An act to amend title 38, United States Code, to extend certain expiring provisions of law administered by the Secretary of Veterans Affairs, and for other purposes
PL 115-251 (S.3479), enacted 09/29/2018

132 STAT. 3166 
PUBLIC LAW 115–251—SEPT. 29, 2018 
Public Law 115–251 
115th Congress 
An Act 
To amend title 38, United States Code, to extend certain expiring provisions of 
law administered by the Secretary of Veterans Affairs, and for other purposes. 
Be it enacted by the Senate and House of Representatives of 
the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the ‘‘Department 
of Veterans Affairs Expiring Authorities Act of 2018’’. 
(b) TABLE OF CONTENTS.—The table of contents for this Act 
is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. References to title 38, United States Code. 
TITLE I—EXTENSIONS OF AUTHORITY 
Subtitle A—Health Care Matters 
Sec. 101. Extension of authority for collection of copayments for hospital care and 
nursing home care. 
Sec. 102. Extension of requirement to provide nursing home care to certain vet-
erans with service-connected disabilities. 
Sec. 103. Removal of authorization of appropriations to provide assistance and sup-
port services for caregivers. 
Sec. 104. Making permanent authority for recovery from third parties of cost of 
care and services furnished to veterans with health-plan contracts for 
non-service-connected disability. 
Sec. 105. Extension of authority for transfer of real property. 
Sec. 106. Extension of authority for pilot program on assistance for child care for 
certain veterans receiving health care. 
Sec. 107. Extension of authority to make grants to veterans service organizations 
for transportation of highly rural veterans. 
Sec. 108. Extension of authority for pilot program on counseling in retreat settings 
for women veterans newly separated from service. 
Sec. 109. Extension of temporary expansion of payments and allowances for bene-
ficiary travel in connection with veterans receiving care from vet cen-
ters. 
Subtitle B—Benefits Matters 
Sec. 121. Making permanent authority for temporary expansion of eligibility for 
specially adapted housing assistance for certain veterans with disabil-
ities causing difficulty ambulating. 
Sec. 122. Extension of authority for specially adapted housing assistive technology 
grant program. 
Sec. 123. Making permanent authority to guarantee payment of principal and in-
terest on certificates or other securities. 
Sec. 124. Making permanent authority for calculating net value of real property at 
time of foreclosure. 
Sec. 125. Extension of authority relating to vendee loans. 
Sec. 126. Making permanent authority to provide rehabilitation and vocational ben-
efits to members of the Armed Forces with severe injuries or illnesses. 
Sec. 127. Extension of authority to enter into agreement with the National Acad-
emy of Sciences regarding associations between diseases and exposure 
to dioxin and other chemical compounds in herbicides. 
Department of 
Veterans Affairs 
Expiring 
Authorities 
Act of 2018. 
38 USC 101 note. 
Sept. 29, 2018 
[S. 3479] 
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132 STAT. 3167 
PUBLIC LAW 115–251—SEPT. 29, 2018 
Subtitle C—Homeless Veterans Matters 
Sec. 141. Extension of authority for homeless veterans reintegration programs. 
Sec. 142. Extension of authority for homeless women veterans and homeless vet-
erans with children reintegration program. 
Sec. 143. Extension of authority for referral and counseling services for veterans at 
risk of homelessness transitioning from certain institutions. 
Sec. 144. Extension of authority for treatment and rehabilitation services for seri-
ously mentally ill and homeless veterans. 
Sec. 145. Extension of authority for financial assistance for supportive services for 
very low-income veteran families in permanent housing. 
Sec. 146. Extension of authority for grant program for homeless veterans with spe-
cial needs. 
Sec. 147. Extension of authority for the Advisory Committee on Homeless Veterans. 
Subtitle D—Other Matters 
Sec. 161. Extension of authority for transportation of individuals to and from De-
partment of Veterans Affairs facilities. 
Sec. 162. Extension of authority for operation of the Department of Veterans Af-
fairs regional office in Manila, the Republic of the Philippines. 
Sec. 163. Extension of authority for monthly assistance allowances under the Office 
of National Veterans Sports Programs and Special Events. 
Sec. 164. Extension of requirement to provide reports to Congress regarding equi-
table relief in the case of administrative error. 
Sec. 165. Extension of authorization of appropriations for adaptive sports programs 
for disabled veterans and members of the armed forces. 
Sec. 166. Extension of authority for Advisory Committee on Minority Veterans. 
TITLE II—IMPROVEMENT OF HEALTH CARE FROM DEPARTMENT OF 
VETERANS AFFAIRS 
Sec. 201. Treatment of modifications of contracts under Veterans Community Care 
program. 
Sec. 202. Modification of provision requiring recognition and acceptance, on an in-
terim basis, of credentials and qualifications of health care providers 
under community care program. 
Sec. 203. Expansion of coverage of Veterans Care Agreements. 
Sec. 204. Modification of authority for deduction of overpayments for health care. 
Sec. 205. Modification of eligibility of former members of the Armed Forces for 
mental and behavioral health care from the Department of Veterans Af-
fairs. 
Sec. 206. Access of health care providers of the Department of Veterans Affairs to 
drug monitoring programs that do not participate in the national net-
work. 
Sec. 207. Elimination of report on activities and proposals involving contracting for 
performance by contractor personnel of work previously performed by 
Department employees. 
Sec. 208. Additional report on increased availability of opioid receptor antagonists. 
Sec. 209. Expansion of health care assessment to include all territories of the 
United States and the assessment of extended care services. 
Sec. 210. Authorization of major medical facility project at Department of Veterans 
Affairs West Los Angeles Medical Center. 
Sec. 211. Technical amendments to VA MISSION Act of 2018 and amendments 
made by that Act. 
TITLE III—OTHER MATTERS 
Sec. 301. Approval of courses of education provided by public institutions of higher 
education for purposes of training and rehabilitation for veterans with 
service-connected disabilities conditional on in-State tuition rate for vet-
erans. 
