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 termi-
nate the agreement based on the health care needs 
of a veteran or veterans. 
‘‘(f) PERIODIC
REVIEW
OF
CERTAIN
AGREE-
MENTS.—(1) Not less frequently than once every two 
years, the Secretary shall review each Veterans 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 hospital care, med-
ical services, or extended care furnished under such agree-
ment 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 
Care Agreement is of material size as determined by the 
Secretary for purposes of this section. 
‘‘(B) A Veterans Care Agreement entered into after 
September 30, 2016, for the purchase of extended care 
services is of material size if the purchase of such services 
under the agreement exceeds $1,000,000 annually. The 
Secretary may adjust such amount to account for changes 
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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. 
‘‘(g) EXCLUSION
OF
CERTAIN
FEDERAL
CON-
TRACTING 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 agree-
ment. 
‘‘(2)(A) Except as provided in subparagraph (B) and 
unless otherwise provided in this section or in 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 
to which 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. 
‘‘(B) An eligible provider that enters into an agree-
ment under this section is subject to— 
‘‘(i) all laws regarding integrity, ethics, fraud, 
or that subject a person to civil or criminal pen-
alties; and 
‘‘(ii) all laws that protect against employment 
discrimination or that otherwise ensure equal em-
ployment opportunities. 
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‘‘(h) MONITORING OF QUALITY OF CARE.—The Sec-
retary shall establish a system or systems, consistent with 
survey and certification procedures used by the Centers 
for Medicare & Medicaid Services and State survey agen-
cies to the extent practicable— 
‘‘(1) to monitor the quality of care and services 
furnished to veterans under this section; and 
‘‘(2) to assess the quality of care and services 
furnished by an eligible provider for purposes of de-
termining whether to renew an agreement under this 
section with the eligible provider. 
‘‘(i) 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 aris-
ing under an agreement under this section, an eligible pro-
vider must first exhaust the administrative procedures es-
tablished by the Secretary under paragraph (1).’’. 
(b) REGULATIONS.—The Secretary of Veterans Af-
fairs shall prescribe an interim final rule to carry out sec-
tion 1703B of such title, as added by subsection (a), not 
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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 1703A the 
following new item: 
‘‘1703B. Veterans Care Agreements.’’. 
SEC. 202. MODIFICATION OF AUTHORITY TO ENTER INTO 
AGREEMENTS WITH STATE HOMES TO PRO-
VIDE NURSING HOME CARE. 
(a) USE OF AGREEMENTS.— 
(1) IN GENERAL.—Paragraph (1) of subsection 
(a) of section 1745 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 sub-
section is amended by striking ‘‘contract (or agree-
ment)’’ each place it appears and inserting ‘‘agree-
ment’’. 
(b) EXCLUSION
OF
CERTAIN
FEDERAL
CON-
TRACTING
PROVISIONS.—Such subsection is further 
amended by adding at the end the following new para-
graph: 
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‘‘(4)(A) An agreement under this section may be en-
tered 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 in regulations pre-
scribed pursuant to this section, a State home that enters 
into an agreement under this section is not subject to, in 
the carrying out of the agreement, any law to which pro-
viders of services and suppliers under the Medicare pro-
gram under title XVIII of the Social Security Act (42 
U.S.C. 1395 et seq.) are not subject. 
‘‘(ii) A State home that enters into an agreement 
under this section is subject to— 
‘‘(I) all laws regarding integrity, ethics, fraud, 
or that subject a person to civil or criminal pen-
alties; and 
‘‘(II) all laws that protect against employment 
discrimination or that otherwise ensure equal em-
ployment opportunities.’’. 
(c) EFFECTIVE DATE.— 
(1) IN GENERAL.—The amendments made by 
this section shall apply to agreements entered into 
under section 1745 of such title on and after the 
date on which the regulations prescribed by the Sec-
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retary of Veterans Affairs to implement such amend-
ments take effect. 
(2) PUBLICATION.—The Secretary shall publish 
the date described in paragraph (1) in the Federal 
Register not later than 30 days before such date. 
SEC. 203. REQUIREMENT FOR ADVANCE APPROPRIATIONS 
FOR THE CARE IN THE COMMUNITY AC-
COUNT OF THE DEPARTMENT OF VETERANS 
AFFAIRS. 
(a) IN GENERAL.—Section 117(c) of title 38, United 
States Code, is amended by adding at the end the fol-
lowing new paragraph: 
‘‘(7) Veterans Health Administration, Care in 
the Community.’’. 
(b) 
CONFORMING
AMENDMENT.—Section 
1105(a)(37) of title 31, United States Code, is amended 
by adding at the end the following new subparagraph: 
‘‘(G) 
Veterans 
Health 
Administration, 
Care in the Community.’’. 
(c) APPLICABILITY.—The amendments made by this 
section shall apply to fiscal years beginning on and after 
October 1, 2016. 
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SEC. 204. ANNUAL TRANSFER OF AMOUNTS WITHIN DE-
PARTMENT OF VETERANS AFFAIRS TO PAY 
FOR HEALTH CARE FROM NON-DEPARTMENT 
PROVIDERS. 
Section 106 of the Veterans Access, Choice, and Ac-
countability Act of 2014 (Public Law 113–146; 38 U.S.C. 
1701 note) is amended by adding at the end the following 
new subsection: 
‘‘(c) ANNUAL TRANSFER OF AMOUNTS.— 
‘‘(1) IN GENERAL.—At the beginning of each 
fiscal year, the Secretary of Veterans Affairs shall 
transfer to the Chief Business Office of the Veterans 
Health Administration an amount equal to the 
amount estimated to be required to furnish hospital 
care, medical services, and other health care through 
non-Department of Veterans Affairs providers dur-
ing that fiscal year. 
‘‘(2) ADJUSTMENTS.—During a fiscal year, the 
Secretary may make adjustments to the amount 
transferred under paragraph (1) for that fiscal year 
to accommodate any variances in demand for hos-
pital care, medical services, or other health care 
through non-Department providers.’’. 
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SEC. 205. ELIMINATION OF REQUIREMENT TO ACT AS SEC-
ONDARY PAYER FOR CARE RELATING TO 
NON-SERVICE-CONNECTED 
DISABILITIES 
UNDER CHOICE PROGRAM. 
(a) IN GENERAL.—Section 101(e) of the Veterans 
Access, Choice, and Accountability Act of 2014 (Public 
Law 113–146; 38 U.S.C. 1701 note) is amended— 
(1) by striking paragraphs (2) and (3); 
(2) by redesignating paragraph (4) as para-
graph (3); and 
(3) by inserting after paragraph (1) the fol-
lowing new paragraph (2): 
‘‘(2) RESPONSIBILITY FOR COSTS OF CERTAIN 
CARE.—In any case in which an eligible veteran is 
furnished hospital care or medical services under 
this section for a non-service-connected disability de-
scribed in subsection (a)(2) of section 1729 of title 
38, United States Code, the Secretary may recover 
or collect reasonable charges for such care or serv-
ices from a health-care plan described in paragraph 
(3) in accordance with such section.’’. 
