#aahth ,,congress #b;d ,session ,s4 #ada ,,an ,,act ,to amend title #ch1 ,united ,states ,code1 to improve certain programs of the ,department of ,veterans ,affairs for home and community based services for veterans1 and for other purposes4 #a4 ,short title2 table of contents 7a7 ,short title ,this ,act may be cited as the ,senator ,elizabeth ,dole #bast ,century ,veterans ,healthcare and ,benefits ,improvement ,act4 7b7 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents4,,title ,i--,health ,care ,matters,subtitle ,a--,veterans ,community ,care ,program ,matters,sec4 #aja4 ,implementation of provision of care under ,veterans ,community ,care ,program upon determination of eligibility by veteran and veteran's referring clinician4,sec4 #ajb4 ,outreach regarding care and services under ,veterans ,community ,care ,program4,sec4 #ajc4 ,annual review and report on waivers of certain payment rates under ,veterans ,community ,care ,program4,sec4 #ajd4 ,modification of requirements for standards for quality of care from ,department of ,veterans ,affairs4,sec4 #aje4 ,pilot program to improve administration of care under ,veterans ,community ,care ,program4,sec4 #ajf4 ,pilot program on consolidating approval process of ,department of ,veterans ,affairs for covered dental care4,sec4 #ajg4 ,strategic plan on value-based health care system for ,veterans ,health ,administration2 pilot program4,sec4 #ajh4 ,plan on adoption of certain health information standards for ,department of ,veterans ,affairs and certain health care providers4,sec4 #aji4 ,report on use of value-based reimbursement models under ,veterans ,community ,care ,program4,sec4 #aaj4 ,inspector ,general assessment of implementation of ,veterans ,community ,care ,program4,sec4 #aaa4 ,comptroller ,general report on dentistry under ,veterans ,community ,care ,program4,subtitle ,b--,matters ,relating to ,nursing ,home and ,other ,long ,term ,care and ,family ,caregivers,sec4 #abj4 ,increase of expenditure cap for noninstitutional care alternatives to nursing home care4,sec4 #aba4 ,coordination with ,program of ,all-,inclusive ,care for the ,elderly4,sec4 #abb4 ,authority for ,secretary of ,veterans ,affairs to award grants or contracts to entities to improve provision of mental health support to family caregivers of veterans4,sec4 #abc4 ,home- and community-based services3 programs4,sec4 #abd4 ,coordination with assistance and support services for caregivers4,sec4 #abe4 ,improvements to program of comprehensive assistance for family caregivers4,sec4 #abf4 ,improvements relating to ,homemaker and ,home ,health ,aide program4,sec4 #abg4 ,pilot program to furnish assisted living services to certain veterans4,sec4 #abh4 ,provision of medicine1 equipment1 and supplies available to ,department of ,veterans ,affairs to ,state homes4,sec4 #abi4 ,recognition of organizations and individuals to assist veterans1 family members1 and caregivers navigating programs and services of ,veterans ,health ,administration4,sec4 #acj4 ,reviews and other improvements relating to home- and community-based services4,sec4 #aca4 ,,gao report on mental health support for caregivers4,sec4 #acb4 ,development of centralized website for program information4,sec4 #acc4 ,definitions4,subtitle ,c--,medical ,treatment and ,other ,matters,sec4 #adj4 ,quarterly report on referrals for non-,department of ,veterans ,affairs health care4,sec4 #ada4 ,elimination of certain requirements for certain ,department of ,veterans ,affairs ,assistant ,under ,secretaries4,sec4 #adb4 ,modification of pay limitation for physicians1 podiatrists1 optometrists1 and dentists of ,department of ,veterans ,affairs4,sec4 #adc4 ,reimbursement of ambulance cost for care for certain rural veterans4,sec4 #add4 ,pilot program to furnish dental care from the ,department of ,veterans ,affairs to certain veterans diagnosed with ischemic heart disease4,sec4 #ade4 ,documentation of preferences of veterans for scheduling of appointments for health care under laws administered by ,secretary of ,veterans ,affairs4,sec4 #adf4 ,staffing model and performance metrics for certain employees of the ,department of ,veterans ,affairs4,sec4 #adg4 ,online health education portal for veterans enrolled in patient enrollment system of ,department of ,veterans ,affairs4,sec4 #adh4 ,limitation on detail of directors of medical centers of ,department of ,veterans ,affairs to different positions4,sec4 #adi4 ,national ,veteran ,suicide ,prevention ,annual ,report4,sec4 #aej4 ,report on physical infrastructure required by medical facilities of ,department of ,veterans ,affairs to provide dental care services4,sec4 #aea4 ,comptroller ,general report on certain oral health care programs under laws administered by ,secretary of ,veterans ,affairs4,sec4 #aeb4 ,review of workflows associated with processing referrals between facilities of the ,veterans ,health ,administration4,sec4 #aec4 ,plan for timely scheduling of appointments at medical facilities of ,department of ,veterans ,affairs4,sec4 #aed4 ,authorization of appropriations to support initiatives for mobile mammography services for veterans4,,title ,,ii--,economic ,opportunity ,matters,subtitle ,a--,educational ,assistance,sec4 #bja4 ,temporary expansion of eligibility for ,marine ,gunnery ,sergeant ,john ,david ,fry ,scholarship4,sec4 #bjb4 ,removal of expiration on entitlement to ,marine ,gunnery ,sergeant ,john ,david ,fry ,scholarship for surviving spouses4,sec4 #bjc4 ,sole liability for transferred educational assistance by an individual who fails to complete a service agreement4,sec4 #bjd4 ,notice to educational institutions of risk-based surveys4,sec4 #bje4 ,relationship of participation by an educational institution in certain ,federal student financial aid programs to approval of such institution for purposes of ,department of ,veterans ,affairs educational assistance programs4,sec4 #bjf4 ,expansion of ,department of ,veterans ,affairs oversight of certain educational institutions4,sec4 #bjg4 ,requirement that educational institutions approved for purposes of ,department of ,veterans ,affairs educational assistance programs provide digital official transcripts4,sec4 #bjh4 ,payment of full monthly housing stipend for veterans enrolled in final semester using educational assistance under ,post-#i_/aa ,educational ,assistance ,program4,sec4 #bji4 ,modification of rules for approval of commercial driver education programs for purposes of educational assistance programs of the ,department of ,veterans ,affairs4,sec4 #baj4 ,provision of certificates of eligibility and award letters using electronic means4,sec4 #baa4 ,retroactive effective date of law regarding charge to entitlement to educational assistance for individuals who do not transfer credits from certain closed or disapproved programs of education4,sec4 #bab4 ,department of ,veterans ,affairs high technology program4,sec4 #bac4 ,notice of changes to ,department of ,veterans ,affairs policies and guidance affecting the educational assistance programs of the ,department4,sec4 #bad4 ,payment of ,,va educational assistance via electronic fund transfer to a foreign institution of higher education4,sec4 #bae4 ,improving transparency and accountability of educational institutions for purposes of veterans educational assistance4,subtitle ,b--,employment and ,training,sec4 #bba4 ,improvements to reemployment rights of members of the ,armed ,forces4,sec4 #bbb4 ,review of investigations manual of ,veterans' ,employment and ,training ,service4,sec4 #bbc4 ,warrior ,training ,advancement ,course4,subtitle ,c--,home ,loans,sec4 #bca4 ,improvements to program for direct housing loans made to ,native ,american veterans by the ,secretary of ,veterans ,affairs4,sec4 #bcb4 ,native community development financial institution relending program4,,title ,,iii--,disability and ,memorial ,affairs ,matters,sec4 #cja4 ,burial allowance for certain veterans who die at home while in receipt of hospice care furnished by ,department of ,veterans ,affairs4,sec4 #cjb4 ,authority for ,secretary of ,veterans ,affairs to award grants to ,states and ,indian ,tribes to improve outreach to veterans4,sec4 #cjc4 ,definition of surviving spouse4,sec4 #cjd4 ,ensuring only licensed health care professionals perform medical disability examinations under certain ,department of ,veterans ,affairs pilot program4,sec4 #cje4 ,provision of information regarding an agent or attorney to a licensed health care professional who performs a medical disability examination under certain ,department of ,veterans ,affairs pilot program4,sec4 #cjf4 ,modernization of ,department of ,veterans ,affairs disability benefit questionnaires4,sec4 #cjg4 ,department of ,veterans ,affairs automatic processing of certain claims for temporary disability ratings4,,title ,,iv--,homelessness ,matters,sec4 #dja4 ,short title4,sec4 #djb4 ,per diem payments provided by the ,secretary of ,veterans ,affairs for services furnished to homeless veterans4,sec4 #djc4 ,authorization for ,secretary of ,veterans ,affairs to use certain funds for improved flexibility in assistance to homeless veterans4,sec4 #djd4 ,access to ,department of ,veterans ,affairs telehealth services4,,title ,v--,oversight and ,investigations ,matters,sec4 #eja4 ,department of ,veterans ,affairs employee training regarding ,office of ,inspector ,general4,sec4 #ejb4 ,annual review of security at covered facilities of the ,department of ,veterans ,affairs4,sec4 #ejc4 ,modification of certain housing loan fees4 ,i ,health ,care ,matters ,a ,veterans ,community ,care ,program ,matters #aja4 ,implementation of provision of care under ,veterans ,community ,care ,program upon determination of eligibility by veteran and veteran's referring clinician 7a7 ,in general ,during the period specified in subsection 7c71 the ,secretary of ,veterans ,affairs shall implement section #agjc7;d77#a77;,e7 of title #ch1 ,united ,states ,code1 in compliance with the implementing regulations for such section under section #ag4djaj7;a77#e7 of title #ch1 ,code of ,federal ,regulations1 such that the determination of eligibility for care is final and shall be made by the veteran and the veteran's referring clinician4 7b7 ,correction of errors ,a covered veteran and the referring clinician of such veteran may correct any errors made with respect to a determination described in subsection 7a74 7c7 ,period specified ,the period specified in this subsection is the two-year period beginning on the date that is #ij days after the date of the enactment of this ,act4 7d7 ,report ,not later than one year and not later than two years after the commencement of the period specified by subsection 7c71 the ,secretary of ,veterans ,affairs shall submit to ,congress a report on the care provided under section #agjc7;d77#a77;,e7 of title #ch1 ,united ,states ,code1 during the one-year period preceding the date of the report1 including-- 7#a7 the number of instances of care provided2 7#b7 the type of care provided2 and 7#c7 the cost of such care4 7e7 ,rule of construction ,nothing in this section shall be construed to limit the ,secretary's authority to prescribe1 amend1 or rescind regulations under section #agjc of title #ch1 ,united ,states ,code4 7f7 ,covered veteran defined ,in this section1 the term covered veteran has the meaning given that term in section #agjc7;b7 of title #ch1 ,united ,states ,code4 #ajb4 ,outreach regarding care and services under ,veterans ,community ,care ,program 7a7 ,requirement ,section #agjc of title #ch1 ,united ,states ,code1 is amended-- 7#a7 by redesignating subsection 7o7 as subsection 7p72 and 7#b7 by inserting after subsection 7n7 the following new subsection 7o73 7o7 ,outreach regarding availability of care and services 7#a7 ,the ,secretary shall conduct outreach to inform veterans of the following3 7,a7 ,the conditions for care or services under subsections 7d7 and 7e74 7,b7 ,how to request such care or services4 7,c7 ,how to appeal a denial of a request for such care or services using the clinical appeals process of the ,veterans ,health ,administration4 7#b7 ,upon enrollment of a veteran in the system of annual patient enrollment established and operated under section #agje of this title1 and not less frequently than every two years thereafter1 the ,secretary shall inform the veteran of information described in paragraph 7#a74 7#c7 ,the ,secretary shall ensure that information described in paragraph 7#a7 is-- 7,a7 publicly displayed in each medical facility of the ,department2 7,b7 prominently displayed on a website of the ,department2 and 7,c7 included in other outreach campaigns and activities conducted by the ,secretary4 4 7b7 ,solid ,start program ,section #fcbj7;a77#b77;,a7 of title #ch1 ,united ,states ,code1 is amended by inserting 1 including how to enroll in the system of annual patient enrollment established and operated under section #agje of this title and the ability to seek care and services under sections #agjc and #agaj of this title before the semicolon4 7c7 ,comptroller ,general report on outreach ,not later than two years after the date of the enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall submit to ,congress a report on the efforts of the ,secretary of ,veterans ,affairs to ensure that veterans are informed of the conditions for eligibility for care and services under section #agjc of title #ch1 ,united ,states ,code1 including such efforts to conduct outreach pursuant to subsection 7o7 of such section 7as added by subsection 7a774 #ajc4 ,annual review and report on waivers of certain payment rates under ,veterans ,community ,care ,program 7a7 ,in general ,section #agjc of title #ch1 ,united ,states ,code1 is further amended-- 7#a7 by redesignating subsection 7p7 as subsection 7q72 and 7#b7 by inserting after subsection 7o7 the following new subsection 7p73 7p7 ,annual review and report on waivers of payment rates 7#a7 ,on an annual basis1 the ,secretary shall-- 7,a7 conduct a review of waivers of payment rates under subsection 7i7 for ,third ,party ,administrators to identify whether such waivers help to alleviate community-specific challenges1 including scarcity of medical services associated with access to health care2 and 7,b7 submit to ,congress a report on the results of such review4 7#b7 ,each report under paragraph 7#a77;,b7 shall include1 with respect to the period covered by the report-- 7,a7 a statement1 disaggregated by region1 of the total number of waivers described in subparagraph 7,a7 of such paragraph requested by ,third ,party ,administrators2 7,b7 a statement of the total number of such waivers that were-- 7i7 granted by the ,secretary2 7ii7 denied by the ,secretary2 or 7iii7 withdrawn by a ,third ,party ,administrator2 7,c7 a description of the process for the review required under paragraph 7#a72 7,d7 a statement1 disaggregated by region1 of the average time to process such waivers2 7,e7 an assessment1 disaggregated by region1 of the extent to which such waivers that were granted by the ,secretary improved access to health care for covered veterans2 and 7,f7 a description of trends1 if any1 identified by the ,secretary with respect to such waivers4 7#c7 ,in this subsection1 the term ,third ,party ,administrator has the meaning given such term in section #agjc;,b of this title4 4 7b7 ,deadline ,the ,secretary shall submit the first report required under subsection 7p7 of section #agjc of such title 7as added by subsection 7a77 not later than #ahj days after the date of the enactment of this ,act4 #ajd4 ,modification of requirements for standards for quality of care from ,department of ,veterans ,affairs 7a7 ,in general ,section #agjc;,c of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#b7-- 7i7 by striking ,in establishing and inserting 7,a7 ,in establishing2 and 7ii7 by adding at the end the following new subparagraph3 7,b7 ,the ,secretary shall ensure that the standards for quality established under paragraph 7#a7 are comparable to industry standards to ensure there is adequate data transference between care furnished by the ,department and care furnished by a non-,department provider4 2 7,b7 in paragraph 7#c77;,b71 by adding at the end the following new clause3 7v7 ,outcomes relating to patient quality of life4 2 7,c7 in paragraph 7#d7-- 7i7 by striking and the ,centers for ,medicare ,medicaid ,services and inserting the ,centers for ,medicare ,medicaid ,services1 and the ,indian ,health ,service2 and 7ii7 by striking and other nongovernmental entities and inserting and other non-governmental entities including ,third ,party ,administrators2 and 7,d7 by striking paragraph 7#e7 and inserting the following new paragraphs3 7#e7 ,when collecting1 considering1 and applying data related to patient care for purposes of establishing standards for quality under paragraph 7#a71 the ,secretary shall ensure no metric is being over or under analyzed4 7#f7 ,in establishing standards for quality under paragraph 7#a71 the ,secretary shall-- 7,a7 utilize the most up-to-date practices for extracting and analyzing relevant data2 7,b7 utilize all relevant data available to the ,secretary2 7,c7 ensure the most efficient use of time and resources related to the use of data scientists employed by the ,department2 and 7,d7 collaborate1 as appropriate1 with entities specified in paragraph 7#d74 7#g7 7,a7 ,not less frequently than once every five years1 the ,secretary shall update the standards for quality established under paragraph 7#a7 pursuant to the requirements for the establishment of such standards under this subsection4 7,b7 ,not later than #cj days after any date on which the ,secretary updates1 pursuant to subparagraph 7,a71 the standards for quality under paragraph 7#a71 the ,secretary shall submit to the appropriate committees of ,congress a report on such updated standards for quality4 2 and 7#b7 in subsection 7b7-- 7,a7 in paragraph 7#a7-- 7i7 by striking ,not later than #a year after the date on which the ,secretary establishes standards for quality under subsection 7a7 and inserting ,not less frequently than once every three years2 and 7ii7 by inserting pursuant to standards for quality under subsection 7a7 after medical facilities of the ,department2 and 7,b7 in paragraph 7#b71 by inserting or updates after establishes4 7b7 ,deadline for update ,the ,secretary1 pursuant to paragraph 7#g7 of section #agjc;,c7a7 of title #ch1 ,united ,states ,code 7as added by subsection 7a771 shall make the first update to the standards for quality established under paragraph 7#a7 of such section not later than the date that is five years after the date on which the ,secretary submits the report under paragraph 7#b7 of subsection 7d74 7c7 ,report ,not later than one year 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 how the ,secretary-- 7#a7 has consulted with entities specified in paragraph 7#d7 of section #agjc;,c7a7 of title #ch1 ,united ,states ,code1 before the date of the enactment of this ,act in establishing standards for quality under such section2 7#b7 has continued to consult with those entities on and after such date of enactment2 and 7#c7 intends to leverage data sciences to improve standards for quality care furnished by the ,department of ,veterans ,affairs4 7d7 ,updates to quality care metrics 7#a7 ,initial report ,not later than one year 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 how the ,secretary plans to implement the amendments made by subsections 7a74 7#b7 ,deadline2 summary report ,not later than two years after the date of the enactment of this ,act1 the ,secretary shall-- 7,a7 implement the amendments made by subsection 7a71 including by updating the standards for quality established under section #agjc;,c of title #ch1 ,united ,states ,code2 and 7,b7 submit to the appropriate committees of ,congress a report detailing the standards for quality updated pursuant to such amendments4 7e7 ,audit of quality care metrics 7#a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall enter into one or more contracts with a non-,department entity described in paragraph 7#b7 to conduct an audit on the quality of care from the ,department of ,veterans ,affairs1 including through non-,department health care providers pursuant to section #agjc of title #ch ,united ,states ,code4 7#b7 ,non-,department entity described ,a non-,department entity described in this paragraph is an entity that-- 7,a7 specializes in analyzing large-scale organizational data collection and analysis efforts1 especially with respect to the health care sector2 and 7,b7 has experience and proven outcomes in optimizing the accuracy and comprehensiveness of data collection and analysis related to the quality of health care services4 7#c7 ,elements ,the audit required under paragraph 7#a7 shall include the following3 7,a7 ,an assessment of the methodology used by the ,department to collect and assess data on the quality of care furnished by the ,department1 including any vulnerabilities in such methodology4 7,b7 ,an assessment of the accuracy and reliability of the data sources used by the ,department to compile data on the quality of care furnished by the ,department4 7,c7 ,the extent to which the standards the ,department uses to assess the quality of care furnished by the ,department are-- 7i7 comparable with industry standards2 7ii7 easily accessible to1 and understood by-- 7,i7 veterans2 7,,ii7 employees of the ,department2 and 7,,iii7 other individuals1 as the private sector entity considers appropriate4 7,d7 ,any recommendations of such private sector entity with respect to improvements that the ,secretary could administer to more accurately capture the quality of care furnished by the ,department4 7#d7 ,reports on audit 7,a7 ,report on findings and recommendations ,not later than #fj days after any date on which a private sector entity described in paragraph 7#b7 completes an audit under paragraph 7#a71 such private sector entity shall submit to the ,secretary1 the ,committee on ,veterans' ,affairs of the ,senate1 and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report that includes-- 7i7 the findings of such audit2 and 7ii7 recommendations of such private sector entity with respect to such audit4 7,b7 ,report on planned improvements ,not later than #fj days after any date on which the ,secretary receives a report under subparagraph 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 how the ,secretary plans to improve the standards for quality of care of the ,department4 7f7 ,appropriate committees of ,congress defined ,in this section1 the term appropriate committees of ,congress has the meaning given such term in section #agjc;,c of title #ch1 ,united ,states ,code4 #aje4 ,pilot program to improve administration of care under ,veterans ,community ,care ,program 7a7 ,establishment ,pursuant to section #agjc;,e of title #ch1 ,united ,states ,code1 the ,secretary of ,veterans ,affairs1 acting through the ,center for ,innovation for ,care and ,payment established under such section1 shall carry out a pilot program to seek to develop and implement a plan-- 7#a7 to provide monetary and non-monetary incentives to a covered health care provider-- 7,a7 to allow