,,ii ,calendar ,no4 #dih #aafth ,,congress #b;d ,session ,s4 #ghe ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,march #ac1 #bjai,mr4 ,tester 7for himself1 ,mr4 ,moran1 ,ms4 ,baldwin1 ,ms4 ,stabenow1 ,mr4 ,kaine1 ,mr4 ,markey1 ,ms4 ,sinema1 ,ms4 ,hirono1 ,mr4 ,durbin1 ,mr4 ,casey1 ,ms4 ,harris1 ,mr4 ,udall1 ,mr4 ,blumenthal1 ,mr4 ,murphy1 ,mr4 ,warner1 ,mrs4 ,murray1 ,mrs4 ,feinstein1 ,mr4 ,menendez1 ,mr4 ,booker1 ,ms4 ,smith1 ,mr4 ,manchin1 ,ms4 ,klobuchar1 ,mr4 ,sanders1 ,ms4 ,duckworth1 ,mr4 ,peters1 ,mrs4 ,gillibrand1 ,mr4 ,merkley1 ,mr4 ,sullivan1 ,mr4 ,bennet1 ,ms4 ,hassan1 ,mr4 ,coons1 ,mr4 ,roberts1 ,mrs4 ,shaheen1 ,mr4 ,daines1 ,mr4 ,crapo1 ,mr4 ,boozman1 ,ms4 ,cortez ,masto1 ,mr4 ,cramer1 ,ms4 ,mc,sally1 ,mr4 ,cornyn1 ,ms4 ,rosen1 ,mr4 ,jones1 ,ms4 ,collins1 ,mrs4 ,blackburn1 ,mr4 ,rounds1 ,mr4 ,hoeven1 ,mr4 ,risch1 ,mr4 ,wyden1 ,ms4 ,murkowski1 ,mr4 ,wicker1 ,mr4 ,portman1 and ,mr4 ,heinrich7 introduced the following bill2 which was read twice and referred to the ,committee on ,veterans' ,affairs ,july #bg1 #bjbj,reported by ,mr4 ,moran1 with an amendment,strike out all after the enacting clause and insert the part printed in italic ,a ,,bill ,to improve mental health care provided by the ,department of ,veterans ,affairs1 and for other purposes4 #a4 ,short title2 table of contents 7a7 ,short title ,this ,act may be cited as the ,commander ,john ,scott ,hannon ,veterans ,mental ,health ,care ,improvement ,act of #bjai4 7b7 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents4,,title ,i--,improvement of transition of individuals to services from ,department of ,veterans ,affairs,sec4 #aja4 ,expansion of health care coverage for veterans4,sec4 #ajb4 ,grants for provision of transition assistance to former members of the ,armed ,forces transitioning to civilian life4,sec4 #ajc4 ,study of community-based transition assistance programs for former members of the ,armed ,forces4,sec4 #ajd4 ,modification of eligibility for care from ,department of ,veterans ,affairs for former members of the ,armed ,forces with other than honorable discharges and report on such care4,,title ,,ii--,suicide prevention,sec4 #bja4 ,grants for organizations providing mental health wellness services to veterans4,sec4 #bjb4 ,designation of buddy check week by ,department of ,veterans ,affairs4,sec4 #bjc4 ,post-traumatic growth partnerships4,sec4 #bjd4 ,progress of ,department of ,veterans ,affairs in meeting goals and objectives of ,national ,strategy for ,preventing ,veteran ,suicide4,sec4 #bje4 ,study on feasibility and advisability of providing certain complementary and integrative health services4,sec4 #bjf4 ,program to provide veterans access to complementary and integrative health services through animal therapy1 agri-therapy1 and outdoor sports therapy4,sec4 #bjg4 ,comptroller ,general report on management by ,department of ,veterans ,affairs of veterans at high risk for suicide4,,title ,,iii--,programs1 studies1 and guidelines on mental health,sec4 #cja4 ,program to provide veterans access to computerized cognitive behavioral therapy4,sec4 #cjb4 ,study on connection between living at high altitude and suicide risk factors among veterans4,sec4 #cjc4 ,establishment by ,department of ,veterans ,affairs and ,department of ,defense of clinical practice guidelines for comorbid mental health conditions4,sec4 #cjd4 ,update of clinical practice guidelines for assessment and management of patients at risk for suicide4,sec4 #cje4 ,precision medicine initiative of ,department of ,veterans ,affairs to identify and validate brain and mental health biomarkers4,sec4 #cjf4 ,preventative and complex data analysis by ,department of ,veterans ,affairs4,,title ,,iv--,oversight of mental health care and related services,sec4 #dja4 ,study on effectiveness of suicide prevention and mental health outreach programs of ,department of ,veterans ,affairs4,sec4 #djb4 ,oversight of mental health and suicide prevention media outreach conducted by ,department of ,veterans ,affairs4,sec4 #djc4 ,annual report on progress of ,department of ,veterans ,affairs in meeting goals and objectives of ,executive ,order #achbb4,sec4 #djd4 ,comptroller ,general management review of mental health and suicide prevention services of ,department of ,veterans ,affairs4,sec4 #dje4 ,comptroller ,general report on efforts of ,department of ,veterans ,affairs to integrate mental health care into primary care clinics4,sec4 #djf4 ,joint mental health programs by ,department of ,veterans ,affairs and ,department of ,defense4,,title ,v--,medical workforce,subtitle ,a--,improvement of mental health medical workforce,sec4 #eja4 ,treatment of psychologists4,sec4 #ejb4 ,staffing improvement plan for psychiatrists and psychologists of ,department of ,veterans ,affairs4,sec4 #ejc4 ,occupational series and staffing improvement plan for licensed professional mental health counselors and marriage and family therapists of ,department of ,veterans ,affairs4,sec4 #ejd4 ,staffing improvement plan for peer specialists of ,department of ,veterans ,affairs who are women4,sec4 #eje4 ,establishment of ,department of ,veterans ,affairs ,readjustment ,counseling ,service ,scholarship ,program4,sec4 #ejf4 ,comptroller ,general report on ,readjustment ,counseling ,service of ,department of ,veterans ,affairs4,sec4 #ejg4 ,expansion of reporting requirements on ,readjustment ,counseling ,service of ,department of ,veterans ,affairs4,sec4 #ejh4 ,studies on alternative work schedules for employees of ,veterans ,health ,administration4,sec4 #eji4 ,suicide prevention coordinators4,subtitle ,b--,direct hiring authorities for certain health care positions,sec4 #eba4 ,direct hiring authorities for certain health care positions4,,title ,,vi--,improvement of telehealth services,sec4 #fja4 ,expanded telehealth from ,department of ,veterans ,affairs4,sec4 #fjb4 ,implementation of national protocol for telehealth security and interfacing instructions4 ,i ,improvement of transition of individuals to services from ,department of ,veterans ,affairs #aja4 ,expansion of health care coverage for veterans 7a7 ,in general ,section #agaj7;a77#a7 of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in subparagraph 7,a71 by striking and at the end2 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 to any veteran during the one-year period following the discharge or release of the veteran from active military1 naval1 or air service2 and 4 7b7 ,patient enrollment system ,section #agje7;c7 of such title is amended by adding at the end the following new paragraph3 7#c7 ,nothing in this section shall be construed to prevent the ,secretary from providing hospital care and medical services to a veteran under section #agaj7;a77#a77;,b7 of this title during the period specified in such section notwithstanding the failure of the veteran to enroll in the system of patient enrollment established by the ,secretary under subsection 7a74 4 7c7 ,promotion of expanded eligibility 7#a7 ,transition ,assistance ,program 7,a7 ,in general ,the ,secretary of ,labor1 in consultation with the ,secretary of ,defense and the ,secretary of ,veterans ,affairs1 shall promote to members of the ,armed ,forces transitioning from service in the ,armed ,forces to civilian life through the ,transition ,assistance ,program the expanded eligibility of veterans for health care under the laws administered by the ,secretary of ,veterans ,affairs pursuant to the amendments made by this section4 7,b7 ,transition ,assistance ,program defined ,in this paragraph1 the term ,transition ,assistance ,program means the ,transition ,assistance ,program under sections #aadb and #aadd of title #aj1 ,united ,states ,code4 7#b7 ,publication by ,department of ,veterans ,affairs ,not later than #cj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall publish on a website of the ,department of ,veterans ,affairs notification of the expanded eligibility of veterans for health care under the laws administered by the ,secretary pursuant to the amendments made by this section4 #ajb4 ,grants for provision of transition assistance to former members of the ,armed ,forces transitioning to civilian life 7a7 ,program required ,commencing not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,labor shall1 in coordination with the ,secretary of ,veterans ,affairs1 carry out a program on the provision of assistance to former members of the ,armed ,forces1 and spouses of such members1 transitioning from service in the ,armed ,forces to civilian life4 7b7 ,duration of program ,the ,secretary of ,labor shall carry out the program during the five-year period beginning on the date of the commencement of the program4 7c7 ,grants 7#a7 ,in general ,the ,secretary shall carry out the program through the award of grants to eligible organizations for the provision of assistance described in subsection 7a74 7#b7 ,matching funds required ,a grant under this section shall be in an amount that does not exceed #ej percent of the amount required by the organization to provide the services described in subsection 7f74 7d7 ,eligible organizations ,for purposes of this section1 an eligible organization is any nonprofit organization that the ,secretary of ,labor determines1 in consultation with the ,secretary of ,veterans ,affairs and ,state entities that serve veterans1 is suitable for receipt of a grant under the program pursuant to receipt by the ,secretary of ,labor of an application submitted under subsection 7e77#a74 7e7 ,selection of grant recipients 7#a7 ,applications ,an organization seeking a grant under the program shall submit to the ,secretary of ,labor an application therefor at such time1 in such manner1 and containing such information and assurances as the ,secretary1 in consultation with the ,secretary of ,veterans ,affairs and ,state entities that serve veterans1 may require4 7#b7 ,priority for hubs of services ,in awarding grants under the program1 the ,secretary of ,labor shall give priority to an organization that provides multiple forms of services described in subsection 7f74 7f7 ,use of grant funds ,each organization receiving a grant under the program shall use the grant to provide to former members of the ,armed ,forces and spouses described in subsection 7a7 the following3 7#a7 ,rsum assistance4 7#b7 ,interview training4 7#c7 ,job recruitment training4 7#d7 ,entrepreneurship training4 7#e7 ,financial services4 7#f7 ,legal assistance4 7#g7 ,educational supportive services4 7#h7 ,assistance with accessing benefits provided under laws administered by the ,secretary of ,veterans ,affairs1 including home loan benefits1 education benefits1 adaptive housing grants1 and all other benefits4 7#i7 ,nonclinical case management4 7#aj7 ,other related services leading directly to successful transition1 as determined by the ,secretary of ,labor in consultation with the ,secretary of ,veterans ,affairs4 7g7 ,annual reports 7#a7 ,in general ,not later than one year after the date of the commencement of the program and not less frequently than once each year thereafter until the termination of the program1 the ,secretary of ,labor shall1 in consultation with the ,secretary of ,veterans ,affairs1 submit to the appropriate committees of ,congress a report on the program carried out under this section4 7#b7 ,contents ,each report submitted under paragraph 7#a7 shall include the following3 7,a7 ,a list of the organizations that have received grants under the program1 including the geographic location of the organization and the types of services outlined in subsection 7f7 that each organization provides4 7,b7 ,the number of veterans served by each organization4 7,c7 ,an assessment of the effectiveness of the services provided under the program at improving the transition process for former members of the ,armed ,forces and spouses described in subsection 7a71 based on metrics determined by the ,secretary of ,labor in consultation with the ,secretary of ,veterans ,affairs4 7,d7 ,the amount of each grant awarded to each organization under the program4 7,e7 ,such other matters as the ,secretary of ,labor1 in consultation with the ,secretary of ,veterans ,affairs1 considers appropriate4 7#c7 ,appropriate committees of ,congress ,in this subsection1 the term appropriate committees of ,congress means-- 7,a7 the ,committee on ,veterans' ,affairs and the ,committee on ,appropriations of the ,senate2 and 7,b7 the ,committee on ,veterans' ,affairs and the ,committee on ,appropriations of the ,house of ,representatives4 7h7 ,authorization of appropriations ,there is authorized to be appropriated #aj1jjj1jjj to carry out this section4 #ajc4 ,study of community-based transition assistance programs for former members of the ,armed ,forces 7a7 ,study 7#a7 ,in general ,the ,secretary of ,veterans ,affairs shall1 in consultation with the ,secretary of ,labor and ,state entities that serve former members of the ,armed ,forces1 enter into an agreement with a ,federal or non-,federal entity to develop or access a comprehensive list of community-based programs that-- 7,a7 provide transition assistance to such former members that lead directly to successful transition to civilian life1 such as-- 7i7 rsum assistance2 7ii7 interview training2 7iii7 job recruitment training2 7iv7 entrepreneurship training2 7v7 financial services2 7vi7 legal assistance2 7vii7 educational supportive services2 7viii7 assistance with accessing benefits provided under laws administered by the ,secretary of ,veterans ,affairs1 including home loan benefits1 education benefits1 adaptive housing grants1 and other benefits2 and 7ix7 nonclinical case management2 and 7,b7 are operated by nonprofit organizations4 7#b7 ,updates 7,a7 ,periodic ,not less frequently than once every five years1 the ,secretary shall update the list created under paragraph 7#a74 7,b7 ,upon request ,in addition to periodic updates under subparagraph 7,a71 the ,secretary shall update the list created under paragraph 7#a7 upon request of an organization with a program included in the list4 7,c7 ,verification ,the ,secretary shall1 in consultation with ,state entities that serve former members of the ,armed ,forces and to the degree practicable1 verify changes to the list made under this paragraph4 7b7 ,transmission to members ,the ,secretary shall transmit the list created1 and revised as the case may be1 under subsection 7a7 to the ,secretary of ,labor and the ,secretary of ,defense so the ,secretaries of the military departments may provide information in the list to members of the ,armed ,forces who participate in the ,transition ,assistance ,program under sections #aadb and #aadd of title #aj1 ,united ,states ,code4 7c7 ,online publication ,the ,secretary of ,veterans ,affairs shall publish the list created1 and revised as the case may be1 under subsection 7a7 on a public website of the ,department of ,veterans ,affairs4 #ajd4 ,modification of eligibility for care from ,department of ,veterans ,affairs for former members of the ,armed ,forces with other than honorable discharges and report on such care 7a7 ,eligibility ,subsection 7b77#b77;,b7 of section #agbj;,i of title #ch1 ,united ,states ,code1 is amended by striking a discharge by court martial and inserting a dismissal4 7b7 ,information ,subsection 7e7 of such section is amended-- 7#a7 in paragraph 7#c7-- 7,a7 in subparagraph 7,b71 by striking and at the end2 7,b7 in subparagraph 7,c71 by striking and at the end2 7,c7 by redesignating subparagraph 7,c7 as subparagraph 7,d72 and 7,d7 by inserting after subparagraph 7,b7 the following new subparagraph 7,c73 7,c7 is displayed prominently on a website of the ,department2 and 2 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 shall include outreach on ,internet search engines2 and 4 7c7 ,annual report ,subsection 7f7 of such section is amended-- 7#a7 in paragraph 7#a71 by striking ,not less frequently than once and inserting ,not later than ,february #ae2 and 7#b7 in paragraph 7#b7-- 7,a7 by redesignating subparagraph 7,c7 as subparagraph 7,f72 and 7,b7 by inserting after subsection 7,b7 the following new subparagraphs3 7,c7 ,the types of mental or behavioral health care needs treated under this section4 7,d7 ,the demographics of individuals being treated under this section1 including-- 7i7 age2 7ii7 era of service in the ,armed ,forces2 7iii7 branch of service in the ,armed ,forces2 and 7iv7 geographic location4 7,e7 ,the average number of visits for an individual for mental or behavioral health care under this section4 4 ,,ii ,suicide prevention #bja4 ,grants for organizations providing mental health wellness services to veterans 7a7 ,purpose ,the purpose of this section is to facilitate the provision of mental health services for veterans with mental health conditions who are receiving care outside of the ,department of ,veterans ,affairs4 7b7 ,grants 7#a7 ,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;,j4 ,financial assistance for mental health supportive services for veterans seeking mental health treatment 7a7 ,distribution of financial assistance 7#a7 ,the ,secretary shall provide financial assistance to eligible entities approved under this section to provide or coordinate the provision of mental health supportive services described in subsection 7b7 for a veteran with a mental health condition who is seeking mental health treatment4 7#b7 ,financial assistance under paragraph 7#a7 shall consist of the award of a grant to an approved eligible entity for each veteran described in paragraph 7#a7 for which the approved eligible entity is providing or coordinating the provision of mental health supportive services4 7#c7 7,a7 ,the ,secretary shall award grants under this section to each approved eligible entity that is providing or coordinating the provision of mental health supportive services under this section4 7,b7 ,the ,secretary may establish intervals of payment for the administration of grants under this section and establish a maximum amount to be awarded1 in accordance with the services being provided and the duration of such services4 7#d7 ,in providing financial assistance under paragraph 7#a71 the ,secretary shall give preference to entities providing or coordinating the provision of supportive mental health services for veterans with mental health conditions who face barriers in accessing mental health care services from the ,department4 7#e7 ,the ,secretary shall ensure that1 to the extent practicable1 financial assistance under this subsection is equitably distributed across geographic regions1 including rural communities and tribal lands4 7#f7 ,each entity receiving financial assistance under this section to provide mental health supportive services to a veteran with a mental health condition shall notify that veteran that such services are being paid for1 in whole or in part1 by the ,department4 7#g7 ,the ,secretary shall require entities receiving financial assistance under this section to submit a report to the ,secretary that describes the services provided or coordinated with such financial assistance4 7b7 ,mental health supportive services ,the mental health supportive services described in this subsection are services provided by an eligible entity or a subcontractor of an eligible entity that address the needs of veterans with mental health conditions1 including-- 7#a7 outreach services2 7#b7 case management services2 7#c7 assistance in obtaining any benefits from the ,department that the veteran may be eligible to receive1 including health care services1 vocational and rehabilitation counseling1 employment and training services1 and educational assistance2 and 7#d7 assistance in obtaining and coordinating the provision of other public benefits provided by any ,federal1 ,state1 or local agency1 or any other eligible entity1 including-- 7,a7 health care services 7including obtaining health insurance72 7,b7 daily living services2 7,c7 personal financial planning services2 7,d7 transportation services2 7,e7 income support services2 7,f7 fiduciary and representative payee services2 7,g7 legal services to assist the veteran with issues that interfere with the ability of the veteran to find and retain meaningful employment1 housing1 or benefits to which the veteran may be entitled2 7,h7 child care services2 7,i7 housing counseling2 and 7,j7 other services necessary for maintaining independent living4 7c7 ,application for financial assistance 7#a7 ,an eligible entity seeking financial assistance under subsection 7a7 shall submit to the ,secretary an application therefor in such form1 in such manner1 and containing such commitments and information as the ,secretary determines to be necessary to carry out this section4 7#b7 ,each application submitted by an eligible entity under paragraph 7#a7 shall contain-- 7,a7 a description of the mental health supportive services described in subsection 7b7 proposed to be provided by the eligible entity under this section and the identified needs for those services2 7,b7 a description of the types of veterans with a mental health condition proposed to be provided such services2 7,c7 an estimate of the number of veterans with a mental health condition proposed to be provided such services2 7,d7 evidence of the experience of the eligible entity in providing mental health supportive services to veterans with a mental health condition2 and 7,e7 a description of the managerial capacity of the eligible entity-- 7i7 to coordinate the provision of mental health supportive services with the provision of mental health services by the eligible entity or another organization2 7ii7 to assess continually the needs of veterans with a mental health condition for mental health supportive services2 7iii7 to coordinate the provision of mental health supportive services with the services of the ,department2 and 7iv7 to tailor supportive mental health services to the needs of veterans with a mental health condition4 7#c7 7,a7 ,the ,secretary shall establish criteria for the selection of eligible entities to be provided financial assistance under this section4 7,b7 ,criteria established under subparagraph 7,a7 with respect to an eligible entity shall include the following3 7i7 ,relevant accreditation as may be required by each ,state in which the eligible entity operates4 7ii7 ,experience coordinating care or providing treatment for veterans or members of the ,armed ,forces4 7d7 ,technical assistance 7#a7 ,the ,secretary shall provide training and technical assistance to eligible entities provided financial assistance under this section regarding the planning1 development1 and provision of mental health supportive services under this section4 7#b7 ,the ,secretary may provide the training described in paragraph 7#a7 directly or through grants or contracts with appropriate public or nonprofit private entities1 including through grants awarded under section #bjfd of this title4 7e7 ,collection of information ,to the extent practicable1 the ,secretary may collect information from an eligibility entity awarded a grant under this section relating to a mental health condition of a veteran for inclusion in the electronic health record of the ,department for such veteran for the sole purpose of improving care provided to such veteran4 7f7 ,funding ,from amounts appropriated to the ,department for medical services1 there shall be available to carry out subsections 7a71 7b71 and 7c7 the following3 7#a7 #e1jjj1jjj for fiscal year #bjba4 7#b7 #aj1jjj1jjj for fiscal year #bjbb4 7#c7 #ae1jjj1jjj for fiscal year #bjbc4 7g7 ,definitions ,in this section3 7#a7 ,the term eligible entity means any of the following3 7,a7 ,an incorporated private institution or foundation-- 7i7 no part of the net earnings of which inures to the benefit of any member1 founder1 contributor1 or individual2 7ii7 that has a governing board that is responsible for the operation of the mental health supportive services provided under this section2 and 7iii7 that is approved by the ,secretary with respect to financial responsibility4 7,b7 ,a for-profit limited partnership1 the sole general partner of which is an organization meeting the requirements of clauses 7i71 7ii71 and 7iii7 of subparagraph 7,a74 7,c7 ,a corporation wholly owned and controlled by an organization meeting the requirements of clauses 7i71 7ii71 and 7iii7 of subparagraph 7,a74 7,d7 ,a tribally designated housing entity 7as defined in section #d of the ,native ,american ,housing ,assistance and ,self-,determination ,act of #aiif 7#be ,u4,s4,c4 #dajc774 7#b7 ,the term veteran with a mental health condition means a veteran who has been diagnosed with1 or who is seeking treatment for1 one or more mental health conditions1 as determined by the ,secretary4 4 7#b7 ,clerical amendment ,the table of sections at the beginning of chapter #ag is amended by inserting after the item relating to section #agbj;,i the following new item3 #agbj;,j4 ,financial assistance for mental health supportive services for veterans seeking mental health treatment4 4 7c7 ,study on effectiveness of program 7#a7 ,in general ,the ,secretary of ,veterans ,affairs shall conduct a study on the effectiveness of the program of financial assistance under section #agbj;,j of title #ch1 ,united ,states ,code1 as added by subsection 7b71 in meeting the needs of veterans with a mental health condition1 as that term is defined in that section4 7#b7 ,comparison ,in conducting the study required by paragraph 7#a71 the ,secretary shall compare the results of the program described in that paragraph with other programs of the ,department of ,veterans ,affairs dedicated to the delivery of mental health services to veterans4 7#c7 ,criteria ,in making the comparison required by paragraph 7#b71 the ,secretary shall examine the following3 7,a7 ,the satisfaction of veterans targeted by the programs described in paragraph 7#b74 7,b7 ,the health status of such veterans4 7,c7 ,the mental wellness of such veterans4 7,d7 ,the degree to which such veterans are encouraged to engage in productive activity by such programs4 7,e7 ,the number of veterans using such programs1 disaggregated by-- 7i7 veterans who have received care from the ,department in the previous two years2 and 7ii7 veterans who have not received care from the ,department in the previous two years4 7,f7 ,the number of veterans who die by suicide while receiving services from an entity in receipt of a grant under the program of financial assistance under section #agbj;,j of title #ch1 ,united ,states ,code1 as added by subsection 7b71 or who die by suicide during the #ahj-;day period after receiving such services4 7#d7 ,report ,not later than ,december #ca1 #bjba1 and 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 on the results of the study required by paragraph 7#a74 7d7 ,effective date ,the ,secretary shall begin providing financial assistance under section #agbj;,j of title #ch1 ,united ,states ,code1 as added by subsection 7b71 not later than one year after the date of the enactment of this ,act4 #bjb4 ,designation of buddy check week by ,department of ,veterans ,affairs 7a7 ,in general ,the ,secretary of ,veterans ,affairs shall designate one week per year to organize outreach events and educate veterans on how to conduct peer wellness checks1 which shall be known as ,buddy ,check ,week4 7b7 ,events and education 7#a7 ,in general ,during ,buddy ,check ,week1 the ,secretary1 in consultation with organizations that represent veterans1 non-profits that serve veterans1 mental health experts1 members of the ,armed ,forces1 and such other entities and individuals as the ,secretary considers appropriate1 shall collaborate with organizations that represent veterans to provide educational opportunities for veterans to learn how to conduct peer wellness checks4 7#b7 ,training matters ,as part of the educational opportunities provided under paragraph 7#a71 the ,secretary shall provide the following3 7,a7 ,a script for veterans to use to conduct peer wellness checks that includes information on appropriate referrals to resources veterans might need4 7,b7 ,online and in-person training1 as appropriate1 on how to conduct a peer wellness check4 7,c7 ,opportunities for members of organizations that represent veterans to learn how to train individuals to conduct peer wellness checks4 7,d7 ,training for veterans participating in ,buddy ,check ,week on how to transfer a phone call directly to the ,veterans ,crisis ,line4 7,e7 ,resiliency training for veterans participating in ,buddy ,check ,week on handling a veteran in crisis4 7#c7 ,online materials ,all training materials provided under the educational opportunities under paragraph 7#a7 shall be made available on a website of the ,department4 7c7 ,outreach ,the ,secretary1 in collaboration with organizations that represent veterans1 may conduct outreach regarding educational opportunities under subsection 7b7 at-- 7#a7 public events where many veterans are expected to congregate2 7#b7 meetings of organizations that represent veterans2 7#c7 facilities of the ,department of ,veterans ,affairs2 and 7#d7 such other locations as the ,secretary1 in collaboration with organizations that represent veterans1 considers appropriate4 7d7 ,veterans ,crisis ,line plan 7#a7 ,in general ,the ,secretary shall ensure that the ,veterans ,crisis ,line has a plan for handling the potential increase of calls that may occur during ,buddy ,check ,week4 7#b7 ,submittal of plan ,the head of the ,veterans ,crisis ,line shall submit to the ,secretary a plan for how to handle excess calls during ,buddy ,check ,week1 which may include the following3 7,a7 ,additional hours for staff4 7,b7 ,the use of a backup call center4 7,c7 ,any other plan to ensure that calls from veterans in crisis are being answered in a timely manner by an individual trained at the same level as a ,veterans ,crisis ,line responder4 7e7 ,veterans crisis line defined ,in this section1 the term ,veterans ,crisis ,line means the toll-free hotline for veterans established under section #agbj;,f7h7 of title #ch1 ,united ,states ,code4 #bjc4 ,post-traumatic growth partnerships 7a7 ,in general ,the ,secretary of ,veterans ,affairs1 in consultation with the ,secretary of ,defense and the ,secretary of ,homeland ,security1 shall enter into partnerships with nonprofit mental health organizations to facilitate post-traumatic growth among veterans who have experienced trauma4 7b7 ,consultation ,before entering into a partnership under subsection 7a71 the ,secretary of ,veterans ,affairs shall consult with the ,national ,institute of ,mental ,health1 the ,national ,alliance on ,mental ,illness1 the ,american ,psychological ,association1 the ,posttraumatic ,growth ,research ,group1 and organizations that represent veterans4 7c7 ,selection of partners ,the ,secretary of ,veterans ,affairs shall ensure that each organization with which the ,secretary enters into a partnership under subsection 7a7 has a demonstrated history of success with programs to facilitate post-traumatic growth1 including-- 7#a7 long-term follow-up with veterans who have participated in such a program for not less than one year after completion of the program2 and 7#b7 sustained positive1 clinically significant outcomes for veterans who have participated in such a program for not less than #ahj days after completion of the program4 7d7 ,outcomes from partners ,the ,secretary of ,veterans ,affairs shall require each nonprofit