(b) CONFORMING AMENDMENT.—Paragraph (1) of 
such section is amended by striking ‘‘paragraph (4)’’ and 
inserting ‘‘paragraph (3)’’. 
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SEC. 206. AUTHORIZATION OF USE OF CERTAIN AMOUNTS 
APPROPRIATED TO THE VETERANS CHOICE 
FUND FOR OTHER NON-DEPARTMENT OF 
VETERANS AFFAIRS CARE. 
(a) IN GENERAL.—Section 802 of the Veterans Ac-
cess, Choice, and Accountability Act of 2014 (Public Law 
113–146; 38 U.S.C. 1701 note) is amended— 
(1) in subsection (c)— 
(A) in paragraph (1)— 
(i) by striking ‘‘Except as provided by 
paragraph (3), any’’ and inserting ‘‘Any’’; 
and 
(ii) by striking ‘‘by the Secretary of 
Veterans Affairs’’ and all that follows 
through the period at the end and insert-
ing ‘‘by the Secretary of Veterans Af-
fairs— 
‘‘(A) to carry out section 101, including, 
subject to paragraph (2), any administrative re-
quirements of such section; 
‘‘(B) to furnish health care to individuals 
under chapter 17 of title 38, United States 
Code, at non-Department facilities, including 
pursuant to authority other than the authority 
under section 101; and 
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‘‘(C) to furnish disability examinations 
conducted by health care providers that are not 
health care providers of the Department of Vet-
erans Affairs.’’; and 
(B) by striking paragraph (3) and insert-
ing the following new paragraphs: 
‘‘(3) TREATMENT
OF
AMOUNTS.—Amounts 
made available to the Secretary under this sub-
section shall be used to supplement, not supplant, 
amounts made available to the Secretary in the Med-
ical Services account of the Department of Veterans 
Affairs. 
‘‘(4) 
NON-DEPARTMENT
FACILITIES
DE-
FINED.—In this subsection, the term ‘non-Depart-
ment facilities’ has the meaning given that term in 
section 1701 of title 38, United States Code.’’; and 
(2) in subsection (d)(1), by striking ‘‘only for 
the program’’ and all that follows through the period 
at the end and inserting ‘‘only for the purposes spec-
ified in subsection (c)(1).’’. 
(b) EMERGENCY DESIGNATIONS.— 
(1) IN GENERAL.—This section is designated as 
an emergency requirement pursuant to section 4(g) 
of the Statutory Pay-As-You-Go Act of 2010 (2 
U.S.C. 933(g)). 
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(2) DESIGNATION IN SENATE.—In the Senate, 
this section is designated as an emergency require-
ment pursuant to section 403(a) of S. Con. Res. 13 
(111th Congress), the concurrent resolution on the 
budget for fiscal year 2010. 
SEC. 207. MODIFICATION OF PROCESS THROUGH WHICH 
DEPARTMENT 
OF 
VETERANS 
AFFAIRS 
RECORDS OBLIGATIONS FOR NON-DEPART-
MENT CARE. 
(a) IN GENERAL.—Subchapter III of chapter 17 of 
title 38, United States Code, is amended by adding at the 
end the following new section: 
‘‘§ 1730B. Recording obligations for care at non-De-
partment facilities 
‘‘The Secretary may record as an obligation of the 
United States Government amounts owed for hospital care 
or medical services furnished under this chapter at non- 
Department facilities on the date on which a claim by a 
health care provider for payment is approved rather than 
on the date that the hospital care or medical services are 
authorized by the Secretary.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of chapter 17 of such title is amended 
by inserting after the item relating to section 1730A the 
following new item: 
‘‘1730B. Recording obligations for care at non-Department facilities.’’. 
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SEC. 208. AUTHORITY TO DISCLOSE CERTAIN MEDICAL 
RECORDS OF VETERANS WHO RECEIVE NON- 
DEPARTMENT 
OF 
VETERANS 
AFFAIRS 
HEALTH CARE. 
Section 7332(b)(2) of title 38, United States Code, 
is amended by adding at the end the following new sub-
paragraph: 
‘‘(H) To a non-Department entity (including 
private entities and other departments or agencies of 
the Federal Government) that provides hospital care 
or medical treatment to veterans.’’. 
SEC. 209. CHILD CARE ASSISTANCE FOR VETERANS RE-
CEIVING MENTAL HEALTH CARE AND OTHER 
INTENSIVE HEALTH CARE SERVICES PRO-
VIDED BY THE DEPARTMENT OF VETERANS 
AFFAIRS. 
(a) IN GENERAL.—Subchapter III of chapter 17 of 
title 38, United States Code, is further amended by adding 
at the end the following new section: 
‘‘§ 1730C. Child care assistance for veterans receiving 
mental health care and other intensive 
health care services 
‘‘(a) IN GENERAL.—The Secretary shall provide child 
care assistance to an eligible veteran for any period that 
the veteran— 
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‘‘(1) receives covered health care services at a 
facility of the Department; and 
‘‘(2) is required travel to and return from such 
facility for the receipt of such health care services. 
‘‘(b) CHILD CARE ASSISTANCE.—(1) Child care as-
sistance provided under this section may include any of 
the following: 
‘‘(A) A stipend for the payment of child care of-
fered by a licensed child care center (either directly 
or through a voucher program) which shall be, to 
the extent practicable, modeled after the Depart-
ment of Veterans Affairs Child Care Subsidy Pro-
gram established pursuant to section 590 of title 40. 
‘‘(B) Direct provision of child care at an on-site 
facility of the Department. 
‘‘(C) A payment made directly to a private child 
care agency. 
‘‘(D) A collaboration with a facility or program 
of another Federal department or agency. 
‘‘(E) Such other form of assistance as the Sec-
retary considers appropriate. 
‘‘(2) In the case that child care assistance under this 
section is provided as a stipend under paragraph (1)(A), 
such stipend shall cover the full cost of such child care. 
‘‘(c) DEFINITIONS.—In this section: 
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‘‘(1) The term ‘eligible veteran’ means a vet-
eran who— 
‘‘(A) is the primary caretaker of a child or 
children; and 
‘‘(B) is— 
‘‘(i) receiving covered health care serv-
ices from the Department; or 
‘‘(ii) in need of covered health care 
services, and but for lack of child care 
services, would receive such covered health 
care services from the Department. 
‘‘(2) The term ‘covered health care services’ 
means— 
‘‘(A) regular mental health care services; 
‘‘(B) intensive mental health care services; 
or 
‘‘(C) such other intensive health care serv-
ices that the Secretary determines that provi-
sion of assistance to the veteran to obtain child 
care would improve access to such health care 
services by the veteran.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of such chapter is amended by inserting 
after the item relating to section 1730B, as added by sec-
tion 207, the following new item: 
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‘‘1730C. Child care for veterans receiving mental health care and other intensive 
health care services.’’. 
Subtitle B—Expansion of Care 
SEC. 211. IN VITRO FERTILIZATION FOR CERTAIN DIS-
ABLED VETERANS. 