the ,secretary to see the scheduling system of the provider1 to assess the availability of1 and to assist in scheduling appointments for1 veterans under the ,veterans ,community ,care ,program under section #agjc of such title1 including through synchronous1 asynchronous1 and asynchronous assisted digital scheduling2 7,b7 to complete continuing professional educational training available through the ,,vha ,,train program 7or any successor program or initiative7 regarding veteran cultural competency1 the opioid safety initiative 7or any successor program or initiative71 and other subjects determined appropriate by the ,secretary2 7,c7 to improve methods of accounting for non-,department training that is equivalent or substantially similar to the continuing professional educational training described in subparagraph 7,b72 7,d7 to improve the rate of the timely return to the ,secretary of medical record documentation for care or services provided under the ,veterans ,community ,care ,program2 7,e7 to improve the timeliness and quality of the delivery of care and services to veterans under such program2 and 7,f7 to achieve other objectives determined appropriate by the ,secretary2 and 7#b7 to decrease the rate of no-show appointments under such program4 7b7 ,report ,not later than one year after the date of the establishment of the pilot program under this section1 and annually thereafter during the term of the pilot program1 the ,secretary of ,veterans ,affairs shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a report on the pilot program that includes1 with respect to the period covered by the report-- 7#a7 an assessment of the extent to which-- 7,a7 the system of the ,department of ,veterans ,affairs for scheduling appointments for veterans under the ,veterans ,community ,care ,program has improved2 7,b7 the rate of timely return to the ,secretary of medical record documentation described in subparagraph 7,d7 of subsection 7a77#a7 has improved2 7,c7 the timeliness and quality of the delivery of care and services described in subparagraph 7,e7 of such subsection has improved2 and 7,d7 the frequency of no-show appointments described in paragraph 7#b7 of such subsection decreased2 7#b7 a list of the continuing professional educational training courses under subparagraph 7,b7 of such subsection available to covered health care providers2 7#c7 the rate of participation in such continuing professional education training courses2 and 7#d7 any other matter the ,secretary determines appropriate4 7c7 ,definitions ,in this section3 7#a7 ,the term covered health care provider means a health care provider-- 7,a7 described in subsection 7c7 of section #agjc of title #ch1 ,united ,states ,code1 that furnishes care or services under the ,veterans ,community ,care ,program pursuant to a contract or agreement with a ,third ,party ,administrator2 or 7,b7 that otherwise furnishes care or services outside of ,department facilities pursuant to a contract or agreement with the ,secretary of ,veterans ,affairs4 7#b7 ,the term opioid safety initiative means the programs1 processes1 and guidelines of the ,veterans ,health ,administration of the ,department of ,veterans ,affairs relating to the management of opioid therapy and chronic pain4 7#c7 ,the term ,third ,party ,administrator means an entity that manages a network of health care providers and performs administrative services related to such network under section #agjc of such title4 7#d7 ,the term ,,vha ,,train program means the free program of the ,veterans ,health ,administration that offers veteran-specific continuing medical education courses4 #ajf4 ,pilot program on consolidating approval process of ,department of ,veterans ,affairs for covered dental care 7a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs1 acting through the ,center for ,innovation for ,care and ,payment established under section #agjc;,e of title #ch1 ,united ,states ,code1 shall carry out a pilot program under which the ,secretary shall hire-- 7#a7 general dentists at medical facilities of the ,department of ,veterans ,affairs to manage approval by the ,department of treatment plans requested by dental providers in providing covered dental care2 and 7#b7 dental specialists at ,veterans ,integrated ,service ,networks of the ,department to manage approval by the ,department of treatment plans for specialty dental care requested by dental providers in providing covered dental care4 7b7 ,locations ,the ,secretary shall carry out the pilot program in not fewer than two ,veterans ,integrated ,service ,networks of the ,department4 7c7 ,reports 7#a7 ,initial report ,not later than one year after the date of the commencement of such pilot program1 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives a report on the pilot program1 that includes-- 7,a7 an identification of the ,veterans ,integrated ,service ,networks participating in such pilot program2 7,b7 a description of the implementation of such pilot program2 7,c7 an identification of any barriers or challenges to implementing such pilot program2 7,d7 an assessment of the efficacy of hiring general dentists and dental specialists pursuant to such pilot program2 7,e7 aggregated feedback with respect to such pilot program from dentists of the ,department in ,veterans ,integrated ,service ,networks participating in such pilot program2 and 7,f7 aggregated feedback from dental providers providing covered dental care within such ,veterans ,integrated ,service ,networks regarding any changes in the timeliness of treatment plan approvals by the ,department4 7#b7 ,final report ,not later than #ij days before the date of the completion of such pilot program1 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives a report on the pilot program that-- 7,a7 includes1 with respect to the period covered by the report1 each element of the report required under paragraph 7#a7 described in subparagraphs 7,a7 through 7,f7 of such paragraph2 7,b7 includes recommendations of the ,secretary on whether the pilot program should be-- 7i7 extended2 7ii7 expanded2 or 7iii7 adopted throughout the ,department2 and 7,c7 indicates whether the ,secretary requests action by ,congress to make the pilot program permanent4 7d7 ,sunset ,the authority to carry out the pilot program under this section shall terminate on the date that is two years after the date of the enactment of this ,act4 7e7 ,covered dental care defined ,in this section1 the term covered dental care means dental care provided-- 7#a7 under section #agjc of title #ch1 ,united ,states ,code2 or 7#b7 pursuant to a ,veterans ,care ,agreement under section #agjc;,a of such title4 #ajg4 ,strategic plan on value-based health care system for ,veterans ,health ,administration2 pilot program 7a7 ,establishment of working group 7#a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall-- 7,a7 establish a working group on value-based care2 and 7,b7 submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate the strategic plan developed by the working group pursuant to subsection 7b74 7#b7 ,membership 7,a7 ,required members ,the working group shall include1 at a minimum1 the following members3 7i7 ,the ,under ,secretary for ,health of the ,department of ,veterans ,affairs4 7ii7 ,the ,director of the ,office of ,mental ,health and ,suicide ,prevention of the ,department of ,veterans ,affairs 7or any successor office74 7iii7 ,the ,director of the ,office of ,integrated ,veteran ,care of the ,department 7or any successor office74 7iv7 ,the ,director of the ,office of ,rural ,health of the ,department 7or any successor office74 7v7 ,the ,director of the ,office of ,connected ,care of the ,department 7or any successor office74 7vi7 ,the ,assistant ,secretary for the ,office of ,information ,technology 7or any successor office74 7vii7 ,the ,chief ,officer of the ,office of ,healthcare ,innovation and ,learning of the ,office of ,discovery1 ,education1 and ,affiliate ,networks of the ,veterans ,health ,administration 7or any successor office74 7viii7 ,an individual designated by the ,secretary from the ,center for ,innovation for ,care and ,payment of the ,department under section #agjc;,e of title #ch1 ,united ,states ,code4 7ix7 ,an individual designated by the ,administrator of the ,centers for ,medicare ,medicaid ,services from the ,center for ,medicare and ,medicaid ,innovation4 7x7 ,an individual designated by the ,secretary of ,health and ,human ,services from the ,federal ,office of ,rural ,health ,policy of the ,health ,resources and ,services ,administration4 7xi7 ,the ,chief of ,human ,capital ,management for the ,veterans ,health ,administration4 7xii7 ,an individual designated by the ,secretary of ,defense that is a representative of the ,defense ,health ,agency4 7xiii7 ,an individual selected by the ,secretary of ,veterans ,affairs from the special medical advisory group established under section #gcab of title #ch1 ,united ,states ,code4 7,b7 ,optional members ,the ,secretary of ,veterans ,affairs may appoint any of the following individuals as members of the working group3 7i7 ,an individual representing the ,health and ,medicine ,division of the ,national ,academies of ,sciences1 ,engineering1 and ,medicine4 7ii7 ,three individuals representing a private health care system that has made the transition to value-based care4 7iii7 ,three individuals representing an organization recognized by the ,secretary of ,veterans ,affairs under section #eijb of title #ch1 ,united ,states ,code4 7#c7 ,public availability ,all meetings deliberations1 and products of the working group shall be made publicly available throughout the duration of the working group1 including to individuals representing organizations recognized by the ,secretary of ,veterans ,affairs under section #eijb of title #ch1 ,united ,states ,code4 7#d7 ,exemption from ,,faca ,chapter #aj of title #e1 ,united ,states ,code1 shall not apply to the working group established under paragraph 7#a74 7b7 ,development of strategic plan ,the working group shall develop a strategic plan to implement value-based care into the ,veterans ,health ,administration that includes the following3 7#a7 ,an identification of the state of the ,veterans ,health ,administration as of the date of the enactment of this ,act1 including an assessment of the current model of health care delivery used by the ,veterans ,health ,administration in medical facilities of the ,department of ,veterans ,affairs4 7#b7 ,an assessment of the capacity needs of the ,veterans ,health ,administration during the five-year period beginning on the date of the enactment of this ,act4 7#c7 ,an analysis of the leadership of the ,veterans ,health ,administration1 including an assessment of leadership acumen and ability to implement a clear1 shared vision and effective change management and care coordination4 7#d7 ,an identification of goals for the future of the ,veterans ,health ,administration4 7#e7 ,an identification and classification of the current capabilities1 capacity1 and gaps in access and quality of the health care system of the ,department of ,veterans ,affairs4 7#f7 ,an analysis of value-based care models1 including-- 7,a7 a selection of potential models that would best work for the ,veterans ,health ,administration2 7,b7 the capacity and capabilities of each such model2 and 7,c7 a thorough justification of the selection of each selected model1 including a summary of the ability of such model to improve the metrics described under paragraph 7#i74 7#g7 ,a definition of what quality means with respect to-- 7,a7 access to health care under the laws administered by the ,secretary of ,veterans ,affairs2 and 7,b7 delivery of such health care4 7#h7 ,a definition of what value means with respect to care furnished by the ,veterans ,health ,administration1 7#i7 ,a system for measuring value within the ,veterans ,health ,administration that includes metrics for-- 7,a7 outcomes2 7,b7 safety2 7,c7 service2 7,d7 access2 7,e7 productivity2 7,f7 capacity2 and 7,g7 total cost of patient care4 7#aj7 ,with respect to the system described in subparagraph 7,h71 an analysis of variable value with respect to patient outcomes across different health care types and specialties4 7#aa7 ,an assessment of-- 7,a7 previous or ongoing assessments of the current information technology infrastructure of the ,veterans ,health ,administration1 including-- 7i7 such assessments conducted pursuant to the ,electronic ,health ,record ,modernization program of the ,department of ,veterans ,affairs2 and 7ii7 any other ongoing information technology modernization programs of such ,department and any unimplemented relevant recommendations from such assessments2 7,b7 the information technology infrastructure of the ,veterans ,health ,administration in effect as of the date of the enactment of this ,act2 7,c7 the value-driven framework of the ,department1 in effect as of the date of the enactment of this ,act1 for evaluating health care innovations1 and how improvements in such framework could be used to encourage innovation2 and 7,d7 workforce challenges and needs of the ,veterans ,health ,administration based on-- 7i7 reviews of workforce assessment data available as of the date of the enactment of this ,act2 and 7ii7 the findings of-- 7,i7 the report required by section #cja7;d7 of the ,veterans ,access1 ,choice1 and ,accountability ,act of #bjad 7,public ,law #aac-adf72 7,,ii7 the reports required by section #eje of the ,john ,s4 ,mc,cain ,,iii1 ,daniel ,k4 ,akaka and ,samuel ,r4 ,johnson ,,va ,maintaining ,internal ,systems and ,strengthening ,integrated ,outside ,networks ,act of #bjah 7,public ,law #aae-ahb72 7,,iii7 the report required by section #cja of the ,,va ,choice and ,quality ,employment ,act of #bjag 7,public ,law #aae-df72 and 7,,iv7 any comprehensive health care inspection conducted by the ,inspector ,general of the ,department of ,veterans ,affairs as of the date of the enactment of this ,act4 7#ab7 ,any recommendations of the working group with respect to improving the information technology infrastructure described in clause 7i7 of subparagraph 7,j74 7#ac7 ,an analysis of how the value-driven framework described in clause 7iii7 of such subparagraph could be used to improve the model of care delivery by the ,department4 7#ad7 ,a description of how a value-based care system would apply to primary care1 inpatient and outpatient mental health care1 and inpatient and outpatient substance use treatment1 spinal cord injury disorder care1 and polytrauma care furnished by the ,veterans ,health ,administration4 7#ae7 ,with respect to legislative or administrative action necessary to incorporate value-based care models into the ,veterans ,health ,administration1 a description of the estimated timelines1 effect on workforce1 and costs4 7c7 ,pilot program 7#a7 ,in general ,not later than #ahj days after the submission of the strategic plan pursuant to subsection 7b71 the ,secretary of ,veterans ,affairs1 acting through the ,center for ,innovation for ,care and ,payment established under section #agjc;,e of title #ch1 ,united ,states ,code1 shall commence a three-year pilot program under which the ,secretary shall implement the elements of such strategic plan relating to the delivery1 by the ,veterans ,health ,administration1 of primary care1 inpatient and outpatient mental health treatment1 inpatient and outpatient substance abuse treatment1 spinal cord injury disorder care1 and polytrauma care4 7#b7 ,locations ,the ,secretary shall carry out such pilot program in four ,veterans ,integrated ,service ,networks that are geographically dispersed and shall include the following3 7,a7 ,a ,veterans ,integrated ,service ,network that predominately serves veterans in rural and highly rural areas4 7,b7 ,a ,veterans ,integrated ,service ,network that predominately serves veterans in urban areas4 7,c7 ,a ,veterans ,integrated ,service ,network that has a high rate of suicide among veterans4 7,d7 ,a ,veterans ,integrated ,service ,network that has a high rate of substance use disorder among veterans4 7,e7 ,a ,veterans ,integrated ,service ,network that has access or productivity challenges4 7#c7 ,reports to congress 7,a7 ,annual report ,not later than one year after the commencement of the pilot program1 and annually thereafter during the duration of the pilot program1 the ,secretary shall submit to ,congress a report on the pilot program4 7,b7 ,final report ,not later than #ij days before the conclusion of the pilot program1 the ,secretary shall submit to ,congress a final report on the pilot program that includes-- 7i7 lessons learned during the administration of such pilot program2 and 7ii7 specific health outcomes in veteran patient care compared to the ,veterans ,health ,administration system of care in effect as of the date of the enactment of this ,act4 #ajh4 ,plan on adoption of certain health information standards for ,department of ,veterans ,affairs and certain health care providers 7a7 ,plan for certain health information standards 7#a7 ,in general ,the ,secretary of ,veterans ,affairs1 in consultation with the ,secretary of ,health and ,human ,services1 the ,administrator of the ,centers for ,medicare ,medicaid ,services1 and the ,national ,coordinator for ,health ,information ,technology of the ,department of ,health and ,human ,services1 shall create and implement a plan to adopt1 as rapidly and to the most comprehensive extent feasible1 national health information interoperability standards for the ,department of ,veterans ,affairs and community care providers with respect to-- 7,a7 coordination of-- 7i7 care2 and 7ii7 benefits2 7,b7 patient identity matching2 7,c7 measurement and reporting of quality2 7,d7 population health2 and 7,e7 public health4 7#b7 ,consideration ,in developing the plan under paragraph 7#a71 the ,secretary of ,veterans ,affairs shall consider challenges faced by-- 7,a7 small community care providers2 and 7,b7 community care providers located in rural areas4 7b7 ,plan on electronic health record exchange 7#a7 ,in general ,not later than one year after the date of enactment of this ,act1 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives a plan to provide1 at no cost1 to community care providers of the ,department1 through ,third ,party ,administrators1 a capability to facilitate the electronic direct exchange1 between such providers and the ,department1 of-- 7,a7 the health records of veterans2 and 7,b7 documents relating to health care of veterans1 clinical notes1 and any other information the ,secretary determines necessary4 7#b7 ,prioritization ,in developing the plan required under paragraph 7#a71 the ,secretary shall prioritize providing the capability described in such paragraph to community care providers that-- 7,a7 provide care under the laws administered by the ,secretary to-- 7i7 a lower volume of veterans2 and 7ii7 veterans who are located in rural areas2 and 7,b7 are unable or unwilling to exchange the records and documents described in subparagraphs 7,a7 and 7,b7 of such paragraph with the ,department through standards-based or direct exchange mechanisms in effect as of the date of the enactment of this ,act4 7c7 ,reports on plan for interoperability standards 7#a7 ,initial report ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall submit to the ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives-- 7,a7 the plan required by subsection 7a72 and 7,b7 a report that includes-- 7i7 an analysis of gaps1 if any1 between the use1 by the ,department and other agencies1 health information exchanges1 and technology companies1 of national health information interoperability standards and the potential1 or optimal1 use of such national health information interoperability standards2 7ii7 an analysis and description of the participation by the ,department1 community care providers1 and other relevant entities in the ,trusted ,exchange ,framework and ,common ,agreement program of the ,department of ,health and ,human ,services as of the date of the enactment of this ,act2 7iii7 recommendations of the ,secretary with respect to development of health information interoperability standards2 7iv7 timelines or schedules to implement the plan required by subsection 7a72 and 7v7 an identification of any legislative authorities or resources the ,secretary requires to implement such plan4 7#b7 ,recurring report requirement 7,a7 ,in general ,not later than #ah months after the date of the enactment of this ,act1 and every #ahj days thereafter for four years1 the ,secretary of ,veterans ,affairs shall submit to ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives a report on the status of implementation of the plan required under subsection 7a74 7,b7 ,elements of subsequent reports ,each report under subparagraph 7,a7 submitted after the date on which the first report required by such subparagraph is submitted shall include a description of any revisions to-- 7i7 the plan required by subsection 7a7 made during the period covered by the report2 and 7ii7 the analysis1 recommendations1 timelines1 and legislative authorities reported pursuant to paragraph 7#a74 7d7 ,definitions ,in this section3 7#a7 ,the term community care provider means a non-,department health care provider providing care 7including dental care7-- 7,a7 under section #agjc of title #ch1 ,united ,states ,code2 7,b7 pursuant to a ,veterans ,care ,agreement under section #agjc;,a of such title2 or 7,c7 under any other law administered by the ,secretary of ,veterans ,affairs4 7#b7 ,the term ,third ,party ,administrator means an entity that manages a provider network and performs administrative services related to such network under section #agjc of title #ch1 ,united ,states ,code4 #aji4 ,report on use of value-based reimbursement models under ,veterans ,community ,care ,program 7a7 ,report on value-based reimbursement models ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs1 in consultation with the ,center for ,innovation for ,care and ,payment of the ,department of ,veterans ,affairs under section #agjc;,e of title #ch ,united ,states ,code1 the ,office of ,integrated ,veteran ,care of the ,department1 or successor office1 and ,third ,party ,administrators1 shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a report containing-- 7#a7 an assessment of the efforts of the ,department pursuant to section #agjc7;i77#e7 of such title1 to incorporate value-based reimbursement models under the ,veterans ,community ,care ,program to promote the provision of high-quality care to veterans2 and 7#b7 such recommendations for legislative or administrative action as the ,secretary considers appropriate regarding the use of value-based reimbursement models throughout the ,veterans ,community ,care ,program under section #agjc of such title4 7b7 ,rule of construction ,this section shall not be construed to be a pilot program subject to the requirements of section #agjc;,e of title #ch1 ,united ,states ,code4 7c7 ,third party administrator defined ,in this section1 the term ,third ,party ,administrator means an entity that manages a provider network and performs administrative services related