,,ii ,calendar ,no4 #dfg #aadth         
,,congress  #b;d ,session  ,s4 #biba    
,,in ,,the ,,senate ,,of ,,the ,,united 
,,states  ,may #aa1 #bjaf,mr4 ,isakson  
7for himself1 ,mr4 ,blumenthal1 ,mr4    
,tillis1 ,mr4 ,tester1 ,mr4 ,udall1 ,mr4
 ,bennet1 ,mr4 ,rounds1 ,mrs4           
,feinstein1 ,mr4 ,boozman1 ,mr4 ,heller1
 ,mrs4 ,murray1 ,mr4 ,manchin1 ,ms4     
,hirono1 ,mr4 ,brown1 ,mr4 ,leahy1 ,mr4 
,daines1 ,mr4 ,sullivan1 ,mrs4 ,shaheen1
 ,mr4 ,durbin1 ,mr4 ,nelson1 ,ms4       
,cantwell1 ,ms4 ,baldwin1 ,mr4 ,casey1  
,mr4 ,kaine1 ,mr4 ,booker1 ,mr4 ,schatz1
 ,mr4 ,moran1 ,mr4 ,blunt1 ,mr4         
,franken1 ,ms4 ,klobuchar1 ,mr4         
,heinrich1 ,mrs4 ,mc,caskill1 ,mr4      
,murphy1 and ,mr4 ,whitehouse7          
introduced the following bill2 which was
 read twice and referred to the         
,committee on ,veterans' ,affairs  ,may 
#af1 #bjaf,reported by ,mr4 ,isakson1   
without amendment  ,a ,,bill  ,to amend 
title #ch1 ,united ,states ,code1 to    
improve the accountability of employees 

of the ,department of ,veterans         
,affairs1 to improve health care and    
benefits for veterans1 and for other    
purposes4  #a4 ,short title2 table of   
contents  7a7 ,short title ,this ,act   
may be cited as the ,veterans ,first    
,act4  7b7 ,table of contents ,the table
 of contents for this ,act is as        
follows3 ,sec4 #a4 ,short title2 table  
of contents4,,title ,i--,personnel and  
accountability matters,subtitle         
,a--,office of ,accountability and      
,whistleblower ,protection,sec4 #aja4   
,office of ,accountability and          
,whistleblower ,protection4,sec4 #ajb4  
,protection of whistleblowers in        
,department of ,veterans ,affairs4,sec4 
#ajc4 ,treatment of congressional       
testimony by ,department of ,veterans   
,affairs employees as official          
duty4,sec4 #ajd4 ,report on methods used
 to investigate employees of ,department
 of ,veterans ,affairs4,subtitle        
,b--,supervisors and senior             
executives,sec4 #aaa4 ,treatment of     

,medical ,center ,directors and         
,directors of ,veterans ,integrated     
,service ,networks4,sec4 #aab4 ,pay for 
,medical ,center ,directors and         
,directors of ,veterans ,integrated     
,service ,networks4,sec4 #aac4 ,improved
 authorities of ,secretary of ,veterans 
,affairs to improve accountability of   
senior executives4,sec4 #aad4 ,reduction
 of benefits for members of the ,senior 
,executive ,service within the          
,department of ,veterans ,affairs       
convicted of certain crimes4,sec4 #aae4 
,independent review and assessment of   
management training and appraisal at    
,department of ,veterans ,affairs4,sec4 
#aaf4 ,accountability of leaders for    
managing the ,department of ,veterans   
,affairs4,sec4 #aag4 ,accountability of 
supervisors at ,department of ,veterans 
,affairs for hiring well-qualified      
people4,sec4 #aah4 ,accountability of   
supervisors at ,department of ,veterans 
,affairs for addressing performance of  
employees4,sec4 #aai4 ,improvement of   

training for supervisors4,sec4 #abj4    
,assessment and report on effect on     
senior executives at ,department of     
,veterans ,affairs4,subtitle            
,c--,employees,sec4 #aba4 ,removal of   
employees of ,department of ,veterans   
,affairs based on performance or        
misconduct4,sec4 #abb4 ,prohibition on  
award of bonuses to employees of        
,department of ,veterans ,affairs under 
consideration for adverse actions or    
subject of adverse findings4,sec4 #abc4 
,retention of records of reprimands and 
admonishments received by employees of  
the ,department of ,veterans            
,affairs4,sec4 #abd4 ,limitation on     
administrative leave for employees of   
,department of ,veterans ,affairs4,sec4 
#abe4 ,measurement of ,department of    
,veterans ,affairs disciplinary process 
outcomes and effectiveness4,subtitle    
,d--,other personnel and accountability 
matters,sec4 #aca4 ,written opinion on  
certain employment restrictions after   
terminating employment with the         

,department of ,veterans ,affairs4,sec4 
#acb4 ,requirement for contractors of   
the ,department employing certain       
recently separated ,department          
employees4,sec4 #acc4 ,department of    
,veterans ,affairs program of internal  
audits4,,title ,,ii--,health care       
matters,sec4 #bjj4 ,short               
title4,subtitle ,a--,expansion and      
improvement of health care benefits,sec4
 #bja4 ,improved access to appropriate  
immunizations for veterans4,sec4 #bjb4  
,expansion of provision of chiropractic 
care and services to veterans4,sec4     
#bjc4 ,priority of medal of honor       
recipients in health care system of     
,department of ,veterans                
,affairs4,subtitle ,b--,mental health   
care,sec4 #baa4 ,veterans ,expedited    
,recovery ,commission4,sec4 #bab4       
,mental health treatment for veterans   
who served in classified missions4,sec4 
#bac4 ,inclusion of mental health       
professionals in education and training 
program for health personnel of the     

,department of ,veterans ,affairs4,sec4 
#bad4 ,expansion of qualifications for  
licensed mental health counselors of the
 ,department of ,veterans ,affairs to   
include doctoral degrees4,subtitle      
,c--,improvement of medical             
workforce,sec4 #bba4 ,modification of   
hours of employment for physicians and  
physician assistants employed by the    
,department of ,veterans ,affairs4,sec4 
#bbb4 ,requirement that physician       
assistants employed by the ,department  
of ,veterans ,affairs receive           
competitive pay4,sec4 #bbc4 ,extension  
of period for increase in graduate      
medical education residency positions at
 medical facilities of the ,department  
of ,veterans ,affairs4,sec4 #bbd4       
,additional requirements for hiring of  
health care providers by ,department of 
,veterans ,affairs4,sec4 #bbe4          
,provision of information on health care
 providers of ,department of ,veterans  
,affairs to ,state medical boards4,sec4 
#bbf4 ,report on medical workforce of   

the ,department of ,veterans            
,affairs4,sec4 #bbg4 ,report on         
compliance by ,department of ,veterans  
,affairs with reviews of health care    
providers leaving the ,department or    
transferring to other                   
facilities4,subtitle ,d--,family        
caregivers,sec4 #bca4 ,expansion of     
family caregiver program of ,department 
of ,veterans ,affairs4,sec4 #bcb4       
,implementation of information          
technology system of ,department of     
,veterans ,affairs to assess and improve
 the family caregiver program4,sec4     
#bcc4 ,modifications to annual          
evaluation report on caregiver program  
of ,department of ,veterans             
,affairs4,sec4 #bcd4 ,advisory committee
 on caregiver policy4,sec4 #bce4        
,comprehensive study on seriously       
injured veterans and their              
caregivers4,subtitle ,e--,health care   
administration,sec4 #bda4 ,requirement  
that ,department of ,veterans ,affairs  
collect health-plan contract information

 from veterans4,sec4 #bdb4 ,expansion of
 availability of prosthetic and orthotic
 care for veterans4,sec4 #bdc4 ,revival 
of ,intermediate ,care ,technician      
,pilot ,program of ,department of       
,veterans ,affairs4,sec4 #bdd4 ,transfer
 of health care provider credentialing  
data from ,secretary of ,defense to     
,secretary of ,veterans ,affairs4,sec4  
#bde4 ,authority to place certain       
veterans in non-,department of ,veterans
 ,affairs medical foster homes upon     
request4,sec4 #bdf4 ,examination and    
treatment by ,department of ,veterans   
,affairs for emergency medical          
conditions and women in labor4,sec4     
#bdg4 ,comptroller ,general audit of    
budget of ,veterans ,health             
,administration4,sec4 #bdh4 ,annual     
report on ,veterans ,health             
,administration and furnishing of       
hospital care1 medical services1 and    
nursing home care4,subtitle ,f--,opioid 
therapy and pain management,sec4 #bea4  
,guidelines on management of opioid     

therapy by ,department of ,veterans     
,affairs and ,department of ,defense and
 implementation of such guidelines by   
,department of ,veterans ,affairs4,sec4 
#beb4 ,improvement of opioid safety     
measures by ,department of ,veterans    
,affairs4,sec4 #bec4 ,enhancement of    
joint working group on pain management  
of the ,department of ,veterans ,affairs
 and the ,department of ,defense4,sec4  
#bed4 ,review1 investigation1 and report
 on use of opioids in treatment by      
,department of ,veterans ,affairs4,sec4 
#bee4 ,elimination of copayment         
requirement for veterans receiving      
opioid antagonists or education on use  
of opioid antagonists4,subtitle         
,g--,patient advocacy and outreach,sec4 
#bfa4 ,establishment of ,office of      
,patient ,advocacy of the ,department of
 ,veterans ,affairs4,sec4 #bfb4         
,community meetings on improving care   
from ,department of ,veterans           
,affairs4,sec4 #bfc4 ,outreach to       
veterans regarding effect of certain    

delayed payments by ,chief ,business    
,office of ,department of ,veterans     
,affairs4,sec4 #bfd4 ,improvement of    
awareness of patient advocacy program   
and patient bill of rights of           
,department of ,veterans ,affairs4,sec4 
#bfe4 ,comptroller ,general ,report on  
,patient ,advocacy ,program of          
,department of ,veterans                
,affairs4,subtitle ,h--,administration  
of non-,department health care,sec4     
#bga4 ,payment of non-,department of    
,veterans ,affairs health care          
providers4,sec4 #bgb4 ,authorization of 
agreements between the ,department of   
,veterans ,affairs and non-,department  
providers4,sec4 #bgc4 ,elimination of   
requirement to act as secondary payer   
for care relating to                    
non-service-connected disabilities under
 ,choice ,program4,sec4 #bgd4           
,requirement for advance appropriations 
for the ,medical ,community ,care       
account of the ,department of ,veterans 
,affairs4,sec4 #bge4 ,annual transfer of

 amounts within ,department of ,veterans
 ,affairs to pay for health care from   
non-,department health care             
providers4,sec4 #bgf4 ,authorization of 
use of certain amounts appropriated to  
the ,veterans ,choice ,fund for other   
non-,department of ,veterans ,affairs   
care4,sec4 #bgg4 ,applicability of      
,directive of ,office of ,federal       
,contract ,compliance                   
,programs4,subtitle ,i--,research on    
toxic exposure,sec4 #bha4               
,definitions4,sec4 #bhb4 ,national      
,academy of ,medicine assessment on     
research relating to the descendants of 
individuals with toxic exposure4,sec4   
#bhc4 ,advisory board on research       
relating to health conditions of        
descendants of veterans with toxic      
exposure while serving in the ,armed    
,forces4,sec4 #bhd4 ,research relating  
to health conditions of descendants of  
veterans with toxic exposure while      
serving in the ,armed ,forces4,subtitle 
,j--,other health care matters,sec4     

#bia4 ,authorization of certain major   
medical facility projects of the        
,department of ,veterans ,affairs4,sec4 
#bib4 ,identification and tracking of   
biological implants used in ,department 
of ,veterans ,affairs medical           
facilities4,sec4 #bic4 ,procurement of  
biological implants used in ,department 
of ,veterans ,affairs medical           
facilities4,sec4 #bid4 ,expansion of    
research and education on and delivery  
of complementary and integrative health 
to veterans4,sec4 #bie4 ,pilot program  
on integration of complementary and     
integrative health within ,department of
 ,veterans ,affairs medical             
centers4,sec4 #bif4 ,report on public   
access to research by ,department of    
,veterans ,affairs4,,title              
,,iii--,disability compensation and     
pension,sec4 #cja4 ,expedited payment of
 survivor's benefits4,sec4 #cjb4        
,increase in special pension for ,medal 
of ,honor recipients4,sec4 #cjc4 ,board 
of ,veterans' ,appeals video            

hearings4,sec4 #cjd4 ,improvements to   
authority for performance of medical    
disabilities examinations by contract   
physicians4,sec4 #cje4 ,department of   
,veterans ,affairs pilot program on     
fully developed appeals4,sec4 #cjf4     
,requirement that ,secretary of         
,veterans ,affairs publish the average  
time required to adjudicate timely and  
untimely appeals4,sec4 #cjg4            
,comptroller ,general review of claims  
processing performance of regional      
offices of ,veterans ,benefits          
,administration4,sec4 #cjh4 ,report on  
participation of veterans service       
organizations in ,transition ,assistance
 ,program4,sec4 #cji4 ,inclusion in     
annual budget submission of information 
on capacity of ,veterans ,benefits      
,administration to process benefits     
claims4,sec4 #caj4 ,report on staffing  
levels at regional offices of           
,department of ,veterans ,affairs after 
transition to ,national ,work           
,queue4,sec4 #caa4 ,annual report on    

progress in implementing ,veterans      
,benefits ,management ,system4,sec4     
#cab4 ,report on plans of ,secretary of 
,veterans ,affairs to reduce inventory  
of non-rating workload4,sec4 #cac4      
,sense of ,congress on increased        
transparency relating to claims for     
benefits and appeals of decisions       
relating to benefits in ,monday ,morning
 ,workload ,report4,sec4 #cad4 ,sense of
 ,congress regarding ,american veterans 
disabled for life4,sec4 #cae4 ,sense of 
,congress on submittal of information   
relating to claims for disabilities     
incurred or aggravated by military      
sexual trauma4,,title                   
,,iv--,education,subtitle               
,a--,educational assistance and         
vocational rehabilitation,sec4 #dja4    
,clarification of eligibility for       
,marine ,gunnery ,sergeant ,john ,david 
,fry ,scholarship4,sec4 #djb4           
,restoration of entitlement to          
,post-#i_/aa ,educational ,assistance   
for veterans affected by closures of    

educational institutions4,sec4 #djc4    
,consideration of eligibility for       
,post-#i_/aa ,educational ,assistance   
for certain time on active duty in      
reserve components of ,armed            
,forces4,sec4 #djd4 ,approval of courses
 of education and training for purposes 
of the vocational rehabilitation program
 of the ,department of ,veterans        
,affairs4,sec4 #dje4 ,authority to      
prioritize vocational rehabilitation    
services based on need4,sec4 #djf4      
,codification and improvement of        
election process for ,post-#i_/aa       
,educational ,assistance ,program4,sec4 
#djg4 ,work-study allowance4,sec4 #djh4 
,retention of entitlement to educational
 assistance during certain additional   
periods of active duty4,sec4 #dji4      
,eligibility for ,post-#i_/aa           
,educational ,assistance for certain    
members of reserve components of ,armed 
,forces who lost entitlement to         
educational assistance under ,reserve   
,educational ,assistance ,program4,sec4 

#daj4 ,reports on progress of students  
receiving ,post-#i_/aa ,educational     
,assistance4,subtitle                   
,b--,administration of educational      
assistance,sec4 #dba4 ,centralized      
reporting of veteran enrollment by      
certain groups1 districts1 and          
consortiums of educational              
institutions4,sec4 #dbb4 ,provision of  
information regarding veteran           
entitlement to educational              
assistance4,sec4 #dbc4 ,role of ,state  
approving agencies4,sec4 #dbd4 ,criteria
 used to approve courses4,sec4 #dbe4    
,modification of requirements for       
approval for purposes of educational    
assistance provided by ,department of   
,veterans ,affairs of programs designed 
to prepare individuals for licensure or 
certification4,sec4 #dbf4 ,compliance   
surveys4,sec4 #dbg4 ,survey of          
individuals using their entitlement to  
educational assistance under the        
educational assistance programs         
administered by the ,secretary of       

,veterans ,affairs4,sec4 #dbh4          
,technical amendment relating to        
in-,state tuition rate for individuals  
to whom entitlement is transferred under
 ,all-,volunteer ,force ,educational    
,assistance ,program and ,post-#i_/aa   
,educational ,assistance4,,title        
,v--,employment and transition,sec4     
#eja4 ,required coordination between    
,directors for ,veterans' ,employment   
and ,training with ,state departments of
 labor and veterans affairs4,sec4 #ejb4 
,longitudinal study of job counseling1  
training1 and placement service for     
veterans4,,title ,,vi--,homeless        
veterans,subtitle ,a--,homeless matters 
generally,sec4 #fja4 ,expansion of      
definition of homeless veteran for      
purposes of benefits under the laws     
administered by the ,secretary of       
,veterans ,affairs4,sec4 #fjb4          
,increased per diem payments for        
transitional housing assistance that    
becomes permanent housing for homeless  
veterans4,sec4 #fjc4 ,clarification of  

eligibility for services under homeless 
veterans reintegration programs4,sec4   
#fjd4 ,program to improve retention of  
housing by formerly homeless veterans   
and veterans at risk of becoming        
homeless4,sec4 #fje4 ,pilot program on  
provision of intensive case management  
interventions to homeless veterans who  
receive the most health care from the   
,department of ,veterans ,affairs4,sec4 
#fjf4 ,establishment of ,national       
,center on ,homelessness ,among         
,veterans4,sec4 #fjg4 ,administrative   
improvements to grant and per diem      
programs of ,department of ,veterans    
,affairs4,sec4 #fjh4 ,partnerships with 
public and private entities to provide  
legal services to homeless veterans and 
veterans at risk of homelessness4,sec4  
#fji4 ,comptroller ,general of the      
,united ,states study on homeless       
veterans programs of ,department of     
,veterans ,affairs4,sec4 #faj4          
,requirement for ,department of         
,veterans ,affairs to assess            

comprehensive service programs for      
homeless veterans4,sec4 #faa4 ,report on
 outreach relating to increasing the    
amount of housing available to          
veterans4,subtitle ,b--,eligibility of  
homeless veterans for benefits,sec4     
#fba4 ,waiver of minimum period of      
continuous active duty in ,armed ,forces
 for certain benefits for homeless      
veterans4,sec4 #fbb4 ,authorization to  
furnish certain benefits to homeless    
veterans with discharges or releases    
under other than honorable              
conditions4,sec4 #fbc4 ,modification of 
definition of veteran for purposes of   
providing certain benefits to homeless  
veterans4,sec4 #fbd4 ,training of       
personnel of the ,department of         
,veterans ,affairs and grant            
recipients4,sec4 #fbe4 ,authorization of
 per diem payments for furnishing care  
to dependents of certain homeless       
veterans4,sec4 #fbf4 ,regulations4,sec4 
#fbg4 ,effective date4,,title           
,,vii--,united ,states ,court of        

,appeals for ,veterans ,claims,sec4     
#gja4 ,extension of temporary increase  
in number of judges on ,united ,states  
,court of ,appeals for ,veterans        
,claims4,sec4 #gjb4 ,life insurance     
program relating to judges of ,united   
,states ,court of ,appeals for ,veterans
 ,claims4,sec4 #gjc4 ,voluntary         
contributions to enlarge survivors'     
annuity4,sec4 #gjd4 ,selection of chief 
judge of ,united ,states ,court of      
,appeals for ,veterans ,claims4,,title  
,,viii--,burial benefits,sec4 #hja4     
,expansion of eligibility for           
medallions4,sec4 #hjb4 ,inurnment of    
cremated remains in ,arlington ,national
 ,cemetery of certain persons whose     
service is deemed to be active          
service4,sec4 #hjc4 ,report on capacity 
of ,arlington ,national ,cemetery4,sec4 
#hjd4 ,department of ,veterans ,affairs 
study on matters relating to burial of  
unclaimed remains of veterans in        
national cemeteries4,,title ,,ix--,other
 matters,sec4 #ija4 ,authority to enter 

into certain leases at the ,department  
of ,veterans ,affairs ,west ,los        
,angeles ,campus4,sec4 #ijb4            
,restoration of prior reporting fee     
multipliers4,sec4 #ijc4 ,repeal         
inapplicability of modification of basic
 allowance for housing to benefits under
 laws administered by ,secretary of     
,veterans ,affairs4,sec4 #ijd4          
,observance of ,veterans ,day4,sec4     
#ije4 ,honoring as veterans certain     
persons who performed service in the    
reserve components of the ,armed        
,forces4,sec4 #ijf4 ,extension of       
requirement for collection of fees for  
housing loans guaranteed by ,secretary  
of ,veterans ,affairs4  ,i ,personnel   
and accountability matters  ,a ,office  
of ,accountability and ,whistleblower   
,protection  #aja4 ,office of           
,accountability and ,whistleblower      
,protection  7a7 ,in general ,chapter #c
 of title #ch1 ,united ,states ,code1 is
 amended by adding at the end the       
following new section3  #cbc4 ,office of

 ,accountability and ,whistleblower     
,protection  7a7 ,establishment ,there  
is established in the ,department an    
office to be known as the ,office of    
,accountability and ,whistleblower      
,protection 7in this section referred to
 as the ,office74  7b7 ,head of ,office 
7#a7 ,the head of the ,office shall be  
responsible for the functions of the    
,office and shall be appointed by the   
,president pursuant to section #cjh7;a7 
of this title4  7#b7 ,the head of the   
,office shall be known as the ,assistant
 ,secretary for ,accountability and     
,whistleblower ,protection4  7#c7 ,the  
,assistant ,secretary shall report      
directly to the ,secretary on all       
matters relating to the ,office4  7#d7  
,notwithstanding section #cjh7;b7 of    
this title1 the ,secretary may only     
assign to the ,assistant ,secretary     
responsibilities relating to the        
functions of the ,office set forth in   
subsection 7c74  7c7 ,functions  7#a7   
,the functions of the ,office are as    

follows3 7,a7 ,advising the ,secretary  
on all matters of the ,department       
relating to accountability1 including   
accountability of employees of the      
,department1 retaliation against        
whistleblowers1 and such matters as the 
,secretary considers similar and affect 
public trust in the ,department4  7,b7  
,issuing reports and providing          
recommendations related to the duties   
described in subparagraph 7,a74  7,c7   
,receiving whistleblower disclosures4   
7,d7 ,referring whistleblower           
disclosures received under subparagraph 
7,c7 for investigation to the ,office of
 the ,medical ,inspector1 the ,office of
 ,inspector ,general1 or other          
investigative entity1 as appropriate1 if
 the ,assistant ,secretary has reason to
 believe the whistleblower disclosure is
 evidence of a violation of a provision 
of law1 mismanagement1 gross waste of   
funds1 abuse of authority1 or a         
substantial and specific danger to      
public health and safety4  7,e7         

,receiving and referring disclosures    
from the ,special ,counsel for          
investigation to the ,medical ,inspector
 of the ,department1 the ,inspector     
,general of the ,department1 or such    
other person with investigatory         
authority1 as the ,assistant ,secretary 
considers appropriate4  7,f7 ,recording1
 tracking1 reviewing1 and confirming    
implementation of recommendations from  
audits and investigations carried out by
 the ,inspector ,general of the         
,department1 the ,medical ,inspector of 
the ,department1 the ,special ,counsel1 
and the ,comptroller ,general of the    
,united ,states1 including the          
imposition of disciplinary actions and  
other corrective actions contained in   
such recommendations4  7,g7 ,analyzing  
data from the ,office and the ,office of
 ,inspector ,general telephone hotlines1
 other whistleblower disclosures1       
disaggregated by facility and area of   
health care if appropriate1 and relevant
 audits and investigations to identify  

trends and issue reports to the         
,secretary based on analysis conducted  
under this subparagraph4  7,h7          
,receiving1 reviewing1 and investigating
 allegations of misconduct1 retaliation1
 or poor performance involving--  7i7 an
 individual in a senior executive       
position 7as defined in section #gac7;d7
 of this title7 in the ,department2     
7ii7 an individual employed in a        
confidential1 policy-making1            
policy-determining1 or policy-advocating
 position in the ,department2 or  7iii7 
a supervisory employee1 if the          
allegation involves retaliation against 
an employee for making a whistleblower  
disclosure4  7,i7 ,making such          
recommendations to the ,secretary for   
disciplinary action as the ,assistant   
,secretary considers appropriate after  
substantiating any allegation of        
misconduct or poor performance pursuant 
to an investigation carried out as      
described in subparagraph 7,f7 or 7,h74 
7#b7 ,in carrying out the functions of  

the ,office1 the ,assistant ,secretary  
shall ensure that the ,office maintains 
a toll-free telephone number and        
,internet website to receive anonymous  
whistleblower disclosures4  7#c7 ,in any
 case in which the ,assistant ,secretary
 receives a whistleblower disclosure    
from an employee of the ,department     
under paragraph 7#a77;,c71 the          
,assistant ,secretary may not disclose  
the identity of the employee without the
 consent of the employee1 except in     
accordance with the provisions of       
section #eeb;a of title #e1 or as       
required by any other applicable        
provision of ,federal law4  7d7 ,staff  
and resources ,the ,secretary shall     
ensure that the ,assistant ,secretary   
has such staff1 resources1 and access to
 information as may be necessary to     
carry out the functions of the ,office4 
7e7 ,relation to ,office of ,general    
,counsel ,the ,office shall not be      
established as an element of the ,office
 of the ,general ,counsel and the       

,assistant ,secretary may not report to 
the ,general ,counsel4  7f7 ,reports    
7#a7 7,a7 ,not later than ,june #cj of  
each calendar year1 beginning with ,june
 #cj1 #bjag1 the ,assistant ,secretary  
shall submit to the ,committee on       
,veterans' ,affairs of the ,senate and  
the ,committee on ,veterans' ,affairs of
 the ,house of ,representatives a report
 on the activities of the ,office during
 the calendar year in which the report  
is submitted4  7,b7 ,each report        
submitted under subparagraph 7,a7 shall 
include1 for the period covered by the  
report1 the following3  7i7 ,a full and 
substantive analysis of the activities  
of the ,office1 including such          
statistical information as the          
,assistant ,secretary considers         
appropriate4  7ii7 ,identification of   
any issues reported to the ,secretary   
under subsection 7c77#a77;,g71 including
 such data as the ,assistant ,secretary 
considers relevant to such issues and   
any trends the ,assistant ,secretary may

 have identified with respect to such   
issues4  7iii7 ,identification of such  
concerns as the ,assistant ,secretary   
may have regarding the size1 staffing1  
and resources of the ,office and such   
recommendations as the ,assistant       
,secretary may have for legislative or  
administrative action to address such   
concerns4  7iv7 ,such recommendations as
 the ,assistant ,secretary may have for 
legislative or administrative action to 
improve--  7,i7 the process by which    
concerns are reported to the ,office2   
and  7,,ii7 the protection of           
whistleblowers within the ,department4  
7v7 ,such other matters as the          
,assistant ,secretary considers         
appropriate regarding the functions of  
the ,office or other matters relating to
 the ,office4  7#b7 ,if the ,secretary  
receives a recommendation for           
disciplinary action under subsection    
7c77#a77;,i7 and does not take or       
initiate the recommended disciplinary   
action before the date that is #fj days 

after the date on which the ,secretary  
received the recommendation1 the        
,secretary shall submit to the          
,committee on ,veterans' ,affairs of the
 ,senate and the ,committee on          
,veterans' ,affairs of the ,house of    
,representatives a detailed             
justification for not taking or         
initiating such disciplinary action4    
7g7 ,definitions ,in this section3 7#a7 
,the term supervisory employee means an 
employee of the ,department who is a    
supervisor as defined in section        
#gajc7;a7 of title #e4  7#b7 ,the term  
whistleblower means one who makes a     
whistleblower disclosure4  7#c7 ,the    
term whistleblower disclosure means any 
disclosure of information by an employee
 of the ,department or individual       
applying to become an employee of the   
,department which the employee or       
individual reasonably believes          
evidences--  7,a7 a violation of a      
provision of law2 or  7,b7 gross        
mismanagement1 a gross waste of funds1  

an abuse of authority1 or a substantial 
and specific danger to public health or 
safety4  4  7b7 ,conforming amendment   
,section #cjh7;b7 of such title is      
amended by adding at the end the        
following new paragraph3  7#ab7 ,the    
functions set forth in section #cbc7;c7 
of this title4  4  7c7 ,clerical        
amendment ,the table of sections at the 
beginning of chapter #c of such title is
 amended by adding at the end the       
following new item3  #cbc4 ,office of   
,accountability and ,whistleblower      
,protection4  4  #ajb4 ,protection of   
whistleblowers in ,department of        
,veterans ,affairs  7a7 ,in general     
,chapter #g of title #ch1 ,united       
,states ,code1 is amended by adding at  
the end the following new sections3     
#gbj4 ,protection of whistleblowers as  
criteria in evaluation of supervisors   
7a7 ,development and use of criteria    
required ,the ,secretary1 in            
consultation with the ,assistant        
,secretary of ,accountability and       

,whistleblower ,protection1 shall       
develop criteria that--  7#a7 the       
,secretary shall use as a critical      
element in any evaluation of the        
performance of a supervisory employee2  
and  7#b7 promotes the protection of    
whistleblowers4  7b7 ,principles for    
protection of whistleblowers ,the       
criteria required by subsection 7a7     
shall include principles for the        
protection of whistleblowers1 such as   
the degree to which supervisory         
employees respond constructively when   
employees of the ,department report     
concerns1 take responsible action to    
resolve such concerns1 and foster an    
environment in which employees of the   
,department feel comfortable reporting  
concerns to supervisory employees or to 
the appropriate authorities4  7c7       
,supervisory employee and whistleblower 
defined ,in this section1 the terms     
supervisory employee and whistleblower  
have the meanings given such terms in   
section #cbc of this title4  #gba4      

,training regarding whistleblower       
disclosures  7a7 ,training ,not less    
frequently than once every two years1   
the ,secretary1 in coordination with the
 ,whistleblower ,protection ,ombudsman  
designated under section #c7;d77#a77;,c7
 of the ,inspector ,general ,act of     
#aigh 7#e ,u4,s4,c4 ,app471 shall       
provide to each employee of the         
,department training regarding          
whistleblower disclosures1 including--  
7#a7 an explanation of each method      
established by law in which an employee 
may file a whistleblower disclosure2    
7#b7 the right of the employee to       
petition ,congress regarding a          
whistleblower disclosure in accordance  
with section #gbaa of title #e2  7#c7 an
 explanation that the employee may not  
be prosecuted or reprised against for   
disclosing information to ,congress1 the
 ,inspector ,general1 or another        
investigatory agency in instances where 
such disclosure is permitted by law1    
including under sections #egja1 #egje1  

and #ggcb of this title1 under section  
#eeb;a of title #e 7commonly referred to
 as the ,privacy ,act71 under chapter   
#ic of title #ah1 and pursuant to       
regulations promulgated under section   
#bfd7;c7 of the ,health ,insurance      
,portability and ,accountability ,act of
 #aiif 7,public ,law #ajd-aia72  7#d7 an
 explanation of the language that is    
required to be included in all          
nondisclosure policies1 forms1 and      
agreements pursuant to section          
#aae7;a77#a7 of the ,whistleblower      
,protection ,enhancement ,act of #bjab  
7#e ,u4,s4,c4 #bcjb note72 and  7#e7 the
 right of contractors to be protected   
from reprisal for the disclosure of     
certain information under section #dgje 
or #dgab of title #da4  7b7 ,manner     
training is provided ,the ,secretary    
shall ensure1 to the maximum extent     
practicable1 that training provided     
under subsection 7a7 is provided in     
person4  7c7 ,certification ,not less   
frequently than once every two years1   

the ,secretary shall provide training on
 merit system protection in a manner    
that the ,special ,counsel certifies as 
being satisfactory4  7d7 ,publication   
,the ,secretary shall publish on the    
,internet website of the ,department1   
and display prominently at each facility
 of the ,department1 the rights of an   
employee to make a whistleblower        
disclosure1 including the information   
described in paragraphs 7#a7 through    
7#e7 of subsection 7a74  7e7            
,whistleblower disclosure defined ,in   
this section1 the term whistleblower    
disclosure has the meaning given such   
term in section #cbc of this title4  4  
7b7 ,clerical amendment ,the table of   
sections at the beginning of such       
chapter1 is amended by adding at the end
 the following new items3  #gbj4        
,protection of whistleblowers as        
criteria in evaluation of               
supervisors4#gba4 ,training regarding   
whistleblower disclosures4  4  #ajc4    
,treatment of congressional testimony by

 ,department of ,veterans ,affairs      
employees as official duty  7a7 ,in     
general ,chapter #g of title #ch1       
,united ,states ,code1 as amended by    
section #ajb1 is further amended by     
adding at the end the following new     
section3  #gbb4 ,congressional testimony
 by employees3 treatment as official    
duty  7a7 ,congressional testimony ,an  
employee of the ,department is          
performing official duty during the     
period with respect to which the        
employee is testifying in an official   
capacity in front of either chamber of  
,congress1 a committee of either chamber
 of ,congress1 or a joint or select     
committee of ,congress4  7b7 ,travel    
expenses ,the ,secretary shall provide  
travel expenses1 including per diem in  
lieu of subsistence1 in accordance with 
applicable provisions under subchapter  
,i of chapter #eg of title #e1 to any   
employee of the ,department of ,veterans
 ,affairs performing official duty      
described under subsection 7a74  4  7b7 

,clerical amendment ,the table of       
sections at the beginning of such       
chapter1 as amended by section #ajb1 is 
further amended by inserting after the  
item relating to section #gba the       
following new item3  ,sec4 #gbb4        
,congressional testimony by employees3  
treatment as official duty4  4  #ajd4   
,report on methods used to investigate  
employees of ,department of ,veterans   
,affairs  7a7 ,report required ,not     
later than #edj days after the date of  
the enactment of this ,act1 the         
,assistant ,secretary for               
,accountability and ,whistleblower      
,protection shall submit to the         
,secretary1 the ,committee on ,veterans'
 ,affairs of the ,senate1 and the       
,committee on ,veterans' ,affairs of the
 ,house of ,representatives a report on 
methods used to investigate employees of
 the ,department of ,veterans ,affairs  
and whether such methods are used to    
retaliate against whistleblowers4  7b7  
,contents ,the report required by       

subsection 7a7 shall include the        
following3 7#a7 ,an assessment of the   
use of administrative investigation     
boards1 peer review1 searches of medical
 records1 and other methods for         
investigating employees of the          
,department4  7#b7 ,a determination of  
whether and to what degree the methods  
described in paragraph 7#a7 are being   
used to retaliate against               
whistleblowers4  7#c7 ,recommendations  
for legislative or administrative action
 to implement safeguards to prevent the 
retaliation described in paragraph 7#b74
  7c7 ,whistleblower defined ,in this   
section1 the term whistleblower has the 
meaning given such term in section #cbc 
of title #ch1 ,united ,states ,code1 as 
added by section #aja4  ,b ,supervisors 
and senior executives  #aaa4 ,treatment 
of ,medical ,center ,directors and      
,directors of ,veterans ,integrated     
,service ,networks  7a7 ,establishment  
of ,,visn ,directors in ,office of      
,under ,secretary for ,health           

,subsection 7a77#d7 of section #gcjf of 
title #ch1 ,united ,states ,code1 is    
amended-- 7#a7 by striking ,such        
,medical ,directors and inserting ,such 
,medical ,center ,directors and         
,directors of ,veterans ,integrated     
,service ,networks2 and  7#b7 by        
striking 1 who shall be either a        
qualified doctor of medicine or a       
qualified doctor of dental surgery or   
dental medicine4  7b7 ,qualifications   
,such section is amended by adding at   
the end the following new subsection3   
7g7 ,notwithstanding any provision of   
law that requires the ,office of        
,personnel ,management to determine     
qualifications or certify a candidate   
for appointment under this section1     
,medical ,center ,directors and         
,directors of ,veterans ,integrated     
,service ,networks may be appointed     
under subsection 7a77#d7 in accordance  
with qualifications established by the  
,secretary for purposes of this section4
  4  7c7 ,ability to transfer  7#a7 ,in 

general ,subject to such regulations as 
the ,director of the ,office of         
,personnel ,management may prescribe1   
the ,secretary of ,veterans ,affairs and
 the ,director shall enter into an      
agreement that permits employees        
appointed under section #gcjf7;a77#d7 of
 title #ch1 ,united ,states ,code1 as   
amended by subsection 7a71 to transfer  
to ,senior ,executive ,service positions
 in other ,federal agencies and to be   
deemed career appointees who are not    
subject to competition or certification 
by a qualifications review board under  
section #ccic of title #e1 ,united      
,states ,code4  7#b7 ,definitions ,in   
this subsection1 the terms ,senior      
,executive ,service position and career 
appointee have the meanings given those 
terms in section #cacb7;a7 of title #e1 
,united ,states ,code4  #aab4 ,pay for  
,medical ,center ,directors and         
,directors of ,veterans ,integrated     
,service ,networks  7a7 ,in general     
,chapter #gd of title #ch1 ,united      

,states ,code1 is amended by adding at  
the end the following new subchapter3   
,,vii ,pay for ,medical ,center         
,directors and ,directors of ,veterans  
,integrated ,service ,networks  #gdha4  
,pay for ,medical ,center ,directors and
 ,directors of ,veterans ,integrated    
,service ,networks  7a7 ,elements of pay
 ,pay for a ,medical ,center ,director  
or ,director of a ,veterans ,integrated 
,service ,network appointed under       
section #gcjf7;a77#d7 of this title 7in 
this section referred to as a ,director7
 shall consist of basic pay set forth   
under section #gdjd7;a7 of this title   
and market pay determined under         
subsection 7b74  7b7 ,market pay  7#a7  
,each ,director is eligible for market  
pay determined under this subsection4   
7#b7 ,the amount of market pay payable  
to a ,director under this section shall 
be determined by the ,secretary on a    
case-by-case basis and shall consist of 
pay intended to reflect needs of the    
,department with respect to the         

recruitment and retention 7as determined
 by the ,secretary7 of such ,director4  
7#c7 ,in determining the amount of      
market pay payable to a ,director under 
this section1 the ,secretary shall--    
7,a7 consult not fewer than two national
 surveys on pay for hospital directors1 
medical facility directors1 or other    
similar positions1 whether prepared by  
private1 public1 or quasi-public        
entities1 to make a general assessment  
of the range of potential pay for the   
,director2 and  7,b7 take into account--
 7i7 the experience of the ,director in 
managing facilities or program offices  
of the ,department1 including the       
complexity of such facilities or        
offices2  7ii7 the complexity of the    
facility or facilities to be managed by 
the ,director2  7iii7 the labor market1 
in such geographic area as the          
,secretary considers relevant1 for      
hospital directors1 medical facility    
directors1 and other similar positions2 
7iv7 the experience of the ,director in 

managing medical facilities for other   
,federal agencies1 private entities1 or 
non-profit entities2 and  7v7 such other
 considerations as the ,secretary       
considers appropriate4  7#d7 7,a7 ,the  
,secretary shall evaluate the amount of 
market pay payable to a ,director under 
this section not less frequently than   
once every two years and may adjust the 
market pay payable to such ,director as 
a result of such evaluation4  7,b7 ,a   
,director whose market pay is evaluated 
under subparagraph 7,a7 shall receive   
written notice of the results of such   
evaluation4  7c7 ,requirements and      
limitations on total pay  7#a7 ,not less
 frequently than once every two years1  
the ,secretary shall set forth a        
departmentwide minimum and maximum      
amount for total annual pay under       
subsection 7a7 that may be paid to a    
,director and shall publish each such   
amount in the ,federal ,register4  7#b7 
,the minimum and maximum amounts set    
forth under paragraph 7#a7 shall take   

effect not earlier than the date that is
 #fj days after the publication of such 
amounts under such paragraph4  7#c7 ,the
 sum of the basic pay set forth under   
section #gdjd7;a7 of this title and     
market pay determined under subsection  
7b7 for a ,director for a calendar      
year--  7,a7 may not be less than the   
most recent minimum amount set forth    
under paragraph 7#a7 before the         
beginning of such calendar year2 and    
7,b7 may not be more than the most      
recent maximum amount set forth under   
such paragraph before the beginning of  
such calendar year4  7#d7 ,the total    
amount of compensation paid to a        
,director under this title in any       
calendar year may not exceed the amount 
of annual compensation 7excluding       
expenses7 of the ,president under       
section #ajb of title #c4  7#e7 ,the    
,secretary may not delegate to an       
officer or employee of the ,department  
the requirement of the ,secretary to set
 forth a departmentwide minimum and     

maximum amount under paragraph 7#a74    
7d7 ,treatment of pay ,pay under this   
section shall be considered pay for all 
purposes1 including retirement benefits 
under chapters #hc and #hd of title #e  
and other benefits4  7e7 ,ancillary     
effects of decreases in pay  7#a7 ,a    
decrease in pay of a ,director resulting
 from an adjustment in the amount of    
market pay of the ,director under       
subsection 7b7 shall not be treated as  
an adverse action4  7#b7 ,a decrease in 
the amount of pay of a ,director        
resulting from an involuntary           
reassignment in connection with a       
disciplinary action taken against the   
,director is not subject to appeal or   
judicial review4  4  7b7 ,clerical      
amendment ,the table of sections at the 
beginning of chapter #gd of such title  
is amended by adding at the end the     
following3  ,subchapter ,,vii4 ,pay for 
,medical ,center ,directors and         
,directors of ,veterans ,integrated     
,service ,networks#gdha4 ,pay for       

,medical ,center ,directors and         
,directors of ,veterans ,integrated     
,service ,networks4  4  7c7 ,effective  
date ,the amendments made by this       
section shall take effect on the date   
that is one year after the date of the  
enactment of this ,act4  #aac4 ,improved
 authorities of ,secretary of ,veterans 
,affairs to improve accountability of   
senior executives  7a7 ,accountability  
of senior executives  7#a7 ,in general  
,section #gac of title #ch1 ,united     
,states ,code1 is amended to read as    
follows3  #gac4 ,accountability of      
senior executives  7a7 ,authority  7#a7 
,the ,secretary may1 as provided in this
 section1 reprimand or suspend1         
involuntarily reassign1 demote1 or      
remove a covered individual from a      
senior executive position at the        
,department if the ,secretary determines
 that the misconduct or performance of  
the covered individual warrants such    
action4  7#b7 ,if the ,secretary so     
removes such an individual1 the         

,secretary may remove the individual    
from the civil service 7as defined in   
section #baja of title #e74  7b7 ,rights
 and procedures  7#a7 ,a covered        
individual who is the subject of an     
action under subsection 7a7 is entitled 
to-- 7,a7 be represented by an attorney 
or other representative of the covered  
individual's choice2  7,b7 not fewer    
than #aj business days advance written  
notice of the charges and evidence      
supporting the action and an opportunity
 to respond1 in a manner prescribed by  
the ,secretary1 before a decision is    
made regarding the action2 and  7,c7    
grieve the action in accordance with an 
internal grievance process that the     
,secretary1 in consultation with the    
,assistant ,secretary for               
,accountability and ,whistleblower      
,protection1 shall establish for        
purposes of this subsection4  7#b7 7,a7 
,the ,secretary shall ensure that the   
grievance process established under     
paragraph 7#a77;,c7 takes fewer than #ba

 days4  7,b7 ,the ,secretary shall      
ensure that1 under the process          
established pursuant to paragraph       
7#a77;,c71 grievances are reviewed only 
by employees of the ,department4  7#c7  
,a decision or grievance decision under 
paragraph 7#a77;,c7 shall be final and  
conclusive4  7#d7 ,a covered individual 
adversely affected by a final decision  
under paragraph 7#a77;,c7 may obtain    
judicial review of the decision4  7#e7  
,in any case in which judicial review is
 sought under paragraph 7#d71 the court 
shall review the record and may set     
aside any ,department action found to   
be--  7,a7 arbitrary1 capricious1 an    
abuse of discretion1 or otherwise not in
 accordance with a provision of law2    
7,b7 obtained without procedures        
required by a provision of law having   
been followed2 or  7,c7 unsupported by  
substantial evidence4  7c7 ,relation to 
other provisions of law  7#a7 ,the      
authority provided by subsection 7a7 is 
in addition to the authority provided by

 section #ceib or subchapter ,v of      
chapter #ge of title #e4  7#b7 ,section 
#ceib7;b77#a7 of title #e and the       
procedures under section #gedc7;b7 of   
such title do not apply to an action    
under subsection 7a74  7d7 ,definitions 
,in this section3 7#a7 ,the term covered
 individual means--  7,a7 a career      
appointee 7as that term is defined in   
section #cacb7;a77#d7 of title #e72 or  
7,b7 any individual who occupies an     
administrative or executive position and
 who was appointed under section        
#gcjf7;a7 or section #gdja7a7 of this   
title4  7#b7 ,the term misconduct       
includes neglect of duty1 malfeasance1  
or failure to accept a directed         
reassignment or to accompany a position 
in a transfer of function4  7#c7 ,the   
term senior executive position means--  
7,a7 with respect to a career appointee 
7as that term is defined in section     
#cacb7;a7 of title #e71 a ,senior       
,executive ,service position 7as such   
term is defined in such section72 and   

7,b7 with respect to a covered          
individual appointed under section      
#gcjf7;a7 or section #gdja7a7 of this   
title1 an administrative or executive   
position4  4  7#b7 ,conforming amendment
 ,section #gdfa7;c77#a7 of such title is
 amended by inserting employees in      
senior executive positions 7as defined  
in section #gac7;d7 of this title7 and  
before interns4  7b7 ,performance       
management  7#a7 ,in general ,the       
,secretary of ,veterans ,affairs shall  
establish a performance management      
system for employees in senior executive
 positions1 as defined in section       
#gac7;d7 of title #ch1 ,united ,states  
,code1 as amended by subsection 7a71    
that ensures performance ratings and    
awards given to such employees--  7,a7  
meaningfully differentiate extraordinary
 from satisfactory contributions2 and   
7,b7 substantively reflect              
organizational achievements over which  
the employee has responsibility and     
control4  7#b7 ,regulations ,the        

,secretary shall prescribe regulations  
to carry out paragraph 7#a74  #aad4     
,reduction of benefits for members of   
the ,senior ,executive ,service within  
the ,department of ,veterans ,affairs   
convicted of certain crimes  7a7 ,in    
general ,chapter #g of title #ch1       
,united ,states ,code1 as amended by    
subtitle ,a1 is further amended by      
inserting after section #gac the        
following new section3  #gad4 ,senior   
executives3 reduction of benefits of    
individuals convicted of certain crimes 
7a7 ,reduction of annuity for removed   
individual ,the covered service of an   
individual removed from a senior        
executive position at the ,department by
 the ,secretary for performance or      
misconduct shall not be considered      
creditable service under section #hccb  
or section #hdaa of title #e for        
purposes of calculating an annuity with 
respect to such individual under chapter
 #hc or chapter #hd of such title if the
 individual is convicted of a felony    

7and the conviction is final7 that was  
related1 as determined by the ,director 
of the ,office of ,personnel            
,management1 to the individual's        
performance while employed in such      
senior executive position4  7b7         
,reduction of annuity for retired       
individual  7#a7 ,the ,secretary may    
order that the covered service of an    
individual who is subject to a removal  
or transfer from a senior executive     
position at the ,department by the      
,secretary for performance or misconduct
 but who leaves employment at the       
,department prior to the issuance of a  
final decision with respect to such     
removal or transfer shall not be        
considered creditable service under     
section #hccb or section #hdaa of title 
#e for purposes of calculating an       
annuity with respect to such individual 
under chapter #hc or chapter #hd of such
 title if the individual is convicted of
 a felony 7and the conviction is final7 
that was related1 as determined by the  

,director of the ,office of ,personnel  
,management1 to the individual's        
performance while employed in such      
senior executive position4  7#b7 ,the   
,secretary shall make such an order not 
later than seven days after the date on 
which such individual is convicted of   
such felony4  7#c7 ,not later than #cj  
days after the ,secretary issues any    
order with respect to an individual     
under paragraph 7#a71 the ,director of  
the ,office of ,personnel ,management   
shall recalculate the annuity of the    
individual4  7c7 ,lump-sum annuity      
credit ,any individual with respect to  
whom an annuity is reduced under        
subsection 7a7 or 7b7 shall be entitled 
to be paid so much of such individual's 
lump-sum credit as is attributable to   
the period of covered service4  7d7     
,review of reduction of annuity ,any    
individual with respect to whom an      
annuity is reduced under subsection 7a7 
or 7b7 may appeal the reduction to the  
,director of the ,office of ,personnel  

,management pursuant to such regulations
 as the ,director may prescribe for     
purposes of this section4  7e7          
,definitions ,in this section3 7#a7 ,the
 term covered service means1 with       
respect to an individual subject to a   
removal or transfer from a senior       
executive position at the ,department   
for performance or misconduct1 the      
period of service beginning on the date 
that the ,secretary determines under    
such section that such individual       
engaged in activity that gave rise to   
such action and ending on the date that 
such individual is removed from the     
civil service or leaves employment at   
the ,department prior to the issuance of
 a final decision with respect to such  
action1 as the case may be4  7#b7 ,the  
term lump-sum credit has the meaning    
given such term in section #hcca or     
#hdja of title #e1 as the case may be4  
7#c7 ,the term senior executive position
 has the meaning given such term in     
section #gac7;d7 of this title4  7#d7   