(a) IN GENERAL.—Subchapter II of chapter 17 of 
title 38, United States Code, is amended by adding at the 
end the following new section: 
‘‘§ 1720H. In vitro fertilization for certain disabled 
veterans 
‘‘(a) IN GENERAL.—In addition to any fertility treat-
ment otherwise furnished by the Secretary under this title, 
if the Secretary determines that in vitro fertilization is 
medically necessary, the Secretary shall furnish in vitro 
fertilization to the covered individual upon the joint re-
quest of the covered individual and the spouse of the cov-
ered individual. 
‘‘(b) LIMITATION ON CYCLES AND ATTEMPTS.—In 
furnishing in vitro fertilization to a covered individual 
under this section, the Secretary may provide not more 
than three in vitro fertilization cycles that result in a total 
of not more than six implantation attempts. 
‘‘(c) STORAGE
AND
DISPOSITION
OF
GAMETES, 
ZYGOTES, AND EMBRYOS.—(1) In carrying out this sec-
tion, the Secretary may provide for cryogenic storage of 
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the gametes, zygotes, and embryos of a covered individual 
only for a period not to exceed three years. 
‘‘(2) During the period of cryogenic storage of the 
gametes, zygotes, or embryos of a covered individual under 
paragraph (1)— 
‘‘(A) any determination regarding the disposi-
tion of the gametes, zygotes, or embryos shall be 
made by the covered individual in accordance with 
the laws of the State in which the gametes, zygotes, 
or embryos are located; and 
‘‘(B) the Secretary shall ensure that any activi-
ties relating to the custody or disposition of the 
gametes, zygotes, or embryos are carried out in ac-
cordance with the laws of the State in which the 
gametes, zygotes, or embryos are located. 
‘‘(3) After the period of cryogenic storage of the 
gametes, zygotes, or embryos of a covered individual under 
paragraph (1), the covered individual— 
‘‘(A) shall be solely responsible for— 
‘‘(i) the custody of the gametes, zygotes, or 
embryos; and 
‘‘(ii) the payment of any costs relating to 
the cryogenic storage of the gametes, zygotes, 
or embryos; and 
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‘‘(B) shall, with respect to any action or inac-
tion by the covered individual relating to custody 
under subparagraph (A)(i) or costs under subpara-
graph (A)(ii), be subject to the laws of the State in 
which the gametes, zygotes, or embryos are located. 
‘‘(4) The Secretary may not possess or store the 
gametes, zygotes, or embryos of a covered individual at 
a facility of the Department. 
‘‘(d) PROHIBITIONS.—In carrying out this section, 
the Secretary may not— 
‘‘(1) provide any benefits or services relating to 
surrogacy; 
‘‘(2) furnish in vitro fertilization that includes 
mitochondrial donation; 
‘‘(3) assist with obtaining a donation of 
gametes, zygotes, or embryos from a third party; or 
‘‘(4) use gametes, zygotes, or embryos for re-
search or cloning. 
‘‘(e) ACKNOWLEDGMENT OF REQUIREMENTS.—The 
Secretary may not furnish in vitro fertilization to a cov-
ered individual under this section unless the covered indi-
vidual acknowledges, in writing— 
‘‘(1) the limitation described in subsection (b); 
and 
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‘‘(2) the period of cryogenic storage of gametes, 
zygotes, and embryos described in subsection (c)(1) 
and the responsibilities of the covered individual 
under subsection (c)(3) after such period. 
‘‘(f) ANNUAL REPORT.—(1) Not later than one year 
after the date of the enactment of the Women Veterans 
and Families Health Services Act of 2015, and not less 
frequently than annually thereafter, the Secretary shall 
submit to the Committee on Veterans’ Affairs of the Sen-
ate and the Committee on Veterans’ Affairs of the House 
of Representatives a report on in vitro fertilization fur-
nished to covered individuals under this section. 
‘‘(2) Each report submitted under paragraph (1) 
shall include the following: 
‘‘(A) With respect to the year preceding the 
submittal of the report, the following: 
‘‘(i) The number of covered individuals 
who sought in vitro fertilization under this sec-
tion. 
‘‘(ii) An identification, in aggregate form 
and excluding individually identifying informa-
tion, of the service-connected conditions de-
scribed in subsection (g)(1)(A)(ii) of such cov-
ered individuals. 
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‘‘(iii) The cost of furnishing in vitro fer-
tilization under this section and a comparison 
of such cost to the cost to a covered individual 
of obtaining in vitro fertilization through the 
private sector without assistance from the De-
partment. 
‘‘(iv) The number of successful implanta-
tions or births that occurred through the use of 
in vitro fertilization furnished under this sec-
tion. 
‘‘(v) The number of individuals that the 
Secretary determined were ineligible for in vitro 
fertilization furnished under this section, in-
cluding the reasons for such ineligibility. 
‘‘(B) The total number, in aggregate form and 
excluding individually identifying information, of in 
vitro fertilization cycles and implantation attempts 
furnished to covered individuals under this section 
and the total number of such cycles and attempts 
that such covered individuals have remaining. 
‘‘(g) DEFINITIONS.—In this section: 
‘‘(1) The term ‘covered individual’ means— 
‘‘(A) a veteran, regardless of sex, who— 
‘‘(i) is enrolled in the system of an-
nual patient enrollment established and op-
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erated by the Secretary under section 
1705(a) of this title; and 
‘‘(ii) has a service-connected condition 
and such condition results in the veteran 
being unable to procreate without the use 
of in vitro fertilization; and 
‘‘(B) a spouse of a veteran described in 
subparagraph (A). 
‘‘(2) The term ‘service-connected condition’ 
means a condition that was incurred or aggravated 
in line of duty in the active military, naval, or air 
service.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of chapter 17 of such title is amended 
by inserting after the item relating to section 1720G the 
following new item: 
‘‘1720H. In vitro fertilization for certain disabled veterans.’’. 
SEC. 212. ADOPTION ASSISTANCE FOR CERTAIN DISABLED 
VETERANS. 
(a) IN GENERAL.—Subchapter II of chapter 17 of 
title 38, United States Code, is further amended by adding 
at the end the following new section: 
‘‘§ 1720I. Adoption assistance for certain disabled vet-
erans 
‘‘(a) IN GENERAL.—The Secretary may pay an 
amount, not to exceed the limitation amount, to assist a 
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covered veteran and the spouse of the covered veteran, if 
any, in the adoption of one or more children. 
‘‘(b) DEFINITIONS.—In this section: 
‘‘(1) The term ‘covered veteran’ means a vet-
eran, regardless of sex, who— 
‘‘(A) is enrolled in the system of annual 
patient enrollment established and operated by 
the Secretary under section 1705(a) of this 
title; and 
‘‘(B) has a service-connected condition and 
such condition results in the veteran being un-
able to procreate without the use of in vitro fer-
tilization. 
‘‘(2) The term ‘limitation amount’ means the 
amount equal to the cost the Department would 
incur by paying the expenses of three adoptions by 
covered veterans, as determined by the Secretary. 
‘‘(3) The term ‘service-connected condition’ 
means a condition that was incurred or aggravated 
in line of duty in the active military, naval, or air 
service.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of chapter 17 of such title is further 
amended by inserting after the item relating to section 
1720H the following new item: 
‘‘1720I. Adoption assistance for certain disabled veterans.’’. 