Sec. 302. Corrective action for certain Department of Veterans Affairs employees 
for conflicts of interest with educational institutions operated for profit. 
Sec. 303. Modification of compliance requirements for particular leases relating to 
Department of Veterans Affairs West Los Angeles Campus. 
SEC. 2. REFERENCES TO TITLE 38, UNITED STATES CODE. 
Except as otherwise expressly provided, whenever in this Act 
an amendment or repeal is expressed in terms of an amendment 
to, or repeal of, a section or other provision, the reference shall 
be considered to be made to a section or other provision of title 
38, United States Code. 
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132 STAT. 3168 
PUBLIC LAW 115–251—SEPT. 29, 2018 
TITLE I—EXTENSIONS OF AUTHORITY 
Subtitle A—Health Care Matters 
SEC. 101. EXTENSION OF AUTHORITY FOR COLLECTION OF COPAY-
MENTS FOR HOSPITAL CARE AND NURSING HOME CARE. 
Section 1710(f)(2)(B) is amended by striking ‘‘September 30, 
2019’’ and inserting ‘‘September 30, 2020’’. 
SEC. 102. EXTENSION OF REQUIREMENT TO PROVIDE NURSING HOME 
CARE TO CERTAIN VETERANS WITH SERVICE-CONNECTED 
DISABILITIES. 
Section 1710A(d) is amended by striking ‘‘September 30, 2019’’ 
and inserting ‘‘September 30, 2020’’. 
SEC. 103. REMOVAL OF AUTHORIZATION OF APPROPRIATIONS TO PRO-
VIDE ASSISTANCE AND SUPPORT SERVICES FOR CARE-
GIVERS. 
Section 1720G is amended by striking subsection (e). 
SEC. 104. MAKING PERMANENT AUTHORITY FOR RECOVERY FROM 
THIRD PARTIES OF COST OF CARE AND SERVICES FUR-
NISHED TO VETERANS WITH HEALTH-PLAN CONTRACTS 
FOR NON-SERVICE-CONNECTED DISABILITY. 
Section 1729(a)(2)(E) is amended, in the matter preceding 
clause (i), by striking ‘‘before September 30, 2019,’’. 
SEC. 105. EXTENSION OF AUTHORITY FOR TRANSFER OF REAL PROP-
ERTY. 
Section 8118(a)(5) is amended by striking ‘‘December 31, 2018’’ 
and inserting ‘‘September 30, 2020’’. 
SEC. 106. EXTENSION OF AUTHORITY FOR PILOT PROGRAM ON ASSIST-
ANCE 
FOR 
CHILD 
CARE 
FOR 
CERTAIN 
VETERANS 
RECEIVING HEALTH CARE. 
(a) EXTENSION.—Subsection (e) of section 205 of the Caregivers 
and Veterans Omnibus Health Services Act of 2010 (Public Law 
111–163; 124 Stat. 1144; 38 U.S.C. 1710 note) is amended by 
striking ‘‘September 30, 2019’’ and inserting ‘‘September 30, 2020’’. 
(b) AUTHORIZATION OF APPROPRIATIONS.—Subsection (h) of such 
section is amended by striking ‘‘and 2019’’ and inserting ‘‘2019, 
and 2020’’. 
SEC. 107. EXTENSION OF AUTHORITY TO MAKE GRANTS TO VETERANS 
SERVICE 
ORGANIZATIONS 
FOR 
TRANSPORTATION 
OF 
HIGHLY RURAL VETERANS. 
Section 307(d) of the Caregivers and Veterans Omnibus Health 
Services Act of 2010 (Public Law 111–163; 124 Stat. 1154; 38 
U.S.C. 1710 note) is amended by striking ‘‘2019’’ and inserting 
‘‘2020’’. 
SEC. 108. EXTENSION OF AUTHORITY FOR PILOT PROGRAM ON COUN-
SELING IN RETREAT SETTINGS FOR WOMEN VETERANS 
NEWLY SEPARATED FROM SERVICE. 
(a) EXTENSION.—Subsection (d) of section 203 of the Caregivers 
and Veterans Omnibus Health Services Act of 2010 (Public Law 
111–163; 124 Stat. 1143; 38 U.S.C. 1712A note) is amended by 
striking ‘‘September 30, 2019’’ and inserting ‘‘September 30, 2020’’. 
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132 STAT. 3169 
PUBLIC LAW 115–251—SEPT. 29, 2018 
(b) AUTHORIZATION OF APPROPRIATIONS.—Subsection (f) of such 
section is amended by striking ‘‘and 2019’’ and inserting ‘‘2019, 
and 2020’’. 
SEC. 109. EXTENSION OF TEMPORARY EXPANSION OF PAYMENTS AND 
ALLOWANCES FOR BENEFICIARY TRAVEL IN CONNECTION 
WITH VETERANS RECEIVING CARE FROM VET CENTERS. 
Section 104(a) of the Honoring America’s Veterans and Caring 
for Camp Lejeune Families Act of 2012 (Public Law 112–154; 126 
Stat. 1169), as amended by section 109(a) of the Department of 
Veterans Affairs Expiring Authorities Act of 2017 (Public Law 115– 
62; 131 Stat. 1162), is amended by striking ‘‘September 30, 2018’’ 
and inserting ‘‘September 30, 2019’’. 
Subtitle B—Benefits Matters 
SEC. 121. MAKING PERMANENT AUTHORITY FOR TEMPORARY EXPAN-
SION OF ELIGIBILITY FOR SPECIALLY ADAPTED HOUSING 
ASSISTANCE FOR CERTAIN VETERANS WITH DISABILITIES 
CAUSING DIFFICULTY AMBULATING. 
Section 2101(a)(4) is amended by striking ‘‘(A) Except’’ and 
all that follows through ‘‘(B) In each of fiscal years 2014 through 
2018, the Secretary’’ and inserting ‘‘In any fiscal year, the Sec-
retary’’. 