,the term service has the meaning given 
such term in section #hcca or #hdja of  
title #e1 as the case may be4  4  7b7   
,application ,section #gad of such      
title1 as added by subsection 7a71 shall
 apply to any action of removal or      
transfer from a senior executive        
position 7as defined in section #gac7;d7
 of such title7 at the ,department of   
,veterans ,affairs commencing on or     
after the date of the enactment of this 
title4  7c7 ,clerical amendment ,the    
table of sections at the beginning of   
such chapter1 as amended by subtitle ,a1
 is further amended by inserting after  
the item relating to section #gac the   
following new item3  #gad4 ,senior      
executives3 reduction of benefits of    
individuals convicted of certain crimes4
  4  #aae4 ,independent review and      
assessment of management training and   
appraisal at ,department of ,veterans   
,affairs  7a7 ,review and assessment    
7#a7 ,in general ,not later than #ahj   
days after the date of the enactment of 

this title1 the ,secretary of ,veterans 
,affairs shall enter into a contract    
with a nongovernmental entity to review 
and assess the following3  7,a7 ,the    
management training program for         
individuals employed in senior executive
 positions of the ,department of        
,veterans ,affairs that is being        
provided as of the date of the enactment
 of this title4  7,b7 ,the performance  
appraisal system of the ,department in  
effect on the day before the date of the
 enactment of this title for individuals
 employed in senior executive positions4
  7#b7 ,elements ,the review and        
assessment required by paragraph 7#a7   
shall include the following3 7,a7 ,a    
comparison of the training provided by  
the ,department to the management       
training provided for senior executives 
of other ,federal departments and       
agencies and to the management training 
provided to senior executives in the    
private sector4  7,b7 ,recommendations  
for improving the program described in  

paragraph 7#a77;,a74  7,c7              
,recommendations for improving the      
system described in paragraph 7#a77;,b74
  7,d7 ,an assessment of the ability of 
the ,department to attract and develop  
employees suitable for senior executive 
service positions of the ,department4   
7,e7 ,an assessment of the leadership   
and management actions of the           
,department resulting from ,department  
of ,veterans ,affairs ,performance and  
,accountability ,reports submitted in   
the two most recent fiscal years ending 
before the date of the enactment of this
 title4  7,f7 ,a review of the strategy 
of the ,secretary called ,lean          
,management4  7,g7 ,an assessment of the
 compliance of the ,department with     
provisions of law added or amended by   
the ,,gpra ,modernization ,act of #bjaj 
7,public ,law #aaa-ceb7 and an          
explanation of the changes made to the  
,department and the activities carried  
out by the ,secretary in response to the
 enactment of such ,act4  7,h7 ,an      

assessment of the results of the most   
recent ,annual ,employee ,survey carried
 out pursuant to part #bej of title #e1 
,code of ,federal ,regulations4  7,i7   
,an assessment of the efforts of the    
,secretary to conduct data-driven       
reviews and develop a results-oriented  
culture pursuant to part #f of ,circular
 ,a-#aa of the ,office of ,management   
and ,budget4  7,j7 ,an assessment of the
 ,department of ,veterans ,affairs      
,federal ,performance ,improvement      
,officer role and oversight function4   
7,k7 ,a survey of the morale of         
employees and their satisfaction with   
their work and work environment in each 
,department of ,veterans ,affairs staff 
organization1 staff office1 and         
administration as described by          
,directive #jbaa of the ,department and 
provided for in version #c4j;a of the   
,functional ,organization ,manual of the
 ,department4  7#c7 ,report to          
,secretary ,the contract required by    
paragraph 7#a7 shall provide that the   

nongovernmental entity must complete and
 submit to the ,secretary a report      
containing the findings and conclusions 
of the review by not later than #ahj    
days after the date on which the        
,secretary and the nongovernmental      
entity enter into the contract4  7b7    
,report to ,congress ,not later than #fj
 days after the date on which the       
,secretary receives the report under    
subsection 7a77#c71 the ,secretary shall
 submit to the ,committee on ,veterans' 
,affairs of the ,senate and the         
,committee on ,veterans' ,affairs of the
 ,house of ,representatives the report  
together with a plan for carrying out   
the recommendations contained in the    
report or1 as the case may be1 a        
detailed explanation and justification  
for the ,secretary's determination not  
to implement any of the recommendations 
contained in the report4  7c7 ,senior   
executive position defined ,in this     
section1 the term senior executive      
position has the meaning given that term

 in section #gac7;d7 of title #ch1      
,united ,states ,code4  #aaf4           
,accountability of leaders for managing 
the ,department of ,veterans ,affairs   
7a7 ,in general ,chapter #g of title    
#ch1 ,united ,states ,code1 is further  
amended by inserting after section #gji 
the following new section3  #gaj4       
,annual performance plan for political  
appointees  7a7 ,in general ,the        
,secretary shall conduct an annual      
performance plan for each political     
appointee of the ,department that is    
similar to the annual performance plan  
conducted for an employee of the        
,department who is appointed as a career
 appointee in a ,senior ,executive      
,service position at the ,department4   
7b7 ,elements of plan ,each annual      
performance plan conducted under        
subsection 7a7 with respect to a        
political appointee of the ,department  
shall include1 to the extent applicable1
 an assessment of whether the appointee 
is meeting the following goals3  7#a7   

,recruiting1 selecting1 and retaining   
well-qualified individuals for          
employment at the ,department4  7#b7    
,engaging and motivating employees4     
7#c7 ,training and developing employees 
and preparing those employees for future
 leadership roles within the            
,department4  7#d7 ,holding each        
employee of the ,department that is a   
supervisor accountable for addressing   
issues relating to performance1 in      
particular issues relating to the       
performance of employees that report to 
the supervisor4  7#e7 ,promoting a      
positive culture of service that-- 7,a7 
reflects the mission of the ,department 
and the values of integrity1 commitment1
 advocacy1 respect1 and excellence2 and 
7,b7 emphasizes the greatest degree of  
performance and conduct4  7c7           
,definitions ,in this section3  7#a7    
,the terms career appointee and ,senior 
,executive ,service position have the   
meanings given such terms in section    
#cacb7;a7 of title #e4  7#b7 ,the term  

supervisor has the meaning given such   
term in section #gajc7;a7 of such title4
  4  7b7 ,clerical amendment ,the table 
of sections at the beginning of chapter 
#g of such title is further amended by  
inserting after the item relating to    
section #gji the following new item3    
#gaj4 ,annual performance plan for      
political appointees4  4  #aag4         
,accountability of supervisors at       
,department of ,veterans ,affairs for   
hiring well-qualified people  7a7       
,assessment during probationary period  
7#a7 ,determination required ,with      
respect to any employee of the          
,department of ,veterans ,affairs who is
 required to serve a probationary period
 in a position in the ,department1 the  
,secretary of ,veterans ,affairs shall  
require the supervisor of such employee 
to determine1 during the #cj-;day period
 ending on the date on which the        
probationary period ends1 whether the   
employee--  7,a7 has demonstrated       
successful performance2 and  7,b7 should

 continue past the probationary period4 
7#b7 ,limitation on employment after    
probationary period  7,a7 ,in general   
,except as provided in subparagraph     
7,b71 no employee of the ,department    
serving a probationary period as        
described in paragraph 7#a7 may complete
 that probationary period unless and    
until the supervisor of the employee1 or
 another supervisor capable of making   
the requisite determination1 has made an
 affirmative determination under such   
paragraph4  7,b7 ,probationary period   
deemed completed  7i7 ,no determination 
,if no determination under paragraph    
7#a7 is made with respect to an employee
 before the end of the #fj-;day period  
following the end of the #cj-;day period
 specified in such paragraph1 the       
employee shall be deemed to have        
completed the probationary period of the
 employee effective as of the end of    
that #fj-;day period4  7ii7 ,retroactive
 effect of determination ,if an         
affirmative determination under         

paragraph 7#a7 is made with respect to  
an employee after the end of the        
#cj-;day period specified in such       
paragraph1 the employee shall be deemed 
to have completed the probationary      
period of the employee effective as of  
the end of that #cj-;day period4  7#c7  
,notification to ,congress regarding    
determinations ,not less frequently than
 monthly1 the ,secretary shall notify   
the ,committee on ,veterans' ,affairs of
 the ,senate and the ,committee on      
,veterans' ,affairs of the ,house of    
,representatives regarding--  7,a7 each 
instance during such month in which a   
supervisor did not make a determination 
required under paragraph 7#a7 during the
 period required in such paragraph2 and 
7,b7 each such instance included in a   
previous notification under this        
paragraph for which the supervisor still
 has not made such a determination4  7b7
 ,supervisors ,with respect to any      
employee of the ,department who is      
serving a probationary period in a      

supervisory position at the ,department1
 successful performance under subsection
 7a7 shall include demonstrating        
management competencies in addition to  
the technical skills required for such  
position4  7c7 ,performance plan ,each  
annual performance plan conducted for a 
supervisor of an employee serving a     
probationary period shall hold the      
supervisor accountable for--  7#a7      
providing regular feedback to such      
employee during such period before      
making a determination under subsection 
7a7 regarding the probationary status of
 such employee2 and  7#b7 making a      
timely determination under subsection   
7a7 regarding the probationary status of
 such employee4  7d7 ,supervisor defined
 ,in this section1 the term supervisor  
has the meaning given such term in      
section #gajc7;a7 of title #e1 ,united  
,states ,code4  #aah4 ,accountability of
 supervisors at ,department of ,veterans
 ,affairs for addressing performance of 
employees  7a7 ,in general ,the         

,secretary of ,veterans ,affairs shall  
ensure that1 as a part of the annual    
performance plan of a supervisor in the 
,department1 the supervisor is evaluated
 on the following3  7#a7 ,taking action 
to address poor performance and         
misconduct among the employees that     
report to the supervisor4  7#b7 ,taking 
steps to improve or sustain high levels 
of employee engagement4  7#c7 ,promoting
 a positive culture of service that--   
7,a7 reflects the mission of the        
,department and the values of integrity1
 commitment1 advocacy1 respect1 and     
excellence2 and  7,b7 emphasizes the    
greatest degree of performance and      
conduct4  7b7 ,supervisor defined ,in   
this section1 the term supervisor has   
the meaning given such term in section  
#gajc7;a7 of title #e1 ,united ,states  
,code4  #aai4 ,improvement of training  
for supervisors  7a7 ,in general ,the   
,secretary of ,veterans ,affairs shall  
provide to each employee of the         
,department of ,veterans ,affairs who is

 employed as a supervisor periodic      
training on the following3  7#a7 ,the   
rights of whistleblowers and how to     
address a report by an employee of a    
hostile work environment1 reprisal1 or  
harassment4  7#b7 ,how to effectively   
motivate1 manage1 and reward the        
employees who report to the supervisor4 
7#c7 ,how to effectively manage         
employees who are performing at an      
unacceptable level and access assistance
 from the human resources office of the 
,department and the ,office of the      
,general ,counsel of the ,department    
with respect to those employees4  7b7   
,definitions ,in this section3 7#a7     
,supervisor ,the term supervisor has the
 meaning given such term in section     
#gajc7;a7 of title #e1 ,united ,states  
,code4  7#b7 ,whistleblower ,the term   
whistleblower has the meaning given such
 term in section #cbc7;g7 of title #ch1 
,united ,states ,code1 as added by      
section #aja4  #abj4 ,assessment and    
report on effect on senior executives at

 ,department of ,veterans ,affairs  7a7 
,in general ,not later than two years   
after the date of the enactment of this 
,act1 the ,secretary of ,veterans       
,affairs shall--  7#a7 measure and      
assess the effect of the enactment of   
this title on the morale1 engagement1   
hiring1 promotion1 retention1           
discipline1 and productivity of         
individuals in senior executive         
positions at the ,department of         
,veterans ,affairs2 and  7#b7 submit to 
the ,committee on ,veterans' ,affairs of
 the ,senate and the ,committee on      
,veterans' ,affairs of the ,house of    
,representatives a report on the        
findings of the ,secretary with respect 
to the measurement and assessment       
carried out under paragraph 7#a74  7b7  
,elements ,the assessment required by   
subsection 7a77#a7 shall include the    
following3 7#a7 ,with respect to        
engagement1 trends in morale of         
individuals in senior executive         
positions and individuals aspiring to   

senior executive positions4  7#b7 ,with 
respect to promotions-- 7,a7 whether the
 ,department is experiencing an increase
 or decrease in the number of employees 
participating in leadership development 
and candidate development programs with 
the intention of becoming candidates for
 senior executive positions2 and  7,b7  
trends in applications to senior        
executive positions within the          
,department4  7#c7 ,with respect to     
retention--  7,a7 trends in retirement  
rates of individuals in senior executive
 positions at the ,department2  7,b7    
trends in quit rates of individuals in  
senior executive positions at the       
,department2  7,c7 rates of transfer    
of-- 7i7 individuals from other ,federal
 agencies into senior executive         
positions at the ,department2 and  7ii7 
individuals from senior executive       
positions at the ,department to other   
,federal agencies2 and  7,d7 trends in  
total loss rates by job function4  7#d7 
,with respect to disciplinary           

processes--  7,a7 regarding individuals 
in senior executive positions at the    
,department who are the subject of      
disciplinary action--  7i7 the length of
 the disciplinary process in days for   
such individuals both before the date of
 the enactment of this ,act and under   
the provisions of this ,act described in
 subsection 7a77#a72 and  7ii7 the      
extent to which appeals by such         
individuals are upheld under such       
provisions as compared to before the    
date of the enactment of this ,act2     
7,b7 the components or offices of the   
,department which experience the        
greatest number of proposed adverse     
actions against individuals in senior   
executive positions and components and  
offices which experience the least      
relative to the size of the components  
or offices' total number of senior      
executive positions2  7,c7 the tenure of
 individuals in senior executive        
positions who are the subject of        
disciplinary action2  7,d7 whether the  

individuals in senior executive         
positions who are the subject of        
disciplinary action have previously been
 disciplined2 and  7,e7 the number of   
instances of disciplinary action taken  
by the ,secretary against individuals in
 senior executive positions at the      
,department as compared to              
governmentwide discipline against       
individuals in ,senior ,executive       
,service positions 7as defined in       
section #cacb7;a7 of title #e1 ,united  
,states ,code7 as a percentage of the   
total number of individuals in senior   
executive positions at the ,department  
and ,senior ,executive ,service         
positions 7as so defined74  7#e7 ,with  
respect to hiring-- 7,a7 the degree to  
which the skills of newly hired         
individuals in senior executive         
positions at the ,department are        
appropriate with respect to the needs of
 the ,department2  7,b7 the types of    
senior executive positions at the       
,department most commonly filled under  

the authorities in the provisions       
described in subsection 7a77#a72  7,c7  
the number of senior executive positions
 at the ,department filled by hires     
outside of the ,department compared to  
hires from within the ,department2  7,d7
 the length of time to fill a senior    
executive position at the ,department   
and for a new hire to begin working in a
 new senior executive position2  7,e7   
the mission-critical deficiencies filled
 by newly hired individuals in senior   
executive positions and the connection  
between mission-critical deficiencies   
filled under the provisions described in
 subsection 7a7 and annual performance  
of the ,department2  7,f7 the           
satisfaction of applicants for senior   
executive positions at the ,department  
with the hiring process1 including the  
clarity of job announcements1 reasons   
for withdrawal of applications1         
communication regarding status of       
applications1 and timeliness of hiring  
decision2 and  7,g7 the satisfaction of 

newly hired individuals in senior       
executive positions at the ,department  
with the hiring process and the process 
of joining and becoming oriented with   
the ,department4  7c7 ,senior executive 
position defined ,in this section1 the  
term senior executive position has the  
meaning given such term in section #gac 
of title #ch1 ,united ,states ,code4  ,c
 ,employees  #aba4 ,removal of employees
 of ,department of ,veterans ,affairs   
based on performance or misconduct  7a7 
,in general ,chapter #g of title #ch1   
,united ,states ,code1 as amended by    
subtitles ,a and ,b1 is further amended 
by inserting after section #gad1 as     
added by section #aad1 the following new
 section3  #gae4 ,employees3 removal    
based on performance or misconduct  7a7 
,in general  7#a7 ,the ,secretary may   
remove a covered individual who is an   
employee of the ,department if the      
,secretary determines that--  7,a7 the  
performance or misconduct of the covered
 individual warrants such removal2 and  

7,b7 in the case of removal for         
performance1 a portion of such          
performance occurred during the two-year
 period ending on the date of the       
determination4  7#b7 ,if the ,secretary 
removes a covered individual under      
paragraph 7#a71 the ,secretary may      
remove the covered individual from the  
civil service 7as defined in section    
#baja of title #e74  7#c7 ,nothing in   
this section may be construed to        
authorize a finalized performance       
appraisal of an employee to be          
retroactively amended4  7b7 ,notice to  
,congress ,not later than #cj days after
 removing a covered individual under    
subsection 7a71 the ,secretary shall    
submit to the ,committees on ,veterans' 
,affairs of the ,senate and ,house of   
,representatives notice in writing of   
such removal and the reason for such    
removal4  7c7 ,procedure  7#a7 ,an      
employee removed under subsection 7a7 is
 entitled1 before removal1 to-- 7,a7 at 
least #aj business days written notice  

7which1 in the case of removal for      
performance1 shall identify specific    
instances as described in clause 7i7 of 
section #dcjc7;b77#a77;,a7 of title #e  
and critical elements as described in   
clause 7ii7 of such section71 unless    
there is reasonable cause to believe    
that the employee committed a crime for 
which a sentence of imprisonment can be 
imposed--  7i7 stating the specific     
reasons for the proposed action2 and    
7ii7 including a file containing all    
evidence in support of the proposed     
action2  7,b7 #aj business days to      
answer the charges orally and in writing
 and to furnish affidavits and other    
documentary evidence in support of the  
answer2  7,c7 be represented by an      
attorney or other representative2  7,d7 
a review of the case by the ,secretary  
before a decision adverse to the        
employee is made final2  7,e7 as soon as
 practicable1 a decision of the         
,secretary with respect to the charges  
of the employee2 and  7,f7 a written    

statement of the decision of the        
,secretary that-- 7i7 includes the      
specific reasons of the decision2 and   
7ii7 in the case of a removal based on  
performance1 complies with section      
#dcjc7;b77#a77;,d7 of title #e4  7#b7   
7,a7 ,subject to subparagraph 7,b7 and  
subsection 7e71 any final decision of   
the ,secretary regarding removal under  
subsection 7a7 may be appealed to the   
,merit ,systems ,protection ,board4     
7,b7 ,an appeal under subparagraph 7,a7 
of a removal may only be made if such   
appeal is made not later than #aj       
business days after the date of such    
removal4  7,c7 7i7 ,subject to clause   
7ii71 the decision of the ,secretary    
shall be sustained under subparagraph   
7,a7 only if the ,secretary's decision--
  7,i7 in the case of an action based on
 performance1 is supported by           
substantial evidence2 or  7,,ii7 in any 
other case1 is supported by a           
preponderance of the evidence4  7ii7    
,notwithstanding clause 7i71 the        

,secretary's decision may not be        
sustained under subparagraph 7,a7 if the
 covered individual--  7,i7 shows       
harmful error in the application of the 
,secretary's procedures in arriving at  
such decision2  7,,ii7 shows that the   
decision was based on any prohibited    
personnel practice described in section 
#bcjb7;b7 of title #e2 or  7,,iii7 shows
 that the decision was not in accordance
 with law4  7#c7 ,the procedures under  
section #geac7;b7 of title #e and       
chapter #dc of such title shall not     
apply to a removal under this section4  
7d7 ,expedited review  7#a7 ,the ,merit 
,systems ,protection ,board shall       
promulgate such rules as the ,board     
considers appropriate to expedite       
appeals under subsection 7c77#b74  7#b7 
,the ,board shall ensure that a final   
decision on an appeal described in      
paragraph 7#a7 is issued not later than 
#ij days after the appeal is made4  7#c7
 ,during the period beginning on the    
date on which a covered individual      

appeals a removal from the civil service
 under subsection 7c77#b7 and ending on 
the date that the ,board issues a final 
decision on such appeal1 such covered   
individual may not receive any pay1     
awards1 bonuses1 incentives1 allowances1
 differentials1 student loan repayments1
 special payments1 or benefits4  7#d7   
,to the maximum extent practicable1 the 
,secretary shall provide to the ,merit  
,systems ,protection ,board such        
information and assistance as may be    
necessary to ensure an appeal under     
subsection 7c77#b7 is expedited4  7e7   
,relation to title #e ,the authority    
provided by this section is in addition 
to the authority provided by subchapter 
,v of chapter #ge of title #e and       
chapter #dc of such title4  7f7         
,definitions ,in this section3 7#a7 ,the
 term covered individual means an       
individual occupying a position at the  
,department but does not include--  7,a7
 an individual1 as that term is defined 
in section #gac7;d72 or  7,b7 a         

political appointee4  7#b7 ,the term    
misconduct includes a violation of      
paragraph 7#h7 or 7#i7 of section       
#bcjb7;b7 of title #e1 neglect of duty1 
malfeasance1 or failure to accept a     
directed reassignment or to accompany a 
position in a transfer of function4     
7#c7 ,the term political appointee means
 an individual who is-- 7,a7 employed in
 a position described under sections    
#ecab through #ecaf of title #e         
7relating to the ,executive ,schedule72 
7,b7 a limited term appointee1 limited  
emergency appointee1 or noncareer       
appointee in the ,senior ,executive     
,service1 as defined under paragraphs   
7#e71 7#f71 and 7#g71 respectively1 of  
section #cacb7;a7 of title #e2 or  7,c7 
employed in a position of a confidential
 or policy-determining character under  
schedule ,c of subpart ,c of part #bac  
of title #e of the ,code of ,federal    
,regulations4  4  7b7 ,clerical and     
conforming amendments  7#a7 ,clerical   
,the table of sections at the beginning 

of such chapter is amended by inserting 
after the item relating to section #gad1
 as added by section #aad1 the following
 new item3  #gae4 ,employees3 removal   
based on performance or misconduct4  4  
7#b7 ,conforming  7,a7 ,title #e        
,section #dcjc7;f7 of title #e1 ,united 
,states ,code1 is amended-- 7i7 in      
paragraph 7#b71 by striking or at the   
end2  7ii7 in paragraph 7#c71 by        
striking the period at the end and      
inserting 1 or2 and  7iii7 by adding at 
the end the following3  7#d7 any removal
 under section #gae of title #ch4  4    
7,b7 ,title #ch ,subchapter ,v of       
chapter #gd of title #ch1 ,united       
,states ,code1 is amended--  7i7 in     
section #gdfa7;b77#a71 by striking ,if  
the and inserting ,except as provided in
 section #gae of this title1 if the2 and
  7ii7 in section #gdfb--  7,i7 in      
subsection 7a77#a71 by striking         
,disciplinary and inserting ,except as  
provided in section #gae of this title1 
the ,disciplinary2 and  7,,ii7 in       

subsection 7b77#a71 by striking ,in any 
case and inserting ,except as provided  
in section #gae of this title1 in any   
case4  #abb4 ,prohibition on award of   
bonuses to employees of ,department of  
,veterans ,affairs under consideration  
for adverse actions or subject of       
adverse findings  7a7 ,in general       
,chapter #g of title #ch1 ,united       
,states ,code1 is further amended by    
inserting after section #gae1 as added  
by section #aba1 the following new      
section3  #gaf4 ,prohibition on award of
 bonuses to employees under             
consideration for adverse actions or    
subject of adverse findings  7a7 ,under 
consideration for adverse action        
,notwithstanding any other provision of 
law1 the ,secretary may not pay any     
bonus to any employee of the            
,department1 including an employee in a 
senior executive position 7as defined in
 section #gac7;d7 of this title71 while 
the ,secretary is considering carrying  
out an adverse personnel action with    

respect to the employee under this title
 or title #e4  7b7 ,subject of adverse  
finding  7#a7 ,notwithstanding any other
 provision of law1 in a case in which   
the ,secretary makes an adverse finding 
relating to an employee of the          
,department1 the ,secretary may not     
award a bonus to such employee until the
 earlier of--  7,a7 such date as the    
,secretary considers appropriate1 but   
not sooner than the date that is two    
years after the end of the fiscal year  
in which the adverse finding was made   
and not more than five years after the  
end of such fiscal year2 or  7,b7 the   
date that the finding is found to have  
been made in error4  7#b7 ,the          
,secretary may base an adverse finding  
under paragraph 7#a7 on an investigation
 by1 determination of1 or information   
provided by the ,inspector ,general of  
the ,department or another senior ethics
 official of the ,department or the     
,comptroller ,general of the ,united    
,states in connection with the carrying 

out by such official of an activity1    
authority1 or function under a provision
 of law other than this section4  7c7   
,previously awarded bonuses  7#a7 ,if   
the ,secretary makes an adverse finding 
relating to an employee under subsection
 7b71 the ,secretary1 after notice and  
an opportunity for a hearing1 shall     
issue an order directing the employee to
 repay the amount of any bonus awarded  
to the employee during the year during  
which the adverse finding is made1      
unless such finding is found to have    
been made in error4  7#b7 ,a hearing    
under paragraph 7#a7 shall be conducted 
in accordance with regulations relating 
to hearings promulgated by the          
,secretary under chapter #ge of title   
#e4  7d7 ,condition of receipt ,as a    
condition of receiving a bonus awarded  
after the date of the enactment of this 
section1 an employee of the ,department 
shall sign a certification stating that 
the employee shall repay the bonus in   
accordance with a final order issued in 

accordance with subsection 7c74  7e7    
,appeal ,an employee determined to be   
ineligible for a bonus under subsection 
7b7 or against whom an order is issued  
under subsection 7c7 may appeal to the  
,merit ,systems ,protection ,board under
 section #ggja of title #e4  7f7        
,rulemaking ,the ,secretary may         
promulgate such rules as the ,secretary 
considers appropriate to carry out this 
section4  7g7 ,definitions ,in this     
section3 7#a7 ,the term adverse finding 
relating to an employee means a         
determination that the conduct of the   
employee--  7,a7 violated a policy of   
the ,department for which the employee  
may be removed or suspended for a period
 of not less than #ad days2 or  7,b7    
violated a law for which the employee   
may be imprisoned for more than #a year4
  7#b7 ,the term adverse personnel      
action means any of the adverse actions 
described in section #gdfa7;c77#b7 of   
this title4  7#c7 ,the term bonus means 
any bonus or cash award1 including--    

7,a7 an award under chapter #de of title
 #e2  7,b7 an award under section #echd 
of such title2 and  7,c7 a retention    
bonus under section #eged of such title4
  4  7b7 ,clerical amendment ,the table 
of sections at the beginning of such    
chapter is further amended by inserting 
after the item relating to section #gae1
 as added by section #aba1 the following
 new item3  #gaf4 ,prohibition on award 
of bonuses to employees under           
consideration for adverse actions or    
subject of adverse findings4  4  #abc4  
,retention of records of reprimands and 
admonishments received by employees of  
the ,department of ,veterans ,affairs   
7a7 ,in general ,chapter #g of title    
#ch1 ,united ,states ,code1 is further  
amended by inserting after section #gaf1
 as added by section #abb1 the following
 new section3  #gag4 ,record of         
reprimands and admonishments  7a7 ,in   
general ,except as provided in          
subsection 7b71 if any employee of the  
,department receives a reprimand or     

admonishment from the ,secretary1 the   
,secretary shall retain a copy of such  
reprimand or admonishment in the        
permanent record of the employee for not
 less than three years after the date on
 which the employee received the        
reprimand or admonishment4  7b7 ,removal
 ,after the end of the three-year period
 specified in subsection 7a7 with       
respect to a reprimand or admonishment  
received by an employee1 the ,secretary 
shall remove the reprimand or           
admonishment1 as the case may be1 from  
the permanent record of the employee on 
the earlier of the following3  7#a7 ,the
 date on which the ,secretary determines
 that the reprimand or admonishment     
merits removal from the permanent record
 of the employee4  7#b7 ,the date that  
is five years after the date on which   
the employee received the reprimand or  
admonishment4  7c7 ,appeals ,if an      
employee receives a reprimand or        
admonishment that the employee believes 
he or she received improperly1 the      

employee may immediately appeal the     
reprimand or admonishment4  4  7b7      
,clerical amendment ,the table of       
sections at the beginning of such       
chapter is further amended by inserting 
after the item relating to section #gaf1
 as added by section #abb1 the following
 new item3  #gag4 ,record of reprimands 
and admonishments4  4  #abd4 ,limitation
 on administrative leave for employees  
of ,department of ,veterans ,affairs    
7a7 ,in general ,chapter #g of title    
#ch1 ,united ,states ,code1 is further  
amended by inserting after section #gag1
 as added by section #abc1 the following
 new section3  #gah4 ,administrative    
leave limitation and report  7a7        
,limitation applicable to employees     
within the ,department  7#a7 ,the       
,secretary may not place any covered    
individual on administrative leave for  
more than a total of #ad business days  
during any #cfe-;day period4  7#b7 7,a7 
,the ,secretary may waive the limitation
 under paragraph 7#a7 and extend the    

period of administrative leave of a     
covered individual if the ,secretary    
submits to the ,committee on ,veterans' 
,affairs of the ,senate and the         
,committee on ,veterans' ,affairs of the
 ,house of ,representatives a detailed  
explanation of the reasons the covered  
individual was placed on administrative 
leave and the reasons for the extension 
of such leave4  7,b7 ,such explanation  
shall include the position of the       
covered individual and the location     
where the covered individual is         
employed4  7#c7 ,in this subsection1 the
 term covered individual means an       
employee of the ,department1 including  
an employee in a senior executive       
position 7as defined in section #gac7;d7
 of this title7--  7,a7 who is subject  
to an investigation for purposes of     
determining whether such individual     
should be subject to any disciplinary   
action under this title or title #e2 or 
7,b7 against whom any disciplinary      
action is proposed or initiated under   

this title or title #e4  7b7 ,report on 
administrative leave  7#a7 ,not later   
than #cj days after the end of each     
fiscal year1 the ,secretary shall submit
 to the ,committee on ,veterans'        
,affairs of the ,senate and the         
,committee on ,veterans' ,affairs of the
 ,house of ,representatives a report    
listing the position of each employee of
 the ,department 7if any7 who has been  
placed on administrative leave for a    
period longer than #ad business days    
during such fiscal year4  7#b7 ,each    
report submitted under paragraph 7#a7   
shall include1 with respect to each     
employee listed in such report1 the     
following3  7,a7 ,the position occupied 
by the employee4  7,b7 ,the number of   
business days of such leave4  7,c7 ,the 
reason that such employee was placed on 
such leave4  7#c7 ,in submitting each   
report under paragraph 7#a71 the        
,secretary shall take such measures to  
protect the privacy of the employees    
listed in the report as the ,secretary  

considers appropriate4  7c7             
,administrative leave defined ,in this  
section1 the term administrative leave--
 7#a7 means an administratively         
authorized absence from duty without    
loss of pay or charge to leave1 for     
which the employee is placed--  7,a7 due
 to an investigation2 or  7,b7 while    
disciplinary action is proposed or      
initiated2 and  7#b7 includes any type  
of paid nonduty status without a charge 
to leave4  4  7b7 ,application  7#a7    
,administrative leave limitation        
,subsection 7a7 of section #gah of title
 #ch1 ,united ,states ,code1 as added by
 subsection 7a7 of this section1 shall  
apply to any period of administrative   
leave 7as defined in such section7      
commencing on or after the date of the  
enactment of this title4  7#b7 ,report  
,the report under section #gah7;b7 of   
such title 7as added by subsection 7a77 
shall apply beginning in the first      
quarter that ends after the date that is
 #ahj days after the date of the        

enactment of this ,act4  7c7 ,clerical  
amendment ,the table of sections at the 
beginning of chapter #g of such title is
 further amended by inserting after the 
item relating to section #gag1 as added 
by section #abc1 the following new item3
  #gah4 ,administrative leave limitation
 and report4  4  #abe4 ,measurement of  
,department of ,veterans ,affairs       
disciplinary process outcomes and       
effectiveness  7a7 ,measuring and       
collecting  7#a7 ,in general ,the       
,secretary of ,veterans ,affairs shall  
measure and collect information on the  
outcomes of disciplinary actions carried
 out by the ,department of ,veterans    
,affairs during the three-year period   
ending on the date of the enactment of  
this ,act and the effectiveness of such 
actions4  7#b7 ,elements ,in measuring  
and collecting pursuant to paragraph    
7#a71 the ,secretary shall measure and  
collect information regarding the       
following3  7,a7 ,the average time from 
the initiation of an adverse action     

against an employee at the ,department  
to the final resolution of that action4 
7,b7 ,the number of distinct steps and  
levels of review within the ,department 
involved in the disciplinary process and
 the average length of time required to 
complete these steps4  7,c7 ,the rate of
 use of alternate disciplinary          
procedures compared to traditional      
disciplinary procedures and the         
frequency with which employees who are  
subject to alternative disciplinary     
procedures commit additional offenses4  
7,d7 ,the number of appeals from adverse
 actions filed against employees of the 
,department1 the number of appeals      
upheld1 and the reasons for which the   
appeals were upheld4  7,e7 ,the use of  
paid administrative leave during the    
disciplinary process and the length of  
such leave4  7b7 ,report  7#a7 ,in      
general ,not later than ,december #ca1  
#bjaf1 the ,secretary shall submit to   
the appropriate committees of ,congress 
a report on the disciplinary procedures 

and actions of the ,department4  7#b7   
,contents ,the report submitted under   
paragraph 7#a7 shall include the        
following3 7,a7 ,the information        
collected under subsection 7a74  7,b7   
,the findings of the ,secretary with    
respect to the measurement and          
collection carried out under subsection 
7a74  7,c7 ,an analysis of the          
disciplinary procedures and actions of  
the ,department4  7,d7 ,suggestions for 
improving the disciplinary procedures   
and actions of the ,department4  7,e7   
,such other matters as the ,secretary   
considers appropriate4  7#c7            
,appropriate committees of ,congress ,in
 this subsection1 the term appropriate  
committees of ,congress means--  7,a7   
the ,committee on ,appropriations and   
the ,committee on ,veterans' ,affairs of
 the ,senate2 and  7,b7 the ,committee  
on ,appropriations and the ,committee on
 ,veterans' ,affairs of the ,house of   
,representatives4  ,d ,other personnel  
and accountability matters  #aca4       

,written opinion on certain employment  
restrictions after terminating          
employment with the ,department of      
,veterans ,affairs  7a7 ,in general     
,chapter #g of title #ch1 ,united       
,states ,code1 as amended by subtitles  
,a1 ,b1 and ,c1 is further amended by   
inserting after section #gah1 as added  
by section #abd1 the following new      
section3  #gai4 ,written opinion on     
certain employment restrictions after   
terminating employment with the         
,department  7a7 ,in general ,before    
terminating employment with the         
,department1 any official of the        
,department who has participated        
personally and substantially during the 
one-year period ending on the date of   
the termination in an acquisition by the
 ,department that exceeds #aj1jjj1jjj   
shall obtain a written opinion from an  
appropriate ethics counselor at the     
,department regarding any restrictions  
on activities that the official may     
undertake on behalf of a covered        

contractor during the two-year period   
beginning on the date on which the      
official terminates such employment4    
7b7 ,covered contractor defined ,in this
 section1 the term covered contractor   
means a contractor carrying out a       
contract entered into with the          
,department1 including pursuant to a    
subcontract4  4  7b7 ,clerical amendment
 ,the table of sections at the beginning
 of chapter #g of such title is further 
amended by inserting after the item     
relating to section #gah1 as added by   
section #abd1 the following new item3   
#gai4 ,written opinion on certain       
employment restrictions after leaving   
the ,department4  4  #acb4 ,requirement 
for contractors of the ,department      
employing certain recently separated    
,department employees  7a7 ,in general  
,subchapter ,,ii of chapter #ha of title
 #ch1 ,united ,states ,code1 is amended 
by adding at the end the following new  
section3  #habi4 ,requirement for       
contractors employing certain recently  

separated ,department employees  7a7 ,in
 general ,a covered contractor may not  
knowingly provide compensation to an    
individual described in subsection 7b7  
during the two-year period beginning on 
the date on which the individual        
terminates employment with the          
,department unless the covered          
contractor determines that the          
individual--  7#a7 has obtained the     
written opinion required under section  
#gai7;a7 of this title2 or  7#b7 has    
requested such written opinion not later
 than #cj days before receiving         
compensation from the covered           
contractor4  7b7 ,individual described  
,an individual described in this        
subsection is any official of the       
,department who participated personally 
and substantially during the one-year   
period ending on the date of the        
termination of the individual's         
employment with the ,department in an   
acquisition by the ,department that     
exceeds #aj1jjj1jjj4  7c7 ,covered      

contractor defined ,in this section1 the
 term covered contractor means a        
contractor carrying out a contract      
entered into with the ,department1      
including pursuant to a subcontract4  4 
7b7 ,application ,the requirement under 
section #habi7;a7 of title #ch1 ,united 
,states ,code1 as added by subsection   
7a71 shall apply with respect to any    
entity that enters into a contract with 
the ,department on or after the date of 
the enactment of this title4  7c7       
,clerical amendment ,the table of       
sections at the beginning of chapter #ha
 of such title is amended by inserting  
after the item relating to section #habh
 the following new item3  #habi4        
,requirement for contractors employing  
certain recently separated ,department  
employees4  4  #acc4 ,department of     
,veterans ,affairs program of internal  
audits  7a7 ,in general ,subchapter ,,ii
 of chapter #e of title #ch1 ,united    
,states ,code1 is amended by inserting  
after section #ebg the following new    

section3  #ebg;,a4 ,program of internal 
audits  7a7 ,program required  7#a7 ,the
 ,secretary shall carry out a program of
 internal audits and self-analysis to   
improve the furnishing of benefits and  
health care to veterans and their       
families4  7#b7 ,the ,secretary shall   
carry out the program required by       
paragraph 7#a7 through an office the    
,secretary shall establish for purposes 
of the program within the office of the 
,secretary that is interdisciplinary and
 independent of--  7,a7 the other       
offices within the office of the        
,secretary2 and  7,b7 the covered       
administrations 7or functions of such   
administrations71 staff organizations1  
and staff offices identified under      
subsection 7b77#a77;,a74  7b7 ,program  
requirements  7#a7 ,in carrying out the 
program required by subsection 7a71 the 
,secretary shall-- 7,a7 conduct periodic
 risk assessments of the ,department to 
identify those covered administrations  
7or functions of such administrations71 

staff organizations1 and staff offices  
of the ,department the audit of which   
would lead towards the greatest         
improvement in the furnishing of        
benefits and health care to veterans and
 their families2  7,b7 develop plans    
that are informed by the risk           
assessments conducted under paragraph   
7#a7 to conduct internal audits of the  
covered administrations 7or functions of
 such administrations71 staff           
organizations1 and staff offices        
identified under subparagraph 7,a72 and 
7,c7 conduct internal audits in         
accordance with the plans developed     
pursuant to subparagraph 7,b74  7#b7    
,the ,secretary shall carry out under   
the program required by subsection 7a7  
an audit of not fewer than five covered 
administrations 7or functions of such   
administrations71 staff organizations1  
or staff offices of the ,department each
 year4  7#c7 ,in identifying covered    
administrations 7or functions of such   
administrations71 staff organizations1  

and staff offices of the ,department    
under paragraph 7#a77;,a71 the          
,secretary shall accord priority to the 
covered administrations and functions of
 such administrations4  7#d7 7,a7 ,for  
purposes of this subsection1 the covered
 administrations of the ,department are 
the following3 7i7 ,the ,national       
,cemetery ,administration4  7ii7 ,the   
,veterans ,benefits ,administration4    
7iii7 ,the ,veterans ,health            
,administration4  7,b7 ,for purposes of 
this subsection1 the covered staff      
organizations of the ,department are the
 following3  7i7 ,the ,office of        
,acquisition1 ,logistics1 and           
,construction4  7ii7 ,the ,advisory     
,committee ,management ,office4  7iii7  
,the ,board of ,veterans' ,appeals4     
7iv7 ,the ,center for ,faith-,based and 
,neighborhood ,partnerships4  7v7 ,the  
,center for ,minority ,veterans4  7vi7  
,the ,center for ,women ,veterans4      
7vii7 ,the ,office of ,general ,counsel4
  7viii7 ,the ,office of ,regulation    

,policy and ,management4  7ix7 ,the     
,office of ,employment ,discrimination  
,complaint ,adjudication4  7x7 ,the     
,office of ,interagency ,care and       
,benefits ,coordination4  7xi7 ,the     
,office of ,small and ,disadvantaged    
,business ,utilization4  7xii7 ,the     
,office of ,survivors ,assistance4      
7xiii7 ,the ,veterans' ,service         
,organizations ,liaison4  7xiv7 ,the    
,office of ,patient ,advocacy4  7xv7    
,the ,office of ,accountability and     
,whistleblower ,protection4  7,c7 ,for  
purposes of this subsection1 the covered
 staff offices of the ,department are   
the following3 7i7 ,the office of the   
,assistant ,secretary for ,congressional
 and ,legislative ,affairs4  7ii7 ,the  
office of the ,assistant ,secretary for 
,human ,resources and ,administration4  
7iii7 ,the office of the ,assistant     
,secretary for ,information and         
,technology4  7iv7 ,the ,office of      
,management4  7v7 ,the office of the    
,assistant ,secretary for ,operations1  

,security1 and ,preparedness4  7vi7 ,the
 office of the ,assistant ,secretary for
 ,policy and ,planning4  7vii7 ,the     
office of the ,assistant ,secretary for 
,public and ,intergovernmental ,affairs4
  7c7 ,reports  7#a7 7,a7 ,not later    
than #ij days after completing an audit 
under the program required by subsection
 7a71 the ,secretary shall submit to the
 appropriate committees of ,congress a  
report on the audit4  7,b7 ,each report 
submitted under subparagraph 7,a7 with  
respect to an audit shall include the   
following3 7i7 ,a summary of the audit4 
7ii7 ,the findings of the ,secretary    
with respect to the audit4  7iii7 ,such 
recommendations as the ,secretary may   
have for legislative or administrative  
action to improve the furnishing of     
benefits and health care to veterans and
 their families4  7iv7 ,plans to carry  
out the recommendations submitted under 
clause 7iii71 including timelines for   
completion of such plans4  7#b7 7,a7    
,not later than ,september #a of each   

year1 the ,secretary shall submit to the
 appropriate committees of ,congress a  
report on the administration of this    
section4  7,b7 ,each report submitted   
under subparagraph 7,a7 shall include   
the following3 7i7 ,a detailed          
description of each matter for which a  
recommendation was submitted under      
clause 7iii7 of paragraph 7#a77;,b7 and 
with respect to which plans that were   
submitted under clause 7iv7 of such     
paragraph have not been completed4  7ii7
 ,a plan for the conduct of audits under
 this section during the first fiscal   
year beginning after the fiscal year in 
which the report is submitted1 which    
shall include the following3  7,i7 ,a   
description of any risk assessments the 
,secretary plans to conduct in such     
fiscal year4  7,,ii7 ,a summary of each 
audit the ,secretary plans to conduct in
 such fiscal year1 including a          
description of the subject matter of the
 audit and identification of the        
administration1 office1 or function to  

be audited4  7#c7 ,in this subsection1  
the term appropriate committees of      
,congress includes-- 7,a7 the ,committee
 on ,veterans' ,affairs1 the ,committee 
on ,appropriations1 and the ,committee  
on ,homeland ,security and ,governmental
 ,affairs of the ,senate2 and  7,b7 the 
,committee on ,veterans' ,affairs1 the  
,committee on ,appropriations1 and the  
,committee on ,oversight and ,government
 ,reform of the ,house of               
,representatives4  4  7b7 ,first risk   
assessment ,the ,secretary of ,veterans 
,affairs shall complete the first risk  
assessment required by section          
#ebg;,a7b77#a77;,a7 of such title1 as   
added by subsection 7a71 by not later   
than #ahj days after the date of the    
enactment of this ,act4  7c7 ,clerical  
amendment ,the table of sections at the 
beginning of chapter #e of such title is
 amended by inserting after the item    
relating to section #ebg the following  
new item3  #ebg;,a4 ,program of internal
 audits4  4  ,,ii ,health care matters  

#bjj4 ,short title ,this title may be   
cited as the ,jason ,simcakoski         
,memorial ,act4  ,a ,expansion and      
improvement of health care benefits     
#bja4 ,improved access to appropriate   
immunizations for veterans  7a7         
,inclusion of recommended adult         
immunizations as medical services  7#a7 
,covered benefit ,subparagraph 7,f7 of  
section #agja7i7 of title #ch1 ,united  
,states ,code1 is amended to read as    
follows3  7,f7 immunizations against    
infectious diseases1 including each     
immunization on the recommended adult   
immunization schedule at the time such  
immunization is indicated on that       
schedule2  4  7#b7 ,recommended adult   
immunization schedule defined ,section  
#agja of such title is amended by adding
 at the end the following new paragraph3
  7#aj7 ,the term recommended adult     
immunization schedule means the schedule
 established 7and periodically reviewed 
and1 as appropriate1 revised7 by the    
,advisory ,committee on ,immunization   

,practices established by the ,secretary
 of ,health and ,human ,services and    
delegated to the ,centers for ,disease  
,control and ,prevention4  4  7b7       
,inclusion of recommended adult         
immunizations in annual report ,section 
#agjd7a77;,a7 of such title is amended--
 7#a7 in clause 7i71 by striking and at 
the end2  7#b7 in clause 7ii71 by       
striking the period at the end and      
inserting 2 and2 and  7#c7 by inserting 
after clause 7ii7 the following new     
clause3  7iii7 to provide veterans each 
immunization on the recommended adult   
immunization schedule at the time such  
immunization is indicated on that       
schedule4  4  7c7 ,report to ,congress  
7#a7 ,in general ,not later than two    
years after the date of the enactment of
 this ,act1 the ,secretary of ,veterans 
,affairs shall submit to the ,committee 
on ,veterans' ,affairs of the ,senate   
and the ,committee on ,veterans'        
,affairs of the ,house of               
,representatives a report on the        

development and implementation by the   
,department of ,veterans ,affairs of    
quality measures and metrics1 including 
targets for compliance1 to ensure that  
veterans receiving medical services     
under chapter #ag of title #ch1 ,united 
,states ,code1 receive each immunization
 on the recommended adult immunization  
schedule at the time such immunization  
is indicated on that schedule4  7#b7    
,recommended adult immunization schedule
 defined ,in this subsection1 the term  
recommended adult immunization schedule 
has the meaning given that term in      
section #agja7aj7 of title #ch1 ,united 
,states ,code1 as added by subsection   
7a77#b74  7d7 ,rule of construction     
,nothing in this section or the         
amendments made by this section may be  
construed to require a veteran to       
receive an immunization that the veteran
 does not want to receive4  #bjb4       
,expansion of provision of chiropractic 
care and services to veterans  7a7      
,program for provision of chiropractic  

care and services to veterans ,section  
#bjd7;c7 of the ,department of ,veterans
 ,affairs ,health ,care ,programs       
,enhancement ,act of #bjja 7,public ,law
 #ajg-ace2 #aae ,stat4 #bdei2 #ch       
,u4,s4,c4 #agaj note7 is amended--  7#a7
 by inserting 7#a7 before ,the program2 
and  7#b7 by adding at the end the      
following new paragraph3  7#b7 ,the     
program shall be carried out at not     
fewer than two medical centers or       
clinics in each ,veterans ,integrated   
,service ,network by not later than two 
years after the date of the enactment of
 the ,jason ,simcakoski ,memorial ,act1 
and at not fewer than #ej percent of all
 medical centers in each ,veterans      
,integrated ,service ,network by not    
later than three years after such date  
of enactment4  4  7b7 ,expanded         
chiropractor services available to      
veterans  7#a7 ,medical services        
,paragraph 7#f7 of section #agja of     
title #ch1 ,united ,states ,code1 is    
amended by adding at the end the        

following new subparagraph3  7,h7       
,chiropractic services4  4  7#b7        
,rehabilitative services ,paragraph 7#h7
 of such section is amended by inserting
 chiropractic1 after counseling14  7#c7 
,preventive health services ,paragraph  
7#i7 of such section is amended-- 7,a7  
by redesignating subparagraphs 7,f7     
through 7,k7 as subparagraphs 7,g7      
through 7,l71 respectively2 and  7,b7 by
 inserting after subparagraph 7,e7 the  
following new subparagraph 7,f73  7,f7  
periodic and preventive chiropractic    
examinations and services2  4  #bjc4    
,priority of medal of honor recipients  
in health care system of ,department of 
,veterans ,affairs  7a7 ,enrollment     
priority  7#a7 ,in general ,section     
#agje7;a7 of title #ch1 ,united ,states 
,code1 is amended-- 7,a7 in paragraph   
7#a71 by striking the period at the end 
and inserting the following3 and        
veterans who were awarded the medal of  
honor under section #cgda1 #fbda1 or    
#hgda of title #aj or section #dia of   

title #ad42 and  7,b7 in paragraph 7#c71
 by striking veterans who were awarded  
the medal of honor under section #cgda1 
#fbda1 or #hgda of title #aj or section 
#dia of title #ad14  7#b7 ,application  
,the priority of enrollment of medal of 
honor recipients in the system of annual
 patient enrollment established and     
operated under section #agje7;a7 of such
 title1 as amended by paragraph 7#a71   
shall apply to each such recipient1     
regardless of the date on which the     
medal is awarded4  7b7 ,eligibility     
,section #agaj7;a77#b77;,d7 of such     
title is amended by inserting after war 
the following3 1 who was awarded the    
medal of honor under section #cgda1     
#fbda1 or #hgda of title #aj or section 
#dia of title #ad14  7c7 ,extended care 
services ,section #agaj;,b7c77#b7 of    
such title is amended-- 7#a7 in         
subparagraph 7,b71 by striking or2  7#b7
 in subparagraph 7,c71 by striking the  
period at the end and inserting 2 or2   
and  7#c7 by adding at the end the      

following new subparagraph3  7,d7 to a  
veteran who was awarded the medal of    
honor under section #cgda1 #fbda1 or    
#hgda of title #aj or section #dia of   
title #ad4  4  7d7 ,copayment for       
medications ,section #agbb;,a7a77#c7 of 
such title is amended-- 7#a7 in         
subparagraph 7,b71 by striking or2  7#b7
 in subparagraph 7,c71 by striking the  
period at the end and inserting 2 or2   
and  7#c7 by adding at the end the      
following new subparagraph3  7,d7 to a  
veteran who was awarded the medal of    
honor under section #cgda1 #fbda1 or    
#hgda of title #aj or section #dia of   
title #ad4  4  ,b ,mental health care   
#baa4 ,veterans ,expedited ,recovery    
,commission  7a7 ,establishment ,there  
is established the ,veterans ,expedited 
,recovery ,commission 7in this section  
referred to as the ,commission74  7b7   
,duties ,the ,commission shall perform  
the following duties3  7#a7 ,examine the
 efficacy of the evidence-based therapy 
model used by the ,department of        

,veterans ,affairs for treating mental  
health conditions of veterans and       
identify areas to improve wellness-based
 outcomes4  7#b7 ,conduct a             
patient-centered survey within each of  
the ,veterans ,integrated ,service      
,networks to examine--  7,a7 the        
experience of veterans with the         
,department when seeking medical        
assistance for mental health conditions 
through the health care system of the   
,department2  7,b7 the experience of    
veterans with non-,department medical   
facilities and health professionals for 
treating mental health conditions2  7,c7
 the preferences of veterans regarding  
available treatments for mental health  
conditions and which methods the        
veterans believe to be most effective2  
7,d7 the experience1 if any1 of veterans
 with respect to the complementary and  
integrative health services described in
 subparagraphs 7,a7 through 7,i7 of     
paragraph 7#c72  7,e7 the prevalence of 
prescribing prescription medication     

among veterans seeking treatment through
 the health care system of the          
,department as remedies for addressing  
mental health conditions2 and  7,f7 the 
outreach efforts of the ,secretary of   
,veterans ,affairs regarding the        
availability of benefits and treatments 
for veterans for addressing mental      
health conditions1 including by         
identifying ways to reduce barriers to  
and gaps in such benefits and           
treatments4  7#c7 ,examine available    
research on complementary and           
integrative health services for mental  
health conditions and identify what     
benefits could be made with the         
inclusion of such treatments for        
veterans1 including with respect to--   
7,a7 music therapy2  7,b7 equine        
therapy2  7,c7 training and caring for  
service dogs2  7,d7 yoga therapy2  7,e7 
acupuncture therapy2  7,f7 meditation   
therapy2  7,g7 outdoor sports therapy2  
7,h7 hyperbaric oxygen therapy2 and     
7,i7 such other therapies as the        

,commission determines appropriate4     
7#d7 ,study the potential increase of   
claims relating to mental health        
conditions submitted to the ,secretary  
by veterans who served in ,operation    
,enduring ,freedom1 ,operation ,iraqi   
,freedom1 or ,operation ,new ,dawn1     
including an assessment of the resources
 available within the ,department to    
ensure that quality health care demands 
relating to such claims can be delivered
 in a timely manner4  7c7 ,membership   
7#a7 ,number and appointment  7,a7 ,in  
general ,the ,commission shall be       
composed of #aj members1 appointed as   
follows3 7i7 ,two members appointed by  
the ,speaker of the ,house of           
,representatives1 at least one of whom  
shall be a veteran4  7ii7 ,two members  
appointed by the ,minority ,leader of   
the ,house of ,representatives1 at least
 one of whom shall be a veteran4  7iii7 
,two members appointed by the ,majority 
,leader of the ,senate1 at least one of 
whom shall be a veteran4  7iv7 ,two     

members appointed by the ,minority      
,leader of the ,senate1 at least one of 
whom shall be a veteran4  7v7 ,two      
members appointed by the ,president1 at 
least one of whom shall be a veteran4   
7,b7 ,qualifications ,members of the    
,commission shall be individuals who--  
7i7 are of recognized standing and      
distinction within the medical community
 with a background in treating mental   
health2  7ii7 have experience working   
with the military and veteran           
population2 and  7iii7 do not have a    
financial interest in any of the        
complementary and integrative health    
services reviewed by the ,commission4   
7#b7 ,chair ,the ,president shall       
designate a member of the ,commission to
 be the ,chair4  7#c7 ,period of        
,appointment ,members of the ,commission
 shall be appointed for the life of the 
,commission4  7#d7 ,vacancy ,a vacancy  
in the ,commission shall be filled in   
the manner in which the original        
appointment was made4  7#e7 ,appointment