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SEC. 213. EXPANSION OF ELIGIBILITY FOR PARTICIPATION 
IN AND SERVICES PROVIDED UNDER FAMILY 
CAREGIVER PROGRAM OF DEPARTMENT OF 
VETERANS AFFAIRS. 
(a) FAMILY CAREGIVER PROGRAM.— 
(1) EXPANSION
OF
ELIGIBILITY.—Subsection 
(a)(2)(B) of section 1720G of title 38, United States 
Code, is amended by striking ‘‘on or after September 
11, 2001’’. 
(2) CLARIFICATION OF ELIGIBILITY FOR ILL-
NESS.—Such subsection is further amended by in-
serting ‘‘or illness’’ after ‘‘serious injury’’. 
(3) EXPANSION OF NEEDED SERVICES IN ELI-
GIBILITY CRITERIA.—Subsection (a)(2)(C) of such 
section is amended— 
(A) in clause (ii), by striking ‘‘; or’’ and in-
serting a semicolon; 
(B) by redesignating clause (iii) as clause 
(iv); and 
(C) by inserting after clause (ii) the fol-
lowing new clause (iii): 
‘‘(iii) a need for regular or extensive in-
struction or supervision without which the abil-
ity of the veteran to function in daily life would 
be seriously impaired; or’’. 
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(4) EXPANSION OF SERVICES PROVIDED.—Sub-
section (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 a semicolon; and 
(C) by adding at the end the following new 
subclauses: 
‘‘(VI) child care services or a monthly sti-
pend for such services if such services are not 
readily available from the Department; 
‘‘(VII) financial planning services relating 
to the needs of injured and ill veterans and 
their caregivers; and 
‘‘(VIII) legal services, including legal ad-
vice and consultation, relating to the needs of 
injured and ill veterans and their caregivers.’’. 
(5) EXPANSION OF RESPITE CARE PROVIDED.— 
Subsection (a)(3)(B) of such section is amended by 
striking ‘‘shall be’’ and all that follows through the 
period at the end and inserting ‘‘shall— 
‘‘(i) be medically and age-appropriate; 
‘‘(ii) include in-home care; and 
‘‘(iii) include peer-oriented group activities.’’. 
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(6) MODIFICATION
OF
STIPEND
CALCULA-
TION.—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 fol-
lowing new clause (iii): 
‘‘(iii) In determining the amount and degree of per-
sonal 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 instruc-
tion or supervision under paragraph (2)(C)(iii), the Sec-
retary 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 func-
tion 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, protec-
tion, or instruction to the veteran.’’. 
(7) PERIODIC EVALUATION OF NEED FOR CER-
TAIN SERVICES.—Subsection (a)(3) of such section 
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is amended by adding at the end the following new 
subparagraph: 
‘‘(D) In providing instruction, preparation, and train-
ing 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 nec-
essary.’’. 
(8) USE OF PRIMARY CARE TEAMS.—Subsection 
(a)(5) of such section is amended, in the matter pre-
ceding subparagraph (A), by inserting ‘‘(in collabo-
ration with the primary care team for the eligible 
veteran to the maximum extent practicable)’’ after 
‘‘evaluate’’. 
(9) ELIGIBILITY OF AND ASSISTANCE FOR FAM-
ILY CAREGIVERS.—Subsection (a) of such section is 
amended by adding at the end the following new 
paragraphs: 
‘‘(11) Notwithstanding any other provision of this 
subsection, a family caregiver of an eligible veteran who 
is eligible under paragraph (2) solely because of a serious 
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injury or illness (including traumatic brain injury, psycho-
logical trauma, or other mental disorder) incurred or ag-
gravated in the line of duty in the active military, naval, 
or air service before September 11, 2001, is eligible for 
assistance under this subsection as follows: 
‘‘(A) Not earlier than October 1, 2016, if the 
family caregiver would merit a monthly personal 
caregiver stipend under paragraph (3)(A)(ii)(V) in 
an amount that is in the highest tier specified in the 
schedule established by the Secretary under para-
graph (3)(C)(i). 
‘‘(B) Not earlier than October 1, 2018, if the 
family caregiver would merit such a stipend in an 
amount that is in the middle tier specified in such 
schedule. 
‘‘(C) Not earlier than October 1, 2020, if the 
family caregiver would merit such a stipend in an 
amount that is in the lowest tier specified in such 
schedule. 
‘‘(12)(A) In providing assistance under this sub-
section to family caregivers of eligible veterans, the Sec-
retary may enter into contracts, provider agreements, and 
memoranda of understanding with Federal agencies, 
States, and private, nonprofit, and other entities to pro-
vide such assistance to such family caregivers. 
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‘‘(B) The Secretary may provide assistance under 
this paragraph only if such assistance is reasonably acces-
sible to the family caregiver and is substantially equivalent 
or better in quality to similar services provided by the De-
partment. 
‘‘(C) The Secretary may provide fair compensation 
to Federal agencies, States, and other entities that provide 
assistance under this paragraph. 
‘‘(D) In carrying out this paragraph, the Secretary 
shall work with the interagency working group on policies 
relating to caregivers of veterans and members of the 
Armed Forces established under section 7 of the Military 
and Veteran Caregiver Services Improvement Act of 
2015.’’. 
(b) TERMINATION OF GENERAL CAREGIVER SUP-
PORT PROGRAM.— 
(1) IN GENERAL.—Subsection (b) of such sec-
tion is amended by adding at the end the following 
new paragraph: 
‘‘(6) The authority of the Secretary to provide sup-
port services for caregivers of covered veterans under this 
subsection shall terminate on October 1, 2020.’’. 
(2) CONTINUATION OF CERTAIN ASSISTANCE.— 
The Secretary of Veterans Affairs shall ensure that 
any activities carried out under subsection (b) of 
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such section on September 30, 2020, are continued 
under subsection (a) of such section on and after 
October 1, 2020. 
(c) MODIFICATION OF DEFINITION OF FAMILY MEM-
BER.—Subparagraph (B) of subsection (d)(3) of such sec-
tion is amended to read as follows: 
‘‘(B) is not a member of the family of the 
veteran and does not provide care to the vet-
eran on a professional basis.’’. 
(d) MODIFICATION OF DEFINITION OF PERSONAL 
CARE SERVICES.—Subsection (d)(4) of such section is 
amended— 
(1) in subparagraph (A), by striking ‘‘inde-
pendent’’; 
(2) by redesignating subparagraph (B) as sub-
paragraph (D); and 
(3) by inserting after subparagraph (A) the fol-
lowing 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 vet-
eran to function in daily life would be seriously 
impaired.’’. 
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(e) ANNUAL EVALUATION REPORT.—Paragraph (2) 
of section 101(c) of the Caregivers and Veterans Omnibus 
Health Services Act of 2010 (Public Law 111–163; 38 
U.S.C. 1720G note) is amended to read as follows: 
‘‘(2) CONTENTS.—Each report required by 
paragraph (1) after the date of the enactment of the 
Military and Veteran Caregiver Services Improve-
ment Act of 2015 shall include the following with re-
spect to the program of comprehensive assistance for 
family caregivers required by subsection (a)(1) of 
such section 1720G: 
‘‘(A) The number of family caregivers that 
received assistance under such program. 