SEC. 122. EXTENSION OF AUTHORITY FOR SPECIALLY ADAPTED 
HOUSING ASSISTIVE TECHNOLOGY GRANT PROGRAM. 
Section 2108(g) is amended by striking ‘‘September 30, 2018’’ 
and inserting ‘‘September 30, 2020’’. 
SEC. 123. MAKING PERMANENT AUTHORITY TO GUARANTEE PAYMENT 
OF PRINCIPAL AND INTEREST ON CERTIFICATES OR 
OTHER SECURITIES. 
Section 3720(h) is amended— 
(1) by striking paragraph (2); and 
(2) by striking ‘‘(1)’’. 
SEC. 124. MAKING PERMANENT AUTHORITY FOR CALCULATING NET 
VALUE OF REAL PROPERTY AT TIME OF FORECLOSURE. 
Section 3732(c) is amended by striking paragraph (11). 
SEC. 125. EXTENSION OF AUTHORITY RELATING TO VENDEE LOANS. 
Section 3733(a)(7) is amended— 
(1) in the matter preceding subparagraph (A), by striking 
‘‘September 30, 2018’’ and inserting ‘‘September 30, 2019’’; and 
(2) in subparagraph (C), by striking ‘‘September 30, 2018,’’ 
and inserting ‘‘September 30, 2019,’’. 
SEC. 126. MAKING PERMANENT AUTHORITY TO PROVIDE REHABILITA-
TION AND VOCATIONAL BENEFITS TO MEMBERS OF THE 
ARMED FORCES WITH SEVERE INJURIES OR ILLNESSES. 
Section 1631(b) of the Wounded Warrior Act (title XVI of Public 
Law 110–181; 10 U.S.C. 1071 note) is amended— 
(1) by striking paragraph (2); and 
(2) by striking ‘‘(1) IN GENERAL.—’’. 
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132 STAT. 3170 
PUBLIC LAW 115–251—SEPT. 29, 2018 
SEC. 127. EXTENSION OF AUTHORITY TO ENTER INTO AGREEMENT 
WITH THE NATIONAL ACADEMY OF SCIENCES REGARDING 
ASSOCIATIONS BETWEEN DISEASES AND EXPOSURE TO 
DIOXIN AND OTHER CHEMICAL COMPOUNDS IN HERBI-
CIDES. 
Section 3(i) of the Agent Orange Act of 1991 (Public Law 
102–4; 38 U.S.C. 1116 note) is amended by striking ‘‘September 
30, 2018’’ and inserting ‘‘September 30, 2020’’. 
Subtitle C—Homeless Veterans Matters 
SEC. 141. EXTENSION OF AUTHORITY FOR HOMELESS VETERANS RE-
INTEGRATION PROGRAMS. 
Section 2021(e)(1)(F) is amended by striking ‘‘2018’’ and 
inserting ‘‘2020’’. 
SEC. 142. EXTENSION OF AUTHORITY FOR HOMELESS WOMEN VET-
ERANS AND HOMELESS VETERANS WITH CHILDREN RE-
INTEGRATION PROGRAM. 
Section 2021A(f)(1) is amended by striking ‘‘2018’’ and inserting 
‘‘2020’’. 
SEC. 143. EXTENSION OF AUTHORITY FOR REFERRAL AND COUN-
SELING SERVICES FOR VETERANS AT RISK OF HOMELESS-
NESS TRANSITIONING FROM CERTAIN INSTITUTIONS. 
Section 2023(d) is amended by striking ‘‘September 30, 2018’’ 
and inserting ‘‘September 30, 2020’’. 
SEC. 
144. 
EXTENSION 
OF 
AUTHORITY 
FOR 
TREATMENT 
AND 
REHABILITATION SERVICES FOR SERIOUSLY MENTALLY 
ILL AND HOMELESS VETERANS. 
(a) GENERAL TREATMENT.—Section 2031(b) is amended by 
striking ‘‘September 30, 2019’’ and inserting ‘‘September 30, 2020’’. 
(b) ADDITIONAL SERVICES
AT CERTAIN LOCATIONS.—Section 
2033(d) is amended by striking ‘‘September 30, 2019’’ and inserting 
‘‘September 30, 2020’’. 
SEC. 145. EXTENSION OF AUTHORITY FOR FINANCIAL ASSISTANCE FOR 
SUPPORTIVE SERVICES FOR VERY LOW-INCOME VETERAN 
FAMILIES IN PERMANENT HOUSING. 
Section 2044(e)(1) is amended by striking subparagraph (F) 
and inserting the following: 
‘‘(F) $340,000,000 for fiscal year 2018. 
‘‘(G) $380,000,000 for fiscal year 2019.’’. 
SEC. 146. EXTENSION OF AUTHORITY FOR GRANT PROGRAM FOR 
HOMELESS VETERANS WITH SPECIAL NEEDS. 
Section 2061(d)(1) is amended by striking ‘‘2019’’ and inserting 
‘‘2020’’. 
SEC. 147. EXTENSION OF AUTHORITY FOR THE ADVISORY COMMITTEE 
ON HOMELESS VETERANS. 
Section 2066(d) is amended by striking ‘‘September 30, 2018’’ 
and inserting ‘‘September 30, 2022’’. 
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132 STAT. 3171 
PUBLIC LAW 115–251—SEPT. 29, 2018 
Subtitle D—Other Matters 
SEC. 161. EXTENSION OF AUTHORITY FOR TRANSPORTATION OF 
INDIVIDUALS TO AND FROM DEPARTMENT OF VETERANS 
AFFAIRS FACILITIES. 
Section 111A(a)(2) is amended by striking ‘‘September 30, 2019’’ 
and inserting ‘‘September 30, 2020’’. 