 ,deadline ,the appointment of members  
of the ,commission in this section shall
 be made not later than #ij days after  
the date of the enactment of this ,act4 
7d7 ,powers of ,commission  7#a7        
,meeting  7,a7 ,initial meeting ,the    
,commission shall hold its first meeting
 not later than #cj days after a        
majority of members are appointed to the
 ,commission4  7,b7 ,meeting ,the       
,commission shall regularly meet at the 
call of the ,chair4 ,such meetings may  
be carried out through the use of       
telephonic or other appropriate         
telecommunication technology if the     
,commission determines that such        
technology will allow the members to    
communicate simultaneously4  7#b7       
,hearings ,the ,commission may hold such
 hearings1 sit and act at such times and
 places1 take such testimony1 and       
receive such evidence as the ,commission
 considers advisable to carry out the   
responsibilities of the ,commission4    
7#c7 ,information from ,federal         

,agencies ,the ,commission may secure   
directly from any ,federal agency such  
information as the ,commission considers
 necessary to carry out the duties of   
the ,commission under subsection 7b74   
7#d7 ,information from nongovernmental  
organizations ,in carrying out the      
duties of the ,commission under         
subsection 7b71 the ,commission may seek
 guidance through consultation with     
foundations1 veterans service           
organizations1 nonprofit groups1        
faith-based organizations1 private and  
public institutions of higher education1
 and such other organizations as the    
,commission determines appropriate4     
7#e7 ,commission ,records ,the          
,commission shall keep an accurate and  
complete record of the actions and      
meetings of the ,commission4 ,such      
record shall be made available for      
public inspection and the ,comptroller  
,general of the ,united ,states may     
audit and examine such record4  7#f7    
,personnel ,matters ,upon request of the

 ,chair of the ,commission1 the head of 
any ,federal agency may detail1 on a    
reimbursable basis1 any personnel of    
that agency to assist the ,commission in
 carrying out the duties of the         
,commission4  7#g7 ,compensation of     
,members2 ,travel ,expenses ,each member
 shall serve without pay1 except that   
each member shall receive travel        
expenses to perform the duties of the   
,commission under subsection 7b71       
including per diem in lieu of           
subsistence1 at rates authorized under  
subchapter ,i of chapter #eg of title   
#e1 ,united ,states ,code4  7#h7 ,staff 
,the ,chair1 in accordance with rules   
agreed upon by the ,commission1 may     
appoint and fix the compensation of a   
staff director and such other personnel 
as may be necessary to enable the       
,commission to carry out its functions1 
without regard to the provisions of     
title #e1 ,united ,states ,code1        
governing appointments in the           
competitive service or chapter #ea and  

subchapter ,,iii of chapter #ec of such 
title relating to classification and    
,general ,schedule pay rates1 except    
that no rate of pay fixed under this    
subsection may exceed the equivalent of 
the rate payable for a position at level
 ,,iv of the ,executive ,schedule under 
section #ecae of such title4  7#i7      
,personnel as ,federal employees  7,a7  
,in general ,the executive director and 
any personnel of the ,commission are    
employees under section #baje of title  
#e1 ,united ,states ,code1 for purposes 
of chapters #fc1 #ha1 #hc1 #hd1 #he1    
#hg1 #hi1 and #ij of such title4  7,b7  
,members of the ,commission             
,subparagraph 7,a7 shall not be         
construed to apply to members of the    
,commission4  7#aj7 ,contracting ,the   
,commission may1 to such extent and in  
such amounts as are provided in         
appropriations ,acts1 enter into        
contracts to enable the ,commission to  
discharge the duties of the ,commission 
under this section4  7#aa7 ,expert and  

,consultant ,services ,the ,commission  
may procure the services of experts and 
consultants in accordance with section  
#caji of title #e1 ,united ,states      
,code1 at rates not to exceed the daily 
rate paid to a person occupying a       
position at level ,,iv of the ,executive
 ,schedule under section #ecae of such  
title4  7#ab7 ,postal ,service ,the     
,commission may use the ,united ,states 
mails in the same manner and under the  
same conditions as a ,federal agency4   
7#ac7 ,physical ,facilities and         
,equipment ,upon the request of the     
,commission1 the ,administrator of      
,general ,services shall provide to the 
,commission1 on a reimbursable basis1   
the administrative support services     
necessary for the ,commission to carry  
out its responsibilities under this     
section4 ,these administrative services 
may include human resource management1  
budget1 leasing1 accounting1 and payroll
 services4  7e7 ,reports  7#a7 ,interim 
,reports  7,a7 ,cooperation by heads of 

,federal agencies ,not later than #fj   
days after the date on which the        
,commission first meets1 and not less   
frequently than once during each        
#cj-;day period thereafter ending on the
 date on which the ,commission submits  
the final report under paragraph 7#b71  
the ,commission shall submit to the     
,committee on ,veterans' ,affairs of the
 ,senate1 the ,committee on ,veterans'  
,affairs of the ,house of               
,representatives1 and the ,president a  
report detailing the level of           
cooperation the ,secretary of ,veterans 
,affairs 7and the heads of other        
,federal agencies7 has provided to the  
,commission4  7,b7 ,other reports ,in   
carrying out the duties of the          
,commission under subsection 7b71 at    
times that the ,commission determines   
appropriate1 the ,commission shall      
submit to the ,committee on ,veterans'  
,affairs of the ,senate1 the ,committee 
on ,veterans' ,affairs of the ,house of 
,representatives1 and such other        

entities as the ,commission determines  
appropriate an interim report with      
respect to the findings identified by   
the ,commission4  7#b7 ,final report    
7,a7 ,in general ,not later than #ah    
months after the date on which the      
,commission first meets1 the ,commission
 shall submit to the ,committee on      
,veterans' ,affairs of the ,senate1 the 
,committee on ,veterans' ,affairs of the
 ,house of ,representatives1 the        
,president1 and the ,secretary of       
,veterans ,affairs a final report on the
 findings of the ,commission4  7,b7     
,elements ,the report required by       
subparagraph 7,a7 shall include the     
following3 7i7 ,recommendations to      
implement in a feasible1 timely1 and    
cost-effective manner any solutions and 
remedies identified by the ,commission  
in carrying out the duties of the       
,commission under subsection 7b74  7ii7 
,an analysis of the evidence-based      
therapy model used by the ,secretary for
 treating veterans with mental health   

conditions and an examination of the    
prevalence and efficacy of prescription 
drugs as a means of treatment4  7iii7   
,the findings of the patient-centered   
survey conducted within each of the     
,veterans ,integrated ,service ,networks
 under subsection 7b77#b74  7iv7 ,an    
examination of the complementary and    
integrative health services described in
 subsection 7b77#c7 and the potential   
benefits of incorporating such services 
in the therapy model used by the        
,secretary for treating veterans with   
mental health conditions4  7#c7 ,plan   
,not later than #ij days after the date 
on which the ,commission submits the    
final report under paragraph 7#b71 the  
,secretary of ,veterans ,affairs shall  
submit to the ,committee on ,veterans'  
,affairs of the ,senate and the         
,committee on ,veterans' ,affairs of the
 ,house of ,representatives a report on 
the following3  7,a7 ,an action plan for
 implementing the recommendations set   
forth by the ,commission in such report 

regarding solutions and remedies for    
improving wellness-based outcomes for   
veterans with mental health conditions4 
7,b7 ,a feasible timeframe on when      
complementary and integrative health    
services described in subsection 7b77#c7
 can be implemented throughout the      
,department4  7,c7 ,with respect to each
 recommendation set forth by the        
,commission1 including regarding any    
complementary and integrative health    
service1 that the ,secretary determines 
is not appropriate or feasible to       
implement1 a justification for each such
 determination and an alternative       
solution to improve the efficacy of the 
therapy model used by the ,secretary for
 treating veterans with mental health   
conditions4  7f7 ,termination of        
,commission ,the ,commission shall      
terminate #cj days after the ,commission
 submits the final report under         
subsection 7e77#b74  7g7 ,complementary 
and integrative health defined ,in this 
section1 the term complementary and     

integrative health has the meaning given
 that term or any subsequent similar    
term by the ,national ,institutes of    
,health4  #bab4 ,mental health treatment
 for veterans who served in classified  
missions  7a7 ,sense of ,congress ,it is
 the sense of ,congress that veterans   
who experience combat-related mental    
health wounds should have immediate1    
appropriate1 and consistent access to   
comprehensive mental health care4  7b7  
,in general ,subchapter ,,ii of chapter 
#ag of title #ch1 ,united ,states ,code1
 is amended by adding at the end the    
following new section3  #agbj;,h4       
,mental health treatment for veterans   
who served in classified missions  7a7  
,establishment of standards  7#a7 ,the  
,secretary shall establish standards and
 procedures to ensure that each eligible
 veteran may access mental health care  
furnished by the ,secretary in a manner 
that fully accommodates the obligation  
of the veteran to not improperly        
disclose classified information4  7#b7  

,in establishing standards and          
procedures under paragraph 7#a71 the    
,secretary shall consult with the       
,secretary of ,defense to ensure that   
such standards and procedures are       
consistent with the policies on         
classified information of the           
,department of ,defense4  7#c7 ,the     
,secretary shall disseminate guidance to
 employees of the ,veterans ,health     
,administration1 including mental health
 professionals1 on the standards and    
procedures established under paragraph  
7#a7 and how to best engage eligible    
veterans during the course of mental    
health treatment with respect to        
classified information4  7b7            
,identification ,in carrying out this   
section1 the ,secretary shall ensure    
that a veteran may elect to identify as 
an eligible veteran on an appropriate   
form4  7c7 ,definitions ,in this        
section3 7#a7 ,the term classified      
information means any information or    
material that has been determined by an 

official of the ,united ,states pursuant
 to law to require protection against   
unauthorized disclosure for reasons of  
national security4  7#b7 ,the term      
eligible veteran means a veteran who--  
7,a7 is enrolled in the system of annual
 patient enrollment established and     
operated under section #agje7;a7 of this
 title2  7,b7 is seeking mental health  
treatment2 and  7,c7 in the course of   
serving in the ,armed ,forces1          
participated in a sensitive mission or  
served in a sensitive unit4  7#c7 ,the  
term sensitive mission means a mission  
of the ,armed ,forces that1 at the time 
at which a eligible veteran seeks       
treatment1 is classified4  7#d7 ,the    
term sensitive unit has the meaning     
given that term in section #acj;b7c77#d7
 of title #aj4  4  7c7 ,clerical        
amendment ,the table of sections at the 
beginning of chapter #ag of such title  
is amended by inserting after the item  
relating to section #agbj;,g the        
following new item3  #agbj;,h4 ,mental  

health treatment for veterans who served
 in classified missions4  4  #bac4      
,inclusion of mental health             
professionals in education and training 
program for health personnel of the     
,department of ,veterans ,affairs  7a7  
,in general ,in carrying out the program
 of education and training required     
under section #gcjb7;a77#a7 of title    
#ch1 ,united ,states ,code1 the         
,secretary of ,veterans ,affairs shall  
include education and training of       
marriage and family therapists and      
licensed professional mental health     
counselors4  7b7 ,effective date        
,subsection 7a7 shall take effect on the
 date that is one year after the date of
 the enactment of this ,act4  #bad4     
,expansion of qualifications for        
licensed mental health counselors of the
 ,department of ,veterans ,affairs to   
include doctoral degrees ,section       
#gdjb7;b77#aa77;,a7 of title #ch1       
,united ,states ,code1 is amended by    
inserting or doctoral degree after      

master's degree4  ,c ,improvement of    
medical workforce  #bba4 ,modification  
of hours of employment for physicians   
and physician assistants employed by the
 ,department of ,veterans ,affairs      
,section #gdbc7;a7 of title #ch1 ,united
 ,states ,code1 is amended--  7#a7 by   
striking 7a7 ,the hours and inserting   
7a77#a7 ,except as provided in paragraph
 7#b71 the hours2 and  7#b7 by adding at
 the end the following new paragraph3   
7#b7 ,the ,secretary may modify the     
hours of employment for a physician or  
physician assistant appointed in the    
,administration under any provision of  
this chapter on a full-time basis to be 
more than or less than #hj hours in a   
biweekly pay period if the total hours  
of employment for such employee in a    
calendar year does not exceed #b1jhj    
hours4  4  #bbb4 ,requirement that      
physician assistants employed by the    
,department of ,veterans ,affairs       
receive competitive pay  7a7 ,in general
 ,section #gdea7;a77#b7 of title #ch1   

,united ,states ,code1 is amended-- 7#a7
 by redesignating subparagraph 7,b7 as  
subparagraph 7,c72  7#b7 by inserting   
after subparagraph 7,a7 the following   
new subparagraph 7,b73  7,b7 ,physician 
assistant4  2 and  7#c7 in subparagraph 
7,c71 as redesignated by paragraph 7#a71
 by striking and registered nurse and   
inserting registered nurse1 and         
physician assistant4  7b7 ,effective    
date ,the amendments made by subsection 
7a7 shall take effect on the date that  
is one year after the date of the       
enactment of this ,act4  #bbc4          
,extension of period for increase in    
graduate medical education residency    
positions at medical facilities of the  
,department of ,veterans ,affairs  7a7  
,in general ,paragraph 7#b7 of section  
#cja7;b7 of the ,veterans ,access1      
,choice1 and ,accountability ,act of    
#bjad 7,public ,law #aac-adf2 #ch       
,u4,s4,c4 #gcjb note7 is amended--  7#a7
 in the paragraph heading1 by striking  
,five-year and inserting ,ten-year2 and 

7#b7 in subparagraph 7,a71 by striking  
#e-year period and inserting #aj-year   
period4  7b7 ,report ,paragraph         
7#c77;,a7 of such section is amended by 
striking until #bjai and inserting until
 #bjbd4  #bbd4 ,additional requirements 
for hiring of health care providers by  
,department of ,veterans ,affairs  7a7  
,in general ,the ,secretary of ,veterans
 ,affairs shall1 as part of the hiring  
process for each health care provider   
considered for a position at the        
,department of ,veterans ,affairs after 
the date specified in subsection 7c71   
require from the medical board of each  
,state in which the health care provider
 holds or has held a medical license--  
7#a7 information on any violation of the
 requirements of the medical license of 
the health care provider2 and  7#b7     
information on whether the health care  
provider has entered into any settlement
 agreement for a disciplinary charge    
relating to the practice of medicine by 
the health care provider4  7b7          

,regulations ,the ,secretary shall      
prescribe regulations to carry out this 
section4  7c7 ,date specified  7#a7 ,in 
general ,the date specified in this     
subsection is the date on which the     
,secretary prescribes regulations to    
carry out this section4  7#b7           
,publication ,the ,secretary shall      
publish in the ,federal ,register the   
date specified in this subsection not   
later than #cj days before such date4   
#bbe4 ,provision of information on      
health care providers of ,department of 
,veterans ,affairs to ,state medical    
boards  7a7 ,in general ,notwithstanding
 section #eeb;a of title #e1 ,united    
,states ,code1 the ,secretary of        
,veterans ,affairs shall1 with respect  
to each health care provider of the     
,department of ,veterans ,affairs that  
violates a requirement of the medical   
license of the health care provider     
after the date of the enactment of this 
,act1 provide to the medical board of   
each ,state in which the health care    

provider is licensed or practices all   
relevant information contained in the   
,state ,licensing ,board ,reporting     
,file or any successor file of the      
,department with respect to such        
violation4  7b7 ,no request required    
,the ,secretary shall provide the       
information required in subsection 7a7  
to a medical board described in such    
subsection notwithstanding that such    
board may not have formally requested   
such information from the ,department4  
#bbf4 ,report on medical workforce of   
the ,department of ,veterans ,affairs   
7a7 ,in general ,not later than #abj    
days after the date of the enactment of 
this ,act1 the ,secretary of ,veterans  
,affairs shall submit to the ,committee 
on ,veterans' ,affairs of the ,senate   
and the ,committee on ,veterans'        
,affairs of the ,house of               
,representatives a report on the medical
 workforce of the ,department of        
,veterans ,affairs4  7b7 ,elements ,the 
report required by subsection 7a7 shall 

include the following3 7#a7 ,with       
respect to licensed professional mental 
health counselors and marriage and      
family therapists of the ,department--  
7,a7 how many such counselors and       
therapists are currently enrolled in the
 mental health professionals trainee    
program of the ,department2  7,b7 how   
many such counselors and therapists are 
expected to enroll in the mental health 
professionals trainee program of the    
,department during the #ahj-;day period 
beginning on the date of the submittal  
of the report2  7,c7 a description of   
the eligibility criteria for such       
counselors and therapists as compared to
 other behavioral health professions in 
the ,department2  7,d7 a description of 
the objectives1 goals1 and timing of the
 ,department with respect to increasing 
the representation of such counselors   
and therapists in the behavioral health 
workforce of the ,department2 and  7,e7 
a description of the actions taken by   
the ,secretary1 in consultation with the

 ,director of the ,office of ,personnel 
,management1 to create an occupational  
series for such counselors and          
therapists and a timeline for the       
creation of such an occupational series4
  7#b7 ,a breakdown of spending by the  
,department in connection with the      
education debt reduction program of the 
,department under subchapter ,,vii of   
chapter #gf of title #ch1 ,united       
,states ,code1 including--  7,a7 the    
amount spent by the ,department in debt 
reduction payments during the three-year
 period preceding the submittal of the  
report disaggregated by the medical     
profession of the individual receiving  
the payments2  7,b7 a description of how
 the ,department prioritizes such       
spending by medical profession1         
including an assessment of whether such 
priority reflects the five occupations  
identified in the most recent           
determination by the ,inspector ,general
 of the ,department of ,veterans        
,affairs as having the largest staffing 

shortages in the ,veterans ,health      
,administration2 and  7,c7 a description
 of the actions taken by the ,secretary 
to increase the effectiveness of such   
spending for purposes of recruitment of 
health care providers to the            
,department1 including efforts to more  
consistently include eligibility for the
 education debt reduction program in    
vacancy announcements of positions for  
health care providers at the            
,department4  7#c7 ,a description of any
 impediments to the delivery by the     
,department of telemedicine services to 
veterans and any actions taken by the   
,department to address such impediments1
 including with respect to--  7,a7      
restrictions under ,federal or ,state   
law2  7,b7 licensing or credentialing   
issues for health care providers1       
including non-,department health care   
providers1 practicing telemedicine with 
a veteran located in a different ,state2
  7,c7 the effect of limited broadband  
access or limited information technology

 capabilities on the delivery of health 
care2  7,d7 the distance a veteran is   
required to travel1 if the veteran is   
required to travel1 to access a facility
 or clinic with telemedicine            
capabilities2  7,e7 the effect on the   
provision of telemedicine services to   
veterans of policies of and limited     
liability protection for certain        
entities2 and  7,f7 issues relating to  
reimbursement and travel limitations for
 veterans that affect the participation 
of non-,department health care providers
 in the telemedicine program4  7#d7 ,an 
update on the efforts of the ,secretary 
to offer training opportunities in      
telemedicine to medical residents in    
medical facilities of the ,department   
that use telemedicine1 consistent with  
medical residency program requirements  
established by the ,accreditation       
,council for ,graduate ,medical         
,education1 as required in section      
#ajh7;b7 of the ,honoring ,america's    
,veterans and ,caring for ,camp ,lejeune

 ,families ,act of #bjab 7,public ,law  
#aab-aed2 #ch ,u4,s4,c4 #gdjf note74    
7#e7 ,an assessment of the development  
and implementation by the ,secretary of 
succession planning policies to address 
the prevalence of vacancies in positions
 in the ,veterans ,health               
,administration of more than #ahj days1 
including the development of an         
enterprise position management system to
 more effectively identify1 track1 and  
resolve such vacancies4  7#f7 ,a        
description of the actions taken by the 
,secretary1 in consultation with the    
,director of the ,office of ,personnel  
,management1 to address any impediments 
to the timely appointment and           
determination of qualifications for     
,directors of ,veterans ,integrated     
,service ,networks and ,medical ,center 
,directors of the ,department4  #bbg4   
,report on compliance by ,department of 
,veterans ,affairs with reviews of      
health care providers leaving the       
,department or transferring to other    

facilities ,not later than #ahj days    
after the date of the enactment of this 
,act1 the ,secretary of ,veterans       
,affairs shall submit to the ,committee 
on ,veterans' ,affairs of the ,senate   
and the ,committee on ,veterans'        
,affairs of the ,house of               
,representatives a report on the        
compliance by the ,department of        
,veterans ,affairs with the policy of   
the ,department--  7#a7 to conduct a    
review of each health care provider of  
the ,department who transfers to another
 medical facility of the ,department or 
leaves the ,department to determine     
whether there are any concerns1         
complaints1 or allegations of violations
 relating to the medical practice of the
 health care provider2 and  7#b7 to take
 appropriate action with respect to any 
such concern1 complaint1 or allegation4 
,d ,family caregivers  #bca4 ,expansion 
of family caregiver program of          
,department of ,veterans ,affairs  7a7  
,family caregiver program  7#a7         

,expansion of eligibility  7,a7 ,in     
general ,subsection 7a77#b77;,b7 of     
section #agbj;,g of title #ch1 ,united  
,states ,code1 is amended to read as    
follows3  7,b7 for assistance provided  
under this subsection-- 7i7 before the  
date on which the ,secretary submits to 
,congress a certification that the      
,department has fully implemented the   
information technology system required  
by section #bcb7;a7 of the ,jason       
,simcakoski ,memorial ,act1 has a       
serious injury 7including traumatic     
brain injury1 psychological trauma1 or  
other mental disorder7 incurred or      
aggravated in the line of duty in the   
active military1 naval1 or air service  
on or after ,september #aa1 #bjja2  7ii7
 during the two-year period beginning on
 the date specified in clause 7i71 has a
 serious injury 7including traumatic    
brain injury1 psychological trauma1 or  
other mental disorder7 incurred or      
aggravated in the line of duty in the   
active military1 naval1 or air service--

  7,i7 on or before ,may #g1 #aige2 or  
7,,ii7 on or after ,september #aa1      
#bjja2 or  7iii7 after the date that is 
two years after the date specified in   
clause 7i71 has a serious injury        
7including traumatic brain injury1      
psychological trauma1 or other mental   
disorder7 incurred or aggravated in the 
line of duty in the active military1    
naval1 or air service2 and  4  7,b7     
,publication in ,federal ,register ,not 
later than #cj days after the date on   
which the ,secretary of ,veterans       
,affairs submits to ,congress the       
certification described in subsection   
7a77#b77;,b77i7 of section #agbj;,g of  
such title1 as amended by subparagraph  
7,a7 of this paragraph1 the ,secretary  
shall publish the date specified in such
 subsection in the ,federal ,register4  
7#b7 ,expansion of needed services in   
eligibility criteria ,subsection        
7a77#b77;,c7 of such section is         
amended-- 7,a7 in clause 7ii71 by       
striking 2 or and inserting a semicolon2

  7,b7 by redesignating clause 7iii7 as 
clause 7iv72 and  7,c7 by inserting     
after clause 7ii7 the following new     
clause 7iii73  7iii7 a need for regular 
or extensive instruction or supervision 
without which the ability of the veteran
 to function in daily life would be     
seriously impaired2 or  4  7#c7         
,expansion of services provided         
,subsection 7a77#c77;,a77ii7 of such    
section is amended-- 7,a7 in subclause  
7,,iv71 by striking 2 and and inserting 
a semicolon2  7,b7 in subclause 7,v71 by
 striking the period at the end and     
inserting 2 and2 and  7,c7 by adding at 
the end the following new subclause3    
7,,vi7 through the use of contracts     
with1 or the provision of grants to1    
public or private entities-- 7aa7       
financial planning services relating to 
the needs of injured veterans and their 
caregivers2 and  7bb7 legal services1   
including legal advice and consultation1
 relating to the needs of injured       
veterans and their caregivers4  4  7#d7 

,modification of stipend calculation    
,subsection 7a77#c77;,c7 of such section
 is amended-- 7,a7 by redesignating     
clause 7iii7 as clause 7iv72 and  7,b7  
by inserting after clause 7ii7 the      
following new clause 7iii73  7iii7 ,in  
determining the amount and degree of    
personal care services provided under   
clause 7i7 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 7#b77;,c77ii7 or regular
 or extensive instruction or supervision
 under paragraph 7#b77;,c77iii71 the    
,secretary shall take into account the  
following3  7,i7 ,the assessment by the 
family caregiver of the needs and       
limitations of the veteran4  7,,ii7 ,the
 extent to which the veteran can        
function safely and independently in the
 absence of such supervision1           
protection1 or instruction4  7,,iii7    
,the amount of time required for the    
family caregiver to provide such        

supervision1 protection1 or instruction 
to the veteran4  4  7#e7 ,periodic      
evaluation of need for certain services 
,subsection 7a77#c7 of such section is  
amended by adding at the end the        
following new subparagraph3  7,d7 ,in   
providing instruction1 preparation1 and 
training under subparagraph 7,a77i77,i7 
and technical support under subparagraph
 7,a77i77,,ii7 to each family caregiver 
who is approved as a provider of        
personal care services for an eligible  
veteran under paragraph 7#f71 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 
instruction1 preparation1 training1 or  
technical support under those           
subparagraphs is necessary4  4  7#f7    
,use of primary care teams ,subsection  
7a77#e7 of such section is amended1 in  
the matter preceding subparagraph 7,a71 
by inserting 7in collaboration with the 
primary care team for the eligible      

veteran to the maximum extent           
practicable7 after evaluate4  7#g7      
,assistance for family caregivers       
,subsection 7a7 of such section is      
amended by adding at the end the        
following new paragraph3  7#aa7 7,a7 ,in
 providing assistance under this        
subsection to family caregivers of      
eligible veterans1 the ,secretary may   
enter into contracts1 provider          
agreements1 and memoranda of            
understanding with ,federal agencies1   
,states1 and private1 nonprofit1 and    
other entities to provide such          
assistance to such family caregivers4   
7,b7 ,the ,secretary may provide        
assistance under this paragraph only if 
such assistance is reasonably accessible
 to the family caregiver and is         
substantially equivalent or better in   
quality to similar services provided by 
the ,department4  7,c7 ,the ,secretary  
may provide fair compensation to        
,federal agencies1 ,states1 and other   
entities that provide assistance under  

this paragraph4  4  7b7 ,modification of
 definition of personal care services   
,subsection 7d77#d7 of such section is  
amended-- 7#a7 in subparagraph 7,a71 by 
striking independent2  7#b7 by          
redesignating subparagraph 7,b7 as      
subparagraph 7,d72 and  7#c7 by         
inserting after subparagraph 7,a7 the   
following new subparagraphs3  7,b7      
,supervision or protection based on     
symptoms or residuals of neurological or
 other impairment or injury4  7,c7      
,regular or extensive instruction or    
supervision without which the ability of
 the veteran to function in daily life  
would be seriously impaired4  4  #bcb4  
,implementation of information          
technology system of ,department of     
,veterans ,affairs to assess and improve
 the family caregiver program  7a7      
,implementation of new system  7#a7 ,in 
general ,not later than ,december #ca1  
#bjaf1 the ,secretary of ,veterans      
,affairs shall implement an information 
technology system that fully supports   

the ,program and allows for data        
assessment and comprehensive monitoring 
of the ,program4  7#b7 ,elements of     
system ,the information technology      
system required to be implemented under 
paragraph 7#a7 shall include the        
following3  7,a7 ,the ability to easily 
retrieve data that will allow all       
aspects of the ,program 7at the medical 
center and aggregate levels7 and the    
workload trends for the ,program to be  
assessed and comprehensively monitored4 
7,b7 ,the ability to manage data with   
respect to a number of caregivers that  
is more than the number of caregivers   
that the ,secretary expects to apply for
 the ,program4  7,c7 ,the ability to    
integrate the system with other relevant
 information technology systems of the  
,veterans ,health ,administration4  7b7 
,assessment of ,program ,not later than 
#ahj days after implementing the system 
described in subsection 7a71 the        
,secretary shall1 through the ,under    
,secretary for ,health1 use data from   

the system and other relevant data to   
conduct an assessment of how key aspects
 of the ,program are structured and     
carried out4  7c7 ,ongoing monitoring of
 and modifications to ,program  7#a7    
,monitoring ,the ,secretary shall use   
the system implemented under subsection 
7a7 to monitor and assess the workload  
of the ,program1 including monitoring   
and assessment of data on--  7,a7 the   
status of applications1 appeals1 and    
home visits in connection with the      
,program2 and  7,b7 the use by          
caregivers participating in the ,program
 of other support services under the    
,program such as respite care4  7#b7    
,modifications ,based on the monitoring 
and assessment conducted under paragraph
 7#a71 the ,secretary shall identify and
 implement such modifications to the    
,program as the ,secretary considers    
necessary to ensure the ,program is     
functioning as intended and providing   
veterans and caregivers participating in
 the ,program with services in a timely 

manner4  7d7 ,reports  7#a7 ,initial    
report  7,a7 ,in general ,not later than
 #ij days after the date of the         
enactment of this ,act1 the ,secretary  
shall submit to the ,committee on       
,veterans' ,affairs of the ,senate1 the 
,committee on ,veterans' ,affairs of the
 ,house of ,representatives1 and the    
,comptroller ,general of the ,united    
,states a report that includes--  7i7   
the status of the planning1 development1
 and deployment of the system required  
to be implemented under subsection 7a71 
including any changes in the timeline   
for the implementation of the system2   
and  7ii7 an assessment of the needs of 
family caregivers of veterans described 
in subparagraph 7,b71 the resources     
needed for the inclusion of such family 
caregivers in the ,program1 and such    
changes to the ,program as the          
,secretary considers necessary to ensure
 the successful expansion of the        
,program to include such family         
caregivers4  7,b7 ,veterans described   

,veterans described in this subparagraph
 are veterans who are eligible for the  
,program under clause 7ii7 or 7iii7 of  
section #agbj;,g7a77#b77;,b7 of title   
#ch1 ,united ,states ,code1 as amended  
by section #bca7;a77#a7 of this ,act1   
solely due to a serious injury          
7including traumatic brain injury1      
psychological trauma1 or other mental   
disorder7 incurred or aggravated in the 
line of duty in the active military1    
naval1 or air service before ,september 
#aa1 #bjja4  7#b7 ,notification by      
,comptroller ,general ,the ,comptroller 
,general shall review the report        
submitted under paragraph 7#a7 and      
notify the ,committee on ,veterans'     
,affairs of the ,senate and the         
,committee on ,veterans' ,affairs of the
 ,house of ,representatives with respect
 to the progress of the ,secretary in-- 
7,a7 fully implementing the system      
required under subsection 7a72 and  7,b7
 implementing a process for using such  
system to monitor and assess the        

,program under subsection 7c77#a7 and   
modify the ,program as considered       
necessary under subsection 7c77#b74     
7#c7 ,final report  7,a7 ,in general    
,not later than ,december #ca1 #bjag1   
the ,secretary shall submit to the      
,committee on ,veterans' ,affairs of the
 ,senate1 the ,committee on ,veterans'  
,affairs of the ,house of               
,representatives1 and the ,comptroller  
,general a report on the implementation 
of subsections 7a7 through 7c74  7,b7   
,elements ,the report required by       
subparagraph 7,a7 shall include the     
following3 7i7 ,a certification by the  
,secretary with respect to whether the  
information technology system described 
in subsection 7a7 has been implemented4 
7ii7 ,a description of how the          
,secretary has implemented such system4 
7iii7 ,a description of the             
modifications to the ,program1 if any1  
that were identified and implemented    
under subsection 7c77#b74  7iv7 ,a      
description of how the ,secretary is    

using such system to monitor the        
workload of the ,program4  7e7          
,definitions ,in this section3  7#a7    
,active military1 naval1 or air service 
,the term active military1 naval1 or air
 service has the meaning given that term
 in section #aja of title #ch1 ,united  
,states ,code4  7#b7 ,program ,the term 
,program means the program of           
comprehensive assistance for family     
caregivers under section #agbj;,g7a7 of 
title #ch1 ,united ,states ,code1 as    
amended by section #bca of this ,act4   
#bcc4 ,modifications to annual          
evaluation report on caregiver program  
of ,department of ,veterans ,affairs    
7a7 ,barriers to care and services      
,subparagraph 7,a77iv7 of section       
#aja7;c77#b7 of the ,caregivers and     
,veterans ,omnibus ,health ,services    
,act of #bjaj 7,public ,law #aaa-afc2   
#ch ,u4,s4,c4 #agbj;,g note7 is amended 
by inserting 1 including a description  
of any barriers to accessing and        
receiving care and services under such  

programs before the semicolon4  7b7     
,sufficiency of training for family     
caregiver program ,subparagraph 7,b7 of 
such section is amended-- 7#a7 in clause
 7i71 by striking 2 and and inserting a 
semicolon2  7#b7 in clause 7ii71 by     
striking the period at the end and      
inserting 2 and2 and  7#c7 by adding at 
the end the following new clause3  7iii7
 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 program4  4 
#bcd4 ,advisory committee on caregiver  
policy  7a7 ,establishment ,there is    
established in the ,department of       
,veterans ,affairs an advisory committee
 on policies relating to caregivers of  
veterans 7in this section referred to as
 the ,committee74  7b7 ,composition ,the
 ,committee shall be composed of the    
following3 7#a7 ,a ,chair selected by   
the ,secretary of ,veterans ,affairs4   
7#b7 ,a representative from each of the 

following agencies or organizations     
selected by the head of such agency or  
organization3  7,a7 ,the ,department of 
,veterans ,affairs4  7,b7 ,the          
,department of ,defense4  7,c7 ,the     
,department of ,health and ,human       
,services4  7,d7 ,the ,department of    
,labor4  7,e7 ,the ,centers for         
,medicare and ,medicaid ,services4  7#c7
 ,not fewer than seven individuals who  
are not employees of the ,federal       
,government selected by the ,secretary  
from among the following individuals3   
7,a7 ,academic experts in fields        
relating to caregivers4  7,b7           
,clinicians4  7,c7 ,caregivers4  7,d7   
,individuals in receipt of caregiver    
services4  7,e7 ,such other individuals 
with expertise that is relevant to the  
duties of the ,committee as the         
,secretary considers appropriate4  7c7  
,duties ,the duties of the ,committee   
are as follows3 7#a7 ,to regularly      
review and recommend policies of the    
,department of ,veterans ,affairs       

relating to caregivers of veterans4     
7#b7 ,to examine and advise the         
implementation of such policies4  7#c7  
,to evaluate the effectiveness of such  
policies4  7#d7 ,to recommend standards 
of care for caregiver services and      
respite care services provided to a     
caregiver or veteran by a nonprofit or  
private sector entity4  7#e7 ,to develop
 recommendations for legislative or     
administrative action to enhance the    
provision of services to caregivers and 
veterans1 including eliminating gaps in 
such services and eliminating           
disparities in eligibility for such     
services4  7#f7 ,to make recommendations
 on coordination with ,state and local  
agencies and relevant nonprofit         
organizations on maximizing the use and 
effectiveness of resources for          
caregivers of veterans4  7d7 ,reports   
7#a7 ,annual report to ,secretary  7,a7 
,in general ,not later than ,september  
#a1 #bjag1 and not less frequently than 
annually thereafter until the           

termination date specified in subsection
 7e71 the ,chair of the ,committee shall
 submit to the ,secretary a report on   
policies and services of the ,department
 of ,veterans ,affairs relating to      
caregivers of veterans4  7,b7 ,elements 
,each report required by subparagraph   
7,a7 shall include the following3 7i7   
,an assessment of the policies of the   
,department relating to caregivers of   
veterans and services provided pursuant 
to such policies as of the date of the  
submittal of the report4  7ii7 ,a       
description of any recommendations made 
by the ,committee to improve the        
coordination of services for caregivers 
of veterans between the ,department and 
the entities specified in subparagraphs 
7,b7 through 7,e7 of subsection 7b77#b7 
and to eliminate barriers to the        
effective use of such services1         
including with respect to eligibility   
criteria4  7iii7 ,an evaluation of the  
effectiveness of the ,department in     
providing services for caregivers of    

veterans4  7iv7 ,an evaluation of the   
quality and sufficiency of services for 
caregivers of veterans available from   
nongovernmental organizations4  7v7 ,a  
description of any gaps identified by   
the ,committee in care or services      
provided by caregivers to veterans and  
recommendations for legislative or      
administrative action to address such   
gaps4  7vi7 ,such other matters or      
recommendations as the ,chair considers 
appropriate4  7#b7 ,transmittal to      
,congress ,not later than #ij days after
 the receipt of a report under paragraph
 7#a71 the ,secretary shall transmit to 
the ,committee on ,veterans' ,affairs of
 the ,senate and the ,committee on      
,veterans' ,affairs of the ,house of    
,representatives a copy of such report1 
together with such comments and         
recommendations concerning such report  
as the ,secretary considers appropriate4
  7e7 ,termination ,the ,committee shall
 terminate on ,december #ca1 #bjbb4     
#bce4 ,comprehensive study on seriously 

injured veterans and their caregivers   
7a7 ,study required ,during the period  
specified in subsection 7d71 the        
,secretary of ,veterans ,affairs shall  
provide for the conduct by an           
independent entity of a comprehensive   
study on the following3  7#a7 ,veterans 
who have incurred a serious injury or   
illness1 including a mental health      
injury or illness4  7#b7 ,individuals   
who are acting as caregivers for        
veterans4  7b7 ,elements ,the           
comprehensive study required by         
subsection 7a7 shall include the        
following with respect to each veteran  
included in such study3  7#a7 ,the      
health of the veteran and1 if           
applicable1 the impact of the caregiver 
of such veteran on the health of such   
veteran4  7#b7 ,the employment status of
 the veteran and1 if applicable1 the    
impact of the caregiver of such veteran 
on the employment status of such        
veteran4  7#c7 ,the financial status and
 needs of the veteran4  7#d7 ,the use by

 the veteran of benefits available to   
such veteran from the ,department of    
,veterans ,affairs4  7#e7 ,such other   
information as the ,secretary considers 
appropriate4  7c7 ,contract ,the        
,secretary shall enter into a contract  
with an appropriate independent entity  
to conduct the study required by        
subsection 7a74  7d7 ,period specified  
,the period specified in this subsection
 is the one-year period beginning on the
 date that is four years after the date 
specified in section                    
#agbj;,g7a77#b77;,b77i7 of title #ch1   
,united ,states ,code1 as amended by    
section #bca7;a77#a7 of this ,act4  7e7 
,report ,not later than #cj days after  
the end of the period specified in      
subsection 7d71 the ,secretary shall    
submit to the ,committee on ,veterans'  
,affairs of the ,senate and the         
,committee on ,veterans' ,affairs of the
 ,house of ,representatives a report on 
the results of the study required by    
subsection 7a74  ,e ,health care        

administration  #bda4 ,requirement that 
,department of ,veterans ,affairs       
collect health-plan contract information
 from veterans  7a7 ,in general         
,subchapter ,i of chapter #ag is amended
 by inserting after section #agje the   
following new section3  #agje;,a4       
,management of health care3 information 
regarding health-plan contracts  7a7 ,in
 general  7#a7 ,any individual who seeks
 hospital care or medical services under
 this chapter shall provide to the      
,secretary such current information as  
the ,secretary may require to identify  
any health-plan contract under which    
such individual is covered4  7#b7 ,the  
information required to be provided to  
the ,secretary under paragraph 7#a7 with
 respect to a health-plan contract shall
 include1 as applicable1 the following3 
7,a7 ,the name of the entity providing  
coverage under the health-plan contract4
  7,b7 ,if coverage under the           
health-plan contract is in the name of  
an individual other than the individual 

required to provide information under   
this section1 the name of the policy    
holder of the health-plan contract4     
7,c7 ,the identification number for the 
health-plan contract4  7,d7 ,the group  
code for the health-plan contract4  7b7 
,action ,to collect information ,the    
,secretary may take such action as the  
,secretary considers appropriate to     
collect the information required under  
subsection 7a74  7c7 ,effect on services
 from ,department ,the ,secretary may   
not deny any services under this chapter
 to an individual solely due to the fact
 that the individual fails to provide   
information required under subsection   
7a74  7d7 ,health-plan contract defined 
,in this section1 the term health-plan  
contract has the meaning given that term
 in section #agbe7;f7 of this title4  4 
7b7 ,clerical amendment ,the table of   
sections at the beginning of chapter #ag
 of such title is amended by inserting  
after the item relating to section #agje
 the following new item3  #agje;,a4     

,management of health care3 information 
regarding health-plan contracts4  4     
#bdb4 ,expansion of availability of     
prosthetic and orthotic care for        
veterans  7a7 ,establishment or         
expansion of advanced degree programs   
,to expand availability of care ,the    
,secretary of ,veterans ,affairs shall  
work with institutions of higher        
education to develop partnerships for   
the establishment or expansion of       
programs of advanced degrees in         
prosthetics and orthotics in order to   
improve and enhance the availability of 
high quality prosthetic and orthotic    
care for veterans4  7b7 ,report  7#a7   
,in general ,not later than one year    
after the effective date specified in   
subsection 7d71 the ,secretary shall    
submit to the ,committee on ,veterans'  
,affairs of the ,senate and the         
,committee on ,veterans' ,affairs of the
 ,house of ,representatives a report    
setting forth a plan for carrying out   
subsection 7a74  7#b7 ,development of   

plan ,the ,secretary shall develop the  
plan required under paragraph 7#a7 in   
consultation with veterans service      
organizations1 institutions of higher   
education with accredited degree        
programs in prosthetics and orthotics1  
and representatives of the prosthetics  
and orthotics field4  7c7 ,funding  7#a7
 ,authorization of appropriations ,there
 is authorized to be appropriated for   
fiscal year #bjag for the ,department of
 ,veterans ,affairs1 #e1jjj1jjj to carry
 out this section4  7#b7 ,availability  
,the amount authorized to be            
appropriated by paragraph 7#a7 shall    
remain available for expenditure until  
,september #cj1 #bjai4  7d7 ,effective  
date ,this section shall take effect on 
the date that is one year after the date
 of the enactment of this ,act4  #bdc4  
,revival of ,intermediate ,care         
,technician ,pilot ,program of          
,department of ,veterans ,affairs  7a7  
,revival ,the ,secretary of ,veterans   
,affairs shall revive the ,intermediate 

,care ,technician ,pilot ,program of the
 ,department of ,veterans ,affairs that 
was carried out by the ,secretary       
between ,january #bjac and ,february    
#bjad4  7b7 ,technicians  7#a7          
,selection ,the ,secretary shall select 
not fewer than #gb intermediate care    
technicians to participate in the pilot 
program4  7#b7 ,facilities  7,a7 ,in    
general ,any intermediate care          
technician hired pursuant to paragraph  
7#a7 may be assigned to a medical       
facility of the ,department as          
determined by the ,secretary for        
purposes of this section4  7,b7         
,priority ,in assigning intermediate    
care technicians under subparagraph     
7,a71 the ,secretary shall give priority
 to facilities at which veterans have   
the longest wait times for appointments 
for the receipt of hospital care or     
medical services from the ,department1  
as determined by the ,secretary for     
purposes of this section4  7c7          
,termination ,the ,secretary shall carry

 out the pilot program under subsection 
7a7 during the three-year period        
beginning on the effective date         
specified in subsection 7e74  7d7       
,definitions ,in this section1 the terms
 hospital care and medical services have
 the meanings given those terms in      
section #agja of title #ch1 ,united     
,states ,code4  7e7 ,effective date     
,this section shall take effect on the  
date that is one year after the date of 
the enactment of this ,act4  #bdd4      
,transfer of health care provider       
credentialing data from ,secretary of   
,defense to ,secretary of ,veterans     
,affairs  7a7 ,in general ,in a case in 
which the ,secretary of ,veterans       
,affairs hires a covered health care    
provider1 the ,secretary of ,defense    
shall1 after receiving a request from   
the ,secretary of ,veterans ,affairs for
 the credentialing data of the          
,secretary of ,defense relating to such 
health care provider1 transfer to the   
,secretary of ,veterans ,affairs such   

credentialing data4  7b7 ,covered health
 care providers ,for purposes of this   
section1 a covered provider is a health 
care provider who-- 7#a7 is or was      
employed by the ,secretary of ,defense2 
7#b7 provides or provided health care   
related services as part of such        
employment2 and  7#c7 was credentialed  
by the ,secretary of ,defense4  7c7     
,policies and regulations ,the          
,secretary of ,veterans ,affairs and the
 ,secretary of ,defense shall establish 
such policies and prescribe such        
regulations as may be necessary to carry
 out this section4  7d7 ,credentialing  
defined ,in this section1 the term      
credentialing means the systematic      
process of screening and evaluating     
qualifications and other credentials1   
including licensure1 required education1
 relevant training and experience1 and  
current competence and health status4   
7e7 ,effective date ,this section shall 
take effect on the date that is one year
 after the date of the enactment of this

 ,act4  #bde4 ,authority to place       
certain veterans in non-,department of  
,veterans ,affairs medical foster homes 
upon request  7a7 ,in general ,section  
#agbj of title #ch1 ,united ,states     
,code1 is amended by adding at the end  
the following new subsection3  7h7 7#a7 
,subject to paragraph 7#b71 at the      
request of a veteran for whom the       
,secretary is required to provide       
nursing home care under section #agaj;,a
 of this title1 the ,secretary may place
 the veteran in a medical foster home   
that meets ,department standards1 at the
 expense of the ,united ,states1        
pursuant to a contract or agreement     
entered into between the ,secretary and 
the medical foster home for such        
purpose4 ,a veteran who is placed in a  
medical foster home under this          
subsection shall agree1 as a condition  
of such placement1 to accept home health
 services furnished by the ,secretary   
under section #agag of this title4  7#b7
 ,not more than #ijj veterans placed in 

a medical foster home1 whether placed   
before1 on1 or after the enactment of   
the ,jason ,simcakoski ,memorial ,act1  
may have their care covered at the      
expense of the ,united ,states under    
paragraph 7#a74  7#c7 ,in this          
subsection1 the term medical foster home
 means a home designed to provide       
noninstitutional1 long-term1 supportive 
care for veterans who are unable to live
 independently and prefer a family      
setting4  7#d7 ,the authority of the    
,secretary under this subsection        
terminates on ,september #cj1 #bjai4  4 
7b7 ,effective date ,subsection 7h7 of  
such section1 as added by subsection    
7a71 shall take effect on ,october #a1  
#bjaf4  #bdf4 ,examination and treatment
 by ,department of ,veterans ,affairs   
for emergency medical conditions and    
women in labor  7a7 ,in general         
,subchapter ,,viii of chapter #ag of    
title #ch1 ,united ,states ,code1 is    
amended by inserting after section #aghd
 the following new section3  #aghd;,a4  

,examination and treatment for emergency
 medical conditions and women in labor  
7a7 ,in general ,in the case of a       
hospital of the ,department that has an 
emergency department1 if any individual 
comes to the hospital or the campus of  
the hospital and a request is made on   
behalf of the individual for examination
 or treatment for a medical condition1  
the hospital must provide for an        
appropriate medical screening           
examination within the capability of the
 emergency department1 including        
ancillary services routinely available  
to the emergency department1 to         
determine whether or not an emergency   
medical condition exists4  7b7          
,necessary stabilizing treatment for    
emergency medical conditions and labor  
7#a7 ,if any individual comes to a      
hospital of the ,department that has an 
emergency department or the campus of   
such a hospital and the hospital        
determines that the individual has an   
emergency medical condition1 the        

hospital must provide either--  7,a7    
within the staff and facilities         
available at the hospital1 for such     
further medical examination and such    
treatment as may be required to         
stabilize the medical condition2 or     
7,b7 for transfer of the individual to  
another medical facility in accordance  
with subsection 7c74  7#b7 ,a hospital  
is deemed to meet the requirement of    
paragraph 7#a77;,a7 with respect to an  
individual if the hospital offers the   
individual the further medical          
examination and treatment described in  
that paragraph and informs the          
individual 7or a person acting on behalf
 of the individual7 of the risks and    
benefits to the individual of such      
examination and treatment1 but the      
individual 7or a person acting on behalf
 of the individual7 refuses to consent  
to the examination and treatment4 ,the  
hospital shall take all reasonable steps
 to secure the written informed consent 
of the individual 7or person7 to refuse 

such examination and treatment4  7#c7 ,a
 hospital is deemed to meet the         
requirement of paragraph 7#a77;,b7 with 
respect to an individual if the hospital
 offers to transfer the individual to   
another medical facility in accordance  
with subsection 7c7 and informs the     
individual 7or a person acting on behalf
 of the individual7 of the risks and    
benefits to the individual of such      
transfer1 but the individual 7or a      
person acting on behalf of the          
individual7 refuses to consent to the   
transfer4 ,the hospital shall take all  
reasonable steps to secure the written  
informed consent of the individual 7or  
person7 to refuse such transfer4  7c7   
,restricting transfers until individual 
stabilized  7#a7 ,if an individual at a 
hospital of the ,department has an      
emergency medical condition that has not
 been stabilized1 the hospital may not  
transfer the individual unless--  7,a7  
7i7 the individual 7or a legally        
responsible person acting on behalf of  

the individual71 after being informed of
 the obligations of the hospital under  
this section and of the risk of         
transfer1 requests1 in writing1 transfer
 to another medical facility2  7ii7 a   
physician of the ,department has signed 
a certification that1 based upon the    
information available at the time of    
transfer1 the medical benefits          
reasonably expected from the provision  
of appropriate medical treatment at     
another medical facility outweigh the   
increased risks to the individual and1  
in the case of labor1 to the unborn     
child from effecting the transfer2 or   
7iii7 if a physician of the ,department 
is not physically present in the        
emergency department at the time an     
individual is transferred1 a qualified  
medical person 7as defined by the       
,secretary for purposes of this section7
 has signed a certification described in
 clause 7ii7 after a physician of the   
,department1 in consultation with the   
person1 has made the determination      

described in such clause1 and           
subsequently countersigns the           
certification2 and  7,b7 the transfer is
 an appropriate transfer to that        
facility4  7#b7 ,a certification        
described in clause 7ii7 or 7iii7 of    
paragraph 7#a77;,a7 shall include a     
summary of the risks and benefits upon  
which the certification is based4  7#c7 
,for purposes of paragraph 7#a77;,b71 an
 appropriate transfer to a medical      
facility is a transfer-- 7,a7 in which  
the transferring hospital provides the  
medical treatment within its capacity   
that minimizes the risks to the health  
of the individual and1 in the case of a 
woman in labor1 the health of the unborn
 child2  7,b7 in which the receiving    
facility-- 7i7 has available space and  
qualified personnel for the treatment of
 the individual2 and  7ii7 has agreed to
 accept transfer of the individual and  
to provide appropriate medical          
treatment2  7,c7 in which the           
transferring hospital sends to the      

receiving facility all medical records  
7or copies thereof7 available at the    
time of the transfer relating to the    
emergency medical condition for which   
the individual has presented1           
including--  7i7 observations of signs  
or symptoms2  7ii7 preliminary          
diagnosis2  7iii7 treatment provided2   
7iv7 the results of any tests2 and  7v7 
the informed written request or         
certification 7or copy thereof7 provided
 under paragraph 7#a77;,a72  7,d7 in    
which the transfer is effected through  
qualified personnel and transportation  
equipment1 including the use of         
necessary and medically appropriate life
 support measures during the transfer2  
and  7,e7 that meets such other         
requirements as the ,secretary considers
 necessary in the interest of the health
 and safety of the individual or        
individuals transferred4  7d7 ,payment  
to the ,department ,the ,secretary shall
 charge for any care or services        
provided under this section in          

accordance with billing and             
reimbursement authorities available to  
the ,secretary under other provisions of
 law4  7e7 ,definitions ,in this        
section3 7#a7 ,the term campus means1   
with respect to a hospital of the       
,department--  7,a7 the physical area   
immediately adjacent to the main        
buildings of the hospital2  7,b7 other  
areas and structures that are not       
strictly contiguous to the main         
buildings but are located not more than 
#bej yards from the main buildings2 and 
7,c7 any other areas determined by the  
,secretary to be part of the campus of  
the hospital4  7#b7 ,the term emergency 
medical condition means--  7,a7 a       
medical condition manifesting itself by 
acute symptoms of sufficient severity   
7including severe pain7 such that the   
absence of immediate medical attention  
could reasonably be expected to result  
in--  7i7 placing the health of the     
individual 7or1 with respect to a       
pregnant woman1 the health of the woman 

or her unborn child7 in serious         
jeopardy2  7ii7 serious impairment to   
bodily functions2 or  7iii7 serious     
dysfunction of any bodily organ or part2
 or  7,b7 with respect to a pregnant    
woman who is having contractions-- 7i7  
that there is inadequate time to effect 
a safe transfer to another hospital     
before delivery2 or  7ii7 that transfer 
may pose a threat to the health or      
safety of the woman or the unborn child4
  7#c7 7,a7 ,the term to stabilize      
means--  7i7 with respect to an         
emergency medical condition described in
 paragraph 7#b77;,a71 to provide such   
medical treatment of the condition as   
may be necessary to assure1 within      
reasonable medical probability1 that no 
material deterioration of the condition 
is likely to result from or occur during
 the transfer of the individual from a  
facility2 or  7ii7 with respect to an   
emergency medical condition described in
 paragraph 7#b77;,b71 to deliver        
7including the placenta74  7,b7 ,the    

term stabilized means-- 7i7 with respect
 to an emergency medical condition      
described in paragraph 7#b77;,a71 that  
no material deterioration of the        
condition is likely1 within reasonable  
medical probability1 to result from or  
occur during the transfer of the        
individual from a facility2 or  7ii7    
with respect to an emergency medical    
condition described in paragraph        
7#b77;,b71 that the woman has delivered 
7including the placenta74  7#d7 ,the    
term transfer means the movement        
7including the discharge7 of an         
individual outside the facilities of a  
hospital of the ,department at the      
direction of any person employed by 7or 
affiliated or associated1 directly or   
indirectly1 with7 the hospital1 but does
 not include such a movement of an      
individual who--  7,a7 has been declared
 dead2 or  7,b7 leaves the facility     
without the permission of any such      
person4  4  7b7 ,clerical amendment ,the
 table of sections at the beginning of  

chapter #ag of such title is amended by 
inserting after the item relating to    
section #aghd the following new item3   
,sec4 #aghd;,a4 ,examination and        
treatment for emergency medical         
conditions and women in labor4  4  #bdg4
 ,comptroller ,general audit of budget  
of ,veterans ,health ,administration    
7a7 ,in general ,subchapter ,,ii of     
chapter #gc of title #ch1 ,united       
,states ,code1 is amended by adding at  
the end the following new section3      
#gccj;,b4 ,comptroller ,general audit of
 budget of ,veterans ,health            
,administration  7a7 ,in general ,the   
,comptroller ,general of the ,united    
,states shall periodically conduct an   
audit of elements of the budget of the  
,veterans ,health ,administration1      
including the budget formulation1       
execution1 allocation1 and use of funds4
  7b7 ,selection of elements  7#a7 ,in  
selecting elements of the budget of the 
,veterans ,health ,administration for   
purposes of an audit under subsection   