‘‘(B) The cost to the Department of pro-
viding assistance under such program. 
‘‘(C) A description of the outcomes 
achieved by, and any measurable benefits of, 
carrying out such program. 
‘‘(D) An assessment of the effectiveness 
and the efficiency of the implementation of such 
program, including a description of any barriers 
to accessing and receiving care and services 
under such program. 
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‘‘(E) A description of the outreach activi-
ties carried out by the Secretary under such 
program. 
‘‘(F) An assessment of the manner in 
which resources are expended by the Secretary 
under such program, particularly with respect 
to the provision of monthly personal caregiver 
stipends under subsection (a)(3)(A)(ii)(V) of 
such section 1720G. 
‘‘(G) 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. 
‘‘(H) Such recommendations, including 
recommendations for legislative or administra-
tive action, as the Secretary considers appro-
priate in light of carrying out such program.’’. 
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SEC. 214. AUTHORITY TO TRANSFER ENTITLEMENT TO 
POST-9/11 
EDUCATIONAL 
ASSISTANCE 
TO 
FAMILY MEMBERS BY SERIOUSLY INJURED 
VETERANS IN NEED OF PERSONAL CARE 
SERVICES. 
(a) IN GENERAL.—Subchapter II of chapter 33 of 
title 38, United States Code, is amended by adding at the 
end the following new section: 
‘‘§ 3319A. Authority to transfer unused education 
benefits to family members by seriously 
injured veterans 
‘‘(a) IN GENERAL.—Subject to the provisions of this 
section, the Secretary may permit an individual described 
in subsection (b) who is entitled to educational assistance 
under this chapter to elect to transfer to one or more of 
the dependents specified in subsection (c) a portion of 
such individual’s entitlement to such assistance, subject 
to the limitation under subsection (d). 
‘‘(b) ELIGIBLE
INDIVIDUALS.—An individual re-
ferred to in subsection (a) is any individual who is de-
scribed in paragraph (2) of section 1720G(a) of this title 
and who is participating in the program established under 
paragraph (1) of such section. 
‘‘(c) ELIGIBLE DEPENDENTS.—An individual ap-
proved to transfer an entitlement to educational assistance 
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under this section may transfer the individual’s entitle-
ment as follows: 
‘‘(1) To the individual’s spouse. 
‘‘(2) To one or more of the individual’s chil-
dren. 
‘‘(3) To a combination of the individuals re-
ferred to in paragraphs (1) and (2). 
‘‘(d) LIMITATION ON MONTHS OF TRANSFER.—(1) 
The total number of months of entitlement transferred by 
an individual under this section may not exceed 36 
months. 
‘‘(2) The Secretary may prescribe regulations that 
would limit the months of entitlement that may be trans-
ferred under this section to no less than 18 months. 
‘‘(e) DESIGNATION OF TRANSFEREE.—An individual 
transferring an entitlement to educational assistance 
under this section shall— 
‘‘(1) designate the dependent or dependents to 
whom such entitlement is being transferred; 
‘‘(2) designate the number of months of such 
entitlement to be transferred to each such depend-
ent; and 
‘‘(3) specify the period for which the transfer 
shall be effective for each dependent designated 
under paragraph (1). 
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‘‘(f) TIME FOR TRANSFER; REVOCATION AND MODI-
FICATION.—(1) Transfer of entitlement to educational as-
sistance under this section shall be subject to the time lim-
itation for use of entitlement under section 3321 of this 
title. 
‘‘(2)(A) An individual transferring entitlement under 
this section may modify or revoke at any time the transfer 
of any unused portion of the entitlement so transferred. 
‘‘(B) The modification or revocation of the transfer 
of entitlement under this paragraph shall be made by the 
submittal of written notice of the action to the Secretary. 
‘‘(3) Entitlement transferred under this section may 
not be treated as marital property, or the asset of a mar-
ital estate, subject to division in a divorce or other civil 
proceeding. 
‘‘(g) COMMENCEMENT OF USE.—A dependent child 
to whom entitlement to educational assistance is trans-
ferred under this section may not commence the use of 
the transferred entitlement until either— 
‘‘(1) the completion by the child of the require-
ments of a secondary school diploma (or equivalency 
certificate); or 
‘‘(2) the attainment by the child of 18 years of 
age. 
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‘‘(h) ADDITIONAL ADMINISTRATIVE MATTERS.—(1) 
The use of any entitlement to educational assistance 
transferred under this section shall be charged against the 
entitlement of the individual making the transfer at the 
rate of one month for each month of transferred entitle-
ment that is used. 
‘‘(2) Except as provided under subsection (e)(2) and 
subject to paragraphs (5) and (6), a dependent to whom 
entitlement is transferred under this section is entitled to 
educational assistance under this chapter in the same 
manner as the individual from whom the entitlement was 
transferred. 
‘‘(3) The monthly rate of educational assistance pay-
able to a dependent to whom entitlement referred to in 
paragraph (2) is transferred under this section shall be 
payable at the same rate as such entitlement would other-
wise be payable under this chapter to the individual mak-
ing the transfer. 
‘‘(4) The death of an individual transferring an enti-
tlement under this section shall not affect the use of the 
entitlement by the dependent to whom the entitlement is 
transferred. 
‘‘(5)(A) A child to whom entitlement is transferred 
under this section may use the benefits transferred with-
out regard to the 15-year delimiting date specified in sec-
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tion 3321 of this title, but may not, except as provided 
in subparagraph (B), use any benefits so transferred after 
attaining the age of 26 years. 
‘‘(B)(i) Subject to clause (ii), in the case of a child 
who, before attaining the age of 26 years, is prevented 
from pursuing a chosen program of education by reason 
of acting as the primary provider of personal care services 
for a veteran or member of the Armed Forces under sec-
tion 1720G(a) of this title, the child may use the benefits 
beginning on the date specified in clause (iii) for a period 
whose length is specified in clause (iv). 
‘‘(ii) Clause (i) shall not apply with respect to the 
period of an individual as a primary provider of personal 
care services if the period concludes with the revocation 
of the individual’s designation as such a primary provider 
under section 1720G(a)(7)(D) of this title. 
‘‘(iii) The date specified in this clause for the begin-
ning of the use of benefits by a child under clause (i) is 
the later of— 
‘‘(I) the date on which the child ceases acting 
as the primary provider of personal care services for 
the veteran or member concerned as described in 
clause (i); 
‘‘(II) the date on which it is reasonably feasible, 
as determined under regulations prescribed by the 
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Secretary, for the child to initiate or resume the use 
of benefits; or 
‘‘(III) the date on which the child attains the 
age of 26 years. 