SEC. 162. EXTENSION OF AUTHORITY FOR OPERATION OF THE 
DEPARTMENT OF VETERANS AFFAIRS REGIONAL OFFICE 
IN MANILA, THE REPUBLIC OF THE PHILIPPINES. 
Section 315(b) is amended by striking ‘‘September 30, 2018’’ 
and inserting ‘‘September 30, 2019’’. 
SEC. 163. EXTENSION OF AUTHORITY FOR MONTHLY ASSISTANCE 
ALLOWANCES UNDER THE OFFICE OF NATIONAL VET-
ERANS SPORTS PROGRAMS AND SPECIAL EVENTS. 
Section 322(d)(4) is amended by striking ‘‘2019’’ and inserting 
‘‘2020’’. 
SEC. 164. EXTENSION OF REQUIREMENT TO PROVIDE REPORTS TO 
CONGRESS REGARDING EQUITABLE RELIEF IN THE CASE 
OF ADMINISTRATIVE ERROR. 
Section 503(c) is amended by striking ‘‘December 31, 2018’’ 
and inserting ‘‘December 31, 2020’’. 
SEC. 165. EXTENSION OF AUTHORIZATION OF APPROPRIATIONS FOR 
ADAPTIVE SPORTS PROGRAMS FOR DISABLED VETERANS 
AND MEMBERS OF THE ARMED FORCES. 
Section 521A is amended— 
(1) in subsection (g)(1), by striking ‘‘2019’’ and inserting 
‘‘2020’’; and 
(2) in subsection (l), by striking ‘‘2019’’ and inserting ‘‘2020’’. 
SEC. 166. EXTENSION OF AUTHORITY FOR ADVISORY COMMITTEE ON 
MINORITY VETERANS. 
(a) EXTENSION OF AUTHORITY.—Subsection (e) of section 544 
is amended by striking ‘‘September 30, 2018’’ and inserting ‘‘Sep-
tember 30, 2022’’. 
(b) MODIFICATION
OF REPORTING REQUIREMENT.—Subsection 
(c)(1) of such section is amended, in the matter preceding subpara-
graph (A), by striking ‘‘each year’’ and inserting ‘‘every other year’’. 
TITLE II—IMPROVEMENT OF HEALTH 
CARE FROM DEPARTMENT OF VET-
ERANS AFFAIRS 
SEC. 201. TREATMENT OF MODIFICATIONS OF CONTRACTS UNDER VET-
ERANS COMMUNITY CARE PROGRAM. 
(a) IN GENERAL.—Section 1703(h)(1) is amended— 
(1) by striking ‘‘The Secretary shall’’ and inserting ‘‘(A) 
The Secretary shall’’; and 
(2) by adding at the end the following new subparagraph: 
‘‘(B) For purposes of subparagraph (A), the requirement to 
enter into consolidated, competitively bid contracts shall not restrict 
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132 STAT. 3172 
PUBLIC LAW 115–251—SEPT. 29, 2018 
the authority of the Secretary under other provisions of law when 
modifying such a contract after entering into the contract.’’. 
(b) EFFECTIVE DATE.—The amendments made by subsection 
(a) shall take effect on the effective date specified in section 101(b) 
of the John S. McCain III, Daniel K. Akaka, and Samuel R. Johnson 
VA Maintaining Internal Systems and Strengthening Integrated 
Outside Networks Act of 2018 (Public Law 115–182). 
SEC. 202. MODIFICATION OF PROVISION REQUIRING RECOGNITION 
AND ACCEPTANCE, ON AN INTERIM BASIS, OF CREDEN-
TIALS AND QUALIFICATIONS OF HEALTH CARE PROVIDERS 
UNDER COMMUNITY CARE PROGRAM. 
Section 1703(h)(5)(A) is amended by striking ‘‘the date of the 
enactment’’ and inserting ‘‘the effective date specified in section 
101(b)’’. 
SEC. 203. EXPANSION OF COVERAGE OF VETERANS CARE AGREE-
MENTS. 
(a) IN GENERAL.—Section 1703A is amended by adding at the 
end the following new subsection: 
‘‘(l) COVERED INDIVIDUAL DEFINED.—In this section, the term 
‘covered individual’ means any individual eligible for hospital care, 
medical services, or extended care services under this title or any 
other law administered by the Secretary.’’. 
(b) CONFORMING AMENDMENTS.—Section 1703A is amended— 
(1) in subsection (a)(1)— 
(A) in subparagraph (A), by striking ‘‘veteran’’ each 
place it appears and inserting ‘‘covered individual’’; and 
(B) in subparagraph (C)— 
(i) by striking ‘‘veteran’’ and inserting ‘‘covered 
individual’’; and 
(ii) by striking ‘‘veteran’s’’ and inserting ‘‘covered 
individual’s’’; 
(2) in subsection (e)(2)(B), by striking ‘‘veteran’’ each place 
it appears and inserting ‘‘covered individual’’; 
(3) in subsection (f)(2)— 
(A) in subparagraph (C), by striking ‘‘veterans’’ and 
inserting ‘‘covered individuals’’; and 
(B) in subparagraph (D), by striking ‘‘veteran’’ and 
inserting ‘‘covered individual’’; 
(4) in subsection (g), by striking ‘‘to veterans’’ and inserting 
‘‘to covered individuals’’; and 
(5) in subsection (j)— 
(A) by striking ‘‘any veteran’’ and inserting ‘‘any cov-
ered individual’’; and 
(B) by striking ‘‘to veterans’’ each place it appears 
and inserting ‘‘to covered individuals’’. 
SEC. 204. MODIFICATION OF AUTHORITY FOR DEDUCTION OF OVER-
PAYMENTS FOR HEALTH CARE. 
Section 1703D(e)(1) is amended— 
(1) by striking ‘‘shall’’ and inserting ‘‘may’’; and 
(2) by inserting before the period at the end the following: 
‘‘and may use any other means authorized by another provision 
of law to correct or recover overpayments’’. 