mental health organization that enters into a partnership with the ,secretary under subsection 7a7 to submit to the ,secretary a description of the outcomes from such partnership1 including the following3 7#a7 ,the number of veterans who participate in programs of the organization to facilitate post-traumatic growth1 including the number of veterans who drop out before completion of the program4 7#b7 ,the types of mental or behavioral health conditions of veterans who participate in such programs4 7#c7 ,the percentage of veterans who experience significant post-traumatic growth4 7#d7 ,such other topics as the ,secretary may require to track post-traumatic growth4 7e7 ,post-,traumatic growth 7#a7 ,in general ,for purposes of this section1 post-traumatic growth means positive responses described in paragraph 7#c7 experienced after1 and often as a result of1 a traumatic event or a major life crisis4 7#b7 ,measurement of growth ,post-traumatic growth under this section shall be measured through self-reported scales1 use of the post-traumatic stress disorder checklist set forth in the most recent edition of the ,diagnostic and ,statistical ,manual of ,mental ,disorders published by the ,american ,psychiatric ,association1 and such other metrics as the ,secretary considers necessary4 7#c7 ,positive responses described ,positive responses described in this paragraph are positive responses in one or more areas of life1 including the following3 7,a7 ,an appreciation of and for life4 7,b7 ,improved relationships with others4 7,c7 ,realization of new possibilities in life4 7,d7 ,realization of personal strength4 7,e7 ,spiritual change4 7,f7 ,such other areas that the ,secretary1 in consultation with organizations specified in subsection 7b71 considers necessary4 #bjd4 ,progress of ,department of ,veterans ,affairs in meeting goals and objectives of ,national ,strategy for ,preventing ,veteran ,suicide 7a7 ,in general ,the ,secretary of ,veterans ,affairs shall develop metrics to track progress on each of the #ad goals and #dc objectives outlined in the ,national ,strategy for ,preventing ,veteran ,suicide1 #bjah-bjbh prepared by the ,office of ,mental ,health and ,suicide ,prevention of the ,department of ,veterans ,affairs4 7b7 ,metrics ,the metrics developed under subsection 7a7 shall include measures of both performance and effectiveness4 7c7 ,initial report 7#a7 ,in general ,not later than #ahj 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 that contains the metrics developed under subsection 7a74 7#b7 ,elements ,the report submitted under paragraph 7#a7 shall include the following3 7,a7 ,an explanation of why the metrics developed under subsection 7a7 were chosen4 7,b7 ,an assessment of how accurately those metrics will reflect the goals and objectives specified in such subsection4 7d7 ,annual report ,not later than one year after the submittal of the report under subsection 7b71 and 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-- 7#a7 an assessment of the progress of the ,department in meeting the goals and objectives specified in subsection 7a72 7#b7 a description of any action to be taken by the ,department if those goals and objectives are not being met2 7#c7 a description of any changes to those goals and objectives2 7#d7 an identification of any new programs or partnerships that have resulted from the implementation of the ,national ,strategy for ,preventing ,veteran ,suicide1 #bjah-bjbh2 7#e7 an assessment of the effectiveness of the ,national ,strategy for ,preventing ,veterans ,suicide1 #bjah-bjbh at reducing veteran suicide2 and 7#f7 such other topics as the ,secretary considers necessary4 #bje4 ,study on feasibility and advisability of providing certain complementary and integrative health services 7a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall complete a study on the feasibility and advisability of providing complementary and integrative health treatments described in subsection 7b7 at all facilities of the ,department of ,veterans ,affairs4 7b7 ,treatments described ,complementary and integrative health treatments described in this subsection shall consist of the following3 7#a7 ,yoga4 7#b7 ,meditation4 7#c7 ,acupuncture4 7#d7 ,chiropractic care4 7#e7 ,other treatments that show sufficient evidence of efficacy at treating mental or physical health conditions1 as determined by the ,secretary4 7c7 ,provision of treatment ,the ,secretary may provide complementary and integrative health treatments under this section at a facility of the ,department in person or by telehealth4 7d7 ,report ,not later than #ij days after the completion of the study 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 such study1 including-- 7#a7 the results of such study2 and 7#b7 such recommendations regarding the furnishing of complementary and integrative health treatments described in subsection 7b7 as the ,secretary considers appropriate4 #bjf4 ,program to provide veterans access to complementary and integrative health services through animal therapy1 agri-therapy1 and outdoor sports therapy 7a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall commence the conduct of a program to provide complementary and integrative health services described in subsection 7b7 to veterans from the ,department of ,veterans ,affairs or through the use of non-,department entities for the treatment of post-traumatic stress disorder1 depression1 anxiety1 or other conditions as determined by the ,secretary4 7b7 ,treatments described ,complementary and integrative health treatments described in this subsection shall consist of the following3 7#a7 ,equine therapy4 7#b7 ,other animal therapy4 7#c7 ,agri-therapy4 7#d7 ,outdoor sports therapy4 7c7 ,eligible veterans ,a veteran is eligible to participate in the program under this section if the veteran-- 7#a7 is enrolled in the system of patient enrollment of the ,department established and operated under section #agje7;a7 of title #ch1 ,united ,states ,code2 and 7#b7 has received health care under the laws administered by the ,secretary during the two-year period preceding the initial participation of the veteran in the program4 7d7 ,duration 7#a7 ,in general ,the ,secretary shall carry out the program under this section for a two-year period beginning on the commencement of the program4 7#b7 ,extension ,the ,secretary may extend the duration of the program under this section if the ,secretary1 based on the results of the interim report submitted under subsection 7e77#a71 determines that it is appropriate to do so4 7e7 ,locations 7#a7 ,in general ,the ,secretary shall select not fewer than five facilities of the ,department at which to carry out the program under this section4 7#b7 ,selection criteria ,in selecting facilities under paragraph 7#a71 the ,secretary shall ensure that-- 7,a7 the locations are in geographically diverse areas2 and 7,b7 not fewer than three facilities serve veterans in rural or highly rural areas 7as determined through the use of the ,rural-,urban ,commuting ,areas coding system of the ,department of ,agriculture74 7f7 ,reports 7#a7 ,interim report 7,a7 ,in general ,not later than one year after the commencement of the program 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 progress of the program4 7,b7 ,elements ,the report required by subparagraph 7,a7 shall include the following3 7i7 ,the number of participants in the program4 7ii7 ,the types of therapy offered at each facility at which the program is being carried out4 7iii7 ,an assessment of whether participation by a veteran in the program resulted in any changes in clinically relevant endpoints for the veteran with respect to the conditions specified in subsection 7a74 7iv7 ,an assessment of the quality of life of veterans participating in the program1 including the results of a satisfaction survey of the participants in the program1 disaggregated by treatment under subsection 7b74 7v7 ,the determination of the ,secretary with respect to extending the program under subsection 7c77#b74 7vi7 ,any recommendations of the ,secretary with respect to expanding the program4 7#b7 ,final report ,not later than #ij days after the termination of the program 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 final report on the program4 #bjg4 ,comptroller ,general report on management by ,department of ,veterans ,affairs of veterans at high risk for suicide 7a7 ,in general ,not later than #ah months 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 efforts of the ,department of ,veterans ,affairs to manage veterans at high risk for suicide4 7b7 ,elements ,the report required by subsection 7a7 shall include the following3 7#a7 ,a description of how the ,department identifies patients as high risk for suicide1 with particular consideration to the efficacy of inputs into the ,recovery ,engagement and ,coordination for ,health - ,veterans ,enhanced ,treatment program 7commonly referred to as the ,,reach ,,vet program7 of the ,department1 including an assessment of the efficacy of such identifications disaggregated by age1 gender1 ,veterans ,integrated ,service ,network1 and1 to the extent practicable1 medical center of the ,department4 7#b7 ,a description of how the ,department intervenes when a patient is identified as high risk1 including an assessment of the efficacy of such interventions disaggregated by age1 gender1 ,veterans ,integrated ,service ,network1 and1 to the extent practicable1 medical center of the ,department4 7#c7 ,a description of how the ,department monitors patients who have been identified as high risk1 including an assessment of the efficacy of such monitoring and any follow-ups disaggregated by age1 gender1 ,veterans ,integrated ,service ,network1 and1 to the extent practicable1 medical center of the ,department4 7#d7 ,a review of staffing levels of suicide prevention coordinators across the ,veterans ,health ,administration4 7#e7 ,a review of the resources and programming offered to family members and friends of veterans who have a mental health condition in order to assist that veteran in treatment and recovery4 7#f7 ,an assessment of such other areas as the ,comptroller ,general considers appropriate to study4 ,,iii ,programs1 studies1 and guidelines on mental health #cja4 ,program to provide veterans access to computerized cognitive behavioral therapy 7a7 ,in general ,not later than #baj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall commence the conduct of a program to assess the feasibility and advisability of using computerized cognitive behavioral therapy to treat eligible veterans suffering from depression1 anxiety1 post-traumatic stress disorder1 military sexual trauma1 or substance use disorder who are already receiving evidence-based therapy from the ,department of ,veterans ,affairs4 7b7 ,eligible veterans ,a veteran is eligible to participate in the program under this section if the veteran-- 7#a7 is enrolled in the system of patient enrollment of the ,department of ,veterans ,affairs established and operated under section #agje7;a7 of title #ch1 ,united ,states ,code2 and 7#b7 has received health care under the laws administered by the ,secretary during the two-year period preceding the initial participation of the veteran in the program4 7c7 ,duration ,the ,secretary shall carry out the program under this section for a two-year period beginning on the commencement of the program4 7d7 ,locations 7#a7 ,in general ,the ,secretary shall select not fewer than three facilities of the ,department of ,veterans ,affairs at which to carry out the program under this section4 7#b7 ,selection criteria ,in selecting facilities under paragraph 7#a71 the ,secretary shall ensure that-- 7,a7 the locations are in geographically diverse areas2 and 7,b7 not fewer than two facilities serve veterans in rural or highly rural areas 7as determined through the use of the ,rural-,urban ,commuting ,areas coding system of the ,department of ,agriculture74 7e7 ,access to chat ,in carrying out the program under this section1 the ,secretary shall ensure that veterans participating in the program have access via chat to a mental health provider #bd hours per day1 seven days per week4 7f7 ,promotion of ,veterans ,crisis ,line ,the ,secretary shall promote the availability of the ,veterans ,crisis ,line to veterans participating in the program under this section4 7g7 ,department website ,in implementing the program under this section1 the ,secretary1 to the extent feasible1 shall use a website of the ,department of ,veterans ,affairs to host the program4 7h7 ,reports 7#a7 ,interim report 7,a7 ,in general ,not later than one year after the commencement of the program 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 progress of the program4 7,b7 ,elements ,the report required by subparagraph 7,a7 shall include the following3 7i7 ,the number of participants in the program4 7ii7 ,an assessment of whether participation by a veteran in the program resulted in any changes in clinically relevant endpoints for the veteran with respect to the conditions specified in subsection 7a74 7iii7 ,any recommendations of the ,secretary with respect to extending or expanding the program4 7#b7 ,final report ,not later than #ij days after the termination of the program 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 final report on the program4 7i7 ,veterans crisis line defined ,in this section1 the term ,veterans ,crisis ,line means the toll-free hotline for veterans established under section #agbj;,f7h7 of title #ch1 ,united ,states ,code4 #cjb4 ,study on connection between living at high altitude and suicide risk factors among veterans 7a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs1 in consultation with ,rural ,health ,resource ,centers of the ,office of ,rural ,health of the ,department of ,veterans ,affairs1 shall commence the conduct of a study on the connection between living at high altitude and the risk of developing depression or dying by suicide among veterans4 7b7 ,completion of study ,the study conducted under subsection 7a7 shall be completed not later than three years after the date of the commencement of the study4 7c7 ,individual impact ,the study conducted under subsection 7a7 shall be conducted so as to determine the effect of high altitude on suicide risk at the individual level1 not at the ,state or county level4 7d7 ,report ,not later than #aej days after the completion of the study conducted 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 results of the study4 7e7 ,follow-,up study 7#a7 ,in general ,if the ,secretary determines through the study conducted under subsection 7a7 that living at high altitude is a risk factor for developing depression or dying by suicide1 the ,secretary shall conduct an additional study to identify the following3 7,a7 ,the most likely biological mechanism that makes living at high altitude a risk factor for developing depression or dying by suicide4 7,b7 ,the most effective treatment or intervention for reducing the risk of developing depression or dying by suicide associated with living at high altitude4 7#b7 ,report ,not later than #aej days after completing the study conducted under paragraph 7#a71 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 study4 #cjc4 ,establishment by ,department of ,veterans ,affairs and ,department of ,defense of clinical practice guidelines for comorbid mental health conditions 7a7 ,in general ,not later than two years after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs1 in consultation with the ,secretary of ,defense and the ,secretary of ,health and ,human ,services1 shall complete the development of clinical practice guidelines for the treatment of post-traumatic stress disorder1 military sexual trauma1 and traumatic brain injury that is comorbid with substance use disorder or chronic pain4 7b7 ,work group 7#a7 ,establishment ,in carrying out subsection 7a71 the ,secretary of ,veterans ,affairs1 the ,secretary of ,defense1 and the ,secretary of ,health and ,human ,services shall create a ,trauma and ,comorbid ,substance ,use ,disorder or ,chronic ,pain ,work ,group 7in this section referred to as the ,work ,group74 7#b7 ,membership ,the work group created under paragraph 7#a7 shall be comprised of individuals that represent ,federal ,government entities and non-,federal ,government entities with expertise in the areas covered by the work group1 including the following3 7,a7 ,academic institutions that specialize in research for the treatment of conditions described in subsection 7a74 7,b7 ,the ,national ,center for ,posttraumatic ,stress ,disorder of the ,department of ,veterans ,affairs4 7,c7 ,the ,office of the ,assistant ,secretary for ,mental ,health and ,substance ,use of the ,department of ,health and ,human ,services4 7#c7 ,relation to other work groups ,the ,work ,group shall be created and conducted in the same manner as other work groups for the development of clinical practice guidelines for the ,department of ,veterans ,affairs and the ,department of ,defense4 7c7 ,matters included ,in developing the clinical practice guidelines under subsection 7a71 the ,work ,group1 in consultation with the ,post ,traumatic ,stress ,disorder ,work ,group1 ,concussion-m,t,b,i ,work ,group1 ,opioid ,therapy for ,chronic ,pain ,work ,group1 and ,substance ,use ,work ,group1 shall ensure that the clinical practice guidelines include the following3 7#a7 ,guidance with respect to the following3 7,a7 ,the treatment of patients with post-traumatic stress disorder who are also experiencing a substance use disorder or chronic pain4 7,b7 ,the treatment of patients experiencing a mental health condition1 including anxiety1 depression1 or post-traumatic stress disorder as a result of military sexual trauma who are also experiencing a substance use disorder or chronic pain4 7,c7 ,the treatment of patients with traumatic brain injury who are also experiencing a substance use disorder or chronic pain4 7#b7 ,guidance with respect to the following3 7,a7 ,appropriate case management for patients experiencing post-traumatic stress disorder that is comorbid with substance use disorder or chronic pain who transition from receiving care while on active duty in the ,armed ,forces to care from health care networks outside of the ,department of ,defense4 7,b7 ,appropriate case management for patients experiencing a mental health condition1 including anxiety1 depression1 or post-traumatic stress disorder as a result of military sexual trauma that is comorbid with substance use disorder or chronic pain who transition from receiving care while on active duty in the ,armed ,forces to care from health care networks outside of the ,department of ,defense4 7,c7 ,appropriate case management for patients experiencing traumatic brain injury that is comorbid with substance use disorder or chronic pain who transition from receiving care while on active duty in the ,armed ,forces to care from health care networks outside of the ,department of ,defense4 7#c7 ,guidance with respect to the treatment of patients who are still members of the ,armed ,forces and are experiencing a mental health condition1 including anxiety1 depression1 or post-traumatic stress disorder as a result of military sexual trauma that is comorbid with substance use disorder or chronic pain4 7#d7 ,guidance with respect to the assessment by the ,national ,academies of ,sciences1 ,engineering1 and ,medicine of the potential overmedication of veterans1 as required pursuant to the ,senate report accompanying ,s4 #aeeg1 #aaeth ,congress 7,senate ,report #aae-acj71 under the heading ,overprescription ,prevention ,report under the heading ,,committee ,,recommendation4 7d7 ,rule of construction ,nothing in this section shall be construed to prevent the ,secretary of ,veterans ,affairs and the ,secretary of ,defense from considering all relevant evidence1 as appropriate1 in creating the clinical practice guidelines required under subsection 7a7 or from ensuring that the final clinical practice guidelines developed under such subsection and subsequently updated1 as appropriate1 remain applicable to the patient populations of the ,department of ,veterans ,affairs and the ,department of ,defense4 #cjd4 ,update of clinical practice guidelines for assessment and management of patients at risk for suicide 7a7 ,in general ,not later than two years after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs and the ,secretary of ,defense1 through the ,assessment and ,management of ,patients at ,risk for ,suicide ,work ,group 7in this section referred to as the ,work ,group71 shall issue an update to the ,,va_/,,dod ,clinical ,practice ,guideline for ,assessment and ,management of ,patients at ,risk for ,suicide4 7b7 ,matters included ,in carrying out the update under subsection 7a71 the ,work ,group shall ensure that the clinical practice guidelines updated under such subsection includes the following3 7#a7 ,enhanced guidance with respect to the following3 7,a7 ,gender-specific risk factors for suicide and suicidal ideation4 7,b7 ,gender-specific treatment efficacy for depression and suicide prevention4 7,c7 ,gender-specific pharmacotherapy efficacy4 7,d7 ,gender-specific psychotherapy efficacy4 7#b7 ,guidance with respect to the following3 7,a7 ,the efficacy of alternative therapies1 other than psychotherapy and pharmacotherapy1 including the following3 7i7 ,yoga therapy4 7ii7 ,meditation therapy4 7iii7 ,equine therapy4 7iv7 ,other animal therapy4 7v7 ,training and caring for service dogs4 7vi7 ,agri-therapy4 7vii7 ,art therapy4 7viii7 ,outdoor sports therapy4 7ix7 ,music therapy4 7x7 ,any other alternative therapy that the ,work ,group considers appropriate4 7#c7 ,guidance with respect to the findings of the ,creating ,options for ,veterans' ,expedited ,recovery ,commission 7commonly referred to as the ,,cover ,commission7 established under section #ica of the ,jason ,simcakoski ,memorial and ,promise ,act 7title ,,ix of ,public ,law #aad-aih2 #ch ,u4,s4,c4 #agja note74 7c7 ,rule of construction ,nothing in this section 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 ,assessment and ,management of ,patients at ,risk for ,suicide1 as required under subsection 7a71 or from ensuring that the final clinical practice guidelines updated under such subsection remain applicable to the patient populations of the ,department of ,veterans ,affairs and the ,department of ,defense4 #cje4 ,precision medicine initiative of ,department of ,veterans ,affairs to identify and validate brain and mental health biomarkers 7a7 ,in general ,beginning not later than #ah months after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall develop and implement an initiative of the ,department of ,veterans ,affairs to identify and validate brain and mental health biomarkers among veterans1 with specific consideration for depression1 anxiety1 post-traumatic stress disorder1 traumatic brain injury1 and such other mental health conditions as the ,secretary considers appropriate4 ,such initiative may be referred to as the ,precision ,medicine for ,veterans ,initiative4 7b7 ,model of initiative ,the initiative under subsection 7a7 shall be modeled on the ,all of ,us ,precision ,medicine ,initiative administered by the ,national ,institutes of ,health with respect to large-scale collection of standardized data and open data sharing4 7c7 ,use of data 7#a7 ,privacy and security ,in carrying out the initiative under subsection 7a71 the ,secretary shall develop robust data privacy and security measures to ensure that information of veterans participating in the initiative is kept private and secure4 7#b7 ,open platform 7,a7 ,research purposes ,the ,secretary shall make de-identified data collected under the initiative available for research purposes both within and outside of the ,department of ,veterans ,affairs4 7,b7 ,data may not be sold ,data collected under the initiative may not be sold4 7#c7 ,standardization 7,a7 ,in general ,the ,secretary shall ensure that data collected under the initiative is standardized4 7,b7 ,consultation ,the ,secretary shall consult with the ,national ,institutes of ,health and the ,food and ,drug ,administration to determine the most effective1 efficient1 and cost-effective way of standardizing data collected under the initiative4 7,c7 ,manner of standardization ,data collected under the initiative shall be standardized in the manner in which it is collected1 entered into the database1 extracted1 and recorded4 7#d7 ,measures of brain function or structure ,any measures of brain function or structure collected under the initiative shall be collected with a device that is approved by the ,food and ,drug ,administration4 7d7 ,inclusion of initiative in program ,the ,secretary shall assess the feasibility and advisability of coordinating efforts of the initiative under subsection 7a7 with the ,million ,veterans ,program of the ,department4 #cjf4 ,preventative and complex data analysis by ,department of ,veterans ,affairs 7a7 ,in general ,chapter #a of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new section3 #aai4 ,contracting for preventative or complex statistical analysis ,in order to carry out statistical analysis required under section #cjb of the ,commander ,john ,scott ,hannon ,veterans ,mental ,health ,care ,improvement ,act of #bjai1 or any other preventative or complex statistical analysis required under this title or any other provision of law1 the ,secretary may contract with academic institutions or other qualified entities1 as determined by the ,secretary1 to carry out the statistical analysis4 4 7b7 ,clerical amendment ,the table of sections at the beginning of chapter #a of such title is amended by inserting after the item relating to section #aah the following new item3 #aai4 ,contracting for preventative or complex statistical analysis4 4 ,,iv ,oversight of mental health care and related services #dja4 ,study on effectiveness of suicide prevention and mental health outreach programs of ,department of ,veterans ,affairs 7a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall enter into an agreement with a non-,federal ,government entity to conduct a study on the effectiveness of the suicide prevention and mental health outreach materials prepared by the ,department of ,veterans ,affairs and the suicide prevention and mental health outreach campaigns conducted by the ,department4 7b7 ,use of focus groups 7#a7 ,in general ,the ,secretary shall convene not fewer than eight different focus groups to evaluate the effectiveness of the suicide prevention and mental health materials and campaigns as required under subsection 7a74 7#b7 ,location of focus groups ,focus groups convened under paragraph 7#a7 shall be held in geographically diverse areas as follows3 7,a7 ,not fewer than two in rural or highly rural areas4 7,b7 ,not fewer than one in each of the four districts of the ,veterans ,benefits ,administration4 7#c7 ,timing of focus groups ,focus groups convened under paragraph 7#a7 shall be held at a variety of dates and times to ensure an adequate representation of veterans with different work schedules4 7#d7 ,number of participants ,each focus group convened under paragraph 7#a7 shall include not fewer than five and not more than #ab participants4 7#e7 ,representation ,each focus group convened under paragraph 7#a7 shall1 to the extent practicable1 include veterans of diverse backgrounds1 including-- 7,a7 veterans of all eras1 as determined by the ,secretary2 7,b7 women veterans2 7,c7 minority veterans2 7,d7 ,native ,american veterans1 as defined in section #cgfe of title #ch1 ,united ,states ,code2 7,e7 veterans who identify as lesbian1 gay1 bisexual1 transgender1 or queer 7commonly referred to as ,,lgbtq72 7,f7 veterans who live in rural or highly rural areas2 and 7,g7 individuals transitioning from active duty in the ,armed ,forces to civilian life4 7c7 ,report 7#a7 ,in general ,not later than #ij days after the last focus group meeting under subsection 7b71 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 findings of the focus groups4 7#b7 ,elements ,the report required by paragraph 7#a7 shall include the following3 7,a7 ,based on the findings of the focus groups1 an assessment of the effectiveness of current suicide prevention and mental health outreach efforts of the ,department in reaching veterans as a whole as well as specific groups of veterans 7for example1 women veterans74 7,b7 ,based on the findings of the focus groups1 recommendations for future suicide prevention and mental health outreach efforts by the ,department to target specific groups of veterans4 7,c7 ,a plan to change the current approach by the ,department to suicide prevention and mental health outreach or1 if the ,secretary decides not to change the current approach1 an explanation of the reason for maintaining the current approach4 7,d7 ,such other issues as the ,secretary considers necessary4 7d7 ,representative survey 7#a7 ,in general ,not later than one year after the last focus group meeting under subsection 7b71 the ,secretary shall complete a representative survey of the veteran population that is informed by the focus group data in order to collect information about the effectiveness of the mental health and suicide prevention outreach campaigns conducted by the ,department4 7#b7 ,veterans surveyed 7,a7 ,in general ,veterans surveyed under paragraph 7#a7 shall include veterans described in subsection 7b77#e74 7,b7 ,disaggregation of data ,data of veterans surveyed under paragraph 7#a7 shall be disaggregated by-- 7i7 veterans who have received care from the ,department during the two-year period preceding the survey2 and 7ii7 veterans who have not received care from the ,department during the two-year period preceding the survey4 7e7 ,treatment of contracts for suicide prevention and mental health outreach media 7#a7 ,focus groups 7,a7 ,in general ,the ,secretary shall include in each contract to develop media relating to suicide prevention and mental health outreach a requirement that the contractor convene focus groups of veterans to assess the effectiveness of suicide prevention and mental health outreach4 7,b7 ,representation ,each focus group required under subparagraph 7,a7 shall1 to the extent practicable1 include veterans of diverse backgrounds1 including-- 7i7 veterans of all eras1 as determined by the ,secretary2 7ii7 women veterans2 7iii7 minority veterans2 7iv7 ,native ,american veterans1 as defined in section #cgfe of title #ch1 ,united ,states ,code2 7v7 veterans who identify as lesbian1 gay1 bisexual1 transgender1 or queer 7commonly referred to as ,,lgbtq72 7vi7 veterans who live in rural or highly rural areas2 and 7vii7 individuals transitioning from active duty in the ,armed ,forces to civilian life4 7#b7 ,subcontracting 7,a7 ,in general ,the ,secretary shall include in each contract described in paragraph 7#a77;,a7 a requirement that1 if the contractor subcontracts for the development of media1 the contractor shall subcontract with a subcontractor that has experience creating impactful media campaigns that target individuals age #ah to #cd4 7,b7 ,budget limitation ,not more than two percent of the budget of the ,office of ,mental ,health and ,suicide ,prevention of the ,department for contractors for suicide prevention and mental health media outreach shall go to subcontractors described in subparagraph 