this title''; and
            (2) in subsection (b)--
                    (A) in the matter before paragraph (1), by striking 
                ``the Secretary or the State approving agency'' and 
                inserting ``the State approving agency, or the 
                Secretary when acting in the role of a State approving 
                agency,''; and
                    (B) in paragraph (1), by striking ``the Secretary 
                or the State approving agency'' and inserting ``the 
                State approving agency, or the Secretary when acting in 
                the role of a State approving agency''.

SEC. 206. MODIFICATION OF CRITERIA USED TO APPROVE COURSES FOR PURPOSES 
              OF VETERANS EDUCATIONAL BENEFITS.

    (a) Nonaccredited Courses.--Section 3676(c)(14) of title 38, United 
States Code, is amended by inserting before the period the following: 
``if the Secretary, in consultation with the State approving agency and 
pursuant to regulations prescribed to carry out this paragraph, 
determines such criteria are necessary and treat public, private, and 
proprietary for-profit educational institutions equitably''.
    (b) Accredited Courses.--Section 3675(b)(3) of such title is 
amended by striking ``and (3)'' and inserting ``(3), and (14)''.
    (c) Application.--The amendment made by subsection (a) shall apply 
with respect to--
            (1) criteria developed pursuant to paragraph (14) of 
        subsection (c) of section 3676 of title 38, United States Code, 
        on or after January 1, 2013; and
            (2) an investigation conducted under such subsection that 
        is covered by a reimbursement of expenses paid by the Secretary 
        of Veterans Affairs to a State pursuant to section 3674 of such 
        title on or after October 1, 2015.

SEC. 207. SURVEYS FOR COMPLIANCE OF EDUCATIONAL INSTITUTIONS AND 
              TRAINING ESTABLISHMENTS WITH REQUIREMENTS RELATING TO 
              ADMINISTRATION OF VETERANS EDUCATIONAL BENEFITS.

    (a) In General.--Section 3693 of title 38, United States Code, is 
amended--
            (1) by striking subsection (a) and inserting the following 
        new subsection (a):
    ``(a)(1)(A) Except as provided in subsection (b), the Secretary 
shall conduct an annual compliance survey of educational institutions 
and training establishments offering one or more courses approved for 
the enrollment of eligible veterans or persons if at least 20 such 
veterans or persons are enrolled in any such course.
    ``(B) The Secretary shall--
            ``(i) design the compliance surveys to ensure that such 
        institutions or establishments, as the case may be, and 
        approved courses are in compliance with all applicable 
        provisions of chapters 30 through 36 of this title;
            ``(ii) survey each such educational institution and 
        training establishment not less than once during every two-year 
        period; and
            ``(iii) assign not fewer than one education compliance 
        specialist to work on compliance surveys in any year for each 
        40 compliance surveys required to be made under this section 
        for such year.
    ``(2) The Secretary, in consultation with the State approving 
agencies, shall--
            ``(A) annually determine the parameters of the surveys 
        required under paragraph (1); and
            ``(B) not later than September 1 of each year, make 
        available to the State approving agencies a list of the 
        educational institutions and training establishments that will 
        be surveyed during the fiscal year following the date of making 
        such list available.''; and
            (2) by adding at the end the following new subsection:
    ``(c) In this section, the terms `educational institution' and 
`training establishment' have the meaning given such terms in section 
3452 of this title.''.
    (b) Conforming Amendments.--Subsection (b) of such section is 
amended--
            (1) by striking ``subsection (a) of this section for an 
        annual compliance survey'' and inserting ``subsection (a)(1) 
        for a compliance survey'';
            (2) by striking ``institution'' and inserting ``educational 
        institution or training establishment''; and
            (3) by striking ``institution's demonstrated record of 
        compliance'' and inserting ``record of compliance of such 
        institution or establishment''.

SEC. 208. MODIFICATION OF REQUIREMENTS FOR APPROVAL FOR PURPOSES OF 
              EDUCATIONAL ASSISTANCE PROVIDED BY DEPARTMENT OF VETERANS 
              AFFAIRS OF PROGRAMS DESIGNED TO PREPARE INDIVIDUALS FOR 
              LICENSURE OR CERTIFICATION.

    (a) Approval of Non-Accredited Courses.--Subsection (c) of section 
3676 of title 38, United States Code, as amended by section 206, is 
further amended--
            (1) by redesignating paragraph (14) as paragraph (16); and
            (2) by inserting after paragraph (13) the following new 
        paragraphs:
            ``(14) In the case of a course designed to prepare an 
        individual for licensure or certification in a State, the 
        course--
                    ``(A) meets any instructional curriculum licensure 
                or certification requirements of such State; and
                    ``(B) in the case of a course designed to prepare 
                an individual for licensure to practice law in a State, 
                is accredited by an accrediting agency or association 
                recognized by the Secretary of Education under subpart 
                2 of part H of title IV of the Higher Education Act of 
                1965 (20 U.S.C. 1099b).
            ``(15) In the case of a course designed to prepare an 
        individual for employment pursuant to standards developed by a 
        board or agency of a State in an occupation that requires 
        approval, licensure, or certification, the course--
                    ``(A) meets such standards; and
                    ``(B) in the case of a course designed to prepare 
                an individual for licensure to practice law in a State, 
                is accredited by an accrediting agency or association 
                recognized by the Secretary of Education under subpart 
                2 of part H of title IV of the Higher Education Act of 
                1965 (20 U.S.C. 1099b).''.
    (b) Exceptions.--Such section is further amended by adding at the 
end the following new subsection:
    ``(f)(1) The Secretary may waive the requirements of paragraph (14) 
or (15) of subsection (c) in the case of a course of education offered 
by an educational institution (either accredited or not accredited) if 
the Secretary determines all of the following:
            ``(A) The course did not meet the requirements of such 
        paragraph at any time during the two-year period preceding the 
        date of the waiver.
            ``(B) The waiver furthers the purposes of the educational 
        assistance programs administered by the Secretary or would 
        further the education interests of individuals eligible for 
        assistance under such programs.
            ``(C) The educational institution does not provide any 
        commission, bonus, or other incentive payment based directly or 
        indirectly on success in securing enrollments or financial aid 
        to any persons or entities engaged in any student recruiting or 
        admission activities or in making decisions regarding the award 
        of student financial assistance, except for the recruitment of 
        foreign students residing in foreign countries who are not 
        eligible to receive Federal student assistance.
    ``(2) Not later than 30 days after the date on which the Secretary 
issues a waiver under paragraph (1), the Secretary shall submit to 
Congress notice of such waiver and a justification for issuing such 
waiver.''.
    (c) Approval of Accredited Courses.--Section 3675(b)(3) of such 
title, as amended by section 206, is further amended--
            (1) by striking ``and (14)'' and inserting ``(14), (15), 
        and (16)''; and
            (2) by inserting before the period at the end the 
        following: ``(or, with respect to such paragraphs (14) and 
        (15), the requirements under such paragraphs are waived 
        pursuant to subsection (f)(1) of section 3676 of this title)''.
    (d) Approval of Accredited Standard College Degree Programs Offered 
at Public or Not-for-profit Educational Institutions.--Section 
3672(b)(2) of such title is amended--
            (1) in subparagraph (A)(i), by striking ``An accredited'' 
        and inserting ``Except as provided in subparagraph (C), an 
        accredited''; and
            (2) by adding at the end the following new subparagraph:
    ``(C) A course that is described in both subparagraph (A)(i) of 
this paragraph and in paragraph (14) or (15) of section 3676(c) of this 
title shall not be deemed to be approved for purposes of this chapter 
unless--
            ``(i) a State approving agency, or the Secretary when 
        acting in the role of a State approving agency, determines that 
        the course meets the applicable criteria in such paragraphs; or
            ``(ii) the Secretary issues a waiver for such course under 
        section 3676(f)(1) of this title.''.
    (e) Disapproval of Courses.--Section 3679 of such title is amended 
by adding at the end the following new subsection:
    ``(d) Notwithstanding any other provision of this chapter, the 
Secretary or the applicable State approving agency shall disapprove a 
course of education described in paragraph (14) or (15) of section 
3676(c) of this title unless the educational institution providing the 
course of education--
            ``(1) publicly discloses any conditions or additional 
        requirements, including training, experience, or examinations, 
        required to obtain the license, certification, or approval for 
        which the course of education is designed to provide 
        preparation; and
            ``(2) makes each disclosure required by paragraph (1) in a 
        manner that the Secretary considers prominent.''.
    (f) Applicability.--If after enrollment in a course of education 
that is subject to disapproval by reason of an amendment made by this 
Act, an individual pursues one or more courses of education at the same 
educational institution while remaining continuously enrolled (other 
than during regularly scheduled breaks between courses, semesters, or 
terms) at that institution, any course so pursued by the individual at 
that institution while so continuously enrolled shall not be subject to 
disapproval by reason of such amendment.

SEC. 209. EXPANSION OF YELLOW RIBBON G.I. EDUCATION ENHANCEMENT 
              PROGRAM.

    (a) In General.--Section 3317(a) of title 38, United States Code, 
is amended by striking ``in paragraphs (1) and (2)'' and inserting ``in 
paragraphs (1), (2), and (9)''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply with respect to academic years beginning after the date that is 
one year after the date of the enactment of this Act.

SEC. 210. CONSIDERATION OF CERTAIN TIME SPENT RECEIVING MEDICAL CARE 
              FROM SECRETARY OF DEFENSE AS ACTIVE DUTY FOR PURPOSES OF 
              ELIGIBILITY FOR POST-9/11 EDUCATIONAL ASSISTANCE.

    (a) In General.--Section 3301(1)(B) of title 38, United States 
Code, is amended by inserting ``12301(h),'' after ``12301(g),''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
take effect on the date that is one year after the date of the 
enactment of this Act and shall apply with respect to assistance 
provided under chapter 33 of such title on and after the date that is 
one year after the date of the enactment of this Act.

                  TITLE III--HOMELESS VETERANS MATTERS

SEC. 301. EXPANSION OF DEFINITION OF HOMELESS VETERAN FOR PURPOSES OF 
              BENEFITS UNDER THE LAWS ADMINISTERED BY THE SECRETARY OF 
              VETERANS AFFAIRS.

    Section 2002(1) of title 38, United States Code, is amended by 
striking ``in section 103(a) of the McKinney-Vento Homeless Assistance 
Act (42 U.S.C. 11302(a))'' and inserting ``in subsection (a) or (b) of 
section 103 of the McKinney-Vento Homeless Assistance Act (42 U.S.C. 
11302)''.

SEC. 302. INCREASED PER DIEM PAYMENTS FOR TRANSITIONAL HOUSING 
              ASSISTANCE THAT BECOMES PERMANENT HOUSING FOR HOMELESS 
              VETERANS.

    Section 2012(a)(2) of title 38, United States Code, is amended--
            (1) by redesignating subparagraphs (B) through (D) as 
        subparagraphs (C) through (E), respectively;
            (2) in subparagraph (C), as redesignated, by striking ``in 
        subparagraph (D)'' and inserting ``in subparagraph (E)'';
            (3) in subparagraph (D), as redesignated, by striking 
        ``under subparagraph (B)'' and inserting ``under subparagraph 
        (C)'';
            (4) in subparagraph (E), as redesignated, by striking ``in 
        subparagraphs (B) and (C)'' and inserting ``in subparagraphs 
        (C) and (D)''; and
            (5) in subparagraph (A)--
                    (A) by striking ``The rate'' and inserting ``Except 
                as otherwise provided in subparagraph (B), the rate''; 
                and
                    (B) by striking ``under subparagraph (B)'' and all 
                that follows through the end and inserting the 
                following: ``under subparagraph (C).
    ``(B)(i) Except as provided in clause (ii), in no case may the rate 
determined under this paragraph exceed the rate authorized for State 
homes for domiciliary care under subsection (a)(1)(A) of section 1741 
of this title, as the Secretary may increase from time to time under 
subsection (c) of that section.
    ``(ii) In the case of services furnished to a homeless veteran who 
is placed in housing that will become permanent housing for the veteran 
upon termination of the furnishing of such services to such veteran, 
the maximum rate of per diem authorized under this section is 150 
percent of the rate described in clause (i).''.

SEC. 303. EXPANSION OF DEPARTMENT OF VETERANS AFFAIRS AUTHORITY TO 
              PROVIDE DENTAL CARE TO HOMELESS VETERANS.

    (a) In General.--Subsection (b) of section 2062 of title 38, United 
States Code, is amended to read as follows:
    ``(b) Eligible Veterans.--(1) Subsection (a) applies to a veteran 
who--
            ``(A) is enrolled for care under section 1705(a) of this 
        title; and
            ``(B) for a period of 60 consecutive days, is receiving--
                    ``(i) assistance under section 8(o) of the United 
                States Housing Act of 1937 (42 U.S.C. 1437f(o)); or
                    ``(ii) care (directly or by contract) in any of the 
                following settings:
                            ``(I) A domiciliary under section 1710 of 
                        this title.
                            ``(II) A therapeutic residence under 
                        section 2032 of this title.
                            ``(III) Community residential care 
                        coordinated by the Secretary under section 1730 
                        of this title.
                            ``(IV) A setting for which the Secretary 
                        provides funds for a grant and per diem 
                        provider.
    ``(2) For purposes of paragraph (1), in determining whether a 
veteran has received assistance or care for a period of 60 consecutive 
days, the Secretary may disregard breaks in the continuity of 
assistance or care for which the veteran is not responsible.''.
    (b) Effective Date.--Subsection (a) shall take effect on the date 
that is one year after the date of the enactment of this Act.

SEC. 304. CLARIFICATION OF ELIGIBILITY FOR SERVICES UNDER HOMELESS 
              VETERANS REINTEGRATION PROGRAMS.

    Section 2021(a) of title 38, United States Code, is amended by 
striking ``reintegration of homeless veterans into the labor force.'' 
and inserting the following: ``reintegration into the labor force of--
''
            ``(1) homeless veterans;
            ``(2) veterans participating in the Department of Veterans 
        Affairs supported housing program for which rental assistance 
        is provided pursuant to section 8(o)(19) of the United States 
        Housing Act of 1937 (42 U.S.C. 1437f(o)(19));
            ``(3) Indians who are veterans and receiving assistance 
        under the Native American Housing Assistance and Self 
        Determination Act of 1996 (25 U.S.C. 4101 et seq.); and
            ``(4) veterans who are transitioning from being 
        incarcerated.''.

SEC. 305. PROGRAM TO IMPROVE RETENTION OF HOUSING BY FORMERLY HOMELESS 
              VETERANS AND VETERANS AT RISK OF BECOMING HOMELESS.