38 USC 1703 
note. 
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132 STAT. 3173 
PUBLIC LAW 115–251—SEPT. 29, 2018 
SEC. 205. MODIFICATION OF ELIGIBILITY OF FORMER MEMBERS OF 
THE ARMED FORCES FOR MENTAL AND BEHAVIORAL 
HEALTH CARE FROM THE DEPARTMENT OF VETERANS 
AFFAIRS. 
Section 1720I(b)(3) is amended by striking ‘‘is not otherwise 
eligible to enroll’’ and inserting ‘‘is not enrolled’’. 
SEC. 206. ACCESS OF HEALTH CARE PROVIDERS OF THE DEPARTMENT 
OF VETERANS AFFAIRS TO DRUG MONITORING PROGRAMS 
THAT DO NOT PARTICIPATE IN THE NATIONAL NETWORK. 
Section 1730B is amended— 
(1) in subsection (a)— 
(A) in paragraph (1), by inserting ‘‘, or any individual 
State or regional prescription drug monitoring program,’’ 
after ‘‘programs’’; 
(B) in paragraph (2)(A), by striking ‘‘such network’’ 
and inserting ‘‘the national network of State-based prescrip-
tion monitoring programs, or, if providing care in a State 
that does not participate in such national network, an 
individual State or regional prescription drug monitoring 
program,’’; and 
(C) in paragraph (3), by inserting ‘‘, or any individual 
State or regional prescription drug monitoring program,’’ 
after programs; and 
(2) in subsection (c)(2) by inserting ‘‘, or any individual 
State or regional prescription drug monitoring program,’’ after 
‘‘programs’’. 
SEC. 207. ELIMINATION OF REPORT ON ACTIVITIES AND PROPOSALS 
INVOLVING CONTRACTING FOR PERFORMANCE BY CON-
TRACTOR 
PERSONNEL 
OF 
WORK 
PREVIOUSLY 
PER-
FORMED BY DEPARTMENT EMPLOYEES. 
Section 8110 is amended— 
(1) by striking subsection (c); and 
(2) by redesignating subsections (d), (e), and (f) as sub-
sections (c), (d), and (e), respectively. 
SEC. 208. ADDITIONAL REPORT ON INCREASED AVAILABILITY OF 
OPIOID RECEPTOR ANTAGONISTS. 
Section 911(e)(2) of the Jason Simcakoski Memorial and 
Promise Act (Public Law 114–198; 38 U.S.C. 1701 note) is amended 
by inserting ‘‘and not later than one year after the date of the 
enactment of the Department of Veterans Affairs Expiring Authori-
ties Act of 2018’’ before ‘‘the Secretary shall’’. 
SEC. 209. EXPANSION OF HEALTH CARE ASSESSMENT TO INCLUDE 
ALL TERRITORIES OF THE UNITED STATES AND THE 
ASSESSMENT OF EXTENDED CARE SERVICES. 
Section 213 of the John S. McCain III, Daniel K. Akaka, and 
Samuel R. Johnson VA Maintaining Internal Systems and Strength-
ening Integrated Outside Networks Act of 2018 (Public Law 115– 
182) is amended— 
(1) in the section header, by striking ‘‘PACIFIC
TERRI-
TORIES’’ and inserting ‘‘TERRITORIES OF THE UNITED STATES’’; 
(2) in subsection (a)— 
(A) by striking ‘‘180 days’’ and inserting ‘‘270 days’’; 
and 
Ante, p. 1462. 
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132 STAT. 3174 
PUBLIC LAW 115–251—SEPT. 29, 2018 
(B) by striking ‘‘Pacific territories’’ and inserting ‘‘terri-
tories of the United States’’; 
(3) in subsection (b)— 
(A) in paragraph (1)— 
(i) in the matter preceding subparagraph (A), by 
striking ‘‘Pacific territories’’ and inserting ‘‘territories 
of the United States’’; and 
(ii) by adding at the end the following: 
‘‘(E) Extended care.’’; and 
(B) in paragraph (2)— 
(i) by striking ‘‘community-based outpatient clinic’’ 
and inserting ‘‘medical facility’’; and 
(ii) by striking ‘‘Pacific territory’’ and inserting 
‘‘territory of the United States’’; and 
(4) in subsection (c)— 
(A) by striking ‘‘Pacific territories’’ and inserting ‘‘terri-
tories of the United States’’; 
(B) by striking ‘‘and’’; and 
(C) by inserting before the period at the end the fol-
lowing: ‘‘, Puerto Rico, and the United States Virgin 
Islands’’. 
SEC. 210. AUTHORIZATION OF MAJOR MEDICAL FACILITY PROJECT 
AT DEPARTMENT OF VETERANS AFFAIRS WEST LOS 
ANGELES MEDICAL CENTER. 
(a) IN GENERAL.—The Secretary of Veterans Affairs may carry 
out the major medical facility project described in subsection (b) 
in fiscal year 2019, in an amount not to exceed $35,000,000. 
(b) MAJOR MEDICAL FACILITY PROJECT.—The major medical 
facility project described in this subsection is the construction of 
a new regional food services facility building on the campus of 
the medical center of the Department of Veterans Affairs in West 
Los Angeles, California, to replace the seismically deficient Building 
300, Regional Food Service Facility, which is located on the north 
campus of the medical center as of the date of the enactment 
of this Act. 
SEC. 211. TECHNICAL AMENDMENTS TO VA MISSION ACT OF 2018 AND 
AMENDMENTS MADE BY THAT ACT. 
(a) TITLE 38.— 
(1) ANNUAL
REPORT
ON
PERFORMANCE
AWARDS
AND 
BONUSES.—Section 726(c)(3) is amended by striking ‘‘, United 
States Code’’. 
(2) VETERANS CARE AGREEMENTS.—Section 1703A(h)(4) is 
amended by striking ‘‘, United States Code’’. 