7,a74 7f7 ,rural and highly rural defined ,in this section1 with respect to an area1 the terms rural and highly rural have the meanings given those terms in the ,rural-,urban ,commuting ,areas coding system of the ,department of ,agriculture4 #djb4 ,oversight of mental health and suicide prevention media outreach conducted by ,department of ,veterans ,affairs 7a7 ,establishment of goals 7#a7 ,in general ,the ,secretary of ,veterans ,affairs shall establish goals for the mental health and suicide prevention media outreach campaigns of the ,department of ,veterans ,affairs in raising awareness about mental health and suicide prevention4 7#b7 ,use of metrics 7,a7 ,in general ,the goals established under paragraph 7#a7 shall be measured by metrics specific to different media types as follows3 7i7 ,metrics relating to social media shall include the following3 7,i7 ,impressions4 7,,ii7 ,reach4 7,,iii7 ,engagement rate4 7,,iv7 ,such other metrics as the ,secretary considers necessary4 7ii7 ,metrics relating to television shall include the following3 7,i7 ,nielsen ratings4 7,,ii7 ,such other metrics as the ,secretary considers necessary4 7iii7 ,metrics relating to email shall include the following3 7,i7 ,open rate4 7,,ii7 ,response rate 7,,iii7 ,click rate4 7,,iv7 ,such other metrics as the ,secretary considers necessary4 7,b7 ,update ,the ,secretary shall periodically update the metrics under subparagraph 7,a7 as more accurate metrics become available4 7#c7 ,targets ,the ,secretary shall develop targets to track the metrics used under paragraph 7#b74 7#d7 ,consultation ,in establishing goals under paragraph 7#a71 the ,secretary shall consult with the following3 7,a7 ,relevant stakeholders1 such as organizations that represent veterans1 as determined by the ,secretary4 7,b7 ,mental health and suicide prevention experts4 7,c7 ,such other persons as the ,secretary considers appropriate4 7#e7 ,initial report ,not later than #ahj 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 detailing the goals established under paragraph 7#a7 for the mental health and suicide prevention media outreach campaigns of the ,department in raising awareness about mental health and suicide prevention1 including the metrics and targets for such metrics by which those goals are to be measured under paragraph 7#b74 7#f7 ,annual report ,not later than one year after the submittal of the report under paragraph 7#c71 and 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 detailing-- 7,a7 the progress of the ,department in meeting the goals established under paragraph 7#a7 and targets developed under paragraph 7#c72 and 7,b7 a description of action to be taken by the ,department to modify mental health and suicide prevention media outreach campaigns if those goals and targets are not being met4 7b7 ,establishment of oversight process 7#a7 ,in general ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary shall establish a process to oversee the mental health and suicide prevention media outreach campaigns of the ,department4 7#b7 ,components of oversight process ,the process established under paragraph 7#a7 shall include the following components3 7,a7 ,a delineation of the roles and responsibilities of all suicide prevention officials within the ,office of ,mental ,health and ,suicide ,prevention of the ,veterans ,health ,administration4 7,b7 ,a schedule for creating1 approving1 implementing1 and evaluating all unpaid media and paid media content relating to mental health and suicide prevention4 7,c7 ,lines of reporting1 as the ,secretary considers necessary1 to report to management information relating to the mental health and suicide prevention media outreach campaigns of the ,department4 7c7 ,contract requirements ,the ,secretary shall ensure that each contract into which the ,secretary enters to develop mental health and suicide prevention outreach media includes requirements that the contractor-- 7#a7 track metrics used by the ,secretary under subsection 7a77#b72 and 7#b7 not less frequently than quarterly1 report such metrics to the ,office of ,mental ,health and ,suicide ,prevention of the ,veterans ,health ,administration4 7d7 ,report on use of funds by ,office of ,mental ,health and ,suicide ,prevention ,not later than #ahj days after the date of the enactment of this ,act1 and semiannually thereafter1 the ,secretary shall submit to the ,committee on ,appropriations and the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,appropriations and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report containing the expenditures and obligations of the ,office of ,mental ,health and ,suicide ,prevention of the ,veterans ,health ,administration during the period covered by the report4 #djc4 ,annual report on progress of ,department of ,veterans ,affairs in meeting goals and objectives of ,executive ,order #achbb 7a7 ,in general ,not later than #abj days after the date of the enactment of this ,act1 and annually thereafter1 the ,secretary of ,veterans ,affairs1 in consultation with the ,secretary of ,defense and the ,secretary of ,homeland ,security1 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 ,an assessment of the progress of the ,department of ,veterans ,affairs1 the ,department of ,defense1 and the ,department of ,homeland ,security in meeting the goals and objectives outlined in the report required under section #b7;c7 of ,executive ,order #achbb 7#hc ,fed4 ,reg4 #aeac2 relating to supporting our veterans during their transition from uniformed service to civilian life7 with respect to the implementation by the ,department of ,veterans ,affairs of the ,joint ,action ,plan required under section #b7;b7 of such ,executive order4 7#b7 ,a description of action to be taken by the ,department of ,veterans ,affairs1 the ,department of ,defense1 and the ,department of ,homeland ,security if those goals and objectives are not being met4 7#c7 ,an assessment of the effectiveness of ,executive ,order #achbb at improving the transition process for members of the ,armed ,forces and veterans4 7#d7 ,such other topics as the ,secretary of ,veterans ,affairs1 the ,secretary of ,defense1 or the ,secretary of ,homeland ,security consider necessary4 7b7 ,submittal by ,secretary of ,veterans ,affairs ,the ,secretary of ,veterans ,affairs shall submit each report required under paragraph 7#a7 with respect to the ,department of ,veterans ,affairs regardless of whether the ,secretary of ,defense or the ,secretary of ,homeland ,security provides any information for the report4 #djd4 ,comptroller ,general management review of mental health and suicide prevention services 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 management review of the mental health and suicide prevention services provided by the ,department of ,veterans ,affairs4 7b7 ,elements ,the management review required by subsection 7a7 shall include the following3 7#a7 ,an assessment of the infrastructure under the control of or available to the ,office of ,mental ,health and ,suicide ,prevention of the ,department of ,veterans ,affairs or available to the ,department of ,veterans ,affairs for suicide prevention efforts not operated by the ,office of ,mental ,health and ,suicide ,prevention4 7#b7 ,a description of the management and organizational structure of the ,office of ,mental ,health and ,suicide ,prevention1 including roles and responsibilities for each position4 7#c7 ,a description of the operational policies and processes of the ,office of ,mental ,health and ,suicide ,prevention4 7#d7 ,an assessment of suicide prevention practices and initiatives available from the ,department and through community partnerships4 7#e7 ,an assessment of the staffing levels at the ,office of ,mental ,health and ,suicide ,prevention1 dissaggregated by type of position1 and including the location of any staffing deficiencies4 7#f7 ,an assessment of the ,nurse ,advice ,line pilot program conducted by the ,department4 7#g7 ,an assessment of recruitment initiatives in rural areas for mental health professionals of the ,department4 7#h7 ,an assessment of strategic planning conducted by the ,office of ,mental ,health and ,suicide ,prevention4 7#i7 ,an assessment of the communication1 and the effectiveness of such communication-- 7,a7 within the central office of the ,office of ,mental ,health and ,suicide ,prevention2 7,b7 between that central office and any staff member or office in the field1 including chaplains1 attorneys1 law enforcement personnel1 and volunteers2 and 7,c7 between that central office1 local facilities of the ,department1 and community partners of the ,department1 including first responders1 community support groups1 and health care industry partners4 7#aj7 ,an assessment of how effectively the ,office of ,mental ,health and ,suicide ,prevention implements operational policies and procedures4 7#aa7 ,an assessment of how the ,department of ,veterans ,affairs and the ,department of ,defense coordinate suicide prevention efforts1 and recommendations on how the ,department of ,veterans ,affairs and ,department of ,defense can more effectively coordinate those efforts4 7#ab7 ,an assessment of such other areas as the ,comptroller ,general considers appropriate to study4 #dje4 ,comptroller ,general report on efforts of ,department of ,veterans ,affairs to integrate mental health care into primary care clinics 7a7 ,initial ,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 efforts of the ,department of ,veterans ,affairs to integrate mental health care into primary care clinics of the ,department4 7#b7 ,elements ,the report required by subsection 7a7 shall include the following3 7,a7 ,an assessment of the efforts of the ,department to integrate mental health care into primary care clinics of the ,department4 7,b7 ,an assessment of the effectiveness of such efforts4 7,c7 ,an assessment of how the health care of veterans is impacted by such integration4 7,d7 ,a description of how care is coordinated by the ,department between specialty mental health care and primary care1 including a description of the following3 7i7 ,how documents and patient information are transferred and the effectiveness of those transfers4 7ii7 ,how care is coordinated when veterans must travel to different facilities of the ,department4 7iii7 ,how a veteran is reintegrated into primary care after receiving in-patient mental health care4 7,e7 ,an assessment of how the integration of mental health care into primary care clinics is implemented at different types of facilities of the ,department4 7,f7 ,such recommendations on how the ,department can better integrate mental health care into primary care clinics as the ,comptroller ,general considers appropriate4 7,g7 ,an assessment of such other areas as the ,comptroller ,general considers appropriate to study4 7b7 ,community care integration report 7#a7 ,in general ,not later than two years after the date on which the ,comptroller ,general submits the report required under subsection 7a77#a71 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 efforts of the ,department to integrate community-based mental health care into the ,veterans ,health ,administration4 7#b7 ,elements ,the report required by paragraph 7#a7 shall include the following3 7,a7 ,an assessment of the efforts of the ,department to integrate community-based mental health care into the ,veterans ,health ,administration4 7,b7 ,an assessment of the effectiveness of such efforts4 7,c7 ,an assessment of how the health care of veterans is impacted by such integration4 7,d7 ,a description of how care is coordinated between providers of community-based mental health care and the ,veterans ,health ,administration1 including a description of how documents and patient information are transferred and the effectiveness of those transfers between-- 7i7 the ,veterans ,health ,administration and providers of community-based mental health care2 and 7ii7 providers of community-based mental health care and the ,veterans ,health ,administration4 7,e7 ,an assessment of any disparities in the coordination of community-based mental health care into the ,veterans ,health ,administration by location and type of facility4 7,f7 ,an assessment of the military cultural competency of health care providers providing community-based mental health care to veterans4 7,g7 ,such recommendations on how the ,department can better integrate community-based mental health care into the ,veterans ,health ,administration as the ,comptroller ,general considers appropriate4 7,h7 ,an assessment of such other areas as the ,comptroller ,general considers appropriate to study4 7#c7 ,community-based mental health care defined ,in this subsection1 the term community-based mental health care means mental health care paid for by the ,department but provided by a non-,department health care provider at a non-,department facility1 including care furnished under section #agjc of title #ch1 ,united ,states ,code 7as in effect on the date specified in section #aja7;b7 of the ,caring for ,our ,veterans ,act of #bjah 7title ,i of ,public ,law #aae-ahb774 #djf4 ,joint mental health programs by ,department of ,veterans ,affairs and ,department of ,defense 7a7 ,report on mental health programs 7#a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 and annually thereafter1 the ,secretary of ,veterans ,affairs and the ,secretary of ,defense shall submit to the ,committee on ,armed ,services and the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,armed ,services and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report on mental health programs of the ,department of ,veterans ,affairs and the ,department of ,defense and joint programs of the ,departments4 7#b7 ,elements ,the report required by paragraph 7#a7 shall include the following3 7,a7 ,a description of mental health programs operated by the ,department of ,veterans ,affairs1 including the following3 7i7 ,transition assistance programs4 7ii7 ,clinical mental health initiatives1 including-- 7,i7 the ,million ,veterans ,program2 and 7,,ii7 centers of excellence of the ,department of ,veterans ,affairs for traumatic brain injury and post-traumatic stress disorder4 7iii7 ,programs that may secondarily improve mental health1 including employment1 housing assistance1 and financial literacy programs4 7iv7 ,research into mental health issues and conditions4 7,b7 ,a description of mental health programs operated by the ,department of ,defense1 including the following3 7i7 ,transition assistance programs4 7ii7 ,clinical mental health initiatives1 including the ,national ,intrepid ,center of ,excellence4 7iii7 ,programs that may secondarily improve mental health1 including employment1 housing assistance1 and financial literacy programs4 7iv7 ,research into mental health issues and conditions4 7,c7 ,a description of mental health programs jointly operated by the ,department of ,veterans ,affairs and the ,department of ,defense1 including the following3 7i7 ,transition assistance programs4 7ii7 ,clinical mental health initiatives4 7iii7 ,programs that may secondarily improve mental health1 including employment1 housing assistance1 and financial literacy programs4 7iv7 ,research into mental health issues and conditions4 7,d7 ,recommendations for coordinating mental health programs of the ,department of ,veterans ,affairs and the ,department of ,defense to improve the effectiveness of those programs4 7,e7 ,recommendations for novel joint programming of the ,department of ,veterans ,affairs and the ,department of ,defense to improve the mental health of members of the ,armed ,forces and veterans4 7b7 ,establishment of joint center of excellence 7#a7 ,in general ,not later than two years after the date of the enactment of this ,act1 the ,secretary of ,defense1 in consultation with the ,secretary of ,veterans ,affairs1 shall establish a center of excellence to be known as the ,joint ,,dod_/,,va ,national ,intrepid ,center of ,excellence ,intrepid ,spirit ,center 7in this subsection referred to as the ,center74 7#b7 ,duties ,the ,center shall conduct joint mental health programs of the ,department of ,veterans ,affairs and the ,department of ,defense4 7#c7 ,location ,the ,center shall be established in a location that-- 7,a7 is geographically distant from already existing and planned ,intrepid ,spirit ,centers of the ,department of ,defense2 and 7,b7 is in a rural or highly rural area 7as determined through the use of the ,rural-,urban ,commuting ,areas coding system of the ,department of ,agriculture74 ,v ,medical workforce ,a ,improvement of mental health medical workforce #eja4 ,treatment of psychologists 7a7 ,treatment as title #ch employees ,section #gdja of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in paragraph 7#a7 by inserting psychologists1 after chiropractors12 and 7#b7 in paragraph 7#c71 by striking psychologists14 7b7 ,inclusion in contracts for scarce medical specialist services ,section #gdji7;a7 of title #ch1 ,united ,states ,code1 is amended by inserting psychologists1 after chiropractors14 #ejb4 ,staffing improvement plan for psychiatrists and psychologists of ,department of ,veterans ,affairs 7a7 ,staffing plan ,not later than #bgj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs1 in consultation with the ,inspector ,general of the ,department of ,veterans ,affairs1 shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a plan to address staffing shortages of psychiatrists and psychologists of the ,department of ,veterans ,affairs1 including filling any open positions4 7b7 ,elements ,the plan required by subsection 7a7 shall include the following3 7#a7 ,the number of positions for psychiatrists and psychologists of the ,department that need to be filled to meet demand1 disaggregated by ,veterans ,integrated ,service ,network and medical center4 7#b7 ,an identification of the steps that the ,secretary will take in each ,veterans ,integrated ,service ,network to address such shortages1 include the following3 7,a7 ,a description of any region-specific hiring incentives to be used by the ,secretary in consultation with the directors of ,veterans ,integrated ,service ,networks and medical centers of the ,department4 7,b7 ,a description of any local retention or engagement incentives to be used by directors of ,veterans ,integrated ,service ,networks4 7#c7 ,such recommendations for legislative or administrative action as the ,secretary considers necessary to aid in addressing staffing shortages of psychiatrists and psychologists of the ,department4 #ejc4 ,occupational series and staffing improvement plan for licensed professional mental health counselors and marriage and family therapists of ,department of ,veterans ,affairs 7a7 ,occupational series ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs1 in consultation with the ,office of ,personnel ,management1 shall develop an occupational series for licensed professional mental health counselors and marriage and family therapists of the ,department of ,veterans ,affairs4 7b7 ,staffing plan 7#a7 ,in general ,not later than #bgj 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 plan to address staffing shortages of licensed professional mental health counselors and marriage and family therapists of the ,department of ,veterans ,affairs4 7#b7 ,elements ,the plan required by paragraph 7#a7 shall include the following3 7,a7 ,the number of positions for licensed professional mental health counselors and marriage and family therapists of the ,department that need to be filled to meet demand1 disaggregated by ,veterans ,integrated ,service ,network and medical center4 7,b7 ,an identification of the steps that the ,secretary will take in each ,veterans ,integrated ,service ,network to address such shortages1 include the following3 7i7 ,a description of any region-specific hiring incentives to be used by the ,secretary in consultation with the directors of ,veterans ,integrated ,service ,networks and medical centers of the ,department4 7ii7 ,a description of any local retention or engagement incentives to be used by directors of ,veterans ,integrated ,service ,networks4 7,c7 ,such recommendations for legislative or administrative action as the ,secretary1 in consultation with the ,inspector ,general of the ,department of ,veterans ,affairs1 considers necessary to aid in addressing staffing shortages of licensed professional mental health counselors and marriage and family therapists of the ,department4 7c7 ,report ,not later than one year after the submittal of the plan required by subsection 7b71 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 the number of licensed professional mental health counselors and marriage and family therapists hired by the ,department during the one-year period preceding the submittal of the report1 disaggregated by ,veterans ,integrated ,service ,network and medical center4 #ejd4 ,staffing improvement plan for peer specialists of ,department of ,veterans ,affairs who are women 7a7 ,assessment of capacity 7#a7 ,in general ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs1 in consultation with the ,inspector ,general of the ,department of ,veterans ,affairs1 shall commence an assessment of the capacity of peer specialists of the ,department of ,veterans ,affairs who are women4 7#b7 ,elements ,the assessment required by paragraph 7#a7 shall include an assessment of the following3 7,a7 ,the geographical distribution of peer specialists of the ,department who are women4 7,b7 ,the geographical distribution of women veterans4 7,c7 ,the number and proportion of women peer specialists who specialize in peer counseling on mental health or suicide prevention4 7,d7 ,the number and proportion of women peer specialists who specialize in peer counseling on non-mental health related matters4 7b7 ,report ,not later than one year after the assessment required by subsection 7a7 has commenced1 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 detailing the findings of the assessment4 7c7 ,staffing improvement plan 7#a7 ,in general ,not later than #ahj days after submitting the report under subsection 7b71 the ,secretary1 in consultation with the ,inspector ,general1 shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a plan1 based on the results of the assessment required by subsection 7a71 to hire additional qualified peer specialists who are women1 with special consideration for areas that lack peer specialists who are women4 7#b7 ,elements ,the peer specialist positions included in the plan required by paragraph 7#a7-- 7,a7 shall be non-volunteer1 paid positions2 and 7,b7 may be part-time positions4 #eje4 ,establishment of ,department of ,veterans ,affairs ,readjustment ,counseling ,service ,scholarship ,program 7a7 ,in general ,chapter #gf of title #ch1 ,united ,states ,code1 is amended by inserting after subchapter ,,viii the following new subchapter3 ,,ix ,readjustment ,counseling ,service ,scholarship ,program #gfih4 ,requirement for program ,as part of the ,educational ,assistance ,program1 the ,secretary shall carry out a scholarship program under this subchapter4 ,the program shall be known as the ,department of ,veterans ,affairs ,readjustment ,counseling ,service ,scholarship ,program 7in this subchapter referred to as the ,program74 #gfii4 ,eligibility2 agreement 7a7 ,in general ,an individual is eligible to participate in the ,program1 as determined by the ,readjustment ,counseling ,service of the ,department1 if the individual-- 7#a7 is accepted for enrollment or enrolled 7as described in section #gfjb of this title7 in1 a program of study at an accredited educational institution1 school1 or training program leading to-- 7,a7 a bachelor's1 master's1 or doctoral degree in psychology1 social work1 or marriage and family therapy2 or 7,b7 a master's degree in mental health counseling2 and 7#b7 enters into an agreement with the ,secretary under subsection 7c74 7b7 ,priority ,in selecting individuals to participate in the ,program1 the ,secretary shall give priority to the following individuals3 7#a7 ,an individual who agrees to be employed by a ,vet ,center located in a community that is-- 7,a7 designated as a medically underserved population under section #ccj7;b77#c7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b7b77#c772 and 7,b7 in a state with a per capita population of veterans of more than five percent according to the ,national ,center for ,veterans ,analysis and ,statistics and the ,bureau of the ,census4 7#b7 ,an individual who is a veteran4 7c7 ,agreement ,an agreement between the ,secretary and a participant in the ,program shall 7in addition to the requirements set forth in section #gfjd of this title7 include the following3 7#a7 ,an agreement by the ,secretary to provide the participant with a scholarship under the ,program for a specified number of school years during which the participant pursues a program of study described in subsection 7a77#a7 that meets the requirements set forth in section #gfjb7;a7 of this title4 7#b7 ,an agreement by the participant to serve as a full-time employee of the ,department at a ,vet ,center for a three-year period during the six-year period following the completion by the participant of such program of study 7in this subchapter referred to as the period of obligated service74 7d7 ,vet ,center defined ,in this section1 the term ,vet ,center has the meaning given that term in section #agab;,a7h7 of this title4 #gfii;,a4 ,obligated service 7a7 ,in general ,each participant in the ,program shall provide service as a full-time employee of the ,department at a ,vet ,center 7as defined in section #gfii7;c7 of this title7 for the period of obligated service set forth in the agreement of the participant entered into under section #gfjd of this title4 7b7 ,determination of service commencement date 7#a7 ,not later than #fj days before the service commencement date of a participant1 the ,secretary shall notify the participant of that service commencement date4 7#b7 ,the date specified in paragraph 7#a7 with respect to a participant is the date for the beginning of the period of obligated service of the participant4 #gfii;,b4 ,breach of agreement3 liability 7a7 ,liquidated damages 7#a7 ,a participant in the ,program 7other than a participant described in subsection 7b77 who fails to accept payment1 or instructs the educational institution in which the participant is enrolled not to accept payment1 in whole or in part1 of a scholarship under the agreement entered into under section #gfjd of this title shall be liable to the ,united ,states for liquidated damages in the amount of #a1ejj4 7#b7 ,liability under paragraph 7#a7 is in addition to any period of obligated service or other obligation or liability under such agreement4 7b7 ,liability during program of study 7#a7 ,except as provided in subsection 7d71 a participant in the ,program shall be liable to the ,united ,states for the amount which has been paid to or on behalf of the participant under the agreement if any of the following occurs3 7,a7 ,the participant fails to maintain an acceptable level of academic standing in the educational institution in which the participant is enrolled 7as determined by the educational institution under regulations prescribed by the ,secretary74 7,b7 ,the participant is dismissed from such educational institution for disciplinary reasons4 7,c7 ,the participant voluntarily terminates the program of study in such educational institution before the completion of such program of study4 7#b7 ,liability under this subsection is in lieu of any service obligation arising under the agreement4 7c7 ,liability during period of obligated service 7#a7 ,except as provided in subsection 7d71 if a participant in the ,program does not complete the period of obligated service of the participant1 the ,united ,states shall be entitled to recover from the participant an amount determined in accordance with the following formula3 ,a #c7ts_/t74 7#b7 ,in the formula in paragraph 7#a73 7,a7 ,a is the amount the ,united ,states is entitled to recover4 7,b7 is the sum of-- 7i7 the amounts paid under this subchapter to or on behalf of the participant2 and 7ii7 the interest on such amounts which would be payable if at the time the amounts were paid they were loans bearing interest at the maximum legal prevailing rate1 as determined by the ,treasurer of the ,united ,states4 7,c7 t is the total number of months in the period of obligated service of the participant4 7,d7 s is the number of months of such period served by the participant4 7d7 ,limitation on liability for reductions-in-,force ,liability shall not arise under subsection 7c7 if the participant fails to maintain employment as a ,department employee due to a staffing adjustment4 7e7 ,period for payment of damages ,any amount of damages that the ,united ,states is entitled to recover under this section shall be paid to the ,united ,states within the one-year period beginning on the date of the breach of the agreement4 4 7b7 ,conforming and technical amendments 7#a7 ,conforming amendments 7,a7 ,establishment of program ,section #gfja7;a7 of such title is amended-- 7i7 in paragraph 7#e71 by striking and2 7ii7 in paragraph 7#f71 by striking the period and inserting 2 and2 and 7iii7 by adding at the end the following new paragraph3 7#g7 the readjustment counseling service scholarship program provided for in subchapter ,,ix of this chapter4 4 7,b7 ,eligibility ,section #gfjb of such title is amended-- 7i7 in subsection 7a77#a7-- 7,i7 by striking or ,,vi and inserting ,,vi1 or ,,ix2 and 7,,ii7 by striking subchapter ,,vi and inserting subchapter ,,vi or ,,ix2 and 7ii7 in subsection 7b71 by striking or ,,vi and inserting ,,vi1 or ,,ix4 7,c7 ,application ,section #gfjc7;a77#a7 of such title is amended by striking or ,,viii and inserting ,,viii1 or ,,ix4 7,d7 ,terms of agreement ,section #gfjd of such title is amended by striking or ,,viii each place it appears and inserting ,,viii1 or ,,ix4 7,e7 ,annual report ,section #gfcb of such title is amended-- 7i7 in paragraph 7#a71 by striking and the ,specialty ,education ,loan ,repayment ,program and inserting the ,specialty ,education ,loan ,repayment ,program1 and the ,readjustment ,counseling ,service ,scholarship ,program2 and 7ii7 in paragraph 7#d71 by striking and per participant in the ,specialty ,education ,loan ,repayment ,program and inserting per participant in the ,specialty ,education ,loan ,repayment ,program1 and per participant in the ,readjustment ,counseling ,service ,scholarship ,program4 7#b7 ,table of sections ,the table of sections at the beginning of chapter #gf of such title is amended by inserting after the items relating to subchapter ,,viii the following3 ,,subchapter ,,ix--,readjustment ,counseling ,service ,scholarship ,program,sec4 #gfih4 ,requirement for program4#gfii4 ,eligibility2 agreement4#gfii;,a4 ,obligated service4#gfii;,b4 ,breach of agreement3 liability4 4 7c7 ,effective date ,the ,secretary of ,veterans ,affairs shall begin awarding scholarships under subchapter ,,ix of chapter #gf of title #ch1 ,united ,states ,code1 as added by subsection 7a71 for programs of study beginning not later than one year after the date of the enactment of this ,act4 #ejf4 ,comptroller ,general report on ,readjustment ,counseling ,service 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 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 ,readjustment ,counseling ,service of the ,department of ,veterans ,affairs4 7b7 ,elements ,the report required by subsection 7a7 shall include the following3 7#a7 ,an assessment of the adequacy and types of treatment1 counseling1 and other services provided at ,vet ,centers1 including recommendations on whether and how such treatment1 counseling1 and other services can be expanded4 7#b7 ,an assessment of the efficacy of outreach efforts by the ,readjustment ,counseling ,service1 including recommendations for how outreach efforts can be improved4 7#c7 ,an assessment of barriers to care at ,vet ,centers1 including recommendations for overcoming those barriers4 7#d7 ,an assessment of the efficacy and frequency of the use of telehealth by counselors of the ,readjustment ,counseling ,service to provide mental health services1 including recommendations for how the use of telehealth can be improved4 7#e7 ,an assessment of the feasibility and advisability of expanding eligibility for services from the ,readjustment ,counseling ,service1 including-- 7,a7 recommendations on what eligibility criteria could be expanded2 and 7,b7 an assessment of potential costs and increased infrastructure requirements if eligibility is expanded4 7#f7 ,an assessment of the use of ,vet ,centers by members of the reserve components of the ,armed ,forces who were never activated and recommendations on how to better reach those members4 7#g7 ,an assessment of the use of ,vet ,centers by eligible family members of former members of the ,armed ,forces and recommendations on how to better reach those family members4 7#h7 ,an assessment of the efficacy of group therapy and the level of training of providers at ,vet ,centers in administering group therapy4 7c7 ,vet ,center defined ,in this section1 the term ,vet ,center has the meaning given that term in section #agab;,a7h7 of title #ch1 ,united ,states ,code4 #ejg4 ,expansion of reporting requirements on ,readjustment ,counseling ,service of ,department of ,veterans ,affairs 7a7 ,expansion of annual report ,paragraph 7#b77;,c7 of section #gcji7;e7 of title #ch1 ,united ,states ,code1 is amended by inserting before the period at the end the following3 1 including the resources required to meet such unmet need1 such as additional staff1 additional locations1 additional infrastructure1 infrastructure improvements1 and additional mobile ,vet ,centers4 7b7 ,biennial report ,such section is amended by adding at the end the following new paragraph3 7#c7 ,for each even numbered year in which the report required by paragraph 7#a7 is submitted1 the ,secretary shall include in such report a prediction of trends in demand for care1 long-term investments required with respect to the provision of care1 maintenance of infrastructure1 and other capital investments with respect to the ,readjustment ,counseling ,service1 including ,vet ,centers1 ,mobile ,vet ,centers1 and community access points4 4 #ejh4 ,studies on alternative work schedules for employees of ,veterans ,health ,administration 7a7 ,study of veterans 7#a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall conduct a study on the attitudes of eligible veterans toward the ,department of ,veterans ,affairs offering appointments outside the usual operating hours of facilities of the ,department1 including through the use of telehealth appointments4 7#b7 ,eligible veteran defined ,in this subsection1 the term eligible veteran means a veteran who-- 7,a7 is enrolled in the patient enrollment system of the ,department under section #agje7;a7 of title #ch1 ,united ,states ,code2 and 7,b7 received health care from the ,department at least once during the two-year period ending on the date of the commencement of the study under paragraph 7#a74 7b7 ,department study 7#a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary shall conduct a study on the feasibility and advisability of offering appointments outside the usual operating hours of facilities of the ,department4 7#b7 ,study of employees ,the study required by paragraph 7#a7 shall include a study of the opinions of employees of the ,veterans ,health ,administration1 including clinical1 nonclinical1 and support staff1 with respect to offering appointments outside the usual operating hours of facilities of the ,department1 including through the use of telehealth appointments4 #eji4 ,suicide prevention coordinators ,the ,secretary of ,veterans ,affairs shall ensure that each medical center of the ,department of ,veterans ,affairs is staffed with not fewer than one suicide prevention coordinator4 ,b ,direct hiring authorities for certain health care positions #eba4 ,direct hiring authorities for certain health care positions 7a7 ,in general ,subpart ,i of part ,,iii of title #e1 ,united ,states ,code1 is amended by adding at the end the following3 #ajc ,department of ,veterans ,affairs hiring authorities ,sec4#ajcja4 ,department of ,veterans ,affairs personnel authorities4 #ajcja4 ,department of ,veterans ,affairs personnel authorities 7a7 ,flexibilities relating to appointments 7#a7 ,in general ,the ,secretary of ,veterans ,affairs 7referred to in this section as the ,secretary7 shall promulgate regulations to redesign the procedures that are applied by the ,department of ,veterans ,affairs in making appointments to positions described in paragraphs 7#a7 and 7#c7 of section #gdja of title #ch in order to-- 7,a7 better meet mission needs2 7,b7 respond to managers' needs and the needs of applicants2 7,c7 produce high-quality applicants2 7,d7 support timely decisions2 and 7,e7 promote competitive job offers4 7#b7 ,waived requirements ,in redesigning the process by which the appointments described in paragraph 7#a7 shall be made1 the ,secretary may waive the requirements of chapter #cc1 and the regulations implementing that chapter1 to the extent necessary to achieve the objectives of this section1 while providing for the following3 7,a7 ,fair1 credible1 and transparent methods of establishing qualification requirements for1 recruitment for1 and appointments to positions4 7,b7 ,fair and open competition and equitable treatment in the consideration and selection of individuals to positions4 7,c7 ,fair1 credible1 and transparent methods of assigning1 reassigning1 detailing1 transferring1 or promoting employees4 7#c7 ,implementation requirements ,in implementing this subsection1 the ,secretary shall comply with the provisions of section #bcjb7;b77#aa71 regarding veterans' preference requirements1 in a manner consistent with that in which such provisions are applied under chapter #cc4 7#d7 ,training program ,the ,secretary shall develop a training program for ,department of ,veterans ,affairs human resource professionals to implement the requirements of this subsection4 7#e7 ,indicators of effectiveness ,the ,secretary shall develop indicators of effectiveness to determine whether appointment flexibilities under this subsection have achieved the objectives described in paragraph 7#a74 7b7 ,criteria for use of new personnel authorities ,in the redesign of appointment procedures1 as described in subsection 7a71 and with respect to the system of appointment flexibilities established under that subsection1 the ,secretary shall-- 7#a7 include a means for ensuring employee involvement 7for bargaining unit employees1 through their exclusive representatives7 in that redesign and in the implementation of that system2 7#b7 provide for adequate training and retraining for supervisors1 managers1 and employees in the implementation and operation of that redesign and that system2 7#c7 develop-- 7,a7 a comprehensive management succession program to provide training to employees to develop managers for the agency2 and 7,b7 a program to provide training to supervisors on actions1 options1 and strategies that a supervisor may use in administering that system2 7#d7 include effective transparency and accountability measures and safeguards to ensure that the management of that system is fair1 credible1 and equitable1 including appropriate independent reasonableness reviews1 internal assessments1 and employee surveys2 7#e7 provide mentors to advise individuals on their career paths and opportunities to advance and excel within their fields2 7#f7 develop appropriate procedures for warnings during performance evaluations for employees who fail to meet performance standards2 7#g7 utilize the quadrennial strategic plan required under section #gccj;,c7b7 of title #ch2 and 7#h7 ensure that adequate agency resources are allocated for the design1 implementation1 and administration of that system4 4 7b7 ,technical and conforming amendment ,the table of chapters for part ,,iii of title #e1 ,united ,states ,code1 is amended by inserting after the item relating to chapter #ajb the following3 #ajc4;,department of ,veterans ,affairs ,hiring ,authorities#ajcja4 4 ,,vi ,improvement of telehealth services #fja4 ,expanded telehealth from ,department of ,veterans ,affairs 7a7 ,in general ,the ,secretary of ,veterans ,affairs shall enter into partnerships1 and expand existing partnerships1 between the ,department of ,veterans ,affairs1 organizations that represent or serve veterans1 nonprofit organizations1 private businesses1 and other interested parties for the expansion of telehealth capabilities and the provision of telehealth services to veterans through the award of grants under subsection 7c74 7b7 ,preference for partnerships ,the ,secretary shall give preference to entering into or expanding partnerships under subsection 7a7 with organizations that-- 7#a7 represent veterans in rural or highly rural areas 7as determined through the use of the ,rural-,urban ,commuting ,areas coding system of the ,department of ,agriculture72 or 7#b7 operate in a medically underserved community 7as defined in section #gii;,b of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #biep774 7c7 ,award of grants 7#a7 ,in general ,in carrying out partnerships entered into or expanded under this section with entities described in subsection 7a71 the ,secretary shall award grants to those entities4 7#b7 ,maximum amount of grants ,the amount of a grant awarded under this subsection may not exceed #ge1jjj per site per year4 7#c7 ,use of grants 7,a7 ,in general ,grants awarded to an entity under this subsection shall be used for the following3 7i7 ,purchasing or upgrading hardware or software necessary for the provision of secure and private telehealth services4 7ii7 ,upgrading security protocols for consistency with the standardized telehealth security protocol implemented under section #fjb7;a77#b71 or any other security requirements of the ,department4 7iii7 ,training of employees1 including payment of those employees for completing that training1 with respect to-- 7,i7 military and veteran cultural competence1 if the entity is not an organization that represents veterans2 and 7,,ii7 equipment required to provide telehealth services4 7iv7 ,upgrading existing infrastructure owned or leased by the entity to make rooms more conducive to telehealth care1 including-- 7,i7 additional walls to create a new1 private room2 7,,ii7 soundproofing of existing rooms2 or 7,,iii7 new electrical or internet outlets in an existing room4 7v7 ,upgrading existing infrastructure to comply with the ,americans with ,disabilities ,act of #aiij 7#db ,u4,s4,c4 #abaja et seq474 7vi7 ,upgrading internet infrastructure4 7,b7 ,exclusion ,grants may not be used for the purchase of new property or for major construction projects1 as determined by the ,secretary4 7d7 ,memoranda of understanding or agreement on telehealth access points 7#a7 ,in general ,an entity described in subsection 7a7 that seeks to establish a telehealth access point for veterans but does not require grant funding under this section to do so may enter into a memorandum of understanding or memorandum of agreement with the ,department for the establishment of such an access point4 7#b7 ,inspection ,the ,secretary shall inspect the access point proposed to be established under paragraph 7#a7 to ensure that it is adequately private1 secure1 and accessible for veterans before the access point is established4 7e7 ,assessment of barriers to access 7#a7 ,in general ,not later than #ah months after the date of the enactment of this ,act1 the ,secretary shall complete an assessment of barriers faced by veterans in accessing telehealth services from home4 7#b7 ,elements ,the assessment required by paragraph 7#a7 shall include the following3 7,a7 ,an assessment of current and potential future cost barriers to veterans having internet access at home4 7,b7 ,an assessment of current and potential future barriers to veterans accessing broadband services at home4 7,c7 ,a description of how the ,department plans to address the current and potential future cost and access barriers described in subparagraphs 7,a7 and 7,b74 7,d7 ,such other matters related to internet access for veterans in their homes as the ,secretary considers relevant4 7#c7 ,report ,not later than #abj days after the completion of the assessment required by paragraph 7#a71 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 assessment1 including any recommendations for legislative or administrative action based on the results of the assessment4 7f7 ,authorization of appropriations ,there is authorized to be appropriated to the ,secretary of ,veterans ,affairs #aj1jjj1jjj to carry out this section4 #fjb4 ,implementation of national protocol for telehealth security and interfacing instructions 7a7 ,national telehealth security protocol 7#a7 ,assessment 7,a7 ,in general ,the ,secretary of ,veterans ,affairs1 in consultation with industry experts1 the ,chairman of the ,federal ,trade ,commission1 the ,assistant ,secretary of ,veterans ,affairs for ,information and ,technology and ,chief ,information ,officer1 and stakeholders1 shall conduct an assessment of current telehealth security protocols4 7,b7 ,elements ,the assessment conducted under subparagraph 7,a7 shall include the following3 7i7 ,an assessment of current telehealth security protocols1 including protocols used by-- 7,i7 the ,department of ,veterans ,affairs2 7,,ii7 other ,federal agencies2 7,,iii7 other health care providers2 and 7,,iv7 such other organizations as the ,secretary considers necessary to assess under such subparagraph4 7ii7 ,a study of any current or future security risks-- 7,i7 faced by veterans using telehealth services2 or 7,,ii7 faced by the ,department in furnishing those services4 7,c7 ,timeline ,the ,secretary shall complete the assessment conducted under subparagraph 7,a7 not later than one year after the date of the enactment of this ,act4 7#b7 ,implementation ,not later than #ah months after the completion of the assessment under paragraph 7#a71 the ,secretary shall1 using guidance from the assessment1 fully implement a standardized telehealth security protocol at all facilities of the ,department4 7#c7 ,privacy and security ,the ,secretary shall ensure that the security protocol implemented under this subsection protects the privacy and security of veterans1 the health data of veterans1 and data from the ,department4 7b7 ,national telehealth interfacing instructions 7#a7 ,assessment 7,a7 ,in general ,the ,secretary of ,veterans ,affairs1 in consultation with industry experts1 organizations that represent veterans1 the ,chief ,veterans ,experience ,officer1 the ,assistant ,secretary of ,veterans ,affairs for ,information and ,technology and ,chief ,information ,officer1 and stakeholders1 shall conduct an assessment of current telehealth interfacing instructions4 7,b7 ,elements ,the assessment conducted under subparagraph 7,a7 shall include an assessment of interfacing instructions used by-- 7i7 the ,department of ,veterans ,affairs2 7ii7 other ,federal agencies2 7iii7 other health care providers2 and 7iv7 such other organizations as the ,secretary considers necessary to assess under such subparagraph4 7,c7 ,timeline ,the ,secretary shall complete the assessment conducted under subparagraph 7,a7 not later than one year after the date of the enactment of this ,act4 7#b7 ,implementation ,not later than #ah months after the completion of the assessment under paragraph 7#a71 the ,secretary shall1 using guidance from the assessment1 fully implement standardized telehealth interfacing instructions at all facilities of the ,department4 7#c7 ,navigation ,the ,secretary shall ensure that the telehealth interfacing instructions implemented under this subsection are those that are easiest to navigate for veterans and health care providers4 #a4 ,short title2 table of contents 7a7 ,short title ,this ,act may be cited as the ,commander ,john ,scott ,hannon ,veterans ,mental ,health ,care ,improvement ,act of #bjai4 7b7 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents4,,title ,i--,improvement of transition of individuals to services from ,department of ,veterans ,affairs,sec4 #aja4 ,expansion of health care coverage for veterans4,sec4 #ajb4 ,review of records of former members of the ,armed ,forces who die by suicide within one year of separation from the ,armed ,forces4,sec4 #ajc4 ,report on ,,reach ,,vet program of ,department of ,veterans ,affairs4,sec4 #ajd4 ,report on care for former members of the ,armed ,forces with other than honorable discharge4,,title ,,ii--,suicide prevention,sec4 #bja4 ,financial assistance to certain entities to provide and coordinate the provision of suicide prevention services for eligible individuals and their families4,sec4 #bjb4 ,study on feasibility and advisability of the ,department of ,veterans ,affairs providing certain complementary and integrative health services4,sec4 #bjc4 ,pilot program to provide veterans access to complementary and integrative health services through animal therapy1 agritherapy1 post-traumatic growth therapy1 and outdoor sports and recreation therapy4,sec4 #bjd4 ,department of ,veterans ,affairs independent reviews of certain deaths of veterans by suicide and staffing levels of mental health professionals4,sec4 #bje4 ,comptroller ,general report on management by ,department of ,veterans ,affairs of veterans at high risk for suicide4,,title ,,iii--,programs1 studies1 and guidelines on mental health,sec4 #cja4 ,study on connection between living at high altitude and suicide risk factors among veterans4,sec4 #cjb4 ,establishment by ,department of ,veterans ,affairs and ,department of ,defense of a clinical provider treatment toolkit and accompanying training materials for comorbidities4,sec4 #cjc4 ,update of clinical practice guidelines for assessment and management of patients at risk for suicide4,sec4 #cjd4 ,establishment by ,department of ,veterans ,affairs and ,department of ,defense of clinical practice guidelines for the treatment of serious mental illness4,sec4 #cje4 ,precision medicine initiative of ,department of ,veterans ,affairs to identify and validate brain and mental health biomarkers4,sec4 #cjf4 ,statistical analyses and data evaluation by ,department of ,veterans ,affairs4,,title ,,iv--,oversight of mental health care and related services,sec4 #dja4 ,study on effectiveness of suicide prevention and mental health outreach programs of ,department of ,veterans ,affairs4,sec4 #djb4 ,oversight of mental health and suicide prevention media outreach conducted by ,department of ,veterans ,affairs4,sec4 #djc4 ,comptroller ,general management review of mental health and suicide prevention services of ,department of ,veterans ,affairs4,sec4 #djd4 ,comptroller ,general report on efforts of ,department of ,veterans ,affairs to integrate mental health care into primary care clinics4,sec4 #dje4 ,joint mental health programs by ,department of ,veterans ,affairs and ,department of ,defense4,,title ,v--,improvement of mental health medical workforce,sec4 #eja4 ,staffing improvement plan for mental health providers of ,department of ,veterans ,affairs4,sec4 #ejb4 ,staffing improvement plan for peer specialists of ,department of ,veterans ,affairs who are women4,sec4 #ejc4 ,establishment of ,department of ,veterans ,affairs ,readjustment ,counseling ,service ,scholarship ,program4,sec4 #ejd4 ,comptroller ,general report on ,readjustment ,counseling ,service of ,department of ,veterans ,affairs4,sec4 #eje4 ,expansion of reporting requirements on ,readjustment ,counseling ,service of ,department of ,veterans ,affairs4,sec4 #ejf4 ,studies on alternative work schedules for employees of ,veterans ,health ,administration4,sec4 #ejg4 ,suicide prevention coordinators4,sec4 #ejh4 ,report on efforts by ,department of ,veterans ,affairs to implement safety planning in emergency departments4,,title ,,vi--,improvement of care and services for women veterans,sec4 #fja4 ,expansion of capabilities of ,women ,veterans ,call ,center to include text messaging4,sec4 #fjb4 ,gap analysis of ,department of ,veterans ,affairs programs that provide assistance to women veterans who are homeless4,sec4 #fjc4 ,requirement for ,department of ,veterans ,affairs internet website to provide information on services available to women veterans4,sec4 #fjd4 ,report on locations where women veterans are using health care from ,department of ,veterans ,affairs4,,title ,,vii--,other matters,sec4 #gja4 ,expanded telehealth from ,department of ,veterans ,affairs4,sec4 #gjb4 ,partnerships with non-,federal ,government entities to provide hyperbaric oxygen therapy to veterans and studies on the use of such therapy for treatment of post-traumatic stress disorder and traumatic brain injury4,sec4 #gjc4 ,prescription of technical qualifications for licensed hearing aid specialists and requirement for appointment of such specialists4,sec4 #gjd4 ,use by ,department of ,veterans ,affairs of commercial institutional review boards in sponsored research trials4,sec4 #gje4 ,creation of ,office of ,research ,reviews within the ,office of ,information and ,technology of the ,department of ,veterans ,affairs4 ,i ,improvement of transition of individuals to services from ,department of ,veterans ,affairs #aja4 ,expansion of health care coverage for veterans 7a7 ,in general ,section #agaj7;a77#a7 of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in subparagraph 7,a71 by striking and at the end2 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 to any veteran during the one-year period following the discharge or release of the veteran from active military1 naval1 or air service2 and 4 7b7 ,patient enrollment system ,section #agje7;c7 of such title is amended by adding at the end the following new paragraph3 7#c7 ,nothing in this section shall be construed to prevent the ,secretary from providing hospital care and medical services to a veteran under section #agaj7;a77#a77;,b7 of this title during the period specified in such section notwithstanding the failure of the veteran to enroll in the system of patient enrollment established by the ,secretary under subsection 7a74 4 7c7 ,promotion of expanded eligibility 7#a7 ,transition ,assistance ,program 7,a7 ,in general ,the ,secretary of ,labor1 in consultation with the ,secretary of ,defense and the ,secretary of ,veterans ,affairs1 shall promote to members of the ,armed ,forces transitioning from service in the ,armed ,forces to civilian life through the ,transition ,assistance ,program the expanded eligibility of veterans for health care under the laws administered by the ,secretary of ,veterans ,affairs pursuant to the amendments made by this section4 7,b7 ,transition ,assistance ,program defined ,in this paragraph1 the term ,transition ,assistance ,program means the ,transition ,assistance ,program under sections #aadb and #aadd of title #aj1 ,united ,states ,code4 7#b7 ,publication by ,department of ,veterans ,affairs ,not later than #cj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall publish on a website of the ,department of ,veterans ,affairs notification of the expanded eligibility of veterans for health care under the laws administered by the ,secretary pursuant to the amendments made by this section4 #ajb4 ,review of records of former members of the ,armed ,forces who die by suicide within one year of separation from the ,armed ,forces 7a7 ,in general ,the ,secretary of ,defense and the ,secretary of ,veterans ,affairs shall jointly review the records of each former member of the ,armed ,forces who died by suicide within one year of separation from the ,armed ,forces during the five-year period preceding the date of the enactment of this ,act4 7b7 ,elements ,the review required by subsection 7a7 with respect to a former member of the ,armed ,forces shall include consideration of the following3 7#a7 ,if the ,department of ,defense had previously identified the former member as being at risk for suicide and if that identification had been communicated to the ,department of ,veterans ,affairs4 7#b7 ,what risk factors were present with respect to the former member and how those risk factors correlated to the circumstances of the death of the former member4 7#c7 ,if the former member was eligible to receive health care services from the ,department of ,veterans ,affairs4 7#d7 ,if the former member received health care services1 including mental health care services1 from a facility of the ,department of ,veterans ,affairs1 including readjustment counseling services1 following separation from the ,armed ,forces4 7#e7 ,if the former member had received a mental health waiver during service in the ,armed ,forces4 7#f7 ,the employment status1 housing status1 marital status1 age1 rank within the ,armed ,forces 7such as enlisted or officer71 and branch of service within the ,armed ,forces of the former member4 7#g7 ,if support services1 specified by the type of service 7such as employment1 mental health1 etc471 were provided to the former member during their period of separation from the ,armed ,forces1 disaggregated by-- 7,a7 services furnished by the ,department of ,defense1 including through contracts2 7,b7 services furnished by the ,department of ,veterans ,affairs1 including through contracts2 and 7,c7 services not covered under subparagraph 7,a7 or 7,b74 7c7 ,report 7#a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,defense and the ,secretary of ,veterans ,affairs shall jointly submit to the appropriate committees of ,congress an aggregated report on the results of the review conducted under subsection 7a74 7#b7 ,appropriate committees of ,congress defined ,in this subsection1 the term appropriate committees of ,congress means-- 7,a7 ,the ,committee on ,armed ,services and the ,committee on ,veterans' ,affairs of the ,senate2 and 7,b7 ,the ,committee on ,armed ,services and the ,committee on ,veterans' ,affairs of the ,house of ,representatives4 #ajc4 ,report on ,,reach ,,vet program of ,department of ,veterans ,affairs 7a7 ,in general ,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 ,,reach ,,vet program4 7b7 ,elements ,the report required by subsection 7a7 shall include the following3 7#a7 ,an assessment of the impact of the ,,reach ,,vet program on rates of suicide among veterans4 7#b7 ,an assessment of how limits within the ,,reach ,,vet program1 such as caps on the number of veterans who may be flagged as high risk1 are adjusted for differing rates of suicide across the country4 7#c7 ,a detailed explanation1 with evidence1 for why the conditions included in the model used by the ,,reach ,,vet program were chosen1 including an explanation as to why certain conditions1 such as bipolar disorder ,,ii1 were not included even though they show a similar rate of risk for suicide as other conditions that were included4 7#d7 ,an assessment of the feasibility of incorporating certain economic data held by the ,veterans ,benefits ,administration into the model used by the ,,reach ,,vet program1 including financial data and employment status1 which research indicates may have an impact on risk for suicide4 7c7 ,,reach ,,vet program defined ,in this section1 the term ,,reach ,,vet program means the ,recovery ,engagement and ,coordination for ,health--,veterans ,enhanced ,treatment program of the ,department of ,veterans ,affairs4 #ajd4 ,report on care for former members of the ,armed ,forces with other than honorable discharge ,section #agbj;,i7f7 of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in paragraph 7#a7 by striking ,not less frequently than once and inserting ,not later than ,february #ae2 and 7#b7 in paragraph 7#b7-- 7,a7 by redesignating subparagraph 7,c7 as subparagraph 7,f72 and 7,b7 by inserting after subsection 7,b7 the following new subparagraphs3 7,c7 ,the types of mental or behavioral health care needs treated under this section4 7,d7 ,the demographics of individuals being treated under this section1 including-- 7i7 age2 7ii7 era of service in the ,armed ,forces2 7iii7 branch of service in the ,armed ,forces2 and 7iv7 geographic location4 7,e7 ,the average number of visits for an individual for mental or behavioral health care under this section4 4 ,,ii ,suicide prevention #bja4 ,financial assistance to certain entities to provide and coordinate the provision of suicide prevention services for eligible individuals and their families 7a7 ,purpose ,the purpose of this section is to reduce veteran suicide through a community-based grant program to award grants to eligible entities to provide suicide prevention services to eligible individuals and their family4 7b7 ,distribution of financial assistance 7#a7 ,in general ,the ,secretary of ,veterans ,affairs shall provide financial assistance to eligible entities approved under this section through the award of grants each fiscal year to such entities to provide and coordinate the provision of suicide prevention services to eligible individuals and their family to reduce the risk of suicide4 7#b7 ,coordination with task force ,the ,secretary shall carry out this section in coordination with the ,president's ,roadmap to ,empower ,veterans and ,end the ,national ,tragedy of ,suicide ,task ,force1 to the extent practicable4 7c7 ,award of grants 7#a7 ,in general ,the ,secretary shall award a grant to each eligible entity for which the ,secretary has approved an application under subsection 7f7 to provide or coordinate the provision of suicide prevention services under this section4 7#b7 ,grant amounts1 intervals of payment1 and matching funds ,in accordance with the services being provided under a grant under this section and the duration of those services1 the ,secretary shall establish-- 7,a7 a maximum amount to be awarded under the grant that is not greater than #gej1jjj per grantee per fiscal year2 7,b7 intervals of payment for the administration of the grant2 and 7,c7 a requirement for the recipient of the grant to provide matching funds in a specified percentage4 7d7 ,distribution of financial assistance and preference 7#a7 ,distribution 7,a7 ,priority ,subject to subparagraphs 7,b7 and 7,c71 in determining how to distribute grants under this section1 the ,secretary may prioritize the award of grants in-- 7i7 rural communities2 7ii7 ,tribal lands2 7iii7 territories of the ,united ,states2 7iv7 medically underserved areas2 7v7 areas with a high number or percentage of minority veterans or women veterans2 and 7vi7 areas with a high number or percentage of calls to the ,veterans ,crisis ,line4 7,b7 ,areas with need ,the ,secretary shall ensure that1 to the extent practicable1 financial assistance under this section is distributed-- 7i7 to