    (a) Program Required.--
            (1) In general.--Subchapter II of chapter 20 of title 38, 
        United States Code, is amended--
                    (A) by redesignating section 2013 as section 2014; 
                and
                    (B) by inserting after section 2012 the following 
                new section 2013:
``Sec. 2013. Program to improve retention of housing by formerly 
              homeless veterans and veterans at risk of becoming 
              homeless
    ``(a) Program Required.--The Secretary shall carry out a program 
under which the Secretary shall provide case management services to 
improve the retention of housing by veterans who were previously 
homeless and are transitioning to permanent housing and veterans who 
are at risk of becoming homeless.
    ``(b) Grants.--(1) The Secretary shall carry out the program 
through the award of grants.
    ``(2)(A) In awarding grants under paragraph (1), the Secretary 
shall give priority to organizations that demonstrate a capability to 
provide case management services as described in subsection (a), 
particularly organizations that are successfully providing or have 
successfully provided transitional housing services using amounts 
provided by the Secretary under sections 2012 and 2061 of this title.
    ``(B) In giving priority under subparagraph (A), the Secretary 
shall give extra priority to an organization described in such 
subparagraph that--
            ``(i) voluntarily stops receiving amounts provided by the 
        Secretary under sections 2012 and 2061 of this title; and
            ``(ii) converts a facility that the organization used to 
        provide transitional housing services into a facility that the 
        organization uses to provide permanent housing that meets 
        housing quality standards established under section 8(o)(8)(B) 
        of the United States Housing Act of 1937 (42 U.S.C. 
        1437f(o)(8)(B)).
    ``(C) In any case in which a facility, with respect to which a 
person received a grant for construction, rehabilitation, or 
acquisition under section 2011 of this title, is converted as described 
in subparagraph (B)(ii), such conversion shall be considered to have 
been carried out pursuant to the needs of the Department and such 
person shall not be considered in non-compliance with the terms of such 
grant by reason of such conversion.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of chapter 20 of such title is amended by striking 
        the item relating to section 2013 and inserting the following 
        new items:

``2013. Program to improve retention of housing by formerly homeless 
                            veterans and veterans at risk of becoming 
                            homeless.
``2014. Authorization of appropriations.''.
    (b) Regulations.--Not later than one year after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall 
prescribe regulations to carry out section 2013 of such title, as added 
by subsection (a)(1)(B).
    (c) Report.--
            (1) In general.--Not later than June 1, 2019, the Secretary 
        shall submit to the Committee on Veterans' Affairs of the 
        Senate and the Committee on Veterans' Affairs of the House of 
        Representatives a report on the program required by section 
        2013 of such title, as added by subsection (a)(1)(B).
            (2) Contents.--The report submitted under paragraph (1) 
        shall include assessments of the following:
                    (A) The percentage of veterans who received case 
                management services under the program who were able to 
                retain permanent housing by the end of the program, 
                disaggregated by each recipient of a grant under such 
                section.
                    (B) The percentage of veterans who received case 
                management services under the program who were not in 
                permanent housing at the end of the program, 
                disaggregated by housing status and reason for failing 
                to retain permanent housing under the program.
                    (C) The use by veterans who received case 
                management services under the program of housing 
                assistance furnished by the Department of Veterans 
                Affairs, including a comparison of the use of such 
                assistance by such veterans before and after receiving 
                such services.
                    (D) An assessment of the employment status of 
                veterans who received case management services under 
                the program, including a comparison of the employment 
                status of such veterans before and after receiving such 
                services.

SEC. 306. PILOT PROGRAM ON PROVISION OF INTENSIVE CASE MANAGEMENT 
              INTERVENTIONS TO HOMELESS VETERANS WHO RECEIVE THE MOST 
              HEALTH CARE FROM THE DEPARTMENT OF VETERANS AFFAIRS.

    (a) Pilot Program Required.--Not later than September 1, 2016, the 
Secretary of Veterans Affairs shall commence a pilot program to assess 
the feasibility and advisability of providing intensive case management 
interventions to covered veterans.
    (b) Covered Veterans.--For purposes of the pilot program, a covered 
veteran is a veteran who is enrolled in--
            (1) the homeless registry of the Department; and
            (2) the system of annual patient enrollment established and 
        operated by the Secretary under section 1705(a) of title 38, 
        United States Code.
    (c) Location.--
            (1) In general.--The Secretary shall carry out the pilot 
        program at not fewer than six locations selected by the 
        Secretary for purposes of the pilot program as follows:
                    (A) Not fewer than three locations in cities that 
                have the largest populations of homeless veterans in 
                the United States.
                    (B) Not fewer than three locations in suburban or 
                rural settings.
            (2) Interaction and coordination with community 
        organizations.--In selecting locations under paragraph (1), the 
        Secretary shall only select locations in areas in which the 
        Secretary determines that there is a high degree of interaction 
        and coordination between the Department and community 
        organizations that provide housing and social services for 
        veterans, such as outreach, employment, and financial 
        assistance for homeless veterans, veterans at risk of becoming 
        homeless, and low-income veterans.
    (d) Provision of Intensive Case Management Interventions.--
            (1) Minimum number of veterans to receive interventions.--
        In carrying out the program at each location selected under 
        subsection (c), the Secretary shall provide intensive case 
        management interventions to not fewer than 20 covered veterans 
        at each such location who the Secretary determines are the 
        covered veterans at such location who receive the most health 
        care and related services furnished by the Department of 
        Veterans Affairs.
            (2) Nature of interventions.--The intensive case management 
        interventions provided to covered veterans under paragraph (1) 
        shall include assistance with gaining and maintaining access to 
        such housing and services, including benefits and services to 
        which covered veterans may be entitled or eligible under the 
        laws administered by the Secretary, as may be necessary to 
        improve the stability of their housing and the appropriateness 
        of the health care that they receive.
    (e) Report.--
            (1) In general.--Not later than December 1, 2018, the 
        Secretary shall submit to the Committee on Veterans' Affairs of 
        the Senate and the Committee on Veterans' Affairs of the House 
        of Representatives a report on the pilot program carried out 
        under this section.
            (2) Contents.--The report submitted under paragraph (1) 
        shall include assessments of the following:
                    (A) The types and frequencies of intensive case 
                management interventions provided under the pilot 
                program.
                    (B) The housing status of each veteran who received 
                an intensive case management intervention under the 
                pilot program.
                    (C) The employment status of each veteran who 
                received an intensive case management intervention 
                under the pilot program, including a comparison of the 
                employment status of such veteran before and after 
                receiving such intervention.
                    (D) The use by veterans who received intensive case 
                management interventions under the pilot program of 
                health care and related services furnished by the 
                Department of Veterans Affairs and the costs incurred 
                by the Department in furnishing such care and services, 
                including a comparison of the use by such veterans of 
                such care and services and the costs incurred from 
                furnishing such care and services before and after 
                receiving such interventions.
                    (E) The number of veterans who received intensive 
                case management interventions under the pilot program, 
                disaggregated by whether the intensive case management 
                intervention was provided in a location described in 
                subparagraph (A) or (B) of subsection (c)(1).
                    (F) The costs incurred by the Department in 
                carrying out the pilot program, disaggregated by 
                provision of intensive case management interventions in 
                locations described in subparagraphs (A) and (B) of 
                such subsection.
                    (G) An estimate of the costs the Department would 
                have incurred for the provision of health care and 
                associated services to covered veterans but for the 
                provision of intensive case management interventions 
                under the pilot program, disaggregated by provision of 
                intensive case management interventions in locations 
                described in subparagraphs (A) and (B) of subsection 
                (c)(1).

SEC. 307. ESTABLISHMENT OF NATIONAL CENTER ON HOMELESSNESS AMONG 
              VETERANS.

    (a) In General.--Subchapter VII of chapter 20 of title 38, United 
States Code, is amended by adding at the end the following new section:
``Sec. 2067. National Center on Homelessness Among Veterans
    ``(a) In General.--(1) The Secretary shall establish and operate a 
center to carry out the functions described in subsection (b).
    ``(2) The center established under paragraph (1) shall be known as 
the `National Center on Homelessness Among Veterans'.
    ``(3) To the degree practicable, the Secretary shall operate the 
center established under paragraph (1) independently of the other 
programs of the Department that address homelessness among veterans.
    ``(b) Functions.--The functions described in this subsection are as 
follows:
            ``(1) To carry out and promote research into the causes and 
        contributing factors to veteran homelessness.
            ``(2) To assess the effectiveness of programs of the 
        Department to meet the needs of homeless veterans.
            ``(3) To identify and disseminate best practices with 
        regard to housing stabilization, income support, employment 
        assistance, community partnerships, and such other matters as 
        the Secretary considers appropriate with respect to addressing 
        veteran homelessness.
            ``(4) To integrate evidence-based and best practices, 
        policies, and programs into programs of the Department for 
        homeless veterans and veterans at risk of homelessness and to 
        ensure that the staff of the Department and community partners 
        can implement such practices, policies, and programs.
            ``(5) To serve as a resource center for, and promote and 
        seek to coordinate the exchange of information regarding, all 
        research and training activities carried out by the Department 
        and by other Federal and non-Federal entities with respect to 
        veteran homelessness.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 20 of such title is amended by inserting after the item 
relating to section 2066 the following new item:

``2067. National Center on Homelessness Among Veterans.''.

SEC. 308. PARTNERSHIPS WITH PUBLIC AND PRIVATE ENTITIES TO PROVIDE 
              LEGAL SERVICES TO HOMELESS VETERANS AND VETERANS AT RISK 
              OF HOMELESSNESS.

    (a) In General.--Chapter 20 of title 38, United States Code, is 
amended by inserting after section 2022 the following new section:
``Sec. 2022A. Partnerships with public and private entities to provide 
              legal services to homeless veterans and veterans at risk 
              of homelessness
    ``(a) Partnerships Authorized.--Subject to the availability of 
funds for that purpose, the Secretary may enter into partnerships with 
public or private entities to fund a portion of the general legal 
services specified in subsection (c) that are provided by such entities 
to homeless veterans and veterans at risk of homelessness.
    ``(b) Locations.--(1) The Secretary shall ensure that, to the 
extent practicable, partnerships under this section are made with 
entities equitably distributed across the geographic regions of the 
United States, including rural communities, tribal lands of the United 
States, Native Americans, and tribal organizations.
    ``(2) In this subsection, the terms `Native American' and `tribal 
organization' have the meanings given such terms in section 3765 of 
this title.
    ``(c) Legal Services.--Legal services specified in this subsection 
include legal services provided by public or private entities that 
address the needs of homeless veterans and veterans at risk of 
homelessness, such as the following:
            ``(1) Legal services related to housing, including eviction 
        defense and representation in landlord-tenant cases.
            ``(2) Legal services related to family law, including 
        assistance in court proceedings for child support, divorce, and 
        estate planning.
            ``(3) Legal services related to income support, including 
        assistance in obtaining public benefits.
            ``(4) Legal services related to criminal defense, including 
        defense in matters symptomatic of homelessness, such as 
        outstanding warrants, fines, and driver's license revocation, 
        to reduce recidivism and facilitate the overcoming of reentry 
        obstacles in employment or housing.
    ``(d) Consultation.--In developing and carrying out partnerships 
under this section, the Secretary shall, to the extent practicable, 
consult with public and private entities--
            ``(1) for assistance in identifying and contacting 
        organizations described in subsection (c); and
            ``(2) to coordinate appropriate outreach relationships with 
        such organizations.
    ``(e) Reports.--The Secretary may require entities that have 
entered into partnerships under this section to submit to the Secretary 
periodic reports on legal services provided to homeless veterans and 
veterans at risk of homelessness pursuant to such partnerships.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 20 of such title is amended by adding after the item relating 
to section 2022 the following new item:

``2022A. Partnerships with public and private entities to provide legal 
                            services to homeless veterans and veterans 
                            at risk of homelessness.''.

SEC. 309. ADMINISTRATIVE IMPROVEMENTS TO GRANT AND PER DIEM PROGRAMS OF 
              DEPARTMENT OF VETERANS AFFAIRS.

    Section 2012 of title 38, United States Code, is amended--
            (1) in subsection (a)(1), in the matter before subparagraph 
        (A), by inserting ``and except as otherwise provided in this 
        section'' after ``such purpose''; and
            (2) by adding at the end the following new subsection:
    ``(e) Review and Conditional Renewal.--(1) Each year, the Secretary 
shall review each grant recipient and eligible entity that received a 
per diem payment under this section for a service furnished to a 
veteran during the one-year period preceding the review to evaluate the 
performance of the grant recipient or eligible entity during that 
period with respect to--
            ``(A) the success of the grant recipient or eligible entity 
        in assisting veterans to obtain, transition into, and retain 
        permanent housing; and
            ``(B) increasing the income of veterans, whether by helping 
        veterans obtain employment or by helping veterans obtain 
        income-related benefits to which such veterans may be eligible 
        or entitled.
    ``(2) For any grant recipient or eligible entity whose performance 
was evaluated for a year under paragraph (1), the Secretary may only 
provide per diem under this section to that grant recipient or eligible 
entity in the following year if the Secretary determines that such 
performance merits continued receipt of per diem under this section.
    ``(3) The Secretary shall establish uniform performance targets 
throughout the United States for all grant recipients and eligible 
entities that receive per diem payments under this section for purposes 
of evaluating the performance of each such grant recipient and eligible 
entity under this subsection.''.

SEC. 310. REPEAL OF REQUIREMENT FOR ANNUAL REPORTS ON ASSISTANCE TO 
              HOMELESS VETERANS.

    (a) In General.--Section 2065 of title 38, United States Code, is 
hereby repealed.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 20 of such title is amended by striking the item relating to 
section 2065.

SEC. 311. COMPTROLLER GENERAL OF THE UNITED STATES STUDY ON HOMELESS 
              VETERANS PROGRAMS OF DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--Not later than 270 days after the date of the 
enactment of this Act, the Comptroller General of the United States 
shall complete a study of programs of the Department of Veterans 
Affairs that provide assistance to homeless veterans.
    (b) Elements.--The study required by subsection (a) shall include 
the following:
            (1) An assessment of whether programs described in 
        subsection (a) are meeting the needs of veterans who are 
        eligible for assistance provided by such programs, including 
        any gaps or duplication in the provision of services.
            (2) A review of recent efforts of the Secretary of Veterans 
        Affairs to improve the privacy, safety, and security of female 
        veterans receiving assistance from such programs.

SEC. 312. REQUIREMENT FOR DEPARTMENT OF VETERANS AFFAIRS TO ASSESS 
              COMPREHENSIVE SERVICE PROGRAMS FOR HOMELESS VETERANS.

    (a) In General.--Not later than one year after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall--
            (1) assess and measure the capacity of programs for which 
        entities receive grants under section 2011 of title 38, United 
        States Code, or per diem payments under section 2012 or 2061 of 
        such title; and
            (2) assess such programs with respect to--
                    (A) how well they achieve their stated goals at a 
                national level;
                    (B) placements in permanent housing;
                    (C) placements in employment; and
                    (D) increases in the regular income of participants 
                in the programs.
    (b) Assessment at National and Local Levels.--In assessing and 
measuring under subsection (a)(1), the Secretary shall develop and use 
tools to examine the capacity of programs described in such subsection 
at both the national and local level in order to assess the following:
            (1) Whether sufficient capacity exists to meet the needs of 
        homeless veterans in each geographic area.
            (2) Whether existing capacity meets the needs of the 
        subpopulations of homeless veterans located in each geographic 
        area.
            (3) The amount of capacity that recipients of grants under 
        sections 2011 and 2061 and per diem payments under section 2012 
        of such title have to provide services for which the recipients 
        are eligible to receive per diem under section 
        2012(a)(2)(B)(ii) of title 38, United States Code, as added by 
        section 302(5)(B).
    (c) Consideration of Other Resources.--In assessing and measuring 
programs under subsection (a)(1), the Secretary shall consider the 
availability to such programs of resources made available to such 
programs and to homeless veterans, including resources provided by the 
Department of Veterans Affairs and by entities other than the 
Department.
    (d) Use of Information.--The Secretary shall use the information 
collected under this section as follows:
            (1) To set specific goals to ensure that programs described 
        in subsection (a) are effectively serving the needs of homeless 
        veterans.
            (2) To assess whether programs described in subsection (a) 
        are meeting goals set under paragraph (1).
            (3) To inform funding allocations for programs described in 
        subsection (a).
            (4) To improve the referral of homeless veterans to 
        programs described in subsection (a).
    (e) Report.--Not later than 180 days after the date on which the 
assessment required by subsection (a) is completed, the Secretary shall 
submit to the Committee on Veterans' Affairs of the Senate and the 
Committee on Veterans' Affairs of the House of Representatives a report 
on such assessment and such recommendations for legislative and 
administrative action as the Secretary may have to improve the programs 
and per diem payments described in subsection (a).

SEC. 313. REPORT ON OUTREACH RELATING TO INCREASING THE AMOUNT OF 
              HOUSING AVAILABLE TO VETERANS.

    Not later than one year after the date of the enactment of this 
Act, the Secretary of Veterans Affairs shall submit to the Committee on 
Veterans' Affairs of the Senate and the Committee on Veterans' Affairs 
of the House of Representatives a report describing and assessing the 
outreach conducted by the Secretary to realtors, landlords, property 
management companies, and developers to educate them about the housing 
needs of veterans and the benefits of having veterans as tenants.

                     TITLE IV--HEALTH CARE MATTERS

SEC. 401. SHORT TITLE.

    This title may be cited as the ``Jason Simcakoski Memorial Act''.

     Subtitle A--Employment of Directors and Health Care Providers

SEC. 411. EXTENSION OF PERIOD FOR INCREASE IN GRADUATE MEDICAL 
              EDUCATION RESIDENCY POSITIONS AT MEDICAL FACILITIES OF 
              THE DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--Paragraph (2) of section 301(b) of the Veterans 
Access, Choice, and Accountability Act of 2014 (Public Law 113-146; 38 
U.S.C. 7302 note) is amended--
            (1) in the paragraph heading, by striking ``Five-year'' and 
        inserting ``Ten-year''; and
            (2) in subparagraph (A), by striking ``5-year period'' and 
        inserting ``10-year period''.
    (b) Report.--Paragraph (3)(A) of such section is amended by 
striking ``until 2019'' and inserting ``until 2024''.