‘‘(iv) The length of the period specified in this clause 
for the use of benefits by a child under clause (i) is the 
length equal to the length of the period that— 
‘‘(I) begins on the date on which the child be-
gins acting as the primary provider of personal care 
services for the veteran or member concerned as de-
scribed in clause (i); and 
‘‘(II) ends on the later of— 
‘‘(aa) the date on which the child ceases 
acting as the primary provider of personal care 
services for the veteran or member as described 
in clause (i); or 
‘‘(bb) the date on which it is reasonably 
feasible, as so determined, for the child to ini-
tiate or resume the use of benefits. 
‘‘(6) The purposes for which a dependent to whom 
entitlement is transferred under this section may use such 
entitlement shall include the pursuit and completion of the 
requirements of a secondary school diploma (or equiva-
lency certificate). 
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‘‘(7) The administrative provisions of this chapter 
shall apply to the use of entitlement transferred under this 
section, except that the dependent to whom the entitle-
ment is transferred shall be treated as the eligible indi-
vidual for purposes of such provisions. 
‘‘(i) OVERPAYMENT.—In the event of an overpayment 
of educational assistance with respect to a dependent to 
whom entitlement is transferred under this section, the de-
pendent and the individual making the transfer shall be 
jointly and severally liable to the United States for the 
amount of the overpayment for purposes of section 3685 
of this title. 
‘‘(j) REGULATIONS.—(1) The Secretary shall pre-
scribe regulations to carry out this section. 
‘‘(2) Such regulations shall specify— 
‘‘(A) the manner of authorizing the transfer of 
entitlements under this section; 
‘‘(B) the eligibility criteria in accordance with 
subsection (b); and 
‘‘(C) the manner and effect of an election to 
modify or revoke a transfer of entitlement under 
subsection (f)(2).’’. 
(b) CONFORMING AMENDMENTS.— 
(1) TRANSFERS
BY
MEMBERS
OF
ARMED 
FORCES.—The heading of section 3319 of such title 
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is amended by inserting ‘‘by members of the 
Armed Forces’’ after ‘‘family members’’. 
(2) BAR TO DUPLICATION OF EDUCATIONAL AS-
SISTANCE BENEFITS.—Section 3322(e) of such title 
is amended by inserting ‘‘or 3319A’’ after ‘‘and 
3319’’. 
(c) CLERICAL AMENDMENT.—The table of sections 
at the beginning of chapter 33 of such title is amended 
by striking the item relating to section 3319 and inserting 
the following new items: 
‘‘3319. Authority to transfer unused education benefits to family members by 
members of the Armed Forces. 
‘‘3319A. Authority to transfer unused education benefits to family members by 
seriously injured veterans.’’. 
SEC. 215. ENHANCEMENT OF SPECIAL COMPENSATION FOR 
MEMBERS OF THE UNIFORMED SERVICES 
WITH INJURIES OR ILLNESSES REQUIRING 
ASSISTANCE IN EVERYDAY LIVING. 
(a) EXPANSION
OF
COVERED
MEMBERS.—Sub-
section (b) of section 439 of title 37, United States Code, 
is amended— 
(1) by striking paragraphs (1) through (3) and 
inserting the following new paragraphs: 
‘‘(1) has a serious injury or illness that was in-
curred or aggravated in the line of duty; 
‘‘(2) is in need of personal care services (includ-
ing supervision or protection or regular instruction 
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or supervision) as a result of such injury or illness; 
and’’; and 
(2) by redesignating paragraph (4) as para-
graph (3). 
(b) NONTAXABILITY OF SPECIAL COMPENSATION.— 
Such section is further amended— 
(1) by redesignating subsections (e), (f), (g), 
and (h) as subsections (g), (h), (i), and (j), respec-
tively; and 
(2) by inserting after subsection (d) the fol-
lowing new subsection (e): 
‘‘(e) NONTAXABILITY OF COMPENSATION.—Monthly 
special compensation paid under subsection (a) shall not 
be included in income for purposes of the Internal Rev-
enue Code of 1986.’’. 
(c) PROVISION OF ASSISTANCE TO FAMILY CARE-
GIVERS.—Such section is further amended by inserting 
after subsection (e), as amended by subsection (b) of this 
section, the following new subsection (f): 
‘‘(f) ASSISTANCE
FOR FAMILY CAREGIVERS.—(1) 
The Secretary of Veterans Affairs shall provide family 
caregivers of a member in receipt of monthly special com-
pensation under subsection (a) the assistance required to 
be provided to family caregivers of eligible veterans under 
section 1720G(a)(3)(A) of title 38 (other than the monthly 
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personal caregiver stipend provided for in clause (ii)(V) 
of such section). For purposes of the provision of such 
assistance under this subsection, the definitions in section 
1720G(d) of title 38 shall apply, except that any reference 
in such definitions to a veteran or eligible veteran shall 
be deemed to be a reference to the member concerned. 
‘‘(2) The Secretary of Veterans Affairs shall provide 
assistance under this subsection— 
‘‘(A) in accordance with a memorandum of un-
derstanding entered into by the Secretary of Vet-
erans Affairs and the Secretary of Defense; and 
‘‘(B) in accordance with a memorandum of un-
derstanding entered into by the Secretary of Vet-
erans Affairs and the Secretary of Homeland Secu-
rity (with respect to members of the Coast Guard).’’. 
(d) EXPANSION OF COVERED INJURIES AND ILL-
NESSES.—Subsection (i) of such section, as redesignated 
by subsection (b)(1) of this section, is amended to read 
as follows: 
‘‘(i) SERIOUS INJURY OR ILLNESS DEFINED.—In 
this section, the term ‘serious injury or illness’ means an 
injury, disorder, or illness (including traumatic brain in-
jury, psychological trauma, or other mental disorder) 
that— 
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‘‘(1) renders the afflicted person unable to 
carry out one or more activities of daily living; 
‘‘(2) renders the afflicted person in need of su-
pervision or protection due to the manifestation by 
such person of symptoms or residuals of neurological 
or other impairment or injury; 
‘‘(3) renders the afflicted person in need of reg-
ular or extensive instruction or supervision in com-
pleting two or more instrumental activities of daily 
living; or 
‘‘(4) otherwise impairs the afflicted person in 
such manner as the Secretary of Defense (or the 
Secretary of Homeland Security, with respect to the 
Coast Guard) prescribes for purposes of this sec-
tion.’’. 
(e) CLERICAL AMENDMENTS.— 
(1) HEADING AMENDMENT.—The heading for 
such section is amended to read as follows: 
‘‘§ 439. Special compensation: members of the uni-
formed services with serious injuries or 
illnesses requiring assistance in everyday 
living’’. 
(2) TABLE
OF
SECTIONS
AMENDMENT.—The 
table of sections at the beginning of chapter 7 of 
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such title is amended by striking the item relating 
to section 439 and inserting the following new item: 
‘‘439. Special compensation: members of the uniformed services with serious in-
juries or illnesses requiring assistance in everyday living.’’. 
SEC. 216. FLEXIBLE WORK ARRANGEMENTS FOR CERTAIN 
FEDERAL EMPLOYEES. 