to such network under section #agjc of title #ch1 ,united ,states ,code4 #aaj4 ,inspector ,general assessment of implementation of ,veterans ,community ,care ,program 7a7 ,in general ,not later than #ah months after the date of the enactment of this ,act1 and periodically thereafter1 the ,inspector ,general shall assess the performance of the ,department of ,veterans ,affairs in-- 7#a7 appropriately identifying veterans eligible for care and services under section #agjc of title #ch1 ,united ,states ,code2 7#b7 informing veterans of their eligibility for such care and services2 and 7#c7 delivering such care and services in a timely manner4 7b7 ,briefing on assessments ,upon the submission of the assessment required by subsection 7a71 the ,inspector ,general of the ,department of ,veterans ,affairs shall provide to the ,committees on ,veterans ,affairs of the ,house of ,representatives and the ,senate a briefing on the results of such assessment4 #aaa4 ,comptroller ,general report on dentistry under ,veterans ,community ,care ,program 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 ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives a report on dental care furnished by the ,secretary of ,veterans ,affairs under the ,veterans ,community ,care ,program under section #agjc of title #ch1 ,united ,states ,code1 that includes a review of-- 7#a7 the impact current reimbursement rates provided by the ,department of ,veterans ,affairs to dental providers under such program have on-- 7,a7 the availability of dental care for veterans2 and 7,b7 the ability of ,third ,party ,administrators to meet their contractual obligations for network adequacy2 7#b7 the satisfaction of dental providers providing dental care under such program with the processes of the ,department for approving dental care under such program2 and 7#c7 the current processes of the ,department for approving emergent dental care under such program4 7b7 ,third party administrator defined ,in this section1 the term ,third ,party ,administrator means an entity that manages a provider network and performs administrative services related to such network under section #agjc of title #ch1 ,united ,states ,code4 ,b ,matters ,relating to ,nursing ,home and ,other ,long ,term ,care and ,family ,caregivers #abj4 ,increase of expenditure cap for noninstitutional care alternatives to nursing home care 7a7 ,increase of expenditure cap ,section #agbj;,c7d7 of title #ch1 ,united ,states ,code1 is amended-- 7#a7 by striking ,the total cost and inserting 7#a7 ,except as provided in paragraph 7#b71 the total cost2 7#b7 by striking #fe percent and inserting #ajj percent2 and 7#c7 by adding at the end the following new paragraph3 7#b7 7,a7 ,the total cost of providing services or in-kind assistance in the case of any veteran described in subparagraph 7,b7 for any fiscal year under the program may exceed #ajj percent of the cost that would otherwise have been incurred as specified in paragraph 7#a7 if the ,secretary determines1 based on a consideration of clinical need1 geographic market factors1 and such other matters as the ,secretary may prescribe through regulation1 that such higher total cost is in the best interest of the veteran4 7,b7 ,a veteran described in this subparagraph is a veteran with amyotrophic lateral sclerosis1 a spinal cord injury1 or a condition the ,secretary determines to be similar to such conditions4 4 7b7 ,applicability ,the amendments made by subsection 7a7 shall apply with respect to fiscal years beginning on or after the date of the enactment of this ,act4 #aba4 ,coordination with ,program of ,all-,inclusive ,care for the ,elderly ,section #agbj;,c of title #ch1 ,united ,states ,code1 as amended by section #abj1 is further amended by adding at the end the following new subsection3 7f7 ,in furnishing services to a veteran under the program conducted pursuant to subsection 7a71 if a medical center of the ,department through which such program is administered is located in a geographic area in which services are available to the veteran under a ,,pace program 7as such term is defined in sections #ahid7;a77#b7 and #aicd7;a77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;eee7a77#b72 #acifu-#d7;a77#b7771 the ,secretary shall seek to enter into an agreement with the ,,pace program operating in that area for the furnishing of such services4 4 #abb4 ,authority for ,secretary of ,veterans ,affairs to award grants or contracts to entities to improve provision of mental health support to family caregivers of veterans ,subchapter ,,ii of chapter #ag of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new section 7and conforming the table of sections at the beginning of such chapter accordingly73 #agbj,k4 ,grants or contracts to provide mental health support to family caregivers of veterans 7a7 ,authority ,the ,secretary may award grants or contracts to carry out1 coordinate1 improve1 or otherwise enhance mental health counseling1 treatment1 or support to the family caregivers of veterans participating in the family caregiver program4 7b7 ,application 7#a7 ,to be eligible for a grant or contract under this section1 an entity shall submit to the ,secretary an application therefor at such time1 in such manner1 and containing such information as the ,secretary may require4 7#b7 ,each application submitted under paragraph 7#a7 shall include the following3 7,a7 ,a detailed plan for the use of the grant or contract4 7,b7 ,a description of the programs or efforts through which the entity will meet the outcome measures developed by the ,secretary under subsection 7f74 7,c7 ,a description of how the entity will distribute grant or contract amounts equitably among areas with varying levels of urbanization4 7,d7 ,a plan for how the grant or contract will be used to meet the unique needs of veterans residing in rural areas1 ,native ,american1 ,native ,hawaiian1 or ,alaska ,native veterans1 elderly veterans1 women veterans1 and veterans from other underserved communities4 7c7 ,distribution ,the ,secretary shall seek to ensure that grants and contracts awarded under this section are equitably distributed among entities located in ,states with varying levels of urbanization4 7d7 ,priority ,the ,secretary shall prioritize awarding grants or contracts under this section that will serve the following areas3 7#a7 ,areas with high rates of veterans enrolled in the family caregiver program4 7#b7 ,areas with high rates of-- 7,a7 suicide among veterans2 or 7,b7 referrals to the ,veterans ,crisis ,line4 7e7 ,required activities ,any grant or contract awarded under this section shall be used-- 7#a7 to expand existing programs1 activities1 and services2 7#b7 to establish new or additional programs1 activities1 and services2 or 7#c7 for travel and transportation to facilitate carrying out paragraph 7#a7 or 7#b74 7f7 ,outcome measures 7#a7 ,the ,secretary shall develop and provide to each entity that receives a grant or contract under this section written guidance on the following3 7,a7 ,outcome measures4 7,b7 ,policies of the ,department4 7#b7 ,in developing outcome measures under paragraph 7#a71 the ,secretary shall consider the following goals3 7,a7 ,increasing the utilization of mental health services among family caregivers of veterans participating in the family caregiver program4 7,b7 ,reducing barriers to mental health services among family caregivers of veterans participating in such program4 7g7 ,tracking requirements 7#a7 ,the ,secretary shall establish appropriate tracking requirements with respect to the entities receiving a grant or contract under this section4 7#b7 ,not less frequently than annually1 the ,secretary shall submit to ,congress a report on such tracking requirements4 7h7 ,performance review ,the ,secretary shall-- 7#a7 review the performance of each entity that receives a grant or contract under this section2 and 7#b7 make information regarding such performance publicly available4 7i7 ,remediation plan 7#a7 ,in the case of an entity that receives a grant or contract under this section and does not meet the outcome measures developed by the ,secretary under subsection 7f71 the ,secretary shall require the entity to submit to the ,secretary a remediation plan under which the entity shall describe how and when it plans to meet such outcome measures4 7#b7 ,the ,secretary may not award a subsequent grant or contract under this section to an entity described in paragraph 7#a7 unless the ,secretary approves the remediation plan submitted by the entity under such paragraph4 7j7 ,maximum amount ,the amount of a grant or contract awarded under this section may not exceed #aj percent of amounts made available for grants or contracts under this section for the fiscal year in which the grant or contract is awarded4 7k7 ,supplement1 not supplant ,any grant or contract awarded under this section shall be used to supplement and not supplant funding that is otherwise available through the ,department to provide mental health support among family caregivers of veterans participating in the family caregiver program4 7l7 ,outreach to family caregivers ,the ,secretary shall include1 in the outreach materials regularly provided to a family caregiver who participates in the family caregiver program1 notice of mental health support provided by recipients of grants or contracts under this section that are located in the relevant ,veterans ,integrated ,service ,network4 7m7 ,funding 7#a7 ,amounts for the activities of the ,department under this section shall be budgeted and appropriated through a separate appropriation account4 7#b7 ,in the budget justification materials submitted to ,congress in support of the budget of the ,department for any fiscal year 7as submitted with the budget of the ,president under section #aaje7;a7 of title #ca71 the ,secretary shall include a separate statement of the amount requested to be appropriated for that fiscal year for the account specified in paragraph 7#a74 7n7 ,authorization of appropriations ,there is authorized to be appropriated to the ,secretary1 for each of fiscal years #bjbe and #bjbf1 #aj1jjj1jjj to carry out this section4 7o7 ,definitions ,in this section3 7#a7 ,the terms caregiver and family caregiver have the meanings given those terms in section #agbj;,g of this title4 7#b7 ,the term family caregiver program means the program of comprehensive assistance for family caregivers under section #agbj;,g of this title4 7#c7 ,the term ,veterans ,crisis ,line means the toll-free hotline for veterans established under section #agbj;,f of this title4 4 #abc4 ,home- and community-based services3 programs 7a7 ,programs ,such subchapter is further amended by inserting after section #agbj,k 7as added by section #abb7 the following new section 7and conforming the table of sections at the beginning of such chapter accordingly73 #agbj,l4 ,home- and community-based services3 programs 7a7 ,in general ,in furnishing noninstitutional alternatives to nursing home care pursuant to the authority of section #agbj;,c of this title 7or any other authority under this chapter or other provision of law administered by the ,secretary of ,veterans ,affairs71 the ,secretary shall carry out each of the programs specified in this section in accordance with such relevant authorities except as otherwise provided in this section4 7b7 ,veteran-,directed ,care program 7#a7 ,the ,secretary of ,veterans ,affairs1 in collaboration with the ,secretary of ,health and ,human ,services1 shall carry out a program to be known as the ,veteran-,directed ,care program4 ,under such program1 the ,secretary of ,veterans ,affairs may enter into agreements with the providers described in paragraph 7#b7 to provide to eligible veterans funds1 to the extent practicable1 to obtain such in-home care services and related items that support clinical need and improve quality of life1 as may be determined appropriate by the ,secretary of ,veterans ,affairs and selected by the veteran1 including through the veteran hiring individuals to provide such services and items or directly purchasing such services and items4 7#b7 ,the providers described in this paragraph are the following3 7,a7 ,an ,aging and ,disability ,resource ,center1 an area agency on aging1 or a ,state agency4 7,b7 ,a center for independent living4 7,c7 ,an ,indian tribe or tribal organization receiving assistance under title ,,vi of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjeg et seq474 7,d7 ,any other entity that the ,secretary1 in consultation with the ,secretary of ,health and ,human ,services1 determines appropriate4 7#c7 ,in carrying out the ,veteran-,directed ,care program1 the ,secretary of ,veterans ,affairs shall-- 7,a7 administer such program through each medical center of the ,department of ,veterans ,affairs2 7,b7 seek to ensure the availability of such program in ,american ,samoa1 ,guam1 the ,commonwealth of the ,northern ,mariana ,islands1 the ,commonwealth of ,puerto ,rico1 the ,virgin ,islands of the ,united ,states1 and any other territory or possession of the ,united ,states1 to the extent practicable2 and 7,c7 seek to ensure the availability of such program for eligible veterans who are ,native ,american veterans receiving care and services furnished by the ,indian ,health ,service1 a tribal health program1 an ,urban ,indian organization1 or 7in the case of a ,native ,hawaiian veteran7 a ,native ,hawaiian health care system1 to the extent practicable4 7#d7 ,if a veteran participating in the ,veteran-,directed ,care program is hospitalized1 the veteran may continue to use funds under the program during a period of hospitalization in the same manner that the veteran would be authorized to use such funds under the program if the veteran were not hospitalized4 7c7 ,homemaker and ,home ,health ,aide program 7#a7 ,the ,secretary shall carry out a program to be known as the ,homemaker and ,home ,health ,aide program under which the ,secretary may enter into agreements with home health agencies to provide to eligible veterans such home health aide services as may be determined appropriate by the ,secretary4 7#b7 ,in carrying out the ,homemaker and ,home ,health ,aide program1 the ,secretary shall-- 7,a7 administer such program in the locations specified in subparagraph 7,a7 of subsection 7b77#c72 7,b7 seek to ensure the availability of such program in the locations specified in subparagraph 7,b7 of subsection 7b77#c72 and 7,c7 seek to ensure the availability of such program for the veteran populations specified in subparagraph 7,c7 of subsection 7b77#c74 7d7 ,home-,based ,primary ,care program ,the ,secretary shall carry out a program to be known as the ,home-,based ,primary ,care program under which the ,secretary may furnish to eligible veterans in-home health care1 the provision of which is overseen by a provider of the ,department4 7e7 ,purchased ,skilled ,home ,care program ,the ,secretary shall carry out a program to be known as the ,purchased ,skilled ,home ,care program under which the ,secretary may furnish to eligible veterans such in-home care services as may be determined appropriate and selected by the ,secretary for the veteran4 7f7 ,caregiver support 7#a7 ,with respect to a resident eligible caregiver of a veteran participating in a program under this section1 the ,secretary shall-- 7,a7 if the veteran meets the requirements of a covered veteran under section #agbj;,g7b7 of this title1 provide to such caregiver the option of enrolling in the program of general caregiver support services under such section2 7,b7 provide to such caregiver covered respite care of not less than #cj days annually2 and 7,c7 conduct on an annual basis 7and1 to the extent practicable1 in connection with in-person services provided under the program in which the veteran is participating71 a wellness contact of such caregiver4 7#b7 ,covered respite care provided to a resident eligible caregiver of a veteran under paragraph 7#a7 may exceed #cj days annually if such extension is requested by the resident eligible caregiver or veteran and determined medically appropriate by the ,secretary4 7g7 ,rule of construction ,nothing in this section shall be construed to limit the authority of the ,secretary to carry out programs providing home- and community-based services under any other provision of law4 7h7 ,definitions ,in this section3 7#a7 ,the terms ,aging and ,disability ,resource ,center1 area agency on aging1 and ,state agency have the meanings given those terms in section #ajb of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjjb74 7#b7 ,the terms caregiver and family caregiver1 with respect to a veteran1 have the meanings given those terms1 respectively1 under subsection 7e7 of section #agbj;,g of this title with respect to an eligible veteran under subsection 7a7 of such section or a covered veteran under subsection 7b7 of such section1 as the case may be4 7#c7 ,the term center for independent living has the meaning given that term in section #gjb of the ,rehabilitation ,act of #aigc 7#bi ,u4,s4,c4 #gif;a74 7#d7 ,the term covered respite care has the meaning given such term in section #agbj;,g7d7 of this title4 7#e7 ,the term eligible veteran means any veteran-- 7,a7 for whom the ,secretary determines participation in a specific program under this section is medically necessary to promote1 preserve1 or restore the health of the veteran2 and 7,b7 who absent such participation would be at increased risk for hospitalization1 placement in a nursing home1 or emergency room care4 7#f7 ,the term home health aide means an individual employed by a home health agency to provide in-home care services4 7#g7 ,the term in-home care service means any service1 including a personal care service1 provided to enable the recipient of such service to live at home4 7#h7 ,the terms ,indian tribe and tribal organization have the meanings given those terms in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd74 7#i7 ,the terms ,native ,american and ,native ,american veteran have the meanings given those terms in section #cgfe of this title4 7#aj7 ,the terms ,native ,hawaiian and ,native ,hawaiian health care system have the meanings given those terms in section #ab of the ,native ,hawaiian ,health ,care ,improvement ,act 7#db ,u4,s4,c4 #aagaa74 7#aa7 ,the terms tribal health programs and ,urban ,indian organizations have the meanings given those terms in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc74 7#ab7 ,the term resident eligible caregiver means an individual who-- 7,a7 is a caregiver1 or a family caregiver1 of a veteran and resides with that veteran2 and 7,b7 has not entered into a contract1 agreement1 or other arrangement for such individual to act as a caregiver for that veteran unless such individual is a family member of the veteran or is furnishing caregiver services through a medical foster home4 4 7b7 ,deadline for improved administration ,the ,secretary of ,veterans ,affairs shall ensure that the ,veteran-,directed ,care program and the ,homemaker and ,home ,health ,aide program are administered through each medical center of the ,department of ,veterans ,affairs in accordance with section #agbj,l of title #ch1 ,united ,states ,code 7as added by subsection 7a771 by not later than two years after the date of the enactment of this ,act4 7c7 ,administration of ,veteran-,directed ,care program 7#a7 ,procedures 7,a7 ,the ,secretary shall establish procedures to-- 7i7 identify the staffing needs for the ,veteran-,directed ,care program of the ,department of ,veterans ,affairs under such section 7as added by subsection 7a772 and 7ii7 define the roles and responsibilities for personnel of the ,department responsible for the administration of such program1 including such personnel employed at the national1 ,veterans ,integrated ,service ,network1 or medical facility level4 7,b7 ,the responsibilities described in clause 7ii7 of subparagraph 7,a7 shall include responsibilities for engagement with-- 7i7 veterans participating in such program2 7ii7 veterans interested in participating in such program2 and 7iii7 providers described in section #agbj,l7b77#b7 7as added by subsection 7a774 7#b7 ,staffing model2 report ,not later than two years after enactment of this ,act1 the ,secretary of ,veterans ,affairs shall-- 7,a7 establish a staffing model for the administration of such program at each medical facility of the ,department of ,veterans ,affairs2 and 7,b7 submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a report containing the following3 7i7 ,a description of-- 7,i7 the staffing model described in subparagraph 7,a72 and 7,,ii7 the rationale for such staffing model4 7ii7 ,an identification of the ratio of staff required to administer such program to the number of veterans served by such program1 disaggregated by each medical facility of the ,department of ,veterans ,affairs4 7iii7 ,a description of budgetary resources or other support1 if any1 required to accommodate an increase in staffing at medical facilities of the ,department of ,veterans ,affairs pursuant to the requirements of the staffing model described in subparagraph 7,a74 7iv7 ,such other matters as the ,secretary of ,veterans ,affairs determines appropriate4 #abd4 ,coordination with assistance and support services for caregivers 7a7 ,coordination with ,program of ,comprehensive ,assistance for ,family ,caregivers 7#a7 ,coordination ,section #agbj;,g7a7 of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new paragraph3 7#ad7 7,a7 ,in the case of a veteran or caregiver who seeks services under this subsection and is denied such services1 or a veteran or the family caregiver of a veteran who is discharged from the program under this subsection1 the ,secretary shall-- 7i7 if the veteran meets the requirements of a covered veteran under subsection 7b71 provide to such caregiver the option of enrolling in the program of general caregiver support services under such subsection2 7ii7 assess the veteran or caregiver for participation in any other available program of the ,department for home- and community-based services 7including the programs specified in section #agbj,l of this title7 for which the veteran or caregiver may be eligible and1 with respect to the veteran1 store 7and make accessible to the veteran7 the results of such assessment in the electronic medical record of the veteran2 and 7iii7 provide to the veteran or caregiver written information on any such program identified pursuant to the assessment under clause 7ii71 including information about facilities1 eligibility requirements1 and relevant contact information for each such program4 7,b7 ,the ,secretary shall1 to the extent practicable1 provide to a veteran or family caregiver the option of obtaining clinically appropriate services under any other available program of the ,department for home- and community-based services 7including the programs specified in section #agbj,l of this title7 for which the veteran or family caregiver may be eligible prior to discharging the veteran or family caregiver from the program under this subsection4 7,c7 ,for each veteran or family caregiver who is discharged from the program under this