SEC. 412. MODIFICATION OF HOURS OF EMPLOYMENT FOR PHYSICIANS AND 
              PHYSICIAN ASSISTANTS EMPLOYED BY THE DEPARTMENT OF 
              VETERANS AFFAIRS.

    Section 7423(a) of title 38, United States Code, is amended--
            (1) by striking ``(a) The hours'' and inserting ``(a)(1) 
        Except as provided in paragraph (2), the hours''; and
            (2) by adding at the end the following new paragraph:
    ``(2) The Secretary may modify the hours of employment for a 
physician or physician assistant appointed in the Administration under 
any provision of this chapter on a full-time basis to be more than or 
less than 80 hours in a biweekly pay period if the total hours of 
employment for such employee in a calendar year does not exceed 2,080 
hours.''.

SEC. 413. REQUIREMENT THAT PHYSICIAN ASSISTANTS EMPLOYED BY THE 
              DEPARTMENT OF VETERANS AFFAIRS RECEIVE COMPETITIVE PAY.

    (a) In General.--Section 7451(a)(2) of title 38, United States 
Code, is amended--
            (1) by redesignating subparagraph (B) as subparagraph (C);
            (2) by inserting after subparagraph (A) the following new 
        subparagraph (B):
            ``(B) Physician assistant.''; and
            (3) in subparagraph (C), as redesignated by paragraph (1), 
        by striking ``and registered nurse'' and inserting ``registered 
        nurse, and physician assistant''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
take effect on the date that is one year after the date of the 
enactment of this Act.

SEC. 414. ESTABLISHMENT OF POSITIONS OF DIRECTORS OF VETERANS 
              INTEGRATED SERVICE NETWORKS IN OFFICE OF UNDER SECRETARY 
              FOR HEALTH OF DEPARTMENT OF VETERANS AFFAIRS AND 
              MODIFICATION OF QUALIFICATIONS FOR MEDICAL DIRECTORS.

    Section 7306(a)(4) of title 38, United States Code, is amended--
            (1) by inserting ``and Directors of Veterans Integrated 
        Service Networks'' after ``Such Medical Directors''; and
            (2) by striking ``, who shall be either a qualified doctor 
        of medicine or a qualified doctor of dental surgery or dental 
        medicine''.

SEC. 415. PAY FOR MEDICAL DIRECTORS AND DIRECTORS OF VETERANS 
              INTEGRATED SERVICE NETWORKS.

    (a) In General.--Chapter 74 of title 38, United States Code, is 
amended by adding at the end the following new subchapter:

 ``Subchapter VII--Pay for Medical Directors and Directors of Veterans 
                      Integrated Service Networks

``Sec. 7481. Pay for Medical Directors and Directors of Veterans 
              Integrated Service Networks
    ``(a) Elements of Pay.--Pay for a Medical Director or Director of a 
Veterans Integrated Service Network appointed under section 7306(a)(4) 
of this title (in this section referred to as a `Director') shall 
consist of basic pay set forth under section 7404(a) of this title and 
market pay determined under subsection (b).
    ``(b) Market Pay.--(1) Each Director is eligible for market pay 
determined under this subsection.
    ``(2) The amount of market pay payable to a Director under this 
section shall be determined by the Secretary on a case-by-case basis 
and shall consist of pay intended to reflect needs of the Department 
with respect to the recruitment and retention (as determined by the 
Secretary) of such Director.
    ``(3) In determining the amount of market pay payable to a Director 
under this section, the Secretary shall--
            ``(A) consult not less than two national surveys on pay for 
        hospital directors, medical facility directors, or other 
        similar positions, whether prepared by private, public, or 
        quasi-public entities, to make a general assessment of the 
        range of potential pay for the Director; and
            ``(B) take into account--
                    ``(i) the experience of the Director in managing 
                facilities or program offices of the Department, 
                including the complexity of such facilities or offices;
                    ``(ii) the complexity of the facility or facilities 
                to be managed by the Director;
                    ``(iii) the labor market, in such geographic area 
                as the Secretary considers relevant, for hospital 
                directors, medical facility directors, and other 
                similar positions;
                    ``(iv) the experience of the Director in managing 
                medical facilities for other Federal agencies, private 
                entities, or non-profit entities; and
                    ``(v) such other considerations as the Secretary 
                considers appropriate.
    ``(4)(A) The Secretary shall evaluate the amount of market pay 
payable to a Director under this section not less frequently than once 
every two years and may adjust the market pay payable to such Director 
as a result of such evaluation.
    ``(B) A Director whose market pay is evaluated under subparagraph 
(A) shall receive written notice of the results of such evaluation.
    ``(c) Requirements and Limitations on Total Pay.--(1) Not less 
frequently than once every two years, the Secretary shall set forth a 
Department-wide minimum and maximum amount for total annual pay under 
subsection (a) that may be paid to a Director and shall publish each 
such amount in the Federal Register.
    ``(2) The minimum and maximum amounts set forth under paragraph (1) 
shall take effect not earlier than the date that is 60 days after the 
publication of such amounts under such paragraph.
    ``(3) The sum of the basic pay set forth under section 7404(a) of 
this title and market pay determined under subsection (b) for a 
Director for a calendar year--
            ``(A) may not be less than the most recent minimum amount 
        set forth under paragraph (1) before the beginning of such 
        calendar year; and
            ``(B) may not be more than the most recent maximum amount 
        set forth under such paragraph before the beginning of such 
        calendar year.
    ``(4) The total amount of compensation paid to a Director under 
this title in any calendar year may not exceed the amount of annual 
compensation (excluding expenses) of the President under section 102 of 
title 3.
    ``(5) The Secretary may not delegate to an officer or employee of 
the Department the requirement of the Secretary to set forth a 
Department-wide minimum and maximum amount under paragraph (1).
    ``(d) Treatment of Pay.--Pay under this section shall be considered 
pay for all purposes, including retirement benefits under chapters 83 
and 84 of title 5 and other benefits.
    ``(e) Ancillary Effects of Decreases in Pay.--(1) A decrease in pay 
of a Director resulting from an adjustment in the amount of market pay 
of the Director under subsection (b) shall not be treated as an adverse 
action.
    ``(2) A decrease in the amount of pay of a Director resulting from 
an involuntary reassignment in connection with a disciplinary action 
taken against the Director is not subject to appeal or judicial 
review.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 74 of such title is amended by adding at the end the following:

 ``subchapter vii. pay for medical directors and directors of veterans 
                      integrated service networks

``7481. Pay for Medical Directors and Directors of Veterans Integrated 
                            Service Networks.''.
    (c) Effective Date.--The amendments made by this section shall take 
effect on the date that is one year after the date of the enactment of 
this Act.

SEC. 416. ADDITIONAL REQUIREMENTS FOR HIRING OF HEALTH CARE PROVIDERS 
              BY DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--The Secretary of Veterans Affairs shall, as part 
of the hiring process for each health care provider considered for a 
position at the Department of Veterans Affairs after the date of the 
enactment of this Act, require from the medical board of each State in 
which the health care provider holds or has held a medical license--
            (1) information on any violation of the requirements of the 
        medical license of the health care provider; and
            (2) information on whether the health care provider has 
        entered into any settlement agreement for a disciplinary charge 
        relating to the practice of medicine by the health care 
        provider.
    (b) Regulations.--The Secretary shall prescribe regulations to 
carry out this section.

SEC. 417. PROVISION OF INFORMATION ON HEALTH CARE PROVIDERS OF 
              DEPARTMENT OF VETERANS AFFAIRS TO STATE MEDICAL BOARDS.

    (a) In General.--Notwithstanding section 552a of title 5, United 
States Code, the Secretary of Veterans Affairs shall, with respect to 
each health care provider of the Department of Veterans Affairs that 
has violated a requirement of their medical license, provide to the 
medical board of each State in which the health care provider is 
licensed or practices all relevant information contained in the State 
Licensing Board Reporting File or any successor file of the Department 
with respect to such violation.
    (b) No Request Required.--The Secretary shall provide the 
information required in subsection (a) to a medical board described in 
such subsection notwithstanding that such board may not have formally 
requested such information from the Department.

SEC. 418. REPORT ON COMPLIANCE BY DEPARTMENT OF VETERANS AFFAIRS WITH 
              REVIEWS OF HEALTH CARE PROVIDERS LEAVING THE DEPARTMENT 
              OR TRANSFERRING TO OTHER FACILITIES.

    Not later than two years after the date of the enactment of this 
Act, the Secretary of Veterans Affairs shall submit to the Committee on 
Veterans' Affairs of the Senate and the Committee on Veterans' Affairs 
of the House of Representatives a report on the compliance by the 
Department of Veterans Affairs with the policy of the Department--
            (1) to conduct a review of each health care provider of the 
        Department who transfers to another medical facility of the 
        Department or leaves the Department to determine whether there 
        are any concerns, complaints, or allegations of violations 
        relating to the medical practice of the health care provider; 
        and
            (2) to take appropriate action with respect to any such 
        concern, complaint, or allegation.

             Subtitle B--Opioid Therapy and Pain Management

SEC. 421. GUIDELINES ON MANAGEMENT OF OPIOID THERAPY BY DEPARTMENT OF 
              VETERANS AFFAIRS AND DEPARTMENT OF DEFENSE AND 
              IMPLEMENTATION OF SUCH GUIDELINES BY DEPARTMENT OF 
              VETERANS AFFAIRS.

    (a) Guidelines.--
            (1) In general.--Not later than one year after the date of 
        the enactment of this Act, the Secretary of Veterans Affairs 
        and the Secretary of Defense shall jointly update the VA/DOD 
        Clinical Practice Guideline for Management of Opioid Therapy 
        for Chronic Pain to include the following:
                    (A) Except as provided in paragraph (2), guidelines 
                developed by the Centers for Disease Control and 
                Prevention for safely prescribing opioids for the 
                treatment of chronic, non-cancer pain in outpatient 
                settings upon the release of such guidelines by the 
                Centers for Disease Control and Prevention.
                    (B) Enhanced guidance with respect to absolute 
                contraindications for opioid therapy, including 
                guidance with respect to the following:
                            (i) The coadministration of drugs that are 
                        capable of inducing a life-limiting drug-drug 
                        interaction, including benzodiazepines.
                            (ii) The treatment of patients with current 
                        acute psychiatric instability or substance use 
                        disorder or patients at risk of suicide.
                            (iii) The use of opioid therapy to treat 
                        patients without any pain, including to treat 
                        mental health disorders other than opioid use 
                        disorder.
                    (C) Enhanced guidance with respect to the treatment 
                of patients with behaviors or comorbidities, such as 
                post-traumatic stress disorder, psychiatric disorders, 
                or a history of substance abuse or addiction, that 
                require consultation or comanagement of opioid therapy 
                with one or more specialists in pain management, mental 
                health, or addictions.
                    (D) Enhanced guidance with respect to the conduct 
                by health care providers of an effectiveness assessment 
                for patients receiving opioid therapy, including 
                patients on long-term opioid therapy, to determine--
                            (i) whether opioid therapy is meeting the 
                        expected goals of the patient and health care 
                        provider of relieving pain and improving 
                        function; and
                            (ii) whether opioid therapy should be 
                        continued.
                    (E) Requirements that each health care provider of 
                the Department of Veterans Affairs, before initiating 
                opioid therapy to treat a patient, use the Opioid 
                Therapy Risk Report tool of the Department, including 
                by accessing the most recent patient information from 
                the prescription drug monitoring program of each State, 
                as required to be included in such tool under section 
                422(d)(1), to assess the risk for adverse outcomes of 
                opioid therapy for the patient, including the 
                concurrent use of controlled substances such as 
                benzodiazepines, as part of the comprehensive 
                assessment conducted by the health care provider.
                    (F) Guidelines to govern the methodologies used by 
                health care providers of the Department of Veterans 
                Affairs and the Department of Defense to safely titrate 
                and taper opioid therapy when adjusting or 
                discontinuing the use of opioid therapy, including--
                            (i) prescription of the lowest effective 
                        dose based on patient need;
                            (ii) use of opioids only for a limited 
                        period of time; and
                            (iii) augmentation of opioid therapy with 
                        other pain management therapies and modalities.
                    (G) Guidelines with respect to appropriate case 
                management for patients receiving opioid therapy who 
                transition between inpatient and outpatient health care 
                settings, which may include the use of care transition 
                plans.
                    (H) Enhanced recommendations with respect to the 
                use of routine and random urine drug tests for all 
                patients before and during opioid therapy to help 
                prevent substance abuse, dependence, and diversion, 
                including requirements--
                            (i) that such tests occur not less 
                        frequently than once each year; and
                            (ii) that health care providers 
                        appropriately interpret and respond to the 
                        results from such tests to tailor pain therapy, 
                        safeguards, and risk management strategies to 
                        each patient.
                    (I) Guidance that health care providers discuss 
                with patients, before initiating opioid therapy, 
                options for pain management therapies without the use 
                of opioids and options to augment opioid therapy with 
                other clinical and complementary and integrative health 
                services to minimize opioid dependence.
            (2) Treatment of certain guidelines developed after 
        deadline.--If the Centers for Disease Control and Prevention 
        release the guidelines described in paragraph (1)(A) after the 
        date on which the Secretary of Veterans Affairs and the 
        Secretary of Defense jointly update the VA/DOD Clinical 
        Practice Guideline for Management of Opioid Therapy for Chronic 
        Pain, as required under paragraph (1), the Secretary of 
        Veterans Affairs and the Secretary of Defense shall jointly 
        modify such updated clinical practice guideline to include the 
        guidelines described in paragraph (1)(A).
    (b) Consultation Before Update.--Before updating the clinical 
practice guideline under subsection (a), the Secretary of Veterans 
Affairs and the Secretary of Defense shall jointly consult with the 
Pain Management Working Group of the Health Executive Committee of the 
Department of Veterans Affairs-Department of Defense Joint Executive 
Committee established under section 320 of title 38, United States 
Code.
    (c) Controlled Substance Defined.--In this section, the term 
``controlled substance'' has the meaning given that term in section 102 
of the Controlled Substances Act (21 U.S.C. 802).

SEC. 422. IMPROVEMENT OF OPIOID SAFETY MEASURES BY DEPARTMENT OF 
              VETERANS AFFAIRS.