7a71 the ,comptroller ,general shall    
take into consideration--  7,a7         
knowledge of the programs of the        
,veterans ,health ,administration2  7,b7
 current issues2  7,c7 national         
priorities2 and  7,d7 priorities        
expressed by the appropriate            
congressional committees4  7#b7 ,not    
later than #cj days before conducting an
 audit under subsection 7a71 the        
,comptroller ,general shall submit to   
the appropriate congressional committees
 notice of the elements selected by the 
,comptroller ,general for purposes of   
the audit4  7c7 ,appropriate            
congressional committees ,in this       
section1 the term appropriate           
congressional committees means-- 7#a7   
the ,committee on ,veterans' ,affairs1  
the ,committee on ,appropriations1 and  
the ,committee on the ,budget of the    
,senate2 and  7#b7 the ,committee on    
,veterans' ,affairs1 the ,committee on  
,appropriations1 and the ,committee on  
the ,budget of the ,house of            

,representatives4  4  7b7 ,clerical     
amendment ,the table of sections at the 
beginning of chapter #gc of such title  
is amended by inserting after the item  
relating to section #gccj;,a the        
following new item3  #gccj;,b4          
,comptroller ,general audit of budget of
 ,veterans ,health ,administration4  4  
#bdh4 ,annual report on ,veterans       
,health ,administration and furnishing  
of hospital care1 medical services1 and 
nursing home care  7a7 ,in general      
,subchapter ,,ii of chapter #gc of title
 #ch1 ,united ,states ,code1 as amended 
by section #bdg7;a71 is further amended 
by adding at the end the following new  
section3  #gccj;,c4 ,annual report on   
,veterans ,health ,administration and   
furnishing of hospital care1 medical    
services1 and nursing home care  7a7    
,report required ,not later than ,march 
#a of each of years #bjah through #bjbb1
 the ,secretary shall submit to the     
,committee on ,veterans' ,affairs of the
 ,senate and the ,committee on          

,veterans' ,affairs of the ,house of    
,representatives a report on1 for the   
calendar year preceding the calendar    
year during which the report is         
submitted--  7#a7 the furnishing of     
hospital care1 medical services1 and    
nursing home care under the laws        
administered by the ,secretary2 and     
7#b7 the administration of the          
furnishing of such care and services by 
the ,veterans ,health ,administration4  
7b7 ,elements ,each report required by  
subsection 7a7 shall include each of the
 following for the year covered by the  
report3  7#a7 ,an evaluation of the     
effectiveness of the ,veterans ,health  
,administration in increasing the access
 of veterans to hospital care1 medical  
services1 and nursing home care         
furnished by the ,secretary for which   
such veterans are eligible4  7#b7 ,an   
evaluation of the effectiveness of the  
,veterans ,health ,administration in    
improving the quality of health care    
provided to veterans1 without increasing

 the costs incurred for such health care
 by the ,federal ,government or         
veterans1 including relevant information
 for each medical center and ,veterans  
,integrated ,service ,network of the    
,department set forth separately4  7#c7 
,an assessment of-- 7,a7 the workload of
 physicians and other employees of the  
,veterans ,health ,administration2  7,b7
 patient demographics and utilization   
rates2  7,c7 physician compensation2    
7,d7 the productivity of physicians and 
other employees of the ,veterans ,health
 ,administration2  7,e7 the percentage  
of hospital care1 medical services1 and 
nursing home care provided to veterans  
in facilities of the ,department and in 
non-,department facilities and any      
changes in such percentages compared to 
the year preceding the year covered by  
the report2  7,f7 pharmaceutical prices2
 and  7,g7 third-party health billings  
owed to the ,department1 including the  
total amount of such billings and the   
total amount collected by the           

,department1 set forth separately for   
claims greater than #a1jjj and for      
claims equal to or less than #a1jjj4    
7c7 ,definitions ,in this section1 the  
terms hospital care1 medical services1  
nursing home care1 facilities of the    
,department1 and non-,department        
facilities have the meanings given those
 terms in section #agja of this title4  
4  7b7 ,clerical amendment ,the table of
 sections at the beginning of chapter   
#gc of such title1 as amended by section
 #bdg7;b71 is further amended by        
inserting after the item relating to    
section #gccj;,b the following new item3
  #gccj;,c4 ,annual report on ,veterans 
,health ,administration and furnishing  
of hospital care1 medical services1 and 
nursing home care4  4  ,f ,opioid       
therapy and pain management  #bea4      
,guidelines on management of opioid     
therapy by ,department of ,veterans     
,affairs and ,department of ,defense and
 implementation of such guidelines by   
,department of ,veterans ,affairs  7a7  

,guidelines  7#a7 ,in general ,not later
 than one year after the date of the    
enactment of this ,act1 the ,secretary  
of ,veterans ,affairs and the ,secretary
 of ,defense shall jointly update the   
,,va_/,,dod ,clinical ,practice         
,guideline for ,management of ,opioid   
,therapy for ,chronic ,pain to include  
the following3  7,a7 ,guidelines        
developed by the ,centers for ,disease  
,control and ,prevention for safely     
prescribing opioids for the treatment of
 chronic1 noncancer related pain in     
outpatient settings4  7,b7 ,enhanced    
guidance with respect to absolute       
contraindications for opioid therapy1   
including guidance with respect to the  
following3  7i7 ,the coadministration of
 drugs1 including benzodiazepines1 that 
are capable of inducing a life-limiting 
drug-drug interaction4  7ii7 ,the       
treatment of patients with current acute
 psychiatric instability or substance   
use disorder or patients at risk of     
suicide4  7iii7 ,the use of opioid      

therapy to treat patients without any   
pain1 including to treat mental health  
disorders other than opioid use         
disorder4  7,c7 ,enhanced guidance with 
respect to the treatment of patients    
with behaviors or comorbidities1 such as
 post-traumatic stress disorder1        
psychiatric disorders1 or a history of  
substance abuse or addiction1 that      
require consultation or comanagement of 
opioid therapy with one or more         
specialists in pain management1 mental  
health1 or addictions4  7,d7 ,enhanced  
guidance with respect to the conduct by 
health care providers of an             
effectiveness assessment for patients   
receiving opioid therapy1 including     
patients on long-term opioid therapy1 to
 determine--  7i7 whether opioid therapy
 is meeting the expected goals of the   
patient and health care provider of     
relieving pain and improving function2  
and  7ii7 whether opioid therapy should 
be continued4  7,e7 ,requirements that  
each health care provider of the        

,department of ,veterans ,affairs1      
before initiating opioid therapy to     
treat a patient1 use the ,opioid        
,therapy ,risk ,report tool of the      
,department1 including by accessing the 
most recent patient information from the
 prescription drug monitoring program of
 each ,state1 as required to be included
 in such tool under section             
#beb7;d77#a71 to assess the risk for    
adverse outcomes of opioid therapy for  
the patient1 including the concurrent   
use of controlled substances such as    
benzodiazepines1 as part of the         
comprehensive assessment conducted by   
the health care provider4  7,f7         
,guidelines to inform the methodologies 
used by health care providers of the    
,department of ,veterans ,affairs and   
the ,department of ,defense to safely   
titrate and taper opioid therapy when   
adjusting or discontinuing the use of   
opioid therapy1 including--  7i7        
prescription of the lowest effective    
dose based on patient need2  7ii7 use of

 opioids only for a limited period of   
time2 and  7iii7 augmentation of opioid 
therapy with other pain management      
therapies and modalities4  7,g7         
,enhanced recommendations with respect  
to the use of routine and random urine  
drug tests for all patients before and  
during opioid therapy to help prevent   
substance abuse1 dependence1 and        
diversion1 including--  7i7 that such   
tests should occur not less frequently  
than annually or as otherwise determined
 according to patient treatment         
protocols2 and  7ii7 that health care   
providers should appropriately interpret
 and respond to the results from such   
tests to tailor pain therapy1           
safeguards1 and risk management         
strategies to each patient4  7,h7       
,guidance that health care providers    
discuss with patients1 before initiating
 opioid therapy1 options for pain       
management therapies without the use of 
opioids and options to augment opioid   
therapy with other clinical and         

complementary and integrative health    
services to minimize opioid dependence4 
7#b7 ,rule of construction ,nothing in  
this subsection shall be construed to   
prevent the ,secretary of ,veterans     
,affairs and the ,secretary of ,defense 
from considering all relevant evidence1 
as appropriate1 in updating the         
,,va_/,,dod ,clinical ,practice         
,guideline for ,management of ,opioid   
,therapy for ,chronic ,pain1 as required
 under paragraph 7#a71 or from ensuring 
that the final clinical practice        
guideline updated under such paragraph  
remains applicable to the patient       
populations of the ,department of       
,veterans ,affairs and the ,department  
of ,defense4  7b7 ,consultation before  
update ,before updating the clinical    
practice guideline under subsection 7a71
 the ,secretary of ,veterans ,affairs   
and the ,secretary of ,defense shall    
jointly consult with the ,pain          
,management ,working ,group of the      
,health ,executive ,committee of the    

,department of ,veterans                
,affairs-,department of ,defense ,joint 
,executive ,committee established under 
section #cbj of title #ch1 ,united      
,states ,code4  7c7 ,controlled         
substance defined ,in this section1 the 
term controlled substance has the       
meaning given that term in section #ajb 
of the ,controlled ,substances ,act 7#ba
 ,u4,s4,c4 #hjb74  #beb4 ,improvement of
 opioid safety measures by ,department  
of ,veterans ,affairs  7a7 ,expansion of
 ,opioid ,safety ,initiative ,not later 
than #ahj days after the date of the    
enactment of this ,act1 the ,secretary  
of ,veterans ,affairs shall expand the  
,opioid ,safety ,initiative of the      
,department of ,veterans ,affairs to    
include all medical facilities of the   
,department4  7b7 ,pain management      
education and training  7#a7 ,in general
 ,in carrying out the ,opioid ,safety   
,initiative of the ,department1 the     
,secretary shall require all employees  
of the ,department responsible for      

prescribing opioids to receive education
 and training described in paragraph    
7#b74  7#b7 ,education and training     
,education and training described in    
this paragraph is education and training
 on pain management and safe opioid     
prescribing practices for purposes of   
safely and effectively managing patients
 with chronic pain1 including education 
and training on the following3  7,a7    
,the implementation of and full         
compliance with the ,,va_/,,dod         
,clinical ,practice ,guideline for      
,management of ,opioid ,therapy for     
,chronic ,pain1 including any update to 
such guideline4  7,b7 ,the use of       
evidence-based pain management          
therapies1 including                    
cognitive-behavioral therapy1 nonopioid 
alternatives1 and non-drug methods and  
procedures for managing pain and related
 health conditions including            
complementary and integrative health    
services4  7,c7 ,screening and          
identification of patients with         

substance use disorder1 including       
drug-seeking behavior1 before           
prescribing opioids1 assessment of the  
risk potential for patients developing  
an addiction1 and referral of patients  
to appropriate addiction treatment      
professionals if addiction is identified
 or strongly suspected4  7,d7           
,communication with patients on the     
potential harm associated with the use  
of opioids and other controlled         
substances1 including the need to safely
 store and dispose of supplies relating 
to the use of opioids and other         
controlled substances4  7,e7 ,such other
 education and training as the          
,secretary considers appropriate to     
ensure that veterans receive safe and   
high-quality pain management care from  
the ,department4  7#c7 ,use of existing 
program ,in providing education and     
training described in paragraph 7#b71   
the ,secretary shall use the            
,interdisciplinary ,chronic ,pain       
,management ,training ,team ,program of 

the ,department 7or any successor       
program74  7c7 ,pain management teams   
7#a7 ,in general ,in carrying out the   
,opioid ,safety ,initiative of the      
,department1 the director of each       
medical facility of the ,department     
shall identify and designate a pain     
management team of health care          
professionals1 which may include board  
certified pain medicine specialists1    
responsible for coordinating and        
overseeing pain management therapy at   
such facility for patients experiencing 
acute and chronic pain that is noncancer
 related4  7#b7 ,establishment of       
protocols  7,a7 ,in general ,in         
consultation with the ,directors of the 
,veterans ,integrated ,service          
,networks1 the ,secretary shall         
establish standard protocols for the    
designation of pain management teams at 
each medical facility of the            
,department4  7,b7 ,consultation on     
prescription of opioids ,each protocol  
established for a medical facility under

 subparagraph 7,a7 shall ensure that any
 health care provider without expertise 
in prescribing analgesics or who has not
 completed the education and training   
under subsection 7b71 such as a mental  
health care provider1 does not prescribe
 opioids to a patient unless that health
 care provider--  7i7 consults with a   
health care provider with pain          
management expertise or who is on the   
pain management team of the medical     
facility2 and  7ii7 refers the patient  
to that pain management team for any    
subsequent prescriptions and related    
therapy4  7#c7 ,report  7,a7 ,in general
 ,not later than one year after the date
 of the enactment of this ,act1 the     
director of each medical facility of the
 ,department shall submit to the ,under 
,secretary for ,health of the           
,department and the ,director of the    
,veterans ,integrated ,service ,network 
in which the medical facility is located
 a report identifying the health care   
professionals that have been designated 

as members of the pain management team  
at the medical facility under paragraph 
7#a74  7,b7 ,elements ,each report      
submitted under subparagraph 7,a7 with  
respect to a medical facility of the    
,department shall include--  7i7 a      
certification as to whether all members 
of the pain management team at the      
medical facility have completed the     
education and training required under   
subsection 7b72  7ii7 a plan for the    
management and referral of patients to  
such pain management team if health care
 providers without expertise in         
prescribing analgesics prescribe opioid 
medications to treat acute and chronic  
pain that is noncancer related2 and     
7iii7 a certification as to whether the 
medical facility-- 7,i7 fully complies  
with the stepped-care model of pain     
management and other pain management    
policies of the ,department2 or  7,,ii7 
does not fully comply with the          
stepped-care model of pain management   
and other pain management policies of   

the ,department but is carrying out a   
corrective plan of action to ensure such
 full compliance4  7d7 ,tracking and    
monitoring of opioid use  7#a7          
,prescription drug monitoring programs  
of ,states ,in carrying out the ,opioid 
,safety ,initiative and the ,opioid     
,therapy ,risk ,report tool of the      
,department1 the ,secretary shall--     
7,a7 ensure access by health care       
providers of the ,department to         
information on controlled substances1   
including opioids and benzodiazepines1  
prescribed to veterans who receive care 
outside the ,department through the     
prescription drug monitoring program of 
each ,state with such a program1        
including by seeking to enter into      
memoranda of understanding with ,states 
to allow shared access of such          
information between ,states and the     
,department2  7,b7 include such         
information in the ,opioid ,therapy     
,risk ,report tool of the ,department2  
and  7,c7 require health care providers 

of the ,department to submit to the     
prescription drug monitoring program of 
each ,state with such a program         
information on prescriptions of         
controlled substances received by       
veterans in that ,state under the laws  
administered by the ,secretary4  7#b7   
,report on tracking of data on opioid   
use ,not later than #ah months after the
 date of the enactment of this ,act1 the
 ,secretary shall submit to the         
,committee on ,veterans' ,affairs of the
 ,senate and the ,committee on          
,veterans' ,affairs of the ,house of    
,representatives a report on the        
feasibility and advisability of         
improving the ,opioid ,therapy ,risk    
,report tool of the ,department to allow
 for more advanced real-time tracking of
 and access to data on--  7,a7 the key  
clinical indicators with respect to the 
totality of opioid use by veterans2     
7,b7 concurrent prescribing by health   
care providers of the ,department of    
opioids in different health care        

settings1 including data on concurrent  
prescribing of opioids to treat mental  
health disorders other than opioid use  
disorder2 and  7,c7 mail-order          
prescriptions of opioids prescribed to  
veterans under the laws administered by 
the ,secretary4  7e7 ,availability of   
opioid receptor antagonists  7#a7       
,increased availability and use  7,a7   
,in general ,the ,secretary shall       
increase the availability of opioid     
receptor antagonists approved by the    
,food and ,drug ,administration1 such as
 naloxone1 to veterans4  7,b7           
,availability1 training1 and            
distribution ,in carrying out           
subparagraph 7,a71 the ,secretary shall1
 not later than #ij days after the date 
of the enactment of this ,act--  7i7    
equip each pharmacy of the ,department  
with opioid receptor antagonists        
approved by the ,food and ,drug         
,administration to be dispensed to      
outpatients as needed2 and  7ii7 expand 
the ,overdose ,education and ,naloxone  

,distribution program of the ,department
 to ensure that all veterans in receipt 
of health care under the laws           
administered by the ,secretary who are  
at risk of opioid overdose may access   
such opioid receptor antagonists and    
training on the proper administration of
 such opioid receptor antagonists4  7,c7
 ,veterans who are at risk ,for purposes
 of subparagraph 7,b71 veterans who are 
at risk of opioid overdose include-- 7i7
 veterans receiving long-term opioid    
therapy2  7ii7 veterans receiving opioid
 therapy who have a history of substance
 use disorder or prior instances of     
overdose2 and  7iii7 veterans who are at
 risk as determined by a health care    
provider who is treating the veteran4   
7#b7 ,report ,not later than #abj days  
after the date of the enactment of this 
,act1 the ,secretary shall submit to the
 ,committee on ,veterans' ,affairs of   
the ,senate and the ,committee on       
,veterans' ,affairs of the ,house of    
,representatives a report on compliance 

with paragraph 7#a7 that includes an    
assessment of any remaining steps to be 
implemented by the ,secretary to comply 
with such paragraph4  7f7 ,inclusion of 
certain information and capabilities in 
,opioid ,therapy ,risk ,report tool     
7#a7 ,information ,the ,secretary shall 
include in the ,opioid ,therapy ,risk   
,report tool of the ,department-- 7,a7  
information on the most recent time the 
tool was accessed by a health care      
provider of the ,department with respect
 to each veteran2 and  7,b7 information 
on the results of the most recent urine 
drug test for each veteran4  7#b7       
,capabilities ,the ,secretary shall     
include in the ,opioid ,therapy ,risk   
,report tool the ability of health care 
providers of the ,department to         
determine whether a health care provider
 of the ,department prescribed opioids  
to a veteran without checking the       
information in the tool with respect to 
the veteran4  7g7 ,notification of risk 
in computerized health record ,the      

,secretary shall modify the             
,computerized ,patient ,record ,system  
of the ,department to ensure that any   
health care provider that accesses the  
record of a veteran1 regardless of the  
reason the veteran seeks care from the  
health care provider1 will be           
immediately notified whether the        
veteran--  7#a7 is receiving opioid     
therapy and has a history of substance  
use disorder or prior instances of      
overdose2  7#b7 has a history of opioid 
abuse2 or  7#c7 is at risk of becoming  
an opioid abuser as determined by a     
health care provider who is treating the
 veteran4  7h7 ,definitions ,in this    
section3 7#a7 ,controlled substance ,the
 term controlled substance has the      
meaning given that term in section #ajb 
of the ,controlled ,substances ,act 7#ba
 ,u4,s4,c4 #hjb74  7#b7 ,state ,the term
 ,state means each of the several       
,states1 territories1 and possessions of
 the ,united ,states1 the ,district of  
,columbia1 and the ,commonwealth of     

,puerto ,rico4  #bec4 ,enhancement of   
joint working group on pain management  
of the ,department of ,veterans ,affairs
 and the ,department of ,defense  7a7   
,in general ,not later than #ij days    
after the date of the enactment of this 
,act1 the ,secretary of ,veterans       
,affairs and the ,secretary of ,defense 
shall ensure that the ,pain ,management 
,working ,group of the ,health          
,executive ,committee of the ,department
 of ,veterans ,affairs-,department of   
,defense ,joint ,executive ,committee   
established under section #cbj of title 
#ch1 ,united ,states ,code1 includes a  
focus on the following3  7#a7 ,the      
opioid prescribing practices of health  
care providers of each ,department4     
7#b7 ,the ability of each ,department to
 manage acute and chronic pain among    
individuals receiving health care from  
that ,department1 including training    
health care providers with respect to   
pain management4  7#c7 ,the use by each 
,department of complementary and        

integrative health in treating such     
individuals4  7#d7 ,the concurrent use  
by health care providers of each        
,department of opioids for patients who 
take prescription drugs1 including      
benzodiazepines1 to treat mental health 
disorders4  7#e7 ,the use of care       
transition plans by health care         
providers of each ,department to address
 case management issues for patients    
receiving opioid therapy who transition 
between inpatient and outpatient        
settings4  7#f7 ,the coordination in    
coverage of and consistent access to    
medications prescribed for patients     
transitioning from receiving health care
 from the ,department of ,defense to    
receiving health care from the          
,department of ,veterans ,affairs4  7#g7
 ,the ability of each ,department to    
properly screen1 identify1 and refer for
 treatment patients with substance abuse
 disorders who are seeking treatment for
 acute and chronic pain management      
conditions4  7b7 ,coordination and      

consultation ,the ,secretary of         
,veterans ,affairs and the ,secretary of
 ,defense shall ensure that the working 
group described in subsection 7a7--     
7#a7 coordinates the activities of the  
working group with other relevant       
working groups established under section
 #cbj of title #ch1 ,united ,states     
,code1 including the working groups on  
evidence based practice1 patient safety1
 pharmacy1 and psychological health2    
7#b7 consults with other relevant       
,federal agencies1 including the        
,centers for ,disease ,control and      
,prevention1 with respect to the        
activities of the working group2  7#c7  
consults with the ,department of        
,veterans ,affairs and the ,department  
of ,defense with respect to the         
,,va_/,,dod ,clinical ,practice         
,guideline for ,management of ,opioid   
,therapy for ,chronic ,pain1 or any     
successor guideline1 before any update  
to the guideline is released2 and  7#d7 
reviews and comments on the guideline   

described in paragraph 7#c7 before any  
update to such guideline is released4   
7c7 ,consultation ,the ,secretary of    
,veterans ,affairs and the ,secretary of
 ,defense shall ensure that the working 
group described in subsection 7a7 is    
able to meaningfully consult with       
respect to the updated guideline        
required under subsection 7a7 of section
 #bea1 as required by subsection 7b7 of 
such section1 not later than one year   
after the date of the enactment of this 
,act4  #bed4 ,review1 investigation1 and
 report on use of opioids in treatment  
by ,department of ,veterans ,affairs    
7a7 ,comptroller ,general report  7#a7  
,in general ,not later than two years   
after the date of the enactment of this 
,act1 the ,comptroller ,general of the  
,united ,states shall submit to the     
,committee on ,veterans' ,affairs of the
 ,senate and the ,committee on          
,veterans' ,affairs of the ,house of    
,representatives a report on the ,opioid
 ,safety ,initiative of the ,department 

of ,veterans ,affairs and the opioid    
prescribing practices of health care    
providers of the ,department4  7#b7     
,elements ,the report submitted under   
paragraph 7#a7 shall include the        
following3 7,a7 ,an assessment of the   
implementation and monitoring by the    
,veterans ,health ,administration of the
 ,opioid ,safety ,initiative of the     
,department1 including examining1 as    
appropriate1 the following3  7i7 ,how   
the ,department monitors the key        
clinical outcomes of such safety        
initiative 7for example1 the percentage 
of unique veterans visiting each medical
 center of the ,department that are     
prescribed an opioid or an opioid and   
benzodiazepine concurrently7 and how the
 ,department uses that information--    
7,i7 to improve prescribing practices2  
and  7,,ii7 to identify high prescribing
 or otherwise inappropriate prescribing 
practices by health care providers4     
7ii7 ,how the ,department monitors the  
use of the ,opioid ,therapy ,risk       

,report tool of the ,department 7as     
developed through such safety           
initiative7 and compliance with such    
tool by medical facilities and health   
care providers of the ,department1      
including any findings by the           
,department of prescription rates or    
prescription practices by medical       
facilities or health care providers that
 are inappropriate4  7iii7 ,the         
implementation of academic detailing    
programs within the ,veterans           
,integrated ,service ,networks of the   
,department and how such programs are   
being used to improve opioid prescribing
 practices4  7,b7 ,information with     
respect to known deaths resulting from  
sentinel events involving veterans      
prescribed opioids by a health care     
provider of the ,department4  7,c7      
,information made available under the   
,opioid ,therapy ,risk ,report tool of  
the ,department with respect to the     
following3  7i7 ,overall prescription   
rates and1 if available1 indications    

used by health care providers for       
prescribing chronic opioid therapy to   
treat noncancer1 non-palliative care1   
and non-hospice care patients4  7ii7    
,the prescription rates and indications 
used by health care providers of the    
,department for prescribing             
benzodiazepines and chronic opioid      
therapy concurrently4  7iii7 ,the       
practice by health care providers of the
 ,department of prescribing opioids to  
treat patients without any known pain1  
including to treat patients with mental 
health disorders other than an opioid   
use disorder4  7,d7 ,an evaluation of   
processes of the ,department to oversee 
opioid use among veterans1 including    
processes to identify and remedy        
potential overprescribing of opioids by 
health care providers of the            
,department1 and an evaluation of the   
use and effectiveness of such processes4
  7,e7 ,an evaluation of processes of   
the ,department to oversee and ensure   
the implementation by medical centers of

 the ,department of the ,,va_/,,dod     
,clinical ,practice ,guideline for      
,management of ,opioid ,therapy1 as     
updated under section #bea7;a71         
including any figures or approaches used
 by the ,department to assess           
implementation and compliance with such 
guideline by medical centers and whether
 any medical centers are operating      
action plans to improve compliance with 
such guideline4  7,f7 ,an assessment of 
the data that the ,department has       
developed to review the opioid          
prescribing practices of health care    
providers of the ,department1 as        
required by this subtitle1 including a  
review of how the ,department identifies
 the practices of individual health care
 providers that warrant further review  
based on--  7i7 prescribing levels2     
7ii7 health conditions for which the    
health care provider is prescribing     
opioids or opioids and benzodiazepines  
concurrently2 or  7iii7 other practices 
of the health care provider4  7b7       

,review of prescription rates ,not later
 than one year after the date of the    
enactment of this ,act1 and not less    
frequently than annually thereafter1 the
 ,secretary of ,veterans ,affairs shall1
 with respect to each medical facility  
of the ,department of ,veterans         
,affairs1 collect and review information
 on opioids prescribed by health care   
providers at the facility to treat      
noncancer1 non-palliative care1 and     
non-hospice care patients1 including    
information on--  7#a7 the prescription 
rate at which each health care provider 
at the facility prescribed opioids1 and 
benzodiazepines and opioids             
concurrently1 to such patients and the  
aggregate of such prescription rates for
 all health care providers at the       
facility2  7#b7 the prescription rate at
 which each health care provider at the 
facility prescribed benzodiazepines or  
opioids to such patients to treat       
conditions for which benzodiazepines or 
opioids are not a recommended treatment 

and the aggregate of such prescription  
rates for all health care providers at  
the facility2  7#c7 the prescription    
rate at which each health care provider 
at the facility prescribed or dispensed 
mail-order prescriptions of opioids to  
such patients while such patients were  
being treated with opioids on an        
inpatient-basis and the aggregate of    
such prescription rates for all health  
care providers at the facility2 and     
7#d7 the prescription rate at which each
 health care provider at the facility   
prescribed opioids to such patients who 
were also concurrently prescribed       
opioids by a health care provider who is
 not a health care provider of the      
,department and the aggregate of such   
prescription rates for all health care  
providers at the facility4  7c7         
,investigation of prescription rates ,if
 the ,secretary determines that a       
prescription rate described in          
subsection 7b7 with respect to a health 
care provider or medical facility of the

 ,department conflicts with or is       
otherwise inconsistent with the         
standards of appropriate and safe care1 
the ,secretary shall--  7#a7 through the
 ,office of the ,medical ,inspector of  
the ,veterans ,health ,administration1  
conduct a full investigation of the     
health care provider or medical         
facility1 as the case may be2  7#b7     
immediately notify the ,committee on    
,veterans' ,affairs of the ,senate1 the 
,committee on ,veterans' ,affairs of the
 ,house of ,representatives1 and each   
,member of the ,senate and the ,house of
 ,representatives who represents the    
area in which the health care provider  
or medical facility1 as the case may be1
 is located2 and  7#c7 include          
information relating to such            
determination1 prescription rate1 and   
health care provider or medical         
facility1 as the case may be1 in the    
report required under subsection 7d74   
7d7 ,report on opioid therapy  7#a7 ,in 
general ,not later than one year after  

the date of the enactment of this ,act1 
and not less frequently than annually   
thereafter through #bjbf1 the ,secretary
 shall submit to the ,committee on      
,veterans' ,affairs of the ,senate and  
the ,committee on ,veterans' ,affairs of
 the ,house of ,representatives a report
 that contains1 for the one-year period 
preceding the submittal of the report1  
the following3  7,a7 ,the number of     
patients and the percentage of the      
patient population of the ,department of
 ,veterans ,affairs who were prescribed 
opioids1 and benzodiazepines and opioids
 concurrently1 by a health care provider
 of the ,department4  7,b7 ,the number  
of patients and the percentage of the   
patient population of the ,department   
without any documented pain who were    
prescribed opioids by a health care     
provider of the ,department1 including  
those who were prescribed               
benzodiazepines and opioids             
concurrently4  7,c7 ,the number of      
noncancer1 non-palliative care1 and     

non-hospice care patients and the       
percentage of such patients who were    
treated with opioids by a health care   
provider of the ,department on an       
inpatient-basis and who were also sent  
prescription opioids by mail by the     
,department while being treated on an   
inpatient-basis4  7,d7 ,the number of   
noncancer1 non-palliative care1 and     
non-hospice care patients and the       
percentage of such patients who were    
prescribed opioids concurrently by a    
health care provider of the ,department 
and a health care provider who is not a 
health care provider of the ,department4
  7,e7 ,with respect to each medical    
facility of the ,department1 the number 
of times a pharmacist at the facility   
overrode a critical drug interaction    
warning with respect to an interaction  
between opioids and another medication  
before dispensing such other medication 
to a veteran4  7,f7 ,the results of the 
review conducted under subsection 7b7   
7including a summary of such review at  

the ,veterans ,integrated ,service      
,network level7 and the investigation   
conducted under subsection 7c7          
7including information described in     
subsection 7c77#c771 compiled in such a 
manner as the ,secretary determines     
appropriate to ensure that the          
information is easily accessible4  7#b7 
,subsequent reports ,each report        
submitted under paragraph 7#a7 after the
 date that is two years after the date  
of the enactment of this ,act shall     
include an assessment of the compliance 
of the ,department with the ,,va_/,,dod 
,clinical ,practice ,guideline for      
,management of ,opioid ,therapy for     
,chronic ,pain1 including any update to 
such guideline4  7e7 ,prescription rate 
defined ,in this section1 the term      
prescription rate means1 with respect to
 a health care provider or medical      
facility of the ,department1 each of the
 following3  7#a7 ,the number of        
patients treated with opioids by the    
health care provider or at the medical  

facility1 as the case may be1 divided by
 the total number of pharmacy users of  
that health care provider or medical    
facility4  7#b7 ,the average number of  
morphine equivalents per day prescribed 
by the health care provider or at the   
medical facility1 as the case may be1 to
 patients being treated with opioids4   
7#c7 ,of the patients being treated with
 opioids by the health care provider or 
at the medical facility1 as the case may
 be1 the average number of prescriptions
 of opioids per patient4  #bee4         
,elimination of copayment requirement   
for veterans receiving opioid           
antagonists or education on use of      
opioid antagonists  7a7 ,copayment for  
opioid antagonists ,section #agbb;,a7a7 
of title #ch1 ,united ,states ,code1 is 
amended by adding at the end the        
following new paragraph3  7#d7          
,paragraph 7#a7 does not apply to opioid
 antagonists furnished under this       
chapter to a veteran who is at high risk
 for overdose of a specific medication  

or substance in order to reverse the    
effect of such an overdose4  4  7b7     
,copayment for education on use of      
opioid antagonists ,section             
#agaj7;g77#c7 of such title is amended--
 7#a7 by striking with respect to home  
health services and inserting 8with     
respect to the following3  7,a7 ,home   
health services  2 and  7#b7 by adding  
at the end the following new            
subparagraph3  7,b7 ,education on the   
use of opioid antagonists to reverse the
 effects of overdoses of specific       
medications or substances4  4  ,g       
,patient advocacy and outreach  #bfa4   
,establishment of ,office of ,patient   
,advocacy of the ,department of         
,veterans ,affairs  7a7 ,in general     
,subchapter ,i of chapter #gc of title  
#ch1 ,united ,states ,code1 is amended  
by adding at the end the following new  
section3  #gcji;,a4 ,office of ,patient 
,advocacy  7a7 ,establishment ,there is 
established in the ,department within   
the ,office of the ,under ,secretary for

 ,health an office to be known as the   
,office of ,patient ,advocacy 7in this  
section referred to as the ,office74    
7b7 ,head  7#a7 ,the ,director of the   
,office of ,patient ,advocacy shall be  
the head of the ,office4  7#b7 ,the     
,director of the ,office of ,patient    
,advocacy shall be appointed by the     
,under ,secretary for ,health from among
 individuals qualified to perform the   
duties of the position and shall report 
directly to the ,under ,secretary for   
,health4  7c7 ,function  7#a7 ,the      
function of the ,office is to carry out 
the ,patient ,advocacy ,program of the  
,department4  7#b7 ,in carrying out the 
,patient ,advocacy ,program of the      
,department1 the ,director shall ensure 
that patient advocates of the           
,department--  7,a7 advocate on behalf  
of veterans with respect to health care 
received and sought by veterans under   
the laws administered by the ,secretary2
  7,b7 carry out the responsibilities   
specified in subsection 7d72 and  7,c7  

receive training in patient advocacy4   
7d7 ,patient advocacy responsibilities  
,the responsibilities of each patient   
advocate at a medical facility of the   
,department are the following3  7#a7 ,to
 resolve complaints by veterans with    
respect to health care furnished under  
the laws administered by the ,secretary 
that cannot be resolved at the point of 
service or at a higher level easily     
accessible to the veteran4  7#b7 ,to    
present at various meetings and to      
various committees the issues           
experienced by veterans in receiving    
such health care at such medical        
facility4  7#c7 ,to express to veterans 
their rights and responsibilities as    
patients in receiving such health care4 
7#d7 ,to manage the ,patient ,advocate  
,tracking ,system of the ,department at 
such medical facility4  7#e7 ,to compile
 data at such medical facility of       
complaints made by veterans with respect
 to the receipt of such health care at  
such medical facility and the           

satisfaction of veterans with such      
health care at such medical facility to 
determine whether there are trends in   
such data4  7#f7 ,to ensure that a      
process is in place for the distribution
 of the data compiled under paragraph   
7#e7 to appropriate leaders1 committees1
 services1 and staff of the ,department4
  7#g7 ,to identify1 not less frequently
 than quarterly1 opportunities for      
improvements in the furnishing of such  
health care to veterans at such medical 
facility based on complaints by         
veterans4  7#h7 ,to ensure that any     
significant complaint by a veteran with 
respect to such health care is brought  
to the attention of appropriate staff of
 the ,department to trigger an          
assessment of whether there needs to be 
a further analysis of the problem at the
 facility-wide level4  7#i7 ,to support 
any patient advocacy programs carried   
out by the ,department4  7#aj7 ,to      
ensure that all appeals and final       
decisions with respect to the receipt of

 such health care are entered into the  
,patient ,advocate ,tracking ,system of 
the ,department4  7#aa7 ,to understand  
all laws1 directives1 and other rules   
with respect to the rights and          
responsibilities of veterans in         
receiving such health care1 including   
the appeals processes available to      
veterans4  7#ab7 ,to ensure that        
veterans receiving mental health care1  
or the surrogate decision-makers for    
such veterans1 are aware of the rights  
of veterans to seek representation from 
systems established under section #ajc  
of the ,protection and ,advocacy for    
,mentally ,ill ,individuals ,act of     
#aihf 7#db ,u4,s4,c4 #ajhjc7 to protect 
and advocate the rights of individuals  
with mental illness and to investigate  
incidents of abuse and neglect of such  
individuals4  7#ac7 ,to fulfill         
requirements established by the         
,secretary with respect to the          
inspection of controlled substances4    
7#ad7 ,to document potentially          

threatening behavior and report such    
behavior to appropriate authorities4    
7e7 ,training ,in providing training to 
patient advocates under subsection      
7c77#b77;,c71 the ,director shall ensure
 that such training is consistent       
throughout the ,department4  7f7        
,controlled substance defined ,in this  
section1 the term controlled substance  
has the meaning given that term in      
section #ajb of the ,controlled         
,substances ,act 7#ba ,u4,s4,c4 #hjb74  
4  7b7 ,clerical amendment ,the table of
 sections at the beginning of chapter   
#gc of such title is amended by         
inserting after the item relating to    
section #gcji the following new item3   
#gcji;,a4 ,office of ,patient ,advocacy4
  4  7c7 ,date fully operational ,the   
,secretary of ,veterans ,affairs shall  
ensure that the ,office of ,patient     
,advocacy established under section     
#gcji;,a of title #ch1 ,united ,states  
,code1 as added by subsection 7a71 is   
fully operational not later than the    

date that is one year after the date of 
the enactment of this ,act4  #bfb4      
,community meetings on improving care   
from ,department of ,veterans ,affairs  
7a7 ,community meetings  7#a7 ,medical  
centers ,not later than #ij days after  
the date of the enactment of this ,act1 
and not less frequently than once every 
#ij days thereafter1 each medical center
 of the ,department of ,veterans        
,affairs shall host a community meeting 
open to the public on improving health  
care from the ,department4  7#b7        
,community-based outpatient clinics ,not
 later than one year after the date of  
the enactment of this ,act1 and not less
 frequently than annually thereafter1   
each community-based outpatient clinic  
of the ,department shall host a         
community meeting open to the public on 
improving health care from the          
,department4  7b7 ,attendance by        
,director of ,veterans ,integrated      
,service ,network or designee  7#a7 ,in 
general ,subject to paragraph 7#b71 each

 community meeting hosted by a medical  
center or community-based outpatient    
clinic under subsection 7a7 shall be    
attended by the ,director of the        
,veterans ,integrated ,service ,network 
in which the medical center or          
community-based outpatient clinic1 as   
the case may be1 is located1 or an      
employee designated by the ,director who
 works in the office of the ,director4  
7#b7 ,attendance by ,director ,each     
,director of a ,veterans ,integrated    
,service ,network shall attend not fewer
 than one community meeting under       
subsection 7a7 hosted by each medical   
center located in the ,veterans         
,integrated ,service ,network each year4
  7c7 ,notice ,with respect to any      
community meeting at a medical facility 
of the ,department under subsection 7a71
 the ,secretary of ,veterans ,affairs   
shall notify the ,committee on          
,veterans' ,affairs of the ,senate1 the 
,committee on ,veterans' ,affairs of the
 ,house of ,representatives1 and each   

,member of ,congress who represents the 
area in which the medical facility is   
located of such meeting not later than  
#aj days before such meeting occurs4    
#bfc4 ,outreach to veterans regarding   
effect of certain delayed payments by   
,chief ,business ,office of ,department 
of ,veterans ,affairs  7a7 ,outreach    
7#a7 ,in general ,the ,secretary of     
,veterans ,affairs shall conduct        
outreach1 including through national and
 local veterans service organizations1  
to inform veterans of how to resolve    
credit issues caused by delayed payment 
of a claim for emergency hospital care1 
medical services1 or other emergency    
health care furnished through a         
non-,department of ,veterans ,affairs   
provider4  7#b7 ,telephone number ,the  
,secretary shall establish a toll-free  
telephone number for veterans to report 
credit issues described in paragraph    
7#a7 to the ,chief ,business ,office of 
the ,department of ,veterans ,affairs4  
7b7 ,annual report  7#a7 ,report        

required  7,a7 ,in general ,during the  
five-year period beginning on the date  
of the enactment of this ,act1 the      
,secretary shall annually submit to     
,congress a report on the effectiveness 
of the ,chief ,business ,office of the  
,department in providing timely payment 
of proper invoices for emergency        
hospital care1 medical services1 or     
other emergency health care furnished   
through non-,department providers by the
 required payment date during both the  
five-year period preceding the date of  
the report and the one-year period      
preceding such date4  7,b7 ,payments by 
,v,i,s,ns ,for any part of the period   
covered by a report under this          
subsection that occurred before ,october
 #a1 #bjad1 the report shall evaluate   
the provision of payments described in  
subparagraph 7,a7 by the ,veterans      
,integrated ,service ,networks4  7#b7   
,matters included ,each report submitted
 under paragraph 7#a7 shall include1 for
 each period covered by the report1 the 

following3  7,a7 ,the number of veterans
 who contacted the ,secretary regarding 
a delayed payment that negatively       
affected1 or will potentially negatively
 affect1 the credit of the veteran4     
7,b7 ,the total amount of interest      
penalties paid by the ,secretary under  
section #cijb of title #ca1 ,united     
,states ,code1 by reason of a delayed   
payment4  7,c7 ,the number of proper    
invoices submitted1 listed in a table   
for each quarter and fiscal year of each
 such period that includes--  7i7 the   
total amount owed by the ,secretary     
under the proper invoices2  7ii7 the    
payment status of each proper invoice1  
as of the date of the report2 and  7iii7
 the period that elapsed until each     
proper invoice was paid1 including an   
explanation of any delayed payment4     
7,d7 ,any comments by the ,secretary    
regarding delayed payments made by      
health care providers4  7,e7 ,a         
description of the best practices that  
the ,chief ,business ,office of the     

,department uses to provide timely      
payment of proper invoices1 including a 
plan to improve such timely payments4   
7c7 ,quarterly reports on pending claims
  7#a7 ,in general ,during the five-year
 period beginning on the date of the    
enactment of this ,act1 the ,chief      
,business ,office of the ,department    
shall submit to ,congress quarterly     
reports on the number of pending claims 
for reimbursement for emergency hospital
 care1 medical services1 and other      
emergency health care furnished through 
non-,department providers4  7#b7        
,elements ,each report submitted under  
paragraph 7#a7 shall include1 with      
respect to pending claims described in  
such paragraph1 the following3  7,a7    
,the total number of such pending claims
 for each hospital system of the        
,department1 as of the last day of the  
quarter covered by the report4  7,b7    
,the total number of veterans who       
submitted such a pending claim in each  
,state1 as of such day4  7,c7 ,the      

aggregate amount of all such pending    
claims in each ,state1 as of such day4  
7,d7 ,as of such day-- 7i7 the number of
 such pending claims that have been     
pending for #cj days or longer2  7ii7   
the number of such pending claims that  
have been pending for #ij days or       
longer2 and  7iii7 the number of such   
pending claims that have been pending   
for one year or longer4  7,e7 ,for each 
hospital system1 for the quarter covered
 by the report-- 7i7 the number of      
claims for reimbursement for emergency  
hospital care1 medical services1 and    
other emergency health care furnished   
through non-,department providers       
approved during such quarter2  7ii7 the 
number of such claims denied during such
 quarter2 and  7iii7 the number of such 
claims denied listed by each denial     
reason group4  7d7 ,comptroller ,general
 study  7#a7 ,in general ,the           
,comptroller ,general of the ,united    
,states shall conduct a study that      
evaluates the effectiveness of the      

,chief ,business ,office of the         
,department in providing timely payment 
of proper invoices for emergency        
hospital care1 medical services1 or     
other emergency health care furnished   
through non-,department providers by the
 required payment date4  7#b7 ,submittal
 ,the ,comptroller ,general shall submit
 to ,congress a report on the study     
conducted under paragraph 7#a71         
including the total amount of interest  
penalties paid by the ,secretary under  
section #cijb of title #ca1 ,united     
,states ,code1 by reason of a delayed   
payment4  7e7 ,definitions ,in this     
section3 7#a7 ,the term delayed payment 
means a proper invoice that is not paid 
by the ,secretary of ,veterans ,affairs 
until after the required payment date4  
7#b7 ,the term proper invoice has the   
meaning given that term in section      
#cija7;a7 of title #ca1 ,united ,states 
,code4  7#c7 ,the term required payment 
date means the date that payment is due 
under a contract pursuant to section    