subsection1 a caregiver support coordinator shall provide for a smooth and personalized transition from such program to an appropriate program of the ,department for home- and community-based services 7including the programs specified in section #agbj,l of this title71 including by integrating caregiver support across programs4 4 7#b7 ,applicability ,the amendments made by paragraph 7#a7 shall apply with respect to denials and discharges occurring on or after the date that is #ahj days after the date of the enactment of this ,act4 7#c7 ,technical and conforming amendments ,section #agbj;,g7d7 of such title is amended-- 7,a7 by striking or a covered veteran each place it appears and inserting 1 a veteran denied or discharged as specified in paragraph 7#ad7 of such subsection1 or a covered veteran2 and 7,b7 by striking under subsection 7a71 means each place it appears and inserting under subsection 7a7 or a veteran denied or discharged as specified in paragraph 7#ad7 of such subsection1 means4 7b7 ,conformity of respite care across programs ,section #agbj;,g of title #ch1 ,united ,states ,code1 as amended by subsection 7a77#c71 is further amended-- 7#a7 in subsection 7a77#c7-- 7,a7 by amending subparagraph 7,a77ii77,,iii7 to read as follows3 7,,iii7 covered respite care of not less than #cj days annually2 2 and 7,b7 by striking subparagraph 7,b7 and redesignating subparagraphs 7,c7 and 7,d7 as subparagraphs 7,b7 through 7,c71 respectively2 and 7#b7 by amending subsection 7b77#c77;,a77iii7 to read as follows3 7iii7 ,covered respite care of not less than #cj days annually4 2 and 7#c7 in subsection 7d7-- 7,a7 by redesignating paragraphs 7#b7 through 7#d7 as paragraphs 7#c7 through 7#e71 respectively2 and 7,b7 by inserting after paragraph 7#a7 the following new paragraph3 7#b7 ,the term covered respite care means1 with respect to a caregiver of a veteran1 respite care under section #agbj;,b of this title that-- 7,a7 is medically and age appropriate for the veteran 7including #bd-;hour per day care of the veteran commensurate with the care provided by the caregiver72 and 7,b7 includes in-home care4 4 7c7 ,review relating to caregiver contact ,the ,secretary shall conduct a review of the capacity of the ,department to establish a streamlined system for contacting all caregivers enrolled in the program of general caregiver support services under section #agbj;,g7b7 of title #ch1 ,united ,states ,code1 to provide to such caregivers program updates and alerts relating to emerging services for which such caregivers or the veterans for which they provide care may be eligible4 #abe4 ,improvements to program of comprehensive assistance for family caregivers ,section #agbj;,g7a7 of title #ch1 ,united ,states ,code1 as amended by section #abd1 is further amended-- 7#a7 in paragraph 7#ab7-- 7,a7 in subparagraph 7,a71 by inserting 1 which shall include all criteria used to determine eligibility for such assistance and1 in the case of a completed evaluation1 how such criteria were used to evaluate information provided in assessments to determine such eligibility before the period at the end2 and 7,b7 in subparagraph 7,c77i71 by striking who submits and all that follows through the end of the clause and inserting the following3 who-- 7,i7 submits an application for the program established under paragraph 7#a72 or 7,,ii7 is being reassessed for eligibility to continue in such program4 2 and 7#b7 by adding at the end the following new paragraph3 7#ae7 7,a7 ,not less frequently than annually1 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives a comprehensive report on the program required by paragraph 7#a7 that includes1 with respect to the one-year period preceding the date of the submission of such report1 the following3 7i7 ,the number of applications received for such program4 7ii7 ,the number1 disaggregated by race1 sex1 and era and branch of service in the ,armed ,forces of the applicant1 of-- 7,i7 approvals of such applications2 and 7,,ii7 denials of such applications4 7iii7 ,the number of reassessments conducted for such program4 7iv7 ,an identification of each decision made with respect to a reassessment conducted for such program1 disaggregated by decisions resulting in-- 7,i7 disenrollment1 including removal1 discharge1 or voluntary withdrawal2 7,,ii7 tier reduction2 and 7,,iii7 tier continuation4 7v7 ,the number of appeals of decisions made with respect to such program1 disaggregated by type of appeal4 7vi7 ,with respect to each appeal described in clause 7v71 the decision rendered1 if any4 7vii7 ,a description of all tools used in assessments conducted for such program1 including an explanation of how and by whom such tools are administered4 7viii7 ,a description of procedures used under such program for reviewing and integrating clinical records from health care providers that includes an explanation of how such records are used in determinations of eligibility for such program4 7ix7 ,a description of procedures available under such program for health care providers to communicate medical opinions to the teams conducting assessments to determine eligibility for such program1 including health care providers in the private sector and health care providers specified in subsection 7c7 of section #agjc of this title4 7x7 ,a description of information technology systems and processes used under such program to upload and integrate all clinical records from all non-,department providers1 including providers in the private sector and providers under the ,veterans ,community ,care ,program established under such section4 7,b7 ,the ,secretary shall ensure that all data included in a report under subparagraph 7,a7-- 7i7 relating to a decision made under the program required by paragraph 7#a71 are disaggregated by the specific reason for the decision2 7ii7 relating to a veteran1 include comprehensive demographic information of the veteran1 including the time period of the injuries1 if any1 of the veteran and the ,veterans ,integrated ,service ,network in which the veteran is located2 and 7iii7 with respect to eligibility determinations relating to a serious injury of a veteran1 specify-- 7,i7 how many such determinations relate to the ability of the veteran to perform activities of daily living2 and 7,,ii7 how many such determinations relate to the need of a veteran for supervision and protection4 7,c7 ,the ,secretary shall provide the data under paragraph 7,b7 pursuant to ,federal laws and in a manner that is wholly consistent with applicable ,federal privacy and confidentiality laws1 including the ,privacy ,act 7#e ,u4,s4,c4 #eeb;a71 the ,health ,insurance ,portability and ,accountability ,act 7,public ,law #ajd-aia2 #db ,u4,s4,c4 #bja note7 and regulations 7title #de1 ,code of ,federal ,regulations1 parts #afj and #afd1 or successor regulations71 and sections #egja1 #egje1 and #gccb of this title to ensure that the provided data1 or some portion of the data1 will not undermine the anonymity of a veteran4 4 #abf4 ,improvements relating to ,homemaker and ,home ,health ,aide program 7a7 ,pilot program for communities with shortage of home health aides 7#a7 ,program ,beginning not later than #ah months after the date of the enactment of this ,act1 the ,secretary shall carry out a three-year pilot program under which the ,secretary shall provide homemaker and home health aide services to veterans who reside in communities with a shortage of home health aides4 7#b7 ,locations ,the ,secretary shall select not fewer than five geographic locations in which the ,secretary determines there is a shortage of home health aides at which to carry out the pilot program under paragraph 7#a74 7#c7 ,nursing assistants 7,a7 ,in general ,in carrying out the pilot program under paragraph 7#a71 the ,secretary may hire nursing assistants as new employees of the ,department of ,veterans ,affairs1 or reassign nursing assistants who are existing employees of the ,department1 to provide to veterans in-home care services 7including basic tasks authorized by the ,state certification of the nursing assistant7 under the pilot program1 in lieu of or in addition to the provision of such services through non-,department home health aides4 7,b7 ,relationship to ,home-,based ,primary ,care program ,nursing assistants hired or reassigned under subparagraph 7,a7 may provide services to a veteran under the pilot program under paragraph 7#a7 while serving as part of a health care team for the veteran under the ,home-,based ,primary ,care program4 7#d7 ,report to ,congress ,not later than one year before the date of the termination of the pilot program under paragraph 7#a71 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a report that includes-- 7,a7 a statement of the results of such pilot program2 and 7,b7 an assessment of the feasibility and advisability of-- 7i7 extending such pilot program2 or 7ii7 making such pilot program a permanent program of the ,department of ,veterans ,affairs4 7b7 ,report on use of funds ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a report containing1 with respect to the period beginning in fiscal year #bjab and ending in fiscal year #bjbd1 the following3 7#a7 ,an identification of the amount of funds that were included in a budget of the ,department of ,veterans ,affairs during such period for the provision of in-home care to veterans under the ,homemaker and ,home ,health ,aide program but were not expended for such provision1 disaggregated by medical center of the ,department for which such unexpended funds were budgeted 7if such disaggregation is possible74 7#b7 ,to the extent practicable1 an identification of the number of veterans for whom1 during such period1 the hours during which a home health aide was authorized to provide services to the veteran under the ,homemaker and ,home ,health ,aide program were reduced for a reason other than a change in the health care needs of the veteran1 and a detailed description of the reasons why any such reductions may have occurred4 7c7 ,updated guidance on program ,not later than one year after the date of the enactment of this ,act1 the ,secretary shall issue updated guidance for the ,homemaker and ,home ,health ,aide program4 ,such updated guidance shall include the following3 7#a7 ,a process for the transition of veterans from the ,homemaker and ,home ,health ,aide program to other covered programs4 7#b7 ,a requirement for the directors of the medical facilities of the ,department to complete such process whenever a veteran with care needs has been denied services from home health agencies under the ,homemaker and ,home ,health ,aide program as a result of the clinical needs or behavioral issues of the veteran4 #abg4 ,pilot program to furnish assisted living services to certain veterans 7a7 ,establishment ,beginning not later than two years after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall carry out a pilot program to assess-- 7#a7 the effectiveness of providing assisted living services to eligible veterans1 at the election of such veterans2 and 7#b7 the satisfaction with the pilot program of veterans participating in such pilot program4 7b7 ,program locations 7#a7 ,veterans ,integrated ,service ,networks ,the ,secretary shall select two ,veterans ,integrated ,service ,networks of the ,department of ,veterans ,affairs at which to carry out the pilot program under subsection 7a74 7#b7 ,facilities 7,a7 ,in general ,within the ,veterans ,integrated ,service ,networks selected under paragraph 7#a71 the ,secretary shall select facilities at which to carry out the pilot program under subsection 7a77#a74 7,b7 ,selection criteria ,in selecting facilities under subparagraph 7,a7 at which to carry out the pilot program under subsection 7a77#a71 the ,secretary shall ensure that-- 7i7 the locations of such facilities are in geographically diverse areas2 7ii7 not fewer than one such facility serves 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 7iii7 not fewer than one such facility is located in each ,veterans ,integrated ,service ,network selected under paragraph 7#a72 and 7iv7 not fewer than one such facility is a ,state home4 7c7 ,program participants ,not more than #fj eligible veterans may participate in the pilot program under subsection 7a77#a7 in each ,veterans ,integrated ,service ,network selected under subsection 7b77#a74 7d7 ,provision of assisted living services 7#a7 ,agreements ,in carrying out the pilot program under subsection 7a77#a71 the ,secretary may enter into agreements for the provision of assisted living services on behalf of eligible veterans with-- 7,a7 a provider participating under a ,state plan or waiver under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq472 or 7,b7 a ,state home recognized and certified under subpart ,b of part #ea of title #ch1 ,code of ,federal ,regulations1 or successor regulations4 7#b7 ,standards ,the ,secretary may not place1 transfer1 or admit a veteran to any facility for assisted living services under the pilot program under subsection 7a77#a7 unless the ,secretary determines that-- 7,a7 the facility meets the standards for community residential care established under sections #ag4fa through #ag4gb of title #ch1 ,code of ,federal ,regulations1 or successor regulations1 and any additional standards of care as the ,secretary may specify2 or 7,b7 in the case of a facility that is a ,state home1 the ,state home meets such standards of care as the ,secretary may specify4 7#c7 ,inspection ,the ,secretary shall inspect facilities at which veterans are placed under the pilot program under subsection 7a77#a7-- 7,a7 with respect to a facility that is a ,state home1 not less frequently than annually and in the same manner as the ,secretary conducts inspection of ,state homes under section #agdb of title #ch1 ,united ,states ,code2 and 7,b7 with respect to any other facility1 not less frequently than annually and in the same manner as the ,secretary conducts inspection of facilities under section #agcj of such title4 7#d7 ,payment to certain facilities 7,a7 ,state homes ,in the case of a facility participating in the pilot program under subsection 7a77#a7 that is a ,state home1 the ,secretary shall pay to the ,state home a per diem for each veteran participating in the pilot program at a rate agreed to by the ,secretary and the ,state home4 7,b7 ,community assisted living facilities ,in the case of a facility participating in the pilot program under subsection 7a77#a7 that is a community assisted living facility1 the ,secretary shall-- 7i7 pay to the facility an amount that is less than the average rate paid by the ,department for placement in a community nursing home in the same ,veterans ,integrated ,service ,network2 and 7ii7 re-evaluate payment rates annually to account for current economic conditions and current costs of assisted living services4 7e7 ,continuity of care ,upon the termination of the pilot program under subsection 7a77#a71 the ,secretary shall-- 7#a7 provide to all veterans participating in the pilot program at the time of such termination the option to continue to receive assisted living services at the site they were assigned to under the pilot program1 at the expense of the ,department2 and 7#b7 for such veterans who do not opt to continue to receive such services-- 7,a7 ensure such veterans do not experience lapses in care2 and 7,b7 provide such veterans with information on1 and furnish such veterans with1 other extended care services based on their preferences and best medical interest4 7f7 ,determination of quality ,the ,secretary shall determine a method for assessment of quality of care provided to veterans participating in the pilot program under subsection 7a77#a7 and shall communicate that method to providers of services under the pilot program4 7g7 ,annual report ,not later than one year after the initiation of the pilot program under subsection 7a77#a71 and annually thereafter for the duration of such pilot program1 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a report on the pilot program that includes-- 7#a7 an identification of ,veterans ,integrated ,services ,networks and facilities of the ,department participating in the pilot program and assisted living facilities and ,state homes at which veterans are placed under the pilot program2 7#b7 the number of participants in the pilot program1 disaggregated by facility2 7#c7 general demographic information of participants in the pilot program1 including average age1 sex1 and race or ethnicity2 7#d7 disability status of participants in the pilot program2 7#e7 an identification of any barriers or challenges to furnishing care to veterans under the pilot program1 conducting oversight of the pilot program1 or any other barriers or challenges2 7#f7 the cost of care at each assisted living facility and ,state home participating in the pilot program1 including an analysis of any cost savings by the ,department when comparing that cost to the cost of nursing home care2 7#g7 aggregated feedback from participants in the pilot program1 including from veteran resident surveys and interviews2 and 7#h7 such other matters the ,secretary considers appropriate4 7h7 ,final report ,not later than one year after the pilot program terminates under subsection 7j71 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a report on the pilot program that-- 7#a7 includes the matters required under paragraphs 7#a7 through 7#h7 of subsection 7g72 7#b7 includes recommendations on whether the model studied in the pilot program should be continued or adopted throughout the ,department2 and 7#c7 indicates whether the ,secretary requests action by ,congress to make the pilot program permanent4 7i7 ,inspector ,general report 7#a7 ,in general ,not later than three years after the initiation of the pilot program under subsection 7a77#a71 the ,inspector ,general of the ,department of ,veterans ,affairs shall submit to the ,secretary of ,veterans ,affairs and the ,committees on ,veterans' ,affairs of ,house of ,representatives and the ,senate a report on the pilot program4 7#b7 ,elements ,the report required by paragraph 7#a7 shall include an assessment of-- 7,a7 the quality of care provided to veterans at facilities participating in the pilot program1 measured pursuant to the method determined under subsection 7f72 7,b7 the oversight of such facilities1 as conducted by the ,department1 the ,centers for ,medicare ,medicaid ,services1 ,state agencies1 and other relevant entities2 and 7,c7 such other matters as the ,inspector ,general considers appropriate4 7#c7 ,plan required ,not later than #ij days after the submission of the report under paragraph 7#a71 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a plan to address the deficiencies identified in the report1 if any4 7j7 ,termination 7#a7 ,in general ,subject to paragraph 7#b71 the pilot program under subsection 7a77#a7 shall terminate on ,september #cj1 #bjbh4 7#b7 ,extension ,the ,secretary may extend the duration of the pilot program for an additional two-year period if the ,secretary1 based on the results of the reports submitted under subsection 7g71 determines such an extension is appropriate4 7k7 ,definitions ,in this section3 7#a7 ,the term assisted living services means services of a facility in providing room1 board1 and personal care for and supervision of residents for their health1 safety1 and welfare4 7#b7 ,the term eligible veteran means a veteran who is-- 7,a7 receiving nursing home care paid for by the ,department of ,veterans ,affairs1 eligible to receive such care pursuant to section #agaj;,a of title #ch1 ,united ,states ,code1 or requires a higher level of care than the domiciliary care provided by the ,department of ,veterans ,affairs1 but does not meet the requirements for nursing home level care provided by the ,department pursuant to such section2 and 7,b7 eligible for assisted living services1 as determined by the ,secretary or meets such additional criteria for eligibility for the pilot program under subsection 7a77#a7 as the ,secretary may establish4 7#c7 ,the term ,state home has the meaning given that term in section #aja of title #ch1 ,united ,states ,code4 #abh4 ,provision of medicine1 equipment1 and supplies available to ,department of ,veterans ,affairs to ,state homes 7a7 ,provision authorized ,the ,secretary of ,veterans ,affairs may provide to ,state homes medicine1 personal protective equipment1 medical supplies1 and any other equipment1 supplies1 and assistance available to the ,department of ,veterans ,affairs4 7b7 ,definition ,in this section3 7#a7 ,the term personal protective equipment means any protective equipment required to prevent the wearer from contracting an infectious disease1 including gloves1 ,n-#ie respirator masks1 gowns1 goggles1 face shields1 or other equipment required for safety4 7#b7 ,the term ,state home has the meaning given such term in section #aja of title #ch1 ,united ,states ,code4 #abi4 ,recognition of organizations and individuals to assist veterans1 family members1 and caregivers navigating programs and services of ,veterans ,health ,administration 7a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall establish a process through which the ,department of ,veterans ,affairs may recognize organizations and individuals to assist a veteran1 a family member of a veteran1 or a caregiver of a veteran 7as defined in section #agbj;,g7d7 of title #ch1 ,united ,states ,code7 in navigating the programs and services of the ,veterans ,health ,administration4 7b7 ,solicitation of feedback ,the ,secretary shall solicit feedback and recommendations in the creation of the process under subsection 7a7 from such organizations as the ,secretary may consider relevant4 7c7 ,limitation ,the ,secretary may not recognize an organization or individual pursuant to the process established under subsection 7a7 unless the organization or individual has certified to the ,secretary that no fee or compensation of any nature will be charged to any individual for services rendered in providing assistance pursuant to such subsection4 #acj4 ,reviews and other improvements relating to home- and community-based services 7a7 ,office of ,geriatric and ,extended ,care 7#a7 ,review of programs ,the ,under ,secretary for ,health of the ,department of ,veterans ,affairs shall conduct a review of each program administered through the ,office of ,geriatric and ,extended ,care of the ,department and the ,caregiver ,support ,program ,office of the ,department1 or any successor offices1 to-- 7,a7 eliminate service gaps at the medical center level2 and 7,b7 ensure-- 7i7 the clinical needs of veterans are met2 7ii7 consistency in program management2 7iii7 the availability of1 and the access by veterans to1 home- and community-based services1 including for veterans living in rural areas2 and 7iv7 proper coordination between covered programs4 7#b7 ,assessment of staffing needs ,the ,secretary of ,veterans ,affairs shall conduct an assessment of the staffing needs of the ,office of ,geriatric and ,extended ,care of the ,department and the ,caregiver ,support ,program ,office of the ,department1 or any successor offices4 7#c7 ,goals for