    (a) Expansion of Opioid Safety Initiative.--Not later than 180 days 
after the date of the enactment of this Act, the Secretary of Veterans 
Affairs shall expand the Opioid Safety Initiative of the Department of 
Veterans Affairs to include all medical facilities of the Department.
    (b) Pain Management Education and Training.--
            (1) In general.--In carrying out the Opioid Safety 
        Initiative of the Department, the Secretary shall require all 
        employees of the Department responsible for prescribing opioids 
        to receive education and training described in paragraph (2).
            (2) Education and training.--Education and training 
        described in this paragraph is education and training on pain 
        management and safe opioid prescribing practices for purposes 
        of safely and effectively managing patients with chronic pain 
        and includes education and training on the following:
                    (A) The implementation of and full compliance with 
                the VA/DOD Clinical Practice Guideline for Management 
                of Opioid Therapy for Chronic Pain, including any 
                update to such guideline.
                    (B) The use of evidence-based pain management 
                therapies, including cognitive-behavioral therapy, non-
                opioid alternatives, and non-drug approaches to 
                managing pain and related health conditions including 
                complementary and integrative health services.
                    (C) Screening and identification of patients with 
                substance use disorder, including drug-seeking 
                behavior, before prescribing opioids, assessment of the 
                risk potential for patients developing an addiction, 
                and referral of patients to appropriate addiction 
                treatment professionals if addiction is identified or 
                strongly suspected.
                    (D) Communication with patients on the potential 
                harm associated with the use of opioids and other 
                controlled substances, including the need to safely 
                store and dispose of supplies relating to the use of 
                opioids and other controlled substances.
                    (E) Such other education and training as the 
                Secretary considers appropriate to ensure that veterans 
                receive safe, high-quality pain management care from 
                the Department.
            (3) Use of existing program.--In providing education and 
        training described in paragraph (2), the Secretary shall use 
        the Interdisciplinary Chronic Pain Management Training Team 
        Program of the Department.
    (c) Pain Management Teams.--
            (1) In general.--In carrying out the Opioid Safety 
        Initiative of the Department, each medical facility of the 
        Department shall identify and designate a pain management team 
        of health care professionals, which may include board certified 
        pain medicine specialists, responsible for coordinating and 
        overseeing therapy at such facility for patients experiencing 
        acute and chronic pain that is non-cancer related.
            (2) Establishment of protocols.--
                    (A) In general.--The director of each Veterans 
                Integrated Service Network shall establish protocols 
                for the designation of pain management teams at each 
                medical facility within that Veterans Integrated 
                Service Network.
                    (B) Consultation on prescription of opioids.--Each 
                protocol established for a medical facility under 
                subparagraph (A) shall ensure that any health care 
                provider without expertise in prescribing analgesics or 
                who has not completed the education and training under 
                subsection (b), such as a mental health care provider, 
                does not prescribe opioids to a patient unless that 
                health care provider--
                            (i) consults with a health care provider 
                        with pain management expertise or who is on the 
                        pain management team of the medical facility; 
                        and
                            (ii) refers the patient to that pain 
                        management team for any subsequent 
                        prescriptions and related therapy.
            (3) Report.--
                    (A) In general.--Not later than one year after the 
                date of the enactment of this Act, the head of each 
                medical facility of the Department shall submit to the 
                director of the Veterans Integrated Service Network in 
                which the medical facility is located a report 
                identifying the health care professionals that have 
                been designated as members of the pain management team 
                at the medical facility.
                    (B) Elements.--Each report submitted under 
                subparagraph (A) with respect to a medical facility of 
                the Department shall include--
                            (i) a certification as to whether all 
                        members of the pain management team at the 
                        medical facility have completed the education 
                        and training required under subsection (b); and
                            (ii) a plan for the management and referral 
                        of patients to such pain management team if 
                        health care providers without expertise in 
                        prescribing analgesics prescribe opioid 
                        medications to treat acute and chronic pain 
                        that is non-cancer related.
    (d) Tracking and Monitoring of Opioid Use.--
            (1) Prescription drug monitoring programs of states.--In 
        carrying out the Opioid Safety Initiative and the Opioid 
        Therapy Risk Report tool of the Department, the Secretary 
        shall--
                    (A) ensure access by health care providers of the 
                Department to information on controlled substances, 
                including opioids and benzodiazepines, prescribed to 
                veterans who receive care outside the Department 
                through the prescription drug monitoring program of 
                each State, including by seeking to enter into 
                memoranda of understanding with States to allow such 
                access;
                    (B) include such information in the Opioid Therapy 
                Risk Report; and
                    (C) require health care providers of the Department 
                to submit to the prescription drug monitoring program 
                of each State information on prescriptions of 
                controlled substances received by veterans in that 
                State under the laws administered by the Secretary.
            (2) Report on tracking of data on opioid use.--Not later 
        than 180 days after the date of the enactment of this Act, the 
        Secretary shall submit to Congress a report on the feasibility 
        and advisability of improving the Opioid Therapy Risk Report 
        tool of the Department to allow for more advanced real-time 
        tracking of and access to data on--
                    (A) the key clinical indicators with respect to the 
                totality of opioid use by veterans;
                    (B) concurrent prescribing by health care providers 
                of the Department of opioids in different health care 
                settings, include data on concurrent prescribing of 
                opioids to treat mental health disorders other than 
                opioid use disorder; and
                    (C) mail-order prescriptions of opioids prescribed 
                to veterans under the laws administered by the 
                Secretary.
    (e) Availability of Opioid Receptor Antagonists.--
            (1) Increased availability and use.--
                    (A) In general.--The Secretary shall increase the 
                availability of opioid receptor antagonists approved by 
                the Food and Drug Administration, such as naloxone, to 
                veterans.
                    (B) Availability, training, and distribution.--In 
                carrying out subparagraph (A), the Secretary shall, not 
                later than 90 days after the date of the enactment of 
                this Act--
                            (i) equip each pharmacy of the Department 
                        with opioid receptor antagonists approved by 
                        the Food and Drug Administration to be 
                        dispensed to outpatients as needed; and
                            (ii) expand the Overdose Education and 
                        Naloxone Distribution program of the Department 
                        to ensure that all veterans in receipt of 
                        health care under the laws administered by the 
                        Secretary who are at risk of opioid overdose 
                        may access such opioid receptor antagonists and 
                        training on the proper administration of such 
                        opioid receptor antagonists.
                    (C) Veterans who are at risk.--For purposes of 
                subparagraph (B), veterans who are at risk of opioid 
                overdose include--
                            (i) veterans receiving long-term opioid 
                        therapy;
                            (ii) veterans receiving opioid therapy who 
                        have a history of substance use disorder or 
                        prior instances of overdose; and
                            (iii) veterans who are at risk as 
                        determined by a health care provider who is 
                        treating the veteran.
            (2) Report.--Not later than 120 days after the date of the 
        enactment of this Act, the Secretary shall submit to the 
        Committee on Veterans' Affairs of the Senate and the Committee 
        on Veterans' Affairs of the House of Representatives a report 
        on compliance with paragraph (1) that includes an assessment of 
        any remaining steps to be carried out by the Department to 
        comply with such paragraph.
    (f) Inclusion of Certain Information and Capabilities in Opioid 
Therapy Risk Report Tool.--
            (1) Information.--The Secretary shall include in the Opioid 
        Therapy Risk Report tool of the Department--
                    (A) information on the most recent time the tool 
                was accessed by a health care provider of the 
                Department with respect to each veteran; and
                    (B) information on the results of the most recent 
                urine drug test for each veteran.
            (2) Capabilities.--The Secretary shall include in the 
        Opioid Therapy Risk Report tool the ability of health care 
        providers of the Department to determine whether a health care 
        provider of the Department prescribed opioids to a veteran 
        without checking the information in the tool with respect to 
        the veteran.
    (g) Notification of Risk in Computerized Health Record.--The 
Secretary shall modify the Computerized Patient Record System of the 
Department to ensure that any health care provider that accesses the 
record of a veteran, regardless of the reason the veteran seeks care 
from the health care provider, will be immediately notified whether the 
veteran--
            (1) is receiving opioid therapy and has a history of 
        substance use disorder or prior instances of overdose;
            (2) has a history of opioid abuse; or
            (3) is at risk of becoming an opioid abuser as determined 
        by a health care provider who is treating the veteran.
    (h) Controlled Substance Defined.--In this section, the term 
``controlled substance'' has the meaning given that term in section 102 
of the Controlled Substances Act (21 U.S.C. 802).

SEC. 423. ENHANCEMENT OF JOINT WORKING GROUP ON PAIN MANAGEMENT OF THE 
              DEPARTMENT OF VETERANS AFFAIRS AND THE DEPARTMENT OF 
              DEFENSE.

    (a) In General.--Not later than 90 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs and the 
Secretary of Defense shall ensure that the Pain Management Working 
Group of the Health Executive Committee of the Department of Veterans 
Affairs-Department of Defense Joint Executive Committee established 
under section 320 of title 38, United States Code, includes a focus on 
the following:
            (1) The opioid prescribing practices of health care 
        providers of each Department.
            (2) The ability of each Department to manage acute and 
        chronic pain among individuals receiving health care from that 
        Department, including training health care providers with 
        respect to pain management.
            (3) The use by each Department of complementary and 
        integrative health in treating such individuals.
            (4) The concurrent use by health care providers of each 
        Department of opioids and prescription drugs to treat mental 
        health disorders, including benzodiazepines.
            (5) The practice by health care providers of each 
        Department of prescribing opioids to treat mental health 
        disorders.
            (6) The coordination in coverage of and consistent access 
        to medications prescribed for patients transitioning from 
        receiving health care from the Department of Defense to 
        receiving health care from the Department of Veterans Affairs.
            (7) The ability of each Department to identify and treat 
        substance use disorders among individuals receiving health care 
        from that Department.
    (b) Coordination and Consultation.--The Secretary of Veterans 
Affairs and the Secretary of Defense shall ensure that the working 
group described in subsection (a)--
            (1) coordinates the activities of the working group with 
        other relevant working groups established under section 320 of 
        title 38, United States Code, including the working groups on 
        evidence based practice, patient safety, pharmacy, and 
        psychological health;
            (2) consults with other relevant Federal agencies, 
        including the Centers for Disease Control and Prevention, with 
        respect to the activities of the working group; and
            (3) consults with the Department of Veterans Affairs and 
        the Department of Defense with respect to, reviews, and 
        comments on the VA/DOD Clinical Practice Guideline for 
        Management of Opioid Therapy for Chronic Pain, or any successor 
        guideline, before any update to the guideline is released.
    (c) Consultation.--The Secretary of Veterans Affairs and the 
Secretary of Defense shall ensure that the working group described in 
subsection (a) is able to meaningfully consult with respect to the 
updated guideline required under subsection (a) of section 421, as 
required by subsection (b) of such section, not later than one year 
after the date of the enactment of this Act.

SEC. 424. ESTABLISHMENT OF PAIN MANAGEMENT BOARDS OF DEPARTMENT OF 
              VETERANS AFFAIRS.

    (a) In General.--Subchapter I of chapter 73 of title 38, United 
States Code, is amended by adding at the end the following new section:
``Sec. 7309A. Pain management boards
    ``(a) Establishment.--The Secretary shall establish in each 
Veterans Integrated Service Network a Pain Management Board (in this 
section referred to as a `Board').
    ``(b) Activities.--(1) Each Board may--
            ``(A) consult with health care professionals and other 
        employees of the Department located in the Veterans Integrated 
        Service Network covered by the Board, patients who are being 
        treated at medical facilities of the Department located in such 
        Veterans Integrated Service Network, and family members of such 
        patients with respect to the pain management resources and best 
        practices of the Department;
            ``(B) oversee compliance by the health care professionals 
        and other employees of the Department with the best practices 
        of the Department, including by issuing recommendations to 
        improve compliance with those best practices;
            ``(C) provide oversight of the pain management practices of 
        the pain management teams of each medical facility of the 
        Department and the health care professionals and other 
        employees of the Department that are located in the Veterans 
        Integrated Service Network covered by the Board;
            ``(D) host educational events, as the Board considers 
        appropriate, for individuals specified in subparagraph (A) on 
        pain management and treatment that may include the sharing of 
        updated research and best practices from medical experts, other 
        health care systems, and such other Federal agencies as the 
        Board considers necessary to carry out this subparagraph; and
            ``(E) host public events, as the Board considers 
        appropriate, during which health care professionals discuss and 
        share best practices on pain management and complementary and 
        integrative health.
    ``(2)(A) Each Board may provide treatment recommendations for 
patients with complex clinical pain who are being treated at a medical 
facility of the Department located in the Veterans Integrated Service 
Network covered by the Board, and assist in facilitating communication 
between such patients and their health care providers, regardless of 
whether such treatment is on an in-patient or out-patient basis, and 
for whom a request for such recommendations, subject to subparagraph 
(C), has been made by an individual described in subparagraph (B).
    ``(B) An individual described in this subparagraph is one of the 
following individuals:
            ``(i) The patient.
            ``(ii) The spouse of the patient.
            ``(iii) A family member of the patient or another 
        individual if such family member or individual has been 
        designated by the patient to make health care decisions for the 
        patient or to receive health care information with respect to 
        the patient.
            ``(iv) A physician of the patient.
            ``(v) An employee of the medical facility of the Department 
        described in subparagraph (A).
    ``(C) An individual described in subparagraph (B) may not request 
treatment recommendations under subparagraph (A) unless the 
individual--
            ``(i) has requested treatment recommendations from the pain 
        management team of the medical facility of the Department at 
        which the patient is receiving treatment; and
            ``(ii) has received treatment recommendations from such 
        team and is not satisfied with those treatment recommendations.
    ``(D) Treatment recommendations provided under subparagraph (A) 
shall assist the patient and health care provider in determining the 
best treatment plan for the patient and shall not dictate the treatment 
plan used by the health care provider.
    ``(3) Based on treatment recommendations developed under paragraph 
(2)(A), consultations conducted under paragraph (1)(A), and educational 
and public events hosted under subparagraphs (D) and (E) of paragraph 
(1), each Board may provide to health care professionals of the 
Department located in the Veterans Integrated Service Network covered 
by the Board recommendations on the best practices regarding pain 
management in cases of complex clinical pain.
    ``(4)(A) Not later than January 31 of each year, the Secretary 
shall submit to the Committee on Veterans' Affairs of the Senate and 
the Committee on Veterans' Affairs of the House of Representatives a 
report that contains comprehensive information from each Board (with 
all personally identifiable information of patients redacted) on pain 
management practices carried out in the Veterans Integrated Service 
Network covered by the Board.
    ``(B) Each report submitted by the Secretary under subparagraph (A) 
shall include, for the year preceding the submittal of the report--
            ``(i) a summary and explanation of the treatment 
        recommendations provided under paragraph 2(A) during such year; 
        and
            ``(ii) the recommendations for best practices provided to 
        health care professionals under paragraph (3) during such year.
    ``(5) The Federal Advisory Committee Act (5 U.S.C. App.) shall not 
apply to any Board.
    ``(c) Membership.--(1) Each Board shall include the following 
individuals appointed by the Secretary:
            ``(A) A board certified pain medicine specialist.
            ``(B) A trained and qualified member of the primary care 
        team of a medical facility of the Department with experience in 
        pain care, such as a nurse practitioner.
            ``(C) A pain psychologist.
            ``(D) A pain social worker.
            ``(E) A clinical pharmacist.
            ``(F) A pain point of contact for a Veterans Integrated 
        Service Network.
            ``(G) A physician with addiction and psychopharmacology 
        expertise and experience.
            ``(H) An allied health care professional.
            ``(I) A clinician with expertise in complementary and 
        integrative health.
            ``(J) A clinical behavioral therapist.
            ``(K) A patient advocate.
            ``(L) A representative of the labor interests of employees 
        of the Department who are responsible for prescribing drugs.
            ``(M) Two current or former clinical patients who are 
        representative of the demographic of patients served by the 
        Veterans Integrated Service Network covered by the Board.
            ``(N) A family member of a current or former clinical 
        patient who is representative of the demographic of patients 
        served by the Veterans Integrated Service Network covered by 
        the Board.
    ``(2) The Secretary shall determine the terms of service of the 
members of each Board, taking into consideration the clinical duties of 
members who are employees of the Department.
    ``(3)(A) Members of each Board shall serve without pay and, except 
as provided in subparagraph (B), members who are full-time officers or 
employees of the United States may not receive additional pay, 
allowances, or benefits by reason of their service on the Board.
    ``(B) Members may receive travel expenses, including per diem in 
lieu of subsistence, for travel in connection with their duties as 
members of the Board.
    ``(C)(i) Except as provided in clause (ii), any member who has 
clinical duties as an officer or employee of the United States shall be 
relieved of such duties during periods in which such relief is 
necessary for the member to carry out the duties of the Board.
    ``(ii) The Secretary shall ensure that carrying out the duties of 
the Board does not prevent any member who has clinical duties as an 
employee of the Department from furnishing direct clinical care as 
appropriate to maintain quality patient care.
    ``(d) Participation of Certain Members.--(1) In carrying out the 
activities of a Board under subsection (b), any member appointed under 
subsection (c)(1) solely based on qualifications under subparagraph 
(K), (L), (M), or (N) of subsection (c)(1)--
            ``(A) may not have access to specific information 
        identifying a patient and other confidential information 
        relating to a patient; and
            ``(B) except as provided in paragraph (2), may not 
        participate in providing treatment recommendations under 
        subsection (b)(2)(A).
    ``(2) In carrying out the activities of the Board under subsection 
(b), a member appointed under subsection (c)(1) solely based on 
qualifications under subparagraph (K) of subsection (c)(1) may be 
present during the provision of treatment recommendations under 
subsection (b)(2)(A) with the consent and upon the request of the 
patient for which such treatment recommendations are provided for 
purposes of representing the interests of the patient.
    ``(e) Employment Protections.--No adverse personnel action may be 
made against an employee of the Department in connection with a 
communication by the employee with a member of a Board relating to the 
activities of the Board under subsection (b) and any such communication 
shall be covered by the employment and whistleblower protections 
otherwise applicable to communications by employees of the Department.
    ``(f) Resources of Department.--The Secretary shall make available 
to each Board the resources and personnel of the Department necessary 
for the Board to carry out the activities of the Board under subsection 
(b), including resources and personnel of the General Counsel of the 
Department.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 73 of such title is amended by inserting after the item 
relating to section 7309 the following new item:

``7309A. Pain management boards.''.
    (c) Effective Date.--The amendments made by this section shall take 
effect on the date that is one year after the date of the enactment of 
this Act.