(3) ACCESS STANDARDS.—Section 1703B(i) is amended— 
(A) by striking ‘‘(1) The term’’ and inserting ‘‘In this 
section: 
‘‘(1) The term’’; 
(B) in paragraph (1), by moving subparagraphs (A) 
and (B) two ems to the right; 
(C) by moving paragraph (2) two ems to the right; 
and 
(D) in paragraph (2), by striking ‘‘refers to’’ and 
inserting ‘‘means’’. 
(4) 
STANDARDS
FOR
QUALITY.—Section 
1703C(c) 
is 
amended— 
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132 STAT. 3175 
PUBLIC LAW 115–251—SEPT. 29, 2018 
(A) by striking ‘‘(c)(1) The term’’ and inserting ‘‘(c) 
DEFINITIONS.— In this section: 
‘‘(1) The term’’; 
(B) in paragraph (1), by moving subparagraphs (A) 
and (B) two ems to the right; 
(C) by moving paragraph (2) two ems to the right; 
and 
(D) in paragraph (2), by striking ‘‘refers to’’ and 
inserting ‘‘means’’. 
(5) PROMPT
PAYMENT
STANDARD.—Section 1703D(g)(3) is 
amended by striking ‘‘of this Act, as amended by the Caring 
for Our Veterans Act of 2018,’’ and inserting ‘‘of this title’’. 
(6) REMEDIATION
OF
MEDICAL
SERVICE
LINES.—Section 
1706A is amended— 
(A) in subsection (a), in the matter preceding paragraph 
(1), by inserting ‘‘of this title’’ after ‘‘section 1703(e)(1)’’; 
and 
(B) in subsection (d)(1), by striking ‘‘paragraph (1)’’ 
and inserting ‘‘subsection (a)’’. 
(7) WALK-IN CARE.—Section 1725A is amended— 
(A) in subsection (c), by striking ‘‘or other agreement’’ 
and inserting ‘‘agreement, or other arrangement’’; and 
(B) in subsection (f)(4), by striking ‘‘Section 8153(c)’’ 
and inserting ‘‘Sections 8153(c) and 1703A(j)’’. 
(8) AUTHORITY TO RECOVER THE COST OF SERVICES FUR-
NISHED
FOR
NON-SERVICE-CONNECTED
DISABILITIES.—Section 
1729(a)(2)(D) is amending by striking the period at the end 
and inserting ‘‘; or’’. 
(9) 
AGREEMENTS
WITH
STATE
HOMES.—Section 
1745(a)(4)(B)(ii)(III) is amended by striking ‘‘subchapter V of 
chapter 17 of this title’’ and inserting ‘‘this subchapter’’. 
(10) TRANSPLANT
PROCEDURES
WITH
LIVE
DONORS
AND 
RELATED
SERVICES.—Section 1788(c) is amended by striking 
‘‘this chapter’’ and inserting ‘‘this title’’. 
(11) QUADRENNIAL
VETERANS
HEALTH
ADMINISTRATION 
REVIEW.—Section 7330C is amended— 
(A) in subsection (a)— 
(i) in paragraph (1), by striking ‘‘Secretary of Vet-
erans Affairs’’ and inserting ‘‘Secretary’’; 
(ii) in paragraph (2)— 
(I) in subparagraph (B), by striking ‘‘Depart-
ment of Veterans Affairs’’ and inserting ‘‘Depart-
ment’’; 
(II) in subparagraph (C), by striking ‘‘of title 
38, as added by section 102’’ and inserting ‘‘of 
this title’’; and 
(III) in subparagraph (H)(i), by striking 
‘‘Department of Veterans Affairs’’ and inserting 
‘‘Department’’; and 
(iii) in paragraph (4)— 
(I) in subparagraph (A)(iii), by inserting ‘‘of 
this title’’ after ‘‘section 1703C’’; and 
(II) in subparagraph (B), by inserting ‘‘of this 
title’’ after ‘‘section 1703(b)’’; 
(B) in subsection (b)(2)(I), by inserting ‘‘of this title’’ 
after ‘‘section 1706A’’; and 
(C) in subsection (c)— 
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132 STAT. 3176 
PUBLIC LAW 115–251—SEPT. 29, 2018 
(i) in paragraph (1), by striking ‘‘such high per-
forming’’ and inserting ‘‘a high-performing’’; and 
(ii) in paragraph (3), by inserting ‘‘such’’ before 
‘‘a high-performing’’. 
(12) DEPARTMENT OF VETERANS AFFAIRS SPECIALTY EDU-
CATION
LOAN
REPAYMENT
PROGRAM.—Section 7693(a)(1) is 
amended by striking ‘‘is hired’’ and inserting ‘‘will be eligible 
for appointment’’. 
(b) VA MISSION ACT.— 
(1) TRAINING
PROGRAM
FOR
ADMINISTRATION
OF
NON- 
DEPARTMENT HEALTH CARE.—Section 122(a)(2) of the John S. 
McCain III, Daniel K. Akaka, and Samuel R. Johnson VA 
Maintaining Internal Systems and Strengthening Integrated 
Outside Networks Act of 2018 (Public Law 115–182) is amended 
by striking ‘‘such title’’ and inserting ‘‘title 38, United States 
Code’’. 
(2) PROCESSES
FOR
SAFE
OPIOID
PRESCRIBING
PRACTICES 
BY NON-DEPARTMENT PROVIDERS.—Section 131 of the John S. 
McCain III, Daniel K. Akaka, and Samuel R. Johnson VA 
Maintaining Internal Systems and Strengthening Integrated 
Outside Networks Act of 2018 (Public Law 115–182) is 
amended— 
(A) in subsection (c)(1)— 
(i) by inserting ‘‘of title 38, United States Code,’’ 
after ‘‘section 1703(a)(2)(A)’’; 
(ii) by striking ‘‘of this title’’ each place it appears 
and inserting ‘‘of this Act’’; and 
(iii) by inserting ‘‘of such title’’ after ‘‘section 
1703A(e)(2)(F)’’; and 
(B) in subsection (d), by striking ‘‘covered veterans’’ 
each place it appears and inserting ‘‘veterans’’. 