geographic alignment of care 7,a7 ,establishment of goals ,the ,director of the ,office of ,geriatric and ,extended ,care1 or successor office1 shall establish quantitative goals to enable aging or disabled veterans who are not located near medical centers of the ,department to access extended care services 7including by improving access to home- and community-based services for such veterans74 7,b7 ,implementation timeline ,each goal established under subparagraph 7,a7 shall include a timeline for the implementation of the goal at each medical center of the ,department4 7#d7 ,goals for in-home specialty care ,the ,director of the ,office of ,geriatric and ,extended ,care1 or successor office1 shall establish quantitative goals to address the specialty care needs of veterans through in-home care1 including by ensuring the education of home health aides and caregivers of veterans in the following areas3 7,a7 ,dementia care4 7,b7 ,care for spinal cord injuries and diseases4 7,c7 ,ventilator care4 7,d7 ,other speciality care areas as determined by the ,secretary4 7#e7 ,input on goals ,to the extent practicable1 the head of the ,caregiver ,support ,program ,office1 or successor office1 shall provide to the ,director of the ,office of ,geriatric and ,extended ,care1 or successor office1 input with respect to the establishment of the goals under paragraphs 7#c7 and 7#d74 7#f7 ,report to ,congress ,not later than one year after the date of the enactment of this ,act1 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a report containing the findings of the review under paragraph 7#a71 the results of the assessment under paragraph 7#b71 and the goals established under paragraphs 7#c7 and 7#d74 7b7 ,review of incentives and efforts relating to home- and community-based services 7#a7 ,review ,the ,secretary of ,veterans ,affairs shall conduct a review of the following3 7,a7 ,the financial and organizational incentives or disincentives for the directors of medical centers of the ,department to establish or expand covered programs at such medical centers4 7,b7 ,any incentives or disincentives for such directors to provide to veterans home- and community-based services in lieu of institutional care4 7,c7 ,the efforts taken by the ,secretary to enhance spending of the ,department for extended care by balancing spending between institutional care and home- and community-based services consistent with the demand for such services4 7,d7 ,the plan of the ,under ,secretary for ,health of the ,department to accelerate efforts to enhance spending as specified in subparagraph 7,c71 to match the progress of similar efforts taken by the ,administrator of the ,centers for ,medicare ,medicaid ,services with respect to spending of the ,centers for ,medicare ,medicaid ,services for extended care4 7#b7 ,report to ,congress ,not later than one year after the date of the enactment of this ,act1 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a report on the findings of the review under paragraph 7#a74 7c7 ,review of respite care services ,not later than two years after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall conduct a review of the use1 availability1 cost1 and effectiveness1 of the respite care services furnished by the ,secretary under chapter #ag of title #ch1 ,united ,states ,code1 including-- 7#a7 the frequency at which the ,department of ,veterans ,affairs is unable to meet demand for such services2 7#b7 a detailed description of-- 7,a7 the reasons the ,department of ,veterans ,affairs is unable to meet the demand for such services2 and 7,b7 any actions1 or planned actions1 of the ,secretary of ,veterans ,affairs to ensure such demand is met4 7d7 ,collaboration to improve home- and community-based services 7#a7 ,recommendations 7,a7 ,development ,the ,secretary of ,veterans ,affairs shall develop recommendations as follows3 7i7 ,with respect to home- and community-based services for veterans1 the ,secretary of ,veterans ,affairs shall develop recommendations regarding new services 7in addition to those furnished as of the date of enactment of this ,act7 in collaboration with the ,secretary of ,health and ,human ,services4 7ii7 ,with respect to the national shortage of home health aides1 the ,secretary of ,veterans ,affairs shall develop recommendations regarding methods to address such shortage in collaboration with the ,secretary of ,health and ,human ,services and the ,secretary of ,labor4 7,b7 ,submission to ,congress ,the ,secretary of ,veterans ,affairs shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a report containing the recommendations developed under subparagraph 7,a7 and an identification of any changes in existing law or new statutory authority necessary to implement the recommendations1 as determined by the ,secretary4 7,c7 ,consultation with ,secretary of ,labor ,in carrying out this paragraph1 the ,secretary of ,veterans ,affairs shall consult with the ,secretary of ,labor4 7#b7 ,feedback and recommendations on caregiver support 7,a7 ,feedback and recommendations ,the ,secretary of ,veterans ,affairs shall solicit from the entities described in subparagraph 7,b7 feedback and recommendations regarding opportunities for the ,secretary to enhance home- and community-based services for veterans and the caregivers of veterans1 including through the potential provision by the entity of care and respite services to veterans and caregivers who may not be eligible for any program under section #agbj;,g of title #ch1 ,united ,states ,code1 or section #agbj,l of such title 7as added by section #abc71 but have a need for assistance4 7,b7 ,covered entities ,the entities described in this subparagraph are veterans service organizations and nonprofit organizations with a focus on caregiver support or long term care 7as determined by the ,secretary74 7#c7 ,collaboration for certain veterans ,the ,secretary of ,veterans ,affairs shall collaborate with the ,director of the ,indian ,health ,service and representatives from tribal health programs and ,urban ,indian organizations to ensure the availability of home- and community-based services for-- 7,a7 ,native ,american veterans1 including ,native ,american veterans receiving health care and medical services under multiple health care systems2 and 7,b7 ,native ,hawaiian veterans1 including ,native ,hawaiian veterans receiving health care and medical services under the ,native ,hawaiian health care system4 #aca4 ,,gao report on mental health support for caregivers 7a7 ,report required ,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 provision of mental health support to caregivers of veterans4 7b7 ,contents ,the report submitted under subsection 7a7 shall include the following3 7#a7 ,an assessment of the need for mental health support among caregivers participating in the caregiver programs4 7#b7 ,an assessment of options for mental health support in facilities of the ,department of ,veterans ,affairs and in the community for caregivers participating in the caregiver programs4 7#c7 ,an assessment of the availability and accessibility of mental health support in facilities of the ,department and in the community for caregivers participating in the caregiver programs4 7#d7 ,an assessment of the awareness among caregivers of the availability of mental health support in facilities of the ,department and in the community for caregivers participating in the caregiver programs4 7#e7 ,an assessment of barriers to mental health support in facilities of the ,department and in the community for caregivers participating in the caregiver programs4 7c7 ,definitions ,in this section3 7#a7 ,the term caregiver has the meaning given that term in section #agbj;,g of title #ch1 ,united ,states ,code4 7#b7 ,the term caregiver programs means-- 7,a7 the program of comprehensive assistance for family caregivers under subsection 7a7 of section #agbj;,g of title #ch1 ,united ,states ,code2 and 7,b7 the program of support services for caregivers under subsection 7b7 of such section4 #acb4 ,development of centralized website for program information 7a7 ,centralized website ,the ,secretary shall develop and maintain a centralized and publically accessible internet website of the ,department as a clearinghouse for information and resources relating to covered programs4 7b7 ,contents ,the website under subsection 7a7 shall contain the following3 7#a7 ,a description of each covered program4 7#b7 ,an informational assessment tool that-- 7,a7 explains the administrative eligibility1 if applicable1 of a veteran1 or a caregiver of a veteran1 for any covered program2 and 7,b7 provides information1 as a result of such explanation1 on any covered program for which the veteran or caregiver 7as the case may be7 may be eligible4 7#c7 ,a list of required procedures for the directors of the medical facilities of the ,department to follow in determining the eligibility and suitability of veterans for participation in a covered program1 including procedures applicable to instances in which the resource constraints of a facility 7or of a community in which a facility is located7 may result in the inability to address the health needs of a veteran under a covered program in a timely manner4 7c7 ,updates ,the ,secretary shall ensure the website under subsection 7a7 is updated on a periodic basis4 #acc4 ,definitions ,in this subtitle3 7#a7 ,the terms caregiver and family caregiver have the meanings given those terms under section #agbj,l7h7 of title #ch1 ,united ,states ,code 7as added by section #abc74 7#b7 ,the term covered program-- 7,a7 means any program of the ,department of ,veterans ,affairs for home- and community-based services2 and 7,b7 includes the programs specified in section #agbj,l of title #ch1 ,united ,states ,code 7as added by section #abc74 7#c7 ,the term home- and community-based services-- 7,a7 means the services referred to in section #agja7f77;,e7 of title #ch1 ,united ,states ,code2 and 7,b7 includes services furnished under a program specified in section #agbj,l of such title 7as added by section #abc74 7#d7 ,the terms ,home-,based ,primary ,care program1 ,homemaker and ,home ,health ,aide program1 and ,veteran-,directed ,care program mean the programs of the ,department of ,veterans ,affairs specified in subsection 7d71 7c71 and 7b7 of such section #agbj,l1 respectively4 7#e7 ,the terms home health aide1 ,native ,american1 ,native ,american veteran1 tribal health programs1 and ,urban ,indian organizations have the meanings given those terms in subsection 7h7 of such section #agbj,l4 7#f7 ,the term veterans service organization means any organization recognized by the ,secretary under section #eijb of such title4 ,c ,medical ,treatment and ,other ,matters #adj4 ,quarterly report on referrals for non-,department of ,veterans ,affairs health care 7a7 ,in general ,subchapter ,i of chapter #ag of title #ch1 ,united ,states ,code1 is amended by inserting after section #agjc;,f the following new section 7and amending the table of sections at the beginning of such chapter accordingly73 #agjc;,g4 ,quarterly report on referrals for non-,department health care ,the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives a quarterly report containing1 with respect to referrals for non-,department health care originating from a medical facility of the ,department during the quarter preceding the date of the submission of the report1 a measurement of1 for each such medical facility-- 7#a7 the period of time between-- 7,a7 the date on which a clinician employed by the ,department determines that a veteran requires care1 or a veteran presents to the ,department requesting care1 and the date on which the referral for care is sent to a non-,department health care provider2 7,b7 the date on which such referral is sent to a non-,department health care provider and the date on which such non-,department health care provider accepts such referral2 7,c7 the date on which such non-,department health care provider accepts such referral and the date on which such referral is completed2 7,d7 the date on which such referral is completed and the date on which an appointment with a non-,department health care provider is made2 and 7,e7 the date on which such an appointment is made and the date on which such appointment occurs2 and 7#b7 any other period of time that the ,secretary determines necessary4 4 7b7 ,effective date ,the first report under section #agjc;,g1 as added by this section1 shall be due not later than #ahj days after the date of the enactment of this section4 #ada4 ,elimination of certain requirements for certain ,department of ,veterans ,affairs ,assistant ,under ,secretaries ,section #gcjf of title #ch1 ,united ,states ,code1 is amended-- 7#a7 by striking subsection 7b72 7#b7 by redesignating subsections 7c7 through 7g7 as subsections 7b7 through 7f71 respectively2 and 7#c7 in subsection 7c7 7as so redesignated71 by striking subsection 7e7 and inserting subsection 7d74 #adb4 ,modification of pay limitation for physicians1 podiatrists1 optometrists1 and dentists of ,department of ,veterans ,affairs 7a7 ,pay 7#a7 ,in general ,section #gdca of title #ch1 ,united ,states ,code1 is amended-- 7,a7 by inserting optometrists1 after podiatrists1 each place it appears2 7,b7 by inserting optometrist after podiatrist1 each place it appears2 7,c7 in subsection 7c7-- 7i7 in paragraph 7#e71 by adding at the end the following new sentence3 ,such a notice shall include a statement of whether the market pay will increase1 decrease1 or remain unchanged following such evaluation42 and 7ii7 by adding at the end the following new paragraphs3 7#g7 ,the ,secretary shall ensure that each physician1 podiatrist1 optometrist1 and dentist in the ,veterans ,health ,administration is-- 7,a7 advised1 on an annual basis1 of the criteria described in subparagraph 7,f7 of paragraph 7#d72 7,b7 evaluated in accordance with such criteria2 and 7,c7 compensated in accordance with-- 7i7 applicable assignment and pay levels1 subject to relevant pay limitations2 and 7ii7 the extent to which such criteria are met4 7#h7 ,not later than #abj days after the end of each fiscal year1 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives a report that includes the following3 7,a7 ,a list of each facility and specialty that conducted an evaluation of pay during the period covered by the report4 7,b7 ,for each evaluation described in subparagraph 7,a7-- 7i7 a list of occupations for which pay was evaluated1 disaggregated by medical specialty1 number of authorized full-time employees1 and onsite full-time employees as of the date of the evaluation2 7ii7 the date such evaluation was completed2 7iii7 whether a market pay adjustment was made following the evaluation per each occupation and specialty evaluated2 7iv7 whether applicable employees were notified of such evaluation2 7v7 whether local labor partners were notified of such evaluation2 and 7vi7 in the case of an evaluation that resulted in an adjustment of pay-- 7,i7 the date such adjustment-- 7aa7 was implemented2 and 7bb7 became effective2 and 7,,ii7 the percentage of employees of each occupation and specialty for which pay was adjusted pursuant to such evaluation4 7,c7 ,a list of facilities of the ,department that have not conducted an evaluation of market pay1 pursuant to paragraph 7#e71 during the #ah-month-period that precedes the date of the submission of such report4 2 and 7,d7 in subsection 7e71 by adding at the end the following new paragraphs3 7#e7 ,notwithstanding any compensation or pay limitations under this title or title #e1 the ,secretary may authorize the ,under ,secretary for ,health to pay physicians1 podiatrists1 optometrists1 and dentists-- 7,a7 awards authorized under this title2 7,b7 advance payments1 recruitment or relocation bonuses1 and retention allowances authorized under section #gdaj7;a7 of this title or as otherwise provided by law2 7,c7 incentives or bonuses under section #gjf of this title or as otherwise provided by law2 and 7,d7 earnings from fee-basis appointments under section #gdje7;a77#b7 of this title4 7#f7 7,a7 ,the ,secretary may waive any pay limitation described in this section 7including tier limitations7 that the ,secretary determines necessary for the recruitment or retention of critical health care personnel whom the ,secretary determines would provide direct patient care4 7,b7 ,priority for such waivers shall be given for positions1 locations1 and care provided through agreements that are costly to the ,department4 7,c7 ,the ,chief ,human ,capital ,officer of the ,department1 the ,chief ,financial ,officer of the ,department1 and the ,office of the ,general ,counsel of the ,department shall review any waiver issued under subparagraph 7,a74 7,d7 ,during the period the authority under subparagraph 7,a7 is effective1 the ,secretary may not issue more than #cjj waivers under such subparagraph4 7,e7 ,the ,secretary may prescribe requirements1 limitations1 and other considerations for waivers under such subparagraph4 7,f7 ,not later than #ahj days after the date of the enactment of the ,senator ,elizabeth ,dole #bast ,century ,veterans ,healthcare and ,benefits ,improvement ,act1 and annually thereafter1 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives a report that includes-- 7i7 any updates to the requirements1 limitations1 and considerations prescribed under subparagraph 7,b7 during the period covered by the report2 7ii7 a description of the findings of each review1 if any1 conducted pursuant to subparagraph 7,c72 7iii7 a description of each waiver under subparagraph 7,a7 in effect as of the date of the submission of the report1 including the-- 7,i7 duty location1 position1 specialty1 market and performance considerations for the waiver2 and 7,,ii7 impact1 if any1 of the waiver on care furnished by the ,department pursuant to an agreement regarding the geographic area2 and 7iv7 a list of any separation actions during the period covered by the report with respect to a position for which a waiver under subparagraph 7,a7 is in effect4 7,g7 ,the authority of the ,secretary under subparagraph 7,a7 shall terminate on the last day of the third full fiscal year following the date of the enactment of the ,senator ,elizabeth ,dole #bast ,century ,veterans ,healthcare and ,benefits ,improvement ,act4 4 7#b7 ,report on waiver authority ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall submit to the ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives a report that includes a description of the requirements1 limitations1 and other considerations prescribed under section #gdca7;b77#f77;,d7 of title #ch1 ,united ,states ,code1 as added by paragraph 7#a74 7#c7 ,conforming amendments 7,a7 ,pay of ,under ,secretary for ,health ,section #gdcb7;b77#a7 of such title is amended by inserting 1 podiatrist1 optometrist1 after physician4 7,b7 ,administrative matters ,section #gdcc of such title is amended by inserting optometrists1 after physicians1 each place it appears4 7,c7 ,competitive pay ,section #gdea7;a77#b77;,c7 of such title is amended by inserting optometrist1 after physician14 7#d7 ,clerical amendments 7,a7 ,subchapter heading ,subchapter ,,iii of chapter #gd of such title is amended in the heading by inserting ,optometrists1 after ,podiatrists14 7,b7 ,table of sections ,the table of sections for such chapter is amended by striking the item relating to subchapter ,,iii and inserting the following3 ,subchapter ,,iii--,pay for ,physicians and ,other ,health-,care ,personnel 4 7#e7 ,applicability dates ,the amendments made by this subsection shall apply to any pay period of the ,department of ,veterans ,affairs beginning on or after the date that is #ahj days after the date of the enactment of this ,act4 7b7 ,modification and clarification of pay grade for optometrists ,section #gdjd of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in subsection 7a77#b77;,a71 by striking podiatrists1 and dentists and inserting podiatrists1 optometrists1 and dentists2 and 7#b7 in subsection 7b7-- 7,a7 by striking podiatrist 7dpm71 and dentist and inserting podiatrist 7dpm71 optometrist 7od71 and dentist2 7,b7 by striking clinical chiropractor and optometrist schedule1 and inserting clinical chiropractor schedule2 and 7,c7 by inserting optometrist grade after ,podiatrist grade4 7c7 ,retroactive authority for compensation 7#a7 ,in general ,the ,secretary of ,veterans ,affairs may pay retroactive compensation to a covered employee in an amount that equals the amount of compensation that was authorized to be paid to such covered employee during the period specified in paragraph 7#b71 but was deferred and paid to such employee in the calendar year following the calender year in which such compensation was authorized because the payment such compensation would have exceeded an applicable cap on annual compensation4 7#b7 ,period specified ,the period specified in this paragraph is the period beginning on ,january #h1 #bjjf1 and ending on ,december #ca1 #bjag4 7#c7 ,exclusion ,compensation authorized under this subsection shall not be included in the calculation of any aggregate limit on compensation for a covered employee for the year in which it is paid4 7#d7 ,charging of compensation ,compensation authorized under this subsection shall be charged to the appropriate medical care appropriation account of the ,department of ,veterans ,affairs for the fiscal year in which the work was performed except as follows3 7,a7 ,in the case of an account that has closed pursuant to section #aeeb of title #ca1 ,united ,states ,code1 the compensation shall be charged to a current appropriation account in accordance with section #aeec of such title4 7,b7 ,in the case of an expired account that has not closed1 if charging the compensation to the expired account would cause such account to have a negative unliquidated or unexpended balance1 the compensation may be charged to a current appropriation account available for the same purpose4 7#e7 ,definitions ,in this subsection3 7,a7 ,the term compensation means any pay1 including salary1 awards1 and incentives4 7,b7 ,the term covered employee means a physician1 podiatrist1 or dentist subject to market pay under section #gdca of title #ch1 ,united ,states ,code4 #adc4 ,reimbursement of ambulance cost for care for certain rural veterans 7a7 ,in general ,the ,secretary of ,veterans ,affairs shall pay1 or reimburse a covered veteran for1 the cost of transporting the veteran by ambulance1 including air ambulance1 from a covered location to a provider of the ,department of ,veterans ,affairs1 a non-,department provider1 or the nearest hospital that can meet the needs of the veteran 7including a hospital that compacts with the ,indian ,health ,service7 for covered care4 7b7 ,amount covered ,the maximum cumulative amount covered under this section for a covered veteran is #df1jjj4 7c7 ,sunset ,this section shall cease to be effective on ,september #cj1 #bjbf4 7d7 ,definitions ,in this section3 7#a7 ,the term covered care means care for a veteran eligible for care provided by the ,department of ,veterans ,affairs under title #ch1 ,united ,states ,code1 or any other law administered