SEC. 425. REVIEW, INVESTIGATION, AND REPORT ON USE OF OPIOIDS IN 
              TREATMENT BY DEPARTMENT OF VETERANS AFFAIRS.

    (a) Independent Review.--
            (1) In general.--Not later than two years after the date of 
        the enactment of this Act, the Secretary of Veterans Affairs 
        shall enter into a contract with an independent entity with 
        expertise in assessing clinical prescribing practices to 
        conduct an independent review of the Opioid Safety Initiative 
        of the Department of Veterans Affairs and the opioid 
        prescribing practices of health care providers of the 
        Department.
            (2) Report.--
                    (A) In general.--Not later than 30 days after 
                completing the independent review under paragraph (1), 
                the independent entity that carried out such review 
                shall submit to the Secretary, the Committee on 
                Veterans' Affairs of the Senate, and the Committee on 
                Veterans' Affairs of the House of Representatives a 
                report on the findings and recommendations of the 
                independent entity with respect to such review.
                    (B) Elements.--The report submitted under 
                subparagraph (A) by the independent entity described in 
                such subparagraph--
                            (i) shall include--
                                    (I) recommendations on such 
                                improvements to the Opioid Safety 
                                Initiative of the Department as the 
                                independent entity considers 
                                appropriate;
                                    (II) information with respect to--
                                            (aa) deaths resulting from 
                                        sentinel events involving 
                                        veterans prescribed opioids by 
                                        a health care provider of the 
                                        Department;
                                            (bb) overall prescription 
                                        rates and prescription 
                                        indications of opioids at all 
                                        medical facilities of the 
                                        Department to treat non-cancer, 
                                        non-palliative, and non-hospice 
                                        care patients, including 
                                        whether such prescription rates 
                                        for each medical facility or 
                                        health care provider of the 
                                        Department conflicts with or is 
                                        otherwise inconsistent with the 
                                        standards of appropriate and 
                                        safe care with respect to such 
                                        prescription rates;
                                            (cc) the prescription rates 
                                        and prescription indications of 
                                        benzodiazepines and opioids 
                                        concomitantly by health care 
                                        providers of the Department, 
                                        including whether such 
                                        prescription rates for each 
                                        medical facility or health care 
                                        provider of the Department 
                                        conflicts with or is otherwise 
                                        inconsistent with the standards 
                                        of appropriate and safe care 
                                        with respect to such 
                                        prescription rates;
                                            (dd) the practice by health 
                                        care providers of the 
                                        Department of prescribing 
                                        opioids to treat patients 
                                        without any pain, including to 
                                        treat patients with mental 
                                        health disorders other than 
                                        opioid use disorder; and
                                            (ee) the effectiveness of 
                                        opioid therapy for patients 
                                        receiving such therapy, 
                                        including the effectiveness of 
                                        long-term opioid therapy; and
                                    (III) an assessment of the 
                                compliance of the Department with the 
                                VA/DOD Clinical Practice Guideline for 
                                Management of Opioid Therapy for 
                                Chronic Pain, as updated under section 
                                421(a); and
                            (ii) may include recommendations with 
                        respect to whether the Department should 
                        implement policies relating to performance 
                        management, such as written warnings or 
                        performance improvement plans, for health care 
                        providers of the Department that are--
                                    (I) not practicing at a level 
                                meeting or exceeding the minimum level 
                                standard of care established by the 
                                Department; and
                                    (II) not following the enhanced 
                                guidance with respect to absolute 
                                contraindications for opioid therapy 
                                set forth in the VA/DOD Clinical 
                                Practice Guideline for Management of 
                                Opioid Therapy for Chronic Pain, as 
                                updated under section 421(a).
    (b) Annual Review, Investigation, and Report on Opioid Therapy.--
            (1) Annual review of prescription rates.--Not later than 
        one year after the date of the enactment of this Act, and not 
        less frequently than annually thereafter, the Secretary of 
        Veterans Affairs shall, with respect to each medical facility 
        of the Department of Veterans Affairs, collect and review 
        information on opioids prescribed by health care providers at 
        the facility to treat non-cancer, non-palliative, and non-
        hospice care patients, including information on--
                    (A) the prescription rate at which each health care 
                provider at the facility prescribed benzodiazepines and 
                opioids concurrently to such patients and the aggregate 
                such prescription rate for all health care providers at 
                the facility;
                    (B) the prescription rate at which each health care 
                provider at the facility prescribed benzodiazepines or 
                opioids to such patients to treat conditions for which 
                opioids or benzodiazepines are not an approved 
                treatment and the aggregate such prescription rate for 
                all health care providers at the facility;
                    (C) the prescription rate at which each health care 
                provider at the facility prescribed or dispensed mail-
                order prescriptions of opioids to such patients while 
                such patients were being treated with opioids on an 
                inpatient-basis and the aggregate such prescription 
                rate for all health care providers at the facility; and
                    (D) the prescription rate at which each health care 
                provider at the facility prescribed opioids to such 
                patients who were also concurrently prescribed opioids 
                by a health care provider that is not a health care 
                provider of the Department and the aggregate such 
                prescription rate for all health care providers at the 
                facility.
            (2) Investigation of prescription rates.--If the Secretary 
        determines that a prescription rate described in paragraph (1) 
        with respect to a health care provider or medical facility of 
        the Department conflicts with or is otherwise inconsistent with 
        the standards of appropriate and safe care, the Secretary 
        shall--
                    (A) include information relating to such 
                determination, prescription rate, and health care 
                provider or medical facility, as the case may be, in 
                the report submitted under paragraph (3)(F);
                    (B) through the Office of the Medical Inspector of 
                the Veterans Health Administration, conduct a full 
                investigation of the health care provider or medical 
                facility, as the case may be; and
                    (C) immediately notify the Committee on Veterans' 
                Affairs of the Senate, the Committee on Veterans' 
                Affairs of the House of Representatives, and each 
                Member of the Senate and the House of Representatives 
                who represents the area in which the health care 
                provider or medical facility, as the case may be, is 
                located.
            (3) Report on opioid therapy.--Not later than one year 
        after the date of the enactment of this Act, and not less 
        frequently than annually thereafter, the Secretary shall submit 
        to the Committee on Veterans' Affairs of the Senate and the 
        Committee on Veterans' Affairs of the House of Representatives 
        a report that contains, for the one year period preceding the 
        submittal of the report, the following:
                    (A) The number of patients and the percentage of 
                the patient population of the Department of Veterans 
                Affairs who were prescribed benzodiazepines and opioids 
                concurrently by a health care provider of the 
                Department.
                    (B) The number of patients and the percentage of 
                the patient population of the Department without any 
                pain who were prescribed opioids by a health care 
                provider of the Department, including those who were 
                prescribed benzodiazepines and opioids concurrently.
                    (C) The number of non-cancer, non-palliative, and 
                non-hospice care patients and the percentage of such 
                patients who were treated with opioids by a health care 
                provider of the Department on an inpatient-basis and 
                who also received prescription opioids by mail from the 
                Department while being treated on an inpatient-basis.
                    (D) The number of non-cancer, non-palliative, and 
                non-hospice care patients and the percentage of such 
                patients who were prescribed opioids concurrently by a 
                health care provider of the Department and a health 
                care provider that is not a health care provider of the 
                Department.
                    (E) With respect to each medical facility of the 
                Department, the number of times a pharmacist at the 
                facility overrode a critical drug interaction warning 
                with respect to an interaction between opioids and 
                another medication before dispensing a medication to a 
                veteran.
                    (F) The results of the review conducted under 
                paragraph (1) (including a summary of such review at 
                the Veterans Integrated Service Network level) and the 
                investigation conducted under paragraph (2) (including 
                information described in paragraph (2)(A)), compiled in 
                such a manner as the Secretary determines appropriate 
                to ensure that the information is easily accessible.
                    (G) An assessment of the compliance of the 
                Department with the VA/DOD Clinical Practice Guideline 
                for Management of Opioid Therapy for Chronic Pain, 
                including any update to such guideline.
    (c) Prescription Rate Defined.--In this section, the term 
``prescription rate'' means, with respect to a health care provider or 
medical facility of the Department, each of the following:
            (1) The number of patients treated with opioids by the 
        health care provider or at the medical facility, as the case 
        may be, divided by the total number of pharmacy users of that 
        health care provider or at that medical facility.
            (2) The average number of morphine equivalents per day 
        prescribed by the health care provider or at the medical 
        facility, as the case may be, to patients being treated with 
        opioids.
            (3) Of the patients being treated with opioids by the 
        health care provider or at the medical facility, as the case 
        may be, the average number of prescriptions of opioids per 
        patient.

                      Subtitle C--Patient Advocacy

SEC. 431. ESTABLISHMENT OF OFFICE OF PATIENT ADVOCACY OF THE DEPARTMENT 
              OF VETERANS AFFAIRS.

    (a) In General.--Subchapter I of chapter 73 of title 38, United 
States Code, as amended by section 424(a), is further amended by adding 
at the end the following new section:
``Sec. 7309B. Office of Patient Advocacy
    ``(a) Establishment.--There is established in the Department within 
the Office of the Under Secretary for Health an office to be known as 
the `Office of Patient Advocacy' (in this section referred to as the 
`Office').
    ``(b) Head.--(1) The Director of the Office of Patient Advocacy 
shall be the head of the Office.
    ``(2) The Director of the Office of Patient Advocacy shall be 
appointed by the Under Secretary for Health from among individuals 
qualified to perform the duties of the position and shall report 
directly to the Under Secretary for Health.
    ``(c) Function.--(1) The function of the Office is to carry out the 
Patient Advocacy Program of the Department.
    ``(2) In carrying out the Patient Advocacy Program of the 
Department, the Director shall ensure that patient advocates of the 
Department--
            ``(A) advocate on behalf of veterans with respect to health 
        care received and sought by veterans under the laws 
        administered by the Secretary;
            ``(B) carry out the responsibilities specified in 
        subsection (d); and
            ``(C) receive training in patient advocacy.
    ``(d) Patient Advocacy Responsibilities.--The responsibilities of 
each patient advocate at a medical facility of the Department are the 
following:
            ``(1) To resolve complaints by veterans with respect to 
        health care furnished under the laws administered by the 
        Secretary that cannot be resolved at the point of service or at 
        a higher level easily accessible to the veteran.
            ``(2) To present at various meetings and to various 
        committees the issues experienced by veterans in receiving such 
        health care at such medical facility.
            ``(3) To express to veterans their rights and 
        responsibilities as patients in receiving such health care.
            ``(4) To manage the Patient Advocate Tracking System of the 
        Department at such medical facility.
            ``(5) To compile data at such medical facility of 
        complaints made by veterans with respect to the receipt of such 
        health care at such medical facility and the satisfaction of 
        veterans with such health care at such medical facility to 
        determine whether there are trends in such data.
            ``(6) To ensure that a process is in place for the 
        distribution of the data compiled under paragraph (5) to 
        appropriate leaders, committees, services, and staff of the 
        Department.
            ``(7) To identify, not less frequently than quarterly, 
        opportunities for improvements in the furnishing of such health 
        care to veterans at such medical facility based on complaints 
        by veterans.
            ``(8) To ensure that any significant complaint by a veteran 
        with respect to such health care is brought to the attention of 
        appropriate staff of the Department to trigger an assessment of 
        whether there needs to be a further analysis of the problem at 
        the facility-wide level.
            ``(9) To support any patient advocacy programs carried out 
        by the Department.
            ``(10) To ensure that all appeals and final decisions with 
        respect to the receipt of such health care are entered into the 
        Patient Advocate Tracking System of the Department.
            ``(11) To understand all laws, directives, and other rules 
        with respect to the rights and responsibilities of veterans in 
        receiving such health care, including the appeals processes 
        available to veterans.
            ``(12) To ensure that veterans receiving mental health 
        care, or the surrogate decision makers for such veterans, are 
        aware of the rights of veterans to seek representation from 
        systems established under section 103 of the Protection and 
        Advocacy for Mentally Ill Individuals Act of 1986 (42 U.S.C. 
        10803) to protect and advocate the rights of individuals with 
        mental illness and to investigate incidents of abuse and 
        neglect of such individuals.
            ``(13) To fulfill requirements established by the Secretary 
        with respect to the inspection of controlled substances.
            ``(14) To document potentially threatening behavior and 
        report such behavior to appropriate authorities.
    ``(e) Training.--In providing training to patient advocates under 
subsection (c)(2)(C), the Director shall ensure that such training is 
consistent throughout the Department.
    ``(f) Controlled Substance Defined.--In this section, the term 
`controlled substance' has the meaning given that term in section 102 
of the Controlled Substances Act (21 U.S.C. 802).''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 73 of such title, as amended by section 424(b), is further 
amended by adding after the item relating to section 7309A the 
following new item:

``7309B. Office of Patient Advocacy.''.
    (c) Date Fully Operational.--The Secretary of Veterans Affairs 
shall ensure that the Office of Patient Advocacy established in section 
7309B of title 38, United States Code, as added by subsection (a), is 
fully operational not later than the date that is one year after the 
date of the enactment of this Act.

SEC. 432. COMMUNITY MEETINGS ON IMPROVING CARE FROM DEPARTMENT OF 
              VETERANS AFFAIRS.

    (a) Community Meetings.--
            (1) Medical centers.--Not later than 90 days after the date 
        of the enactment of this Act, and not less frequently than once 
        every 90 days thereafter, each medical center of the Department 
        of Veterans Affairs shall host a community meeting open to the 
        public on improving health care from the Department.
            (2) Community based outpatient clinics.--Not later than one 
        year after the date of the enactment of this Act, and not less 
        frequently than annually thereafter, each community based 
        outpatient clinic of the Department shall host a community 
        meeting open to the public on improving health care from the 
        Department.
    (b) Attendance by Director of Veterans Integrated Service Network 
or Designee.--
            (1) In general.--Subject to paragraph (2), each community 
        meeting hosted by a medical center or community based 
        outpatient clinic under subsection (a) shall be attended by the 
        Director of the Veterans Integrated Service Network in which 
        the medical center or community based outpatient clinic, as the 
        case may be, is located, or an employee designated by the 
        Director who works in the office of the Director .
            (2) Attendance by director.--Each Director of a Veterans 
        Integrated Service Network shall attend not less than one 
        community meeting under subsection (a) hosted by each medical 
        center located in the Veterans Integrated Service Network each 
        year.
    (c) Notice.--Each medical center or community based outpatient 
clinic hosting a community meeting shall send timely notice of the 
community meeting to the Committee on Veterans' Affairs of the Senate, 
the Committee on Veterans' Affairs of the House of Representatives, and 
each Member of the Senate and the House of Representatives who 
represents the area in which the medical facility is located.

SEC. 433. IMPROVEMENT OF AWARENESS OF PATIENT ADVOCACY PROGRAM AND 
              PATIENT BILL OF RIGHTS OF DEPARTMENT OF VETERANS AFFAIRS.

    Not later than 90 days after the date of the enactment of this Act, 
the Secretary of Veterans Affairs shall, in as many prominent locations 
as appropriate to be seen by the largest percentage of patients and 
family members of patients at each medical facility of the Department 
of Veterans Affairs--
            (1) display the purposes of the Patient Advocacy Program of 
        the Department and the contact information for the patient 
        advocate at such medical facility; and
            (2) display the rights and responsibilities of--
                    (A) patients and family members of patients at such 
                medical facility; and
                    (B) with respect to community living centers and 
                other residential facilities of the Department, 
                residents and family members of residents at such 
                medical facility.