provide services in areas of the ,united ,states1 including territories of the ,united ,states1 that have experienced high rates or a high burden of veteran suicide2 and 7ii7 to eligible entities that can assist eligible individuals at risk of suicide who are not currently receiving health care furnished by the ,department of ,veterans ,affairs4 7,c7 ,geography ,in distributing financial assistance under subparagraph 7,b71 the ,secretary may provide grants to eligible entities that furnish services to eligible individuals in geographically dispersed areas4 7#b7 ,preference 7,a7 ,in general ,the ,secretary shall give preference in the provision of financial assistance under this section to eligible entities that have demonstrated the ability to provide or coordinate multiple suicide prevention services using a collective impact model4 7,b7 ,rule of construction ,nothing in this paragraph shall be construed to limit the award of grants under this section only to organizations that provide or coordinate multiple suicide prevention services through a collective impact model4 7e7 ,requirements for receipt of financial assistance 7#a7 ,notification that services are from ,department ,each entity receiving financial assistance under this section to provide suicide prevention services to eligible individuals and their family shall notify the recipients of such services that such services are being paid for1 in whole or in part1 by the ,department4 7#b7 ,coordination with other services from ,department ,each entity receiving a grant under this section shall-- 7,a7 coordinate with the ,secretary with respect to the provision of clinical services to eligible individuals in accordance with any other provision of law regarding the delivery of health care under the laws administered by the ,secretary2 7,b7 inform a veteran in receipt of assistance under this section of the eligibility of the veteran to enroll in the patient enrollment system of the ,department under section #agje of title #ch1 ,united ,states ,code2 and 7,c7 if such veteran wishes to so enroll1 inform the veteran of the point of contact at the nearest medical center of the ,department who can assist the veteran in such enrollment4 7#c7 ,measurement and monitoring ,each entity receiving a grant under this section shall submit to the ,secretary a description of the tools and assessments the entity uses or will use to determine the effectiveness of the services furnished by the entity under this section1 including the effect of those services on-- 7,a7 the financial stability of eligible individuals receiving those services2 7,b7 the mental resiliency and mental outlook of those eligible individuals2 and 7,c7 the social support of those eligible individuals4 7#d7 ,reports ,the ,secretary-- 7,a7 shall require each entity receiving financial assistance under this section to submit to the ,secretary an annual report that describes the projects carried out with such financial assistance during the year covered by the report1 including the number of eligible individuals served2 7,b7 shall specify to each such entity the evaluation criteria and data and information1 which shall include a mental health measurement of each eligible individual served1 to be submitted in such report2 and 7,c7 may require such entities to submit to the ,secretary such additional reports as the ,secretary considers appropriate4 7f7 ,application for financial assistance 7#a7 ,in general ,an eligible entity seeking financial assistance under this section shall submit to the ,secretary an application therefor in such form1 in such manner1 and containing such commitments and information as the ,secretary considers necessary to carry out this section4 7#b7 ,matters ,to be included ,each application submitted by an eligible entity under paragraph 7#a7 shall contain the following3 7,a7 ,a description of the suicide prevention services proposed to be provided by the eligible entity and the identified need for those services4 7,b7 ,a detailed plan describing how the eligible entity proposes to coordinate and deliver suicide prevention services 7including by providing opportunities for mental wellness and personal growth7 to eligible individuals not currently receiving care furnished by the ,department1 including-- 7i7 an identification of the community partners1 if any1 with which the eligible entity proposes to work in delivering such services2 7ii7 a description of the arrangements currently in place between the eligible entity and such partners2 and 7iii7 an identification of how long such arrangements have been in place4 7,c7 ,clearly defined objectives for the provision of suicide prevention services4 7,d7 ,a description of the services the eligible entity proposes to deliver directly and a description of any services the eligible entity proposes to deliver through an agreement with a community partner1 if any4 7,e7 ,a description of the types of eligible individuals at risk of suicide and their family proposed to be provided suicide prevention services4 7,f7 ,an estimate of the number of eligible individuals at risk of suicide and their family proposed to be provided suicide prevention services and the basis for such estimate1 including the percentage of those individuals who are not currently receiving care furnished by the ,department4 7,g7 ,the physical address of the primary location of the eligible entity4 7,h7 ,a description of the geographic area and boundaries the eligible entity plans to serve during the year for which the application applies4 7,i7 ,evidence of the experience of the eligible entity 7and the proposed partners of the entity7 in providing suicide prevention services to individuals at risk of suicide1 particularly to eligible individuals at risk of suicide and their family4 7,j7 ,a description of the managerial and technological capacity of the eligible entity-- 7i7 to coordinate the provision of suicide prevention services with the provision of other services2 7ii7 to assess continuously the needs of eligible individuals at risk of suicide and their family for suicide prevention services2 7iii7 to coordinate the provision of suicide prevention services with the services of the ,department for which the beneficiaries are eligible2 7iv7 to continuously seek new sources of assistance to ensure the continuity of suicide prevention services for eligible individuals at risk of suicide and their family as long as the individual is determined to be at risk of suicide2 and 7v7 to measure1 over a long-term period1 the improved mental resiliency and mental outlook of the eligible individual served4 7,k7 ,an agreement to use the measurement tool provided by the ,department for purposes of measuring effectiveness of the programming as described in paragraph 7#b7 of subsection 7h74 7,l7 ,a description of how the eligible entity plans to assess the effectiveness of the provision of suicide prevention services under this section4 7,m7 ,such additional application criteria as the ,secretary considers appropriate4 7g7 ,technical assistance 7#a7 ,in general ,the ,secretary shall provide training and technical assistance to eligible entities in receipt of financial assistance under this section regarding-- 7,a7 the data required to be collected and shared with the ,department2 7,b7 the means of data collection and sharing2 7,c7 familiarization with and appropriate use of any tool to be used to measure the effectiveness of the use of the financial assistance provided2 and 7,d7 the requirements for reporting under subsection 7e77#d7 on services provided via such financial assistance4 7#b7 ,provision of training and technical assistance ,the ,secretary may provide the training and technical assistance described in paragraph 7#a7 directly or through grants or contracts with appropriate public or nonprofit entities4 7h7 ,administration of grant program 7#a7 ,selection criteria ,the ,secretary1 in consultation with entities specified in paragraph 7#c71 shall establish criteria for the selection of eligible entities that have submitted applications under subsection 7f74 7#b7 ,development of measures and metrics ,the ,secretary shall develop1 in consultation with entities specified in paragraph 7#c71 the following3 7,a7 ,a framework for collecting and sharing information about entities in receipt of financial assistance under this section for purposes of improving the discovery of services available for eligible individuals at risk of suicide and their family1 set forth by service type1 locality1 and eligibility criteria4 7,b7 ,the measures to be used by each entity in receipt of financial assistance under this section to determine the effectiveness of the programming being provided by such entity in improving mental resiliency and mental outlook of eligible individuals at risk of suicide and their family4 7,c7 ,metrics for measuring the effectiveness of the provision of financial assistance under this section1 including reducing suicide risk among eligible individuals4 7#c7 ,coordination ,in developing a plan for the design and implementation of the provision of financial assistance under this section1 including criteria for the award of grants1 the ,secretary shall consult with the following3 7,a7 ,veterans service organizations4 7,b7 ,national organizations representing potential community partners of eligible entities in providing supportive services to address the needs of eligible individuals at risk of suicide and their family1 including national organizations that-- 7i7 advocate for the needs of individuals with or at risk of behavioral health conditions2 7ii7 represent mayors2 7iii7 represent first responders2 7iv7 represent chiefs of police and sheriffs2 7v7 represent governors2 7vi7 represent a territory of the ,united ,states2 or 7vii7 represent a ,tribal alliance4 7,c7 ,national organizations that represent counties4 7,d7 ,organizations with which the ,department has a current memorandum of agreement or understanding related to mental health or suicide prevention4 7,e7 ,state departments of veterans affairs4 7,f7 ,national organizations representing members of the reserve components of the ,armed ,forces4 7,g7 ,vet ,centers4 7,h7 ,organizations1 including institutions of higher education1 with experience in creating measurement tools for purposes of determining programmatic effectiveness4 7,i7 ,the ,national ,alliance on ,mental ,illness4 7,j7 ,the ,centers for ,disease ,control and ,prevention4 7,k7 ,the ,substance ,abuse and ,mental ,health ,services ,administration of the ,department of ,health and ,human ,services4 7,l7 ,a labor organization 7as such term is defined in section #gajc7;a77#d7 of title #e1 ,united ,states ,code74 7,m7 ,the ,,prevents task force established under ,executive ,order #achfa 7#hd ,fed4 ,reg4 #hehe2 relating to the national roadmap to empower veterans and end suicide7 4 7,n7 ,such other organizations as the ,secretary considers appropriate4 7#d7 ,report on grant criteria ,not later than #cj days before notifying eligible entities of the availability of funding under this section1 the ,secretary shall submit to the appropriate committees of ,congress a report containing-- 7,a7 criteria for the award of a grant under this section2 7,b7 the tool or tools and metrics to be used by the ,department to measure the effectiveness of the use of financial assistance provided under this section2 7,c7 a framework for the sharing of information about entities in receipt of financial assistance under this section2 and 7,d7 the method by which the ,secretary determines financial responsibility for purposes of paragraph 7#c7 of subsection 7m74 7i7 ,information on potential beneficiaries 7#a7 ,in general ,the ,secretary may make available to recipients of financial assistance under this section certain information regarding potential beneficiaries of services for which such financial assistance is provided4 7#b7 ,information included ,the information made available under paragraph 7#a7 with respect to potential beneficiaries may include the following3 7,a7 ,confirmation of the status of a potential beneficiary as a veteran4 7,b7 ,confirmation of whether the potential beneficiary is enrolled in the patient enrollment system of the ,department under section #agje of title #ch1 ,united ,states ,code4 7,c7 ,confirmation of whether a potential beneficiary is currently receiving care furnished by the ,department or has recently received such care4 7#c7 ,opt-out ,the ,secretary shall allow an eligible individual to opt out of having their information shared under this subsection with recipients of financial assistance under this section4 7j7 ,duration ,the authority of the ,secretary to provide financial assistance under this section shall terminate on the date that is three years after the date on which the first grant is awarded under this section4 7k7 ,reporting and assessment 7#a7 ,interim report 7,a7 ,in general ,not later than #ah months after the date on which the first grant is awarded under this section1 the ,secretary shall submit to the appropriate committees of ,congress a report on the provision of financial assistance under this section4 7,b7 ,elements ,the report submitted under subparagraph 7,a7 shall include the following3 7i7 ,an assessment of the effectiveness of the provision of financial assistance under this section1 including-- 7,i7 the effectiveness of community partners in conducting outreach to eligible individuals at risk of suicide and their family and reducing suicide rates for eligible individuals2 and 7,,ii7 the effectiveness of the measures and metrics developed under subsection 7h77#b7 at improving coordination of suicide prevention services4 7ii7 ,a list of grant recipients and their partner organizations that delivered services funded by the grant and the amount of such grant received by each recipient and partner organization4 7iii7 ,the number of eligible individuals supported by each grant recipient1 including through services provided to family members4 7iv7 ,the types of suicide prevention services provided by each grant recipient and partner organization4 7v7 ,the number of eligible individuals supported by each grant recipient under this section1 including through services provided to family members1 who were not previously receiving care furnished by the ,department4 7vi7 ,the number of eligible individuals whose mental resiliency and mental outlook received a baseline measurement assessment under this section and the number of such individuals whose mental resiliency and mental outlook will be measured by the ,department or a community partner over a period of time4 7vii7 ,the types of data the ,department was able to collect and share with partners1 including a characterization of the benefits of that data4 7viii7 ,the number of eligible individuals newly enrolled in the ,veterans ,health ,administration by grant recipients1 set forth by grant recipient4 7#b7 ,final report ,not later than three years after the date on which the first grant is awarded under this section1 the ,secretary shall submit to the appropriate committees of ,congress-- 7,a7 a follow-up on the interim report submitted under paragraph 7#a7 containing the elements set forth in subparagraph 7,b7 of such paragraph2 and 7,b7 a report on-- 7i7 the effectiveness of the provision of financial assistance under this section1 including the effectiveness of community partners in conducting outreach to eligible individuals at risk of suicide and their family and reducing suicide rates for eligible individuals2 7ii7 an assessment of the increased capacity of the ,department to provide services to eligible individuals at risk of suicide and their family1 set forth by ,state1 as a result of the provision of financial assistance under this section2 and 7iii7 the feasibility and advisability of extending or expanding the provision of financial assistance under this section4 7#c7 ,third party assessment 7,a7 ,study of grant program 7i7 ,in general ,not later than #ahj days after the date on which the first grant is awarded under this section1 the ,secretary shall seek to enter into a contract with an appropriate entity described in subparagraph 7,c7 to conduct a study on the provision of grants under this section4 7ii7 ,elements ,in conducting the study under clause 7i71 the appropriate entity shall-- 7,i7 evaluate the effectiveness of grants under this section in addressing the factors that contribute to suicide through the provision of services by eligible entities located in the communities where the eligible individuals receiving those services live2 and 7,,ii7 compare the results of the provision of grants under this section with other national programs in delivering resources to eligible individuals in the communities where they live that address the factors that contribute to suicide4 7,b7 ,assessment 7i7 ,in general ,the contract under subparagraph 7,a7 shall require that not later than two years after the date on which the first grant is awarded under this section1 the appropriate entity shall submit to the ,secretary an assessment of the provision of grants under this section based on the study conducted pursuant to such contract4 7ii7 ,submittal to congress ,upon receipt of the assessment under clause 7i71 the ,secretary shall submit to the appropriate committees of ,congress a copy of the assessment4 7,c7 ,appropriate entity ,an appropriate entity described in this subparagraph is a nongovernment entity with experience optimizing and assessing organizations that deliver services4 7l7 ,provision of care to eligible individuals 7#a7 ,in general ,when the ,secretary determines it is clinically appropriate1 the ,secretary shall furnish to an eligible individual receiving suicide prevention services through a grant provided under this section an initial mental health assessment and mental health or behavioral health care services authorized under chapter #ag of title #ch1 ,united ,states ,code1 that are required to treat the mental or behavioral health care needs of the eligible individual1 including risk of suicide4 7#b7 ,ineligible ,if an eligible individual refuses to receive services under paragraph 7#a7 or is ineligible for such services1 any ongoing clinical services provided by an eligible entity receiving a grant under this section1 or a community partner of such entity1 shall be at the expense of the entity4 7m7 ,definitions ,in this section3 7#a7 ,appropriate committees of ,congress ,the term appropriate committees of ,congress means-- 7,a7 the ,committee on ,veterans' ,affairs and the ,subcommittee on ,military ,construction1 ,veterans ,affairs1 and ,related ,agencies of the ,committee on ,appropriations of the ,senate2 and 7,b7 the ,committee on ,veterans' ,affairs and the ,subcommittee on ,military ,construction1 ,veterans ,affairs1 and ,related ,agencies of the ,committee on ,appropriations of the ,house of ,representatives4 7#b7 ,collective impact model ,the term collective impact model means a partnership between several entities that-- 7,a7 collectively provides multiple suicide prevention services2 7,b7 shares the common goal of reducing the risk of suicide among eligible individuals2 7,c7 has a shared measurement system2 7,d7 engages in continuous communication2 and 7,e7 includes an organization that acts as the supporting infrastructure of the model by creating a structured process for-- 7i7 strategic planning2 7ii7 project management2 and 7iii7 supporting partner entities through ongoing-- 7,i7 facilitation2 7,,ii7 technology and communications support2 7,,iii7 data collection and reporting2 and 7,,iv7 administrative support4 7#c7 ,eligible entity ,the term eligible entity means-- 7,a7 an incorporated private institution or foundation-- 7i7 no part of the net earnings of which incurs to the benefit of any member1 founder1 contributor1 or individual2 7ii7 that has a governing board that would be responsible for the operation of the suicide prevention services provided under this section2 and 7iii7 that is approved by the ,secretary as to financial responsibility2 7,b7 a corporation wholly owned and controlled by an organization meeting the requirements of clauses 7i71 7ii71 and 7iii7 of subparagraph 7,a72 7,c7 a tribally designated housing entity 7as defined in section #d of the ,native ,american ,housing ,assistance and ,self-,determination ,act of #aiif 7#be ,u4,s4,c4 #dajc772 7,d7 a community-based organization-- 7i7 that is physically based in the targeted community2 7ii7 that can effectively network with local civic organizations1 regional health systems1 and other settings where eligible individuals at risk of suicide and their family are likely to have contact2 and 7iii7 that is approved by the ,secretary as to financial responsibility2 7,e7 a community-based organization-- 7i7 that is physically based in the targeted community2 7ii7 that has demonstrated the potential to use a collective impact model to effectively network and partner with community partners that offer suicide prevention services to reduce the risk of suicide for eligible individuals2 and 7iii7 that is approved by the ,secretary as to financial responsibility2 or 7,f7 a ,state or local government that is approved by the ,secretary as to financial responsibility4 7#d7 ,eligible individual ,the term eligible individual means-- 7,a7 a veteran1 as defined in section #aja of title #ch1 ,united ,states ,code2 7,b7 an eligible individual described in section #agbj;,i7b7 of such title2 7,c7 an individual described in any of clauses 7i7 through 7iv7 of section #agab;,a7a77#a77;,c7 of such title2 or 7,d7 such other individual as the ,secretary considers appropriate4 7#e7 ,emergency medical condition defined ,the term emergency medical condition means a medical or behavioral condition manifesting itself by acute symptoms of sufficient severity1 including severe pain1 such that the absence of immediate medical attention could reasonably be expected to result in-- 7,a7 placing the health of the individual in serious jeopardy2 7,b7 serious impairment to bodily functions2 or 7,c7 serious dysfunction of bodily organs4 7#f7 ,family ,the term family means1 with respect to an eligible individual at risk of suicide1 any of the following3 7,a7 ,a parent4 7,b7 ,a spouse4 7,c7 ,a child4 7,d7 ,a sibling4 7,e7 ,a step-family member4 7,f7 ,an extended family member4 7,g7 ,any other individual who lives with the eligible individual4 7#g7 ,necessary stabilizing treatment defined ,the term necessary stabilizing treatment means1 with respect to an emergency medical condition1 to provide1 for not greater than #gb hours1 such medical treatment for the condition 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 facility4 7#h7 ,peer specialist ,the term peer specialist means a person eligible to be appointed as a peer specialist under section #gdjb7;b77#ac7 of title #ch1 ,united ,states ,code4 7#i7 ,risk of suicide ,the term risk of suicide means exposure to or the existence of any of the following3 7,a7 ,health risk factors1 including the following3 7i7 ,mental health challenges4 7ii7 ,substance abuse4 7iii7 ,serious or chronic health conditions or pain4 7iv7 ,traumatic brain injury4 7,b7 ,environmental risk factors1 including the following3 7i7 ,access to lethal means 7such as drugs1 firearms1 etc474 7ii7 ,prolonged stress4 7iii7 ,stressful life events4 7iv7 ,exposure to the suicide of another person or to graphic or sensationalized accounts of suicide4 7v7 ,unemployment4 7vi7 ,homelessness4 7vii7 ,recent loss4 7viii7 ,legal or financial challenges4 7,c7 ,historical risk factors1 including the following3 7i7 ,previous suicide attempts4 7ii7 ,family history of suicide4 7iii7 ,history of abuse1 neglect1 or trauma4 7#aj7 ,rural ,with respect to an area or community1 the term rural has the meaning given that term in the ,rural-,urban ,commuting ,areas coding system of the ,department of ,agriculture4 7#aa7 ,state ,the term ,state means each of several ,states1 the ,district of ,columbia1 the ,northern ,mariana ,islands1 ,american ,samoa1 ,guam1 ,puerto ,rico1 and the ,united ,states ,virgin ,islands4 7#ab7 ,suicide prevention services 7,a7 ,in general ,the term suicide prevention services means services to address the needs of eligible individuals at risk of suicide and their family and includes the following3 7i7 ,outreach to identify eligible individuals at risk of suicide1 with an emphasis on eligible individuals who are at highest risk or who are not receiving health care or other services furnished by the ,department4 7ii7 ,a baseline mental health assessment for risk screening and referral to care at-- 7,i7 a medical facility of the ,department2 7,,ii7 a ,vet ,center2 or 7,,iii7 a non-,department facility if the eligible individual refuses to or is ineligible for care from the ,department or a ,vet ,center4 7iii7 ,education on suicide risk and prevention to families and communities4 7iv7 ,individual and group therapy4 7v7 ,case management services4 7vi7 ,peer support services provided by peer specialists4 7vii7 ,assistance in obtaining any benefit from the ,department that the eligible individual at risk of suicide or their family may be eligible to receive1 including-- 7,i7 vocational and rehabilitation counseling2 7,,ii7 supportive services for homeless veterans2 7,,iii7 employment and training services2 7,,iv7 educational assistance2 and 7,v7 health care services4 7viii7 ,assistance in obtaining and coordinating the provision of other benefits provided by the ,federal ,government1 a ,state or local government1 or an eligible entity4 7ix7 ,the provision of emergency mental health treatment to an eligible individual1 which may include-- 7,i7 assessing the eligible individual for immediate suicide risk2 7,,ii7 connecting the eligible individual to the ,veterans ,crisis ,line2 and 7,,iii7 in the case of an eligible individual who is experiencing an emergency medical condition-- 7aa7 paying for the provision of necessary stabilizing treatment provided in a hospital or other medical facility2 and 7bb7 transporting the individual-- 7,,aa7 if the individual is eligible for care from the ,department1 to a medical facility of the ,department2 or 7,,bb7 if the individual is not eligible for care from the ,department1 to a medical facility not operated by the ,department4 7x7 ,such other services necessary for improving the resiliency of eligible individuals at risk of suicide and their family as the ,secretary considers appropriate1 which may include-- 7,i7 assistance with emergent needs relating to-- 7aa7 daily living services2 7bb7 personal financial planning2 7cc7 transportation services2 7dd7 legal services to assist the eligible individual with issues that may contribute to risk of suicide2 and 7ee7 child care 7not to exceed #e1jjj per family of the eligible individual per fiscal year72 7,,ii7 adaptive sports1 equine assisted therapy1 or in-place or outdoor recreational therapy2 7,,iii7 substance use reduction programming2 7,,iv7 individual1 group1 or family counseling2 and 7,v7 relationship coaching4 7,b7 ,exclusion ,the term suicide prevention services does not include direct cash assistance to eligible individuals or their family4 7#ac7 ,vet center ,the term ,vet ,center has the meaning given that term in section #agab;,a7h77#a7 of title #ch1 ,united ,states ,code4 7#ad7 ,veterans crisis line ,the term ,veterans ,crisis ,line means the toll-free hotline for veterans established under section #agbj;,f7h7 of such title4 7#ae7 ,veterans service organization ,the term veterans service organization means any organization recognized by the ,secretary of ,veterans ,affairs for the representation of veterans included as part of the annually updated list at https3_/_/www4va4gov_/vso_/ or a successor website4 #bjb4 ,study on feasibility and advisability of the ,department of ,veterans ,affairs providing certain complementary and integrative health services 7a7 ,in general ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall complete a study on the feasibility and advisability of providing complementary and integrative health treatments described in subsection 7c7 at all medical facilities of the ,department of ,veterans ,affairs4 7b7 ,inclusion of assessment of report ,the study conducted under subsection 7a7 shall include an assessment of the final report of the ,creating ,options for ,veterans' ,expedited ,recovery ,commission 7commonly referred to as the ,,cover ,commission7 established under section #ica of the ,jason ,simcakoski ,memorial and ,promise ,act 7title ,,ix of ,public ,law #aad-aih2 #ch ,u4,s4,c4 #agja note74 7c7 ,treatments described ,complementary and integrative health treatments described in this subjection shall consist of the following3 7#a7 ,yoga4 7#b7 ,meditation4 7#c7 ,acupuncture4 7#d7 ,chiropractic care4 7#e7 ,other treatments that show sufficient evidence of efficacy at treating mental or physical health conditions1 as determined by the ,secretary4 7d7 ,report ,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 study completed under subsection 7a71 including-- 7#a7 the results of such study2 and 7#b7 such recommendations regarding the furnishing of complementary and integrative health treatments described in subsection 7c7 as the ,secretary considers appropriate4 #bjc4 ,pilot program to provide veterans access to complementary and integrative health services through animal therapy1 agritherapy1 post-traumatic growth therapy1 and outdoor sports and recreation therapy 7a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall commence the conduct of a pilot program to provide complementary and integrative health services described in subsection 7b7 to eligible veterans from the ,department of ,veterans ,affairs or through the use of non-,department entities for the treatment of post-traumatic stress disorder1 depression1 anxiety1 or other conditions as determined by the ,secretary4 7b7 ,treatments described ,complementary and integrative health treatments described in this subsection shall consist of the following3 7#a7 ,equine therapy4 7#b7 ,other animal therapy4 7#c7 ,agritherapy4 7#d7 ,post-traumatic growth therapy4 7#e7 ,outdoor sports and recreation therapy4 7c7 ,eligible veterans ,a veteran is eligible to participate in the pilot program under this section if the veteran-- 7#a7 is enrolled in the system of patient enrollment of the ,department under section #agje7;a7 of title #ch1 ,united ,states ,code2 and 7#b7 has received health care under the laws administered by the ,secretary during the two-year period preceding the initial participation of the veteran in the pilot program4 7d7 ,duration 7#a7 ,in general ,the ,secretary shall carry out the pilot program under this section for a three-year period beginning on the commencement of the pilot program4 7#b7 ,extension ,the ,secretary may extend the duration of the pilot program under this section if the ,secretary1 based on the results of the interim report submitted under subsection 7f77#a71 determines that it is appropriate to do so4 7e7 ,locations 7#a7 ,in general ,the ,secretary shall select not fewer than five facilities of the ,department at which to carry out the pilot program under this section4 7#b7 ,selection criteria ,in selecting facilities under paragraph 7#a71 the ,secretary shall ensure that-- 7,a7 the locations are in geographically diverse areas2 and 7,b7 not fewer than three facilities