by the ,secretary of ,veterans ,affairs1 even if the care associated with the transport described in subsection 7a7 is not authorized by the ,department4 7#b7 ,the term covered location means a location that is-- 7,a7 in a ,state that is #ajj miles or more from the nearest medical center of the ,department of ,veterans ,affairs2 and 7,b7 in an area rated as a #aj or higher under the rural-urban commuting areas coding system of the ,department of ,agriculture4 7#c7 ,the term covered veteran means a veteran who-- 7,a7 has a service-connected disability rated by the ,secretary as between #j and #cj percent disabling2 7,b7 is not eligible for payments or reimbursements for beneficiary travel or other transportation under the laws administered by the ,secretary of ,veterans ,affairs1 other than under this section2 and 7,c7 is not entitled to care or services under a non-,department of ,veterans ,affairs health-plan contract4 7#d7 ,the term health-plan contract has the meaning given that term in section #agbe of title #ch1 ,united ,states ,code4 7#e7 ,the term service-connected has the meaning given that term in section #aja of such title4 #add4 ,pilot program to furnish dental care from the ,department of ,veterans ,affairs to certain veterans diagnosed with ischemic heart disease 7a7 ,in general ,beginning not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall carry out a two-year pilot program 7in this section referred to as the pilot program7 under which the ,secretary shall furnish covered care to covered veterans through means that include the use of community care4 7b7 ,locations 7#a7 ,in general ,the ,secretary shall select not more than four ,states in which to carry out the pilot program4 7#b7 ,selection criteria ,in selecting ,states under paragraph 7#a71 the ,secretary shall prioritize ,states in which-- 7,a7 the ,department of ,veterans ,affairs serves a high proportion1 as determined by the ,secretary1 of veterans residing in rural or highly rural areas 7as determined through the use of the ,rural-,urban ,commuting ,areas coding system of the ,department of ,agriculture72 7,b7 dental clinics operated by the ,department of ,veterans ,affairs currently utilize teledentistry2 7,c7 the ,department of ,veterans ,affairs does not currently operate a dental clinic2 or 7,d7 the ,secretary determines a large percentage of veterans enrolled in the system of annual patient enrollment of the ,department of ,veterans ,affairs established and operated under paragraphs 7#a7 or 7#b7 of section #agje7;a7 of title #ch1 ,united ,states ,code1 visit emergency rooms for dental emergencies at high rates4 7c7 ,participation limitation ,participation in a pilot program established pursuant to this section shall be limited to a covered veteran who receives health care in a facility of the ,department located in a ,state selected under subsection 7b74 7d7 ,use of certain methods to provide care 7#a7 ,mobile dental clinics ,in carrying out the pilot program1 the ,secretary shall test the efficacy of mobile dental clinics to service rural areas that do not have a population base to warrant a full-time clinic but where there are covered veterans in need of dental care4 7#b7 ,home-based dental care ,in carrying out the pilot program1 the ,secretary shall test the efficacy of portable dental care units to service rural veterans in their homes1 as the ,secretary considers medically appropriate4 7e7 ,administration 7#a7 ,community care network review 7,a7 ,in general ,before commencing the pilot program1 the ,secretary shall work with third party administrators to conduct a review of dental providers who are part of the community care network of the ,department in each ,state selected under subsection 7b77#a7 to ensure-- 7i7 dental providers who are no longer accepting patients from the ,department-- 7,i7 are not still listed as providers accepting referrals from the ,department2 and 7,,ii7 are not sent referrals from the ,department2 and 7ii7 dental providers participating in each such network are capable of receiving an influx of patients from the ,department under the pilot program4 7,b7 ,expansion of network ,if1 pursuant to a review under subparagraph 7,a71 the ,secretary determines the community care network in a ,state selected under subsection 7b77#a7 is not capable of receiving an influx of patients under the pilot program1 the ,secretary shall coordinate with the ,third ,party ,administrator for such ,state to ensure the dental provider network of such community care network is sufficiently expanded before the initiation of the pilot program4 7#b7 ,notice to covered veterans ,in carrying out the pilot program1 the ,secretary shall inform all covered veterans in ,states selected under subsection 7b77#a7 of the covered care available under the pilot program4 7#c7 ,loss of eligibility ,any veteran participating in the pilot program who ceases to be a covered veteran shall be removed from the pilot program on the date that is #ij days after the ,secretary determines the participant is no longer a covered veteran4 7#d7 ,continuity of care 7,a7 ,in general ,upon the termination of the pilot program1 the ,secretary shall provide to all veterans participating in the pilot program at the time of such termination-- 7i7 information on how to enroll in the dental insurance plan of the ,department of ,veterans ,affairs under section #agab;,c of title #ch1 ,united ,states ,code2 7ii7 if appropriate1 information on the ,v,e,t,smile program of the ,department of ,veterans ,affairs1 or any successor program2 and 7iii7 contact information for dental providers in the surrounding community who provide low- or no-cost dental care and whom the ,secretary has confirmed are available to take on new patients4 7,b7 ,continuation of treatment plan ,any veteran participating in the pilot program may continue to receive services under the pilot program after the termination of the pilot program to complete a treatment plan commenced under the pilot program1 as determined necessary by the ,secretary4 7f7 ,reports 7#a7 ,annual report ,not later than one year after the commencement of the pilot program1 and annually thereafter for the duration of the pilot program1 the ,secretary of ,veterans ,affairs shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a report on the pilot program that includes-- 7,a7 an identification of the ,states participating in the pilot program2 7,b7 a description of the implementation and operation of the pilot program2 7,c7 the number of participants in the pilot program1 disaggregated by-- 7i7 ,state2 and 7ii7 disability rating2 7,d7 an identification of any barriers or challenges to implementing the pilot program2 7,e7 aggregated feedback from participants in the pilot program1 including from interviews and surveys2 7,f7 the average annual cost of providing covered care to a participant in the pilot program1 disaggregated by-- 7i7 ,state2 7ii7 disability rating2 and 7iii7 whether the care was provided through the community care network or through a provider of the ,department2 7,g7 an analysis of the communication and collaboration of the ,department with ,third ,party ,administrators and community care dental providers1 disaggregated by ,state2 7,h7 an analysis of any cost savings by the ,department with respect to the treatment of ischemic heart disease2 7,i7 an assessment of the impact of the pilot program on appointments for care1 prescriptions1 hospitalizations1 emergency room visits1 wellness1 employability1 satisfaction1 and perceived quality of life of covered veterans related to their diagnosis of ischemic heart disease2 7,j7 an analysis and assessment of the efficacy of mobile clinics and portable dental care units1 to the extent such modalities are used1 to service the needs of covered veterans under the pilot program2 7,k7 an analysis and assessment of the usage of teledentistry to service the needs of covered veterans under the pilot program1 to include a cost benefit analysis of such services2 and 7,l7 such other matters as the ,secretary considers appropriate4 7#b7 ,final report ,not later than #ij days before the completion of the pilot program1 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a report on the pilot program that-- 7,a7 includes the matters required under paragraph 7#a72 7,b7 includes recommendations on whether the pilot program should be continued1 expanded1 or adopted throughout the ,department2 and 7,c7 indicates whether the ,secretary requests action by ,congress to make the pilot program permanent4 7g7 ,impact on community care ,participants in the pilot program shall be able to access covered care in the community under section #agjc of title #ch1 ,united ,states ,code4 7h7 ,definitions ,in this section3 7#a7 ,the term covered care means dental care that is consistent with the dental services and treatment furnished by the ,secretary of ,veterans ,affairs to veterans pursuant to section #agab7;a77#a77;,g7 of title #ch1 ,united ,states ,code4 7#b7 ,the term covered veteran means a veteran who-- 7,a7 is enrolled in the system of annual patient enrollment of the ,department established and operated under paragraphs 7#a7 or 7#b7 of section #agje7;a7 of title #ch1 ,united ,states ,code2 7,b7 is not eligible for dental services and treatment and related dental appliances under the laws administered by the ,secretary as of the date of the enactment of this ,act2 and 7,c7 has a diagnosis of ischemic heart disease4 7#c7 ,the term ,third ,party ,administrator has the meaning given such term in section #agjc;,f of such title4 #ade4 ,documentation of preferences of veterans for scheduling of appointments for health care under laws administered by ,secretary 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 develop a mechanism to solicit information regarding the preference of veterans enrolled in the system of annual patient enrollment of the ,department of ,veterans ,affairs established and operated under section #agje7;a7 of title #ch1 ,united ,states ,code1 for scheduling of appointments for health care and related services under the laws administered by the ,secretary1 including through non-,department providers4 7b7 ,documentation of preference ,preferences provided voluntarily by a veteran pursuant to subsection 7a7 shall be documented on ,my ,healthe,vet or another system designated by the ,secretary that allows the veteran to view and change such preferences at any time4 7c7 ,inclusion in preference ,preferences solicited under subsection 7a7 shall include the following3 7#a7 ,how and when the veteran prefers to be contacted about an appointment for health care4 7#b7 ,whether the veteran prefers to schedule appointments without the assistance of the ,department1 if able4 7#c7 ,whether the veteran prefers to select a provider without the assistance of the ,department1 if able4 7#d7 ,whether the veteran prefers appointments to be scheduled during certain days or times4 7d7 ,use of preference ,the ,secretary shall make the preferences provided under subsection 7a7 easily accessible to medical support assistants and other staff of the ,department1 or non-,department staff1 as the ,secretary determines appropriate1 who assist in the appointment scheduling process4 7e7 ,deployment of mechanism 7#a7 ,in general ,beginning after the date on which the ,secretary develops the mechanism required under subsection 7a71 the ,secretary shall-- 7,a7 test the mechanism in not fewer than three geographically diverse ,veterans ,integrated ,service ,networks2 and 7,b7 gather feedback about the effectiveness of such mechanism from veterans1 medical support assistants1 staff and other stakeholders as the ,secretary determines appropriate4 7#b7 ,limitation ,the ,secretary may not implement such mechanism across the ,veterans ,health ,administration of the ,department before the ,secretary addresses the feedback described in paragraph 7#a77;,b74 #adf4 ,staffing model and performance metrics for certain employees of the ,department of ,veterans ,affairs 7a7 ,staffing model 7#a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall-- 7,a7 develop1 validate1 and implement a staffing model for the ,office of ,integrated ,veteran ,care of the ,department of ,veterans ,affairs1 or successor office1 ,veterans ,integrated ,services ,networks1 and medical centers of the ,department that includes appropriate target staffing levels nationally1 regionally1 and locally to ensure timely access to care and effectively oversee the provision of care by the ,department1 whether at a facility of the ,department or through a non-,department provider2 and 7,b7 provide to ,congress a briefing on such staffing model1 which shall include-- 7i7 the metrics and measures used by the ,secretary in developing such staffing model2 7ii7 an analysis of how such staffing model compares to the staffing models of other relevant ,government-owned and private sector health care systems2 and 7iii7 an estimate of the portion of the roles in such staffing model that will be filled by contracted staff at any given time4 7#b7 ,report on implementation of staffing model ,not later than one year after the date on which the ,secretary implements the staffing model required under paragraph 7#a71 the ,secretary shall submit to ,congress and the ,comptroller ,general of the ,united ,states a report containing-- 7,a7 an update on such implementation2 and 7,b7 information on the outcomes yielded by such staffing model in terms of improved access to care for veterans and improved compliance with relevant laws1 regulations1 policy directives1 and guidance governing access to care4 7b7 ,performance metrics 7#a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary shall develop and implement a plan1 with an appropriate tracking system1 to incorporate appropriate standardized performance metrics and oversight measures within the performance appraisal systems for employees of the ,department specified in paragraph 7#b74 7#b7 ,employees of the ,department specified ,employees of the ,department specified in this paragraph are employees who are responsible for ensuring timely access to care from the ,department1 compliance with relevant statutes and regulations relating to the provision of care1 including section #agjc of title #ch1 ,united ,states ,code1 and overseeing the provision of care1 whether at a facility of the ,department or through a non-,department provider1 including employees within the ,office of ,integrated ,veteran ,care of the ,department1 or successor office1 employees of a ,veterans ,integrated ,service ,network1 and employees of a medical center of the ,department4 7#c7 ,report on implementation of performance metrics ,not later than one year after implementing the performance metrics required under paragraph 7#a71 the ,secretary shall submit to ,congress and the ,comptroller ,general of the ,united ,states a report containing-- 7,a7 an update on such implementation2 and 7,b7 information on the outcomes yielded by such performance metrics in terms of improved access to care for veterans and improved compliance with relevant laws1 policy directives1 and guidance governing access to care4 7c7 ,,gao report ,not later than two years after the later of the date on which the ,comptroller ,general receives the report under subsection 7a77#b7 or the report under subsection 7b77#c71 the ,comptroller ,general shall submit to ,congress a report that includes-- 7#a7 an assessment of the performance of the ,office of ,integrated ,veteran ,care of the ,department1 or successor office1 in improving access to care for veterans in facilities of the ,department and pursuant to section #agjc of title #ch1 ,united ,states ,code2 and 7#b7 such recommendations as the ,comptroller ,general considers appropriate with respect to improving access to the care described in paragraph 7#a7 for veterans4 #adg4 ,online health education portal for veterans enrolled in patient enrollment system of ,department of ,veterans ,affairs ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall establish1 on an ,internet website of the ,department1 a health education portal that includes interactive educational modules to ensure veterans enrolled in the patient enrollment system of the ,department of ,veterans ,affairs established and operated under section #agje7;a7 of title #ch1 ,united ,states ,code1 understand the basic health care eligibilities and entitlements of veterans under the laws administered by the ,secretary1 including under the ,veterans ,community ,care ,program under section #agjc of such title4 #adh4 ,limitation on detail of directors of medical centers of ,department of ,veterans ,affairs to different positions 7a7 ,notification 7#a7 ,in general ,not later than #ij days after detailing a director of a medical center of the ,department of ,veterans ,affairs to a different position within the ,department1 the ,secretary of ,veterans ,affairs shall notify the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives of such detail4 7#b7 ,matters to be included ,the notification required by paragraph 7#a7 shall include1 with respect to a director of a medical center who is detailed to a different position within the ,department1 the following information3 7,a7 ,the location at which the director is detailed4 7,b7 ,the position title of the detail4 7,c7 ,the estimated time the director is expected to be absent from their duties at the medical center4 7,d7 ,such other information as the ,secretary may determine appropriate4 7b7 ,appointment of acting director ,not later than #abj days after detailing a director of a medical center of the ,department to a different position within the ,department1 the ,secretary shall appoint an individual as acting director of such medical center with all of the authority and responsibilities of the detailed director4 7c7 ,update on detail ,not later than #abj days after detailing a director of a medical center of the ,department to a different position within the ,department1 and not less frequently than every #cj days thereafter while the detail is in effect or while the director position at the medical center is vacant1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives an update regarding the status of the detail4 7d7 ,return to position or reassignment 7#a7 ,in general ,except as provided in paragraph 7#b71 not later than #ahj days after detailing a director of a medical center of the ,department to a different position within the ,department1 for a reason other than an ongoing investigation or administrative action with respect to the director1 the ,secretary shall-- 7,a7 return the individual to the position as director of the medical center2 or 7,b7 reassign the individual from the position as director of the medical center and begin the process of hiring a new director for such position4 7#b7 ,waiver 7,a7 ,in general ,the ,secretary may waive the requirement under paragraph 7#a7 with respect to an individual for successive #ij-;day increments for a total period of not more than #edj days from the original date the individual was detailed away from their position as director of a medical center4 7,b7 ,notification ,not later than #cj days after exercising a waiver under subparagraph 7,a71 the ,secretary shall notify ,congress of the waiver and provide to ,congress information as to why the waiver is necessary4 #adi4 ,national ,veteran ,suicide ,prevention ,annual ,report 7a7 ,national ,veteran ,suicide ,prevention ,annual ,report 7#a7 ,in general ,not later than #ah months after the date of the enactment of this ,act1 and not later than ,september #cj of each year thereafter1 the ,secretary of ,veterans ,affairs shall submit to the appropriate congressional committees and publish on a publicly available website of the ,department of ,veterans ,affairs a report to be known as the ,national ,veteran ,suicide ,prevention ,annual ,report4 7#b7 ,extension 7,a7 ,in general ,if the ,secretary requires an extension of the deadline for a report under subsection 7a71 the ,secretary shall submit to the appropriate congressional committees a written request for such an extension4 7,b7 ,elements ,each written request under paragraph 7#a7 for an extension for a report shall include the following3 7i7 ,the rationale for the delay in the submission of the report4 7ii7 ,an explanation of the need for an extension4 7iii7 ,a proposed amended date for the submission and publication of the report4 7#c7 ,briefing ,with respect to each report required under paragraph 7#a71 the ,secretary shall1 before the date on which the ,secretary submits such report1 provide to the appropriate congressional committees a briefing on such report4 7#d7 ,elements 7,a7 ,in general ,each report required under paragraph 7#a7 shall include-- 7i7 the findings of the national analysis of veteran suicide rates for the latest year for which data is available2 7ii7 an identification of trends1 if any1 demonstrated by such data2 and 7iii7 a comparison of such data to data on veteran suicide rates during preceding years4 7,b7 ,additional elements ,each report under paragraph 7#a7 shall include1 for the year covered by the report1 the following3 7i7 ,suicide rates of veterans disaggregated by age1 gender1 and race or ethnicity4 7ii7 ,trends in suicide rates of veterans compared to engagement of those veterans with health care from the ,veterans ,health ,administration1 including an examination of trends in suicide rates or deaths among-- 7,i7 veterans who have recently received health care from the ,veterans ,health ,administration as compared to veterans who have never received health care from the ,veterans ,health ,administration2 7,,ii7 veterans who are enrolled in the patient enrollment system of the ,department of ,veterans ,affairs under section #agje7;a7 of title #ch1 ,united ,states ,code1 as compared to veterans who have never enrolled in such system2 7,,iii7 veterans who have recently used services from a ,vet ,center as compared to veterans who have never used such services2 7,,iv7 to the extent practicable1 veterans who have a diagnosis of substance use disorder2 and 7,v7 other groups of veterans relating to engagement with health care from the ,veterans ,health ,administration1 as the ,secretary considers practicable4 7iii7 ,to the extent practicable1 trends in suicide rates of veterans compared to engagement of those veterans with benefits from the ,veterans ,benefits ,administration1 including an examination of trends in suicide rates or deaths among-- 7,i7 veterans who are currently using1 have previously used1 or have never used educational assistance under the laws administered by the ,secretary2 7,,ii7 veterans who are currently receiving1 have previously received1 or have never received services or assistance under chapter #ca of title #ch1 ,united ,states ,code2 7,,iii7 with respect to compensation under chapter #aa of such title-- 7aa7 veterans who were recipients of such compensation as compared to veterans who never applied for such compensation prior to death2 7bb7 veterans who had a claim denied for such compensation prior to death2 7cc7 veterans who had a pending claim for such compensation