SEC. 434. COMPTROLLER GENERAL REPORT ON PATIENT ADVOCACY PROGRAM OF 
              DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--Not later than three years after the date of the 
enactment of this Act, the Comptroller General of the United States 
shall submit to the Committee on Veterans' Affairs of the Senate and 
the Committee on Veterans' Affairs of the House of Representatives a 
report on the Patient Advocacy Program of the Department of Veterans 
Affairs (in this section referred to as the ``Program'') as carried out 
under the Office of Patient Advocacy of the Department established in 
section 7309B of title 38, United States Code, as added by section 
431(a).
    (b) Elements.--The report required by subsection (a)--
            (1) shall include--
                    (A) such recommendations and proposals for 
                improving or modifying the Program as the Comptroller 
                General considers appropriate; and
                    (B) such other information with respect to the 
                Program as the Comptroller General considers 
                appropriate; and
            (2) may include--
                    (A) a description of the Program, including--
                            (i) the purposes of the Program;
                            (ii) the activities carried out under the 
                        Program; and
                            (iii) the sufficiency of the Program in 
                        achieving the purposes of the Program;
                    (B) an assessment of the sufficiency of staffing of 
                employees of the Department responsible for carrying 
                out the Program;
                    (C) an assessment of the sufficiency of the 
                training of such employees; and
                    (D) an assessment of--
                            (i) awareness of the Program among veterans 
                        and their family members; and
                            (ii) the use of the Program by veterans and 
                        their family members.

            Subtitle D--Complementary and Integrative Health

SEC. 441. EXPANSION OF RESEARCH AND EDUCATION ON AND DELIVERY OF 
              COMPLEMENTARY AND INTEGRATIVE HEALTH TO VETERANS.

    (a) Development of Plan To Expand Research, Education, and 
Delivery.--Not later than 180 days after the date of the enactment of 
this Act, the Secretary of Veterans Affairs shall develop a plan to 
expand materially and substantially the scope of the effectiveness of 
research and education on, and delivery and integration of, 
complementary and integrative health services into the health care 
services provided to veterans.
    (b) Elements.--The plan required by subsection (a) shall provide 
for the following:
            (1) Research on the following:
                    (A) The effectiveness of various complementary and 
                integrative health services, including the 
                effectiveness of such services integrated with clinical 
                therapies.
                    (B) Approaches to integrating complementary and 
                integrative health services into other health care 
                services provided by the Department.
            (2) Education and training for health care professionals of 
        the Department on the following:
                    (A) complementary and integrative health services 
                selected by the Secretary for purposes of the plan.
                    (B) Appropriate uses of such services.
                    (C) Integration of such services into the delivery 
                of health care to veterans.
            (3) Research, education, and clinical activities on 
        complementary and integrative health at centers of innovation 
        at medical centers of the Department.
            (4) Identification or development of metrics and outcome 
        measures to evaluate the effectiveness of the provision and 
        integration of complementary and integrative health services 
        into the delivery of health care to veterans.
            (5) Integration and delivery of complementary and 
        integrative health services with other health care services 
        provided by the Department.
    (c) Consultation.--
            (1) In general.--In carrying out subsection (a), the 
        Secretary shall consult with the following:
                    (A) The Director of the National Center for 
                Complementary and Integrative Health of the National 
                Institutes of Health.
                    (B) The Commissioner of Food and Drugs.
                    (C) Institutions of higher education, private 
                research institutes, and individual researchers with 
                extensive experience in complementary and integrative 
                health and the integration of complementary and 
                integrative health practices into the delivery of 
                health care.
                    (D) Nationally recognized providers of 
                complementary and integrative health.
                    (E) Such other officials, entities, and individuals 
                with expertise on complementary and integrative health 
                as the Secretary considers appropriate.
            (2) Scope of consultation.--The Secretary shall undertake 
        consultation under paragraph (1) in carrying out subsection (a) 
        with respect to the following:
                    (A) To develop the plan.
                    (B) To identify specific complementary and 
                integrative health practices that, on the basis of 
                research findings or promising clinical interventions, 
                are appropriate to include as services to veterans.
                    (C) To identify barriers to the effective provision 
                and integration of complementary and integrative health 
                services into the delivery of health care to veterans, 
                and to identify mechanisms for overcoming such 
                barriers.
    (d) Complementary and Integrative Health Defined.--In this section, 
the term ``complementary and integrative health'' has the meaning given 
that term by the National Institutes of Health.

SEC. 442. PILOT PROGRAM ON INTEGRATION OF COMPLEMENTARY AND INTEGRATIVE 
              HEALTH WITHIN DEPARTMENT OF VETERANS AFFAIRS MEDICAL 
              CENTERS.

    (a) Pilot Program Required.--Not later than 180 days after the 
completion of the development of the plan under section 441, the 
Secretary of Veterans Affairs shall--
            (1) carry out, through the Office of Patient Centered Care 
        and Cultural Transformation of the Department of Veterans 
        Affairs, a pilot program to assess the feasibility and 
        advisability of integrating the delivery of complementary and 
        integrative health services selected by the Secretary with 
        other health care services provided by the Department for 
        veterans with mental health conditions, chronic pain 
        conditions, other chronic conditions, and such other conditions 
        as the Secretary determines appropriate; and
            (2) in developing the pilot program--
                    (A) use the plan developed under section 441; and
                    (B) identify and, to the extent practicable, 
                resolve barriers to the provision of complementary and 
                integrative health services selected by the Secretary 
                and the integration of those services with other health 
                care services provided by the Department.
    (b) Duration of Pilot Program.--The Secretary shall carry out the 
pilot program during the three-year period beginning on the date that 
is 180 days after the completion of the development of the plan under 
section 441.
    (c) Locations.--
            (1) In general.--The Secretary shall carry out the pilot 
        program at not fewer than 15 medical centers of the Department.
            (2) Polytrauma centers.--Not less than two of the medical 
        centers designated under paragraph (1) shall be located at 
        polytrauma rehabilitation centers of the Department.
            (3) Medical centers with prescription rate of opioids that 
        conflicts with care standards.--
                    (A) In general.--In selecting medical centers under 
                paragraph (1), the Secretary shall give priority to 
                medical centers of the Department at which there is a 
                prescription rate of opioids that conflicts with or is 
                otherwise inconsistent with the standards of 
                appropriate and safe care.
                    (B) Prescription rate defined.--In this paragraph, 
                the term ``prescription rate'' means, with respect to a 
                medical center of the Department, each of the 
                following:
                            (i) The number of patients treated with 
                        opioids at the medical center divided by the 
                        total number of pharmacy users at the medical 
                        center.
                            (ii) The average number of morphine 
                        equivalents per day prescribed at the medical 
                        center to patients being treated with opioids.
                            (iii) Of the patients being treated with 
                        opioids at the medical center, the average 
                        number of prescriptions of opioids per patient.
            (4) Selection of locations.--In carrying out the pilot 
        program, the Secretary shall select locations that include the 
        following areas:
                    (A) Rural areas.
                    (B) Areas that are not in close proximity to an 
                active duty military installation.
                    (C) Areas representing different geographic 
                locations, such as census tracts established by the 
                Bureau of the Census.
    (d) Provision of Services.--Under the pilot program, the Secretary 
shall provide covered services to covered veterans by integrating 
complementary and integrative health services with other services 
provided by the Department at the medical centers designated under 
subsection (c)(1).
    (e) Covered Veterans.--For purposes of the pilot program, a covered 
veteran is any veteran who--
            (1) has a mental health condition diagnosed by a clinician 
        of the Department;
            (2) experiences chronic pain;
            (3) has a chronic condition being treated by a clinician of 
        the Department; or
            (4) is not described in paragraph (1), (2), or (3) and 
        requests to participate in the pilot program or is referred by 
        a clinician of the Department who is treating the veteran.
    (f) Covered Services.--
            (1) In general.--For purposes of the pilot program, covered 
        services are services consisting of complementary and 
        integrative health services as selected by the Secretary.
            (2) Administration of services.--Covered services shall be 
        administered under the pilot program as follows:
                    (A) Covered services shall be administered by 
                professionals or other instructors with appropriate 
                training and expertise in complementary and integrative 
                health services who are employees of the Department or 
                with whom the Department enters into an agreement to 
                provide such services.
                    (B) Covered services shall be included as part of 
                the Patient Aligned Care Teams initiative of the Office 
                of Patient Care Services, Primary Care Program Office, 
                in coordination with the Office of Patient Centered 
                Care and Cultural Transformation.
                    (C) Covered services shall be made available to--
                            (i) covered veterans who have received 
                        conventional treatments from the Department for 
                        the conditions for which the covered veteran 
                        seeks complementary and integrative health 
                        services under the pilot program; and
                            (ii) covered veterans who have not received 
                        conventional treatments from the Department for 
                        such conditions.
    (g) Voluntary Participation.--The participation of a veteran in the 
pilot program shall be at the election of the veteran and in 
consultation with a clinician of the Department.
    (h) Report.--
            (1) In general.--Not later than three years after the date 
        of the commencement of the pilot program, the Secretary shall 
        submit to the Committee on Veterans' Affairs of the Senate and 
        the Committee on Veterans' Affairs of the House of 
        Representatives a report on the pilot program.
            (2) Elements.--The report submitted under paragraph (1) 
        shall include the following:
                    (A) The findings and conclusions of the Secretary 
                with respect to the pilot program, including with 
                respect to--
                            (i) the use and efficacy of the 
                        complementary and integrative health services 
                        established under the pilot program;
                            (ii) the outreach conducted by the 
                        Secretary to inform veterans and community 
                        organizations about the pilot program; and
                            (iii) an assessment of the benefit of the 
                        pilot program to covered veterans in mental 
                        health diagnoses, pain management, and 
                        treatment of chronic illness.
                    (B) Barriers identified under subsection (a)(2)(B) 
                that were not resolved.
                    (C) Such recommendations for the continuation or 
                expansion of the pilot program as the Secretary 
                considers appropriate.
    (i) Complementary and Integrative Health Defined.--In this section, 
the term ``complementary and integrative health'' shall have the 
meaning given that term in section 441(d).

                     Subtitle E--Family Caregivers

SEC. 451. EXPANSION OF FAMILY CAREGIVER PROGRAM OF DEPARTMENT OF 
              VETERANS AFFAIRS.

    (a) Family Caregiver Program.--
            (1) Expansion of eligibility.--
                    (A) In general.--Subsection (a)(2)(B) of section 
                1720G of title 38, United States Code, is amended to 
                read as follows:
            ``(B) for assistance provided under this subsection--
                    ``(i) before the date on which the Secretary 
                submits to Congress a certification that the Department 
                has fully implemented the information technology system 
                required by section 452(a) of the Jason Simcakoski 
                Memorial Act, has a serious injury (including traumatic 
                brain injury, psychological trauma, or other mental 
                disorder) incurred or aggravated in the line of duty in 
                the active military, naval, or air service on or after 
                September 11, 2001;
                    ``(ii) during the two-year period beginning on the 
                date specified in clause (i), has a serious injury 
                (including traumatic brain injury, psychological 
                trauma, or other mental disorder) incurred or 
                aggravated in the line of duty in the active military, 
                naval, or air service--
                            ``(I) on or before May 7, 1975; or
                            ``(II) on or after September 11, 2001; or
                    ``(iii) after the date that is two years after the 
                date specified in clause (i), has a serious injury 
                (including traumatic brain injury, psychological 
                trauma, or other mental disorder) incurred or 
                aggravated in the line of duty in the active military, 
                naval, or air service; and''.
                    (B) Publication in federal register.--Not later 
                than 30 days after the date on which the Secretary of 
                Veterans Affairs submits to Congress the certification 
                described in subsection (a)(2)(B)(i) of section 1720G 
                of such title, as amended by subparagraph (A) of this 
                paragraph, the Secretary shall publish the date 
                specified in such subsection in the Federal Register.
            (2) Expansion of needed services in eligibility criteria.--
        Subsection (a)(2)(C) of such section is amended--
                    (A) in clause (ii), by striking ``; or'' and 
                inserting a semicolon;
                    (B) by redesignating clause (iii) as clause (iv); 
                and
                    (C) by inserting after clause (ii) the following 
                new clause (iii):
                    ``(iii) a need for regular or extensive instruction 
                or supervision without which the ability of the veteran 
                to function in daily life would be seriously impaired; 
                or''.
            (3) Expansion of services provided.--Subsection 
        (a)(3)(A)(ii) of such section is amended--
                    (A) in subclause (IV), by striking ``; and'' and 
                inserting a semicolon;
                    (B) in subclause (V), by striking the period at the 
                end and inserting ``; and''; and
                    (C) by adding at the end the following new 
                subclause:
                    ``(VI) through the use of contracts with, or the 
                provision of grants to, public or private entities--
                            ``(aa) financial planning services relating 
                        to the needs of injured veterans and their 
                        caregivers; and
                            ``(bb) legal services, including legal 
                        advice and consultation, relating to the needs 
                        of injured veterans and their caregivers.''.
            (4) Modification of stipend calculation.--Subsection 
        (a)(3)(C) of such section is amended--
                    (A) by redesignating clause (iii) as clause (iv); 
                and
                    (B) by inserting after clause (ii) the following 
                new clause (iii):
    ``(iii) In determining the amount and degree of personal care 
services provided under clause (i) with respect to an eligible veteran 
whose need for personal care services is based in whole or in part on a 
need for supervision or protection under paragraph (2)(C)(ii) or 
regular instruction or supervision under paragraph (2)(C)(iii), the 
Secretary shall take into account the following:
            ``(I) The assessment by the family caregiver of the needs 
        and limitations of the veteran.
            ``(II) The extent to which the veteran can function safely 
        and independently in the absence of such supervision, 
        protection, or instruction.
            ``(III) The amount of time required for the family 
        caregiver to provide such supervision, protection, or 
        instruction to the veteran.''.
            (5) Periodic evaluation of need for certain services.--
        Subsection (a)(3) of such section is amended by adding at the 
        end the following new subparagraph:
    ``(D) In providing instruction, preparation, and training under 
subparagraph (A)(i)(I) and technical support under subparagraph 
(A)(i)(II) to each family caregiver who is approved as a provider of 
personal care services for an eligible veteran under paragraph (6), the 
Secretary shall periodically evaluate the needs of the eligible veteran 
and the skills of the family caregiver of such veteran to determine if 
additional instruction, preparation, training, or technical support 
under those subparagraphs is necessary.''.
            (6) Use of primary care teams.--Subsection (a)(5) of such 
        section is amended, in the matter preceding subparagraph (A), 
        by inserting ``(in collaboration with the primary care team for 
        the eligible veteran to the maximum extent practicable)'' after 
        ``evaluate''.
            (7) Assistance for family caregivers.--Subsection (a) of 
        such section is amended by adding at the end the following new 
        paragraph:
    ``(11)(A) In providing assistance under this subsection to family 
caregivers of eligible veterans, the Secretary may enter into 
contracts, provider agreements, and memoranda of understanding with 
Federal agencies, States, and private, nonprofit, and other entities to 
provide such assistance to such family caregivers.
    ``(B) The Secretary may provide assistance under this paragraph 
only if such assistance is reasonably accessible to the family 
caregiver and is substantially equivalent or better in quality to 
similar services provided by the Department.
    ``(C) The Secretary may provide fair compensation to Federal 
agencies, States, and other entities that provide assistance under this 
paragraph.''.
    (b) Modification of Definition of Personal Care Services.--
Subsection (d)(4) of such section is amended--
            (1) in subparagraph (A), by striking ``independent'';
            (2) by redesignating subparagraph (B) as subparagraph (D); 
        and
            (3) by inserting after subparagraph (A) the following new 
        subparagraphs:
                    ``(B) Supervision or protection based on symptoms 
                or residuals of neurological or other impairment or 
                injury.
                    ``(C) Regular or extensive instruction or 
                supervision without which the ability of the veteran to 
                function in daily life would be seriously impaired.''.

SEC. 452. IMPLEMENTATION OF INFORMATION TECHNOLOGY SYSTEM OF DEPARTMENT 
              OF VETERANS AFFAIRS TO ASSESS AND IMPROVE THE FAMILY 
              CAREGIVER PROGRAM.