(a) DEFINITION OF COVERED EMPLOYEE.—In this 
section, the term ‘‘covered employee’’ means an employee 
(as defined in section 2105 of title 5, United States Code) 
who— 
(1) is a caregiver, as defined in section 1720G 
of title 38, United States Code; or 
(2) is a caregiver of an individual who receives 
compensation under section 439 of title 37, United 
States Code. 
(b) AUTHORITY TO ALLOW FLEXIBLE WORK AR-
RANGEMENTS.—The Director of the Office of Personnel 
Management may promulgate regulations under which a 
covered employee may— 
(1) use a flexible schedule or compressed sched-
ule in accordance with subchapter II of chapter 61 
of title 5, United States Code; or 
(2) telework in accordance with chapter 65 of 
title 5, United States Code. 
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SEC. 217. LIFESPAN RESPITE CARE. 
(a) DEFINITIONS.—Section 2901 of the Public 
Health Service Act (42 U.S.C. 300ii) is amended— 
(1) in paragraph (1)— 
(A) by redesignating subparagraphs (A) 
through (C) as clauses (i) through (iii), respec-
tively, and realigning the margins accordingly; 
(B) by striking ‘‘who requires care or su-
pervision to—’’ and inserting ‘‘who— 
‘‘(A) requires care or supervision to—’’; 
(C) by striking the period and inserting ‘‘; 
or’’; and 
(D) by adding at the end the following: 
‘‘(B) is a veteran participating in the pro-
gram of comprehensive assistance for family 
caregivers under section 1720G(a) of title 38, 
United States Code.’’; and 
(2) in paragraph (5), by striking ‘‘or another 
unpaid adult,’’ and inserting ‘‘another unpaid adult, 
or a family caregiver as defined in section 1720G of 
title 38, United States Code, who receives compensa-
tion under such section,’’. 
(b) GRANTS AND COOPERATIVE AGREEMENTS.—Sec-
tion 2902(c) of the Public Health Service Act (42 U.S.C. 
300ii–1(c)) is amended by inserting ‘‘and the interagency 
working group on policies relating to caregivers of vet-
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erans established under section 7 of the Military and Vet-
eran Caregiver Services Improvement Act of 2015’’ after 
‘‘Human Services’’. 
(c) AUTHORIZATION OF APPROPRIATIONS.—Section 
2905 of the Public Health Service Act (42 U.S.C. 300ii– 
4) is amended by striking ‘‘There are’’ and all that follows 
through ‘‘2011.’’ and inserting ‘‘There are authorized to 
be appropriated to carry out this title $15,000,000 for 
each of fiscal years 2016 through 2020.’’. 
SEC. 218. INTERAGENCY WORKING GROUP ON CAREGIVER 
POLICY. 
(a) ESTABLISHMENT.—There shall be established in 
the executive branch an interagency working group on 
policies relating to caregivers of veterans and members of 
the Armed Forces (in this section referred to as the 
‘‘working group’’). 
(b) COMPOSITION.— 
(1) IN GENERAL.—The working group shall be 
composed of the following: 
(A) A chair selected by the President. 
(B) A representative from each of the fol-
lowing agencies or organizations selected by the 
head of such agency or organization: 
(i) The Department of Veterans Af-
fairs. 
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(ii) The Department of Defense. 
(iii) The Department of Health and 
Human Services. 
(iv) The Department of Labor. 
(v) The Centers for Medicare and 
Medicaid Services. 
(2) ADVISORS.—The chair may select any of 
the following individuals that the chair considers ap-
propriate to advise the working group in carrying 
out the duties of the working group: 
(A) Academic experts in fields relating to 
caregivers. 
(B) Clinicians. 
(C) Caregivers. 
(D) Individuals in receipt of caregiver serv-
ices. 
(c) DUTIES.—The duties of the working group are 
as follows: 
(1) To regularly review policies relating to care-
givers of veterans and members of the Armed 
Forces. 
(2) To coordinate and oversee the implementa-
tion of policies relating to caregivers of veterans and 
members of the Armed Forces. 
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(3) To evaluate the effectiveness of policies re-
lating to caregivers of veterans and members of the 
Armed Forces, including programs in each relevant 
agency, by developing and applying specific goals 
and performance measures. 
(4) To develop standards of care for caregiver 
services and respite care services provided to a care-
giver, veteran, or member of the Armed Forces by 
a nonprofit or private sector entity. 
(5) To ensure the availability of mechanisms for 
agencies, and entities affiliated with or providing 
services on behalf of agencies, to enforce the stand-
ards described in paragraph (4) and conduct over-
sight on the implementation of such standards. 
(6) To develop recommendations for legislative 
or administrative action to enhance the provision of 
services to caregivers, veterans, and members of the 
Armed Forces, including eliminating gaps in such 
services and eliminating disparities in eligibility for 
such services. 
(7) To coordinate with State and local agencies 
and relevant nonprofit organizations on maximizing 
the use and effectiveness of resources for caregivers 
of veterans and members of the Armed Forces. 
(d) REPORTS.— 
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(1) IN GENERAL.—Not later than December 31, 
2015, and annually thereafter, the chair of the work-
ing group shall submit to Congress a report on poli-
cies and services relating to caregivers of veterans 
and members of the Armed Forces. 
(2) ELEMENTS.—Each report required by para-
graph (1) shall include the following: 
(A) An assessment of the policies relating 
to caregivers of veterans and members of the 
Armed Forces and services provided pursuant 
to such policies as of the date of submittal of 
the report. 
(B) A description of any steps taken by 
the working group to improve the coordination 
of services for caregivers of veterans and mem-
bers of the Armed Forces among the entities 
specified in subsection (b)(1)(B) and eliminate 
barriers to effective use of such services, includ-
ing aligning eligibility criteria. 
(C) An evaluation of the performance of 
the entities specified in subsection (b)(1)(B) in 
providing services for caregivers of veterans and 
members of the Armed Forces. 
(D) An evaluation of the quality and suffi-
ciency of services for caregivers of veterans and 
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members of the Armed Forces available from 
nongovernmental organizations. 
(E) A description of any gaps in care or 
services provided by caregivers to veterans or 
members of the Armed Forces identified by the 
working group, and steps taken by the entities 
specified in subsection (b)(1)(B) to eliminate 
such gaps or recommendations for legislative or 
administrative action to address such gaps. 
(F) Such other matters or recommenda-
tions as the chair considers appropriate. 
SEC. 219. STUDIES ON POST-SEPTEMBER 11, 2001, VET-
ERANS AND SERIOUSLY INJURED VETERANS. 
(a) LONGITUDINAL
STUDY
ON
POST-9/11 VET-
ERANS.— 
(1) IN GENERAL.—The Secretary of Veterans 
Affairs shall provide for the conduct of a longitu-
dinal study on members of the Armed Forces who 
commenced service in the Armed Forces after Sep-
tember 11, 2001. 
(2) GRANT OR CONTRACT.—The Secretary shall 
award a grant to, or enter into a contract with, an 
appropriate entity unaffiliated with the Department 
of Veterans Affairs to conduct the study required by 
paragraph (1). 
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100 
(3) PLAN.—Not later than one year 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’ Af-
fairs of the House of Representatives a plan for the 
conduct of the study required by paragraph (1). 