at time of death2 and 7dd7 veterans who had an entitlement for such compensation reduced prior to death2 7,,iv7 veterans who are currently receiving or have never received pension under chapter #ae of title #ch1 ,united ,states ,code2 7,v7 veterans who are currently using1 have recently used1 or have never used programs or services provided by the ,homeless ,programs ,office of the ,department1 including an examination of trends in suicide rates or deaths among veterans who made contact with such office but were denied or deemed ineligible for any such program or service2 7,,vi7 with respect to housing loans guaranteed by the ,secretary under chapter #cg of title #ch1 ,united ,states ,code1 veterans who are current recipients of1 were recent recipients of1 or have never received such a loan2 7,,vii7 veterans owing debts to the ,department2 7,,viii7 veterans who were involved in a veterans treatment court program1 whether they graduated successfully or not2 and 7,,ix7 veterans who were successfully contacted1 unsuccessfully contacted1 or never contacted by the ,department through the ,solid ,start program under section #fcbj of title #ch1 ,united ,states ,code4 7,c7 ,strategy and recommendations 7i7 ,initial report ,the initial report under paragraph 7#a7 shall include a strategy and recommendations developed by the ,secretary of ,veterans ,affairs1 in collaboration with the ,director of the ,centers for ,disease ,control and ,prevention1 for-- 7,i7 improving data collection at the ,state and local levels to accurately capture suicide deaths of veterans2 7,,ii7 improving the timeliness1 efficacy1 and standardization of data reporting on suicide deaths of veterans at the ,federal level1 including by the ,centers for ,disease ,control and ,prevention and the ,department of ,veterans ,affairs2 7,,iii7 improving the timeliness of identification and analysis of suicide deaths of veterans by ,federal agencies1 including the ,centers for ,disease ,control and ,prevention1 and the ,department of ,veterans ,affairs2 and 7,,iv7 any other necessary process improvements for improving the timeliness1 efficacy1 and standardization of reporting of data relating to suicide deaths of veterans1 particularly with respect to the annual report under this section4 7ii7 ,subsequent reports ,each report after the initial report under paragraph 7#a7 shall include updates on actions taken to meet the strategy and recommendations developed under subparagraph 7,a74 7#e7 ,definitions ,in this subsection3 7,a7 ,the term appropriate congressional committees means the ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives4 7,b7 ,the term ,vet ,center means a center for readjustment counseling and related mental health services for veterans under section #agab;,a of title #ch1 ,united ,states ,code4 7b7 ,independent assessment of ,national ,veteran ,suicide ,prevention ,annual ,report 7#a7 ,in general ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall enter into one or more contracts with a private sector entity described in paragraph 7#e7 to conduct an independent assessment of the ,national ,veteran ,suicide ,prevention ,annual ,report required under subsection 7a74 7#b7 ,frequency ,the private sector entity or entities carrying out the assessment required under paragraph 7#a7 shall complete such assessment not later than #bdj days after entering into the contract described in such subsection and not less frequently than every five years thereafter4 7#c7 ,elements ,each assessment required under paragraph 7#a7 shall analyze the following3 7,a7 ,the methodology used by the ,department to track1 analyze1 categorize1 and report suicide deaths and suicide rates among veterans4 7,b7 ,whether data sources used by the ,department to compile data on suicide deaths and suicide rates among veterans are accurately reflecting such data4 7,c7 ,vulnerabilities in the methodology used by the ,department that could lead to inaccurate counting of suicide deaths and suicide rates among veterans4 7,d7 ,the ability of the ,department to cross reference suicide deaths and suicide rates among veterans with trends in usage of programs of the ,veterans ,health ,administration or the ,veterans ,benefits ,administration or other programs that could serve as widespread protective factors against suicide4 7,e7 ,improvements that could be made to ensure the ,national ,veteran ,suicide ,prevention ,annual ,report required under subsection 7a7 is accurate and comprehensive and provides insights for making improvements to the suicide prevention efforts of the ,department4 7#d7 ,report on assessment 7,a7 ,report on findings and recommendations ,not later than #fj days after completing an assessment required by paragraph 7#a71 the private sector entity or entities carrying out the assessment shall submit to the ,secretary of ,veterans ,affairs and the ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives a report on the findings and recommendations of the private sector entity or entities with respect to such assessment4 7,b7 ,report on planned improvements ,not later than #fj days after receiving a report under paragraph 7#a7 with respect to an assessment required by paragraph 7#a71 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives a report on how the ,department plans to improve the ,national ,veteran ,suicide ,prevention ,annual ,report required under subsection 7a7 based on such assessment4 7#e7 ,private sector entity described ,a private sector entity described in this paragraph is a private entity that-- 7,a7 specializes in analyzing large-scale organizational data collection and analysis efforts1 especially with respect to the health care sector2 and 7,b7 has experience and proven outcomes in optimizing the accuracy and comprehensiveness of data collection and analysis related to suicide4 7c7 ,report on additional benefits and services from ,department of ,veterans ,affairs to prevent veteran suicide 7#a7 ,in general ,not later than three years after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall submit to the ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives and publish on a publicly available website of the ,department of ,veterans ,affairs a report that analyzes which benefits and services under the laws administered by such ,secretary1 including such benefits and services furnished by the ,veterans ,benefits ,administration1 have the greatest impact on the prevention of suicide among veterans1 including recommendations for potential expansion of services and benefits to reduce the number of veteran suicides4 7#b7 ,assessment of ,solid ,start program ,the report required by paragraph 7#a7 shall include an analysis of the effectiveness of the ,solid ,start program under section #fcbj of title #ch1 ,united ,states ,code1 on prevention of suicide among veterans4 7d7 ,toolkit for ,state and local coroners and medical examiners on best practices for identifying and reporting on suicide deaths of veterans 7#a7 ,in general ,the ,secretary of ,veterans ,affairs1 in collaboration with the ,director of the ,centers for ,disease ,control and ,prevention1 shall develop a toolkit for ,state and local coroners and medical examiners that contains best practices for-- 7,a7 accurately identifying and reporting suicide deaths of veterans1 including how to identify veteran status2 and 7,b7 reporting such deaths to the ,centers for ,disease ,control and ,prevention and other applicable entities4 7#b7 ,availability ,not later than two years after the date of the enactment of this ,act1 the ,secretary shall make the toolkit developed under paragraph 7#a7 available on a publicly available website of the ,department of ,veterans ,affairs4 7#c7 ,outreach ,the ,secretary1 in collaboration with the ,director of the ,centers for ,disease ,control and ,prevention1 shall conduct outreach to appropriate ,state and local agencies to promote the availability and use of the toolkit developed under paragraph 7#a74 #aej4 ,report on physical infrastructure required by medical facilities of ,department of ,veterans ,affairs to provide dental care services ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall submit to the ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives a report1 for each medical center or other relevant health care facility of the ,department of ,veterans ,affairs1 that includes-- 7#a7 an identification of the physical infrastructure1 including new facilities1 renovations1 remodels1 leases1 or other infrastructure1 such medical center or health care facility requires to provide dental care services to veterans eligible for such services under the laws administered by the ,secretary2 and 7#b7 an analysis of the physical infrastructure such medical center or health care facility would require if a greater number of veterans became eligible for such dental care services pursuant to a modification of the laws administered by the ,secretary4 #aea4 ,comptroller ,general report on certain oral health care programs under laws administered by ,secretary 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 ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives a report on the status of the oral health care programs of the ,department of ,veterans ,affairs1 that includes an assessment of-- 7#a7 any issues with information technology programs1 including ,dental ,record ,manager ,plus1 that affect dental care staff of the ,department2 7#b7 the implementation of the dental insurance plan of the ,department under section #agab;,c of title #ch1 ,united ,states ,code2 7#c7 the implementation and expansion of the ,v,e,t,smile program of the ,department2 7#d7 barriers preventing the ,department from expanding dental care eligibility to all veterans with ischemic heart disease1 including such barriers relating to physical infrastructure1 workforce1 and cost of such dental care2 7#e7 barriers preventing dental clinics of the ,department1 if any1 from adopting teledentistry2 7#f7 the demographic makeup of veterans eligible for dental care paid for by the ,department as of the commencement of the pilot program under section #add of this ,act1 including information on-- 7,a7 age2 7,b7 gender2 7,c7 race or ethnicity1 disaggregated by-- 7i7 membership in an ,indian ,tribe2 and 7ii7 the major race groups used in the decennial census2 7,d7 employment status2 and 7,e7 location of residence1 disaggregated by rural1 highly rural1 and urban locations2 and 7#g7 changes to such demographic makeup if any1 that would result from an expansion of eligibility for dental care under the laws administered by the ,secretary to all veterans with ischemic heart disease including changes to demographics specified in paragraph 7#f74 7b7 ,third ,party ,administrator defined ,in this section1 the term ,third ,party ,administrator means an entity that manages a provider network and performs administrative services related to such network under section #agjc of title #ch1 ,united ,states ,code4 #aeb4 ,review of workflows associated with processing referrals between facilities of the ,veterans ,health ,administration 7a7 ,in general ,the ,secretary of ,veterans ,affairs shall conduct a review of the workflows directly associated with processing referrals of patients between facilities of the ,veterans ,health ,administration of the ,department of ,veterans ,affairs to identify specific delays or bottlenecks in such referrals4 7b7 ,elements of review ,the review required under subsection 7a7 shall include a review of-- 7#a7 the interfacility consult management guidance of the ,veterans ,health ,administration that assists facilities described in subsection 7a7 in constructing a workflow for consults between such facilities2 and 7#b7 the roles and responsibilities of the individuals involved in the consult management process in managing such consults1 including the role of the referral coordination team4 7c7 ,report ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary shall submit to ,congress a report on the results of the review required under subsection 7a74 #aec4 ,plan for timely scheduling of appointments at medical facilities of ,department of ,veterans ,affairs 7a7 ,plan required ,to improve responsiveness in the provision of hospital care and medical services at medical facilities of the ,department of ,veterans ,affairs1 the ,secretary of ,veterans ,affairs shall develop a plan to-- 7#a7 ensure that whenever a covered veteran contacts the ,department by telephone to request the scheduling of an appointment for care or services for the covered veteran at such a facility1 the scheduling for the appointment occurs during that telephone call 7regardless of the prospective date of the appointment being scheduled72 and 7#b7 provide timely and1 where applicable1 same-day scheduling for an appointment described in paragraph 7#a74 7b7 ,report ,not later than one year after the date of the enactment of this ,act1 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a report on the plan under subsection 7a74 7c7 ,covered veteran defined ,in this section1 the term covered veteran means a veteran who is enrolled in the system of patient enrollment of the ,department under section #agje7;a7 of title #ch1 ,united ,states ,code4 #aed4 ,authorization of appropriations to support initiatives for mobile mammography services for veterans ,there is authorized to be appropriated to the ,secretary of ,veterans ,affairs #e1jjj1jjj for fiscal year #bjbe for the ,office of ,women's ,health of the ,department of ,veterans ,affairs under section #gcaj of title #ch1 ,united ,states ,code1 to be used by the ,secretary to expand access of women veterans to-- 7#a7 mobile mammography initiatives2 7#b7 advanced mammography equipment2 and 7#c7 outreach activities to publicize those initiatives and equipment4 ,,ii ,economic ,opportunity ,matters ,a ,educational ,assistance #bja4 ,temporary expansion of eligibility for ,marine ,gunnery ,sergeant ,john ,david ,fry ,scholarship 7a7 ,in general ,the ,secretary of ,veterans ,affairs shall treat an individual described in subsection 7b7 as a covered individual described in section #ccaa7;b7 of title #ch1 ,united ,states ,code4 7b7 ,covered individual described ,an individual described in this subsection is an individual who is the child or spouse of a person-- 7#a7 who dies from a service-connected disability during the #abj-;day period immediately following the day on which the person was discharged or released from duty as a member of the ,armed ,forces 7without regard to whether such duty was active duty72 and 7#b7 7,a7 who received an honorable discharge2 or 7,b7 whose service in the ,armed ,forces is characterized by the ,secretary concerned as honorable service4 7c7 ,applicability ,this section shall apply with respect to-- 7#a7 deaths that occur before1 on1 or after the date of the enactment of this ,act2 and 7#b7 a quarter1 semester1 or term1 as applicable1 commencing-- 7,a7 on or after ,august #a1 #bjbe2 and 7,b7 before ,october #a1 #bjbg4 #bjb4 ,removal of expiration on entitlement to ,marine ,gunnery ,sergeant ,john ,david ,fry ,scholarship for surviving spouses ,section #ccaa7;f7 of title #ch1 ,united ,states ,code1 is amended-- 7#a7 by striking paragraph 7#b72 7#b7 by redesignating paragraphs 7#c7 through 7#e7 as paragraphs 7#b7 through 7#d71 respectively2 7#c7 in paragraph 7#b71 as redesignated by paragraph 7#b7 of this section1 by striking in paragraph 7#d7 and inserting in paragraph 7#c72 and 7#d7 in paragraph 7#c77;,a71 as redesignated by paragraph 7#b7 of this section1 by striking under paragraph 7#c7 and inserting under paragraph 7#b74 #bjc4 ,sole liability for transferred educational assistance by an individual who fails to complete a service agreement ,subsection 7i7 of section #ccai of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in paragraph 7#a7-- 7,a7 by striking ,in the event and inserting ,subject to paragraph 7#b71 in the event2 and 7,b7 by inserting of this title after section #cfhe2 7#b7 in subparagraph 7,a7 of paragraph 7#b7-- 7,a7 in the heading1 by striking ,in general and inserting ,sole liability2 and 7,b7 by striking under paragraph 7#a7 and inserting for which the individual shall be solely liable to the ,united ,states for the amount of the overpayment for purposes of section #cfhe of this title2 and 7#c7 in subparagraph 7,b7 of paragraph 7#b7-- 7,a7 in the matter preceding clause 7i71 by striking ,subparagraph 7,a7 shall not apply and inserting ,neither the individual nor the dependent shall be liable to the ,united ,states for the amount of the overpayment for purposes of section #cfhe of this title2 and 7,b7 in clause 7ii71 by inserting of this title after section #ccaa7;c77#d74 #bjd4 ,notice to educational institutions of risk-based surveys ,section #cfgc;,a7d7 of title #ch1 ,united ,states ,code1 is amended by striking one business day and inserting two business days4 #bje4 ,relationship of participation by an educational institution in certain ,federal student financial aid programs to approval of such institution for purposes of ,department of ,veterans ,affairs educational assistance programs ,paragraph 7#d7 of section #cfge7;b7 of title #ch1 ,united ,states ,code1 is amended to read as follows3 7#d7 ,the educational institution-- 7,a7 is approved and participates in a program under title ,,iv of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajgj et seq472 or 7,b7 does not participate in such a program and the ,secretary has waived the requirement under this paragraph with respect to the educational institution1 and submits to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives notice of such waiver1 because the ,secretary determines that the educational institution-- 7i7 elects not to participate in such a program2 7ii7 cannot participate in such a program2 or 7iii7 is in the process of making a good-faith effort to submit an initial application for approval to participate in such a program1 except that a waiver under this clause may not be provided for a period of longer than #cf months4 4 #bjf4 ,expansion of ,department of ,veterans ,affairs oversight of certain educational institutions 7a7 ,additional requirement for approval ,section #cfge7;b7 of title #ch1 ,united ,states ,code1 as amended by section #bje1 is further amended by adding at the end the following new paragraph3 7#e7 ,the educational institution agrees to1 not later than #cj days after any date on which such educational institution becomes subject to an action or event described in section #cfgc7;e77#c7 of this title1 submit to the ,state approving agency1 or the ,secretary when acting in the role of a ,state approving agency1 a notification of such action or event in such form and containing such information as the ,secretary determines appropriate4 4 7b7 ,additional requirement for approval of nonaccredited courses 7#a7 ,in general ,section #cfgf7;c7 of such title is amended-- 7,a7 by redesignating paragraphs 7#ad7 through 7#af7 as paragraphs 7#ae7 through 7#ag71 respectively2 and 7,b7 by inserting after paragraph 7#ac7 the following new paragraph3 7#ad7 ,the institution agrees to1 not later than #cj days after any date on which such institution becomes subject to an action or event described in section #cfgc7;e77#c7 of this title1 submit to the ,state approving agency1 or the ,secretary when acting in the role of a ,state approving agency1 a notification of such action or event in such form and containing such information as the ,secretary determines appropriate4 4 7#b7 ,conforming amendments ,such title is further amended-- 7,a7 in section #cfgb7;b77#b77;,c71 by striking paragraph 7#ad7 or 7#ae7 and inserting paragraph 7#ae7 or 7#af72 7,b7 in section #cfge7;b77#c71 by striking 7#ad71 7#ae71 and 7#af7 and inserting 7#ae71 7#af71 and 7#ag72 7,c7 in section #cfgi7;d71 by striking described in paragraph 7#ad7 or 7#ae7 and inserting described in paragraph 7#ae7 or 7#af72 and 7,d7 in section #cfhj;,a7a77#d77;,c77iii71 by striking section #cfgf7;c77#ad7 and 7#ae7 and inserting section #cfgf7;c77#ae7 and 7#af74 7c7 ,additional grounds for suspension of approval ,section #cfgi7;f77#a7 of such title is amended by adding at the end the following new subparagraph3 7,i7 ,comply with the notification requirements under sections #cfge7;b77#e7 and #cfgf7;c77#ad7 of this title1 when applicable4 4 7d7 ,deadline for risk-based surveys database ,the ,secretary of ,veterans ,affairs shall establish the database required under section #cfgc;,a7c7 of title #ch1 ,united ,states ,code1 by not later than #ahj days after the date of the enactment of this ,act4 #bjg4 ,requirement that educational institutions approved for purposes of ,department of ,veterans ,affairs educational assistance programs provide digital official transcripts 7a7 ,requirement ,section #cfge7;b7 of title #ch1 ,united ,states ,code1 as amended by sections #bje and #bjf1 is further amended by adding at the end the following new paragraph3 7#f7 ,the educational institution makes available to each eligible person or veteran a copy of the person or veteran's official transcript in a digital format4 4 7b7 ,conforming amendments 7#a7 ,approval of courses ,section #cfgb7;b77#b77;,a7 of such title is amended by striking 7b77#a7 and 7b77#b7 and inserting paragraphs 7#a71 7#b71 and 7#f7 of section #cfge7;b74 7#b7 ,approval of nonaccredited courses ,section #cfgf7;c7 of such title is amended-- 7,a7 by redesignating paragraph 7#ag7 as paragraph 7#ah72 and 7,b7 by inserting after paragraph 7#af7 the following new paragraph 7#ag73 7#ag7 ,in the case of a course that leads to a standard college degree1 the educational institution satisfies the requirements of section #cfge7;b77#f7 of this title4 4 7#c7 ,conforming amendments ,section #cfge7;b77#c7 of such title is amended by striking 7#ae71 7#af71 and 7#ag7 and inserting 7#ae71 7#af71 and 7#ah74 7c7 ,effective date ,the amendments made by this section shall take effect on ,august #a1 #bjbe1 and apply with respect to a quarter1 semester1 or term1 as applicable1 commencing on or after such date4 #bjh4 ,payment of full monthly housing stipend for veterans enrolled in final semester using educational assistance under ,post-#i_/aa ,educational ,assistance ,program 7a7 ,housing allowance ,section #cfhj7;a77#c7 of title #ch1 ,united ,states ,code1 is amended-- 7#a7 by redesignating subparagraphs 7,a7 and 7,b7 as clauses 7i7 and 7ii71 respectively 7and by redesignating each subordinate provision and the margins thereof accordingly72 7#b7 by striking ,notwithstanding paragraph 7#a7 and inserting 7,a7 ,notwithstanding paragraph 7#a72 7#c7 by striking 1 including a monthly housing stipend described in section #ccac7;c7 of this title12 and 7#d7 by adding at the end the following new subparagraph 7,b73 7,b7 ,for purposes of providing a monthly housing stipend described in section #ccac7;c7 to an eligible veteran or eligible person for whom the ,secretary is providing educational assistance under chapter #cc of this title during a period that is the last semester1 term1 or academic period pursuant to subparagraph 7,a71 the ,secretary shall treat the veteran or person as pursuing a program of education on a