serve veterans in rural or highly rural areas 7as determined through the use of the ,rural-,urban ,commuting ,areas coding system of the ,department of ,agriculture74 7f7 ,research on effectiveness of treatment 7#a7 ,in general ,the ,secretary shall carry out the pilot program in conjunction with academic researchers affiliated with the ,department of ,veterans ,affairs1 including through agreements under paragraph 7#b71 in order for those researchers to research the effectiveness of the treatments described in subsection 7b74 7#b7 ,agreements ,before commencing the pilot program1 the ,secretary shall seek to enter into agreements with academic researchers to ensure robust data collection and gathering procedures are in place under the pilot program in order to produce peer-reviewed journal articles4 7g7 ,reports 7#a7 ,interim report 7,a7 ,in general ,not later than one year after the commencement of the pilot program 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 progress of the pilot program4 7,b7 ,elements ,the report required by subparagraph 7,a7 shall include the following3 7i7 ,the number of participants in the pilot program4 7ii7 ,the type or types of therapy offered at each facility at which the pilot program is being carried out4 7iii7 ,an assessment of whether participation by a veteran in the pilot program resulted in any changes in clinically relevant endpoints for the veteran with respect to the conditions specified in subsection 7a74 7iv7 ,an assessment of the quality of life of veterans participating in the pilot program1 including the results of a satisfaction survey of the participants in the pilot program1 disaggregated by treatment under subsection 7b74 7v7 ,the determination of the ,secretary with respect to extending the pilot program under subsection 7d77#b74 7vi7 ,any recommendations of the ,secretary with respect to expanding the pilot program4 7#b7 ,final report ,not later than #ij days after the termination of the pilot program 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 final report on the pilot program4 #bjd4 ,department of ,veterans ,affairs independent reviews of certain deaths of veterans by suicide and staffing levels of mental health professionals 7a7 ,review of deaths of veterans by suicide 7#a7 ,in general ,not later than #ij 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 ,academies of ,sciences1 ,engineering1 and ,medicine under which the ,national ,academies shall conduct a review of the deaths of all covered veterans who died by suicide during the five-year period ending on the date of the enactment of this ,act1 regardless of whether information relating to such deaths has been reported by the ,centers for ,disease ,control and ,prevention4 7#b7 ,elements ,the review required by paragraph 7#a7 shall include the following3 7,a7 ,the total number of covered veterans who died by suicide during the five-year period ending on the date of the enactment of this ,act4 7,b7 ,the total number of covered veterans who died by a violent death during such five-year period4 7,c7 ,the total number of covered veterans who died by an accidental death during such five-year period4 7,d7 ,a description of each covered veteran described in subparagraphs 7,a7 through 7,c71 including age1 gender1 race1 and ethnicity4 7,e7 ,a comprehensive list of prescribed medications and legal or illegal substances as annotated on toxicology reports of covered veterans described in subparagraphs 7,a7 through 7,c71 specifically listing any medications that carried a black box warning1 were prescribed for off-label use1 were psychotropic1 or carried warnings that included suicidal ideation4 7,f7 ,a summary of medical diagnoses by physicians of the ,department of ,veterans ,affairs or physicians providing services to covered veterans through programs of the ,department that led to the prescribing of medications referred to in subparagraph 7,e7 in cases of post-traumatic stress disorder1 traumatic brain injury1 military sexual trauma1 and other anxiety and depressive disorders4 7,g7 ,the number of instances in which a covered veteran described in subparagraph 7,a71 7,b71 or 7,c7 was concurrently on multiple medications prescribed by physicians of the ,department or physicians providing services to veterans through programs of the ,department to treat post-traumatic stress disorder1 traumatic brain injury1 military sexual trauma1 other anxiety and depressive disorders1 or instances of comorbidity4 7,h7 ,the number of covered veterans described in subparagraphs 7,a7 through 7,c7 who were not taking any medication prescribed by a physician of the ,department or a physician providing services to veterans through a program of the ,department4 7,i7 ,with respect to the treatment of post-traumatic stress disorder1 traumatic brain injury1 military sexual trauma1 or other anxiety and depressive disorders1 the percentage of covered veterans described in subparagraphs 7,a7 through 7,c7 who received a non-medication first-line treatment compared to the percentage of such veterans who received medication only4 7,j7 ,with respect to the treatment of covered veterans described in subparagraphs 7,a7 through 7,c7 for post-traumatic stress disorder1 traumatic brain injury1 military sexual trauma1 or other anxiety and depressive disorders1 the number of instances in which a non-medication first-line treatment 7such as cognitive behavioral therapy7 was attempted and determined to be ineffective for such a veteran1 which subsequently led to the prescribing of a medication referred to in subparagraph 7,e74 7,k7 ,a description and example of how the ,department determines and continually updates the clinical practice guidelines governing the prescribing of medications4 7,l7 ,an analysis of the use by the ,department1 including protocols or practices at medical facilities of the ,department1 of systematically measuring pain scores during clinical encounters under the ,pain as the #eth ,vital ,sign ,toolkit of the ,department and an evaluation of the relationship between the use of such measurements and the number of veterans concurrently on multiple medications prescribed by physicians of the ,department4 7,m7 ,the percentage of covered veterans described in subparagraphs 7,a7 through 7,c7 with combat experience or trauma related to combat experience 7including military sexual trauma1 traumatic brain injury1 and post-traumatic stress74 7,n7 ,an identification of the medical facilities of the ,department with markedly high prescription rates and suicide rates for veterans receiving treatment at those facilities4 7,o7 ,an analysis1 by ,state1 of programs of the ,department that collaborate with ,state ,medicaid agencies and the ,centers for ,medicare and ,medicaid ,services1 including the following3 7i7 ,an analysis of the sharing of prescription and behavioral health data for veterans4 7ii7 ,an analysis of whether ,department staff check with ,state prescription drug monitoring programs before prescribing medications to veterans4 7iii7 ,a description of the procedures of the ,department for coordinating with prescribers outside of the ,department to ensure that veterans are not overprescribed4 7iv7 ,a description of actions that the ,department takes when a veteran is determined to be overprescribed4 7,p7 ,an analysis of the collaboration of medical centers of the ,department with medical examiners' offices or local jurisdictions to determine veteran mortality and cause of death4 7,q7 ,an identification and determination of a best practice model to collect and share veteran death certificate data between the ,department of ,veterans ,affairs1 the ,department of ,defense1 ,states1 and tribal entities4 7,r7 ,a description of how data relating to death certificates of veterans is collected1 determined1 and reported by the ,department of ,veterans ,affairs4 7,s7 ,an assessment of any patterns apparent to the ,national ,academies of ,sciences1 ,engineering1 and ,medicine based on the review conducted under paragraph 7#a74 7,t7 ,such recommendations for further action that would improve the safety and well-being of veterans as the ,national ,academies of ,sciences1 ,engineering1 and ,medicine determine appropriate4 7b7 ,review of staffing levels for mental health professionals 7#a7 ,in general ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary shall seek to enter into an agreement with the ,national ,academies of ,sciences1 ,engineering1 and ,medicine under which the ,national ,academies shall conduct a review of the staffing levels for mental health professionals of the ,department4 7#b7 ,elements ,the review required by paragraph 7#a7 shall include a description of the efforts of the ,department to maintain appropriate staffing levels for mental health professionals1 such as mental health counselors1 marriage and family therapists1 and other appropriate counselors1 including the following3 7,a7 a description of any impediments to carry out the education1 training1 and hiring of mental health counselors and marriage and family therapists under section #gcjb7;a7 of title #ch1 ,united ,states ,code1 and strategies for addressing those impediments2 7,b7 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 ,department1 including-- 7i7 a review of eligibility criteria for such counselors and therapists and a comparison of such criteria to that of other behavioral health professions in the ,department2 and 7ii7 an assessment of the participation of such counselors and therapists in the mental health professionals trainee program of the ,department and any impediments to such participation2 7,c7 an assessment of the development by the ,department of hiring guidelines for mental health counselors1 marriage and family therapists1 and other appropriate counselors2 7,d7 a description of how the ,department-- 7i7 identifies gaps in the supply of mental health professionals2 and 7ii7 determines successful staffing ratios for mental health professionals of the ,department2 7,e7 a description of actions taken by the ,secretary1 in consultation with the ,director of the ,office of ,personnel ,management1 to create an occupational series for mental health counselors and marriage and family therapists of the ,department and a timeline for the creation of such an occupational series2 and 7,f7 a description of actions taken by the ,secretary to ensure that the national1 regional1 and local professional standards boards for mental health counselors and marriage and family therapists are comprised of only mental health counselors and marriage and family therapists and that the liaison from the ,department to such boards is a mental health counselor or marriage and family therapist4 7c7 ,compilation of data 7#a7 ,form of compilation ,the ,secretary of ,veterans ,affairs shall ensure that data compiled under subsections 7a7 and 7b7 is compiled in a manner that allows it to be analyzed across all data fields for purposes of informing and updating clinical practice guidelines of the ,department of ,veterans ,affairs4 7#b7 ,compilation of data regarding covered veterans ,in compiling data under subsection 7a77#b7 regarding covered veterans described in subparagraphs 7,a7 through 7,c7 of such subsection1 data regarding veterans described in each such subparagraph shall be compiled separately and disaggregated by year4 7d7 ,completion of reviews and reports ,each agreement entered into under subsections 7a77#a7 and 7b77#a7 shall require that the ,national ,academies of ,sciences1 ,engineering1 and ,medicine complete the review under each such subsection and submit to the ,secretary of ,veterans ,affairs a report containing the results of the review-- 7#a7 with respect to the review under subsection 7a77#a71 not later than #bd months after entering into the agreement2 and 7#b7 with respect to the review under subsection 7b77#a71 not later than #ah months after entering into the agreement4 7e7 ,reports ,not later than #ij days after the completion by the ,national ,academies of ,sciences1 ,engineering1 and ,medicine of each of the reviews required under subsections 7a7 and 7b71 the ,secretary of ,veterans ,affairs shall-- 7#a7 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 review2 and 7#b7 make such report publicly available4 7f7 ,definitions ,in this section3 7#a7 ,the term black box warning means a warning displayed on the label of a prescription drug that is designed to call attention to the serious or life-threatening risk of the prescription drug4 7#b7 ,the term covered veteran means a veteran who received hospital care or medical services furnished by the ,department of ,veterans ,affairs during the five-year period preceding the death of the veteran4 7#c7 ,the term first-line treatment means a potential intervention that has been evaluated and assigned a high score within clinical practice guidelines4 7#d7 ,the term ,state means each of the ,states1 territories1 and possessions of the ,united ,states1 the ,district of ,columbia1 and the ,commonwealth of ,puerto ,rico4 #bje4 ,comptroller ,general report on management by ,department of ,veterans ,affairs of veterans at high risk for suicide 7a7 ,in general ,not later than #ah months 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 efforts of the ,department of ,veterans ,affairs to manage veterans at high risk for suicide4 7b7 ,elements ,the report required by subsection 7a7 shall include the following3 7#a7 ,a description of how the ,department identifies patients as high risk for suicide1 with particular consideration to the efficacy of inputs into the ,recovery ,engagement and ,coordination for ,health - ,veterans ,enhanced ,treatment program 7commonly referred to as the ,,reach ,,vet program7 of the ,department1 including an assessment of the efficacy of such identifications disaggregated by age1 gender1 ,veterans ,integrated ,service ,network1 and1 to the extent practicable1 medical center of the ,department4 7#b7 ,a description of how the ,department intervenes when a patient is identified as high risk1 including an assessment of the efficacy of such interventions disaggregated by age1 gender1 ,veterans ,integrated ,service ,network1 and1 to the extent practicable1 medical center of the ,department4 7#c7 ,a description of how the ,department monitors patients who have been identified as high risk1 including an assessment of the efficacy of such monitoring and any follow-ups disaggregated by age1 gender1 ,veterans ,integrated ,service ,network1 and1 to the extent practicable1 medical center of the ,department4 7#d7 ,a review of staffing levels of suicide prevention coordinators across the ,veterans ,health ,administration4 7#e7 ,a review of the resources and programming offered to family members and friends of veterans who have a mental health condition in order to assist that veteran in treatment and recovery4 7#f7 ,an assessment of such other areas as the ,comptroller ,general considers appropriate to study4 ,,iii ,programs1 studies1 and guidelines on mental health #cja4 ,study on connection between living at high altitude and suicide risk factors among veterans 7a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs1 in consultation with ,rural ,health ,resource ,centers of the ,office of ,rural ,health of the ,department of ,veterans ,affairs1 shall commence the conduct of a study on the connection between living at high altitude and the risk of developing depression or dying by suicide among veterans4 7b7 ,completion of study ,the study conducted under subsection 7a7 shall be completed not later than three years after the date of the commencement of the study4 7c7 ,individual impact ,the study conducted under subsection 7a7 shall be conducted so as to determine the effect of high altitude on suicide risk at the individual level1 not at the ,state or county level4 7d7 ,report ,not later than #aej days after the completion of the study conducted 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 results of the study4 7e7 ,follow-up study 7#a7 ,in general ,if the ,secretary determines through the study conducted under subsection 7a7 that living at high altitude is a risk factor for developing depression or dying by suicide1 the ,secretary shall conduct an additional study to identify the following3 7,a7 ,the most likely biological mechanism that makes living at high altitude a risk factor for developing depression or dying by suicide4 7,b7 ,the most effective treatment or intervention for reducing the risk of developing depression or dying by suicide associated with living at high altitude4 7#b7 ,report ,not later than #aej days after completing the study conducted under paragraph 7#a71 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 study4 #cjb4 ,establishment by ,department of ,veterans ,affairs and ,department of ,defense of a clinical provider treatment toolkit and accompanying training materials for comorbidities 7a7 ,in general ,not later than two years after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs1 in consultation with the ,secretary of ,defense1 shall develop a clinical provider treatment toolkit and accompanying training materials for the evidence-based management of comorbid mental health conditions1 comorbid mental health and substance use disorders1 and a comorbid mental health condition and chronic pain4 7b7 ,matters included ,in developing the clinical provider treatment toolkit and accompanying training materials under subsection 7a71 the ,secretary of ,veterans ,affairs and the ,secretary of ,defense shall ensure that the toolkit and training materials include guidance with respect to the following3 7#a7 ,the treatment of patients with post-traumatic stress disorder who are also experiencing an additional mental health condition1 a substance use disorder1 or chronic pain4 7#b7 ,the treatment of patients experiencing a mental health condition1 including anxiety1 depression1 or bipolar disorder1 who are also experiencing a substance use disorder or chronic pain4 7#c7 ,the treatment of patients with traumatic brain injury who are also experiencing-- 7,a7 a mental health condition1 including post-traumatic stress disorder1 anxiety1 depression1 or bipolar disorder2 7,b7 a substance use disorder2 or 7,c7 chronic pain4 #cjc4 ,update of clinical practice guidelines for assessment and management of patients at risk for suicide 7a7 ,in general ,in the first publication of the ,department of ,veterans ,affairs and ,department of ,defense ,clinical ,practice ,guideline for ,assessment and ,management of ,patients at ,risk for ,suicide published after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs and the ,secretary of ,defense1 through the ,assessment and ,management of ,patients at ,risk for ,suicide ,work ,group 7in this section referred to as the ,work ,group71 shall ensure the publication includes the following3 7#a7 ,enhanced guidance with respect to the following3 7,a7 ,gender-specific risk factors for suicide and suicidal ideation4 7,b7 ,gender-specific treatment efficacy for depression and suicide prevention4 7,c7 ,gender-specific pharmacotherapy efficacy4 7,d7 ,gender-specific psychotherapy efficacy4 7#b7 ,guidance with respect to the efficacy of alternative therapies1 other than psychotherapy and pharmacotherapy1 including the following3 7,a7 ,yoga therapy4 7,b7 ,meditation therapy4 7,c7 ,equine therapy4 7,d7 ,other animal therapy4 7,e7 ,training and caring for service dogs4 7,f7 ,agritherapy4 7,g7 ,art therapy4 7,h7 ,outdoor sports therapy4 7,i7 ,music therapy4 7,j7 ,any other alternative therapy that the ,work ,group considers appropriate4 7#c7 ,guidance with respect to the findings of the ,creating ,options for ,veterans' ,expedited ,recovery ,commission 7commonly referred to as the ,,cover ,commission7 established under section #ica of the ,jason ,simcakoski ,memorial and ,promise ,act 7title ,,ix of ,public ,law #aad-aih2 #ch ,u4,s4,c4 #agja note74 7b7 ,rule of construction ,nothing in this section 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 ,department of ,veterans ,affairs and ,department of ,defense ,clinical ,practice ,guideline for ,assessment and ,management of ,patients at ,risk for ,suicide1 as required under subsection 7a71 or from ensuring that the final clinical practice guidelines updated under such subsection remain applicable to the patient populations of the ,department of ,veterans ,affairs and the ,department of ,defense4 #cjd4 ,establishment by ,department of ,veterans ,affairs and ,department of ,defense of clinical practice guidelines for the treatment of serious mental illness 7a7 ,in general ,not later than two years after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs1 in consultation with the ,secretary of ,defense and the ,secretary of ,health and ,human ,services1 shall complete the development of a clinical practice guideline or guidelines for the treatment of serious mental illness1 to include the following conditions3 7#a7 ,schizophrenia4 7#b7 ,schizoaffective disorder4 7#c7 ,persistent mood disorder1 including bipolar disorder ,i and ,,ii4 7#d7 ,any other mental1 behavioral1 or emotional disorder resulting in serious functional impairment that substantially interferes with major life activities as the ,secretary of ,veterans ,affairs1 in consultation with the ,secretary of ,defense and the ,secretary of ,health and ,human ,services1 considers appropriate4 7b7 ,matters included in guidelines ,the clinical practice guideline or guidelines developed under subsection 7a7 shall include the following3 7#a7 ,guidance contained in the #bjaf ,clinical ,practice ,guidelines for the ,management of ,major ,depressive ,disorders of the ,department of ,veterans ,affairs and the ,department of ,defense4 7#b7 ,guidance with respect to the treatment of patients with a condition described in subsection 7a74 7#c7 ,a list of evidence-based therapies for the treatment of conditions described in subsection 7a74 7#d7 ,an appropriate guideline for the administration of pharmacological therapy1 psychological or behavioral therapy1 or other therapy for the management of conditions described in subsection 7a74 7c7 ,assessment of existing guidelines ,not later than two years after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs1 in consultation with the ,secretary of ,defense and the ,secretary of ,health and ,human ,services1 shall complete an assessment of the #bjaf ,clinical ,practice ,guidelines for the ,management of ,major ,depressive ,disorders to determine whether an update to such guidelines is necessary4 7d7 ,work group 7#a7 ,establishment ,the ,secretary of ,veterans ,affairs1 the ,secretary of ,defense1 and the ,secretary of ,health and ,human ,services shall create a work group to develop the clinical practice guideline or guidelines under subsection 7a7 to be known as the ,serious ,mental ,illness ,work ,group 7in this subsection referred to as the ,work ,group74 7#b7 ,membership ,the ,work ,group created under paragraph 7#a7 shall be comprised of individuals that represent ,federal ,government entities and non-,federal ,government entities with expertise in the areas covered by the ,work ,group1 including the following entities3 7,a7 ,academic institutions that specialize in research for the treatment of conditions described in subsection 7a74 7,b7 ,the ,health ,services ,research and ,development ,service of the ,department of ,veterans ,affairs4 7,c7 ,the ,office of the ,assistant ,secretary for ,mental ,health and ,substance ,use of the ,department of ,health and ,human ,services4 7,d7 ,the ,national ,institute of ,mental ,health4 7,e7 ,the ,indian ,health ,service4 7,f7 ,relevant organizations with expertise in researching1 diagnosing1 or treating conditions described in subsection 7a74 7#c7 ,relation to other work groups ,the ,work ,group shall be created and conducted in the same manner as other work groups for the development of clinical practice guidelines for the ,department of ,veterans ,affairs and the ,department of ,defense4 7e7 ,rule of construction ,nothing in this section shall be construed to prevent the ,secretary of ,veterans ,affairs and the ,secretary of ,defense from considering all relevant evidence1 as appropriate1 in creating the clinical practice guideline or guidelines required under subsection 7a7 or from ensuring that the final clinical practice guideline or guidelines developed under such subsection and subsequently updated1 as appropriate1 remain applicable to the patient populations of the ,department of ,veterans ,affairs and the ,department of ,defense4 #cje4 ,precision medicine initiative of ,department of ,veterans ,affairs to identify and validate brain and mental health biomarkers 7a7 ,in general ,beginning not later than #ah months after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall develop and implement an initiative of the ,department of ,veterans ,affairs to identify and validate brain and mental health biomarkers among veterans1 with specific consideration for depression1 anxiety1 post-traumatic stress disorder1 bipolar disorder1 traumatic brain injury1 and such other mental health conditions as the ,secretary considers appropriate4 ,such initiative may be referred to as the ,precision ,medicine for ,veterans ,initiative4 7b7 ,model of initiative ,the initiative under subsection 7a7 shall be modeled on the ,all of ,us ,precision ,medicine ,initiative administered by the ,national ,institutes of ,health with respect to large-scale collection of standardized data and open data sharing4 7c7 ,use of data 7#a7 ,privacy and security ,in carrying out the initiative under subsection 7a71 the ,secretary shall develop robust data privacy and security measures to ensure that information of veterans participating in the initiative is kept private and secure4 7#b7 ,open platform 7,a7 ,research purposes 7i7 ,in general ,the ,secretary shall make de-identified data collected under the initiative available for research purposes both within and outside of the ,department of ,veterans ,affairs4 7ii7 ,research ,the ,secretary shall assist the ,national ,institutes of ,health and the ,department of ,energy in the use by the ,national ,institutes of ,health or the ,department of ,energy of data collected under the initiative for research purposes under clause 7i74 7,b7 ,data may not be sold ,data collected under the initiative may not be sold4 7#c7 ,standardization 7,a7 ,in general ,the ,secretary shall ensure that data collected under the initiative is standardized4 7,b7 ,consultation ,the ,secretary shall consult with the ,national ,institutes of ,health and the ,food and ,drug ,administration to determine the most effective1 efficient1 and cost-effective way of standardizing data collected under the initiative4 7,c7 ,manner of standardization ,data collected under the initiative shall be standardized in the manner in which it is collected1 entered into the database1 extracted1 and recorded4 7#d7 ,measures of brain function or structure ,any measures of brain function or structure collected under the initiative shall be collected with a device that is approved by the ,food and ,drug ,administration4 7d7 ,inclusion of initiative in program ,the ,secretary shall assess the feasibility and advisability of coordinating efforts of the initiative under subsection 7a7 with the ,million ,veterans ,program of the ,department4 #cjf4 ,statistical analyses and data evaluation by ,department of ,veterans ,affairs 7a7 ,in general ,chapter #a of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new section3 #aai4 ,contracting for statistical analyses and data evaluation 7a7 ,in general ,the ,secretary may enter into a contract or other agreement with an academic institution or other qualified entity1 as determined by the ,secretary1 to carry out statistical analyses and data evaluation as required of the ,secretary by law4 4 7b7 ,rule of construction ,nothing in this section may be construed to limit the authority of the ,secretary to enter into contracts or other agreements for statistical analyses and data evaluation under any other provision of law4 4 7b7 ,clerical amendment ,the table of sections at the beginning of chapter #a of such title is amended by adding at the end the following new item3 #aai4 ,contracting for statistical analyses and data evaluation4 4 ,,iv ,oversight of mental health care and related services #dja4 ,study on effectiveness of suicide prevention and mental health outreach programs of ,department of ,veterans ,affairs 7a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall enter into an agreement with a non-,federal ,government entity to conduct a study on the effectiveness of the suicide prevention and mental health outreach materials prepared by the ,department of ,veterans ,affairs and the suicide prevention and mental health outreach campaigns conducted by the ,department4 7b7 ,use of focus groups 7#a7 ,in general ,the ,secretary shall convene not fewer than eight different focus groups to evaluate the effectiveness of the suicide prevention and mental health materials and campaigns as required under subsection 7a74 7#b7 ,location of focus groups ,focus groups convened under paragraph 7#a7 shall be held in geographically diverse areas as follows3 7,a7 ,not fewer than two in rural or highly rural areas4 7,b7 ,not fewer than one in each of the four districts of the ,veterans ,benefits ,administration4 7#c7 ,timing of focus groups ,focus groups convened under paragraph 7#a7 shall be held at a variety of dates and times to ensure an adequate representation of veterans with different work schedules4 7#d7 ,number of participants ,each focus group convened under paragraph 7#a7 shall include not fewer than five and not more than #ab participants4 7#e7 ,representation ,each focus group convened under paragraph 7#a7 shall1 to the extent practicable1 include veterans of diverse backgrounds1 including-- 7,a7 veterans of all eras1 as determined by the ,secretary2 7,b7 women veterans2 7,c7 minority veterans2 7,d7 ,native ,american veterans1 as defined in section #cgfe of title #ch1 ,united ,states ,code2 7,e7 veterans who identify as lesbian1 gay1 bisexual1 transgender1 or queer 7commonly referred to as ,,lgbtq72 7,f7 veterans who live in rural or highly rural areas2 and 7,g7 individuals transitioning from active duty in the ,armed ,forces to civilian life4 7c7 ,report 7#a7 ,in general ,not later than #ij days after the last focus group meeting under subsection 7b71 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 findings of the focus groups4 7#b7 ,elements ,the report required by paragraph 7#a7 shall include the following3 7,a7 ,based on the findings of the focus groups1 an assessment of the effectiveness of current suicide prevention and mental health outreach efforts of the ,department in reaching veterans as a whole as well as specific groups of veterans 7for example1 women veterans74 7,b7 ,based on the findings of the focus groups1 recommendations for future suicide prevention and mental health outreach efforts by the ,department to target specific groups of veterans4 7,c7 ,a plan to change the current approach by the ,department to suicide prevention and mental health outreach or1 if the ,secretary decides not to change the current approach1 an explanation of the reason for maintaining the current approach4 7,d7 ,such other issues as the ,secretary considers necessary4 7d7 ,representative survey 