(4) REPORTS.—Not later than October 1, 2019, 
and not less frequently than once every four years 
thereafter, the Secretary shall submit to the Com-
mittee 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 paragraph (1) as of the date of such re-
port. 
(b) COMPREHENSIVE STUDY
ON SERIOUSLY IN-
JURED VETERANS AND THEIR CAREGIVERS.— 
(1) IN GENERAL.—The Secretary of Veterans 
Affairs shall provide for the conduct of a comprehen-
sive study on the following: 
(A) Veterans who have incurred a serious 
injury or illness, including a mental health in-
jury. 
(B) Individuals who are acting as care-
givers for veterans. 
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102 
of the Senate and the Committee on Veterans’ Af-
fairs of the House of Representatives a report on the 
results of the study required by paragraph (1). 
SEC. 220. INCREASE OF MAXIMUM AGE FOR CHILDREN ELI-
GIBLE FOR MEDICAL CARE UNDER CHAMPVA 
PROGRAM. 
(a) INCREASE.—Section 1781(c) of title 38, United 
States Code, is amended— 
(1) by striking ‘‘twenty-three’’ and inserting 
‘‘twenty-six’’; and 
(2) by striking ‘‘twenty-third birthday’’ and in-
serting ‘‘twenty-sixth birthday’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall apply with respect to medical care pro-
vided on or after the date of the enactment of this title. 
SEC. 221. EXPANSION OF REIMBURSEMENT OF VETERANS 
FOR EMERGENCY TREATMENT AND URGENT 
CARE. 
(a) IN GENERAL.—Section 1725 of title 38, United 
States Code, is amended to read as follows: 
‘‘§ 1725. Reimbursement for emergency treatment 
and urgent care 
‘‘(a) IN GENERAL.—(1) Subject to the provisions of 
this section, the Secretary shall reimburse a veteran de-
scribed in subsection (b) for the reasonable value of emer-
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103 
gency treatment or urgent care furnished the veteran in 
a non-Department facility. 
‘‘(2) In any case in which reimbursement of a veteran 
is authorized under paragraph (1), the Secretary may, in 
lieu of reimbursing the veteran, make payment of the rea-
sonable value of the furnished emergency treatment or ur-
gent care directly— 
‘‘(A) to the hospital or other health care pro-
vider that furnished the treatment or care; or 
‘‘(B) to the person or organization that paid for 
such treatment or care on behalf of the veteran. 
‘‘(b) ELIGIBILITY.—A veteran described in this sub-
section is an individual who— 
‘‘(1) is enrolled in the patient enrollment sys-
tem of the Department established and operated 
under section 1705 of this title; and 
‘‘(2) has received care under this chapter dur-
ing the 24-month period preceding the furnishing of 
the emergency treatment or urgent care for which 
reimbursement is sought under this section. 
‘‘(c) 
EMERGENCY
TRANSPORTATION.—Notwith-
standing section 111 of this title, reimbursement of emer-
gency treatment or urgent care under this section shall 
include reimbursement for the reasonable value of emer-
gency transportation. 
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104 
‘‘(d) RESPONSIBILITY
FOR PAYMENT.—The Sec-
retary shall be primarily responsible for reimbursing or 
otherwise paying the reasonable value of emergency treat-
ment or urgent care under this section. 
‘‘(e) LIMITATIONS ON PAYMENT.—(1) The Secretary, 
in accordance with regulations prescribed by the Secretary 
for purposes of this section, shall— 
‘‘(A) establish the maximum amount payable 
under subsection (a); and 
‘‘(B) delineate the circumstances under which 
such payments may be made, including such require-
ments on requesting reimbursement as the Secretary 
may establish. 
‘‘(2)(A) Payment by the Secretary under this section 
on behalf of a veteran to a provider of emergency treat-
ment or urgent care shall, unless rejected and refunded 
by the provider within 30 days of receipt— 
‘‘(i) constitute payment in full for the emer-
gency treatment or urgent care provided; and 
‘‘(ii) extinguish any liability on the part of the 
veteran for that treatment or care. 
‘‘(B) Neither the absence of a contract or agreement 
between the Secretary and a provider of emergency treat-
ment or urgent care nor any provision of a contract, agree-
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105 
ment, or assignment to the contrary shall operate to mod-
ify, limit, or negate the requirements of subparagraph (A). 
‘‘(C) A provider of emergency treatment or urgent 
care may not seek to recover from any third party the 
cost of emergency treatment or urgent care for which the 
provider has received payment from the Secretary under 
this section. 
‘‘(f) RECOVERY.—The United States has the right to 
recover or collect reasonable charges for emergency treat-
ment or urgent care furnished under this section in ac-
cordance with the provisions of section 1729 of this title. 
‘‘(g) COPAYMENTS.—(1) Except as provided in para-
graph (2), a veteran shall pay to the Department a copay-
ment (in an amount prescribed by the Secretary for pur-
poses of this section) for each episode of emergency treat-
ment or urgent care for which reimbursement is provided 
to the veteran under this section. 
‘‘(2) The requirement under paragraph (1) to pay a 
copayment does not apply to a veteran who— 
‘‘(A) would not be required to pay to the De-
partment a copayment for emergency treatment or 
urgent care furnished at facilities of the Depart-
ment; 
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106 
‘‘(B) meets an exemption specified by the Sec-
retary in regulations prescribed by the Secretary for 
purposes of this section; or 
‘‘(C) is admitted to a hospital for treatment or 
observation following, and in connection with, the 
emergency treatment or urgent care for which the 
veteran is provided reimbursement under this sec-
tion. 
‘‘(3) The requirement that a veteran pay a copayment 
under this section shall apply notwithstanding the author-
ity of the Secretary to offset such a requirement with 
amounts recovered from a third party under section 1729 
of this title. 
‘‘(h) DEFINITIONS.—In this section: 
‘‘(1) The term ‘emergency treatment’ means 
medical care or services furnished, in the judgment 
of the Secretary— 
‘‘(A) when such care or services are ren-
dered in a medical emergency of such nature 
that a prudent layperson reasonably expects 
that delay in seeking immediate medical atten-
tion would be hazardous to life or health; and 
‘‘(B) until— 
‘‘(i) such time as the veteran can be 
transferred safely to a Department facility 
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107 
or community care provider authorized by 
the Secretary and such facility or provider 
is capable of accepting such transfer; or 
‘‘(ii) such time as a Department facil-
ity or community care provider authorized 
by the Secretary accepts such transfer if— 
‘‘(I) at the time the veteran could 
have been transferred safely to such a 
facility or provider, no such facility or 
provider agreed to accept such trans-
fer; and 
‘‘(II) the non-Department facility 
in which such medical care or services 
was furnished made and documented 
reasonable attempts to transfer the 
veteran to a Department facility or 
community care provider. 
‘‘(2) The term ‘health-plan contract’ includes 
any of the following: 
‘‘(A) An insurance policy or contract, med-
ical or hospital service agreement, membership 
or subscription contract, or similar arrangement 
under which health services for individuals are 
provided or the expenses of such services are 
paid. 
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