#cijc7;a7 of title #ca1 ,united ,states 
,code4  #bfd4 ,improvement of awareness 
of patient advocacy program and patient 
bill of rights of ,department of        
,veterans ,affairs ,not later than #ij  
days after the date of the enactment of 
this ,act1 the ,secretary of ,veterans  
,affairs shall1 in as many prominent    
locations as appropriate to be seen by  
the largest percentage of patients and  
family members of patients at each      
medical facility of the ,department of  
,veterans ,affairs--  7#a7 display the  
purposes of the ,patient ,advocacy      
,program of the ,department and the     
contact information for the patient     
advocate at such medical facility2 and  
7#b7 display the rights and             
responsibilities of-- 7,a7 patients and 
family members of patients at such      
medical facility2 and  7,b7 with respect
 to community living centers and other  
residential facilities of the           
,department1 residents and family       
members of residents at such medical    

facility4  #bfe4 ,comptroller ,general  
,report on ,patient ,advocacy ,program  
of ,department of ,veterans ,affairs    
7a7 ,in general ,not later than three   
years after the date of the enactment of
 this ,act1 the ,comptroller ,general of
 the ,united ,states shall submit to the
 ,committee on ,veterans' ,affairs of   
the ,senate and the ,committee on       
,veterans' ,affairs of the ,house of    
,representatives a report on the        
,patient ,advocacy ,program of the      
,department of ,veterans ,affairs 7in   
this section referred to as the         
,program74  7b7 ,elements ,the report   
required by subsection 7a7-- 7#a7 shall 
include--  7,a7 such recommendations and
 proposals for improving or modifying   
the ,program as the ,comptroller        
,general considers appropriate2 and     
7,b7 such other information with respect
 to the ,program as the ,comptroller    
,general considers appropriate2 and     
7#b7 may include-- 7,a7 a description of
 the ,program1 including--  7i7 the     

purposes of the ,program2  7ii7 the     
activities carried out under the        
,program2 and  7iii7 an assessment by   
the ,secretary of ,veterans ,affairs of 
the sufficiency of the ,program in      
achieving the purposes of the ,program2 
7,b7 an assessment of the sufficiency of
 staffing of employees of the           
,department responsible for carrying out
 the ,program2  7,c7 an assessment of   
the sufficiency of the training of such 
employees2 and  7,d7 an assessment of-- 
7i7 awareness of the ,program among     
veterans and their family members2 and  
7ii7 the use of the ,program by veterans
 and their family members4  ,h          
,administration of non-,department      
health care  #bga4 ,payment of          
non-,department of ,veterans ,affairs   
health care providers  7a7 ,payment of  
providers  7#a7 ,in general ,subchapter 
,i of chapter #ag of title #ch1 ,united 
,states ,code1 is amended by inserting  
after section #agjc the following new   
section3  #agjc;,a4 ,payment of         

non-,department health care providers   
7a7 ,prompt payment compliance ,the     
,secretary shall ensure that payments   
made to non-,department health care     
providers pursuant to an agreement under
 this chapter comply with chapter #ci of
 title #ca 7commonly referred to as the 
,prompt ,payment ,act7 and the          
requirements of this section4 ,if there 
is a conflict between the requirements  
of the ,prompt ,payment ,act and the    
requirements of this section1 the       
,secretary shall comply with the        
requirements of this section4  7b7      
,submittal of claim  7#a7 ,a            
non-,department health care provider    
that seeks reimbursement under this     
section for care or services furnished  
under the laws administered by the      
,secretary shall submit to the          
,secretary a claim for reimbursement not
 later than #ahj days after furnishing  
such care or services4  7#b7 ,on and    
after ,january #a1 #bjai1 the ,secretary
 shall not accept any claim under this  

section that is submitted to the        
,secretary in a manner other than       
electronically4  7c7 ,payment schedule  
7#a7 ,the ,secretary shall reimburse a  
non-,department health care provider for
 care or services furnished under the   
laws administered by the ,secretary--   
7,a7 in the case of a clean claim       
submitted to the ,secretary             
electronically1 not later than #cj days 
after receiving the claim2 or  7,b7 in  
the case of a clean claim submitted to  
the ,secretary in a manner other than   
electronically1 not later than #de days 
after receiving the claim4  7#b7 7,a7   
,if the ,secretary determines that a    
claim received from a non-,department   
health care provider for care or        
services furnished under the laws       
administered by the ,secretary is a     
non-clean claim1 the ,secretary shall   
submit to the provider1 not later than  
#cj days after receiving the claim--    
7i7 a notification that the claim is a  
non-clean claim2  7ii7 an explanation of

 why the claim has been determined to be
 a non-clean claim2 and  7iii7 an       
identification of the information or    
documentation that is required to make  
the claim a clean claim4  7,b7 ,if the  
,secretary does not comply with the     
requirements of subparagraph 7,a7 with  
respect to a claim1 the claim shall be  
deemed a clean claim for purposes of    
paragraph 7#a74  7#c7 ,upon receipt by  
the ,secretary of information or        
documentation described in subparagraph 
7,a77iii7 with respect to a claim1 the  
,secretary shall reimburse a            
non-,department health care provider for
 care or services furnished under the   
laws administered by the ,secretary--   
7,a7 in the case of a claim submitted to
 the ,secretary electronically1 not     
later than #cj days after receiving such
 information or documentation2 or  7,b7 
in the case of a claim submitted to the 
,secretary in a manner other than       
electronically1 not later than #de days 
after receiving such information or     

documentation4  7#d7 ,if the ,secretary 
fails to comply with the deadlines for  
payment set forth in this subsection    
with respect to a claim1 interest shall 
accrue on the amount owed under such    
claim in accordance with section #cijb  
of title #ca1 ,united ,states ,code4    
7d7 ,information and documentation      
required  7#a7 ,the ,secretary shall    
provide to all non-,department health   
care providers that furnish care or     
services under the laws administered by 
the ,secretary a list of information and
 documentation that is required to      
establish a clean claim under this      
section4  7#b7 ,the ,secretary shall    
consult with entities in the health care
 industry1 in the public and private    
sector1 to determine the information and
 documentation to include in the list   
under paragraph 7#a74  7#c7 ,if the     
,secretary modifies the information and 
documentation included in the list under
 paragraph 7#a71 the ,secretary shall   
notify all non-,department health care  

providers that furnish care or services 
under the laws administered by the      
,secretary not later than #cj days      
before such modifications take effect4  
7e7 ,definitions ,in this section3 7#a7 
,the term clean claim means a claim for 
reimbursement for care or services      
furnished by a non-,department health   
care provider under the laws            
administered by the ,secretary1 on a    
nationally recognized standard format1  
that includes the information and       
documentation necessary to adjudicate   
the claim4  7#b7 ,the term non-clean    
claim means a claim for reimbursement   
for care or services furnished by a     
non-,department health care provider    
under the laws administered by the      
,secretary1 on a nationally recognized  
standard format1 that does not include  
the information and documentation       
necessary to adjudicate the claim4  7#c7
 ,the term non-,department health care  
provider means a health care provider   
that is not a health care provider of   

the ,department4  4  7#b7 ,clerical     
amendment ,the table of sections at the 
beginning of chapter #ag of such title  
is amended by inserting after the item  
related to section #agjc the following  
new item3  #agjc;,a4 ,payment of        
non-,department health care providers4  
4  7b7 ,electronic submittal of claims  
for reimbursement  7#a7 ,prohibition on 
acceptance of non-electronic claims     
7,a7 ,in general ,except as provided in 
subparagraph 7,b71 on and after ,january
 #a1 #bjai1 the ,secretary of ,veterans 
,affairs shall not accept any claim for 
reimbursement under section #agjc;,a of 
title #ch1 ,united ,states ,code1 as    
added by subsection 7a71 that is        
submitted to the ,secretary in a manner 
other than electronically1 including    
medical records in connection with such 
a claim4  7,b7 ,exception ,if the       
,secretary determines that accepting    
claims and medical records in a manner  
other than electronically is necessary  
for the timely processing of claims for 

reimbursement under such section        
#agjc;,a due to a failure or malfunction
 of the electronic interface established
 under paragraph 7#b71 the ,secretary-- 
7i7 may accept claims and medical       
records in a manner other than          
electronically for a period not to      
exceed #ij days2 and  7ii7 shall submit 
to the ,committee on ,veterans' ,affairs
 of the ,senate and the ,committee on   
,veterans' ,affairs of the ,house of    
,representatives a report setting       
forth--  7,i7 the reason for accepting  
claims and medical records in a manner  
other than electronically2  7,,ii7 the  
duration of time that the ,department of
 ,veterans ,affairs will accept claims  
and medical records in a manner other   
than electronically2 and  7,,iii7 the   
steps that the ,department is taking to 
resolve such failure or malfunction4    
7#b7 ,electronic interface  7,a7 ,in    
general ,not later than ,january #a1    
#bjai1 the ,chief ,information ,officer 
of the ,department of ,veterans ,affairs

 shall establish an electronic interface
 for health care providers to submit    
claims for reimbursement under such     
section #agjc;,a4  7,b7 ,functions ,the 
electronic interface established under  
subparagraph 7,a7 shall include the     
following functions3 7i7 ,a function    
through which a health care provider may
 input all relevant data required for   
claims submittal and reimbursement4     
7ii7 ,a function through which a health 
care provider may upload medical records
 to accompany a claim for reimbursement4
  7iii7 ,a function through which a     
health care provider may ascertain the  
status of a pending claim for           
reimbursement that--  7,i7 indicates    
whether the claim is a clean claim or a 
non-clean claim2 and  7,,ii7 in the     
event that a submitted claim is         
indicated as a non-clean claim1         
provides--  7aa7 an explanation of why  
the claim has been determined to be a   
non-clean claim2 and  7bb7 an           
identification of the information or    

documentation that is required to make  
the claim a clean claim4  7iv7 ,a       
function through which a health care    
provider is notified when a claim for   
reimbursement is accepted or rejected4  
7v7 ,such other features as the         
,secretary considers necessary4  7,c7   
,protection of information  7i7 ,in     
general ,the electronic interface       
established under subparagraph 7,a7     
shall be developed and implemented based
 on industry-accepted information       
security and privacy engineering        
principles and best practices and shall 
provide for the following3  7,i7 ,the   
elicitation1 analysis1 and              
prioritization of functional and        
nonfunctional information security and  
privacy requirements for such interface1
 including specific security and privacy
 services and architectural requirements
 relating to security and privacy based 
on a thorough analysis of all reasonably
 anticipated cyber and noncyber threats 
to the security and privacy of          

electronic protected health information 
made available through such interface4  
7,,ii7 ,the elicitation1 analysis1 and  
prioritization of secure development    
requirements relating to such interface4
  7,,iii7 ,the assurance that the       
prioritized information security and    
privacy requirements of such interface--
 7aa7 are correctly implemented in the  
design and implementation of such       
interface throughout the system         
development lifecycle2 and  7bb7 satisfy
 the information objectives of such     
interface relating to security and      
privacy throughout the system           
development lifecycle4  7ii7            
,definitions ,in this subparagraph3 7,i7
 ,electronic protected health           
information ,the term electronic        
protected health information has the    
meaning given that term in section      
#afj4ajc of title #de1 ,code of ,federal
 ,regulations1 as in effect on the date 
of the enactment of this ,act4  7,,ii7  
,secure development requirements ,the   

term secure development requirements    
means1 with respect to the electronic   
interface established under subparagraph
 7,a71 activities that are required to  
be completed during the system          
development lifecycle of such interface1
 such as secure coding principles and   
test methodologies4  7#c7 ,analysis of  
available technology for electronic     
interface  7,a7 ,in general ,not later  
than ,january #a1 #bjag1 or before      
entering into a contract to procure or  
design and build the electronic         
interface described in paragraph 7#b7 or
 making a decision to internally design 
and build such electronic interface1    
whichever occurs first1 the ,secretary  
shall--  7i7 conduct an analysis of     
commercially available technology that  
may satisfy the requirements of such    
electronic interface set forth in such  
paragraph2 and  7ii7 submit to the      
,committee on ,veterans' ,affairs of the
 ,senate and the ,committee on          
,veterans' ,affairs of the ,house of    

,representatives a report setting forth 
such analysis4  7,b7 ,elements ,the     
report required under subparagraph      
7,a77ii7 shall include the following3   
7i7 ,an evaluation of commercially      
available systems that may satisfy the  
requirements of paragraph 7#b74  7ii7   
,the estimated cost of procuring a      
commercially available system if a      
suitable commercially available system  
exists4  7iii7 ,if no suitable          
commercially available system exists1 an
 assessment of the feasibility of       
modifying a commercially available      
system to meet the requirements of      
paragraph 7#b71 including the estimated 
cost associated with such modifications4
  7iv7 ,if no suitable commercially     
available system exists and modifying a 
commercially available system is not    
feasible1 an assessment of the estimated
 cost and time that would be required to
 contract with a commercial entity to   
design and build an electronic interface
 that meets the requirements of         

paragraph 7#b74  7v7 ,if the ,secretary 
determines that the ,department has the 
capabilities required to design and     
build an electronic interface that meets
 the requirements of paragraph 7#b71 an 
assessment of the estimated cost and    
time that would be required to design   
and build such electronic interface4    
7vi7 ,a description of the decision of  
the ,secretary regarding how the        
,department plans to establish the      
electronic interface required under     
paragraph 7#b7 and the justification of 
the ,secretary for such decision4  7#d7 
,limitation on use of amounts ,the      
,secretary may not spend any amounts to 
procure or design and build the         
electronic interface described in       
paragraph 7#b7 until the date that is   
#fj days after the date on which the    
,secretary submits the report required  
under paragraph 7#c77;,a77ii74  #bgb4   
,authorization of agreements between the
 ,department of ,veterans ,affairs and  
non-,department providers  7a7 ,in      

general ,subchapter ,i of chapter #ag of
 title #ch1 ,united ,states ,code1 as   
amended by section #bga7;a77#a71 is     
further amended by inserting after      
section #agjc;,a the following new      
section3  #agjc;,b4 ,veterans ,care     
,agreements  7a7 ,agreements ,to furnish
 care  7#a7 ,in addition to the         
authority of the ,secretary under this  
chapter to furnish hospital care1       
medical services1 and extended care at  
facilities of the ,department and under 
contracts or sharing agreements entered 
into under authorities other than this  
section1 the ,secretary may furnish     
hospital care1 medical services1 and    
extended care through the use of        
agreements entered into under this      
section4 ,an agreement entered into     
under this section may be referred to as
 a ,veterans ,care ,agreement4  7#b7    
7,a7 ,the ,secretary may enter into     
agreements under this section with      
eligible providers that are certified   
under subsection 7d7 if the ,secretary  

is not feasibly able to furnish care or 
services described in paragraph 7#a7 at 
facilities of the ,department4  7,b7    
,the ,secretary is not feasibly able to 
furnish care or services described in   
paragraph 7#a7 at facilities of the     
,department if the ,secretary determines
 that the medical condition of the      
veteran1 the travel involved1 the nature
 of the care or services required1 or a 
combination of those factors make the   
use of facilities of the ,department    
impracticable or inadvisable4  7#c7 ,an 
eligible provider1 at its discretion1   
may opt to enter into an agreement under
 this section instead of a contract or  
sharing agreement under authorities     
other than this section4  7b7 ,receipt  
of care  7#a7 ,eligibility of a veteran 
under this section for care or services 
described in subsection 7a77#a7 shall be
 determined as if such care or services 
were furnished in a facility of the     
,department and provisions of this title
 applicable to veterans receiving such  

care or services in a facility of the   
,department shall apply to veterans     
receiving such care or services under   
this section4  7#b7 ,in carrying out    
this section1 the ,secretary-- 7,a7 may 
not direct veterans seeking care or     
services described in subsection 7a77#a7
 to health care providers that have     
entered into contracts or sharing       
agreements under authorities other than 
this section1 except for agreements     
under section #aja of the ,veterans     
,access1 ,choice1 and ,accountability   
,act of #bjad 7,public ,law #aac-adf2   
#ch ,u4,s4,c4 #agja note72 and  7,b7    
shall ensure that veterans have the     
option to determine whether to receive  
such care or services from a health care
 provider described in subparagraph 7,a7
 or an eligible provider that has       
entered into an agreement under this    
section4  7c7 ,eligible providers ,for  
purposes of this section1 an eligible   
provider is one of the following3 7#a7  
,a provider of services that has        

enrolled and entered into a provider    
agreement under section #ahff7;a7 of the
 ,social ,security ,act 7#db ,u4,s4,c4  
#acie;cc7a774  7#b7 ,a physician or     
supplier that has enrolled and entered  
into a participation agreement under    
section #ahdb7;h7 of such ,act 7#db     
,u4,s4,c4 #acieu7h774  7#c7 ,a provider 
of items and services receiving payment 
under a ,state plan under title ,,xix of
 such ,act 7#db ,u4,s4,c4 #acif et seq47
 or a waiver of such a plan4  7#d7 ,a   
health care provider that is-- 7,a7 an  
,aging and ,disability ,resource        
,center1 an area agency on aging1 or a  
,state agency 7as defined in section    
#ajb of the ,older ,americans ,act of   
#aife 7#db ,u4,s4,c4 #cjjb772 or  7,b7 a
 center for independent living 7as      
defined in section #gjb of the          
,rehabilitation ,act of #aigc 7#bi      
,u4,s4,c4 #gif;a774  7#e7 ,a provider   
that is located in-- 7,a7 an area that  
is designated as a health professional  
shortage area 7as defined in section    

#ccb of the ,public ,health ,service    
,act 7#db ,u4,s4,c4 #bed;e772 or  7,b7 a
 county that is not in a metropolitan   
statistical area4  7#f7 ,such other     
health care providers as the ,secretary 
considers appropriate for purposes of   
this section4  7d7 ,certification of    
eligible providers  7#a7 ,the ,secretary
 shall establish a process for the      
certification of eligible providers     
under this section that shall1 at a     
minimum1 set forth the following4  7,a7 
,procedures for the submittal of        
applications for certification and      
deadlines for actions taken by the      
,secretary with respect to such         
applications4  7,b7 ,standards and      
procedures for approval and denial of   
certification1 duration of              
certification1 revocation of            
certification1 and recertification4     
7,c7 ,procedures for assessing eligible 
providers based on the risk of fraud1   
waste1 and abuse of such providers      
similar to the level of screening under 

section #ahff7;j77#b77;,b7 of the       
,social ,security ,act 7#db ,u4,s4,c4   
#acie;cc7j77#b77;,b77 and the standards 
set forth under section #i4ajd of title 
#dh1 ,code of ,federal ,regulations1 or 
any successor regulation4  7#b7 ,the    
,secretary shall deny or revoke         
certification to an eligible provider   
under this subsection if the ,secretary 
determines that the eligible provider is
 currently--  7,a7 excluded from        
participation in a ,federal health care 
program 7as defined in section          
#aabh;,b7f7 of the ,social ,security    
,act 7#db ,u4,s4,c4 #acbj;a-#g;b7f777   
under section #aabh or #aabh;,a of the  
,social ,security ,act 7#db ,u4,s4,c4   
#acbj;a-#g and #acbj;a-#g;a72 or  7,b7  
identified as an excluded source on the 
list maintained in the ,system for      
,award ,management1 or any successor    
system4  7e7 ,terms of agreements ,each 
agreement entered into with an eligible 
provider under this section shall       
include provisions requiring the        

eligible provider to do the following3  
7#a7 ,to accept payment for care or     
services furnished under this section at
 rates established by the ,secretary for
 purposes of this section1 which shall  
be1 to the extent practicable1 the rates
 paid by the ,united ,states for such   
care or services to providers of        
services and suppliers under the        
,medicare program under title ,,xviii of
 the ,social ,security ,act 7#db        
,u4,s4,c4 #acie et seq474  7#b7 ,to     
accept payment under paragraph 7#a7 as  
payment in full for care or services    
furnished under this section and to not 
seek any payment for such care or       
services from the recipient of such care
 or services4  7#c7 ,to furnish under   
this section only the care or services  
authorized by the ,department under this
 section unless the eligible provider   
receives prior written consent from the 
,department to furnish care or services 
outside the scope of such authorization4
  7#d7 ,to bill the ,department for care

 or services furnished under this       
section in accordance with a methodology
 established by the ,secretary for      
purposes of this section4  7#e7 ,not to 
seek to recover or collect from a       
health-plan contract or third party1 as 
those terms are defined in section #agbi
 of this title1 for any care or services
 for which payment is made by the       
,department under this section4  7#f7   
,to provide medical records for veterans
 furnished care or services under this  
section to the ,department in a time    
frame and format specified by the       
,secretary for purposes of this section4
  7#g7 ,to meet such other terms and    
conditions1 including quality of care   
assurance standards1 as the ,secretary  
may specify for purposes of this        
section4  7f7 ,termination of agreements
  7#a7 ,an eligible provider may        
terminate an agreement with the         
,secretary under this section at such   
time and upon such notice to the        
,secretary as the ,secretary may specify

 for purposes of this section4  7#b7    
,the ,secretary may terminate an        
agreement with an eligible provider     
under this section at such time and upon
 such notice to the eligible provider as
 the ,secretary may specify for purposes
 of this section1 if the ,secretary--   
7,a7 determines that the eligible       
provider failed to comply substantially 
with the provisions of the agreement or 
with the provisions of this section and 
the regulations prescribed thereunder2  
7,b7 determines that the eligible       
provider is-- 7i7 excluded from         
participation in a ,federal health care 
program 7as defined in section          
#aabh;,b7f7 of the ,social ,security    
,act 7#db ,u4,s4,c4 #acbj;a-#g;b7f777   
under section #aabh or #aabh;,a of the  
,social ,security ,act 7#db ,u4,s4,c4   
#acbj;a-#g and #acbj;a-#g;a72 or  7ii7  
identified as an excluded source on the 
list maintained in the ,system for      
,award ,management1 or any successor    
system2  7,c7 ascertains that the       

eligible provider has been convicted of 
a felony or other serious offense under 
,federal or ,state law and determines   
that the continued participation of the 
eligible provider would be detrimental  
to the best interests of veterans or the
 ,department2 or  7,d7 determines that  
it is reasonable to terminate the       
agreement based on the health care needs
 of a veteran or veterans4  7g7         
,periodic review of certain agreements  
7#a7 ,not less frequently than once     
every two years1 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 care1 
medical services1 or extended care      
furnished under such agreement at       
facilities of the ,department or through
 contracts or sharing agreements entered
 into under authorities other than this 
section4  7#b7 7,a7 ,subject to         
subparagraph 7,b71 a ,veterans ,care    

,agreement is of material size as       
determined by the ,secretary for        
purposes of this section4  7,b7 ,a      
,veterans ,care ,agreement entered into 
after ,september #cj1 #bjaf1 for the    
purchase of extended care services is of
 material size if the purchase of such  
services under the agreement exceeds    
#a1jjj1jjj annually4 ,the ,secretary may
 adjust such amount to account for      
changes in the cost of health care based
 upon recognized health care market     
surveys and other available data and    
shall publish any such adjustments in   
the ,federal ,register4  7h7 ,treatment 
of certain laws  7#a7 ,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      
agreement4  7#b7 7,a7 ,except as        
provided in subparagraph 7,b71 and      
unless otherwise provided in this       
section or section #bgg of the ,jason   

,simcakoski ,memorial ,act or           
regulations prescribed pursuant to this 
section or such section #bgg1 an        
eligible provider that enters into an   
agreement under this section is not     
subject to1 in the carrying out of the  
agreement1 any law to which an eligible 
provider described in subsection        
7b77#a71 7b77#b71 or 7b77#c7 is not     
subject under the original ,medicare    
fee-for-service program under parts ,a  
and ,b of title ,,xviii of the ,social  
,security ,act 7#db ,u4,s4,c4 #acie et  
seq47 or the ,medicaid program under    
title ,,xix of such ,act 7#db ,u4,s4,c4 
#acif et seq474  7,b7 ,the exclusion    
under subparagraph 7,a7 does not apply  
to laws regarding integrity1 ethics1    
fraud1 or that subject a person to civil
 or criminal penalties4  7#c7 ,title    
,,vii of the ,civil ,rights ,act of     
#aifd 7#db ,u4,s4,c4 #bjjj;e et seq47   
shall apply with respect to an eligible 
provider that enters into an agreement  
under this section to the same extent as

 such title applies with respect to the 
eligible provider in providing care or  
services through an agreement or        
arrangement other than under this       
section4  7i7 ,monitoring of quality of 
care ,the ,secretary shall establish a  
system or systems1 consistent with      
survey and certification procedures used
 by the ,centers for ,medicare          
,medicaid ,services and ,state survey   
agencies to the extent practicable--    
7#a7 to monitor the quality of care and 
services furnished to veterans under    
this section2 and  7#b7 to assess the   
quality of care and services furnished  
by an eligible provider under this      
section for purposes of determining     
whether to renew an agreement under this
 section with the eligible provider4    
7j7 ,dispute resolution ,the ,secretary 
shall establish administrative          
procedures for eligible providers with  
which the ,secretary has entered into an
 agreement under this section to present
 any dispute arising under or related to

 the agreement4  7k7 ,termination of    
authority ,the ,secretary may not enter 
into an agreement under this section1   
other than for the provision of extended
 care or hospice care1 after ,september 
#cj1 #bjag4  7l7 ,rule of construction  
,nothing in this section shall be       
construed to alter any contract or      
agreement entered into between the      
,department and a ,state home 7as that  
term is used in subchapter ,v of this   
chapter7 before the date of the         
enactment of the ,jason ,simcakoski     
,memorial ,act4  7m7 ,annual report ,not
 later than one year after the date of  
the enactment of the ,jason ,simcakoski 
,memorial ,act1 and not less frequently 
than annually thereafter1 the ,secretary
 shall submit to the ,committee on      
,veterans' ,affairs of the ,senate and  
the ,committee on ,veterans' ,affairs of
 the ,house of ,representatives a report
 that contains the following3  7#a7 ,the
 total number of agreements entered into
 with eligible providers under this     

section4  7#b7 ,a list of the medical   
centers of the ,department that have    
entered into agreements with eligible   
providers under this section4  4  7b7   
,regulations ,the ,secretary of         
,veterans ,affairs shall prescribe an   
interim final rule to carry out section 
#agjc;,b of such title1 as added by     
subsection 7a71 not later than one year 
after the date of the enactment of this 
,act4  7c7 ,clerical amendment ,the     
table of sections at the beginning of   
chapter #ag of such title1 as amended by
 section #bga7;a77#b71 is further       
amended by inserting after the item     
related to section #agjc;,a the         
following new item3  #agjc;,b4 ,veterans
 ,care ,agreements4  4  #bgc4           
,elimination of requirement to act as   
secondary payer for care relating to    
non-service-connected disabilities under
 ,choice ,program  7a7 ,in general      
,section #aja7;e7 of the ,veterans      
,access1 ,choice1 and ,accountability   
,act of #bjad 7,public ,law #aac-adf2   

#ch ,u4,s4,c4 #agja note7 is amended--  
7#a7 by striking paragraphs 7#b7 and    
7#c72  7#b7 by redesignating paragraph  
7#d7 as paragraph 7#c72 and  7#c7 by    
inserting after paragraph 7#a7 the      
following new paragraph 7#b73  7#b7     
,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      
described in subsection 7a77#b7 of      
section #agbi of title #ch1 ,united     
,states ,code1 the ,secretary shall     
recover or collect reasonable charges   
for such care or services from a        
health-care plan described in paragraph 
7#c7 in accordance with such section4  4
  7b7 ,conforming amendment ,paragraph  
7#a7 of such section is amended by      
striking paragraph 7#d7 and inserting   
paragraph 7#c74  7c7 ,emergency         
designations  7#a7 ,in general ,this    
section is designated as an emergency   
requirement pursuant to section #d7;g7  

of the ,statutory ,pay-,as-,you-,go ,act
 of #bjaj 7#b ,u4,s4,c4 #icc7;g774  7#b7
 ,designation in ,senate ,in the        
,senate1 this section is designated as  
an emergency requirement pursuant to    
section #djc7;a7 of ,s4 ,con4 ,res4 #ac 
7#aaath ,congress71 the concurrent      
resolution on the budget for fiscal year
 #bjaj4  #bgd4 ,requirement for advance 
appropriations for the ,medical         
,community ,care account of the         
,department of ,veterans ,affairs  7a7  
,in general ,section #aag7;c7 of title  
#ch1 ,united ,states ,code1 is amended  
by adding at the end the following new  
paragraph3  7#g7 ,veterans ,health      
,administration1 ,medical ,community    
,care4  4  7b7 ,conforming amendment    
,section #aaje7;a77#cg7 of title #ca1   
,united ,states ,code1 is amended by    
adding at the end the following new     
subparagraph3  7,g7 ,veterans ,health   
,administration1 ,medical ,community    
,care4  4  7c7 ,applicability ,the      
amendments made by this section shall   

apply to fiscal years beginning on and  
after ,october #a1 #bjaf4  #bge4 ,annual
 transfer of amounts within ,department 
of ,veterans ,affairs to pay for health 
care from non-,department health care   
providers ,section #ajf of the ,veterans
 ,access1 ,choice1 and ,accountability  
,act of #bjad 7,public ,law #aac-adf2   
#ch ,u4,s4,c4 #agja note7 is amended by 
adding at the end the following new     
subsection3  7c7 ,transfer of amounts   
,during a fiscal year1 to accommodate   
any variances in demand for hospital    
care1 medical services1 or other health 
care through non-,department of         
,veterans ,affairs health care          
providers1 the ,secretary of ,veterans  
,affairs may transfer amounts between   
the ,medical ,services appropriations   
account of the ,department and the      
appropriations account of the           
,department for non-,department provider
 programs described in section #djjc of 
the ,surface ,transportation and        
,veterans ,health ,care ,choice         

,improvement ,act of #bjae 7,public ,law
 #aad-da2 #ch ,u4,s4,c4 #agja note74  4 
#bgf4 ,authorization of use of certain  
amounts appropriated to the ,veterans   
,choice ,fund for other non-,department 
of ,veterans ,affairs care  7a7 ,in     
general ,section #hjb of the ,veterans  
,access1 ,choice1 and ,accountability   
,act of #bjad 7,public ,law #aac-adf2   
#ch ,u4,s4,c4 #agja note7 is amended--  
7#a7 in subsection 7c7-- 7,a7 in        
paragraph 7#a7--  7i7 by striking       
,except as provided by paragraph 7#c71  
any and inserting ,any2 and  7ii7 by    
striking by the ,secretary of ,veterans 
,affairs and all that follows through   
the period at the end and inserting 8by 
the ,secretary of ,veterans ,affairs--  
7,a7 to carry out section #aja1         
including1 subject to paragraph 7#b71   
any administrative requirements of such 
section2 and  7,b7 to furnish health    
care to individuals under chapter #ag of
 title #ch1 ,united ,states ,code1 at   
non-,department facilities1 including   

pursuant to authority other than the    
authority under section #aja4  4  7,b7  
by striking paragraph 7#c7 and inserting
 the following new paragraphs3  7#c7    
,treatment of amounts ,amounts made     
available to the ,secretary under this  
subsection shall be used to supplement1 
not supplant1 amounts made available to 
the ,secretary in appropriations ,acts  
for the purpose of furnishing health    
care at non-,department facilities4     
7#d7 ,non-,department facilities defined
 ,in this subsection1 the term          
non-,department facilities has the      
meaning given that term in section #agja
 of title #ch1 ,united ,states ,code4  2
 and  7#b7 in subsection 7d77#a71 by    
striking only for the program and all   
that follows through the period at the  
end and inserting only for the purposes 
specified in subsection 7c77#a744  7b7  
,emergency designations  7#a7 ,in       
general ,this section is designated as  
an emergency requirement pursuant to    
section #d7;g7 of the ,statutory        

,pay-,as-,you-,go ,act of #bjaj 7#b     
,u4,s4,c4 #icc7;g774  7#b7 ,designation 
in ,senate ,in the ,senate1 this section
 is designated as an emergency          
requirement pursuant to section #djc7;a7
 of ,s4 ,con4 ,res4 #ac 7#aaath         
,congress71 the concurrent resolution on
 the budget for fiscal year #bjaj4      
#bgg4 ,applicability of ,directive of   
,office of ,federal ,contract           
,compliance ,programs  7a7 ,in general  
,notwithstanding the treatment of       
certain laws under subsection 7h7 of    
section #agjc;,b of title #ch1 ,united  
,states ,code1 as added by section      
#bgb7;a7 of this ,act1 ,directive       
#bjad-ja of the ,office of ,federal     
,contract ,compliance ,programs of the  
,department of ,labor 7effective as of  
,may #g1 #bjad7 shall apply to any      
entity entering into an agreement under 
such section #agjc;,b in the same manner
 as such directive applies to           
subcontractors under the ,,tricare      
program for the duration of the         

moratorium provided under such          
directive4  7b7 ,applicability period   
,the directive described in subsection  
7a71 and the moratorium provided under  
such directive1 shall not be altered or 
rescinded before ,may #g1 #bjai4  7c7   
,,tricare program defined ,in this      
section1 the term ,,tricare program has 
the meaning given that term in section  
#ajgb of title #aj1 ,united ,states     
,code4  ,i ,research on toxic exposure  
#bha4 ,definitions ,in this subtitle3   
7#a7 ,armed ,forces ,the term ,armed    
,forces means the ,united ,states ,army1
 ,navy1 ,marine ,corps1 ,air ,force1 and
 ,coast ,guard4  7#b7 ,descendant ,the  
term descendant means1 with respect to  
an individual1 the biological child or  
grandchild of that individual4  7#c7    
,toxic exposure ,the term toxic exposure
 means a condition in which an          
individual inhaled or ingested an agent 
determined to be hazardous to the health
 of the individual or the agent came in 
contact with the skin or eyes of the    

individual in a manner that could be    
hazardous to the health of the          
individual4  7#d7 ,veteran ,the term    
veteran has the meaning given that term 
in section #aja of title #ch1 ,united   
,states ,code4  #bhb4 ,national ,academy
 of ,medicine assessment on research    
relating to the descendants of          
individuals with toxic exposure  7a7 ,in
 general  7#a7 ,agreement ,not later    
than #ahj days after the date of the    
enactment of this ,act1 the ,secretary  
of ,veterans ,affairs shall seek to     
enter into an agreement with the        
,national ,academy of ,medicine under   
which the ,national ,academy of         
,medicine conducts an assessment on     
scientific research relating to the     
descendants of individuals with toxic   
exposure4  7#b7 ,alternate organization 
7,a7 ,in general ,if the ,secretary is  
unable within the period prescribed in  
paragraph 7#a7 to enter into an         
agreement described in such paragraph   
with the ,national ,academy of ,medicine

 on terms acceptable to the ,secretary1 
the ,secretary shall seek to enter into 
such an agreement with another          
appropriate organization that--  7i7 is 
not part of the ,federal ,government2   
7ii7 operates as a not-for-profit       
entity2 and  7iii7 has expertise and    
objectivity comparable to that of the   
,national ,academy of ,medicine4  7,b7  
,treatment ,if the ,secretary enters    
into an agreement with another          
organization as described in            
subparagraph 7,a71 any reference in this
 section to the ,national ,academy of   
,medicine shall be treated as a         
reference to the other organization4    
7b7 ,elements ,the assessment conducted 
pursuant to the agreement entered into  
under subsection 7a7 shall include the  
following3  7#a7 ,a scientific review of
 the scientific literature regarding    
toxicological and epidemiological       
research on descendants of individuals  
with toxic exposure4  7#b7 ,an          
assessment of areas requiring further   

scientific study relating to the        
descendants of veterans with toxic      
exposure4  7#c7 ,an assessment of the   
scope and methodology required to       
conduct adequate scientific research    
relating to the descendants of          
individuals with toxic exposure1        
including--  7,a7 the types of          
individuals to be studied1 including    
veterans with toxic exposure and the    
descendants of those veterans2  7,b7 the
 number of veterans and descendants     
described in subparagraph 7,a7 to be    
studied2  7,c7 the potential            
alternatives for participation in such a
 study1 including whether it would be   
necessary for participants to travel in 
order to participate2  7,d7 the         
approximate amount of time and resources
 needed to prepare and conduct the      
research2 and  7,e7 the appropriate     
,federal agencies to participate in the 
research1 including the ,department of  
,defense and the ,department of         
,veterans ,affairs4  7#d7 ,the          

establishment of categories1 including  
definitions for each such category1 to  
be used in assessing the evidence that a
 particular health condition is related 
to toxic exposure1 such as--  7,a7      
sufficient evidence of a causal         
relationship2  7,b7 sufficient evidence 
of an association2  7,c7 limited or     
suggestive evidence of an association2  
7,d7 inadequate or insufficient evidence
 to determine whether an association    
exists2 and  7,e7 limited or suggestive 
evidence of no association4  7#e7 ,an   
analysis of--  7,a7 the feasibility of  
conducting scientific research to       
address the areas that require further  
study as described under paragraph 7#b72
  7,b7 the value and relevance of the   
information that could result from such 
scientific research2 and  7,c7 for      
purposes of conducting further research1
 the feasibility and advisability of    
accessing additional information held by
 a ,federal agency that may be          
sensitive4  7#f7 ,an identification of a

 research entity or entities with-- 7,a7
 expertise in conducting research on    
health conditions of descendants of     
individuals with toxic exposure2 and    
7,b7 an ability to conduct research on  
those health conditions to address areas
 requiring further scientific study as  
described under paragraph 7#b74  7c7    
,report ,the agreement entered into     
under subsection 7a7 shall require the  
,national ,academy of ,medicine to      
submit1 not later than two years after  
entering into such agreement1 to the    
,secretary of ,veterans ,affairs1 the   
,committee on ,veterans' ,affairs of the
 ,senate1 and the ,committee on         
,veterans' ,affairs of the ,house of    
,representatives--  7#a7 the results of 
the assessment conducted pursuant to    
such agreement1 including such          
recommendations as the ,national        
,academy of ,medicine considers         
appropriate regarding the scope and     
methodology required to conduct adequate
 scientific research relating to the    

descendants of veterans with toxic      
exposure2 and  7#b7 a determination     
regarding whether the results of such   
assessment indicate that it is feasible 
to conduct further research regarding   
health conditions of descendants of     
veterans with toxic exposure1 including 
an explanation of the basis for the     
determination4  7d7 ,certification  7#a7
 ,in general ,not later than #ij days   
after receiving the results of the      
assessment and determination under      
subsection 7c71 the ,secretary shall    
submit to the ,committee on ,veterans'  
,affairs of the ,senate and the         
,committee on ,veterans' ,affairs of the
 ,house of ,representatives a           
certification of the understanding of   
the ,secretary1 based on such results   
and determination1 regarding the        
feasibility of conducting further       
research regarding health conditions of 
descendants of veterans with toxic      
exposure that is expressed by such      
results and determination4  7#b7 ,basis 

for certification ,the certification    
submitted under paragraph 7#a7 shall    
include an explanation of the basis for 
the certification4  #bhc4 ,advisory     
board on research relating to health    
conditions of descendants of veterans   
with toxic exposure while serving in the
 ,armed ,forces  7a7 ,establishment     
,unless the ,secretary of ,veterans     
,affairs certifies under section        
#bhb7;d7 that the results of the        
assessment and determination under      
section #bhb7;c7 indicate that it is not
 feasible to conduct further research   
regarding health conditions of          
descendants of veterans with toxic      
exposure1 not later than #ahj days after
 receiving such results and             
determination1 the ,secretary shall     
establish an advisory board 7in this    
section referred to as the ,advisory    
,board7 to advise the ,secretary in the 
selection of a research entity or       
entities under section #bhd1 advise such
 entity or entities in conducting       

research under such section1 and advise 
the ,secretary with respect to the      
activities of such entity or entities   
under such section4  7b7 ,membership    
7#a7 ,composition ,the ,secretary1 in   
consultation with the ,national ,academy
 of ,medicine1 the ,director of the     
,national ,institute of ,environmental  
,health ,sciences1 and such other heads 
of ,federal agencies as the ,secretary  
determines appropriate--  7,a7 shall    
select not more than #ac voting members 
of the ,advisory ,board1 of whom--  7i7 
not less than two shall be members of   
organizations exempt from taxation under
 section #eja7;c77#ai7 of the ,internal 
,revenue ,code of #aihf2  7ii7 not less 
than two shall be descendants of        
veterans with toxic exposure while      
serving as members of the ,armed        
,forces2 and  7iii7 not less than seven 
shall be health professionals1          
scientists1 or academics who are not    
employees of the ,federal ,government   
and have expertise in--  7,i7 birth     

defects2  7,,ii7 developmental          
disabilities2  7,,iii7 epigenetics2     
7,,iv7 public health2  7,v7 the science 
of environmental exposure or            
environmental exposure assessment2      
7,,vi7 the science of toxic substances2 
or  7,,vii7 medical and research ethics2
 and  7,b7 may select not more than two 
nonvoting members who are employees of  
the ,federal ,government and who are    
otherwise described in subparagraph     
7,a77iii74  7#b7 ,chair ,the ,secretary 
shall select a ,chair from among the    
members of the ,advisory ,board selected
 under paragraph 7#a77;,a74  7#c7 ,terms
  7,a7 ,in general ,each member of the  
,advisory ,board shall serve a term of  
two or three years as determined by the 
,secretary4  7,b7 ,reappointment ,at the
 end of the term of a member of the     
,advisory ,board1 the ,secretary may    
reselect the member for another term1   
except that no member may serve more    
than four consecutive terms4  7c7       
,duties ,the ,advisory ,board shall--   

7#a7 advise the ,secretary in the       
selection of a research entity or       
entities to conduct research under      
section #bhd from among those identified
 under section #bhb7;b77#f72  7#b7      
advise such entity or entities and      
assess the activities of such entity or 
entities in conducting such research2   
7#c7 develop a research strategy for    
such entity or entities based on1 but   
not limited to1 the results of the      
assessment conducted under section #bhb2
  7#d7 advise the ,secretary with       
respect to the activities of such entity
 or entities under section #bhd2  7#e7  
submit recommendations to be included by
 such entity or entities in the report  
under section #bhd7;d77#b77;,c72 and    
7#f7 not less frequently than           
semiannually1 meet with the ,secretary  
and representatives of such entity or   
entities on the research conducted by   
such entity or entities under section   
#bhd4  7d7 ,meetings ,the ,advisory     
,board shall meet at the call of the    

,chair1 but not less frequently than    
semiannually4  7e7 ,compensation ,the   
members of the ,advisory ,board shall   
serve without compensation4  7f7        
,expenses ,the ,secretary of ,veterans  
,affairs shall determine the appropriate
 expenses of the ,advisory ,board4  7g7 
,personnel  7#a7 ,in general ,the ,chair
 may1 without regard to the civil       
service laws and regulations1 appoint an
 executive director of the ,advisory    
,board1 who shall be a civilian employee
 of the ,department of ,veterans        
,affairs1 and such other personnel as   
may be necessary to enable the ,advisory
 ,board to perform its duties4  7#b7    
,approval ,the appointment of an        
executive director under paragraph 7#a7 
shall be subject to approval by the     
,advisory ,board4  7#c7 ,compensation   
,the ,chair may fix the compensation of 
the executive director and other        
personnel without regard to the         
provisions of chapter #ea and subchapter
 ,,iii of chapter #ec of title #e1      

,united ,states ,code1 except that the  
rate of pay for the executive director  
and other personnel may not exceed the  
rate payable for level ,v of the        
,executive ,schedule under section #ecaf
 of such title4  #bhd4 ,research        
relating to health conditions of        
descendants of veterans with toxic      
exposure while serving in the ,armed    
,forces  7a7 ,in general ,unless the    
,secretary of ,veterans ,affairs        
certifies under section #bhb7;d7 that   
the results of the assessment and       
determination under section #bhb7;c7    
indicate that it is not feasible to     
conduct further research regarding      
health conditions of descendants of     
veterans with toxic exposure1 not later 
than one year after receiving such      
results and determination1 the          
,secretary shall 7in consultation with  
the advisory board established under    
section #bhc 7in this section referred  
to as the ,advisory ,board77 enter into 
an agreement with one or more research  

entities identified under section       
#bhb7;b77#f7 7excluding an entity of the
 ,department of ,veterans ,affairs7 to  
conduct research on health conditions of
 descendants of veterans with toxic     
exposure while serving as members of the
 ,armed ,forces 7in this section        
referred to as the research entity or   
entities74  7b7 ,research  7#a7 ,in     
general ,to the extent included in the  
research strategy developed by the      
,advisory ,board under section          
#bhc7;c77#c71 the research entity or    
entities shall conduct research on      
health conditions of descendants of     
veterans with toxic exposure while      
serving as members of the ,armed        
,forces4  7#b7 ,studies ,in conducting  
research under paragraph 7#a71 the      
research entity or entities may study   
any veteran1 at the election of the     
veteran1 identified under section       
#bhb7;b77#c77;,a7 as a type of          
individual to be studied in order to    
conduct adequate scientific research    

relating to the descendants of veterans 
with toxic exposure4  7#c7              
,categorization ,in conducting research 
under paragraph 7#a71 the research      
entity or entities shall assess1 using  
the categories established under section
 #bhb7;b77#d71 the extent to which a    
health condition of a descendant of a   
veteran is related to the toxic exposure
 of the veteran while serving as a      
member of the ,armed ,forces4  7c7      
,availability of records  7#a7 ,in      
general ,the ,secretary of ,defense1 the
 ,secretary of ,veterans ,affairs1 and  
the head of each ,federal agency        
identified under section                
#bhb7;b77#c77;,e7 shall make available  
to the research entity or entities      
records held by the ,department of      
,veterans ,affairs1 the ,department of  
,defense1 the ,armed ,forces1 that      
,federal agency1 or any other source    
under the jurisdiction of any such      
,federal agency or the ,armed ,forces1  
as appropriate1 that the research entity

 or entities determine are necessary to 
carry out this section4  7#b7 ,mechanism
 for access ,the ,secretary of ,veterans
 ,affairs1 the ,secretary of ,defense1  
and the head of each ,federal agency    
identified under section                
#bhb7;b77#c77;,e7 shall jointly         
establish a mechanism for access by the 
research entity or entities to records  
made available under paragraph 7#a74    
7d7 ,annual report  7#a7 ,in general    
,not later than one year after          
commencing the conduct of research under
 this section1 and not later than       
,september #cj each year thereafter1    
each research entity with which the     
,secretary has entered into an agreement
 under subsection 7a7 shall1 in         
consultation with the ,advisory ,board1 
submit to the ,secretary of ,veterans   
,affairs1 the ,committee on ,veterans'  
,affairs of the ,senate1 and the        
,committee on ,veterans' ,affairs of the
 ,house of ,representatives a report on 
the functions of such entity under this 

section during the year preceding the   
submittal of the report4  7#b7 ,elements
 ,each report submitted under paragraph 
7#a7 shall include the following3 7,a7  
,a summary of the research efforts that 
have been completed during the year     
preceding the submittal of the report   
and that are ongoing as of the date of  
the submittal of the report4  7,b7 ,a   
description of any findings made during 
such year in carrying out such research 
efforts4  7,c7 ,recommendations for     
administrative or legislative action    
made by the ,advisory ,board based on   
such findings1 which may include        
recommendations for further research    
under this section4  7#c7 ,upon request 
,upon the request of any organization   
exempt from taxation under section      
#eja7;c77#ai7 of the ,internal ,revenue 
,code of #aihf1 the ,secretary of       
,veterans ,affairs may transmit to such 
organization a copy of a report received
 by the ,secretary under paragraph 7#a74
  ,j ,other health care matters  #bia4  

,authorization of certain major medical 
facility projects of the ,department of 
,veterans ,affairs  7a7 ,authorization  
,the ,secretary of ,veterans ,affairs   
may carry out the following major       
medical facility projects1 with each    
project to be carried out in an amount  
not to exceed the amount specified for  
that project3  7#a7 ,seismic corrections
 to buildings1 including retrofitting   
and replacement of high-risk buildings1 
in ,san ,francisco1 ,california1 in an  
amount not to exceed #ahj1dhj1jjj4  7#b7
 ,seismic corrections to facilities1    
including facilities to support homeless
 veterans1 at the medical center in     
,west ,los ,angeles1 ,california1 in an 
amount not to exceed #aje1ejj1jjj4  7#c7
 ,seismic corrections to the mental     
health and community living center in   
,long ,beach1 ,california1 in an amount 
not to exceed #bhg1ajj1jjj4  7#d7       
,construction of an outpatient clinic1  
administrative space1 cemetery1 and     
columbarium in ,alameda1 ,california1 in

 an amount not to exceed #hg1ccb1jjj4   
7#e7 ,realignment of medical facilities 
in ,livermore1 ,california1 in an amount
 not to exceed #aid1dcj1jjj4  7#f7      
,construction of a medical center in    
,louisville1 ,kentucky1 in an amount not
 to exceed #aej1jjj1jjj4  7#g7          
,construction of a replacement community
 living center in ,perry ,point1        
,maryland1 in an amount not to exceed   
#ib1gjj1jjj4  7#h7 ,seismic corrections 
and other renovations to several        
buildings and construction of a         
specialty care building in ,american    
,lake1 ,washington1 in an amount not to 
exceed #af1bfj1jjj4  7b7 ,authorization 
of appropriations for construction      
,there is authorized to be appropriated 
to the ,secretary of ,veterans ,affairs 
for fiscal year #bjaf or the year in    
which funds are appropriated for the    
,construction1 ,major ,projects1        
account1 #a1aac1hjb1jjj for the projects
 authorized in subsection 7a74  7c7     
,limitation ,the projects authorized in 

subsection 7a7 may only be carried out  
using-- 7#a7 funds appropriated for     
fiscal year #bjaf pursuant to the       
authorization of appropriations in      
subsection 7b72  7#b7 funds available   
for ,construction1 ,major ,projects1 for
 a fiscal year before fiscal year #bjaf 
that remain available for obligation2   
7#c7 funds available for ,construction1 
,major ,projects1 for a fiscal year     
after fiscal year #bjaf that remain     
available for obligation2  7#d7 funds   
appropriated for ,construction1 ,major  
,projects1 for fiscal year #bjaf for a  
category of activity not specific to a  
project2  7#e7 funds appropriated for   
,construction1 ,major ,projects1 for a  
fiscal year before fiscal year #bjaf for
 a category of activity not specific to 
a project2 and  7#f7 funds appropriated 
for ,construction1 ,major ,projects1 for
 a fiscal year after fiscal year #bjaf  
for a category of activity not specific 
to a project4  #bib4 ,identification and
 tracking of biological implants used in

 ,department of ,veterans ,affairs      
medical facilities  7a7 ,in general     
,subchapter ,,ii of chapter #gc of title
 #ch1 ,united ,states ,code1 as amended 
by section #bdh7;a71 is further amended 
by adding at the end the following new  
section3  #gccj;,d4 ,identification and 
tracking of biological implants  7a7    
,standard identification system for     
biological implants  7#a7 ,the          
,secretary shall adopt the unique device
 identification system developed for    
medical devices by the ,food and ,drug  
,administration under section #eai7;f7  
of the ,federal ,food1 ,drug1 and       
,cosmetic ,act 7#ba ,u4,s4,c4           
#cfj;i7f771 or implement a comparable   
standard identification system1 for use 
in identifying biological implants      
intended for use in medical procedures  
conducted in medical facilities of the  
,department4  7#b7 ,in adopting or      
implementing a standard identification  
system for biological implants under    
paragraph 7#a71 the ,secretary shall    

permit a vendor to use any of the       
accredited entities identified by the   
,food and ,drug ,administration as an   
issuing agency pursuant to section      
#hcj4ajj of title #ba1 ,code of ,federal
 ,regulations1 or any successor         
regulation4  7b7 ,biological implant    
tracking system  7#a7 ,the ,secretary   
shall implement a system for tracking   
the biological implants described in    
subsection 7a7 from human donor or      
animal source to implantation4  7#b7    
,the tracking system implemented under  
paragraph 7#a7 shall be compatible with 
the identification system adopted or    
implemented under subsection 7a74  7#c7 
,the ,secretary shall implement         
inventory controls compatible with the  
tracking system implemented under       
paragraph 7#a7 so that all patients who 
have received1 in a medical facility of 
the ,department1 a biological implant   
subject to a recall can be notified of  
the recall if1 based on the evaluation  
by appropriate medical personnel of the 

,department of the risks and benefits1  
the ,secretary determines such          
notification is appropriate4  7c7       
,consistency with ,food and ,drug       
,administration regulations ,to the     
extent that a conflict arises between   
this section and a provision of the     
,federal ,food1 ,drug1 and ,cosmetic    
,act 7#ba ,u4,s4,c4 #cja et seq47 or    
section #cea or #cfa of the ,public     
,health ,service ,act 7#db ,u4,s4,c4    
#bfb and #bfd7 7including any           
regulations issued under such           
provisions71 the provision of the       
,federal ,food1 ,drug1 and ,cosmetic    
,act or ,public ,health ,service ,act   
7including any regulations issued under 
such provisions7 shall apply4  7d7      
,biological implant defined ,in this    
section1 the term biological implant    
means any human cell1 tissue1 or        
cellular or tissue-based product or     
animal product-- 7#a7 under the meaning 
given the term human cells1 tissues1 or 
cellular or tissue-based products in    

section #abga4c of title #ba1 ,code of  
,federal ,regulations1 or any successor 
regulation2 or  7#b7 that is regulated  
as a device under section #bja7;h7 of   
the ,federal ,food1 ,drug1 and ,cosmetic
 ,act 7#ba ,u4,s4,c4 #cba7;h774  4  7b7 
,clerical amendment ,the table of       
sections at the beginning of chapter #gc
 of such title1 as amended by section   
#bdh7;b71 is further amended by         
inserting after the item relating to    
section #gccj;,c the following new item3
  #gccj;,d4 ,identification and tracking
 of biological implants4  4  7c7        
,implementation deadlines  7#a7         
,standard identification system ,the    
,secretary of ,veterans ,affairs shall  
adopt or implement the standard         
identification system for biological    
implants required by subsection 7a7 of  
section #gccj;,d of title #ch1 ,united  
,states ,code1 as added by subsection   
7a71 with respect to biological implants
 described in--  7,a7 subsection 7d77#a7
 of such section1 by not later than the 

date that is #ahj days after the date of
 the enactment of this ,act2 and  7,b7  
subsection 7d77#b7 of such section1 in  
compliance with the compliance dates    
established by the ,food and ,drug      
,administration under section #eai7;f7  
of the ,federal ,food1 ,drug1 and       
,cosmetic ,act 7#ba ,u4,s4,c4           
#cfj;i7f774  7#b7 ,tracking system ,the 
,secretary of ,veterans ,affairs shall  
implement the biological implant        
tracking system required by section     
#gccj;,d7b7 of title #ch1 ,united       
,states ,code1 as added by subsection   
7a71 by not later than the date that is 
#ahj days after the date of the         
enactment of this ,act4  7d7 ,reporting 
requirement  7#a7 ,in general ,if the   
biological implant tracking system      
required by section #gccj;,d7b7 of title
 #ch1 ,united ,states ,code1 as added by
 subsection 7a71 is not operational by  
the date that is #ahj days after the    
date of the enactment of this ,act1 the 
,secretary of ,veterans ,affairs shall  

submit to the ,committee on ,veterans'  
,affairs of the ,senate and the         
,committee on ,veterans' ,affairs of the
 ,house of ,representatives a report    
explaining why the system is not        
operational for each month until such   
time as the system is operational4  7#b7
 ,elements ,each report submitted under 
paragraph 7#a7 shall include a          
description of the following3 7,a7 ,each
 impediment to the implementation of the
 system described in such paragraph4    
7,b7 ,steps being taken to remediate    
each such impediment4  7,c7 ,target     
dates for a solution to each such       
impediment4  #bic4 ,procurement of      
biological implants used in ,department 
of ,veterans ,affairs medical facilities
  7a7 ,procurement  7#a7 ,in general    
,subchapter ,,ii of chapter #ha of title
 #ch1 ,united ,states ,code1 as amended 
by section #acb7;a71 is further amended 
by adding at the end the following new  
section3  #hacj4 ,procurement of        
biological implants  7a7 ,in general    