7#a7 ,in general ,not later than one year after the last focus group meeting under subsection 7b71 the ,secretary shall complete a representative survey of the veteran population that is informed by the focus group data in order to collect information about the effectiveness of the mental health and suicide prevention outreach campaigns conducted by the ,department4 7#b7 ,veterans surveyed 7,a7 ,in general ,veterans surveyed under paragraph 7#a7 shall include veterans described in subsection 7b77#e74 7,b7 ,disaggregation of data ,data of veterans surveyed under paragraph 7#a7 shall be disaggregated by-- 7i7 veterans who have received care from the ,department during the two-year period preceding the survey2 and 7ii7 veterans who have not received care from the ,department during the two-year period preceding the survey4 7e7 ,treatment of contracts for suicide prevention and mental health outreach media 7#a7 ,focus groups 7,a7 ,in general ,the ,secretary shall include in each contract to develop media relating to suicide prevention and mental health outreach a requirement that the contractor convene focus groups of veterans to assess the effectiveness of suicide prevention and mental health outreach4 7,b7 ,representation ,each focus group required under subparagraph 7,a7 shall1 to the extent practicable1 include veterans of diverse backgrounds1 including-- 7i7 veterans of all eras1 as determined by the ,secretary2 7ii7 women veterans2 7iii7 minority veterans2 7iv7 ,native ,american veterans1 as defined in section #cgfe of title #ch1 ,united ,states ,code2 7v7 veterans who identify as lesbian1 gay1 bisexual1 transgender1 or queer 7commonly referred to as ,,lgbtq72 7vi7 veterans who live in rural or highly rural areas2 and 7vii7 individuals transitioning from active duty in the ,armed ,forces to civilian life4 7#b7 ,subcontracting 7,a7 ,in general ,the ,secretary shall include in each contract described in paragraph 7#a77;,a7 a requirement that1 if the contractor subcontracts for the development of media1 the contractor shall subcontract with a subcontractor that has experience creating impactful media campaigns that target individuals age #ah to #cd4 7,b7 ,budget limitation ,not more than two percent of the budget of the ,office of ,mental ,health and ,suicide ,prevention of the ,department for contractors for suicide prevention and mental health media outreach shall go to subcontractors described in subparagraph 7,a74 7f7 ,rural and highly rural defined ,in this section1 with respect to an area1 the terms rural and highly rural have the meanings given those terms in the ,rural-,urban ,commuting ,areas coding system of the ,department of ,agriculture4 #djb4 ,oversight of mental health and suicide prevention media outreach conducted by ,department of ,veterans ,affairs 7a7 ,establishment of goals 7#a7 ,in general ,the ,secretary of ,veterans ,affairs shall establish goals for the mental health and suicide prevention media outreach campaigns of the ,department of ,veterans ,affairs1 which shall include the establishment of targets1 metrics1 and action plans to describe and assess those campaigns4 7#b7 ,use of metrics 7,a7 ,in general ,the goals established under paragraph 7#a7 shall be measured by metrics specific to different media types4 7,b7 ,factors to consider ,in using metrics under subparagraph 7,a71 the ,secretary shall determine the best methodological approach for each media type and shall consider the following3 7i7 ,metrics relating to social media1 which may include the following3 7,i7 ,impressions4 7,,ii7 ,reach4 7,,iii7 ,engagement rate4 7,,iv7 ,such other metrics as the ,secretary considers necessary4 7ii7 ,metrics relating to television1 which may include the following3 7,i7 ,nielsen ratings4 7,,ii7 ,such other metrics as the ,secretary considers necessary4 7iii7 ,metrics relating to email1 which may include the following3 7,i7 ,open rate4 7,,ii7 ,response rate4 7,,iii7 ,click rate4 7,,iv7 ,such other metrics as the ,secretary considers necessary4 7,c7 ,update ,the ,secretary shall periodically update the metrics under subparagraph 7,b7 as more accurate metrics become available4 7#c7 ,targets ,the ,secretary shall establish targets to track the metrics used under paragraph 7#b74 7#d7 ,consultation ,in establishing goals under paragraph 7#a71 the ,secretary shall consult with the following3 7,a7 ,relevant stakeholders1 such as organizations that represent veterans1 as determined by the ,secretary4 7,b7 ,mental health and suicide prevention experts4 7,c7 ,such other persons as the ,secretary considers appropriate4 7#e7 ,initial report ,not later than #ahj 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 detailing the goals established under paragraph 7#a7 for the mental health and suicide prevention media outreach campaigns of the ,department1 including the metrics and targets for such metrics by which those goals are to be measured under paragraphs 7#b7 and 7#c74 7#f7 ,annual report ,not later than one year after the submittal of the report under paragraph 7#e71 and 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 detailing-- 7,a7 the progress of the ,department in meeting the goals established under paragraph 7#a7 and the targets established under paragraph 7#c72 and 7,b7 a description of action to be taken by the ,department to modify mental health and suicide prevention media outreach campaigns if those goals and targets are not being met4 7b7 ,report on use of funds by ,office of ,mental ,health and ,suicide ,prevention ,not later than #ahj days after the date of the enactment of this ,act1 and semiannually thereafter1 the ,secretary shall submit to the ,committee on ,appropriations and the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,appropriations and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report containing the expenditures and obligations of the ,office of ,mental ,health and ,suicide ,prevention of the ,veterans ,health ,administration during the period covered by the report4 #djc4 ,comptroller ,general management review of mental health and suicide prevention services 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 management review of the mental health and suicide prevention services provided by the ,department of ,veterans ,affairs4 7b7 ,elements ,the management review required by subsection 7a7 shall include the following3 7#a7 ,an assessment of the infrastructure under the control of or available to the ,office of ,mental ,health and ,suicide ,prevention of the ,department of ,veterans ,affairs or available to the ,department of ,veterans ,affairs for suicide prevention efforts not operated by the ,office of ,mental ,health and ,suicide ,prevention4 7#b7 ,a description of the management and organizational structure of the ,office of ,mental ,health and ,suicide ,prevention1 including roles and responsibilities for each position4 7#c7 ,a description of the operational policies and processes of the ,office of ,mental ,health and ,suicide ,prevention4 7#d7 ,an assessment of suicide prevention practices and initiatives available from the ,department and through community partnerships4 7#e7 ,an assessment of the staffing levels at the ,office of ,mental ,health and ,suicide ,prevention1 disaggregated by type of position1 and including the location of any staffing deficiencies4 7#f7 ,an assessment of the ,nurse ,advice ,line pilot program conducted by the ,department4 7#g7 ,an assessment of recruitment initiatives in rural areas for mental health professionals of the ,department4 7#h7 ,an assessment of strategic planning conducted by the ,office of ,mental ,health and ,suicide ,prevention4 7#i7 ,an assessment of the communication1 and the effectiveness of such communication-- 7,a7 within the central office of the ,office of ,mental ,health and ,suicide ,prevention2 7,b7 between that central office and any staff member or office in the field1 including chaplains1 attorneys1 law enforcement personnel1 and volunteers2 and 7,c7 between that central office1 local facilities of the ,department1 and community partners of the ,department1 including first responders1 community support groups1 and health care industry partners4 7#aj7 ,an assessment of how effectively the ,office of ,mental ,health and ,suicide ,prevention implements operational policies and procedures4 7#aa7 ,an assessment of how the ,department of ,veterans ,affairs and the ,department of ,defense coordinate suicide prevention efforts1 and recommendations on how the ,department of ,veterans ,affairs and ,department of ,defense can more effectively coordinate those efforts4 7#ab7 ,an assessment of such other areas as the ,comptroller ,general considers appropriate to study4 #djd4 ,comptroller ,general report on efforts of ,department of ,veterans ,affairs to integrate mental health care into primary care clinics 7a7 ,initial 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 efforts of the ,department of ,veterans ,affairs to integrate mental health care into primary care clinics of the ,department4 7#b7 ,elements ,the report required by subsection 7a7 shall include the following3 7,a7 ,an assessment of the efforts of the ,department to integrate mental health care into primary care clinics of the ,department4 7,b7 ,an assessment of the effectiveness of such efforts4 7,c7 ,an assessment of how the health care of veterans is impacted by such integration4 7,d7 ,a description of how care is coordinated by the ,department between specialty mental health care and primary care1 including a description of the following3 7i7 ,how documents and patient information are transferred and the effectiveness of those transfers4 7ii7 ,how care is coordinated when veterans must travel to different facilities of the ,department4 7iii7 ,how a veteran is reintegrated into primary care after receiving in-patient mental health care4 7,e7 ,an assessment of how the integration of mental health care into primary care clinics is implemented at different types of facilities of the ,department4 7,f7 ,such recommendations on how the ,department can better integrate mental health care into primary care clinics as the ,comptroller ,general considers appropriate4 7,g7 ,an assessment of such other areas as the ,comptroller ,general considers appropriate to study4 7b7 ,community care integration report 7#a7 ,in general ,not later than two years after the date on which the ,comptroller ,general submits the report required under subsection 7a77#a71 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 efforts of the ,department to integrate community-based mental health care into the ,veterans ,health ,administration4 7#b7 ,elements ,the report required by paragraph 7#a7 shall include the following3 7,a7 ,an assessment of the efforts of the ,department to integrate community-based mental health care into the ,veterans ,health ,administration4 7,b7 ,an assessment of the effectiveness of such efforts4 7,c7 ,an assessment of how the health care of veterans is impacted by such integration4 7,d7 ,a description of how care is coordinated between providers of community-based mental health care and the ,veterans ,health ,administration1 including a description of how documents and patient information are transferred and the effectiveness of those transfers between-- 7i7 the ,veterans ,health ,administration and providers of community-based mental health care2 and 7ii7 providers of community-based mental health care and the ,veterans ,health ,administration4 7,e7 ,an assessment of any disparities in the coordination of community-based mental health care into the ,veterans ,health ,administration by location and type of facility4 7,f7 ,an assessment of the military cultural competency of health care providers providing community-based mental health care to veterans4 7,g7 ,such recommendations on how the ,department can better integrate community-based mental health care into the ,veterans ,health ,administration as the ,comptroller ,general considers appropriate4 7,h7 ,an assessment of such other areas as the ,comptroller ,general considers appropriate to study4 7#c7 ,community-based mental health care defined ,in this subsection1 the term community-based mental health care means mental health care paid for by the ,department but provided by a non-,department health care provider at a non-,department facility1 including care furnished under section #agjc of title #ch1 ,united ,states ,code 7as in effect on the date specified in section #aja7;b7 of the ,caring for ,our ,veterans ,act of #bjah 7title ,i of ,public ,law #aae-ahb774 #dje4 ,joint mental health programs by ,department of ,veterans ,affairs and ,department of ,defense 7a7 ,report on mental health programs 7#a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 and annually thereafter1 the ,secretary of ,veterans ,affairs and the ,secretary of ,defense shall submit to the ,committee on ,veterans' ,affairs and the ,committee on ,armed ,services of the ,senate and the ,committee on ,veterans' ,affairs and the ,committee on ,armed ,services of the ,house of ,representatives a report on mental health programs of the ,department of ,veterans ,affairs and the ,department of ,defense and joint programs of the ,departments4 7#b7 ,elements ,the report required by paragraph 7#a7 shall include the following3 7,a7 ,a description of mental health programs operated by the ,department of ,veterans ,affairs1 including the following3 7i7 ,transition assistance programs4 7ii7 ,clinical and non-clinical mental health initiatives1 including centers of excellence of the ,department of ,veterans ,affairs for traumatic brain injury and post-traumatic stress disorder4 7iii7 ,programs that may secondarily improve mental health1 including employment1 housing assistance1 and financial literacy programs4 7iv7 ,research into mental health issues and conditions1 to include post-traumatic stress disorder1 depression1 anxiety1 bipolar disorder1 traumatic brain injury1 suicidal ideation1 and any other issues or conditions as the ,secretary of ,veterans ,affairs considers necessary4 7,b7 ,a description of mental health programs operated by the ,department of ,defense1 including the following3 7i7 ,transition assistance programs4 7ii7 ,clinical and non-clinical mental health initiatives1 including the ,national ,intrepid ,center of ,excellence and the ,intrepid ,spirit ,centers4 7iii7 ,programs that may secondarily improve mental health1 including employment1 housing assistance1 and financial literacy programs4 7iv7 ,research into mental health issues and conditions1 to include post-traumatic stress disorder1 depression1 anxiety1 bipolar disorder1 traumatic brain injury1 suicidal ideation1 and any other issues or conditions as the ,secretary of ,defense considers necessary4 7,c7 ,a description of mental health programs jointly operated by the ,department of ,veterans ,affairs and the ,department of ,defense1 including the following3 7i7 ,transition assistance programs4 7ii7 ,clinical and non-clinical mental health initiatives4 7iii7 ,programs that may secondarily improve mental health1 including employment1 housing assistance1 and financial literacy programs4 7iv7 ,research into mental health issues and conditions1 to include post-traumatic stress disorder1 depression1 anxiety1 bipolar disorder1 traumatic brain injury1 suicidal ideation1 and completed suicides1 including through the use of the joint suicide data repository of the ,department of ,veterans ,affairs and the ,department of ,defense1 and any other issues or conditions as the ,secretary of ,veterans ,affairs and the ,secretary of ,defense consider necessary4 7,d7 ,recommendations for coordinating mental health programs of the ,department of ,veterans ,affairs and the ,department of ,defense to improve the effectiveness of those programs4 7,e7 ,recommendations for novel joint programming of the ,department of ,veterans ,affairs and the ,department of ,defense to improve the mental health of members of the ,armed ,forces and veterans4 7b7 ,authorization of a public-private partnership to establish a joint center of excellence 7#a7 ,in general ,not later than two years after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs1 in consultation with the ,secretary of ,defense1 shall enter into agreements with private entities and philanthropic organizations to establish a center of excellence to be known as the ,joint ,,va_/,,dod ,national ,intrepid ,center of ,excellence ,intrepid ,spirit ,center 7in this subsection referred to as the ,center74 7#b7 ,duties ,the ,center shall conduct the following3 7,a7 ,joint mental health care delivery programs of the ,department of ,veterans ,affairs and the ,department of ,defense for veterans and members of the ,armed ,forces1 including members of the reserve components1 who reside in rural and highly rural areas4 7,b7 ,mental health and suicide prevention research focused on veterans and members of the ,armed ,forces1 including members of the reserve components1 to inform treatment and care delivery programs4 7#c7 ,location ,the ,center shall be established in a location that-- 7,a7 is geographically distant from existing and planned ,intrepid ,spirit ,centers of the ,department of ,defense2 7,b7 is in close proximity to rural and highly rural areas and able to serve veterans in those areas who1 as of the date of the enactment of this ,act1 are underserved by the ,department of ,veterans ,affairs2 and 7,c7 is in close proximity to a medical school of an institution of higher education4 7c7 ,rural and highly rural defined ,in this section1 with respect to an area1 the terms rural and highly rural have the meanings given those terms in the ,rural-,urban ,commuting ,areas coding system of the ,department of ,agriculture4 ,v ,improvement of mental health medical workforce #eja4 ,staffing improvement plan for mental health providers of ,department of ,veterans ,affairs 7a7 ,staffing plan 7#a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs1 in consultation with the ,inspector ,general of the ,department of ,veterans ,affairs1 shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a plan to address staffing of mental health providers of the ,department of ,veterans ,affairs1 including filling any open positions4 7#b7 ,elements ,the plan required by paragraph 7#a7 shall include the following3 7,a7 ,an estimate of the number of positions for mental health providers of the ,department that need to be filled to meet demand4 7,b7 ,an identification of the steps that the ,secretary will take to address mental health staffing for the ,department4 7,c7 ,a description of any region-specific hiring incentives to be used by the ,secretary in consultation with the directors of ,veterans ,integrated ,service ,networks and medical centers of the ,department4 7,d7 ,a description of any local retention or engagement incentives to be used by directors of ,veterans ,integrated ,service ,networks4 7,e7 ,such recommendations for legislative or administrative action as the ,secretary considers necessary to aid in addressing mental health staffing for the ,department4 7#c7 ,report ,not later than one year after the submittal of the plan required by paragraph 7#a71 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 the number of mental health providers hired by the ,department during the one-year period preceding the submittal of the report4 7b7 ,occupational series for certain mental health providers ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs1 in consultation with the ,office of ,personnel ,management1 shall develop an occupational series for licensed professional mental health counselors and marriage and family therapists of the ,department of ,veterans ,affairs4 #ejb4 ,staffing improvement plan for peer specialists of ,department of ,veterans ,affairs who are women 7a7 ,assessment of capacity 7#a7 ,in general ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs1 in consultation with the ,inspector ,general of the ,department of ,veterans ,affairs1 shall commence an assessment of the capacity of peer specialists of the ,department of ,veterans ,affairs who are women4 7#b7 ,elements ,the assessment required by paragraph 7#a7 shall include an assessment of the following3 7,a7 ,the geographical distribution of peer specialists of the ,department who are women4 7,b7 ,the geographical distribution of women veterans4 7,c7 ,the number and proportion of women peer specialists who specialize in peer counseling on mental health or suicide prevention4 7,d7 ,the number and proportion of women peer specialists who specialize in peer counseling on non-mental health related matters4 7b7 ,report ,not later than one year after the assessment required by subsection 7a7 has commenced1 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 detailing the findings of the assessment4 7c7 ,staffing improvement plan 7#a7 ,in general ,not later than #ahj days after submitting the report under subsection 7b71 the ,secretary1 in consultation with the ,inspector ,general1 shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a plan1 based on the results of the assessment required by subsection 7a71 to hire additional qualified peer specialists who are women1 with special consideration for areas that lack peer specialists who are women4 7#b7 ,elements ,the peer specialist positions included in the plan required by paragraph 7#a7-- 7,a7 shall be non-volunteer1 paid positions2 and 7,b7 may be part-time positions4 #ejc4 ,establishment of ,department of ,veterans ,affairs ,readjustment ,counseling ,service ,scholarship ,program 7a7 ,in general ,chapter #gf of title #ch1 ,united ,states ,code1 is amended by inserting after subchapter ,,viii the following new subchapter3 ,,ix ,readjustment ,counseling ,service ,scholarship ,program #gfih4 ,requirement for program ,as part of the ,educational ,assistance ,program1 the ,secretary shall carry out a scholarship program under this subchapter4 ,the program shall be known as the ,department of ,veterans ,affairs ,readjustment ,counseling ,service ,scholarship ,program 7in this subchapter referred to as the ,program74 #gfii4 ,eligibility2 agreement 7a7 ,in general ,an individual is eligible to participate in the ,program1 as determined by the ,readjustment ,counseling ,service of the ,department1 if the individual-- 7#a7 is accepted for enrollment or enrolled 7as described in section #gfjb of this title7 in a program of study at an accredited educational institution1 school1 or training program leading to a terminal degree in psychology1 social work1 marriage and family therapy1 or mental health counseling that would meet the education requirements for appointment to a position under section #gdjb7;b7 of this title2 and 7#b7 enters into an agreement with the ,secretary under subsection 7c74 7b7 ,priority ,in selecting individuals to participate in the ,program1 the ,secretary shall give priority to the following individuals3 7#a7 ,an individual who agrees to be employed by a ,vet ,center located in a community that is-- 7,a7 designated as a medically underserved population under section #ccj7;b77#c7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b7b77#c772 and 7,b7 in a ,state with a per capita population of veterans of more than five percent according to the ,national ,center for ,veterans ,analysis and ,statistics and the ,bureau of the ,census4 7#b7 ,an individual who is a veteran4 7c7 ,agreement ,an agreement between the ,secretary and a participant in the ,program shall 7in addition to the requirements set forth in section #gfjd of this title7 include the following3 7#a7 ,an agreement by the ,secretary to provide the participant with a scholarship under the ,program for a specified number of school years during which the participant pursues a program of study described in subsection 7a77#a7 that meets the requirements set forth in section #gfjb7;a7 of this title4 7#b7 ,an agreement by the participant to serve as a full-time employee of the ,department at a ,vet ,center for a six-year period following the completion by the participant of such program of study 7in this subchapter referred to as the period of obligated service74 7d7 ,vet center defined ,in this section1 the term ,vet ,center has the meaning given that term in section #agab;,a7h7 of this title4 #gfii;,a4 ,obligated service 7a7 ,in general ,each participant in the ,program shall provide service as a full-time employee of the ,department at a ,vet ,center 7as defined in section #gfii7;d7 of this title7 for the period of obligated service set forth in the agreement of the participant entered into under section #gfjd of this title4 7b7 ,determination of service commencement date 7#a7 ,not later than #fj days before the service commencement date of a participant1 the ,secretary shall notify the participant of that service commencement date4 7#b7 ,the date specified in paragraph 7#a7 with respect to a participant is the date for the beginning of the period of obligated service of the participant4 #gfii;,b4 ,breach of agreement3 liability 7a7 ,liquidated damages 7#a7 ,a participant in the ,program 7other than a participant described in subsection 7b77 who fails to accept payment1 or instructs the educational institution in which the participant is enrolled not to accept payment1 in whole or in part1 of a scholarship under the agreement entered into under section #gfjd of this title shall be liable to the ,united ,states for liquidated damages in the amount of #a1ejj4 7#b7 ,liability under paragraph 7#a7 is in addition to any period of obligated service or other obligation or liability under such agreement4 7b7 ,liability during program of study 7#a7 ,except as provided in subsection 7d71 a participant in the ,program shall be liable to the ,united ,states for the amount which has been paid to or on behalf of the participant under the agreement if any of the following occurs3 7,a7 ,the participant fails to maintain an acceptable level of academic standing in the educational institution in which the participant is enrolled 7as determined by the educational institution under regulations prescribed by the ,secretary74 7,b7 ,the participant is dismissed from such educational institution for disciplinary reasons4 7,c7 ,the participant voluntarily terminates the program of study in such educational institution before the completion of such program of study4 7#b7 ,liability under this subsection is in lieu of any service obligation arising under the agreement4 7c7 ,liability during period of obligated service 7#a7 ,except as provided in subsection 7d71 if a participant in the ,program does not complete the period of obligated service of the participant1 the ,united ,states shall be entitled to recover from the participant an amount determined in accordance with the following formula3 ,a #c7ts_/t74 7#b7 ,in the formula in paragraph 7#a73 7,a7 ,a is the amount the ,united ,states is entitled to recover4 7,b7 is the sum of-- 7i7 the amounts paid under this subchapter to or on behalf of the participant2 and 7ii7 the interest on such amounts which would be payable if at the time the amounts were paid they were loans bearing interest at the maximum legal prevailing rate1 as determined by the ,treasurer of the ,united ,states4 7,c7 t is the total number of months in the period of obligated service of the participant4 7,d7 s is the number of months of such period served by the participant4 7d7 ,limitation on liability for reductions-in-force ,liability shall not arise under subsection 7c7 if the participant fails to maintain employment as a ,department employee due to a staffing adjustment4 7e7 ,period for payment of damages ,any amount of damages that the ,united ,states is entitled to recover under this section shall be paid to the ,united ,states within the one-year period beginning on the date of the breach of the agreement4 4 7b7 ,conforming and technical amendments 7#a7 ,conforming amendments 7,a7 ,establishment of program ,section #gfja7;a7 of such title is amended-- 7i7 in paragraph 7#e71 by striking and2 7ii7 in paragraph 7#f71 by striking the period and inserting 2 and2 and 7iii7 by adding at the end the following new paragraph3 7#g7 the readjustment counseling service scholarship program provided for in subchapter ,,ix of this chapter4 4 7,b7 ,eligibility ,section #gfjb of such title is amended-- 7i7 in subsection 7a77#a7-- 7,i7 by striking or ,,vi and inserting ,,vi1 or ,,ix2 and 7,,ii7 by striking subchapter ,,vi and inserting subchapter ,,vi or ,,ix2 and 7ii7 in subsection 7b71 by striking or ,,vi and inserting ,,vi1 or ,,ix4 7,c7 ,application ,section #gfjc7;a77#a7 of such title is amended by striking or ,,viii and inserting ,,viii1 or ,,ix4 7,d7 ,terms of agreement ,section #gfjd of such title is amended by striking or ,,viii each place it appears and inserting ,,viii1 or ,,ix4 7,e7 ,annual report ,section #gfcb of such title is amended-- 7i7 in paragraph 7#a71 by striking and the ,specialty ,education ,loan ,repayment ,program and inserting the ,specialty ,education ,loan ,repayment ,program1 and the ,readjustment ,counseling ,service ,scholarship ,program2 and 7ii7 in paragraph 7#d71 by striking and per participant in the ,specialty ,education ,loan ,repayment ,program and inserting per participant in the ,specialty ,education ,loan ,repayment ,program1 and per participant in the ,readjustment ,counseling ,service ,scholarship ,program4 7#b7 ,table of sections ,the table of sections at the beginning of chapter #gf of such title is amended by inserting after the items relating to subchapter ,,viii the following3 ,,subchapter ,,ix--,readjustment ,counseling ,service ,scholarship ,program ,sec4 #gfih4 ,requirement for program4 #gfii4 ,eligibility2 agreement4 #gfii;,a4 ,obligated service4 #gfii;,b4 ,breach of agreement3 liability4 4 7c7 ,effective date ,the ,secretary of ,veterans ,affairs shall begin awarding scholarships under subchapter ,,ix of chapter #gf of title #ch1 ,united ,states ,code1 as added by subsection 7a71 for programs of study beginning not later than one year after the date of the enactment of this ,act4 #ejd4 ,comptroller ,general report on ,readjustment ,counseling ,service 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 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 ,readjustment ,counseling ,service of the ,department of ,veterans ,affairs4 7b7 ,elements ,the report required by subsection 7a7 shall include the following3 7#a7 ,an assessment of the adequacy and types of treatment1 counseling1 and other services provided at ,vet ,centers1 including recommendations on whether and how such treatment1 counseling1 and other services can be expanded4 7#b7 ,an assessment of the efficacy of outreach efforts by the ,readjustment ,counseling ,service1 including recommendations for how outreach efforts can be improved4 7#c7 ,an assessment of barriers to care at ,vet ,centers1 including recommendations for overcoming those barriers4 7#d7 ,an assessment of the efficacy and frequency of the use of telehealth by counselors of the ,readjustment ,counseling ,service to provide mental health services1 including recommendations for how the use of telehealth can be improved4 7#e7 ,an assessment of the feasibility and advisability of expanding eligibility for services from the ,readjustment ,counseling ,service1 including-- 7,a7 recommendations on what eligibility criteria could be expanded2 and 7,b7 an assessment