(3) PLANS
FOR
SUPPLEMENTAL
APPROPRIATIONS.—Section 
141 of the John S. McCain III, Daniel K. Akaka, and Samuel 
R. Johnson VA Maintaining Internal Systems and Strength-
ening Integrated Outside Networks Act of 2018 (Public Law 
115–182) is amended by striking ‘‘Whenever the Secretary’’ 
and inserting ‘‘Whenever the Secretary of Veterans Affairs’’. 
(4) 
TELEMEDICINE
REPORTING
REQUIREMENT.—Section 
151(c)(1) of the John S. McCain III, Daniel K. Akaka, and 
Samuel R. Johnson VA Maintaining Internal Systems and 
Strengthening Integrated Outside Networks Act of 2018 (Public 
Law 115–182) is amended by striking ‘‘section 1730B’’ and 
inserting ‘‘section 1730C’’. 
(5) EXPANSION OF FAMILY CAREGIVER PROGRAM.—Section 
161(a)(1)(B) of the John S. McCain III, Daniel K. Akaka, and 
Samuel R. Johnson VA Maintaining Internal Systems and 
Strengthening Integrated Outside Networks Act of 2018 (Public 
Law 115–182) is amended by striking ‘‘such title’’ and inserting 
‘‘title 38, United States Code’’. 
(6) SPECIALTY EDUCATION LOAN REPAYMENT PROGRAM.—Sec-
tion 303 of the John S. McCain III, Daniel K. Akaka, and 
Samuel R. Johnson VA Maintaining Internal Systems and 
Strengthening Integrated Outside Networks Act of 2018 (Public 
Law 115–182) is amended— 
(A) in subsection (d), by inserting ‘‘of Veterans Affairs’’ 
after ‘‘Department’’; and 
Ante, p. 1467. 
Ante, p. 1439. 
Ante, p. 1431. 
Ante, p. 1429. 
Ante, p. 1425. 
Ante, p. 1424. 
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132 STAT. 3177 
PUBLIC LAW 115–251—SEPT. 29, 2018 
(B) in subsection (e), in the matter preceding paragraph 
(1), by striking ‘‘established’’ and inserting ‘‘under sub-
chapter VIII of chapter 76 of title 38, United States Code, 
as enacted’’. 
(7) VETERANS
HEALING
VETERANS
MEDICAL
ACCESS
AND 
SCHOLARSHIP PROGRAM.—Section 304 of the John S. McCain 
III, Daniel K. Akaka, and Samuel R. Johnson VA Maintaining 
Internal Systems and Strengthening Integrated Outside Net-
works Act of 2018 (Public Law 115–182) is amended— 
(A) in subsection (a), by striking ‘‘covered medical 
schools’’ and inserting ‘‘covered medical school’’; and 
(B) in subsection (b)— 
(i) in paragraph (2), by striking ‘‘entitled to’’ and 
inserting ‘‘concurrently receiving’’; 
(ii) in paragraph (3), by striking ‘‘2019’’ and 
inserting ‘‘2020’’; and 
(iii) in paragraph (6), by striking ‘‘subsection (e)’’ 
and inserting ‘‘subsection (d)’’; 
(C) in subsection (c)— 
(i) in paragraph (1), by striking ‘‘2019’’ and 
inserting ‘‘2020’’; and 
(ii) in paragraph (3), by striking ‘‘2019’’ and 
inserting ‘‘2020’’; 
(D) in subsection (e), by striking ‘‘2019’’ and inserting 
‘‘2020’’; and 
(E) in subsection (f), by striking ‘‘December 31, 2020’’ 
and inserting ‘‘December 31, 2021’’. 
(8) DEVELOPMENT OF CRITERIA FOR DESIGNATION OF CER-
TAIN MEDICAL FACILITIES AS UNDERSERVED FACILITIES AND PLAN 
TO ADDRESS PROBLEM OF UNDERSERVED FACILITIES.—Section 401 
of the John S. McCain III, Daniel K. Akaka, and Samuel 
R. Johnson VA Maintaining Internal Systems and Strength-
ening Integrated Outside Networks Act of 2018 (Public Law 
115–182) is amended— 
(A) in subsection (b)(5), by adding ‘‘or the applicable 
access standards developed under section 1703B of title 
38, United States Code’’ after ‘‘the wait-time goals of the 
Department’’; and 
(B) in subsection (d)(2)(A), by striking ‘‘section 407’’ 
and inserting ‘‘section 402’’. 
(9) PILOT PROGRAM ON GRADUATE MEDICAL EDUCATION AND 
RESIDENCY.—Section 403(b)(4) of the John S. McCain III, Daniel 
K. Akaka, and Samuel R. Johnson VA Maintaining Internal 
Systems and Strengthening Integrated Outside Networks Act 
of 2018 (Public Law 115–182) is amended by inserting ‘‘under’’ 
after ‘‘an agreement’’. 
(10) DEPARTMENT OF VETERANS AFFAIRS MEDICAL SCRIBE 
PILOT PROGRAM.—Section 507 of the John S. McCain III, Daniel 
K. Akaka, and Samuel R. Johnson VA Maintaining Internal 
Systems and Strengthening Integrated Outside Networks Act 
of 2018 (Public Law 115–182) is amended— 
(A) in subsection (b)(3), by striking ‘‘as determine’’ 
and inserting ‘‘as determined’’; and 
(B) in subsection (c)(2)(C), by striking ‘‘speciality’’ and 
inserting ‘‘specialty’’. 
Ante, p. 1479. 
Ante, p. 1473. 
Ante, p. 1470. 
Ante, p. 1467. 