7#a7 ,the ,secretary may procure        
biological implants of human origin only
 from vendors that meet the following   
conditions3  7,a7 ,the vendor uses the  
standard identification system adopted  
or implemented by the ,secretary under  
section #gccj;,d7a7 of this title and   
has safeguards to ensure that a distinct
 identifier has been in place at each   
step of distribution of each biological 
implant from its donor4  7,b7 ,the      
vendor is registered as required by the 
,food and ,drug ,administration under   
subpart ,b of part #abga of title #ba1  
,code of ,federal ,regulations1 or any  
successor regulation1 and in the case of
 a vendor that uses a tissue            
distribution intermediary or a tissue   
processor1 the vendor provides          
assurances that the tissue distribution 
intermediary or tissue processor is     
registered as required by the ,food and 
,drug ,administration4  7,c7 ,the vendor
 ensures that donor eligibility         
determinations and such other records as

 the ,secretary may require accompany   
each biological implant at all times1   
regardless of the country of origin of  
the donor of the biological material4   
7,d7 ,the vendor agrees to cooperate    
with all biological implant recalls     
conducted on the initiative of the      
vendor1 on the initiative of the        
original product manufacturer used by   
the vendor1 by the request of the ,food 
and ,drug ,administration1 or by a      
statutory order of the ,food and ,drug  
,administration4  7,e7 ,the vendor      
agrees to notify the ,secretary of any  
adverse event or reaction report it     
provides to the ,food and ,drug         
,administration1 as required by sections
 #abga4c and #abga4cej of title #ba1    
,code of ,federal ,regulations1 or any  
successor regulation1 or any warning    
letter from the ,food and ,drug         
,administration issued to the vendor or 
a tissue processor or tissue            
distribution intermediary used by the   
vendor by not later than #fj days after 

the vendor receives such report or      
warning letter4  7,f7 ,the vendor agrees
 to retain all records associated with  
the procurement of a biological implant 
by the ,department for at least #aj     
years after the date of the procurement 
of the biological implant4  7,g7 ,the   
vendor provides assurances that the     
biological implants provided by the     
vendor are acquired only from tissue    
processors that maintain active         
accreditation with the ,american        
,association of ,tissue ,banks or a     
similar national accreditation specific 
to biological implants4  7#b7 ,the      
,secretary may procure biological       
implants of nonhuman origin only from   
vendors that meet the following         
conditions3  7,a7 ,the vendor uses the  
standard identification system adopted  
or implemented by the ,secretary under  
section #gccj;,d7a7 of this title4  7,b7
 ,the vendor is registered as an        
establishment as required by the ,food  
and ,drug ,administration under sections

 #hjg4bj and #hjg4dj of title #ba1 ,code
 of ,federal ,regulations1 or any       
successor regulation 7or is not required
 to register pursuant to section        
#hjg4fe7;a7 of such title1 or any       
successor regulation71 and in the case  
of a vendor that is not the original    
product manufacturer of such implants1  
the vendor provides assurances that the 
original product manufacturer is        
registered as required by the ,food and 
,drug ,administration 7or is not        
required to register74  7,c7 ,the vendor
 agrees to cooperate with all biological
 implant recalls conducted on the       
initiative of the vendor1 on the        
initiative of the original product      
manufacturer used by the vendor1 by the 
request of the ,food and ,drug          
,administration1 or by a statutory order
 of the ,food and ,drug ,administration4
  7,d7 ,the vendor agrees to notify the 
,secretary of any adverse event report  
it provides to the ,food and ,drug      
,administration as required under part  

#hjc of title #ba1 ,code of ,federal    
,regulations1 or any successor          
regulation1 or any warning letter from  
the ,food and ,drug ,administration     
issued to the vendor or the original    
product manufacturer used by the vendor 
by not later than #fj days after the    
vendor receives such report or warning  
letter4  7,e7 ,the vendor agrees to     
retain all records associated with the  
procurement of a biological implant by  
the ,department for at least #aj years  
after the date of the procurement of the
 biological implant4  7#c7 7,a7 ,the    
,secretary shall procure biological     
implants under the ,federal ,supply     
,schedules of the ,general ,services    
,administration unless such implants are
 not available under such ,schedules4   
7,b7 ,with respect to biological        
implants listed on the ,federal ,supply 
,schedules1 the ,secretary shall        
accommodate reasonable vendor requests  
to undertake outreach efforts to educate
 medical professionals of the           

,department about the use and efficacy  
of such biological implants4  7,c7 ,in  
the case of biological implants that are
 unavailable for procurement under the  
,federal ,supply ,schedules1 the        
,secretary shall procure such implants  
using competitive procedures in         
accordance with applicable law and the  
,federal ,acquisition ,regulation1      
including through the use of a national 
contract4  7#d7 ,in procuring biological
 implants under this section1 the       
,secretary shall permit a vendor to use 
any of the accredited entities          
identified by the ,food and ,drug       
,administration as an issuing agency    
pursuant to section #hcj4ajj of title   
#ba1 ,code of ,federal ,regulations1 or 
any successor regulation4  7#e7 ,section
 #habc of this title shall not apply to 
the procurement of biological implants4 
7b7 ,penalties ,in addition to any      
applicable penalty under any other      
provision of law1 any procurement       
employee of the ,department who is found

 responsible for a biological implant   
procurement transaction with intent to  
avoid or with reckless disregard of the 
requirements of this section shall be   
ineligible to hold a certificate of     
appointment as a contracting officer or 
to serve as the representative of an    
ordering officer1 contracting officer1  
or purchase card holder4  7c7           
,definitions ,in this section3 7#a7 ,the
 term biological implant has the meaning
 given that term in section #gccj;,d7d7 
of this title4  7#b7 ,the term distinct 
identifier means a distinct             
identification code that-- 7,a7 relates 
a biological implant to the human donor 
of the implant and to all records       
pertaining to the implant2  7,b7        
includes information designed to        
facilitate effective tracking1 using the
 distinct identification code1 from the 
donor to the recipient and from the     
recipient to the donor2 and  7,c7       
satisfies the requirements of section   
#abga4bij7;c7 of title #ba1 ,code of    

,federal ,regulations1 or any successor 
regulation4  7#c7 ,the term tissue      
distribution intermediary means an      
agency that acquires and stores human   
tissue for further distribution and     
performs no other tissue banking        
functions4  7#d7 ,the term tissue       
processor means an entity processing    
human tissue for use in biological      
implants1 including activities performed
 on tissue other than donor screening1  
donor testing1 tissue recovery and      
collection functions1 storage1 or       
distribution4  4  7#b7 ,clerical        
amendment ,the table of sections at the 
beginning of chapter #ha of such title1 
as amended by section #acb7;c71 is      
further amended by inserting after the  
item relating to section #habi the      
following new item3  #hacj4 ,procurement
 of biological implants4  4  7b7        
,effective date ,section #hacj of title 
#ch1 ,united ,states ,code1 as added by 
subsection 7a71 shall take effect on the
 date that is #ahj days after the date  

on which the tracking system required   
under section #gccj;,d7b7 of such title1
 as added by section #bib7;a71 is       
implemented4  7c7 ,special rule for     
cryopreserved products ,during the      
three-year period beginning on the      
effective date of section #hacj of title
 #ch1 ,united ,states ,code1 as added by
 subsection 7a71 biological implants    
produced and labeled before that        
effective date may be procured by the   
,department of ,veterans ,affairs       
without relabeling under the standard   
identification system adopted or        
implemented under section #gccj;,d of   
such title1 as added by section         
#bib7;a74  #bid4 ,expansion of research 
and education on and delivery of        
complementary and integrative health to 
veterans  7a7 ,development of plan ,to  
expand research1 education1 and delivery
 ,not later than #ahj days after the    
date of the enactment of this ,act1 the 
,secretary of ,veterans ,affairs shall  
develop a plan to expand materially and 

substantially the scope of the          
effectiveness of research and education 
on1 and delivery and integration of1    
complementary and integrative health    
services into the health care services  
provided to veterans4  7b7 ,elements    
,the plan required by subsection 7a7    
shall provide for the following3 7#a7   
,research on the following3  7,a7 ,the  
effectiveness of various complementary  
and integrative health services1        
including the effectiveness of such     
services integrated with clinical       
services4  7,b7 ,approaches to          
integrating complementary and           
integrative health services into other  
health care services provided by the    
,department of ,veterans ,affairs4  7#b7
 ,education and training for health care
 professionals of the ,department on the
 following3 7,a7 complementary and      
integrative health services selected by 
the ,secretary for purposes of the plan4
  7,b7 ,appropriate uses of such        
services4  7,c7 ,integration of such    

services into the delivery of health    
care to veterans4  7#c7 ,research1      
education1 and clinical activities on   
complementary and integrative health at 
centers of innovation at medical centers
 of the ,department4  7#d7              
,identification or development of       
metrics and outcome measures to evaluate
 the effectiveness of the provision and 
integration of complementary and        
integrative health services into the    
delivery of health care to veterans4    
7#e7 ,integration and delivery of       
complementary and integrative health    
services with other health care services
 provided by the ,department4  7c7      
,consultation  7#a7 ,in general ,in     
carrying out subsection 7a71 the        
,secretary shall consult with the       
following3 7,a7 ,the ,director of the   
,national ,center for ,complementary and
 ,integrative ,health of the ,national  
,institutes of ,health4  7,b7 ,the      
,commissioner of ,food and ,drugs4  7,c7
 ,institutions of higher education1     

private research institutes1 and        
individual researchers with extensive   
experience in complementary and         
integrative health and the integration  
of complementary and integrative health 
practices into the delivery of health   
care4  7,d7 ,nationally recognized      
providers of complementary and          
integrative health4  7,e7 ,such other   
officials1 entities1 and individuals    
with expertise on complementary and     
integrative health as the ,secretary    
considers appropriate4  7#b7 ,scope of  
consultation ,the ,secretary shall      
undertake consultation under paragraph  
7#a7 in carrying out subsection 7a7 with
 respect to the following3  7,a7 ,to    
develop the plan4  7,b7 ,to identify    
specific complementary and integrative  
health practices that1 on the basis of  
research findings or promising clinical 
interventions1 are appropriate to       
include as services to veterans4  7,c7  
,to identify barriers to the effective  
provision and integration of            

complementary and integrative health    
services into the delivery of health    
care to veterans1 and to identify       
mechanisms for overcoming such barriers4
  7d7 ,complementary and integrative    
health defined ,in this section1 the    
term complementary and integrative      
health shall have the meaning given that
 term in section #baa7;g74  #bie4 ,pilot
 program on integration of complementary
 and integrative health within          
,department of ,veterans ,affairs       
medical centers  7a7 ,pilot program     
required ,not later than #ahj days after
 the completion of the development of   
the plan under section #bid1 the        
,secretary of ,veterans ,affairs shall--
  7#a7 carry out1 through the ,office of
 ,patient ,centered ,care and ,cultural 
,transformation of the ,department of   
,veterans ,affairs1 a pilot program to  
assess the feasibility and advisability 
of integrating the delivery of          
complementary and integrative health    
services selected by the ,secretary with

 other health care services provided by 
the ,department for veterans with mental
 health conditions1 chronic pain        
conditions1 other chronic conditions1   
and such other conditions as the        
,secretary determines appropriate2 and  
7#b7 in developing the pilot program--  
7,a7 use the plan developed under       
section #bid2  7,b7 identify and1 to the
 extent practicable1 resolve barriers to
 the provision of complementary and     
integrative health services selected by 
the ,secretary and the integration of   
those services with other health care   
services provided by the ,department2   
7,c7 identify means of improving        
coordination between ,federal1 ,state1  
local1 and community providers of health
 care in the provision of pain          
management and related health care      
services to veterans2  7,d7 identify    
means of enhancing outreach1 and        
coordination of outreach1 by and among  
providers of health care described in   
subparagraph 7,c7 regarding the pain    

management and related health care      
services available to veterans2  7,e7   
identify means of using wellness-based  
programs offered by providers of health 
care described in subparagraph 7,c7 to  
complement the provision by the         
,department of pain management and      
related health care services to         
veterans2 and  7,f7 assess whether      
wellness-based programs described in    
subparagraph 7,e7-- 7i7 are effective in
 enhancing the quality of life and      
well-being of veterans2  7ii7 are       
effective in increasing the adherence of
 veterans to the primary pain management
 and related health care services       
provided such veterans by the           
,department2  7iii7 have an effect on   
the sense of well-being of veterans who 
receive primary pain management and     
related health care services from the   
,department2 and  7iv7 are effective in 
encouraging veterans receiving health   
care from the ,department to adopt a    
more healthy lifestyle4  7b7 ,duration  

of pilot program ,the ,secretary shall  
carry out the pilot program during the  
three-year period beginning on the date 
that is #ahj days after the completion  
of the development of the plan under    
section #bid4  7c7 ,locations  7#a7 ,in 
general ,the ,secretary shall carry out 
the pilot program at not fewer than #ae 
medical centers of the ,department4     
7#b7 ,polytrauma centers ,not fewer than
 two of the medical centers designated  
under paragraph 7#a7 shall be located at
 polytrauma rehabilitation centers of   
the ,department4  7#c7 ,medical centers 
with prescription rate of opioids that  
conflicts with care standards  7,a7 ,in 
general ,in selecting medical centers   
under paragraph 7#a71 the ,secretary    
shall give priority to medical centers  
of the ,department at which there is a  
prescription rate of opioids that       
conflicts with or is otherwise          
inconsistent with the standards of      
appropriate and safe care4  7,b7        
,prescription rate defined ,in this     

paragraph1 the term prescription rate   
means1 with respect to a medical center 
of the ,department1 each of the         
following3 7i7 ,the number of patients  
treated with opioids at the medical     
center divided by the total number of   
pharmacy users at the medical center4   
7ii7 ,the average number of morphine    
equivalents per day prescribed at the   
medical center to patients being treated
 with opioids4  7iii7 ,of the patients  
being treated with opioids at the       
medical center1 the average number of   
prescriptions of opioids per patient4   
7#d7 ,selection of locations ,in        
carrying out the pilot program1 the     
,secretary shall select locations that  
include the following areas3  7,a7      
,rural areas4  7,b7 ,areas that are not 
in close proximity to an active duty    
military installation4  7,c7 ,areas     
representing different geographic       
locations1 such as census tracts        
established by the ,bureau of the       
,census4  7d7 ,provision of services    

,under the pilot program1 the ,secretary
 shall provide covered services to      
covered veterans by integrating         
complementary and integrative health    
services with other services provided by
 the ,department at the medical centers 
designated under subsection 7c77#a74    
7e7 ,covered veterans ,for purposes of  
the pilot program1 a covered veteran is 
any veteran who-- 7#a7 has a mental     
health condition diagnosed by a         
clinician of the ,department2  7#b7     
experiences chronic pain2  7#c7 has a   
chronic condition being treated by a    
clinician of the ,department2 or  7#d7  
is not described in paragraph 7#a71     
7#b71 or 7#c7 and requests to           
participate in the pilot program or is  
referred by a clinician of the          
,department who is treating the veteran4
  7f7 ,covered services  7#a7 ,in       
general ,for purposes of the pilot      
program1 covered services are services  
consisting of complementary and         
integrative health services as selected 

by the ,secretary4  7#b7 ,administration
 of services ,covered services shall be 
administered under the pilot program as 
follows3 7,a7 ,covered services shall be
 administered by professionals or other 
instructors with appropriate training   
and expertise in complementary and      
integrative health services who are     
employees of the ,department or with    
whom the ,department enters into an     
agreement to provide such services4     
7,b7 ,covered services shall be included
 as part of the ,patient ,aligned ,care 
,teams initiative of the ,office of     
,patient ,care ,services1 ,primary ,care
 ,program ,office1 in coordination with 
the ,office of ,patient ,centered ,care 
and ,cultural ,transformation4  7,c7    
,covered services shall be made         
available to-- 7i7 covered veterans who 
have received conventional treatments   
from the ,department for the conditions 
for which the covered veteran seeks     
complementary and integrative health    
services under the pilot program2 and   

7ii7 covered veterans who have not      
received conventional treatments from   
the ,department for such conditions4    
7g7 ,voluntary participation ,the       
participation of a veteran in the pilot 
program shall be at the election of the 
veteran and in consultation with a      
clinician of the ,department4  7h7      
,report  7#a7 ,in general ,not later    
than #cj months after the date of the   
commencement of the pilot program1 the  
,secretary shall submit to the          
,committee on ,veterans' ,affairs of the
 ,senate and the ,committee on          
,veterans' ,affairs of the ,house of    
,representatives a report on the pilot  
program4  7#b7 ,elements ,the report    
submitted under paragraph 7#a7 shall    
include the following3 7,a7 ,the        
findings and conclusions of the         
,secretary with respect to the pilot    
program1 including with respect to--    
7i7 the use and efficacy of the         
complementary and integrative health    
services established under the pilot    

program2  7ii7 the outreach conducted by
 the ,secretary to inform veterans and  
community organizations about the pilot 
program2 and  7iii7 an assessment of the
 benefit of the pilot program to covered
 veterans in mental health diagnoses1   
pain management1 and treatment of       
chronic illness4  7,b7 ,a description of
 barriers identified under subsection   
7a77#b77;,b7 that were not resolved4    
7,c7 ,such recommendations for the      
continuation or expansion of the pilot  
program as the ,secretary considers     
appropriate4  7i7 ,complementary and    
integrative health defined ,in this     
section1 the term complementary and     
integrative health shall have the       
meaning given that term in section      
#baa7;g74  #bif4 ,report on public      
access to research by ,department of    
,veterans ,affairs  7a7 ,in general ,not
 later than each of #ahj days and one   
year after the date of the enactment of 
this ,act1 the ,secretary of ,veterans  
,affairs shall submit to the ,committee 

on ,veterans' ,affairs of the ,senate   
and the ,committee on ,veterans'        
,affairs of the ,house of               
,representatives a report on increasing 
public access to scientific publications
 and digital data from research funded  
by the ,department of ,veterans         
,affairs4  7b7 ,elements ,each report   
submitted under subsection 7a7 shall    
include the following3 7#a7 ,an         
identification of the location or       
locations in which the public will be   
able to access the results of research  
funded by the ,department1 whether on an
 ,internet website of the ,department or
 through another source4  7#b7 ,a       
description of the progress made by the 
,department in meeting public access    
requirements set forth in the notice    
entitled ,policy and ,implementation    
,plan for ,public ,access to ,scientific
 ,publications and ,digital ,data from  
,research ,funded by the ,department of 
,veterans ,affairs 7#hj ,fed4 ,reg4     
#fjgea71 including the following3  7,a7 

,compliance of ,department investigators
 with requirements relating to ensuring 
that research funded by the ,department 
is accessible by the public4  7,b7      
,ensuring data management plans of the  
,department include provisions for      
long-term preservation of the scientific
 data resulting from research funded by 
the ,department4  7#c7 ,an explanation  
of the factors used to evaluate the     
merit of data management plans of       
research funded by the ,veterans ,health
 ,administration4  7#d7 ,an explanation 
of the process of the ,department in    
effect that enables stakeholders to     
petition a change to the embargo period 
for a specific field and the factors    
considered during such process4  ,,iii  
,disability compensation and pension    
#cja4 ,expedited payment of survivor's  
benefits  7a7 ,in general ,section      
#eaja7;a77#a7 of title #ch1 ,united     
,states ,code1 is amended-- 7#a7 by     
striking ,a specific and inserting 7,a7 
,except as provided in subparagraph     

7,b71 a specific2 and  7#b7 by adding at
 the end the following new subparagraph3
  7,b7 7i7 ,the ,secretary may pay      
benefits under chapters #ac and #ae and 
sections #bcjb1 #bcjg1 and #eaba of this
 title to a survivor of a veteran who   
has not filed a formal claim if the     
,secretary determines that the record   
contains sufficient evidence to         
establish the entitlement of the        
survivor to such benefits4  7ii7 ,for   
purposes of this subparagraph and       
section #eaaj of this title1 the earlier
 of the following dates shall be treated
 as the date of the receipt of the      
survivor's application for benefits     
described in clause 7i73  7,i7 ,the date
 on which the survivor of a veteran 7or 
the representative of such a survivor7  
notifies the ,secretary of the death of 
the veteran through a death certificate 
or other relevant evidence that         
establishes entitlement to survivors    
benefits identified in clause 7i74      
7,,ii7 ,the head of any other department

 or agency of the ,federal ,government  
notifies the ,secretary of the death of 
the veteran4  7iii7 ,in notifying the   
,secretary of the death of a veteran as 
described in clause 7ii77,i71 the       
survivor 7or the representative of such 
a survivor7 may submit to the ,secretary
 additional documents relating to such  
death without being required to file a  
formal claim4  4  7b7 ,report  7#a7 ,in 
general ,not later than one year after  
the date of the enactment of this ,act1 
the ,secretary of ,veterans ,affairs    
shall submit to the ,committee on       
,veterans' ,affairs of the ,senate and  
the ,committee on ,veterans' ,affairs of
 the ,house of ,representatives a report
 on benefits paid pursuant to covered   
claims4  7#b7 ,contents ,the report     
under paragraph 7#a7 shall include the  
following3 7,a7 ,the number of covered  
claims adjudicated during the one-year  
period preceding the date of the report1
 disaggregated by the following3  7i7   
,claims in which the claimant claimed   

entitlement to benefits under chapters  
#ac or #ae or sections #bcjb1 #bcjg1 or 
#eaba of title #ch1 ,united ,states     
,code1 on the basis of the claimant's   
status as the spouse of a deceased      
veteran4  7ii7 ,claims in which the     
claimant claimed entitlement to such    
benefits on the basis of the claimant's 
status as the child of a deceased       
veteran4  7iii7 ,claims in which the    
claimant claimed entitlement to such    
benefits on the basis of the claimant's 
status as the parent of a deceased      
veteran4  7,b7 ,the number of covered   
claims that were adjudicated during such
 period and for which such benefits were
 not awarded1 disaggregated by clauses  
7i7 through 7iii7 of subparagraph 7,a74 
7,c7 ,a comparison of the accuracy and  
timeliness of covered claims adjudicated
 during such period with noncovered     
claims filed by survivors of a veteran4 
7,d7 ,the findings of the ,secretary    
with respect to adjudicating covered    
claims4  7,e7 ,such recommendations as  

the ,secretary may have for legislative 
or administrative action to improve the 
adjudication of claims submitted to the 
,secretary for benefits under chapters  
#ac and #ae and sections #bcjb1 #bcjg1  
and #eaba of title #ch1 ,united ,states 
,code4  7#c7 ,covered claim defined ,in 
this subsection1 the term covered claim 
means a claim covered by section        
#eaja7;a77#a77;,b7 of title #ch1 ,united
 ,states ,code1 as added by subsection  
7a74  7c7 ,effective date ,the          
amendments made by subsection 7a7 shall 
apply with respect to claims for        
benefits based on a death occurring on  
or after the date of the enactment of   
this ,act4  #cjb4 ,increase in special  
pension for ,medal of ,honor recipients 
7a7 ,in general ,section #aefb7;a7 of   
title #ch1 ,united ,states ,code1 is    
amended by striking #a1jjj and inserting
 #c1jjj4  7b7 ,effective date  7#a7 ,in 
general ,the amendment made by          
subsection 7a7 shall take effect on the 
date that is--  7,a7 except as provided 

in subparagraph 7,b71 one year after the
 date of the enactment of this ,act2 and
  7,b7 in the case that the date that is
 one year after the date of the         
enactment of this ,act is not the first 
day of a month1 the first day of the    
first month beginning after the date    
that is one year after the date of the  
enactment of this ,act4  7#b7 ,delay of 
annual cost of living adjustment  7,a7  
,in general ,the ,secretary shall not   
make an increase pursuant to section    
#aefb7;e7 of such title effective       
,december #a1 #bjaf1 if the amendment   
made by subsection 7a7 takes effect     
before such date4  7,b7 ,resumption ,in 
the case that the ,secretary1 pursuant  
to subparagraph 7,a71 does not make an  
increase pursuant to section #aefb7;e7  
of such title effective ,december #a1   
#bjaf1 the ,secretary shall resume      
making increases pursuant to such       
section with the first such increase    
effective ,december #a1 #bjag4  #cjc4   
,board of ,veterans' ,appeals video     

hearings ,section #gajg of title #ch1   
,united ,states ,code1 is amended-- 7#a7
 in subsection 7d71 by amending         
paragraph 7#a7 to read as follows3  7#a7
 7,a7 7i7 ,upon request for a hearing1  
the ,board shall determine1 for purposes
 of scheduling the hearing for the      
earliest possible date1 whether a       
hearing before the ,board will be held  
at its principal location or at a       
facility of the ,department or other    
appropriate ,federal facility located   
within the area served by a regional    
office of the ,department4  7ii7 ,the   
,board shall also determine whether to  
provide a hearing through the use of the
 facilities and equipment described in  
subsection 7e77#a7 or by the appellant  
personally appearing before a ,board    
member or panel4  7,b7 7i7 ,the ,board  
shall notify the appellant of the       
determinations of the location and type 
of hearing made under subparagraph 7,a74
  7ii7 ,upon notification1 the appellant
 may request a different location or    

type of hearing as described in such    
subparagraph4  7iii7 ,if so requested1  
the ,board shall grant such request and 
ensure that the hearing is scheduled at 
the earliest possible date without any  
undue delay or other prejudice to the   
appellant4  2 and  7#b7 in subsection   
7e71 by amending paragraph 7#b7 to read 
as follows3  7#b7 ,any hearing provided 
through the use of the facilities and   
equipment described in paragraph 7#a7   
shall be conducted in the same manner   
as1 and shall be considered the         
equivalent of1 a personal hearing4  4   
#cjd4 ,improvements to authority for    
performance of medical disabilities     
examinations by contract physicians  7a7
 ,extension of temporary authority      
,subsection 7c7 of section #gjd of the  
,veterans ,benefits ,act of #bjjc 7#ch  
,u4,s4,c4 #eaja note7 is amended by     
striking ,december #ca1 #bjaf and       
inserting ,december #ca1 #bjag4  7b7    
,licensure of contract physicians  7#a7 
,temporary authority ,such section #gjd 

is further amended-- 7,a7 by            
redesignating subsection 7d7 as         
subsection 7e72 and  7,b7 by inserting  
after subsection 7c7 the following new  
subsection 7d73  7d7 ,licensure of      
contract physicians  7#a7 ,in general   
,notwithstanding any law regarding the  
licensure of physicians1 a physician    
described in paragraph 7#b7 may conduct 
an examination pursuant to a contract   
entered into under subsection 7b7 at any
 location in any ,state1 the ,district  
of ,columbia1 or a ,commonwealth1       
territory1 or possession of the ,united 
,states1 so long as the examination is  
within the scope of the authorized      
duties under such contract4  7#b7       
,physician described ,a physician       
described in this paragraph is a        
physician who-- 7,a7 has a current      
unrestricted license to practice the    
health care profession of the physician2
  7,b7 is not barred from practicing    
such health care profession in any      
,state1 the ,district of ,columbia1 or a

 ,commonwealth1 territory1 or possession
 of the ,united ,states2 and  7,c7 is   
performing authorized duties for the    
,department of ,veterans ,affairs       
pursuant to a contract entered into     
under subsection 7b74  4  7#b7 ,pilot   
program ,section #ejd of the ,veterans' 
,benefits ,improvement ,act of #aiif    
7#ch ,u4,s4,c4 #eaja note7 is amended-- 
7,a7 by redesignating subsections 7c7   
and 7d7 as subsections 7d7 and 7e71     
respectively2 and  7,b7 by inserting    
after subsection 7b7 the following new  
subsection 7c73  7c7 ,licensure of      
contract physicians  7#a7 ,in general   
,notwithstanding any law regarding the  
licensure of physicians1 a physician    
described in paragraph 7#b7 may conduct 
an examination pursuant to a contract   
entered into under subsection 7a7 at any
 location in any ,state1 the ,district  
of ,columbia1 or a ,commonwealth1       
territory1 or possession of the ,united 
,states1 so long as the examination is  
within the scope of the authorized      

duties under such contract4  7#b7       
,physician described ,a physician       
described in this paragraph is a        
physician who-- 7,a7 has a current      
unrestricted license to practice the    
health care profession of the physician2
  7,b7 is not barred from practicing    
such health care profession in any      
,state1 the ,district of ,columbia1 or a
 ,commonwealth1 territory1 or possession
 of the ,united ,states2 and  7,c7 is   
performing authorized duties for the    
,department of ,veterans ,affairs       
pursuant to a contract entered into     
under subsection 7a74  4  #cje4         
,department of ,veterans ,affairs pilot 
program on fully developed appeals  7a7 
,in general ,the ,secretary of ,veterans
 ,affairs shall carry out a pilot       
program to provide the option of an     
alternative appeals process that shall  
more quickly determine such appeals in  
accordance with this section4  7b7      
,election  7#a7 ,filing ,in accordance  
with paragraph 7#b71 a claimant may     

elect to file a fully developed appeal  
under the pilot program by filing with  
the ,secretary all of the following3    
7,a7 ,the notice of disagreement under  
chapter #ga of title #ch1 ,united       
,states ,code1 along with the written   
election of the claimant to have the    
appeal determined under the pilot       
program4  7,b7 ,all evidence that the   
claimant believes is needed for the     
appeal as of the date of the filing4    
7,c7 ,a statement of the argument in    
support of the claim1 if any4  7#b7     
,timing ,a claimant shall make an       
election under paragraph 7#a7 as part of
 the notice of disagreement filed by the
 claimant in accordance with paragraph  
7#a77;,a74  7#c7 ,triage ,the ,secretary
 shall1 upon expiration of the period   
specified in subsection 7c77#c77;,c71   
ensure that an assessment is undertaken 
of whether an appeal filed under        
paragraph 7#a7 of this subsection       
satisfies the requirements for appeal   
under the pilot program and provide     

appropriate notification to the claimant
 of the results of that assessment4     
7#d7 ,reversion  7,a7 ,elected reversion
 ,at any time1 a claimant who makes an  
election under paragraph 7#a7 may elect 
to revert to the standard appeals       
process4 ,such a reversion shall be     
final4  7,b7 ,automatic reversion ,a    
claimant described in subparagraph 7,a71
 or a claimant who makes an election    
under paragraph 7#a7 but is later       
determined to be ineligible for the     
pilot program under subsection 7a71     
shall revert to the standard appeals    
process without any penalty to the      
claimant other than the loss of the     
docket number associated with the fully 
developed appeal4  7#e7 ,outreach ,in   
providing claimants with notices of the 
determination of a claim during the     
period in which the pilot program under 
subsection 7a7 is carried out1 the      
,secretary shall conduct outreach as    
follows3  7,a7 ,the ,secretary shall    
provide to the claimant 7and to the     

representative of record of the         
claimant1 if any7 information           
regarding--  7i7 the pilot program1     
including the advantages and            
disadvantages of the program2  7ii7 how 
to make an election under paragraph     
7#a72  7iii7 the limitation on the use  
of new evidence described in paragraph  
7#c7 of subsection 7c7 and the          
development of information under        
paragraph 7#d7 of such subsection2  7iv7
 the ability of the claimant to seek    
advice and education regarding such     
process from veterans service           
organizations1 attorneys1 and claims    
agents recognized under chapter #ei of  
title #ch1 ,united ,states ,code2 and   
7v7 the circumstances under which the   
appeal will automatically revert to the 
standard appeals process1 including by  
making a request for a hearing4  7,b7   
,the ,secretary shall collaborate1      
partner with1 and give weight to the    
advice of the three veterans service    
organizations with the most members and 

such other stakeholders as the          
,secretary considers appropriate to     
publish on the ,internet website of the 
,department of ,veterans ,affairs an    
online tutorial explaining the          
advantages and disadvantages of the     
pilot program4  7c7 ,treatment by       
,department and ,board  7#a7 ,process   
,upon the election of a claimant to file
 a fully developed appeal pursuant to   
subsection 7b77#a71 the ,secretary      
shall--  7,a7 not provide the claimant  
with a statement of the case nor require
 the claimant to file a substantive     
appeal2 and  7,b7 transfer jurisdiction 
over the fully developed appeal directly
 to the ,board of ,veterans' ,appeals4  
7#b7 ,docket  7,a7 ,in general ,the     
,board of ,veterans' ,appeals shall--   
7i7 maintain fully developed appeals on 
a separate docket than standard appeals2
  7ii7 decide fully developed appeals in
 the order that the fully developed     
appeals are received on the fully       
developed appeal docket2  7iii7 except  

as provided by subparagraph 7,b71 decide
 not more than one fully developed      
appeal for each four standard appeals   
decided2 and  7iv7 to the extent        
practicable1 decide each fully developed
 appeal by the date that is one year    
following the date on which the claimant
 files the notice of disagreement4  7,b7
 ,adjustment ,beginning one year after  
the date on which the pilot program     
commences1 the ,board may adjust the    
number of standard appeals decided for  
each fully developed appeal under       
subparagraph 7,a77iii7 if the ,board    
determines that such adjustment is fair 
for both standard appeals and fully     
developed appeals4  7#c7 ,limitation on 
use of new evidence  7,a7 ,in general   
,except as provided by subparagraphs    
7,b7 and 7,c7-- 7i7 a claimant may not  
submit or identify to the ,board of     
,veterans' ,appeals any new evidence    
relating to a fully developed appeal    
after filing such appeal unless the     
claimant reverts to the standard appeals

 process pursuant to subsection 7b77#d72
 and  7ii7 if a claimant submits or     
identifies any such new evidence1 such  
submission or identification shall be   
deemed to be an election to make such a 
reversion pursuant to subsection        
7b77#d74  7,b7 ,evidence gathered by    
,board ,subparagraph 7,a7 shall not     
apply to evidence developed pursuant to 
paragraphs 7#d7 and 7#e74 ,the ,board   
shall consider such evidence in the     
first instance without consideration by 
the ,veterans ,benefits ,administration4
  7,c7 ,representative of record ,the   
representative of record of a claimant  
for appeals purposes1 if any1 shall be  
provided an opportunity to review the   
fully developed appeal of the claimant  
and submit any additional arguments or  
evidence that the representative        
determines necessary during a period    
specified by the ,board for purposes of 
this subparagraph4  7#d7 ,prohibition on
 remand for additional development ,if  
the ,board of ,veterans' ,appeals       

determines that a fully developed appeal
 requires ,federal records1 independent 
medical opinions1 or new medical        
examinations1 the ,board shall--  7,a7  
in accordance with paragraph 7#e71 take 
such actions as may be necessary to     
develop such records1 opinions1 or      
examinations in accordance with section 
#eajc;,a of title #ch1 ,united ,states  
,code2  7,b7 retain jurisdiction of the 
fully developed appeal without requiring
 a determination by the ,veterans       
,benefits ,administration based on such 
records1 opinions1 or examinations2     
7,c7 ensure the claimant1 and the       
representative of record of a claimant1 
if any1 receives a copy of such records1
 opinions1 or examinations2 and  7,d7   
provide the claimant a period of #ij    
days after the date of mailing such     
records1 opinions1 or examinations      
during which the claimant may provide   
the ,board any additional evidence      
without requiring the claimant to make a
 reversion pursuant to subsection       

7b77#d74  7#e7 ,development unit  7,a7  
,establishment ,the ,board of ,veterans'
 ,appeals shall establish an office to  
develop ,federal records1 independent   
medical opinions1 and new medical       
examinations pursuant to paragraph      
7#d77;,a7 that the ,board determines    
necessary to decide a fully developed   
appeal4  7,b7 ,requirements ,the        
,secretary shall-- 7i7 ensure that the  
,veterans ,benefits ,administration     
cooperates with the ,board of ,veterans'
 ,appeals in carrying out subparagraph  
7,a72 and  7ii7 transfer employees of   
the ,veterans ,benefits ,administration 
who1 prior to the enactment of this     
,act1 were responsible for processing   
claims remanded by the ,board of        
,veterans' ,appeals to positions within 
the office of the ,board established    
under subparagraph 7,a7 in a number the 
,secretary determines sufficient to     
carry out such subparagraph4  7#f7      
,hearings ,notwithstanding section #gajg
 of title #ch1 ,united ,states ,code1   

the ,secretary may not provide hearings 
with respect to fully developed appeals 
under the pilot program4 ,if a claimant 
requests to hold a hearing pursuant to  
such section #gajg1 such request shall  
be deemed to be an election to revert to
 the standard appeals process pursuant  
to subsection 7b77#d74  7d7 ,duration2  
applicability  7#a7 ,duration ,the      
,secretary shall carry out the pilot    
program during a five-year period       
beginning not later than one year after 
the date of the enactment of this ,act4 
7#b7 ,applicability ,this section shall 
apply only to fully developed appeals   
that are filed during the period in     
which the pilot program is carried out  
pursuant to paragraph 7#a74  7e7 ,annual
 reports  7#a7 ,in general ,during each 
year in which the pilot program is      
carried out1 the ,secretary shall submit
 to the ,committee on ,veterans'        
,affairs of the ,senate and the         
,committee on ,veterans' ,affairs of the
 ,house of ,representatives a report on 

the pilot program4 ,the first such      
report shall be submitted by not later  
than #ahj days after the date on which  
the pilot program commences4  7#b7      
,contents ,each report submitted under  
paragraph 7#a7 shall include the        
following3  7,a7 ,for the period covered
 by the report-- 7i7 the number of fully
 developed appeals filed under the pilot
 program2  7ii7 the average processing  
time for each such appeal adjudicated by
 the ,board of ,veterans' ,appeals1     
disaggregated by each phase of the      
appeal1 and1 if the processing time for 
appeals exceed one year1 the reasons for
 such processing time2  7iii7 a summary 
of reasons for which the development of 
evidence was required under subsection  
7c77#e72  7iv7 the number of issues     
decided1 disaggregated by the           
disposition of the issue2  7v7 of the   
number identified in clause 7iv71 the   
number of issues for which evidence was 
not so developed1 disaggregated by the  
disposition of the issue2  7vi7 of the  

number of fully developed appeals       
decided by the ,board of ,veterans'     
,appeals1 the number of cases from each 
agency of original jurisdiction1 the    
total number of issues allowed1 and the 
total number of issues denied from those
 cases2  7vii7 the number of fully      
developed appeals appealed to the ,court
 of ,appeals for ,veterans ,claims1     
disaggregated by the disposition of the 
case2  7viii7 the number of reversions  
made under subsection 7b77#d72  7ix7 any
 reasons for why a claimant was         
determined to be ineligible to          
participate in the pilot program2 and   
7x7 to the extent practicable1 a        
qualitative assessment of the results   
achieved by claimants through the pilot 
program compared to results achieved by 
claimants through the standard appeal   
process4  7,b7 ,a review1 made in       
conjunction with veterans service       
organizations and such other            
stakeholders as the ,secretary considers
 appropriate1 of the efforts of the     

,secretary to provide clear rating      
decisions and improve disability rating 
notification letters1 including with    
respect to--  7i7 the opinions of       
veterans service organizations and such 
other stakeholders as the ,secretary    
considers appropriate regarding such    
efforts2 and  7ii7 how the pilot program
 improves such efforts4  7,c7 ,a        
recommendation for such legislative or  
administrative action as the ,secretary 
considers may improve the pilot program4
  7,d7 ,an assessment of the feasibility
 and advisability of expanding the pilot
 program4  7f7 ,regulations ,the        
,secretary shall prescribe such         
regulations as may be necessary to carry
 out the pilot program4  7g7            
,definitions ,in this section3 7#a7     
,claimant ,the term claimant has the    
meaning given that term in section #eajj
 of title #ch1 ,united ,states ,code4   
7#b7 ,compensation ,the term            
compensation has the meaning given that 
term in section #aja of title #ch1      

,united ,states ,code4  7#c7 ,fully     
developed appeal ,the term fully        
developed appeal means an appeal of a   
claim for disability compensation that  
is--  7,a7 filed by a claimant in       
accordance with subsection 7b77#a72 and 
7,b7 considered in accordance with this 
section4  7#d7 ,standard appeal ,the    
term standard appeal means an appeal of 
a claim for disability compensation that
 is not a fully developed appeal4  #cjf4
 ,requirement that ,secretary of        
,veterans ,affairs publish the average  
time required to adjudicate timely and  
untimely appeals  7a7 ,publication      
requirement  7#a7 ,in general ,on an    
ongoing basis1 the ,secretary of        
,veterans ,affairs shall make available 
to the public the following3  7,a7 ,the 
average length of time to adjudicate a  
timely appeal4  7,b7 ,the average length
 of time to adjudicate an untimely      
appeal4  7#b7 ,effective date ,paragraph
 7#a7 shall take effect on the date that
 is one year after the date of the      

enactment of this ,act and shall apply  
until the date that is three years after
 the date of the enactment of this ,act4
  7b7 ,report  7#a7 ,in general ,not    
later than #ci months after the date of 
the enactment of this ,act1 the         
,secretary shall submit to the          
,committee on ,veterans' ,affairs of the
 ,senate and the ,committee on          
,veterans' ,affairs of the ,house of    
,representatives a report on whether    
publication pursuant to subsection      
7a77#a7 has had an effect on the number 
of timely appeals filed4  7#b7 ,contents
 ,the report required by paragraph 7#a7 
shall include the following3 7,a7 ,the  
number of appeals and timely appeals    
that were filed during the one-year     
period ending on the effective date     
specified in subsection 7a77#b74  7,b7  
,the number of appeals and timely       
appeals that were filed during the      
one-year period ending on the date that 
is two years after the effective date   
specified in subsection 7a77#b74  7c7   

,definitions ,in this section3 7#a7     
,appeal ,the term appeal means a notice 
of disagreement filed pursuant to       
section #gaje7;a7 of title #ch1 ,united 
,states ,code1 in response to notice of 
the result of an initial review or      
determination regarding a claim for a   
benefit under a law administered by the 
,secretary of ,veterans ,affairs4  7#b7 
,timely ,the term timely with respect to
 an appeal means that the notice of     
disagreement was filed not more than    
#ahj days after the date of mailing of  
the notice of the result of the initial 
review or determination described in    
paragraph 7#a74  7#c7 ,untimely ,the    
term untimely with respect to an appeal 
means the notice of disagreement was    
filed more than #ahj days after the date
 of mailing of the notice of the result 
of the initial review or determination  
described in paragraph 7#a74  #cjg4     
,comptroller ,general review of claims  
processing performance of regional      
offices of ,veterans ,benefits          

,administration  7a7 ,review required   
,not later than #ae months after the    
effective date specified in subsection  
7e71 the ,comptroller ,general of the   
,united ,states shall complete a review 
of the regional offices of the ,veterans
 ,benefits ,administration to help the  
,veterans ,benefits ,administration     
achieve more consistent performance in  
the processing of claims for disability 
compensation4  7b7 ,elements ,the review
 required by subsection 7a7 shall       
include the following3 7#a7 ,an         
identification of the following3  7,a7  
,the factors1 including management      
practices1 that distinguish higher      
performing regional offices from other  
regional offices with respect to claims 
for disability compensation4  7,b7 ,the 
best practices employed by higher       
performing regional offices that        
distinguish the performance of such     
offices from other regional offices4    
7,c7 ,such other management practices or
 tools as the ,comptroller ,general     

determines could be used to improve the 
performance of regional offices4  7#b7  
,an assessment of the effectiveness of  
communication with respect to the       
processing of claims for disability     
compensation between the regional       
offices and veterans service            
organizations and caseworkers employed  
by ,members of ,congress4  7c7 ,report  
,not later than #ae months after the    
effective date specified in subsection  
7e71 the ,comptroller ,general shall    
submit to the ,committee on ,veterans'  
,affairs of the ,senate and the         
,committee on ,veterans' ,affairs of the
 ,house of ,representatives a report on 
the results of the review completed     
under subsection 7a74  7d7 ,veterans    
service organization defined ,in this   
section1 the term veterans service      
organization means any organization     
recognized by the ,secretary for the    
representation of veterans under section
 #eijb of title #ch1 ,united ,states    
,code4  7e7 ,effective date ,this       

section shall take effect on the date   
that is #bgj days after the date of the 
enactment of this ,act4  #cjh4 ,report  
on participation of veterans service    
organizations in ,transition ,assistance
 ,program  7a7 ,report required ,not    
later than #edj days after the date of  
the enactment of this ,act1 the         
,secretary of ,defense shall submit to  
,congress a report on participation of  
veterans service organizations in the   
program carried out under section #aadd 
of title #aj1 ,united ,states ,code4    
7b7 ,contents ,the report required by   
subsection 7a7 shall include the        
following3 7#a7 ,an assessment of the   
compliance of facilities of the         
,department of ,defense with the        
directives included in the memorandum of
 the ,secretary of ,defense entitled    
,installation ,access and ,support      
,services for ,nonprofit ,non-,federal  
,entities and dated ,december #bc1      
#bjad4  7#b7 ,the number of military    
bases that have complied with such      

directives4  7#c7 ,how many veterans    
service organizations have been present 
at a portion of a program as described  
in subsection 7a74  7c7 ,veterans       
service organization defined ,in this   
section1 the term veterans service      
organization means any organization     
recognized by the ,secretary for the    
representation of veterans under section
 #eijb of title #ch1 ,united ,states    
,code4  #cji4 ,inclusion in annual      
budget submission of information on     
capacity of ,veterans ,benefits         
,administration to process benefits     
claims  7a7 ,in general ,along with the 
supporting information included in the  
budget submitted to ,congress by the    
,president pursuant to section #aaje7;a7
 of title #ca1 ,united ,states ,code1   
the ,president shall include information
 on the capacity of the ,veterans       
,benefits ,administration to process    
claims for benefits under the laws      
administered by the ,secretary of       
,veterans ,affairs1 including           

information described in subsection 7b71
 during the fiscal year covered by the  
budget with which the information is    
submitted4  7b7 ,information described  
,the information described in this      
subsection is the following3 7#a7 ,an   
estimate of the average number of claims
 for benefits under the laws            
administered by the ,secretary1         
excluding such claims completed during  
mandatory overtime1 that a single       
full-time equivalent employee of the    
,administration should be able to       
process in a year1 based on the         
following3  7,a7 ,a time and motion     
study that the ,secretary shall conduct 
on the processing of such claims4  7,b7 
,such other information relating to such
 claims as the ,secretary considers     
appropriate4  7#b7 ,a description of the
 actions the ,secretary will take to    
improve the processing of such claims4  
7#c7 ,an assessment of the actions      
identified by the ,secretary under      
paragraph 7#b7 in the previous year and 

an identification of the effects of     
those actions4  7c7 ,effective date     
,this section shall apply with respect  
to any budget submitted as described in 
subsection 7a7 with respect to any      
fiscal year after fiscal year #bjag4    
#caj4 ,report on staffing levels at     
regional offices of ,department of      
,veterans ,affairs after transition to  
,national ,work ,queue ,not later than  
#ae months after the date of the        
enactment of this ,act1 the ,secretary  
of ,veterans ,affairs shall submit to   
the ,committee on ,veterans' ,affairs of
 the ,senate and the ,committee on      
,veterans' ,affairs of the ,house of    
,representatives a report on the        
criteria and procedures that the        
,secretary will use to determine        
appropriate staffing levels at the      
regional offices of the ,department once
 the ,department has transitioned to    
using the ,national ,work ,queue for the
 distribution of the claims processing  
workload4  #caa4 ,annual report on      

progress in implementing ,veterans      
,benefits ,management ,system  7a7 ,in  
general ,not later than each of one     
year1 two years1 and three years after  
the date of the enactment of this ,act1 
the ,secretary of ,veterans ,affairs    
shall submit to ,congress a report on   
the progress of the ,secretary in       
implementing the ,veterans ,benefits    
,management ,system4  7b7 ,contents     
,each report required by subsection 7a7 
shall include the following3 7#a7 ,an   
assessment of the current functionality 
of the ,veterans ,benefits ,management  
,system4  7#b7 ,recommendations         
submitted to the ,secretary by employees
 of the ,department of ,veterans        
,affairs who are involved in processing 
claims for benefits under the laws      
administered by the ,secretary1         
including veterans service              
representatives1 rating veterans service
 representatives1 and decision review   
officers1 for such legislative or       
administrative action as the employees  

consider appropriate to improve the     
processing of such claims4  7#c7        
,recommendations submitted to the       
,secretary by veterans service          
organizations who use the ,veterans     
,benefits ,management ,system for such  
legislative or administrative action as 
the veterans service organizations      
consider appropriate to improve such    
system4  7c7 ,veterans service          
organization defined ,in this section1  
the term veterans service organization  
means any organization recognized by the
 ,secretary for the representation of   
veterans under section #eijb of title   
#ch1 ,united ,states ,code4  #cab4      
,report on plans of ,secretary of       
,veterans ,affairs to reduce inventory  
of non-rating workload ,not later than  
#abj days after the date of the         
enactment of this ,act1 the ,secretary  
of ,veterans ,affairs shall submit to   
the ,committee on ,veterans' ,affairs of
 the ,senate and the ,committee on      
,veterans' ,affairs of the ,house of    

,representatives a report that details  
the plans of the ,secretary to reduce   
the inventory of work items listed in   
the ,monday ,morning ,workload ,report  
under ,end ,products #acj1 #acg1 #agc1  
#bij1 #djj1 #fjj1 #fjg1 #fij1 #icj1 and 
#ifj4  #cac4 ,sense of ,congress on     
increased transparency relating to      
claims for benefits and appeals of      
decisions relating to benefits in       
,monday ,morning ,workload ,report ,it  
is the sense of ,congress that the      
,secretary of ,veterans ,affairs should 
include in each ,monday ,morning        
,workload ,report published by the      
,secretary the following3  7#a7 ,with   
respect to each regional office of the  
,department of ,veterans ,affairs1 the  
following3 7,a7 ,the number of fully    
developed claims for benefits under the 
laws administered by the ,secretary that
 have been received4  7,b7 ,the number  
of claims described in subparagraph 7,a7
 that are pending a decision4  7,c7 ,the
 number of claims described in          

subparagraph 7,a7 that have been pending
 a decision for more than #abe days4    
7#b7 ,enhanced information on appeals of
 decisions relating to claims for       
benefits under the laws administered by 
the ,secretary that are pending1        
including information contained in the  
reports of the ,department entitled     
,appeals ,pending and ,appeals ,workload
 ,by ,station4  #cad4 ,sense of         
,congress regarding ,american veterans  
disabled for life  7a7 ,findings        
,congress makes the following findings3 
7#a7 ,there are at least #d1bjj1jjj     
veterans currently living with          
service-connected disabilities4  7#b7   
,as a result of their service1 many     
veterans are permanently disabled       
throughout their lives and in many cases
 must rely on the support of their      
families and friends when these visible 
and invisible burdens become too much to
 bear alone4  7#c7 ,october #e1 which is
 the anniversary of the dedication of   
the ,american ,veterans ,disabled for   