    (a) Implementation of New System.--
            (1) In general.--Not later than December 31, 2016, the 
        Secretary of Veterans Affairs shall implement an information 
        technology system that fully supports the Program and allows 
        for data assessment and comprehensive monitoring of the 
        Program.
            (2) Elements of system.--The information technology system 
        required to be implemented under paragraph (1) shall include 
        the following:
                    (A) The ability to easily retrieve data that will 
                allow all aspects of the Program (at the medical center 
                and aggregate levels) and the workload trends for the 
                Program to be assessed and comprehensively monitored.
                    (B) The ability to manage data with respect to a 
                number of caregivers that is more than the number of 
                caregivers that the Secretary expects to apply for the 
                Program.
                    (C) The ability to integrate the system with other 
                relevant information technology systems of the Veterans 
                Health Administration.
    (b) Assessment of Program.--Not later than 180 days after 
implementing the system described in subsection (a), the Secretary 
shall, through the Under Secretary for Health, use data from the system 
and other relevant data to conduct an assessment of how key aspects of 
the Program are structured and carried out.
    (c) Ongoing Monitoring of and Modifications to Program.--
            (1) Monitoring.--The Secretary shall use the system 
        implemented under subsection (a) to monitor and assess the 
        workload of the Program, including monitoring and assessment of 
        data on--
                    (A) the status of applications, appeals, and home 
                visits in connection with the Program; and
                    (B) the use by caregivers participating in the 
                Program of other support services under the Program 
                such as respite care.
            (2) Modifications.--Based on the monitoring and assessment 
        conducted under paragraph (1), the Secretary shall identify and 
        implement such modifications to the Program as the Secretary 
        considers necessary to ensure the Program is functioning as 
        intended and providing veterans and caregivers participating in 
        the Program with services in a timely manner.
    (d) Reports.--
            (1) Initial report.--
                    (A) In general.--Not later than 90 days after the 
                date of the enactment of this Act, the Secretary shall 
                submit to the Committee on Veterans' Affairs of the 
                Senate, the Committee on Veterans' Affairs of the House 
                of Representatives, and the Comptroller General of the 
                United States a report that includes--
                            (i) the status of the planning, 
                        development, and deployment of the system 
                        required to be implemented under subsection 
                        (a), including any changes in the timeline for 
                        the implementation of the system; and
                            (ii) an assessment of the needs of family 
                        caregivers of veterans described in 
                        subparagraph (B), the resources needed for the 
                        inclusion of such family caregivers in the 
                        Program, and such changes to the Program as the 
                        Secretary considers necessary to ensure the 
                        successful expansion of the Program to include 
                        such family caregivers.
                    (B) Veterans described.--Veterans described in this 
                subparagraph are veterans who are eligible for the 
                Program under clause (ii) or (iii) of section 
                1720G(a)(2)(B) of title 38, United States Code, as 
                amended by section 451(a)(1) of this Act, solely due to 
                a serious injury (including traumatic brain injury, 
                psychological trauma, or other mental disorder) 
                incurred or aggravated in the line of duty in the 
                active military, naval, or air service before September 
                11, 2001.
            (2) Notification by comptroller general.--The Comptroller 
        General shall review the report submitted under paragraph (1) 
        and notify the Committee on Veterans' Affairs of the Senate and 
        the Committee on Veterans' Affairs of the House of 
        Representatives with respect to the progress of the Secretary 
        in--
                    (A) fully implementing the system required under 
                subsection (a); and
                    (B) implementing a process for using such system to 
                monitor and assess the Program under subsection (c)(1) 
                and modify the Program as considered necessary under 
                subsection (c)(2).
            (3) Final report.--
                    (A) In general.--Not later than December 31, 2017, 
                the Secretary shall submit to the Committee on 
                Veterans' Affairs of the Senate, the Committee on 
                Veterans' Affairs of the House of Representatives, and 
                the Comptroller General a report on the implementation 
                of subsections (a) through (c).
                    (B) Elements.--The report required by subparagraph 
                (A) shall include the following:
                            (i) A certification by the Secretary with 
                        respect to whether the information technology 
                        system described in subsection (a) has been 
                        implemented.
                            (ii) A description of how the Secretary has 
                        implemented such system.
                            (iii) A description of the modifications to 
                        the Program, if any, that were identified and 
                        implemented under subsection (c)(2).
                            (iv) A description of how the Secretary is 
                        using such system to monitor the workload of 
                        the Program.
    (e) Definitions.--In this section:
            (1) Active military, naval, or air service.--The term 
        ``active military, naval, or air service'' has the meaning 
        given that term in section 101 of title 38, United States Code.
            (2) Program.--The term ``Program'' means the program of 
        comprehensive assistance for family caregivers under section 
        1720G(a) of title 38, United States Code, as amended by section 
        451 of this Act.

SEC. 453. MODIFICATIONS TO ANNUAL EVALUATION REPORT ON CAREGIVER 
              PROGRAM OF DEPARTMENT OF VETERANS AFFAIRS.

    (a) Barriers to Care and Services.--Subparagraph (A)(iv) of section 
101(c)(2) of the Caregivers and Veterans Omnibus Health Services Act of 
2010 (Public Law 111-163; 38 U.S.C. 1720G note) is amended by inserting 
``, including a description of any barriers to accessing and receiving 
care and services under such programs'' before the semicolon.
    (b) Sufficiency of Training for Family Caregiver Program.--
Subparagraph (B) of such section is amended--
            (1) in clause (i), by striking ``; and'' and inserting a 
        semicolon;
            (2) in clause (ii), by striking the period at the end and 
        inserting ``; and''; and
            (3) by adding at the end the following new clause:
                            ``(iii) an evaluation of the sufficiency 
                        and consistency of the training provided to 
                        family caregivers under such program in 
                        preparing family caregivers to provide care to 
                        veterans under such program.''.

SEC. 454. ADVISORY COMMITTEE ON CAREGIVER POLICY.

    (a) Establishment.--There is established in the Department of 
Veterans Affairs an advisory committee on policies relating to 
caregivers of veterans (in this section referred to as the 
``Committee'').
    (b) Composition.--The Committee shall be composed of the following:
            (1) A chair selected by the Secretary of Veterans Affairs.
            (2) A representative from each of the following agencies or 
        organizations selected by the head of such agency or 
        organization:
                    (A) The Department of Veterans Affairs.
                    (B) The Department of Defense.
                    (C) The Department of Health and Human Services.
                    (D) The Department of Labor.
                    (E) The Centers for Medicare and Medicaid Services.
            (3) Not less than seven individuals who are not employees 
        of the Federal Government selected by the Secretary from among 
        the following individuals:
                    (A) Academic experts in fields relating to 
                caregivers.
                    (B) Clinicians.
                    (C) Caregivers.
                    (D) Individuals in receipt of caregiver services.
                    (E) Such other individuals with expertise that is 
                relevant to the duties of the Committee as the 
                Secretary considers appropriate.
    (c) Duties.--The duties of the Committee are as follows:
            (1) To regularly review and recommend policies of the 
        Department of Veterans Affairs relating to caregivers of 
        veterans.
            (2) To examine and advise the implementation of such 
        policies.
            (3) To evaluate the effectiveness of such policies.
            (4) To recommend standards of care for caregiver services 
        and respite care services provided to a caregiver or veteran by 
        a non-profit or private sector entity.
            (5) To develop recommendations for legislative or 
        administrative action to enhance the provision of services to 
        caregivers and veterans, including eliminating gaps in such 
        services and eliminating disparities in eligibility for such 
        services.
            (6) To make recommendations on coordination with State and 
        local agencies and relevant non-profit organizations on 
        maximizing the use and effectiveness of resources for 
        caregivers of veterans.
    (d) Reports.--
            (1) Annual report to secretary.--
                    (A) In general.--Not later than December 31, 2016, 
                and not less frequently than annually thereafter until 
                the termination date specified in subsection (e), the 
                chair of the Committee shall submit to the Secretary a 
                report on policies and services of the Department of 
                Veterans Affairs relating to caregivers of veterans.
                    (B) Elements.--Each report required by subparagraph 
                (A) shall include the following:
                            (i) An assessment of the policies of the 
                        Department relating to caregivers of veterans 
                        and services provided pursuant to such policies 
                        as of the date of submittal of the report.
                            (ii) A description of any recommendations 
                        made by the Committee to improve the 
                        coordination of services for caregivers of 
                        veterans between the Department and the 
                        entities specified in subparagraphs (B) through 
                        (E) of subsection (b)(2) and to eliminate 
                        barriers to the effective use of such services, 
                        including with respect to eligibility criteria.
                            (iii) An evaluation of the effectiveness of 
                        the Department in providing services for 
                        caregivers of veterans.
                            (iv) An evaluation of the quality and 
                        sufficiency of services for caregivers of 
                        veterans available from non-governmental 
                        organizations.
                            (v) A description of any gaps identified by 
                        the Committee in care or services provided by 
                        caregivers to veterans and recommendations for 
                        legislative or administrative action to address 
                        such gaps.
                            (vi) Such other matters or recommendations 
                        as the chair considers appropriate.
            (2) Transmittal to congress.--Not later than 90 days after 
        the receipt of a report under paragraph (1), the Secretary 
        shall transmit to the Committee on Veterans' Affairs of the 
        Senate and the Committee on Veterans' Affairs of the House of 
        Representatives a copy of such report, together with such 
        comments and recommendations concerning such report as the 
        Secretary considers appropriate.
    (e) Termination.--The Committee shall terminate on December 31, 
2021.

SEC. 455. COMPREHENSIVE STUDY ON SERIOUSLY INJURED VETERANS AND THEIR 
              CAREGIVERS.

    (a) Study Required.--During the period specified in subsection (d), 
the Secretary of Veterans Affairs shall provide for the conduct by an 
independent entity of a comprehensive study on the following:
            (1) Veterans who have incurred a serious injury or illness, 
        including a mental health injury or illness.
            (2) Individuals who are acting as caregivers for veterans.
    (b) Elements.--The comprehensive study required by subsection (a) 
shall include the following with respect to each veteran included in 
such study:
            (1) The health of the veteran and, if applicable, the 
        impact of the caregiver of such veteran on the health of such 
        veteran.
            (2) The employment status of the veteran and, if 
        applicable, the impact of the caregiver of such veteran on the 
        employment status of such veteran.
            (3) The financial status and needs of the veteran.
            (4) The use by the veteran of benefits available to such 
        veteran from the Department of Veterans Affairs.
            (5) Such other information as the Secretary considers 
        appropriate.
    (c) Contract.--The Secretary shall enter into a contract with an 
appropriate independent entity to conduct the study required by 
subsection (a).
    (d) Period Specified.--The period specified in this subsection is 
the one-year period beginning on the date that is four years after the 
date specified in section 1720G(a)(2)(B)(i) of title 38, United States 
Code, as amended by section 451(a)(1) of this Act.
    (e) Report.--Not later than 30 days after the end of the period 
specified in subsection (d), the Secretary shall submit to the 
Committee on Veterans' Affairs of the Senate and the Committee on 
Veterans' Affairs of the House of Representatives a report on the 
results of the study required by subsection (a).

                   Subtitle F--Health Care Agreements

SEC. 461. AUTHORIZATION OF AGREEMENTS BETWEEN THE DEPARTMENT OF 
              VETERANS AFFAIRS AND NON-DEPARTMENT EXTENDED CARE 
              PROVIDERS.

    (a) In General.--Subchapter I of chapter 17 of title 38, United 
States Code, is amended by adding after section 1703 the following new 
section:
``Sec. 1703A. Veterans Extended Care Agreements with certain health 
              care providers
    ``(a) Agreements to Furnish Extended Care.--(1) In addition to the 
authority of the Secretary under this chapter to furnish extended care 
at facilities of the Department and under contracts or sharing 
agreements entered into under authorities other than this section, the 
Secretary may furnish extended care through the use of agreements 
entered into under this section. An agreement entered into under this 
section may be referred to as a `Veterans Extended Care Agreement'.
    ``(2) The Secretary may enter into agreements to furnish extended 
care under this section with eligible providers that are certified 
under subsection (d) if the Secretary is not feasibly able to furnish 
extended care at facilities of the Department.
    ``(3) An eligible provider, at its discretion, may opt to enter 
into an agreement under this section instead of a contract or sharing 
agreement under authorities other than this section.
    ``(b) Receipt of Extended Care.--(1) Eligibility of a veteran for 
extended care under this section shall be determined as if such care 
were furnished in a facility of the Department and provisions of this 
title applicable to veterans receiving extended care in a facility of 
the Department shall apply to veterans receiving such care under this 
section.
    ``(2) In carrying out this section, the Secretary--
            ``(A) may not direct veterans seeking extended care to 
        health care providers that have entered into contracts or 
        sharing agreements under authorities other than this section; 
        and
            ``(B) shall ensure that veterans have the option to 
        determine whether to receive extended care from a health care 
        provider described in subparagraph (A) or an eligible provider 
        that has entered into an agreement under this section.
    ``(c) Eligible Providers.--For purposes of this section, an 
eligible provider is one of the following:
            ``(1) A provider of services that has enrolled and entered 
        into a provider agreement under section 1866(a) of the Social 
        Security Act (42 U.S.C. 1395cc(a)).
            ``(2) A physician or supplier that has enrolled and entered 
        into a participation agreement under section 1842(h) of such 
        Act (42 U.S.C. 1395u(h)).
            ``(3) A provider of items and services receiving payment 
        under a State plan under title XIX of such Act (42 U.S.C. 1396 
        et seq.) or a waiver of such a plan.
            ``(4) A provider that is--
                    ``(A) an Aging and Disability Resource Center, an 
                area agency on aging, or a State agency (as defined in 
                section 102 of the Older Americans Act of 1965 (42 
                U.S.C. 3002)); or
                    ``(B) a center for independent living (as defined 
                in section 702 of the Rehabilitation Act of 1973 (29 
                U.S.C. 796a)).
            ``(5) Such other health care providers as the Secretary 
        considers appropriate for purposes of this section.
    ``(d) Certification of Eligible Providers.--(1) The Secretary shall 
establish a process for the certification of eligible providers under 
this section that shall, at a minimum, set forth the following.
            ``(A) Procedures for the submittal of applications for 
        certification and deadlines for actions taken by the Secretary 
        with respect to such applications.
            ``(B) Standards and procedures for approval and denial of 
        certification, duration of certification, revocation of 
        certification, and recertification.
            ``(C) Procedures for assessing eligible providers based on 
        the risk of fraud, waste, and abuse of such providers similar 
        to the level of screening under section 1866(j)(2)(B) of the 
        Social Security Act (42 U.S.C. 1395cc(j)(2)(B)) and the 
        standards set forth under section 9.104 of title 48, Code of 
        Federal Regulations, or any successor regulation.
    ``(2) The Secretary shall deny or revoke certification to an 
eligible provider under this subsection if the Secretary determines 
that the eligible provider is currently--
            ``(A) excluded from participation in a Federal health care 
        program (as defined in section 1128B(f) of the Social Security 
        Act (42 U.S.C. 1320a-7b(f))) under section 1128 or 1128A of the 
        Social Security Act (42 U.S.C. 1320a-7 and 1320a-7a); or
            ``(B) identified as an excluded source on the list 
        maintained in the System for Award Management, or any successor 
        system.
    ``(e) Terms of Agreements.--Each agreement entered into with an 
eligible provider under this section shall include provisions requiring 
the eligible provider to do the following:
            ``(1) To accept payment for extended care furnished under 
        this section at rates established by the Secretary for purposes 
        of this section, which shall be, to the extent practicable, the 
        rates paid by the United States for such care to providers of 
        services and suppliers under the Medicare program under title 
        XVIII of the Social Security Act (42 U.S.C. 1395 et seq.).
            ``(2) To accept payment under paragraph (1) as payment in 
        full for extended care furnished under this section and to not 
        seek any payment for such care from the recipient of such care.
            ``(3) To furnish under this section only the extended care 
        authorized by the Department under this section unless the 
        eligible provider receives prior written consent from the 
        Department to furnish extended care outside the scope of such 
        authorization.
            ``(4) To bill the Department for extended care furnished 
        under this section in accordance with a methodology established 
        by the Secretary for purposes of this section.
            ``(5) Not to seek to recover or collect from a health-plan 
        contract or third party, as those terms are defined in section 
        1729 of this title, for any extended care for which payment is 
        made by the Department under this section.
            ``(6) To provide medical records for veterans furnished 
        extended care under this section to the Department in a time 
        frame and format specified by the Secretary for purposes of 
        this section.
            ``(7) To meet such other terms and conditions, including 
        quality of care assurance standards, as the Secretary may 
        specify for purposes of this section.
    ``(f) Termination of Agreements.--(1) An eligible provider may 
terminate an agreement with the Secretary under this section at such 
time and upon such notice to the Secretary as the Secretary may specify 
for purposes of this section.
    ``(2) The Secretary may terminate an agreement with an eligible 
provider under this section at such time and upon such notice to the 
eligible provider as the Secretary may specify for purposes of this 
section, if the Secretary--
            ``(A) determines that the eligible provider failed to 
        comply substantially with the provisions of the agreement or 
        with the provisions of this section and the regulations 
        prescribed thereunder;
            ``(B) determines that the eligible provider is--
                    ``(i) excluded from participation in a Federal 
                health care program (as defined in section 1128B(f) of 
                the Social Security Act (42 U.S.C. 1320a-7b(f))) under 
                section 1128 or 1128A of the Social Security Act (42 
                U.S.C. 1320a-7 and 1320a-7a); or
                    ``(ii) identified as an excluded source on the list 
                maintained in the System for Award Management, or any 
                successor system;
            ``(C) ascertains that the eligible provider has been 
        convicted of a felony or other serious offense under Federal or 
        State law and determines that the continued participation of 
        the eligible provider would be detrimental to the best 
        interests of veterans or the Department; or
            ``(D) determines that it is reasonable to terminate the 
        agreement based on the health care needs of a veteran or 
        veterans.
    ``(g) Periodic Review of Certain Agreements.--(1) Not less 
frequently than once every two years, the Secretary shall review each 
Veterans Extended Care Agreement of material size entered into during 
the two-year period preceding the review to determine whether it is 
feasible and advisable to furnish the extended care furnished under 
such agreement at facilities of the Department or through contracts or 
sharing agreements entered into under authorities other than this 
section.
    ``(2)(A) Subject to subparagraph (B), a Veterans Extended Care 
Agreement is of material size as determined by the Secretary for 
purposes of this section.
    ``(B) A Veterans Extended Care Agreement entered into after 
September 30, 2016, is of material size if the purchase of extended 
care under the agreement exceeds $1,000,000 annually. The Secretary may 
adjust such amount to account for changes in the cost of health care 
based upon recognized health care market surveys and other available 
data and shall publish any such adjustments in the Federal Register.
    ``(h) Exclusion of Certain Federal Contracting Provisions.--(1) An 
agreement under this section may be entered into without regard to any 
law that would require the Secretary to use competitive procedures in 
selecting the party with which to enter into the agreement.
    ``(2)(A) Except as provided in subparagraph (B) and unless 
otherwise provided in this section or regulations prescribed pursuant 
to this section, an eligible provider that enters into an agreement 
under this section is not subject to, in the carrying out of the 
agreement, any law that providers of services and suppliers under the 
Medicare program under title XVIII of the Social Security Act (42 
U.S.C. 1395 et seq.) are not subject to.
    ``(B) Notwithstanding subparagraph (A), an eligible provider that 
enters into an agreement under this section shall be subject to all 
laws regarding integrity, ethics, fraud, or that subject a person to 
civil or criminal penalties as if such laws were incorporated into its 
provider agreements.
    ``(i) Quality of Care.--The Secretary shall establish through 
regulation a system or systems for--
            ``(1) monitoring the quality of extended care furnished to 
        veterans under this section; and
            ``(2) assessing the quality of extended care furnished by 
        an eligible provider under this section prior to the renewal of 
        a Veterans Extended Care Agreement with the eligible provider.
    ``(j) Dispute Resolution.--(1) The Secretary shall establish 
administrative procedures for eligible providers with which the 
Secretary has entered an agreement under this section to present any 
dispute arising under or related to the agreement.
    ``(2) Before using any dispute resolution mechanism under chapter 
71 of title 41 with respect to a dispute arising under an agreement 
under this section, an eligible provider must first exhaust the 
administrative procedures established by the Secretary under paragraph 
(1).
    ``(k) Sunset.--The Secretary may not furnish extended care through 
the use of an agreement entered into under this section after the date 
that is two years after the date of the enactment of the Jason 
Simcakoski Memorial Act.''.
    (b) Regulations.--The Secretary of Veterans Affairs shall prescribe 
an interim final rule to carry out section 1703A of such title, as 
added by subsection (a), not later than one year after the date of the 
enactment of this Act.
    (c) Clerical Amendment.--The table of sections at the beginning of 
chapter 17 of such title is amended by inserting after the item related 
to section 1703 the following new item:

``1703A. Veterans Extended Care Agreements with certain health care 
                            providers.''.

SEC. 462. MODIFICATION OF AUTHORITY TO ENTER INTO AGREEMENTS WITH STATE 
              HOMES TO PROVIDE NURSING HOME CARE.

    (a) Use of Agreements.--
            (1) In general.--Paragraph (1) of section 1745(a) of title 
        38, United States Code, is amended, in the matter preceding 
        subparagraph (A), by striking ``a contract (or agreement under 
        section 1720(c)(1) of this title)'' and inserting ``an 
        agreement''.
            (2) Payment.--Paragraph (2) of such section is amended by 
        striking ``contract (or agreement)'' each place it appears and 
        inserting ``agreement''.
    (b) Exclusion of Certain Federal Contracting Provisions.--Such 
section is amended by adding at the end the following new paragraphs:
    ``(4)(A) An agreement under paragraph (1) may be entered into 
without regard to any law that would require the Secretary to use 
competitive procedures in selecting the party with which to enter into 
the agreement.
    ``(B)(i) Except as provided in clause (ii) and unless otherwise 
provided in this section or regulations prescribed pursuant to this 
section, a State home that enters into an agreement under paragraph (1) 
is not subject to, in the carrying out of the agreement, any law that a 
provider described in subparagraph (C) is not subject to under the 
original Medicare fee-for-service program under parts A and B of title 
XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) or the 
Medicaid program under title XIX of such Act (42 U.S.C. 1396 et seq.).
    ``(ii) Notwithstanding clause (i), a State home that enters into an 
agreement under paragraph (1) shall be subject to all laws regarding 
integrity, ethics, fraud, or that subject a person to civil or criminal 
penalties as if such laws were incorporated into its provider 
agreements.
    ``(C) A provider described in this subparagraph is one of the 
following:
            ``(i) A provider of services that has enrolled and entered 
        into a provider agreement under section 1866(a) of the Social 
        Security Act (42 U.S.C. 1395cc(a)).
            ``(ii) A physician or supplier that has enrolled and 
        entered into a participation agreement under section 1842(h) of 
        such Act (42 U.S.C. 1395u(h)).
            ``(iii) A provider of items and services receiving payment 
        under a State plan under title XIX of such Act (42 U.S.C. 1396 
        et seq.) or a waiver of such a plan.
    ``(5) The Secretary may not furnish nursing home care under an 
agreement entered into under paragraph (1) after the date that is two 
years after the date of the enactment of the Jason Simcakoski Memorial 
Act.''.
    (c) Effective Date.--The amendments made by this section shall 
apply to agreements entered into under section 1745(a) of such title on 
and after the date that is 30 days after the date of the enactment of 
this Act.

                         TITLE V--OTHER MATTERS

SEC. 501. EXTENSION OF TEMPORARY INCREASE IN NUMBER OF JUDGES ON UNITED 
              STATES COURT OF APPEALS FOR VETERANS CLAIMS.

    (a) In General.--Subsection (i)(2) of section 7253 of title 38, 
United States Code, is amended by striking ``January 1, 2013'' and 
inserting ``January 1, 2021''.
    (b) Report.--
            (1) In general.--Not later than June 30, 2020, the chief 
        judge of the United States Court of Appeals for Veterans Claims 
        shall submit to the Committee on Veterans' Affairs of the 
        Senate and the Committee on Veterans' Affairs of the House of 
        Representatives a report on the temporary expansions of the 
        Court under section 7253 of title 38, United States Code.
            (2) Contents.--The report required by paragraph (1) shall 
        include the following:
                    (A) An assessment of the effect of the expansions 
                on ensuring appeals are handled in a timely manner.
                    (B) A description of the ways in which the 
                complexity levels of the appeals acted on by the Court 
                may have changed based on service during recent 
                conflicts compared to those based on service from 
                previous eras.
                    (C) A recommendation on whether the number of 
                judges should be adjusted at the end of the temporary 
                expansion period, including statistics, projections, 
                trend analyses, and other information to support the 
                recommendation.

SEC. 502. REPEAL INAPPLICABILITY OF MODIFICATION OF BASIC ALLOWANCE FOR 
              HOUSING TO BENEFITS UNDER LAWS ADMINISTERED BY SECRETARY 
              OF VETERANS AFFAIRS.

    (a) Repeal.--Subsection (b) of section 604 of the Carl Levin and 
Howard P. ``Buck'' McKeon National Defense Authorization Act for Fiscal 
Year 2015 (Public Law 113-291; 37 U.S.C. 403 note) is repealed.
    (b) Effective Date.--The amendment made by subsection (a) shall 
take effect on January 1, 2016.

SEC. 503. DEPARTMENT OF VETERANS AFFAIRS PROGRAM OF INTERNAL AUDITS.

    (a) In General.--Subchapter II of chapter 5 of title 38, United 
States Code, is amended by inserting after section 527 the following 
new section:
``Sec. 527A. Program of internal audits
    ``(a) Program Required.--(1) The Secretary shall carry out a 
program of internal audits and self-analysis to improve the furnishing 
of benefits and health care to veterans and their families.
    ``(2) The Secretary shall carry out the program required by 
paragraph (1) through an office the Secretary shall establish for 
purposes of the program within the office of the Secretary that is 
interdisciplinary and independent of--
            ``(A) the other offices within the office of the Secretary; 
        and
            ``(B) the covered administrations (or functions of such 
        administrations), staff organizations, and staff offices 
        identified under subsection (b)(1)(A).
    ``(b) Program Requirements.--(1) In carrying out the program 
required by subsection (a), the Secretary shall--
            ``(A) conduct periodic risk assessments of the Department 
        to identify those covered administrations (or functions of such 
        administrations), staff organizations, and staff offices of the 
        Department the audit of which would lead towards the greatest 
        improvement in the furnishing of benefits and health care to 
        veterans and their families;
            ``(B) develop plans that are informed by the risk 
        assessments conducted under paragraph (1) to conduct internal 
        audits of the covered administrations (or functions of such 
        administrations), staff organizations, and staff offices 
        identified under subparagraph (A); and
            ``(C) conduct internal audits in accordance with the plans 
        developed pursuant to subparagraph (B).
    ``(2) The Secretary shall carry out under the program required by 
subsection (a) an audit of not fewer than five covered administrations 
(or functions of such administrations), staff organizations, or staff 
offices of the Department each year.
    ``(3) In identifying covered administrations (or functions of such 
administrations), staff organizations, and staff offices of the 
Department under paragraph (1)(A), the Secretary shall accord priority 
to the covered administrations and functions of such administrations.
    ``(4)(A) For purposes of this subsection, the covered 
administrations of the Department are the following:
            ``(i) The National Cemetery Administration.
            ``(ii) The Veterans Benefits Administration.
            ``(iii) The Veterans Health Administration.
    ``(B) For purposes this subsection, the covered staff organizations 
of the Department are the following:
            ``(i) The Office of Acquisition, Logistics, and 
        Construction.
            ``(ii) The Advisory Committee Management Office.
            ``(iii) The Board of Veterans' Appeals.
            ``(iv) The Center for Faith-Based and Neighborhood 
        Partnerships.
            ``(v) The Center for Minority Veterans.
            ``(vi) The Center for Women Veterans.
            ``(vii) The Office of General Counsel.
            ``(viii) The Office of Regulation Policy and Management.
            ``(ix) The Office of Employment Discrimination Complaint 
        Adjudication.
            ``(x) The Office of Interagency Care and Benefits 
        Coordination.
            ``(xi) The Office of Small and Disadvantaged Business 
        Utilization.
            ``(xii) The Office of Survivors Assistance.
            ``(xiii) The Veterans' Service Organizations Liaison.
    ``(C) For purposes of this subsection, the covered staff offices of 
the Department are the following:
            ``(i) The office of the Assistant Secretary for 
        Congressional and Legislative Affairs.
            ``(ii) The office of the Assistant Secretary for Human 
        Resources and Administration.
            ``(iii) The office of the Assistant Secretary for 
        Information and Technology.
            ``(iv) The Office of Management.
            ``(v) The office of the Assistant Secretary for Operations, 
        Security, and Preparedness.
            ``(vi) The office of the Assistant Secretary for Policy and 
        Planning.
            ``(vii) The office of the Assistant Secretary for Public 
        and Intergovernmental Affairs.
    ``(c) Reports.--(1)(A) Not later than 90 days after completing an 
audit under the program required by subsection (a), the Secretary shall 
submit to the appropriate committees of Congress a report on the audit.
    ``(B) Each report submitted under subparagraph (A) with respect to 
an audit shall include the following:
            ``(i) A summary of the audit.
            ``(ii) The findings of the Secretary with respect to the 
        audit.
            ``(iii) Such recommendations as the Secretary may have for 
        legislative or administrative action to improve the furnishing 
        of benefits and health care to veterans and their families.
            ``(iv) Plans to carry out the recommendations submitted 
        under clause (iii), including timelines for completion of such 
        plans.
    ``(2)(A) Not later than September 1 of each year, the Secretary 
shall submit to the appropriate committees of Congress a report on the 
administration of this section.
    ``(B) Each report submitted under subparagraph (A) shall include 
the following:
            ``(i) A detailed description of each matter for which a 
        recommendation was submitted under clause (iii) of paragraph 
        (1)(B) and with respect to which plans that were submitted 
        under clause (iv) of such paragraph have not been completed.
            ``(ii) A plan for the conduct of audits under this section 
        during the first fiscal year beginning after the fiscal year in 
        which the report is submitted, which shall include the 
        following:
                    ``(I) A description of any risk assessments the 
                Secretary plans to conduct in such fiscal year.
                    ``(II) A summary of each audit the Secretary plans 
                to conduct in such fiscal year, including a description 
                of the subject matter of the audit and identification 
                of the administration, office, or function to be 
                audited.
    ``(3) In this subsection, the term `appropriate committees of 
Congress' includes--
            ``(A) the Committee on Veterans' Affairs, the Committee on 
        Appropriations, and the Committee on Homeland Security and 
        Governmental Affairs of the Senate; and
            ``(B) the Committee on Veterans' Affairs, the Committee on 
        Appropriations, and the Committee on Oversight and Government 
        Reform of the House of Representatives.''.
    (b) First Risk Assessment.--The Secretary of Veterans Affairs shall 
complete the first risk assessment required by section 527A(b)(1)(A) of 
such title, as added by subsection (a), by not later than 180 days 
after the date of the enactment of this Act.
    (c) Clerical Amendment.--The table of sections at the beginning of 
chapter 5 of such title is amended by inserting after the item relating 
to section 527 the following new item:

``527A. Program of internal audits.''.

SEC. 504. IMPROVEMENT OF TRAINING FOR MANAGERS.

    The Secretary of Veterans Affairs shall provide to each employee of 
the Department of Veterans Affairs who is employed by the Department in 
a managerial position periodic training on the following:
            (1) The rights of whistleblowers and how to address a 
        report by an employee of a hostile work environment, reprisal, 
        or harassment.
            (2) How to effectively motivate, manage, and reward the 
        employees who report to the manager.
            (3) How to effectively manage employees who are performing 
        at an unacceptable level and access assistance from the human 
        resources office of the Department and the Office of the 
        General Counsel of the Department with respect to those 
        employees.
            Amend the title so as to read: ``A bill to amend title 38, 
        United States Code, to improve the benefits and health care 
        provided by the Department of Veterans Affairs, and for other 
        purposes.''.
                                                       Calendar No. 716

114th CONGRESS

  2d Session

                                 S. 425

                          [Report No. 114-395]

_______________________________________________________________________

                                 A BILL

   To amend title 38, United States Code, to provide for a five-year 
   extension to the homeless veterans reintegration programs and to 
  provide clarification regarding eligibility for services under such 
                               programs.

_______________________________________________________________________

                            December 7, 2016

        Reported with an amendment and an amendment to the title
```