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132 STAT. 3178 
PUBLIC LAW 115–251—SEPT. 29, 2018 
TITLE III—OTHER MATTERS 
SEC. 301. APPROVAL OF COURSES OF EDUCATION PROVIDED BY 
PUBLIC INSTITUTIONS OF HIGHER EDUCATION FOR PUR-
POSES OF TRAINING AND REHABILITATION FOR VET-
ERANS WITH SERVICE-CONNECTED DISABILITIES CONDI-
TIONAL ON IN-STATE TUITION RATE FOR VETERANS. 
(a) IN GENERAL.—Section 3679(c) is amended— 
(1) in paragraph (1), by striking ‘‘chapter 30 or 33’’ and 
inserting ‘‘chapter 30, 31, or 33’’; 
(2) in paragraph (2), by adding at the end the following 
new subparagraph: 
‘‘(C) An individual who is entitled to rehabilitation under 
section 3102(a) of this title.’’; 
(3) in paragraph (3), by striking ‘‘paragraph (2)(A) or (2)(B)’’ 
and inserting ‘‘paragraph (2)(A), (2)(B), or (2)(C)’’; and 
(4) in paragraph (6), by striking ‘‘chapters 30 and 33’’ 
and inserting ‘‘chapters 30, 31, and 33’’. 
(b) APPLICABILITY.—The amendments made by subsection (a) 
shall apply with respect to courses of education provided during 
a quarter, semester, or term, as applicable, that begins after March 
1, 2019. 
SEC. 302. CORRECTIVE ACTION FOR CERTAIN DEPARTMENT OF VET-
ERANS 
AFFAIRS 
EMPLOYEES 
FOR 
CONFLICTS 
OF 
INTEREST WITH EDUCATIONAL INSTITUTIONS OPERATED 
FOR PROFIT. 
(a) IN GENERAL.—Section 3683 of title 38, United States Code, 
is amended— 
(1) by striking subsection (a) and inserting the following: 
‘‘(a) DEPARTMENT OFFICERS AND EMPLOYEES.—(1) An officer 
or employee of the Department shall receive corrective action or 
disciplinary action if such officer or employee— 
‘‘(A) has, while serving as such an officer or employee, 
owned any interest in, or received any wage, salary, dividend, 
profit, or gift from, any educational institution operated for 
profit; or 
‘‘(B) has, while serving as a covered officer or employee 
of the Department, received any service from any educational 
institution operated for profit. 
‘‘(2) In this subsection, the term ‘covered officer or employee 
of the Department’ means an officer or employee of the Department 
who— 
‘‘(A) works on the administration of benefits under chapter 
30, 31, 32, 33, 34, 35, or 36 of this title; or 
‘‘(B) has a potential conflict of interest involving an edu-
cational institution operated for profit, as determined by the 
Secretary.’’; 
(2) in subsection (b)— 
(A) by striking ‘‘If the Secretary’’ and inserting the 
following: 
‘‘(b) STATE APPROVING AGENCY EMPLOYEES.—If the Secretary’’; 
(B) by striking ‘‘wages, salary, dividends, profits, gratu-
ities, or services’’ and inserting ‘‘wage, salary, dividend, 
profit, or gift’’; 
38 USC 3679 
note. 
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132 STAT. 3179 
PUBLIC LAW 115–251—SEPT. 29, 2018 
(C) by striking ‘‘in which an eligible person or veteran 
was pursuing a program of education or course under this 
chapter or chapter 34 or 35 of this title’’; 
(D) by striking ‘‘terminate the employment of’’ and 
inserting ‘‘provide corrective action or disciplinary action 
with respect to’’; and 
(E) by striking ‘‘while such person is an officer or 
employee of the State approving agency, or State depart-
ment of veterans’ affairs or State department of education’’ 
and inserting ‘‘until the completion of such corrective action 
or disciplinary action’’; 
(3) in subsection (c)— 
(A) by striking ‘‘A State approving agency’’ and 
inserting the following: 
‘‘(c) DISAPPROVAL
OF COURSES.—A State approving agency’’; 
(B) by striking ‘‘of Veterans Affairs’’; and 
(C) by striking ‘‘wages, salary, dividends, profits, gratu-
ities, or services’’ and inserting ‘‘wage, salary, dividend, 
profit, or gift’’; and 
(4) in subsection (d)— 
(A) by striking ‘‘The Secretary may’’ and inserting the 
following: 
‘‘(d) WAIVER AUTHORITY.—(1) The Secretary may’’; 
(B) by striking ‘‘of Veterans Affairs’’; 
(C) by striking ‘‘, after reasonable notice and public 
hearings,’’; and 
(D) by adding at the end the following new paragraph: 
‘‘(2) The Secretary shall provide public notice of any waiver 
granted under this subsection by not later than 30 days after 
the date on which such waiver is granted.’’. 
(b) EFFECTIVE DATE.—The amendments made by subsection 
(a) shall take effect on the date of the enactment of this Act 
and shall apply with respect to conflicts of interest that occur 
on or after that date. 
SEC. 303. MODIFICATION OF COMPLIANCE REQUIREMENTS FOR PAR-
TICULAR LEASES RELATING TO DEPARTMENT OF VET-
ERANS AFFAIRS WEST LOS ANGELES CAMPUS. 
Section 2(h)(1) of the West Los Angeles Leasing Act of 2016 
(Public Law 114–226) is amended by striking ‘‘any lease or land- 
sharing agreement at the Campus’’ and inserting ‘‘any new lease 
38 USC 3683 
note. 
Notification. 
Deadline. 
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132 STAT. 3180 
PUBLIC LAW 115–251—SEPT. 29, 2018 
LEGISLATIVE HISTORY—S. 3479: 
CONGRESSIONAL RECORD, Vol. 164 (2018): 
Sept. 18, considered and passed Senate. 
Sept. 25, considered and passed House. 
or land-sharing agreement at the Campus that is not in compliance 
with such laws’’. 
Approved September 29, 2018. 
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