of potential costs and increased infrastructure requirements if eligibility is expanded4 7#f7 ,an assessment of the use of ,vet ,centers by members of the reserve components of the ,armed ,forces who were never activated and recommendations on how to better reach those members4 7#g7 ,an assessment of the use of ,vet ,centers by eligible family members of former members of the ,armed ,forces and recommendations on how to better reach those family members4 7#h7 ,an assessment of the efficacy of group therapy and the level of training of providers at ,vet ,centers in administering group therapy4 7#i7 ,an assessment of the efficiency and effectiveness of the task organization structure of ,vet ,centers4 7#aj7 ,an assessment of the use of ,vet ,centers by ,native ,american veterans1 as defined in section #cgfe of title #ch1 ,united ,states ,code1 and recommendations on how to better reach those veterans4 7c7 ,vet center defined ,in this section1 the term ,vet ,center has the meaning given that term in section #agab;,a7h7 of title #ch1 ,united ,states ,code4 #eje4 ,expansion of reporting requirements on ,readjustment ,counseling ,service of ,department of ,veterans ,affairs 7a7 ,expansion of annual report ,paragraph 7#b77;,c7 of section #gcji7;e7 of title #ch1 ,united ,states ,code1 is amended by inserting before the period at the end the following3 1 including the resources required to meet such unmet need1 such as additional staff1 additional locations1 additional infrastructure1 infrastructure improvements1 and additional mobile ,vet ,centers4 7b7 ,biennial report ,such section is amended by adding at the end the following new paragraph3 7#c7 ,for each even numbered year in which the report required by paragraph 7#a7 is submitted1 the ,secretary shall include in such report a prediction of-- 7,a7 trends in demand for care2 7,b7 long-term investments required with respect to the provision of care2 7,c7 requirements relating to maintenance of infrastructure2 and 7,d7 other capital investment requirements with respect to the ,readjustment ,counseling ,service1 including ,vet ,centers1 mobile ,vet ,centers1 and community access points4 4 #ejf4 ,studies on alternative work schedules for employees of ,veterans ,health ,administration 7a7 ,study of veterans 7#a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall conduct a study on the attitudes of eligible veterans toward the ,department of ,veterans ,affairs offering appointments outside the usual operating hours of facilities of the ,department1 including through the use of telehealth appointments4 7#b7 ,eligible veteran defined ,in this subsection1 the term eligible veteran means a veteran who-- 7,a7 is enrolled in the patient enrollment system of the ,department under section #agje7;a7 of title #ch1 ,united ,states ,code2 and 7,b7 received health care from the ,department at least once during the two-year period ending on the date of the commencement of the study under paragraph 7#a74 7b7 ,department study 7#a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary shall conduct a study on the feasibility and advisability of offering appointments outside the usual operating hours of facilities of the ,department4 7#b7 ,study of employees ,the study required by paragraph 7#a7 shall include a study of the opinions of employees of the ,veterans ,health ,administration1 including clinical1 nonclinical1 and support staff1 with respect to offering appointments outside the usual operating hours of facilities of the ,department1 including through the use of telehealth appointments4 #ejg4 ,suicide prevention coordinators 7a7 ,staffing requirement ,beginning not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall ensure that each medical center of the ,department of ,veterans ,affairs has not less than one suicide prevention coordinator4 7b7 ,study on reorganization 7#a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary1 in consultation with the ,office of ,mental ,health and ,suicide ,prevention of the ,department1 shall commence the conduct of a study to determine the feasibility and advisability of-- 7,a7 the realignment and reorganization of suicide prevention coordinators within the ,office of ,mental ,health and ,suicide ,prevention2 and 7,b7 the creation of a suicide prevention coordinator program office4 7#b7 ,program office realignment ,in conducting the study under paragraph 7#a71 the ,secretary shall assess the feasibility of advisability of1 within the suicide prevention coordinator program office described in paragraph 7#a77;,b71 aligning suicide prevention coordinators and suicide prevention case managers within the organizational structure and chart of the ,suicide ,prevention ,program of the ,department1 with the ,director of the ,suicide ,prevention program having ultimate supervisory oversight and responsibility over the suicide prevention coordinator program office4 7c7 ,report ,not later than #ij days after the completion of the study under subsection 7b71 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 study1 including the following3 7#a7 ,an assessment of the feasibility and advisability of creating a suicide prevention coordinator program office to oversee and monitor suicide prevention coordinators and suicide prevention case managers across all medical centers of the ,department4 7#b7 ,a review of current staffing ratios for suicide prevention coordinators and suicide prevention case managers in comparison with current staffing ratios for mental health providers within each medical center of the ,department4 7#c7 ,a description of the duties and responsibilities for suicide prevention coordinators across the ,department to better define1 delineate1 and standardize qualifications1 performance goals1 performance duties1 and performance outcomes for suicide prevention coordinators and suicide prevention case managers4 #ejh4 ,report on efforts by ,department of ,veterans ,affairs to implement safety planning in emergency departments 7a7 ,findings ,congress makes the following findings3 7#a7 ,the ,department of ,veterans ,affairs must be more effective in its approach to reducing the burden of veteran suicide connected to mental health diagnoses1 to include expansion of treatment delivered via telehealth methods and in rural areas4 7#b7 ,an innovative project1 known as ,suicide ,assessment and ,follow-up ,engagement3 ,veteran ,emergency ,treatment 7in this subsection referred to as ,,safe ,,vet71 was designed to help suicidal veterans seen at emergency departments within the ,veterans ,health ,administration and was successfully implemented in five intervention sites beginning in #bjaj4 7#c7 ,a #bjah study found that safety planning intervention under ,,safe ,,vet was associated with #de percent fewer suicidal behaviors in the six-month period following emergency department care and more than double the odds of a veteran engaging in outpatient behavioral health care4 7#d7 ,,safe ,,vet is a promising alternative and acceptable delivery of care system that augments the treatment of suicidal veterans in emergency departments of the ,veterans ,health ,administration and helps ensure that those veterans have appropriate follow-up care4 7#e7 ,beginning in ,september #bjah1 the ,veterans ,health ,administration implemented a suicide prevention program1 known as the ,,sped program1 for veterans presenting to the emergency department who are assessed to be at risk for suicide and are safe to be discharged home4 7#f7 ,the ,,sped program includes issuance and update of a safety plan and post-discharge follow-up outreach for veterans to facilitate engagement in outpatient mental health care4 7b7 ,report 7#a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall submit to the appropriate committees of ,congress a report on the efforts of the ,secretary to implement a suicide prevention program for veterans presenting to an emergency department or urgent care center of the ,veterans ,health ,administration who are assessed to be at risk for suicide and are safe to be discharged home1 including a safety plan and post-discharge outreach for veterans to facilitate engagement in outpatient mental health care4 7#b7 ,elements ,the report required by paragraph 7#a7 shall include the following3 7,a7 ,an assessment of the implementation of the current operational policies and procedures of the ,,sped program at each medical center of the ,department of ,veterans ,affairs1 including an assessment of the following3 7i7 ,training provided to clinicians or other personnel administering protocols under the ,,sped program4 7ii7 ,any disparities in implementation of such protocols between medical centers4 7iii7 ,current criteria used to measure the quality of such protocols including-- 7,i7 methodology used to assess the quality of a safety plan and post-discharge outreach for veterans2 or 7,,ii7 in the absence of such methodology1 a proposed timeline and guidelines for creating a methodology to ensure compliance with the evidence-based model used under the ,suicide ,assessment and ,follow-up ,engagement3 ,veteran ,emergency ,treatment 7,,safe ,,vet7 program of the ,department4 7,b7 ,an assessment of the implementation of the policies and procedures described in subparagraph 7,a71 including the following3 7i7 ,an assessment of the quality and quantity of safety plans issued to veterans4 7ii7 ,an assessment of the quality and quantity of post-discharge outreach provided to veterans4 7iii7 ,the post-discharge rate of veteran engagement in outpatient mental health care1 including attendance at not fewer than one individual mental health clinic appointment or admission to an inpatient or residential unit4 7iv7 ,the number of veterans who decline safety planning efforts during protocols under the ,,sped program4 7v7 ,the number of veterans who decline to participate in follow-up efforts within the ,,sped program4 7,c7 ,a description of how ,,sped primary coordinators are deployed to support such efforts1 including the following3 7i7 ,a description of the duties and responsibilities of such coordinators4 7ii7 ,the number and location of such coordinators4 7iii7 ,a description of training provided to such coordinators4 7iv7 ,an assessment of the other responsibilities for such coordinators and1 if applicable1 differences in patient outcomes when such responsibilities are full-time duties as opposed to secondary duties4 7,d7 ,an assessment of the feasibility and advisability of expanding the total number and geographic distribution of ,,sped primary coordinators4 7,e7 ,an assessment of the feasibility and advisability of providing services under the ,,sped program via telehealth channels1 including an analysis of opportunities to leverage telehealth to better serve veterans in rural areas4 7,f7 ,a description of the status of current capabilities and utilization of tracking mechanisms to monitor compliance1 quality1 and patient outcomes under the ,,sped program4 7,g7 ,such recommendations1 including specific action items1 as the ,secretary considers appropriate with respect to how the ,department can better implement the ,,sped program1 including recommendations with respect to the following3 7i7 ,a process to standardize training under such program4 7ii7 ,any resourcing requirements necessary to implement the ,,sped program throughout ,veterans ,health ,administration1 including by having a dedicated clinician responsible for administration of such program at each medical center4 7iii7 ,an analysis of current statutory authority and any changes necessary to fully implement the ,,sped program throughout the ,veterans ,health ,administration4 7iv7 ,a timeline for the implementation of the ,,sped program through the ,veterans ,health ,administration once full resourcing and an approved training plan are in place4 7,h7 ,such other matters as the ,secretary considers appropriate4 7c7 ,definitions ,in this section3 7#a7 ,appropriate committees of congress ,the term appropriate committees of ,congress means-- 7,a7 the ,committee on ,veterans' ,affairs and the ,subcommittee on ,military ,construction1 ,veterans ,affairs1 and ,related ,agencies of the ,committee on ,appropriations of the ,senate2 and 7,b7 the ,committee on ,veterans' ,affairs and the ,subcommittee on ,military ,construction1 ,veterans ,affairs1 and ,related ,agencies of the ,committee on ,appropriations of the ,house of ,representatives4 7#b7 ,,sped primary coordinator ,the term ,,sped primary coordinator means the main point of contact responsible for administering the ,,sped program at a medical center of the ,department4 7#c7 ,,sped program ,the term ,,sped program means the ,safety ,planning in ,emergency ,departments program of the ,department of ,veterans ,affairs established in ,september #bjah for veterans presenting to the emergency department who are assessed to be at risk for suicide and are safe to be discharged home1 which extends the evidence-based intervention for suicide prevention to all emergency departments of the ,veterans ,health ,administration4 ,,vi ,improvement of care and services for women veterans #fja4 ,expansion of capabilities of ,women ,veterans ,call ,center to include text messaging ,the ,secretary of ,veterans ,affairs shall expand the capabilities of the ,women ,veterans ,call ,center of the ,department of ,veterans ,affairs to include a text messaging capability4 #fjb4 ,gap analysis of ,department of ,veterans ,affairs programs that provide assistance to women veterans who are homeless 7a7 ,in general ,the ,secretary of ,veterans ,affairs shall complete an analysis of programs of the ,department of ,veterans ,affairs that provide assistance to women veterans who are homeless or precariously housed to identify the areas in which such programs are failing to meet the needs of such women4 7b7 ,report ,not later than #bgj 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 the analysis completed under subsection 7a74 #fjc4 ,requirement for ,department of ,veterans ,affairs internet website to provide information on services available to women veterans 7a7 ,in general ,the ,secretary of ,veterans ,affairs shall survey the internet websites and information resources of the ,department of ,veterans ,affairs in effect on the day before the date of the enactment of this ,act and publish an internet website that serves as a centralized source for the provision to women veterans of information about the benefits and services available to them under laws administered by the ,secretary4 7b7 ,elements ,the internet website published under subsection 7a7 shall provide to women veterans information regarding all services available in the district in which the veteran is seeking such services1 including1 with respect to each medical center and community-based outpatient clinic in the applicable ,veterans ,integrated ,service ,network-- 7#a7 the name and contact information of each women's health coordinator2 7#b7 a list of appropriate staff for other benefits available from the ,veterans ,benefits ,administration1 the ,national ,cemetery ,administration1 and such other entities as the ,secretary considers appropriate2 and 7#c7 such other information as the ,secretary considers appropriate4 7c7 ,updated information ,the ,secretary shall ensure that the information described in subsection 7b7 that is published on the internet website required by subsection 7a7 is updated not less frequently than once every #ij days4 7d7 ,outreach ,in carrying out this section1 the ,secretary shall ensure that the outreach conducted under section #agbj;,f7i7 of title #ch1 ,united ,states ,code1 includes information regarding the internet website required by subsection 7a74 7e7 ,derivation of funds ,amounts used by the ,secretary to carry out this section shall be derived from amounts made available to the ,secretary to publish internet websites of the ,department4 #fjd4 ,report on locations where women veterans are using health care from ,department of ,veterans ,affairs 7a7 ,in general ,not later than #ij days after the date of the enactment of this ,act1 and annually thereafter1 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 use by women veterans of health care from the ,department of ,veterans ,affairs4 7b7 ,elements ,each report required by subsection 7a7 shall include the following information3 7#a7 ,the number of women veterans who reside in each ,state4 7#b7 ,the number of women veterans in each ,state who are enrolled in the system of patient enrollment of the ,department established and operated under section #agje7;a7 of title #ch1 ,united ,states ,code4 7#c7 ,of the women veterans who are so enrolled1 the number who have received health care under the laws administered by the ,secretary at least one time during the one-year period preceding the submittal of the report4 7#d7 ,the number of women veterans who have been seen at each medical facility of the ,department during such year4 7#e7 ,the number of appointments that women veterans have had at each such facility during such year4 7#f7 ,if known1 an identification of the medical facility of the ,department in each ,veterans ,integrated ,service ,network with the largest rate of increase in patient population of women veterans as measured by the increase in unique women veteran patient use4 7#g7 ,if known1 an identification of the medical facility of the ,department in each ,veterans ,integrated ,service ,network with the largest rate of decrease in patient population of women veterans as measured by the decrease in unique women veterans patient use4 ,,vii ,other matters #gja4 ,expanded telehealth from ,department of ,veterans ,affairs 7a7 ,in general ,the ,secretary of ,veterans ,affairs shall enter into partnerships1 and expand existing partnerships1 with organizations that represent or serve veterans1 nonprofit organizations1 private businesses1 and other interested parties for the expansion of telehealth capabilities and the provision of telehealth services to veterans through the award of grants under subsection 7b74 7b7 ,award of grants 7#a7 ,in general ,in carrying out partnerships entered into or expanded under this section with entities described in subsection 7a71 the ,secretary shall award grants to those entities4 7#b7 ,locations ,to the extent practicable1 the ,secretary shall ensure that grants are awarded to entities that serve veterans in rural and highly rural areas 7as determined through the use of the ,rural-,urban ,commuting ,areas coding system of the ,department of ,agriculture74 7#c7 ,use of grants 7,a7 ,in general ,grants awarded to an entity under this subsection may be used for one or more of the following3 7i7 ,purchasing or upgrading hardware or software necessary for the provision of secure and private telehealth services4 7ii7 ,upgrading security protocols for consistency with the security requirements of the ,department4 7iii7 ,training of employees1 including payment of those employees for completing that training1 with respect to-- 7,i7 military and veteran cultural competence1 if the entity is not an organization that represents veterans2 7,,ii7 equipment required to provide telehealth services2 or 7,,iii7 any other unique training needs for the provision of telehealth services to veterans4 7iv7 ,upgrading existing infrastructure owned or leased by the entity to make rooms more conducive to telehealth care1 including-- 7,i7 additions or modifications to windows or walls in an existing room1 or other alterations as needed to create a new1 private room2 7,,ii7 soundproofing of an existing room2 7,,iii7 new electrical or internet outlets in an existing room2 or 7,,iv7 aesthetic enhancements to establish a more suitable therapeutic environment4 7v7 ,upgrading existing infrastructure to comply with the ,americans with ,disabilities ,act of #aiij 7#db ,u4,s4,c4 #abaja et seq474 7vi7 ,upgrading internet infrastructure and sustainment of internet services4 7,b7 ,exclusion ,grants may not be used for the purchase of new property or for major construction projects1 as determined by the ,secretary4 7c7 ,agreement on telehealth access points 7#a7 ,in general ,an entity described in subsection 7a7 that seeks to establish a telehealth access point for veterans but does not require grant funding under this section to do so may enter into an agreement with the ,department for the establishment of such an access point4 7#b7 ,adequacy of facilities ,an entity described in paragraph 7#a7 shall be responsible for ensuring that any access point is adequately private1 secure1 and accessible for veterans before the access point is established4 7d7 ,assessment of barriers to access 7#a7 ,in general ,not later than #ah months after the date of the enactment of this ,act1 the ,secretary shall complete an assessment of barriers faced by veterans in accessing telehealth services4 7#b7 ,elements ,the assessment required by paragraph 7#a7 shall include the following3 7,a7 ,a description of the barriers veterans face in using telehealth while not on property of the ,department4 7,b7 ,a description of how the ,department plans to address the barriers described in subparagraph 7,a74 7,c7 ,such other matters related access by veterans to telehealth while not on property of the ,department as the ,secretary considers relevant4 7#c7 ,report ,not later than #abj days after the completion of the assessment required by paragraph 7#a71 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 assessment1 including any recommendations for legislative or administrative action based on the results of the assessment4 #gjb4 ,partnerships with non-,federal ,government entities to provide hyperbaric oxygen therapy to veterans and studies on the use of such therapy for treatment of post-traumatic stress disorder and traumatic brain injury 7a7 ,partnerships to provide hyperbaric oxygen therapy to veterans 7#a7 ,use of partnerships ,the ,secretary of ,veterans ,affairs1 in consultation with the ,center for ,compassionate ,innovation within the ,office of ,community ,engagement of the ,department of ,veterans ,affairs1 may enter into partnerships with non-,federal ,government entities to provide hyperbaric oxygen treatment to veterans to research the effectiveness of such therapy4 7#b7 ,types of partnerships ,partnerships entered into under paragraph 7#a7 may include the following3 7,a7 ,partnerships to conduct research on hyperbaric oxygen therapy4 7,b7 ,partnerships to review research on hyperbaric oxygen therapy provided to nonveterans4 7,c7 ,partnerships to create industry working groups to determine standards for research on hyperbaric oxygen therapy4 7,d7 ,partnerships to provide to veterans hyperbaric oxygen therapy for the purposes of conducting research on the effectiveness of such therapy4 7#c7 ,limitation on ,federal funding ,federal ,government funding may be used to coordinate and administer the partnerships under this subsection but may not be used to carry out activities conducted under such partnerships4 7b7 ,review of effectiveness of hyperbaric oxygen therapy ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary1 in consultation with the ,center for ,compassionate ,innovation1 shall begin using an objective and quantifiable method to review the effectiveness and applicability of hyperbaric oxygen therapy1 such as through the use of a device approved or cleared by the ,food and ,drug ,administration that assesses traumatic brain injury by tracking eye movement4 7c7 ,systematic review of use of hyperbaric oxygen therapy to treat certain conditions 7#a7 ,in general ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary1 in consultation with the ,center for ,compassionate ,innovation1 shall commence the conduct of a systematic review of published research literature on off-label use of hyperbaric oxygen therapy to treat post-traumatic stress disorder and traumatic brain injury among veterans and nonveterans4 7#b7 ,elements ,the review conducted under paragraph 7#a7 shall include the following3 7,a7 ,an assessment of the current parameters for research on the use by the ,department of ,veterans ,affairs of hyperbaric oxygen therapy1 including-- 7i7 tests and questionnaires used to determine the efficacy of such therapy2 and 7ii7 metrics for determining the success of such therapy4 7,b7 ,a comparative analysis of tests and questionnaires used to study post-traumatic stress disorder and traumatic brain injury in other research conducted by the ,department of ,veterans ,affairs1 other ,federal agencies1 and entities outside the ,federal ,government4 7#c7 ,completion of review ,the review conducted under paragraph 7#a7 shall be completed not later than #ahj days after the date of the commencement of the review4 7#d7 ,report ,not later than #ij days after the completion of the review conducted under paragraph 7#a71 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 review4 7d7 ,follow-up study 7#a7 ,in general ,not later than #abj days after the completion of the review conducted under subsection 7c71 the ,secretary1 in consultation with the ,center for ,compassionate ,innovation1 shall commence the conduct of a study on all individuals receiving hyperbaric oxygen therapy through the current pilot program of the ,department for the provision of hyperbaric oxygen therapy to veterans to determine the efficacy and effectiveness of hyperbaric oxygen therapy for the treatment of post-traumatic stress disorder and traumatic brain injury4 7#b7 ,elements ,the study conducted under paragraph 7#a7 shall include the review and publication of any data and conclusions resulting from research conducted by an authorized provider of hyperbaric oxygen therapy for veterans through the pilot program described in such paragraph4 7#c7 ,completion of study ,the study conducted under paragraph 7#a7 shall be completed not later than three years after the date of the commencement of the study4 7#d7 ,report 7,a7 ,in general ,not later than #ij days after completing the study conducted under paragraph 7#a71 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 study4 7,b7 ,elements ,the report required under subparagraph 7,a7 shall include the recommendation of the ,secretary with respect to whether or not hyperbaric oxygen therapy should be made available to all veterans with traumatic brain injury or post-traumatic stress disorder4 #gjc4 ,prescription of technical qualifications for licensed hearing aid specialists and requirement for appointment of such specialists 7a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall prescribe the technical qualifications required under section #gdjb7;a77#ad7 of title #ch1 ,united ,states ,code1 to be appointed as a licensed hearing aid specialist under section #gdja7c7 of such title4 7b7 ,elements for qualifications ,in prescribing the qualifications for licensed hearing aid specialists under subsection 7a71 the ,secretary shall ensure such qualifications are consistent with the following3 7#a7 ,standards of registered apprenticeship programs for the occupation of hearing aid specialists approved by the ,department of ,labor in accordance with the ,act of ,august #af1 #aicg 7commonly known as the ,national ,apprenticeship ,act7 7#ej ,stat4 #ffd1 chapter #ffc2 #bi ,u4,s4,c4 #ej et seq474 7#b7 ,standards for licensure of hearing aid specialists that are required by a majority of ,states4 7#c7 ,competency in completing core tasks for the occupation of hearing aid specialist as determined by the ,occupational ,information ,network ,database 7commonly known as ,o99,,net74 7c7 ,appointment ,not later than ,september #cj1 #bjbb1 the ,secretary shall appoint not fewer than one licensed hearing aid specialist at each medical center of the ,department4 7d7 ,report ,not later than ,september #cj1 #bjbb1 and 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-- 7#a7 assessing the progress of the ,secretary in appointing licensed hearing aid specialists under subsection 7c72 7#b7 assessing potential conflicts or obstacles that prevent the appointment of licensed hearing aid specialists2 7#c7 assessing the factors that led to such conflicts or obstacles2 and 7#d7 indicating the medical centers of the ,department with vacancies for licensed hearing aid specialists4 #gjd4 ,use by ,department of ,veterans ,affairs of commercial institutional review boards in sponsored research trials 7a7 ,in general ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall complete all necessary policy revisions within the directive of the ,veterans ,health ,administration numbered #abjj4je and titled ,requirements for the ,protection of ,human ,subjects in ,research1 to allow sponsored clinical research of the ,department of ,veterans ,affairs to use accredited commercial institutional review boards to review research proposal protocols of the ,department4 7b7 ,identification of review boards ,not later than #ij days after the completion of the policy revisions under subsection 7a71 the ,secretary shall-- 7#a7 identify accredited commercial institutional review boards for use in connection with sponsored clinical research of the ,department2 and 7#b7 establish a process to modify existing approvals in the event that a commercial institutional review board loses its accreditation during an ongoing clinical trial4 7c7 ,report 7#a7 ,in general ,not later than #ij days after the completion of the policy revisions under subsection 7a71 and 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 on all approvals of institutional review boards used by the ,department1 including central institutional review boards and commercial institutional review boards4 7#b7 ,elements ,the report required by paragraph 7#a7 shall include1 at a minimum1 the following3 7,a7 ,the name of each clinical trial with respect to which the use of an institutional review board has been approved4 7,b7 ,the institutional review board or institutional review boards used in the approval process for each clinical trial4 7,c7 ,the amount of time between submission and approval4 #gje4 ,creation of ,office of ,research ,reviews within the ,office of ,information and ,technology of the ,department of ,veterans ,affairs 7a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall establish within the ,office of ,information and ,technology of the ,department of ,veterans ,affairs an ,office of ,research ,reviews 7in this section referred to as the ,office74 7b7 ,elements ,the ,office shall do the following3 7#a7 ,perform centralized security reviews and complete security processes for approved research sponsored outside the ,department1 with a focus on multi-site clinical trials4 7#b7 ,develop and maintain a list of commercially available software preferred for use in sponsored clinical trials of the ,department and ensure such list is maintained as part of the official approved software products list of the ,department4 7#c7 ,develop benchmarks for appropriate timelines for security reviews conducted by the ,office4 7c7 ,report 7#a7 ,in general ,not later than one year after the establishment of the ,office1 the ,office 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 activity of the ,office4 7#b7 ,elements ,the report required by paragraph 7#a7 shall include1 at a minimum1 the following3 7,a7 ,the number of security reviews completed4 7,b7 ,the number of personnel assigned for performing the functions described in subsection 7b74 ,july #bg1 #bjbj,reported with an amendment