,life ,memorial1 has been recognized as 
an appropriate day on which to honor    
,american veterans disabled for life    
each year4  7b7 ,sense of ,congress     
,congress-- 7#a7 expresses its          
appreciation to the men and women left  
permanently wounded1 ill1 or injured as 
a result of their service in the ,armed 
,forces2  7#b7 supports the annual      
recognition of ,american veterans       
disabled for life each year2 and  7#c7  
encourages the ,american people to honor
 ,american veterans disabled for life   
each year with appropriate programs and 
activities4  #cae4 ,sense of ,congress  
on submittal of information relating to 
claims for disabilities incurred or     
aggravated by military sexual trauma    
7a7 ,in general ,it is the sense of     
,congress that the ,secretary of        
,veterans ,affairs should submit to     
,congress information on the covered    
claims submitted to the ,secretary      
during each fiscal year1 including the  
information specified in subsection 7b74

  7b7 ,elements ,the information        
specified in this subsection with       
respect to each fiscal year is the      
following3 7#a7 ,the number of covered  
claims submitted to or considered by the
 ,secretary during such fiscal year4    
7#b7 ,of the covered claims under       
paragraph 7#a71 the number and          
percentage of such claims-- 7,a7        
submitted by each sex2  7,b7 that were  
approved1 including the number and      
percentage of such approved claims      
submitted by each sex2 and  7,c7 that   
were denied1 including the number and   
percentage of such denied claims        
submitted by each sex4  7#c7 ,of the    
covered claims under paragraph 7#a7 that
 were approved1 the number and          
percentage1 listed by each sex1 of      
claims assigned to each rating          
percentage of disability4  7#d7 ,of the 
covered claims under paragraph 7#a7 that
 were denied-- 7,a7 the three most      
common reasons given by the ,secretary  
under section #eajd7;b77#a7 of title    

#ch1 ,united ,states ,code1 for such    
denials2 and  7,b7 the number of denials
 that were based on the failure of a    
veteran to report for a medical         
examination4  7#e7 ,the number of       
covered claims that1 as of the end of   
such fiscal year1 are pending and1      
separately1 the number of such claims on
 appeal4  7#f7 ,the average number of   
days that covered claims take to        
complete beginning on the date on which 
the claim is submitted4  7#g7 ,a        
description of the training that the    
,secretary provides to employees of the 
,veterans ,benefits ,administration     
specifically with respect to covered    
claims1 including the frequency1 length1
 and content of such training4  7c7     
,definitions ,in this section3 7#a7     
,covered claims ,the term covered claims
 means claims for disability            
compensation submitted to the ,secretary
 based on post-traumatic stress disorder
 alleged to have been incurred or       
aggravated by military sexual trauma4   

7#b7 ,military sexual trauma ,the term  
military sexual trauma shall have the   
meaning specified by the ,secretary for 
purposes of this section and shall      
include sexual harassment 7as so        
specified74  ,,iv ,education  ,a        
,educational assistance and vocational  
rehabilitation  #dja4 ,clarification of 
eligibility for ,marine ,gunnery        
,sergeant ,john ,david ,fry ,scholarship
  7a7 ,in ,general ,section #gja7;d7 of 
the ,veterans ,access1 ,choice1 and     
,accountability ,act of #bjad 7,public  
,law #aac-adf2 #abh ,stat4 #agif2 #ch   
,u4,s4,c4 #ccaa note7 is amended to read
 as follows3  7d7 ,applicability  7#a7  
,in general ,the amendments made by this
 section shall apply with respect to a  
quarter1 semester1 or term1 as          
applicable1 commencing on or after      
,january #a1 #bjae4  7#b7 ,deaths that  
occurred between ,september #aa1 #bjja1 
and ,december #ca1 #bjje ,for purposes  
of section #ccaa7;f77#b7 of title #ch1  
,united ,states ,code1 any member of the

 ,armed ,forces who died during the     
period beginning on ,september #aa1     
#bjja1 and ending on ,december #ca1     
#bjje1 is deemed to have died on        
,january #a1 #bjjf4  4  7b7 ,election on
 receipt of certain benefits ,section   
#ccaa7;f7 of title #ch1 ,united ,states 
,code1 is amended-- 7#a7 in paragraph   
7#c71 by striking ,a surviving spouse   
and inserting ,except as provided in    
paragraph 7#d71 a surviving spouse2     
7#b7 by redesignating paragraph 7#d7 as 
paragraph 7#e72 and  7#c7 by inserting  
after paragraph 7#c7 the following new  
paragraph 7#d73  7#d7 ,exception for    
certain elections  7,a7 ,in general ,an 
election made under paragraph 7#c7 by a 
spouse described in subparagraph 7,b7   
may not be treated as irrevocable if    
such election occurred before the date  
of the enactment of this paragraph4     
7,b7 ,eligible surviving spouse ,a      
spouse described in this subparagraph is
 an individual-- 7i7 who is entitled to 
assistance under subsection 7a7 pursuant

 to paragraph 7#i7 of subsection 7b72   
and  7ii7 who was the spouse of a member
 of the ,armed ,forces who died during  
the period beginning on ,september #aa1 
#bjja1 and ending on ,december #ca1     
#bjje4  4  7c7 ,technical amendment     
,paragraph 7#e7 of subsection 7f7 of    
section #ccaa of title #ch1 ,united     
,states ,code1 as redesignated by       
subsection 7b77#b71 is amended by       
striking that paragraph and inserting   
paragraph 7#i7 of subsection 7b74  7d7  
,yellow ,ribbon ,g4,i4 ,education       
,enhancement ,program ,section #ccag7;a7
 of such title is amended by striking   
paragraphs 7#a7 and 7#b7 of section     
#ccaa7;b7 and inserting paragraphs 7#a71
 7#b71 and 7#i7 of section #ccaa7;b7 of 
this title4  #djb4 ,restoration of      
entitlement to ,post-#i_/aa ,educational
 ,assistance for veterans affected by   
closures of educational institutions    
7a7 ,educational assistance  7#a7 ,in   
general ,section #ccab of title #ch1    
,united ,states ,code1 is amended by    

adding at the end the following new     
subsection3  7d7 ,discontinuation of    
education due to closure of educational 
institution  7#a7 ,in general ,any      
payment of educational assistance       
described in paragraph 7#b7 shall not-- 
7,a7 be charged against any entitlement 
to educational assistance of the        
individual concerned under this chapter2
 or  7,b7 be counted against the        
aggregate period for which section #cfie
 of this title limits the individual's  
receipt of educational assistance under 
this chapter4  7#b7 ,description of     
payment of educational assistance       
,subject to paragraph 7#c71 the payment 
of educational assistance described in  
this paragraph is the payment of such   
assistance to an individual for pursuit 
of a course or courses under this       
chapter if the ,secretary finds that the
 individual--  7,a7 was forced to       
discontinue such course pursuit as a    
result of a permanent closure of an     
educational institution2 and  7,b7 did  

not receive credit1 or lost training    
time1 toward completion of the program  
of education being pursued at the time  
of such closure4  7#c7 ,period for which
 payment not charged ,the period for    
which1 by reason of this subsection1    
educational assistance is not charged   
against entitlement or counted toward   
the applicable aggregate period under   
section #cfie of this title shall not   
exceed the aggregate of--  7,a7 the     
portion of the period of enrollment in  
the course or courses from which the    
individual failed to receive credit or  
with respect to which the individual    
lost training time1 as determined under 
paragraph 7#b77;,b71 and  7,b7 the      
period by which a monthly stipend is    
extended under section                  
#cfhj7;a77#b77;,b7 of this title4  4    
7#b7 ,applicability ,subsection 7d7 of  
such section1 as added by paragraph     
7#a71 shall apply with respect to       
courses and programs of education       
discontinued as described in paragraph  

7#b7 of such subsection in fiscal year  
#bjae or any fiscal year thereafter4    
7b7 ,monthly housing stipend  7#a7 ,in  
general ,section #cfhj7;a7 of such title
 is amended-- 7,a7 by striking the      
matter after paragraph 7#c77;,b72  7,b7 
in paragraph 7#c71 by redesignating     
subparagraphs 7,a7 and 7,b7 as clauses  
7i7 and 7ii71 respectively2  7,c7 by    
redesignating paragraphs 7#a7 through   
7#c7 as subparagraphs 7,a7 through 7,c71
 respectively2  7,d7 in the matter      
before subparagraph 7,a71 as            
redesignated1 in the first sentence1 by 
striking ,payment of and inserting 7#a7 
,except as provided in paragraph 7#b71  
payment of2 and  7,e7 by adding at the  
end the following new paragraph 7#b73   
7#b7 ,notwithstanding paragraph 7#a71   
the ,secretary may1 pursuant to such    
regulations as the ,secretary shall     
prescribe1 continue to pay allowances to
 eligible veterans and eligible persons 
enrolled in courses set forth in        
paragraph 7#a77;,a7--  7,a7 during      

periods when schools are temporarily    
closed under an established policy based
 on an ,executive order of the          
,president or due to an emergency       
situation1 except that the total number 
of weeks for which allowances may       
continue to be so payable in any        
#ab-month period may not exceed four    
weeks2 or  7,b7 solely for the purpose  
of awarding a monthly housing stipend   
described in section #ccac of this      
title1 during periods following a       
permanent school closure1 except that   
payment of such a stipend may only be   
continued until the earlier of--  7i7   
the date of the end of the term1        
quarter1 or semester during which the   
school closure occurred2 and  7ii7 the  
date that is #d months after the date of
 the school closure4  4  7#b7           
,conforming amendment ,paragraph        
7#a77;,c77ii7 of such section1 as       
redesignated1 is amended by striking    
described in subclause 7,a7 of this     
clause and inserting described in clause

 7i74  #djc4 ,consideration of          
eligibility for ,post-#i_/aa            
,educational ,assistance for certain    
time on active duty in reserve          
components of ,armed ,forces  7a7 ,in   
general ,section #ccja7a77;,b7 of title 
#ch1 ,united ,states ,code1 is amended  
by striking #abcjb1 or #abcjd and       
inserting #abcja7;h71 #abcjb1 #abcjd1   
#abcjd;a1 or #abcjd;b4  7b7 ,effective  
date and applicability ,the amendment   
made by subsection 7a7 shall-- 7#a7 take
 effect on the date that is one year    
after the date of the enactment of this 
,act2  7#b7 apply with respect to       
assistance provided under chapter #cc of
 such title on and after the date that  
is one year after the date of the       
enactment of this ,act2 and  7#c7 apply 
with respect to any member of a reserve 
component of the ,armed ,forces who     
serves or has served on active duty     
under section #abcja7;h71 #abcjd;a1 or  
#abcjd;b of title #aj1 ,united ,states  
,code1 before1 on1 or after the date of 

the enactment of this ,act4  #djd4      
,approval of courses of education and   
training for purposes of the vocational 
rehabilitation program of the           
,department of ,veterans ,affairs  7a7  
,in general ,section #cajd7;b7 of title 
#ch1 ,united ,states ,code1 is amended--
 7#a7 by inserting 7#a7 before ,a       
rehabilitation2 and  7#b7 by adding at  
the end the following new paragraph3    
7#b7 7,a7 ,except as provided in        
subparagraph 7,b71 to the maximum extent
 practicable1 a course of education or  
training may be pursued by a veteran as 
part of a rehabilitation program under  
this chapter only if the course is      
approved for purposes of chapter #cj or 
#cc of this title4  7,b7 ,the ,secretary
 may waive the requirement under        
subparagraph 7,a7 to the extent the     
,secretary determines appropriate4  4   
7b7 ,effective date ,the amendments made
 by subsection 7a7 shall apply with     
respect to a course of education or     
training pursued by a veteran who first 

begins a program of rehabilitation under
 chapter #ca of title #ch1 ,united      
,states ,code1 on or after the date that
 is one year after the date of the      
enactment of this ,act4  #dje4          
,authority to prioritize vocational     
rehabilitation services based on need   
,section #cajd of title #ch1 ,united    
,states ,code1 as amended by section    
#djd1 is further amended by adding at   
the end the following new subsection3   
7c7 7#a7 ,the ,secretary shall have the 
authority to administer this chapter by 
prioritizing the provision of services  
under this chapter based on need1 as    
determined by the ,secretary4  7#b7 ,in 
evaluating need for purposes of this    
subsection1 the ,secretary shall        
consider disability ratings1 the        
severity of employment handicaps1       
qualification for a program of          
independent living services and         
assistance1 income1 and such other      
factors as the ,secretary considers     
appropriate4  7#c7 ,not later than #ij  

days before making any changes to the   
prioritization of the provision of      
services under this chapter as          
authorized under paragraph 7#a71 the    
,secretary shall submit to ,congress a  
plan describing such changes4  4  #djf4 
,codification and improvement of        
election process for ,post-#i_/aa       
,educational ,assistance ,program  7a7  
,in general ,subchapter ,,iii of chapter
 #cc of title #ch1 ,united ,states      
,code1 is amended-- 7#a7 by             
redesignating section #ccbe as section  
#ccbf2 and  7#b7 by inserting after     
section #ccbd the following new section 
#ccbe3  #ccbe4 ,election to receive     
educational assistance  7a7 ,individuals
 eligible to elect participation in     
post-#i_/aa educational assistance ,an  
individual may elect to receive         
educational assistance under this       
chapter if such individual-- 7#a7 as of 
,august #a1 #bjji--  7,a7 is entitled to
 basic educational assistance under     
chapter #cj of this title and has used1 

but retains unused1 entitlement under   
that chapter2  7,b7 is entitled to      
educational assistance under chapter    
#ajg1 #afjf1 or #afjg of title #aj and  
has used1 but retains unused1           
entitlement under the applicable        
chapter2  7,c7 is entitled to basic     
educational assistance under chapter #cj
 of this title but has not used any     
entitlement under that chapter2  7,d7 is
 entitled to educational assistance     
under chapter #ajg1 #afjf1 or #afjg of  
title #aj but has not used any          
entitlement under such chapter2  7,e7 is
 a member of the ,armed ,forces who is  
eligible for receipt of basic           
educational assistance under chapter #cj
 of this title and is making            
contributions toward such assistance    
under section #cjaa7;b7 or #cjab7;c7 of 
this title2 or  7,f7 is a member of the 
,armed ,forces who is not entitled to   
basic educational assistance under      
chapter #cj of this title by reason of  
an election under section #cjaa7;c77#a7 

or #cjab7;d77#a7 of this title2 and     
7#b7 as of the date of the individual's 
election under this paragraph1 meets the
 requirements for entitlement to        
educational assistance under this       
chapter4  7b7 ,cessation of             
contributions toward ,,gi bill          
,effective as of the first month        
beginning on or after the date of an    
election under subsection 7a7 of an     
individual described by paragraph       
7#a77;,e7 of that subsection1 the       
obligation of the individual to make    
contributions under section #cjaa7;b7 or
 #cjab7;c7 of this title1 as applicable1
 shall cease1 and the requirements of   
such section shall be deemed to be no   
longer applicable to the individual4    
7c7 ,revocation of remaining transferred
 entitlement  7#a7 ,election to revoke  
,if1 on the date an individual described
 in paragraph 7#a77;,a7 or 7#a77;,c7 of 
subsection 7a7 makes an election under  
that subsection1 a transfer of the      
entitlement of the individual to basic  

educational assistance under section    
#cjbj of this title is in effect and a  
number of months of the entitlement so  
transferred remain unutilized1 the      
individual may elect to revoke all or a 
portion of the entitlement so           
transferred that remains unutilized4    
7#b7 ,availability of revoked           
entitlement ,any entitlement revoked by 
an individual under this paragraph shall
 no longer be available to the dependent
 to whom transferred1 but shall be      
available to the individual instead for 
educational assistance under chapter #cc
 of this title in accordance with the   
provisions of this section4  7#c7       
,availability of unrevoked entitlement  
,any entitlement described in paragraph 
7#a7 that is not revoked by an          
individual in accordance with that      
paragraph shall remain available to the 
dependent or dependents concerned in    
accordance with the current transfer of 
such entitlement under section #cjbj of 
this title4  7d7 ,post-#i_/aa           

educational assistance  7#a7 ,in general
 ,subject to paragraph 7#b7 and except  
as provided in subsection 7e71 an       
individual making an election under     
subsection 7a7 shall be entitled to     
educational assistance under this       
chapter in accordance with the          
provisions of this chapter1 instead of  
basic educational assistance under      
chapter #cj of this title1 or           
educational assistance under chapter    
#ajg1 #afjf1 or #afjg of title #aj1 as  
applicable4  7#b7 ,limitation on        
entitlement for certain individuals ,in 
the case of an individual making an     
election under subsection 7a7 who is    
described by paragraph 7#a77;,a7 of that
 subsection1 the number of months of    
entitlement of the individual to        
educational assistance under this       
chapter shall be the number of months   
equal to--  7,a7 the number of months of
 unused entitlement of the individual   
under chapter #cj of this title1 as of  
the date of the election1 plus  7,b7 the

 number of months1 if any1 of           
entitlement revoked by the individual   
under subsection 7c77#a74  7e7          
,continuing entitlement to educational  
assistance not available under #i_/aa   
assistance program  7#a7 ,in general ,in
 the event educational assistance to    
which an individual making an election  
under subsection 7a7 would be entitled  
under chapter #cj of this title1 or     
chapter #ajg1 #afjf1 or #afjg of title  
#aj1 as applicable1 is not authorized to
 be available to the individual under   
the provisions of this chapter the      
individual shall remain entitled to such
 educational assistance in accordance   
with the provisions of the applicable   
chapter4  7#b7 ,charge for use of       
entitlement ,the utilization by an      
individual of entitlement under         
paragraph 7#a7 shall be chargeable      
against the entitlement of the          
individual to educational assistance    
under this chapter at the rate of one   
month of entitlement under this chapter 

for each month of entitlement utilized  
by the individual under paragraph 7#a7  
7as determined as if such entitlement   
were utilized under the provisions of   
chapter #cj of this title1 or chapter   
#ajg1 #afjf1 or #afjg of title #aj1 as  
applicable74  7f7 ,additional           
post-#i_/aa assistance for members      
having made contributions toward ,,gi   
bill  7#a7 ,additional assistance ,in   
the case of an individual making an     
election under subsection 7a7 who is    
described by subparagraph 7,a71 7,c71 or
 7,e7 of paragraph 7#a7 of that         
subsection1 the amount of educational   
assistance payable to the individual    
under this chapter as a monthly stipend 
payable under paragraph 7#a77;,b7 of    
section #ccac7;c7 of this title1 or     
under paragraphs 7#b7 through 7#g7 of   
that section 7as applicable71 shall be  
the amount otherwise payable as a       
monthly stipend under the applicable    
paragraph increased by the amount equal 
to--  7,a7 the total amount of          

contributions toward basic educational  
assistance made by the individual under 
section #cjaa7;b7 or #cjab7;c7 of this  
title1 as of the date of the election1  
multiplied by  7,b7 the fraction-- 7i7  
the numerator of which is--  7,i7 the   
number of months of entitlement to basic
 educational assistance under chapter   
#cj of this title remaining to the      
individual at the time of the election2 
plus  7,,ii7 the number of months1 if   
any1 of entitlement under chapter #cj   
revoked by the individual under         
subsection 7c77#a72 and  7ii7 the       
denominator of which is #cf months4     
7#b7 ,months of remaining entitlement   
for certain individuals ,in the case of 
an individual covered by paragraph 7#a7 
who is described by subsection          
7a77#a77;,e71 the number of months of   
entitlement to basic educational        
assistance remaining to the individual  
for purposes of paragraph               
7#a77;,b77i77,,ii7 shall be #cf months4 
7#c7 ,timing of payment ,the amount     

payable with respect to an individual   
under paragraph 7#a7 shall be paid to   
the individual together with the last   
payment of the monthly stipend payable  
to the individual under paragraph       
7#a77;,b7 of section #ccac7;c7 of this  
title1 or under paragraphs 7#b7 through 
7#g7 of that section 7as applicable71   
before the exhaustion of the            
individual's entitlement to educational 
assistance under this chapter4  7g7     
,continuing entitlement to additional   
assistance for critical skills or       
speciality and additional service ,an   
individual making an election under     
subsection 7a77#a7 who1 at the time of  
the election1 is entitled to increased  
educational assistance under section    
#cjae7;d7 of this title1 or section     
#afaca7;i7 of title #aj1 or supplemental
 educational assistance under subchapter
 ,,iii of chapter #cj of this title1    
shall remain entitled to such increased 
educational assistance or supplemental  
educational assistance in the           

utilization of entitlement to           
educational assistance under this       
chapter1 in an amount equal to the      
quarter1 semester1 or term1 as          
applicable1 equivalent of the monthly   
amount of such increased educational    
assistance or supplemental educational  
assistance payable with respect to the  
individual at the time of the election4 
7h7 ,alternative election by ,secretary 
7#a7 ,in general ,in the case of an     
individual who1 on or after ,january #a1
 #bjaf1 submits to the ,secretary an    
election under this section that the    
,secretary determines is clearly against
 the interests of the individual1 or who
 fails to make an election under this   
section1 the ,secretary may make an     
alternative election on behalf of the   
individual that the ,secretary          
determines is in the best interests of  
the individual4  7#b7 ,notice ,if the   
,secretary makes an election on behalf  
of an individual under this subsection1 
the ,secretary shall notify the         

individual by not later than seven days 
after making such election and shall    
provide the individual with a #cj-;day  
period1 beginning on the date of the    
individual's receipt of such notice1    
during which the individual may modify  
or revoke the election made by the      
,secretary on the individual's behalf4  
,the ,secretary shall include1 as part  
of such notice1 a clear statement of why
 the alternative election made by the   
,secretary is in the best interests of  
the individual as compared to the       
election submitted by the individual4   
,the ,secretary shall provide the notice
 required under this paragraph by       
electronic means whenever possible4  7i7
 ,irrevocability of elections ,an       
election under subsection 7a7 or 7c77#a7
 is irrevocable4  4  7b7 ,clerical      
amendment ,the table of sections at the 
beginning of such chapter is amended by 
striking the item relating to section   
#ccbe and inserting the following new   
items3  #ccbe4 ,election to receive     

educational assistance4#ccbf4 ,reporting
 requirement4  4  7c7 ,conforming repeal
 ,subsection 7c7 of section #ejjc of the
 ,post-#i_/aa ,veterans ,educational    
,assistance ,act of #bjjh 7,public ,law 
#aaj-beb2 #ch ,u4,s4,c4 #ccja note7 is  
hereby repealed4  #djg4 ,work-study     
allowance ,section #cdhe7;a77#d7 of     
title #ch1 ,united ,states ,code1 is    
amended by striking ,june #cj1 #bjac    
each place it appears and inserting     
,june #cj1 #bjac1 or the period         
beginning on ,june #cj1 #bjaf1 and      
ending on ,june #cj1 #bjba4  #djh4      
,retention of entitlement to educational
 assistance during certain additional   
periods of active duty  7a7 ,educational
 assistance allowance ,section          
#afaca7;c77#c77;,b77i7 of title #aj1    
,united ,states ,code1 is amended by    
striking or #abcjd and inserting #abcjd1
 #abcjd;a1 or #abcjd;b4  7b7 ,expiration
 date ,section #afacc7;b77#d7 of such   
title is amended by striking or #abcjd  
and inserting #abcjd1 #abcjd;a1 or      

#abcjd;b4  #dji4 ,eligibility for       
,post-#i_/aa ,educational ,assistance   
for certain members of reserve          
components of ,armed ,forces who lost   
entitlement to educational assistance   
under ,reserve ,educational ,assistance 
,program  7a7 ,election ,section #afafg 
of title #aj1 ,united ,states ,code1 is 
amended by adding at the end the        
following new subsection3  7c7          
,eligibility for ,post-#i_/aa           
,educational ,assistance ,a member who  
loses eligibility for benefits under    
this chapter pursuant to subsection 7b7 
shall be allowed to elect 7in such form 
and manner as the ,secretary of         
,veterans ,affairs may prescribe7 to    
have such service previously credited   
toward this chapter credited towards    
establishing eligibility for educational
 assistance under chapter #cc of title  
#ch1 ,united ,states ,code1             
notwithstanding the provisions of       
section #afafc7;e7 of this title or     
section #ccbb7;h77#a7 of title #ch4  4  

7b7 ,qualification of service ,section  
#ccja7a7 of title #ch1 ,united ,states  
,code1 shall be construed to include1 in
 the case of a member of a reserve      
component of the ,armed ,forces who1    
before ,november #be1 #bjae1 established
 eligibility for educational assistance 
under chapter #afjg of title #aj1       
,united ,states ,code1 pursuant to      
section #afafc7;a77#a7 of such title1   
but lost eligibility for such           
educational assistance pursuant to      
section #afafg7;b7 of such title1       
service on active duty 7as defined in   
section #aja of such title7 that        
satisfies the requirements of section   
#afafc7;a77#a7 of such title4  7c7      
,entitlement ,section #ccaa7;b77#h7 of  
title #ch1 ,united ,states ,code1 shall 
be construed to include an individual   
who1 before ,november #be1 #bjae1       
established eligibility for educational 
assistance under chapter #afjg of title 
#aj1 ,united ,states ,code1 pursuant to 
section #afafc7;b7 of such title1 but   

lost such eligibility pursuant to       
section #afafg7;b7 of such title4  7d7  
,duration ,notwithstanding section #ccab
 of title #ch1 ,united ,states ,code1 an
 individual who establishes eligibility 
for educational assistance under chapter
 #cc of such title by crediting towards 
such chapter service previously credited
 towards chapter #afjg of title #aj1    
,united ,states ,code1 is only entitled 
to a number of months of educational    
assistance under section #ccac of title 
#ch1 ,united ,states ,code1 equal to the
 number of months of entitlement        
remaining under chapter #afjg of title  
#aj1 ,united ,states ,code1 at the time 
of conversion to chapter #cc of title   
#ch1 ,united ,states ,code4  #daj4      
,reports on progress of students        
receiving ,post-#i_/aa ,educational     
,assistance  7a7 ,in general ,chapter   
#cc of title #ch1 ,united ,states ,code1
 as amended by section #djf1 is further 
amended-- 7#a7 in subsection #ccbf7;c71 
as redesignated--  7,a7 in paragraph    

7#b71 by striking and after the         
semicolon2  7,b7 by redesignating       
paragraph 7#c7 as paragraph 7#d72 and   
7,c7 by inserting after paragraph 7#b7  
the following new paragraph 7#c73  7#c7 
the information received by the         
,secretary under section #ccbg of this  
title2 and  2 and  7#b7 by adding at the
 end the following new section3  #ccbg4 
,report on student progress ,as a       
condition on approval under chapter #cf 
of this title of a course offered by an 
educational institution 7as defined in  
section #cdeb of this title71 each year1
 each educational institution 7as so    
defined7 that received a payment in that
 year on behalf of an individual        
entitled to educational assistance under
 this chapter shall submit to the       
,secretary such information regarding   
the academic progress of the individual 
as the ,secretary may require4  4  7b7  
,clerical amendment ,the table of       
sections at the beginning of such       
chapter1 as amended by section #djf1 is 

further amended by adding at the end the
 following new item3  #ccbg4 ,report on 
student progress4  4  7c7 ,effective    
date ,the amendments made by this       
section shall take effect on the date   
that is one year after the date of the  
enactment of this ,act4  ,b             
,administration of educational          
assistance  #dba4 ,centralized reporting
 of veteran enrollment by certain       
groups1 districts1 and consortiums of   
educational institutions  7a7 ,in       
general ,section #cfhd7;a7 of title #ch1
 ,united ,states ,code1 is amended--    
7#a7 in paragraph 7#a71 by inserting    
#cb1 #cc1 after #ca12 and  7#b7 by      
adding at the end the following new     
paragraph3  7#d7 ,for purposes of this  
subsection1 the term educational        
institution may include a group1        
district1 or consortium of separately   
accredited educational institutions     
located in the same ,state that are     
organized in a manner that facilitates  
the centralized reporting of the        

enrollments in such group1 district1 or 
consortium of institutions4  4  7b7     
,effective date ,the amendments made by 
subsection 7a7 shall apply with respect 
to reports submitted on or after the    
date of the enactment of this ,act4     
#dbb4 ,provision of information         
regarding veteran entitlement to        
educational assistance  7a7 ,in general 
,subchapter ,,ii of chapter #cf of title
 #ch1 ,united ,states ,code1 is amended 
by adding at the end the following new  
section3  #cfii4 ,provision of certain  
information to educational institutions 
7a7 ,in general ,for each veteran or    
other individual pursuing a course of   
education that has been approved under  
this chapter using educational          
assistance to which the veteran or other
 individual is entitled under chapter   
#cj1 #cb1 #cc1 or #ce of this title1 the
 ,secretary shall make available to the 
educational institution offering the    
course information about the amount of  
such educational assistance to which the

 veteran or other individual is         
entitled4  7b7 ,manner information is   
provided ,the ,secretary shall ensure   
that information made available to an   
educational institution under subsection
 7a7 is provided to such educational    
institution pursuant to such subsection 
through a secure information technology 
system accessible by the educational    
institution4  7c7 ,regular updates ,the 
,secretary shall regularly update       
information provided under this section 
to reflect any amounts used by veterans 
and other individuals4  4  7b7 ,clerical
 amendment ,the table of sections at the
 beginning of such chapter is amended by
 inserting after the item relating to   
section #cfih the following new item3   
#cfii4 ,provision of certain information
 to educational institutions4  4  #dbc4 
,role of ,state approving agencies  7a7 
,approval of certain courses ,section   
#cfgb7;b77#b77;,a7 of title #ch1 ,united
 ,states ,code1 is amended by striking  
the following and all that follows      

through the colon and inserting the     
following3 a program of education is    
deemed to be approved for purposes of   
this chapter if a ,state approving      
agency1 or the ,secretary when acting in
 the role of a ,state approving agency1 
determines that the program is one of   
the following programs34  7b7 ,approval 
of other courses ,section #cfge of such 
title is amended-- 7#a7 in subsection   
7a77#a7--  7,a7 by striking ,the        
,secretary or a ,state approving agency 
and inserting ,a ,state approving       
agency1 or the ,secretary when acting in
 the role of a ,state approving agency12
 and  7,b7 by striking offered by       
proprietary for-profit educational      
institutions and inserting not covered  
by section #cfgb of this title2 and     
7#b7 in subsection 7b7-- 7,a7 in the    
matter before paragraph 7#a71 by        
striking the ,secretary or the ,state   
approving agency and inserting the      
,state approving agency1 or the         
,secretary when acting in the role of a 

,state approving agency12 and  7,b7 in  
paragraph 7#a71 by striking the         
,secretary or the ,state approving      
agency and inserting the ,state         
approving agency1 or the ,secretary when
 acting in the role of a ,state         
approving agency4  #dbd4 ,criteria used 
to approve courses  7a7 ,nonaccredited  
courses ,section #cfgf7;c77#ad7 of title
 #ch1 ,united ,states ,code1 is amended 
by inserting before the period the      
following3 if the ,secretary1 in        
consultation with the ,state approving  
agency and pursuant to regulations      
prescribed to carry out this paragraph1 
determines such criteria are necessary  
and treat public1 private1 and          
proprietary for-profit educational      
institutions equitably4  7b7 ,accredited
 courses ,section #cfge7;b77#c7 of such 
title is amended by striking and 7#c7   
and inserting 7#c71 and 7#ad74  7c7     
,application ,the amendment made by     
subsection 7a7 shall apply with respect 
to--  7#a7 criteria developed pursuant  

to paragraph 7#ad7 of subsection 7c7 of 
section #cfgf of title #ch1 ,united     
,states ,code1 on or after ,january #a1 
#bjac2 and  7#b7 an investigation       
conducted under such subsection that is 
covered by a reimbursement of expenses  
paid by the ,secretary of ,veterans     
,affairs to a ,state pursuant to section
 #cfgd of such title on or after        
,october #a1 #bjae4  #dbe4 ,modification
 of requirements for approval for       
purposes of educational assistance      
provided by ,department of ,veterans    
,affairs of programs designed to prepare
 individuals for licensure or           
certification  7a7 ,approval of         
nonaccredited courses ,subsection 7c7 of
 section #cfgf of title #ch1 ,united    
,states ,code1 as amended by this       
subtitle1 is further amended--  7#a7 by 
redesignating paragraph 7#ad7 as        
paragraph 7#af72 and  7#b7 by inserting 
after paragraph 7#ac7 the following new 
paragraphs3  7#ad7 ,in the case of a    
course designed to prepare an individual

 for licensure or certification in a    
,state1 the course--  7,a7 meets all    
instructional curriculum licensure or   
certification requirements of such      
,state2 and  7,b7 in the case of a      
course designed to prepare an individual
 for licensure to practice law in a     
,state1 is accredited by an accrediting 
agency or association recognized by the 
,secretary of ,education under subpart  
#b of part ,h of title ,,iv of the      
,higher ,education ,act of #aife 7#bj   
,u4,s4,c4 #ajii;b74  7#ae7 ,in the case 
of a course designed to prepare an      
individual for employment pursuant to   
standards developed by a board or agency
 of a ,state in an occupation that      
requires approval1 licensure1 or        
certification1 the course--  7,a7 meets 
such standards2 and  7,b7 in the case of
 a course designed to prepare an        
individual for licensure to practice law
 in a ,state1 is accredited by an       
accrediting agency or association       
recognized by the ,secretary of         

,education under subpart #b of part ,h  
of title ,,iv of the ,higher ,education 
,act of #aife 7#bj ,u4,s4,c4 #ajii;b74  
4  7b7 ,exceptions ,such section is     
further amended by adding at the end the
 following new subsection3  7f7 7#a7    
,the ,secretary may waive the           
requirements of paragraph 7#ad7 or 7#ae7
 of subsection 7c7 in the case of a     
course of education offered by an       
educational institution 7either         
accredited or not accredited7 if the    
,secretary determines all of the        
following3  7,a7 ,the educational       
institution is not accredited by an     
agency or association recognized by the 
,secretary of ,education4  7,b7 ,the    
course did not meet the requirements of 
such paragraph at any time during the   
two-year period preceding the date of   
the waiver4  7,c7 ,the waiver furthers  
the purposes of the educational         
assistance programs administered by the 
,secretary or would further the         
education interests of individuals      

eligible for assistance under such      
programs4  7,d7 ,the educational        
institution does not provide any        
commission1 bonus1 or other incentive   
payment based directly or indirectly on 
success in securing enrollments or      
financial aid to any persons or entities
 engaged in any student recruiting or   
admission activities or in making       
decisions regarding the award of student
 financial assistance1 except for the   
recruitment of foreign students residing
 in foreign countries who are not       
eligible to receive ,federal student    
assistance4  7#b7 ,not later than #cj   
days after the date on which the        
,secretary issues a waiver under        
paragraph 7#a71 the ,secretary shall    
submit to ,congress notice of such      
waiver and a justification for issuing  
such waiver4  4  7c7 ,approval of       
accredited courses ,section             
#cfge7;b77#c7 of such title1 as amended 
by this subtitle1 is further amended--  
7#a7 by striking and 7#ad7 and inserting

 7#ad71 7#ae71 and 7#af72 and  7#b7 by  
inserting before the period at the end  
the following3 7or1 with respect to such
 paragraphs 7#ad7 and 7#ae71 the        
requirements under such paragraphs are  
waived pursuant to subsection 7f77#a7 of
 section #cfgf of this title74  7d7     
,approval of accredited standard college
 degree programs offered at public or   
not-for-profit educational institutions 
,section #cfgb7;b77#b7 of such title is 
amended-- 7#a7 in subparagraph 7,a77i71 
by striking ,an accredited and inserting
 ,except as provided in subparagraph    
7,c71 an accredited2 and  7#b7 by adding
 at the end the following new           
subparagraph3  7,c7 ,a course that is   
described in both subparagraph 7,a77i7  
of this paragraph and in paragraph 7#ad7
 or 7#ae7 of section #cfgf7;c7 of this  
title shall not be deemed to be approved
 for purposes of this chapter unless--  
7i7 a ,state approving agency1 or the   
,secretary when acting in the role of a 
,state approving agency1 determines that

 the course meets the applicable        
criteria in such paragraphs2 or  7ii7   
the ,secretary issues a waiver for such 
course under section #cfgf7;f77#a7 of   
this title4  4  7e7 ,disapproval of     
courses ,section #cfgi of such title is 
amended by adding at the end the        
following new subsection3  7d7          
,notwithstanding any other provision of 
this chapter1 the ,secretary or the     
applicable ,state approving agency shall
 disapprove a course of education       
described in paragraph 7#ad7 or 7#ae7 of
 section #cfgf7;c7 of this title unless 
the educational institution providing   
the course of education--  7#a7 publicly
 discloses any conditions or additional 
requirements1 including training1       
experience1 or examinations1 required to
 obtain the license1 certification1 or  
approval for which the course of        
education is designed to provide        
preparation2 and  7#b7 makes each       
disclosure required by paragraph 7#a7 in
 a manner that the ,secretary considers 

prominent 7as specified by the          
,secretary in regulations prescribed for
 purposes of this subsection74  4  7f7  
,applicability ,if after enrollment in a
 course of education that is subject to 
disapproval by reason of an amendment   
made by this ,act1 an individual pursues
 one or more courses of education at the
 same educational institution while     
remaining continuously enrolled 7other  
than during regularly scheduled breaks  
between courses1 semesters1 or terms7 at
 that institution1 any course so pursued
 by the individual at that institution  
while so continuously enrolled shall not
 be subject to disapproval by reason of 
such amendment4  #dbf4 ,compliance      
surveys  7a7 ,in general ,section #cfic 
of title #ch1 ,united ,states ,code1 is 
amended-- 7#a7 by striking subsection   
7a7 and inserting the following new     
subsection 7a73  7a7 7#a7 ,except as    
provided in subsection 7b71 the         
,secretary shall conduct an annual      
compliance survey of educational        

institutions and training establishments
 offering one or more courses approved  
for the enrollment of eligible veterans 
or persons if at least #bj such veterans
 or persons are enrolled in any such    
course4  7#b7 ,the ,secretary shall--   
7,a7 design the compliance surveys      
required by paragraph 7#a7 to ensure    
that such institutions or establishments
 described in such paragraph1 as the    
case may be1 and approved courses are in
 compliance with all applicable         
provisions of chapters #cj through #cf  
of this title2  7,b7 survey each such   
educational institution and training    
establishment not less than once during 
every two-year period2 and  7,c7 assign 
not fewer than one education compliance 
specialist to work on compliance surveys
 in any year for each #dj compliance    
surveys required to be made under this  
section for such year4  7#c7 ,the       
,secretary1 in consultation with the    
,state approving agencies1 shall-- 7,a7 
annually determine the parameters of the

 surveys required under paragraph 7#a72 
and  7,b7 not later than ,september #a  
of each year1 make available to the     
,state approving agencies a list of the 
educational institutions and training   
establishments that will be surveyed    
during the fiscal year following the    
date of making such list available4  2  
and  7#b7 by adding at the end the      
following new subsection3  7c7 ,in this 
section1 the terms educational          
institution and training establishment  
have the meanings given such terms in   
section #cdeb of this title4  4  7b7    
,conforming amendments ,subsection 7b7  
of such section is amended-- 7#a7 by    
striking subsection 7a7 of this section 
for an annual compliance survey and     
inserting subsection 7a77#a7 for a      
compliance survey2  7#b7 by striking    
institution and inserting educational   
institution or training establishment2  
and  7#c7 by striking institution's     
demonstrated record of compliance and   
inserting record of compliance of such  

institution or establishment4  #dbg4    
,survey of individuals using their      
entitlement to educational assistance   
under the educational assistance        
programs administered by the ,secretary 
of ,veterans ,affairs  7a7 ,survey      
required  7#a7 ,in general ,by not later
 than #bgj days after the date of the   
enactment of this ,act1 the ,secretary  
of ,veterans ,affairs shall enter into a
 contract with a nongovernmental entity 
for the conduct of a survey of a        
statistically valid sample of           
individuals who have used or are using  
their entitlement to educational        
assistance under chapters #cj1 #cb1 #cc1
 and #ce of title #ch1 ,united ,states  
,code1 to pursue a program of education 
or training4  7#b7 ,contract            
requirements ,the contract shall provide
 that-- 7,a7 not later than one month   
before the collection of data under the 
survey begins1 the survey shall be      
submitted to the ,committee on          
,veterans' ,affairs of the ,senate and  

the ,committee on ,veterans' ,affairs of
 the ,house of ,representatives2  7,b7  
the nongovernmental entity shall        
complete the survey and submit to the   
,secretary the results of the survey by 
not later than #ahj days after entering 
into the contract2 and  7,c7 the survey 
shall be conducted by electronic means  
and by any other means the              
nongovernmental entity determines       
appropriate4  7b7 ,information ,to be   
collected ,the contract under subsection
 7a7 shall provide that the survey shall
 be designed to collect the following   
types of information about each         
individual surveyed1 where applicable3  
7#a7 ,demographic information1 including
 the highest level of education         
completed by the individual1 the        
military occupational specialty or      
specialties of the individual while     
serving on active duty as a member of   
the ,armed ,forces or as a member of the
 ,national ,guard or of a ,reserve      
,component of the ,armed ,forces1 and   

whether the individual has a            
service-connected disability4  7#b7 ,the
 opinion of the individual regarding    
participation in the transition         
assistance program under section #aadd  
of title #aj1 ,united ,states ,code1 and
 the effectiveness of the program1      
including instruction on the use of the 
benefits under laws administered by the 
,secretary of ,veterans ,affairs4  7#c7 
,the resources the individual used to   
help the individual-- 7,a7 decide to use
 the individual's entitlement to        
educational assistance to enroll in a   
program of education or training2 and   
7,b7 choose the program of education or 
training the individual pursued4  7#d7  
,the individual's goal when the         
individual enrolled in the program of   
education or training4  7#e7 ,the nature
 of the individual's experience with the
 education benefits processing system of
 the ,department of ,veterans ,affairs4 
7#f7 ,the nature of the individual's    
experience with the school certifying   

official of the educational institution 
where the individual pursued the program
 of education or training who processed 
the individual's claim4  7#g7 ,any      
services or benefits the educational    
institution or program of education or  
training provided to veterans while the 
individual pursued the program of       
education or training4  7#h7 ,the type  
of educational institution at which the 
individual pursued the program of       
education or training4  7#i7 ,whether   
the individual completed the program of 
education or training or the number of  
credit hours completed by the individual
 as of the time of the survey1 and1 if  
applicable1 any degree or certificate   
obtained by the individual for          
completing the program4  7#aj7 ,the     
employment status of the individual and 
whether such employment status differs  
from the employment status of the       
individual prior to enrolling in the    
program of education or training4  7#aa7
 ,whether the individual is or was      

enrolled in a program of education on a 
full-time or part-time basis4  7#ab7    
,the opinion of the individual on the   
effectiveness of the educational        
assistance program of the ,department of
 ,veterans ,affairs under which the     
individual was entitled to educational  
assistance4  7#ac7 ,whether the         
individual was ever entitled to a       
rehabilitation under chapter #ca of     
title #ch1 ,united ,states ,code1 and   
whether the individual participated in  
such a program4  7#ad7 ,a description of
 any circumstances that prevented the   
individual from using the individual's  
entitlement to educational assistance to
 pursue a desired career path or degree4
  7#ae7 ,whether the individual is using
 the individual's entitlement to        
educational assistance to pursue a      
program of education or training or has 
transferred such an entitlement to a    
dependent4  7#af7 ,such other matters as
 the ,secretary determines appropriate4 
7c7 ,report ,not later than #ij days    

after receiving the results of the      
survey required under this section1 the 
,secretary shall submit to the          
,committee on ,veterans' ,affairs of the
 ,senate and the ,committee on          
,veterans' ,affairs of the ,house of    
,representatives a report on the results
 of the survey and any recommendations  
of the ,secretary relating to such      
results4 ,such report shall also include
 an unedited version of the results of  
the survey submitted by the             
nongovernmental entity that conducted   
the survey4  #dbh4 ,technical amendment 
relating to in-,state tuition rate for  
individuals to whom entitlement is      
transferred under ,all-,volunteer ,force
 ,educational ,assistance ,program and  
,post-#i_/aa ,educational ,assistance   
7a7 ,technical amendment ,subparagraph  
7,b7 of section #cfgi7;c77#b7 of title  
#ch1 ,united ,states ,code1 is amended  
to read as follows3  7,b7 ,an individual
 who is entitled to assistance under--  
7i7 section #ccaa7;b77#i7 of this title2

 or  7ii7 section #ccai of this title by
 virtue of the individual's relationship
 to-- 7,i7 a veteran described in       
subparagraph 7,a72 or  7,,ii7 a member  
of the uniformed services described in  
section #ccai7;b7 of this title who is  
serving on active duty4  4  7b7         
,applicability ,the amendment made by   
subsection 7a7 shall apply with respect 
to a course1 semester1 or term that     
begins after ,july #a1 #bjag4  ,v       
,employment and transition  #eja4       
,required coordination between          
,directors for ,veterans' ,employment   
and ,training with ,state departments of
 labor and veterans affairs  7a7 ,in    
general ,section #dajc of title #ch1    
,united ,states ,code1 is amended by    
adding at the end the following new     
subsection3  7c7 ,coordination with     
,state departments of labor and veterans
 affairs ,each ,director for ,veterans' 
,employment and ,training for a ,state  
shall coordinate the ,director's        
activities under this chapter with the  

,state department of labor and the      
,state department of veterans affairs4  
4  7b7 ,effective date ,subsection 7c7  
of such section1 as added by subsection 
7a71 shall take effect on the date that 
is one year after the date of the       
enactment of this ,act4  #ejb4          
,longitudinal study of job counseling1  
training1 and placement service for     
veterans  7a7 ,in general ,chapter #da  
of title #ch1 ,united ,states ,code1 is 
amended by adding at the end the        
following new section3  #daae4          
,longitudinal study of job counseling1  
training1 and placement service for     
veterans  7a7 ,study required  7#a7 ,the
 ,secretary shall enter into a contract 
with a nongovernmental entity to conduct
 a longitudinal study of a statistically
 valid sample of each of the groups of  
individuals described in paragraph 7#b74
 ,the contract shall provide for the    
study of each such group over a period  
of at least five years4  7#b7 ,the      
groups of individuals described in this 

paragraph are the following3 7,a7       
,veterans who have received intensive   
services4  7,b7 ,veterans who did not   
receive intensive services but who      
otherwise received services under this  
chapter4  7,c7 ,veterans who did not    
seek or receive services under this     
chapter4  7#c7 ,the study required by   
this subsection shall include the       
collection1 for each individual who     
participates in the study1 of the       
following information3  7,a7 ,the       
average number of months such individual
 served on active duty4  7,b7 ,the      
disability ratings of such individual4  
7,c7 ,any unemployment benefits received
 by such individual4  7,d7 ,the average 
number of months such individual was    
employed during the year covered by the 
report4  7,e7 ,the average annual       
starting and ending salaries of any such
 individual who was employed during the 
year covered by the report4  7,f7 ,the  
average annual income of such           
individual4  7,g7 ,the average total    

household income of such individual for 
the year covered by the report4  7,h7   
,the percentage of such individuals who 
own their principal residences4  7,i7   
,the employment status of such          
individual4  7,j7 ,in the case of such  
an individual who received services     
under this chapter1 whether the         
individual believes that any service    
provided by a disabled veterans'        
outreach program specialist or local    
veterans' employment representative     
helped the individual to become         
employed4  7,k7 ,in the case of such an 
individual who believes such a service  
helped the individual to become         
employed1 whether--  7i7 the individual 
retained the position of employment for 
a period of one year or longer2 and     
7ii7 the individual believes such a     
service helped the individual to secure 
a higher wage or salary4  7,l7 ,the     
conditions under which such individual  
was discharged or released from the     
,armed ,forces4  7,m7 ,whether such     

individual has used any educational     
assistance to which the individual is   
entitled under this title4  7,n7        
,whether such individual has            
participated in a rehabilitation program
 under chapter #ca of this title4  7,o7 
,whether such individual had contact    
with a ,one-,stop ,career ,center       
employee while attending a workshop or  
job fair under the ,transition ,,gps    
,program of the ,department of ,defense4
  7,p7 ,demographic information about   
such individual4  7,q7 ,such other      
information as the ,secretary determines
 appropriate4  7b7 ,annual ,report  7#a7
 ,by not later than ,july #a of each    
year covered by the study required under
 subsection 7a71 the ,secretary shall   
submit to the ,committee on ,veterans'  
,affairs of the ,senate and the         
,committee on ,veterans' ,affairs of the
 ,house of ,representatives a report on 
the outcomes of the study during the    
preceding year4  7#b7 ,the ,secretary   
shall include in each report submitted  

under paragraph 7#a7 the following3 7,a7
 ,information with respect to job fairs 
attended by ,one-,stop ,career ,center  
employees at which the employees had    
contact with a veteran1 including1 for  
the year preceding the year in which the
 report is submitted1 the following3    
7i7 ,the number of job fairs attended by
 ,one-,stop ,career ,center employees at
 which the employees had contact with a 
veteran4  7ii7 ,the number of veterans  
contacted at each such job fair4  7,b7  
,such information as the ,secretary     
determines is necessary to determine the
 long-term outcomes of the individuals  
in the groups described in subsection   
7a77#b74  4  7b7 ,clerical amendment    
,the table of sections at the beginning 
of such chapter is amended by adding at 
the end the following new item3  #daae4 
,longitudinal study of job counseling1  
training1 and placement service for     
veterans4  4  ,,vi ,homeless veterans   
,a ,homeless matters generally  #fja4   
,expansion of definition of homeless    

veteran for purposes of benefits under  
the laws administered by the ,secretary 
of ,veterans ,affairs ,section #bjjb7a7 
of title #ch1 ,united ,states ,code1 is 
amended by striking in section #ajc7;a7 
of the ,mc,kinney-,vento ,homeless      
,assistance ,act 7#db ,u4,s4,c4         
#aacjb7;a77 and inserting in subsection 
7a7 or 7b7 of section #ajc of the       
,mc,kinney-,vento ,homeless ,assistance 
,act 7#db ,u4,s4,c4 #aacjb74  #fjb4     
,increased per diem payments for        
transitional housing assistance that    
becomes permanent housing for homeless  
veterans ,section #bjab7;a77#b7 of title
 #ch1 ,united ,states ,code1 is         
amended--  7#a7 by redesignating        
subparagraphs 7,b7 through 7,d7 as      
subparagraphs 7,c7 through 7,e71        
respectively2  7#b7 in subparagraph     
7,c71 as redesignated1 by striking in   
subparagraph 7,d7 and inserting in      
subparagraph 7,e72  7#c7 in subparagraph
 7,d71 as redesignated1 by striking     
under subparagraph 7,b7 and inserting   

under subparagraph 7,c72  7#d7 in       
subparagraph 7,e71 as redesignated1 by  
striking in subparagraphs 7,b7 and 7,c7 
and inserting in subparagraphs 7,c7 and 
7,d72 and  7#e7 in subparagraph 7,a7--  
7,a7 by striking ,the rate and inserting
 ,except as otherwise provided in       
subparagraph 7,b71 the rate2 and  7,b7  
by striking under subparagraph 7,b7 and 
all that follows through the end and    
inserting the following3 8under         
subparagraph 7,c74  7,b7 7i7 ,except as 
provided in clause 7ii71 in no case may 
the rate determined under this paragraph
 exceed the rate authorized for ,state  
homes for domiciliary care under        
subsection 7a77#a77;,a7 of section #agda
 of this title1 as the ,secretary may   
increase from time to time under        
subsection 7c7 of that section4  7ii7   
,in the case of services furnished to a 
homeless veteran who is placed in       
housing that will become permanent      
housing for the veteran upon termination
 of the furnishing of such services to  

such veteran1 the maximum rate of per   
diem authorized under this section is   
#aej percent of the rate authorized for 
,state homes for domiciliary care under 
subsection 7a77#a77;,a7 of section #agda
 of this title1 as the ,secretary may   
increase from time to time under        
subsection 7c7 of that section4  4      
#fjc4 ,clarification of eligibility for 
services under homeless veterans        
reintegration programs ,section         
#bjba7;a7 of title #ch1 ,united ,states 
,code1 is amended by striking           
reintegration of homeless veterans into 
the labor force4 and inserting the      
following3 reintegration into the labor 
force of--  7#a7 homeless veterans2     
7#b7 veterans participating in the      
,department of ,veterans ,affairs       
supported housing program for which     
rental assistance is provided pursuant  
to section #h7o77#ai7 of the ,united    
,states ,housing ,act of #aicg 7#db     
,u4,s4,c4 #adcg;f7o77#ai772  7#c7       
,native ,americans 7as defined in       

section #cgfe of this title7 who are    
veterans and receiving assistance under 
the ,native ,american ,housing          
,assistance and ,self ,determination    
,act of #aiif 7#be ,u4,s4,c4 #daja et   
seq472 and  7#d7 veterans who are       
transitioning from being incarcerated4  
4  #fjd4 ,program to improve retention  
of housing by formerly homeless veterans
 and veterans at risk of becoming       
homeless  7a7 ,program required  7#a7   
,in general ,subchapter ,,ii of chapter 
#bj of title #ch1 ,united ,states ,code1
 is amended--  7,a7 by redesignating    
section #bjac as section #bjad2 and     
7,b7 by inserting after section #bjab   
the following new section #bjac3  #bjac4
 ,program to improve retention of       
housing by formerly homeless veterans   
and veterans at risk of becoming        
homeless  7a7 ,program required ,the    
,secretary shall carry out a program    
under which the ,secretary shall provide
 case management services to improve the
 retention of housing by veterans who   

were previously homeless and are        
transitioning to permanent housing and  
veterans who are at risk of becoming    
homeless4  7b7 ,grants  7#a7 ,the       
,secretary shall carry out the program  
through the award of grants4  7#b7 7,a7 
,in awarding grants under paragraph     
7#a71 the ,secretary shall give priority
 to organizations that demonstrate a    
capability to provide case management   
services as described in subsection 7a71
 particularly organizations that are    
successfully providing or have          
successfully provided transitional      
housing services using amounts provided 
by the ,secretary under sections #bjab  
and #bjfa of this title4  7,b7 ,in      
giving priority under subparagraph 7,a71
 the ,secretary shall give extra        
priority to an organization described in
 such subparagraph that--  7i7          
voluntarily stops receiving amounts     
provided by the ,secretary under        
sections #bjab and #bjfa of this title2 
and  7ii7 converts a facility that the  

organization used to provide            
transitional housing services into a    
facility that the organization uses to  
provide permanent housing that meets    
housing quality standards established   
under section #h7o77#h77;,b7 of the     
,united ,states ,housing ,act of #aicg  
7#db ,u4,s4,c4 #adcg;f7o77#h77;,b774    
7,c7 ,in any case in which a facility1  
with respect to which a person received 
a grant for construction1               
rehabilitation1 or acquisition under    
section #bjaa of this title1 is         
converted as described in subparagraph  
7,b77ii71 such conversion shall be      
considered to have been carried out     
pursuant to the needs of the ,department
 and such person shall not be considered
 in noncompliance with the terms of such
 grant by reason of such conversion4  4 
7#b7 ,clerical amendment ,the table of  
sections at the beginning of chapter #bj
 of such title is amended by striking   
the item relating to section #bjac and  
inserting the following new items3      

#bjac4 ,program to improve retention of 
housing by formerly homeless veterans   
and veterans at risk of becoming        
homeless4#bjad4 ,authorization of       
appropriations4  4  7b7 ,regulations    
,not later than one year after the date 
of the enactment of this ,act1 the      
,secretary of ,veterans ,affairs shall  
prescribe regulations to carry out      
section #bjac of such title1 as added by
 subsection 7a77#a77;,b74  7c7 ,report  
7#a7 ,in general ,not later than ,june  
#a1 #bjbj1 the ,secretary shall submit  
to the ,committee on ,veterans' ,affairs
 of the ,senate and the ,committee on   
,veterans' ,affairs of the ,house of    
,representatives a report on the program
 required by section #bjac of such      
title1 as added by subsection           
7a77#a77;,b74  7#b7 ,contents ,the      
report submitted under paragraph 7#a7   
shall include assessments of the        
following3 7,a7 ,the percentage of      
veterans who received case management   
services under the program who were able

 to retain permanent housing by the end 
of the program1 disaggregated by each   
recipient of a grant under such section4
  7,b7 ,the percentage of veterans who  
received case management services under 
the program who were not in permanent   
housing at the end of the program1      
disaggregated by housing status and     
reason for failing to retain permanent  
housing under the program4  7,c7 ,the   
use by veterans1 who received case      
management services under the program1  
of housing assistance furnished by the  
,department of ,veterans ,affairs1      
including a comparison of the use of    
such assistance by such veterans before 
and after receiving such services4  7,d7
 ,an assessment of the employment status
 of veterans who received case          
management services under the program1  
including a comparison of the employment
 status of such veterans before and     
after receiving such services4  #fje4   
,pilot program on provision of intensive
 case management interventions to       

homeless veterans who receive the most  
health care from the ,department of     
,veterans ,affairs  7a7 ,pilot program  
required ,not later than ,september #a1 
#bjag1 the ,secretary of ,veterans      
,affairs shall commence a pilot program 
to assess the feasibility and           
advisability of providing intensive case
 management interventions to covered    
veterans4  7b7 ,covered veterans ,for   
purposes of the pilot program1 a covered
 veteran is a veteran who is enrolled   
in-- 7#a7 the homeless registry of the  
,department2 and  7#b7 the system of    
annual patient enrollment established   
and operated by the ,secretary under    
section #agje7;a7 of title #ch1 ,united 
,states ,code4  7c7 ,location  7#a7 ,in 
general ,the ,secretary shall carry out 
the pilot program at not fewer than six 
locations selected by the ,secretary for
 purposes of the pilot program as       
follows3  7,a7 ,not fewer than three    
locations in cities that have the       
largest populations of homeless veterans

 in the ,united ,states4  7,b7 ,not     
fewer than three locations in suburban  
or rural settings4  7#b7 ,interaction   
and coordination with community         
organizations ,in selecting locations   
under paragraph 7#a71 the ,secretary    
shall only select locations in areas in 
which the ,secretary determines that    
there is a high degree of interaction   
and coordination between the ,department
 and community organizations that       
provide housing and social services for 
veterans1 such as outreach1 employment1 
and financial assistance for homeless   
veterans1 veterans at risk of becoming  
homeless1 and low-income veterans4  7d7 
,provision of intensive case management 
interventions  7#a7 ,minimum number of  
veterans to receive interventions ,in   
carrying out the program at each        
location selected under subsection 7c71 
the ,secretary shall provide intensive  
case management interventions to not    
fewer than #bj covered veterans at each 
such location who the ,secretary        

determines are the covered veterans at  
such location who receive the most      
health care and related services        
furnished by the ,department of         
,veterans ,affairs4  7#b7 ,nature of    
interventions ,the intensive case       
management interventions provided to    
covered veterans under paragraph 7#a7   
shall include assistance with gaining   
and maintaining access to such housing  
and services1 including benefits and    
services to which covered veterans may  
be entitled or eligible under the laws  
administered by the ,secretary1 as may  
be necessary to improve the stability of
 their housing and the appropriateness  
of the health care that they receive4   
7e7 ,report  7#a7 ,in general ,not later
 than ,december #a1 #bjai1 the          
,secretary shall submit to the          
,committee on ,veterans' ,affairs of the
 ,senate and the ,committee on          
,veterans' ,affairs of the ,house of    
,representatives a report on the pilot  
program carried out under this section4 

7#b7 ,contents ,the report submitted    
under paragraph 7#a7 shall include      
assessments of the following3 7,a7 ,the 
types and frequencies of intensive case 
management interventions provided under 
the pilot program4  7,b7 ,the housing   
status of each veteran who received an  
intensive case management intervention  
under the pilot program4  7,c7 ,the     
employment status of each veteran who   
received an intensive case management   
intervention under the pilot program1   
including a comparison of the employment
 status of such veteran before and after
 receiving such intervention4  7,d7 ,the
 use by veterans who received intensive 
case management interventions under the 
pilot program of health care and related
 services furnished by the ,department  
of ,veterans ,affairs and the costs     
incurred by the ,department in          
furnishing such care and services1      
including a comparison of the use by    
such veterans of such care and services 
and the costs incurred from furnishing  

such care and services before and after 
receiving such interventions4  7,e7 ,the
 number of veterans who received        
intensive case management interventions 
under the pilot program1 disaggregated  
by whether the intensive case management
 intervention was provided in a location
 described in subparagraph 7,a7 or 7,b7 
of subsection 7c77#a74  7,f7 ,the costs 
incurred by the ,department in carrying 
out the pilot program1 disaggregated by 
provision of intensive case management  
interventions in locations described in 
subparagraphs 7,a7 and 7,b7 of such     
subsection4  7,g7 ,an estimate of the   
costs the ,department would have        
incurred for the provision of health    
care and associated services to covered 
veterans but for the provision of       
intensive case management interventions 
under the pilot program1 disaggregated  
by provision of intensive case          
management interventions in locations   
described in subparagraphs 7,a7 and 7,b7
 of subsection 7c77#a74  #fjf4          

,establishment of ,national ,center on  
,homelessness ,among ,veterans  7a7 ,in 
general ,subchapter ,,vii of chapter #bj
 of title #ch1 ,united ,states ,code1 is
 amended by adding at the end the       
following new section3  #bjfg4 ,national
 ,center on ,homelessness ,among        
,veterans  7a7 ,in general  7#a7 ,the   
,secretary shall establish and operate a
 center to carry out the functions      
described in subsection 7b74  7#b7 ,the 
center established under paragraph 7#a7 
shall be known as the ,national ,center 
on ,homelessness ,among ,veterans4  7#c7
 ,to the degree practicable1 the        
,secretary shall operate the center     
established under paragraph 7#a7        
independently of the other programs of  
the ,department that address            
homelessness among veterans4  7b7       
,functions ,the functions described in  
this subsection are as follows3 7#a7 ,to
 carry out and promote research into the
 causes and contributing factors to     
veteran homelessness4  7#b7 ,to assess  

the effectiveness of programs of the    
,department to meet the needs of        
homeless veterans4  7#c7 ,to identify   
and disseminate best practices with     
regard to housing stabilization1 income 
support1 employment assistance1         
community partnerships1 and such other  
matters as the ,secretary considers     
appropriate with respect to addressing  
veteran homelessness4  7#d7 ,to         
integrate evidence-based and best       
practices1 policies1 and programs into  
programs of the ,department for homeless
 veterans and veterans at risk of       
homelessness and to ensure that the     
staff of the ,department and community  
partners can implement such practices1  
policies1 and programs4  7#e7 ,to serve 
as a resource center for1 and promote   
and seek to coordinate the exchange of  
information regarding1 all research and 
training activities carried out by the  
,department and by other ,federal and   
non-,federal entities with respect to   
veteran homelessness4  4  7b7 ,clerical 

amendment ,the table of sections at the 
beginning of chapter #bj of such title  
is amended by inserting after the item  
relating to section #bjff the following 
new item3  #bjfg4 ,national ,center on  
,homelessness ,among ,veterans4  4      
#fjg4 ,administrative improvements to   
grant and per diem programs of          
,department of ,veterans ,affairs  7a7  
,in general ,section #bjab of title #ch1
 ,united ,states ,code1 is amended--    
7#a7 in subsection 7a77#a71 in the      
matter before subparagraph 7,a71 by     
inserting and except as otherwise       
provided in this section after such     
purpose2 and  7#b7 by adding at the end 
the following new subsection3  7e7      
,review and conditional renewal  7#a7   
,each year1 the ,secretary shall review 
each grant recipient and eligible entity
 that received a per diem payment under 
this section for a service furnished to 
a veteran during the one-year period    
preceding the review to evaluate the    
performance of the grant recipient or   

eligible entity during that period with 
respect to--  7,a7 the success of the   
grant recipient or eligible entity in   
assisting veterans to obtain1 transition
 into1 and retain permanent housing2 and
  7,b7 increasing the income of         
veterans1 whether by helping veterans   
obtain employment or by helping veterans
 obtain income-related benefits to which
 such veterans may be eligible or       
entitled4  7#b7 ,for any grant recipient
 or eligible entity whose performance   
was evaluated for a year under paragraph
 7#a71 the ,secretary may only provide  
per diem under this section to that     
grant recipient or eligible entity in   
the following year if the ,secretary    
determines that such performance merits 
continued receipt of per diem under this
 section4  7#c7 ,the ,secretary shall   
establish uniform performance targets   
throughout the ,united ,states for all  
grant recipients and eligible entities  
that receive per diem payments under    
this section for purposes of evaluating 

the performance of each such grant      
recipient and eligible entity under this
 subsection4  4  7b7 ,effective date    
7#a7 ,uniform performance targets ,not  
later than one year after the date of   
the enactment of this ,act1 the         
,secretary shall establish uniform      
performance targets pursuant to         
paragraph 7#c7 of section #bjab7;e7 of  
title #ch1 ,united ,states ,code1 as    
added by subsection 7a77#b74  7#b7      
,review of grant recipients and eligible
 entities ,the ,secretary shall complete
 the first review of each grant         
recipient and eligible entity pursuant  
to paragraph 7#a7 of such section1 as so
 added1 not later than two years after  
the date of the enactment of this ,act4 
#fjh4 ,partnerships with public and     
private entities to provide legal       
services to homeless veterans and       
veterans at risk of homelessness  7a7   
,in general ,chapter #bj of title #ch1  
,united ,states ,code1 is amended by    
inserting after section #bjbb the       

following new section3  #bjbb;,a4       
,partnerships with public and private   
entities to provide legal services to   
homeless veterans and veterans at risk  
of homelessness  7a7 ,partnerships      
authorized ,subject to the availability 
of funds for that purpose1 the          
,secretary may enter into partnerships  
with public or private entities1 through
 the award of grants or the use of      
cooperative agreements1 to fund a       
portion of the general legal services   
specified in subsection 7c7 that are    
provided by such entities to homeless   
veterans and veterans at risk of        
homelessness4  7b7 ,locations  7#a7 ,the
 ,secretary shall ensure that1 to the   
extent practicable1 partnerships under  
this section are made with entities     
equitably distributed across the        
geographic regions of the ,united       
,states1 including rural communities1   
tribal lands of the ,united ,states1    
,native ,americans1 and tribal          
organizations4  7#b7 ,in this           

subsection1 the terms ,native ,american 
and tribal organization have the        
meanings given such terms in section    
#cgfe of this title4  7c7 ,legal        
services ,legal services specified in   
this subsection include legal services  
provided by public or private entities  
that address the needs of homeless      
veterans and veterans at risk of        
homelessness1 such as the following3    
7#a7 ,legal services related to housing1
 including eviction defense and         
representation in landlord-tenant cases4
  7#b7 ,legal services related to family
 law1 including assistance in court     
proceedings for child support1 divorce1 
and estate planning4  7#c7 ,legal       
services related to income support1     
including assistance in obtaining public
 benefits4  7#d7 ,legal services related
 to criminal defense1 including defense 
in matters symptomatic of homelessness1 
such as outstanding warrants1 fines1 and
 driver's license revocation1 to reduce 
recidivism and facilitate the overcoming

 of reentry obstacles in employment or  
housing4  7d7 ,consultation ,in         
developing and carrying out partnerships
 under this section1 the ,secretary     
shall1 to the extent practicable1       
consult with public and private         
entities--  7#a7 for assistance in      
identifying and contacting organizations
 described in subsection 7c72 and  7#b7 
to coordinate appropriate outreach      
relationships with such organizations4  
7e7 ,reports ,the ,secretary may require
 entities that have entered into        
partnerships under this section to      
submit to the ,secretary periodic       
reports on legal services provided to   
homeless veterans and veterans at risk  
of homelessness pursuant to such        
partnerships4  4  7b7 ,clerical         
amendment ,the table of sections at the 
beginning of chapter #bj of such title  
is amended by adding after the item     
relating to section #bjbb the following 
new item3  #bjbb;,a4 ,partnerships with 
public and private entities to provide  

legal services to homeless veterans and 
veterans at risk of homelessness4  4    
#fji4 ,comptroller ,general of the      
,united ,states study on homeless       
veterans programs of ,department of     
,veterans ,affairs  7a7 ,in general ,not
 later than one year after the date of  
the enactment of this ,act1 the         
,comptroller ,general of the ,united    
,states shall--  7#a7 complete a study  
of programs of the ,department of       
,veterans ,affairs that provide         
assistance to homeless veterans2 and    
7#b7 submit to the ,committee on        
,veterans' ,affairs of the ,senate and  
the ,committee on ,veterans' ,affairs of
 the ,house of ,representatives a report
 on the findings of the ,comptroller    
,general with respect to the study      
required by paragraph 7#a74  7b7        
,elements ,the study required by        
subsection 7a77#a7 shall include the    
following3 7#a7 ,an assessment of       
whether programs described in subsection
 7a7 are meeting the needs of veterans  

who are eligible for assistance provided
 by such programs1 including any gaps or
 duplication in the provision of        
services4  7#b7 ,a review of recent     
efforts of the ,secretary of ,veterans  
,affairs to improve the privacy1 safety1
 and security of female veterans        
receiving assistance from such programs4
  #faj4 ,requirement for ,department of 
,veterans ,affairs to assess            
comprehensive service programs for      
homeless veterans  7a7 ,in general ,not 
later than one year after the date of   
the enactment of this ,act1 the         
,secretary of ,veterans ,affairs shall--
  7#a7 assess and measure the capacity  
of programs for which entities receive  
grants under section #bjaa of title #ch1
 ,united ,states ,code1 or per diem     
payments under section #bjab or #bjfa of
 such title2 and  7#b7 assess such      
programs with respect to-- 7,a7 how well
 they achieve their stated goals at a   
national level2  7,b7 placements in     
permanent housing2  7,c7 placements in  

employment2 and  7,d7 increases in the  
regular income of participants in the   
programs4  7b7 ,assessment at national  
and local levels ,in assessing and      
measuring under subsection 7a77#a71 the 
,secretary shall develop and use tools  
to examine the capacity of programs     
described in such subsection at both the
 national and local level in order to   
assess the following3  7#a7 ,whether    
sufficient capacity exists to meet the  
needs of homeless veterans in each      
geographic area4  7#b7 ,whether existing
 capacity meets the needs of the        
subpopulations of homeless veterans     
located in each geographic area4  7#c7  
,the amount of capacity that recipients 
of grants under sections #bjaa and #bjfa
 and per diem payments under section    
#bjab of such title have to provide     
services for which the recipients are   
eligible to receive per diem under      
section #bjab7;a77#b77;,b77ii7 of title 
#ch1 ,united ,states ,code1 as added by 
section #fjb7e77;,b74  7c7              

,consideration of other resources ,in   
assessing and measuring programs under  
subsection 7a77#a71 the ,secretary shall
 consider the availability to such      
programs of resources made available to 
such programs and to homeless veterans1 
including resources provided by the     
,department of ,veterans ,affairs and by
 entities other than the ,department4   
7d7 ,use of information ,the ,secretary 
shall use the information collected     
under this section as follows3  7#a7 ,to
 set specific goals to ensure that      
programs described in subsection 7a7 are
 effectively serving the needs of       
homeless veterans4  7#b7 ,to assess     
whether programs described in subsection
 7a7 are meeting goals set under        
paragraph 7#a74  7#c7 ,to inform funding
 allocations for programs described in  
subsection 7a74  7#d7 ,to improve the   
referral of homeless veterans to        
programs described in subsection 7a74   
7e7 ,report ,not later than #ahj days   
after the date on which the assessment  

required by subsection 7a7 is completed1
 the ,secretary shall submit to the     
,committee on ,veterans' ,affairs of the
 ,senate and the ,committee on          
,veterans' ,affairs of the ,house of    
,representatives a report on such       
assessment and such recommendations for 
legislative and administrative action as
 the ,secretary may have to improve the 
programs and per diem payments described
 in subsection 7a74  #faa4 ,report on   
outreach relating to increasing the     
amount of housing available to veterans 
,not later than one year after the date 
of the enactment of this ,act1 the      
,secretary of ,veterans ,affairs shall  
submit to the ,committee on ,veterans'  
,affairs of the ,senate and the         
,committee on ,veterans' ,affairs of the
 ,house of ,representatives a report    
describing and assessing the outreach   
conducted by the ,secretary to realtors1
 landlords1 property management         
companies1 and developers to educate    
them about the housing needs of veterans

 and the benefits of having veterans as 
tenants4  ,b ,eligibility of homeless   
veterans for benefits  #fba4 ,waiver of 
minimum period of continuous active duty
 in ,armed ,forces for certain benefits 
for homeless veterans ,section          
#ecjc;,a7b77#c7 of title #ch1 ,united   
,states ,code1 is amended-- 7#a7 by     
redesignating subparagraphs 7,f7 and    
7,g7 as subparagraphs 7,g7 and 7,h71    
respectively2 and  7#b7 by inserting    
after subparagraph 7,e7 the following   
new subparagraph 7,f73  7,f7 to benefits
 under section #bjaa1 #bjab1 #bjac1     
#bjdd1 or #bjfa of this title2  4  #fbb4
 ,authorization to furnish certain      
benefits to homeless veterans with      
discharges or releases under other than 
honorable conditions ,section #ecjc7;d7 
of title #ch1 ,united ,states ,code1 is 
amended-- 7#a7 by striking not apply to 
any war-risk insurance and inserting the
 following3 8not apply to the following3
  7#a7 ,any war-risk insurance  2 and   
7#b7 by adding at the end the following 

new paragraph3  7#b7 ,benefits under    
section #bjaa1 #bjab1 #bjac1 #bjdd1 or  
#bjfa of this title 7except for benefits
 for individuals discharged or dismissed
 from the ,armed ,forces by reason of   
the sentence of a general               
court-martial74  4  #fbc4 ,modification 
of definition of veteran for purposes of
 providing certain benefits to homeless 
veterans ,section #bjjb of title #ch1   
,united ,states ,code1 is amended-- 7#a7
 by striking ,in this chapter and       
inserting 7a7 ,in general4--,in this    
chapter2 and  7#b7 by adding at the end 
the following3  7b7 ,veteran defined    
7#a7 ,notwithstanding section #aja7b7 of
 this title and except as provided in   
paragraph 7#b71 for purposes of sections
 #bjaa1 #bjab1 #bjac1 #bjdd1 and #bjfa  
of this title1 the term veteran means a 
person who served in the active         
military1 naval1 or air service1        
regardless of length of service1 and who
 was discharged or released therefrom4  
7#b7 ,for purposes of paragraph 7#a71   

the term veteran excludes a person who--
 7,a7 received a dishonorable discharge 
from the ,armed ,forces2 or  7,b7 was   
discharged or dismissed from the ,armed 
,forces by reason of the sentence of a  
general court-martial4  4  #fbd4        
,training of personnel of the           
,department of ,veterans ,affairs and   
grant recipients ,the ,secretary of     
,veterans ,affairs shall conduct a      
program of training and education to    
ensure that the following persons are   
aware of and implement this subtitle and
 the amendments made by this subtitle3  
7#a7 ,personnel of the ,department of   
,veterans ,affairs who are supporting or
 administering a program under chapter  
#bj of title #ch1 ,united ,states ,code4
  7#b7 ,recipients of grants or other   
amounts for purposes of carrying out    
such a program4  #fbe4 ,authorization of
 per diem payments for furnishing care  
to dependents of certain homeless       
veterans ,section #bjab7;a7 of title    
#ch1 ,united ,states ,code1 is amended  

by adding at the end the following new  
paragraph3  7#d7 ,services for which a  
recipient of a grant under section #bjaa
 of this title 7or an entity described  
in paragraph 7#a77 may receive per diem 
payments under this subsection may      
include furnishing care for a dependent 
of a homeless veteran who is under the  
care of such homeless veteran while such
 homeless veteran receives services from
 the grant recipient 7or entity74  4    
#fbf4 ,regulations ,not later than #bgj 
days after the date of the enactment of 
this ,act1 the ,secretary of ,veterans  
,affairs shall prescribe regulations1   
including such modifications to section 
#c4ab of title #ch1 ,code of ,federal   
,regulations 7or any successor          
regulation71 as the ,secretary considers
 appropriate1 to ensure that the        
,department of ,veterans ,affairs is in 
full compliance with this subtitle and  
the amendments made by this subtitle4   
#fbg4 ,effective date ,this subtitle and
 the amendments made by this subtitle   

shall apply to individuals seeking      
benefits under chapter #bj of title #ch1
 ,united ,states ,code1 before1 on1 and 
after the date of the enactment of this 
,act4  ,,vii ,united ,states ,court of  
,appeals for ,veterans ,claims  #gja4   
,extension of temporary increase in     
number of judges on ,united ,states     
,court of ,appeals for ,veterans ,claims
  7a7 ,in general ,subsection 7i77#b7 of
 section #gbec of title #ch1 ,united    
,states ,code1 is amended by striking   
,january #a1 #bjac and inserting        
,january #a1 #bjba4  7b7 ,report  7#a7  
,in general ,not later than ,june #cj1  
#bjbj1 the chief judge of the ,united   
,states ,court of ,appeals for ,veterans
 ,claims shall submit to the ,committee 
on ,veterans' ,affairs of the ,senate   
and the ,committee on ,veterans'        
,affairs of the ,house of               
,representatives a report on the        
temporary expansions of the ,court under
 section #gbec of title #ch1 ,united    
,states ,code4  7#b7 ,contents ,the     

report required by paragraph 7#a7 shall 
include the following3 7,a7 ,an         
assessment of the effect of the         
expansions on ensuring appeals are      
handled in a timely manner4  7,b7 ,a    
description of the ways in which the    
complexity levels of the appeals acted  
on by the ,court may have changed based 
on service during recent conflicts      
compared to those based on service from 
previous eras4  7,c7 ,a recommendation  
on whether the number of judges should  
be adjusted at the end of the temporary 
expansion period1 including statistics1 
projections1 trend analyses1 and other  
information to support the              
recommendation4  #gjb4 ,life insurance  
program relating to judges of ,united   
,states ,court of ,appeals for ,veterans
 ,claims  7a7 ,in general ,section #gbha
 of title #ch1 ,united ,states ,code1 is
 amended by adding at the end the       
following3  7j7 ,for purposes of chapter
 #hg of title #e1 a judge who is in     
regular active service and a judge who  

is retired under section #gbif of this  
title or under chapter #hc or #hd of    
title #e shall be treated as an employee
 described in section #hgja7;a77#e7 of  
title #e4  7k7 ,notwithstanding any     
other provision of law1 the ,court may  
pay on behalf of its judges1 who are age
 #fe or older1 any increase in the cost 
of ,federal ,employees' ,group ,life    
,insurance imposed after ,april #bd1    
#aiii1 including any expenses generated 
by such payments1 as authorized by the  
chief judge of the ,court in a manner   
consistent with such payment authorized 
by the ,judicial ,conference of the     
,united ,states pursuant to section     
#fjd7;a77#e7 of title #bh4  4  7b7      
,effective ,date ,the amendment made by 
subsection 7a7 shall apply with respect 
to any payment made on or after the     
first day of the first applicable pay   
period beginning on or after the date of
 the enactment of this ,act4  #gjc4     
,voluntary contributions to enlarge     
survivors' annuity ,section #gbig of    

title #ch1 ,united ,states ,code1 is    
amended by adding at the end the        
following new subsection3  7p7 7#a7 ,a  
covered judge who makes an election     
under subsection 7b7 may purchase1 in   
#c-month increments1 up to an additional
 year of service credit for each year of
 ,federal judicial service completed1   
under the terms set forth in this       
section4  7#b7 ,in this subsection1 the 
term covered judge means any of the     
following3 7,a7 ,a judge in regular     
active service4  7,b7 ,a retired judge  
who is a recall-eligible retired judge  
pursuant to subsection 7a7 of section   
#gbeg of this title4  7,c7 ,a retired   
judge who would be a recall-eligible    
retired judge pursuant to subsection 7a7
 of section #gbeg but for--  7i7 meeting
 the aggregate recall service           
requirements under subsection 7b77#c7 of
 such section2 or  7ii7 being           
permanently disabled as described by    
subsection 7b77#d7 of such section4  4  
#gjd4 ,selection of chief judge of      

,united ,states ,court of ,appeals for  
,veterans ,claims  7a7 ,in general      
,section #gbec7;d7 of title #ch1 ,united
 ,states ,code1 is amended-- 7#a7 in    
paragraph 7#a7--  7,a7 in subparagraph  
7,a71 by striking and2  7,b7 by         
redesignating subparagraph 7,b7 as      
subparagraph 7,c72 and  7,c7 by         
inserting after subparagraph 7,a7 the   
following new subparagraph 7,b73  7,b7  
have at least three years remaining in  
term of office2 and  2 and  7#b7 by     
amending paragraph 7#b7 to read as      
follows3  7#b7 7,a7 ,in any case in     
which there is no judge of the ,court in
 regular active service who meets the   
requirements under paragraph 7#a71 the  
judge of the ,court in regular active   
service who is senior in commission and 
meets subparagraph 7,a7 or 7,b7 and     
subparagraph 7,c7 of paragraph 7#a7     
shall act as the chief judge4  7,b7 ,in 
any case under subparagraph 7,a7 of this
 paragraph in which there is no judge of
 the ,court in regular active service   

who meets subparagraph 7,a7 or 7,b7 and 
subparagraph 7,c7 of paragraph 7#a71 the
 judge of the ,court in regular active  
service who is senior in commission and 
meets subparagraph 7,c7 shall act as the
 chief judge4  4  7b7 ,applicability    
,the amendments made by subsection 7a7  
shall apply with respect to the         
selection of a chief judge occurring on 
or after ,january #a1 #bjbj4  ,,viii    
,burial benefits  #hja4 ,expansion of   
eligibility for medallions ,section     
#bcjf7;d77#d7 of title #ch1 ,united     
,states ,code1 is amended to read as    
follows3  7#d7 7,a7 ,in lieu of         
furnishing a headstone or marker under  
this subsection to a deceased individual
 described in subparagraph 7,b71 the    
,secretary may furnish1 upon request1 a 
medallion or other device of a design   
determined by the ,secretary to signify 
the deceased individual's status as a   
veteran1 to be attached to a headstone  
or marker furnished at private expense4 
7,b7 ,a deceased individual described in

 this subsection is an individual who-- 
7i7 served in the ,armed ,forces on or  
after ,april #f1 #aiag2 and  7ii7 is    
eligible for a headstone or marker      
furnished under paragraph 7#a7 7or would
 be so eligible but for the date of the 
death of the individual74  4  #hjb4     
,inurnment of cremated remains in       
,arlington ,national ,cemetery of       
certain persons whose service is deemed 
to be active service  7a7 ,in general   
,section #bdaj of title #ch1 ,united    
,states ,code1 is amended by adding at  
the end the following new subsection3   
7c7 7#a7 ,the ,secretary of the ,army   
shall ensure that1 under such           
regulations as the ,secretary may       
prescribe1 the cremated remains of any  
person described in paragraph 7#b7 are  
eligible for above ground inurnment in  
,arlington ,national ,cemetery with     
military honors in accordance with      
section #adia of title #aj4  7#b7 ,a    
person described in this paragraph is a 
person whose service has been determined

 to be active duty service pursuant to  
section #dja of the ,,gi ,bill          
,improvement ,act of #aigg 7,public ,law
 #ie-bjb2 #ch ,u4,s4,c4 #ajf note7 as of
 the date of the enactment of this ,act4
  4  7b7 ,applicability  7#a7 ,in       
general ,the amendment made by          
subsection 7a7 shall apply with respect 
to-- 7,a7 the remains of a person that  
are not formally interred or inurned as 
of the date of the enactment of this    
,act2 and  7,b7 a person who dies on or 
after the date of the enactment of this 
,act4  7#b7 ,formally interred or       
inurned defined ,in this subsection1 the
 term formally interred or inurned means
 interred or inurned in a cemetery1     
crypt1 mausoleum1 columbarium1 niche1 or
 other similar formal location4  #hjc4  
,report on capacity of ,arlington       
,national ,cemetery ,not later than #ahj
 days after the date of the enactment of
 this ,act1 the ,secretary of the ,army 
shall submit to the ,committees on      
,veterans' ,affairs and the ,committees 

on ,armed ,services of the ,house of    
,representatives and the ,senate a      
report on the interment and inurnment   
capacity of ,arlington ,national        
,cemetery1 including--  7#a7 the        
estimated date that the ,secretary      
determines the cemetery will reach      
maximum interment and inurnment         
capacity2 and  7#b7 in light of the     
unique and iconic meaning of the        
cemetery to the ,united ,states1        
recommendations for legislative actions 
and nonlegislative options that the     
,secretary determines necessary to      
ensure that the maximum interment and   
inurnment capacity of the cemetery is   
not reached until well into the future1 
including such actions and options with 
respect to--  7,a7 redefining           
eligibility criteria for interment and  
inurnment in the cemetery2 and  7,b7    
considerations for additional expansion 
opportunities beyond the current        
boundaries of the cemetery4  #hjd4      
,department of ,veterans ,affairs study 

on matters relating to burial of        
unclaimed remains of veterans in        
national cemeteries  7a7 ,study and     
report required ,not later than one year
 after the effective date specified in  
subsection 7d71 the ,secretary of       
,veterans ,affairs shall--  7#a7        
complete a study on matters relating to 
the interring of unclaimed remains of   
veterans in national cemeteries under   
the control of the ,national ,cemetery  
,administration2 and  7#b7 submit to    
,congress a report on the findings of   
the ,secretary with respect to the study
 required under paragraph 7#a74  7b7    
,matters studied ,the matters studied   
under subsection 7a77#a7 shall include  
the following3 7#a7 ,determining the    
scope of issues relating to unclaimed   
remains of veterans1 including an       
estimate of the number of unclaimed     
remains of veterans4  7#b7 ,assessing   
the effectiveness of the procedures of  
the ,department of ,veterans ,affairs   
for working with persons or entities    

having custody of unclaimed remains to  
facilitate interment of unclaimed       
remains of veterans in national         
cemeteries under the control of the     
,national ,cemetery ,administration4    
7#c7 ,assessing ,state and local laws   
that affect the ability of the          
,secretary to inter unclaimed remains of
 veterans in national cemeteries under  
the control of the ,national ,cemetery  
,administration4  7#d7 ,developing      
recommendations for such legislative or 
administrative action as the ,secretary 
considers appropriate4  7c7 ,methodology
  7#a7 ,number of unclaimed remains ,in 
estimating the number of unclaimed      
remains of veterans under subsection    
7b77#a71 the ,secretary may review such 
subset of applicable entities as the    
,secretary considers appropriate1       
including a subset of funeral homes and 
coroner offices that possess unclaimed  
veterans remains4  7#b7 ,assessment of  
,state and local laws ,in assessing     
,state and local laws under subsection  

7b77#c71 the ,secretary may assess such 
sample of applicable ,state and local   
laws as the ,secretary considers        
appropriate in lieu of reviewing all    
applicable ,state and local laws4  7d7  
,effective date ,this section shall take
 effect on the date that is one year    
after the date of the enactment of this 
,act4  ,,ix ,other matters  #ija4       
,authority to enter into certain leases 
at the ,department of ,veterans ,affairs
 ,west ,los ,angeles ,campus  7a7 ,in   
general ,the ,secretary of ,veterans    
,affairs may carry out leases described 
in subsection 7b7 at the ,department of 
,veterans ,affairs ,west ,los ,angeles  
,campus in ,los ,angeles1 ,california   
7hereinafter in this section referred to
 as the ,campus74  7b7 ,leases described
 ,leases described in this subsection   
are the following3 7#a7 ,any            
enhanced-use lease of real property     
under subchapter ,v of chapter #ha of   
title #ch1 ,united ,states ,code1 for   
purposes of providing supportive        

housing1 as that term is defined in     
section #hafa7c7 of such title1 that    
principally benefit veterans and their  
families4  7#b7 ,any lease of real      
property for a term not to exceed #ej   
years to a third party to provide       
services that principally benefit       
veterans and their families and that are
 limited to one or more of the following
 purposes3  7,a7 ,the promotion of      
health and wellness1 including nutrition
 and spiritual wellness4  7,b7          
,education4  7,c7 ,vocational training1 
skills building1 or other training      
related to employment4  7,d7 ,peer      
activities1 socialization1 or physical  
recreation4  7,e7 ,assistance with legal
 issues and ,federal benefits4  7,f7    
,volunteerism4  7,g7 ,family support    
services1 including child care4  7,h7   
,transportation4  7,i7 ,services in     
support of one or more of the purposes  
specified in subparagraphs 7,a7 through 
7,h74  7#c7 ,a lease of real property   
for a term not to exceed #aj years to   

,the ,regents of the ,university of     
,california1 a corporation organized    
under the laws of the ,state of         
,california1 on behalf of its           
,university of ,california1 ,los        
,angeles 7,,ucla7 campus 7hereinafter in
 this section referred to as ,the       
,regents71 if--  7,a7 the lease is      
consistent with the master plan         
described in subsection 7g72  7,b7 the  
provision of services to veterans is the
 predominant focus of the activities of 
,the ,regents at the ,campus during the 
term of the lease2  7,c7 ,the ,regents  
expressly agrees to provide1 during the 
term of the lease and to an extent and  
in a manner that the ,secretary         
considers appropriate1 additional       
services and support 7for which ,the    
,regents is not compensated by the      
,secretary or through an existing       
medical affiliation agreement7 that--   
7i7 principally benefit veterans and    
their families1 including veterans who  
are severely disabled1 women1 aging1 or 

homeless2 and  7ii7 may consist of      
activities relating to the medical1     
clinical1 therapeutic1 dietary1         
rehabilitative1 legal1 mental1          
spiritual1 physical1 recreational1      
research1 and counseling needs of       
veterans and their families or any of   
the purposes specified in any of        
subparagraphs 7,a7 through 7,i7 of      
paragraph 7#b72 and  7,d7 ,the ,regents 
maintains records documenting the value 
of the additional services and support  
that ,the ,regents provides pursuant to 
subparagraph 7,c7 for the duration of   
the lease and makes such records        
available to the ,secretary4  7c7       
,limitation on ,land-,sharing           
,agreements ,the ,secretary may not     
carry out any land-sharing agreement    
pursuant to section #haec of title #ch1 
,united ,states ,code1 at the ,campus   
unless such agreement--  7#a7 provides  
additional health-care resources to the 
,campus2 and  7#b7 benefits veterans and
 their families other than from the     

generation of revenue for the           
,department of ,veterans ,affairs4  7d7 
,revenues from leases at the ,campus    
,any funds received by the ,secretary   
under a lease described in subsection   
7b7 shall be credited to the applicable 
,department medical facilities account  
and shall be available1 without fiscal  
year limitation and without further     
appropriation1 exclusively for the      
renovation and maintenance of the land  
and facilities at the ,campus4  7e7     
,easements  7#a7 ,in general            
,notwithstanding any other provision of 
law 7other than ,federal laws relating  
to environmental and historic           
preservation71 pursuant to section #habd
 of title #ch1 ,united ,states ,code1   
the ,secretary may grant easements or   
rights-of-way on1 above1 or under lands 
at the ,campus to--  7,a7 any local or  
regional public transportation authority
 to access1 construct1 use1 operate1    
maintain1 repair1 or reconstruct public 
mass transit facilities1 including1     

fixed guideway facilities and           
transportation centers2 and  7,b7 the   
,state of ,california1 ,county of ,los  
,angeles1 ,city of ,los ,angeles1 or any
 agency or political subdivision        
thereof1 or any public utility company  
7including any company providing        
electricity1 gas1 water1 sewage1 or     
telecommunication services to the       
public7 for the purpose of providing    
such public utilities4  7#b7            
,improvements ,any improvements proposed
 pursuant to an easement or right-of-way
 authorized under paragraph 7#a7 shall  
be subject to such terms and conditions 
as the ,secretary considers appropriate4
  7#c7 ,termination ,any easement or    
right-of-way authorized under paragraph 
7#a7 shall be terminated upon the       
abandonment or nonuse of the easement or
 right-of-way and all right1 title1 and 
interest in the land covered by the     
easement or right-of-way shall revert to
 the ,united ,states4  7f7 ,prohibition 
on sale of property ,notwithstanding    

section #hafd of title #ch1 ,united     
,states ,code1 the ,secretary may not   
sell or otherwise convey to a third     
party fee simple title to any real      
property or improvements to real        
property made at the ,campus4  7g7      
,consistency with master plan ,the      
,secretary shall ensure that each lease 
carried out under this section is       
consistent with the draft master plan   
approved by the ,secretary on ,january  
#bh1 #bjaf1 or successor master plans4  
7h7 ,compliance with certain laws  7#a7 
,laws relating to leases and land use   
,if the ,inspector ,general of the      
,department of ,veterans ,affairs       
determines1 as part of an audit report  
or evaluation conducted by the          
,inspector ,general1 that the           
,department is not in compliance with   
all ,federal laws relating to leases and
 land use at the ,campus1 or that       
significant mismanagement has occurred  
with respect to leases or land use at   
the ,campus1 the ,secretary may not     

enter into any lease or land-sharing    
agreement at the ,campus1 or renew any  
such lease or land-sharing agreement    
that is not in compliance with such     
laws1 until the ,secretary certifies to 
the ,committee on ,veterans' ,affairs of
 the ,senate1 the ,committee on         
,veterans' ,affairs of the ,house of    
,representatives1 and each ,member of   
the ,senate and the ,house of           
,representatives who represents the area
 in which the ,campus is located that   
all recommendations included in the     
audit report or evaluation have been    
implemented4  7#b7 ,compliance of       
particular leases ,except as otherwise  
expressly provided by this section1 no  
lease may be entered into or renewed    
under this section unless the lease     
complies with chapter #cc of title #da1 
,united ,states ,code1 and all ,federal 
laws relating to environmental and      
historic preservation4  7i7 ,community  
veterans engagement board  7#a7 ,in     
general ,not later than #ahj days after 

the date of the enactment of this ,act1 
the ,secretary shall establish a        
,community ,veterans ,engagement ,board 
7in this subsection referred to as the  
,board7 for the ,campus to coordinate   
locally with the ,department of         
,veterans ,affairs to--  7,a7 identify  
the goals of the community2 and  7,b7   
provide advice and recommendations to   
the ,secretary to improve services and  
outcomes for veterans1 members of the   
,armed ,forces1 and the families of such
 veterans and members4  7#b7 ,members   
,the ,board shall be comprised of a     
number of members that the ,secretary   
determines appropriate1 of which not    
less than #ej percent shall be veterans4
 ,the nonveteran members shall be family
 members of veterans1 veteran advocates1
 service providers1 or stakeholders4    
7#c7 ,community input ,in carrying out  
subparagraphs 7,a7 and 7,b7 of paragraph
 7#a71 the ,board shall-- 7,a7 provide  
the community opportunities to          
collaborate and communicate with the    

,board1 including by conducting public  
forums on the ,campus2 and  7,b7 focus  
on local issues regarding the           
,department that are identified by the  
community1 including with respect to    
health care1 benefits1 and memorial     
services at the ,campus4  7j7           
,notification and reports  7#a7         
,congressional notification ,with       
respect to each lease or land-sharing   
agreement intended to be entered into or
 renewed at the ,campus1 the ,secretary 
shall notify the ,committee on          
,veterans' ,affairs of the ,senate1 the 
,committee on ,veterans' ,affairs of the
 ,house of ,representatives1 and each   
,member of the ,senate and the ,house of
 ,representatives who represents the    
area in which the ,campus is located of 
the intent of the ,secretary to enter   
into or renew the lease or land-sharing 
agreement not later than #de days before
 entering into or renewing the lease or 
land-sharing agreement4  7#b7 ,annual   
report ,not later than one year after   

the date of the enactment of this ,act1 
and not less frequently than annually   
thereafter1 the ,secretary shall submit 
to the ,committee on ,veterans' ,affairs
 of the ,senate1 the ,committee on      
,veterans' ,affairs of the ,house of    
,representatives1 and each ,member of   
the ,senate and the ,house of           
,representatives who represents the area
 in which the ,campus is located an     
annual report evaluating all leases and 
land-sharing agreements carried out at  
the ,campus1 including--  7,a7 an       
evaluation of the management of the     
revenue generated by the leases2 and    
7,b7 the records described in subsection
 7b77#c77;,d74  7#c7 ,inspector ,general
 report  7,a7 ,in general ,not later    
than each of two years and five years   
after the date of the enactment of this 
,act1 and as determined necessary by the
 ,inspector ,general of the ,department 
of ,veterans ,affairs thereafter1 the   
,inspector ,general shall submit to the 
,committee on ,veterans' ,affairs of the

 ,senate1 the ,committee on ,veterans'  
,affairs of the ,house of               
,representatives1 and each ,member of   
the ,senate and the ,house of           
,representatives who represents the area
 in which the ,campus is located a      
report on all leases carried out at the 
,campus and the management by the       
,department of the use of land at the   
,campus1 including an assessment of the 
efforts of the ,department to implement 
the master plan described in subsection 
7g7 with respect to the ,campus4  7,b7  
,consideration of annual report ,in     
preparing each report required by       
subparagraph 7,a71 the ,inspector       
,general shall take into account the    
most recent report submitted to         
,congress by the ,secretary under       
paragraph 7#b74  7k7 ,rule of           
construction ,nothing in this section   
shall be construed as a limitation on   
the authority of the ,secretary to enter
 into other agreements regarding the    
,campus that are authorized by law and  

not inconsistent with this section4  7l7
 ,principally benefit veterans and their
 families defined ,in this section the  
term principally benefit veterans and   
their families1 with respect to services
 provided by a person or entity under a 
lease of property or land-sharing       
agreement--  7#a7 means services-- 7,a7 
provided exclusively to veterans and    
their families2 or  7,b7 that are       
designed for the particular needs of    
veterans and their families1 as opposed 
to the general public1 and any benefit  
of those services to the general public 
is distinct from the intended benefit to
 veterans and their families2 and  7#b7 
excludes services in which the only     
benefit to veterans and their families  
is the generation of revenue for the    
,department of ,veterans ,affairs4  7m7 
,conforming amendments  7#a7            
,prohibition on disposal of property    
,section #bbd7;a7 of the ,military      
,construction and ,veterans ,affairs and
 ,related ,agencies ,appropriations     

,act1 #bjjh 7,public ,law #aaj-afa2 #aba
 ,stat4 #bbgb7 is amended by striking   
,the ,secretary of ,veterans ,affairs   
and inserting ,except as authorized     
under the ,veterans ,first ,act1 the    
,secretary of ,veterans ,affairs4  7#b7 
,enhanced-use leases ,section #hafb7;c7 
of title #ch1 ,united ,states ,code1 is 
amended by inserting 1 other than an    
enhanced-use lease under the ,veterans  
,first ,act1 before shall be considered4
  #ijb4 ,restoration of prior reporting 
fee multipliers ,during the nine-year   
period beginning on ,september #bf1     
#bjaf1 the second sentence of subsection
 7c7 of section #cfhd of title #ch1     
,united ,states ,code1 shall be         
applied--  7#a7 by substituting #h for  
#ab2 and  7#b7 by substituting #ab for  
#ae4  #ijc4 ,repeal inapplicability of  
modification of basic allowance for     
housing to benefits under laws          
administered by ,secretary of ,veterans 
,affairs  7a7 ,repeal ,subsection 7b7 of
 section #fjd of the ,carl ,levin and   

,howard ,p4 ,buck ,mc,keon ,national    
,defense ,authorization ,act for ,fiscal
 ,year #bjae 7,public ,law #aac-bia2 #cg
 ,u4,s4,c4 #djc note7 is repealed4  7b7 
,effective date ,the amendment made by  
subsection 7a7 shall take effect on     
,january #a1 #bjaf4  #ijd4 ,observance  
of ,veterans ,day  7a7 ,two minutes of  
silence ,chapter #a of title #cf1       
,united ,states ,code1 is amended by    
adding at the end the following new     
section3  #ade4 ,veterans ,day ,the     
,president shall issue each year a      
proclamation calling on the people of   
the ,united ,states to observe two      
minutes of silence on ,veterans ,day in 
honor of the service and sacrifice of   
veterans throughout the history of the  
,united ,states1 beginning at--  7#a7   
#c3aa p4m4 ,atlantic standard time2     
7#b7 #b3aa p4m4 eastern standard time2  
7#c7 #a3aa p4m4 central standard time2  
7#d7 #ab3aa p4m4 mountain standard time2
  7#e7 #aa3aa a4m4 ,pacific standard    
time2  7#f7 #aj3aa a4m4 ,alaska standard

 time2 and  7#g7 #i3aa a4m4             
,hawaii-,aleutian standard time4  4  7b7
 ,clerical amendment ,the table of      
sections for chapter #a of title #cf1   
,united ,states ,code1 is amended by    
adding at the end the following new     
item3  #ade4 ,veterans ,day4  4  #ije4  
,honoring as veterans certain persons   
who performed service in the reserve    
components of the ,armed ,forces ,any   
person who is entitled under chapter    
#abbc of title #aj1 ,united ,states     
,code1 to retired pay for nonregular    
service or1 but for age1 would be       
entitled under such chapter to retired  
pay for nonregular service shall be     
honored as a veteran but shall not be   
entitled to any benefit by reason of    
this honor4  #ijf4 ,extension of        
requirement for collection of fees for  
housing loans guaranteed by ,secretary  
of ,veterans ,affairs ,section          
#cgbi7;b77#b7 of title #ch1 ,united     
,states ,code1 is amended-- 7#a7 in     
subparagraph 7,a7--  7,a7 in clause     

7iii71 by striking ,september #cj1 #bjbd
 and inserting ,october #a1 #bjbf2 and  
7,b7 in clause 7iv71 by striking        
,september #cj1 #bjbd and inserting     
,october #a1 #bjbf2  7#b7 in            
subparagraph 7,b7-- 7,a7 in clause 7i71 
by striking ,september #cj1 #bjbd and   
inserting ,october #a1 #bjbf2 and  7,b7 
in clause 7ii71 by striking ,september  
#cj1 #bjbd and inserting ,october #a1   
#bjbf2  7#c7 in subparagraph 7,c7--     
7,a7 in clause 7i71 by striking         
,september #cj1 #bjbd and inserting     
,october #a1 #bjbf2 and  7,b7 in clause 
7ii71 by striking ,september #cj1 #bjbd 
and inserting ,october #a1 #bjbf2 and   
7#d7 in subparagraph 7,d7-- 7,a7 in     
clause 7i71 by striking ,september #cj1 
#bjbd and inserting ,october #a1 #bjbf2 
and  7,b7 in clause 7ii71 by striking   
,september #cj1 #bjbd and inserting     
,october #a1 #bjbf4  ,may #af1          
#bjaf,reported without amendment