full-time basis4 4 7b7 ,application ,the amendments made by subsection 7a7 shall take effect on the date of the enactment of this ,act and apply with respect to a quarter1 semester1 or term1 as applicable1 commencing on or after ,january #a1 #bjbe4 #bji4 ,modification of rules for approval of commercial driver education programs for purposes of educational assistance programs of the ,department of ,veterans ,affairs 7a7 ,in general ,subsection 7a77#d7 of section #b of the ,veteran ,improvement ,commercial ,driver ,license ,act of #bjbc 7,public ,law #aah-ie7 is amended1 in the matter to be inserted as the new paragraph 7#b7 of section #cfhj;,a7e7 of title #ch1 ,united ,states ,code-- 7#a7 in subparagraph 7,a7-- 7,a7 in the matter preceding clause 7i71 by striking the commercial driver education program offered at the branch by the educational institution-- and inserting and em dash2 and 7,b7 by striking clauses 7i7 and 7ii7 and inserting the following3 7i7 the commercial driver education program offered at the branch by the educational institution is approved for purposes of this chapter by a ,state approving agency 7or the ,secretary when acting in the role of a ,state approving agency72 and 7ii7 7,i7 such branch is located in a ,state in which such educational institution offers such commercial driver education program at another branch of such educational institution2 or 7,,ii7 such branch-- 7aa7 has been operating for at least one year2 and 7bb7 offers such commercial driver education program1 using the same curriculum as another branch of such educational institution4 2 and 7#b7 by adding at the end the following new subparagraph3 7,d7 ,the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,senate and ,house of ,representatives a notification not later than #cj days after the ,secretary grants an exemption under subparagraph 7,a74 ,such notification shall identify the educational institution1 and the branch thereof1 granted such exemption4 4 7b7 ,implementation ,section #b7;b7 of such ,act is amended-- 7#a7 in paragraph 7#b71 by striking #ahj days and inserting #cfe days2 and 7#b7 by adding at the end the following new paragraphs3 7#c7 ,regulations ,in prescribing any regulation to carry out the amendments made by subsection 7a71 the ,secretary of ,veterans ,affairs shall consult with ,state approving agencies designated under section #cfga of such title4 7#d7 ,,gao study ,not later than #cfe days after the applicability date under paragraph 7#b71 the ,comptroller ,general of the ,united ,states shall-- 7,a7 conduct a study to-- 7i7 determine the effects of the amendments made by subsection 7a72 and 7ii7 the feasibility and advisability of similarly amending the rules for approval of programs of education for other vocational programs of education2 and 7,b7 submit to the ,committees on ,veterans' ,affairs of the ,senate and ,house of ,representatives a report on the findings of the ,comptroller ,general with respect to such study4 4 7c7 ,effective date ,the amendments made by this section shall take effect as if included in such ,act on the date of the enactment of such ,act4 #baj4 ,provision of certificates of eligibility and award letters using electronic means 7a7 ,in general ,chapter #cf of title #ch1 ,united ,states ,code1 is amended by inserting after section #cfih the following new section 7and conforming the table of sections at the beginning of such chapter accordingly73 #cfih;,a4 ,provision of certificates of eligibility and award letters using electronic means 7a7 ,requirement ,except as provided by subsection 7b71 the ,secretary shall provide to an individual the following documents using electronic means3 7#a7 ,a certificate of eligibility for the entitlement of the individual to covered educational assistance4 7#b7 ,an award letter regarding the authorization of the individual to receive covered educational assistance4 7b7 ,election to opt out ,an individual may elect to receive the documents specified in subsection 7a7 by mail rather than through electronic means under subsection 7a74 ,an individual may revoke such an election at any time1 by means prescribed by the ,secretary4 7c7 ,covered educational assistance ,in this section1 the term covered educational assistance means educational assistance under chapter #cj1 #cc1 or #ce of this title1 or section #cfii;,c of this title4 4 7b7 ,clerical amendment ,the table of sections at the beginning of such chapter is amended by inserting after the item relating to section #cfih the following new item3 #cfih;,a4 ,provision of certificates of eligibility and award letters using electronic means4 4 #baa4 ,retroactive effective date of law regarding charge to entitlement to educational assistance for individuals who do not transfer credits from certain closed or disapproved programs of education ,section #cfii7;c77#b7 of title #ch1 ,united ,states ,code1 is amended by striking subparagraph 7,c7 and inserting the following new subparagraph 7,c73 7,c7 ,this paragraph1 including clauses 7ii7 and 7iii7 of subparagraph 7,a71 shall apply with respect to the closure or discontinuation of a course or program of education1 as described in subsection 7b77#a71 that occurs during the period beginning on ,august #a1 #bjba1 and ending on ,september #cj1 #bjbe4 4 #bab4 ,department of ,veterans ,affairs high technology program 7a7 ,high technology program 7#a7 ,in general ,chapter #cf of title #ch1 ,united ,states ,code1 as amended by section #baj1 is amended by adding at the end the following new section3 #cfii;,c4 ,high technology program 7a7 ,establishment 7#a7 ,the ,secretary shall carry out a program under which the ,secretary provides covered individuals with the opportunity to enroll in high technology programs of education that the ,secretary determines provide training or skills sought by employers in a relevant field or industry4 7#b7 ,not more than #d1jjj covered individuals may participate in the program under this section in any fiscal year4 7b7 ,amount of assistance 7#a7 ,the ,secretary shall provide1 to each covered individual who pursues a high technology program of education under this section1 educational assistance in amounts equal to the amounts provided under section #ccac7;c77#a7 of this title1 including1 except as provided in paragraph 7#c71 with respect to the housing stipend described in that section and in accordance with the treatment of programs that are distance learning and programs that are less than half-time4 7#b7 ,under paragraph 7#a71 the ,secretary shall provide such amounts of educational assistance to a covered individual for each of the following3 7,a7 ,a high technology program of education4 7,b7 ,a second such program if-- 7i7 the second such program begins at least #ah months after the covered individual graduates from the first such program2 and 7ii7 the covered individual uses educational assistance under chapter #cc of this title to pursue the second such program4 7#c7 ,no covered individual may receive a housing stipend under this subsection for any month if such individual is in receipt of a housing stipend under chapter #cc of this title for that month4 7c7 ,contracts 7#a7 ,for purposes of carrying out subsection 7a71 the ,secretary shall seek to enter into contracts with any number of qualified providers of high technology programs of education for the provision of such programs to covered individuals4 ,each such contract shall provide for the conditions under which the ,secretary may terminate the contract with the provider and the procedures for providing for the graduation of students who were enrolled in a program provided by such provider in the case of such a termination4 7#b7 ,a contract under this subsection shall provide that the ,secretary shall pay to a provider-- 7,a7 upon the enrollment of a covered individual in the program1 #be percent of the cost of the tuition and other fees for the program of education for the individual2 7,b7 upon graduation of the individual from the program1 #be percent of such cost2 and 7,c7 #ej percent of such cost upon-- 7i7 the successful employment of the covered individual for a period-- 7,i7 of #ahj days in the field of study of the program2 and 7,,ii7 that begins not later than #ahj days following graduation of the covered individual from the program2 7ii7 the employment of the individual by the provider for a period of one year2 or 7iii7 the enrollment of the individual in a program of education to continue education in such field of study4 7#c7 ,for purposes of this section1 a provider of a high technology program of education is qualified if-- 7,a7 the provider employs instructors whom the ,secretary determines are experts in their respective fields in accordance with paragraph 7#e72 7,b7 the provider has successfully provided the high technology program for at least one year2 7,c7 the provider does not charge tuition and fees to a covered individual who receives assistance under this section to pursue such program that are higher than the tuition and fees charged by such provider to another individual2 and 7,d7 the provider meets the approval criteria developed by the ,secretary under paragraph 7#d74 7#d7 7,a7 ,the ,secretary shall prescribe criteria for approving providers of a high technology program of education under this section4 7,b7 ,in developing such criteria1 the ,secretary may consult with ,state approving agencies4 7,c7 ,such criteria are not required to meet the requirements of section #cfgb of this title4 7,d7 ,such criteria shall include the job placement rate1 in the field of study of a program of education1 of covered individuals who complete such program of education4 7#e7 ,the ,secretary shall determine whether instructors are experts under paragraph 7#c77;,a7 based on evidence furnished to the ,secretary by the provider regarding the ability of the instructors to-- 7,a7 identify professions in need of new employees to hire1 tailor the programs to meet market needs1 and identify the employers likely to hire graduates2 7,b7 effectively teach the skills offered to covered individuals2 7,c7 provide relevant industry experience in the fields of programs offered to incoming covered individuals2 and 7,d7 demonstrate relevant industry experience in such fields of programs4 7#f7 ,in entering into contracts under this subsection1 the ,secretary shall give preference to a provider of a high technology program of education-- 7,a7 from which at least #gj percent of graduates find full-time employment in the field of study of the program during the #ahj-;day period beginning on the date the student graduates from the program2 or 7,b7 that offers tuition reimbursement for any student who graduates from such a program and does not find employment described in subparagraph 7,a74 7d7 ,effect on other entitlement 7#a7 ,if a covered individual enrolled in a high technology program of education under this section has remaining entitlement to educational assistance under chapter #cj1 #cb1 #cc1 #cd1 or #ce of this title1 such entitlement shall be charged at the rate of one month of such entitlement for each month of educational assistance provided under this section4 7#b7 ,if a covered individual enrolled in a high technology program of education under this section does not have remaining entitlement to educational assistance under chapter #cj1 #cb1 #cc1 #cd1 or #ce of this title1 any educational assistance provided to such individual under this section shall be provided in addition to the entitlement that the individual has used4 7#c7 ,the ,secretary may not consider enrollment in a high technology program of education under this section to be assistance under a provision of law referred to in section #cfie of this title4 7#d7 7,a7 ,an application for enrollment in a high technology program of education under this section shall include notice of the requirements relating to use of entitlement under paragraphs 7#a7 and 7#b71 including-- 7i7 in the case of the enrollment of an individual referred to under paragraph 7#a71 the amount of entitlement that is typically charged for such enrollment2 7ii7 an identification of any methods that may be available for minimizing the amount of entitlement required for such enrollment2 and 7iii7 an element requiring applicants to acknowledge receipt of the notice under this subparagraph4 7,b7 ,if the ,secretary approves the enrollment of a covered individual in a high technology program of education under this section1 the ,secretary shall deliver electronically to the individual an award letter that provides notice of such approval and includes specific information describing how paragraphs 7#a7 and 7#b7 will be applied to the individual if the individual chooses to enroll in the program4 7e7 ,requirements for educational institutions 7#a7 ,the ,secretary shall not approve the enrollment of any covered individual1 not already enrolled1 in any high technology programs of education under this section for any period during which the ,secretary finds that more than #he percent of the students enrolled in the program are having all or part of their tuition1 fees1 or other charges paid to or for them by the educational institution or by the ,department of ,veterans ,affairs under this title or under chapter #afjf or #afjg of title #aj1 except with respect to tuition1 fees1 or other charges that are paid under a payment plan at an educational institution that the ,secretary determines has a history of offering payment plans that are completed not later than #ahj days after the end of the applicable term1 quarter1 or semester4 7#b7 ,the ,secretary may waive a requirement of paragraph 7#a7 if the ,secretary determines1 pursuant to regulations which the ,secretary shall prescribe1 such waiver to be in the interest of the covered individual and the ,federal ,government4 ,not later than #cj days after the ,secretary waives such a requirement1 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,senate and ,house of ,representatives a report regarding such waiver4 7#c7 7,a7 7i7 ,the ,secretary shall establish and maintain a process by which an educational institution may request a review of a determination that the educational institution does not meet the requirements of paragraph 7#a74 7ii7 ,the ,secretary may consult with a ,state approving agency regarding such process or such a review4 7iii7 ,not later than #ahj days after the ,secretary establishes or revises a process under this subparagraph1 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,senate and ,house of ,representatives a report regarding such process4 7,b7 ,an educational institution that requests a review under subparagraph 7,a7-- 7i7 shall request the review not later than #cj days after the start of the term1 quarter1 or semester for which the determination described in subparagraph 7,a7 applies2 and 7ii7 may include any information that the educational institution believes the ,department should have taken into account when making the determination1 including with respect to any mitigating circumstances4 7f7 ,annual reports ,not later than one year after the date of the enactment of this section1 and annually thereafter until the termination date specified in subsection 7i71 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,senate and ,house of ,representatives a report on the operation of program under this section during the year covered by the report4 ,each such report shall include each of the following3 7#a7 ,the number of covered individuals enrolled in the program1 disaggregated by type of educational institution1 during the year covered by the report4 7#b7 ,the number of covered individuals who completed a high technology program of education under the program during the year covered by the report4 7#c7 ,the average employment rate of covered individuals who completed such a program of education during such year1 as of #ahj days after the date of completion4 7#d7 ,the average length of time between the completion of such a program of education and employment4 7#e7 ,the total number of covered individuals who completed a program of education under the program and who1 as of the date of the submission of the report1 are employed in a position related to technology4 7#f7 ,the average salary of a covered individual who completed a program of education under the program and who is employed in a position related to technology1 in various geographic areas determined by the ,secretary4 7#g7 ,the average salary of all individuals employed in positions related to technology in the geographic areas determined under subparagraph 7,f71 and the difference1 if any1 between such average salary and the average salary of a covered individual who completed a program of education under the program and who is employed in a position related to technology4 7#h7 ,the number of covered individuals who completed a program of education under the program and who subsequently enrolled in a second program of education under the program4 7g7 ,collection of information2 consultation 7#a7 ,the ,secretary shall develop practices to use to collect information about covered individuals and providers of high technology programs of education4 7#b7 ,for the purpose of carrying out program under this section1 the ,secretary may consult with providers of high technology programs of education and may establish an advisory group made up of representatives of such providers1 private employers in the technology field1 and other relevant groups or entities1 as the ,secretary determines necessary4 7h7 ,definitions ,in this section3 7#a7 ,the term covered individual means any of the following3 7,a7 ,a veteran whom the ,secretary determines-- 7i7 served an aggregate of at least #cf months on active duty in the ,armed ,forces 7including service on active duty in entry level and skill training7 and was discharged or released therefrom under conditions other than dishonorable2 and 7ii7 has not attained the age of #fb4 7,b7 ,a member of the ,armed ,forces that the ,secretary determines will become a veteran described in subparagraph 7,a7 fewer than #ahj days after the date of such determination4 7#b7 ,the term high technology program of education means a program of education-- 7,a7 offered by a public or private educational institution2 7,b7 if offered by an institution of higher learning1 that is provided directly by such institution rather than by an entity other than such institution under a contract or other agreement2 7,c7 that does not lead to a degree2 7,d7 that has a term of not less than six and not more than #bh weeks2 and 7,e7 that provides instruction in computer programming1 computer software1 media application1 data processing1 or information sciences4 7i7 ,termination ,the ,secretary may not provide educational assistance under this section for a high technology program of education that begins after ,september #cj1 #bjbg4 4 7#b7 ,clerical amendment ,the table of sections at the beginning of such chapter is amended by inserting after the item relating to section #cfii;,b the following new item3 #cfii;,c4 ,high technology program4 4 7b7 ,effect on high technology pilot program ,section #aaf of the ,harry ,w4 ,colmery ,veterans ,educational ,assistance ,act of #bjag 7,public ,law #aae-dh2 #ch ,u4,s4,c4 #cjja note7 is amended-- 7#a7 by amending subsection 7d7 to read as follows3 7d7 ,housing stipend 7#a7 ,in general ,except as provided under paragraph 7#b71 the ,secretary shall pay to each eligible veteran 7not including an individual described in the second sentence of subsection 7b77 who is enrolled in a high technology program of education under the pilot program on a full-time or part-time basis a monthly housing stipend equal to the product-- 7,a7 of-- 7i7 in the case of a veteran pursuing resident training1 the monthly amount of the basic allowance for housing payable under section #djc of title #cg1 ,united ,states ,code1 for a member with dependents in pay grade ,e-#e residing in the military housing area that encompasses all or the majority portion of the ,,zip code area in which is located the campus of the institution where the individual physically participates in a majority of classes2 or 7ii7 in the case of a veteran pursuing a program of education through distance learning1 a monthly amount equal to #ej percent of the national average of the monthly amount of the basic allowance for housing payable under section #djc of title #cg1 ,united ,states ,code1 for a member with dependents in pay grade ,e-#e1 multiplied by 7,b7 the lesser of-- 7i7 #a4j2 or 7ii7 the number of course hours borne by the individual in pursuit of the program of education involved1 divided by the minimum number of course hours required for full-time pursuit of such program of education1 rounded to the nearest multiple of #aj4 7#b7 ,bar to dual eligibility ,no covered individual may receive a housing stipend under this subsection for any month if such individual is in receipt of a housing stipend under chapter #cc of title #ch1 ,united ,states ,code1 for that month4 2 7#b7 in subsection 7g71 by striking paragraph 7#f72 and 7#c7 by striking subsection 7h7 and inserting the following new subsection 7h73 7h7 ,termination ,the ,secretary may not1 under this section1 pay a provider for a high technology program of education that begins after ,september #cj1 #bjbd4 4 7c7 ,approval of certain high technology programs ,section #cfhj;,a of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in subsection 7a71 by striking paragraph 7#d7 and inserting the following3 7#d7 ,any independent study program except-- 7,a7 an independent study program 7including such a program taken over open circuit television7 that-- 7i7 is accredited by an accrediting agency or association recognized by the ,secretary of ,education under subpart #b of part ,h of title ,,iv of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajii;b72 7ii7 leads to-- 7,i7 a standard college degree2 7,,ii7 a certificate that reflects educational attainment offered by an institution of higher learning2 or 7,,iii7 a certificate that reflects graduation from a course of study offered by-- 7aa7 an area career and technical education school 7as defined in subparagraphs 7,c7 and 7,d7 of section #c7c7 of the ,carl ,d4 ,perkins ,career and ,technical ,education ,act of #bjjf 7#bj ,u4,s4,c4 #bcjb7c777 that provides education at the postsecondary level2 or 7bb7 a postsecondary vocational institution 7as defined in section #ajb7;c7 of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajjb7;c777 that provides education at the postsecondary level2 and 7iii7 in the case of a program described in clause 7ii77,,iii7-- 7,i7 provides training aligned with the requirements of employers in the ,state or local area where the program is located1 which may include in-demand industry sectors or occupations2 7,,ii7 provides a student1 upon graduation from the program1 with a recognized postsecondary credential that is recognized by employers in the relevant industry1 which may include a credential recognized by industry or sector partnerships in the ,state or local area where the industry is located2 and 7,,iii7 meets such content and instructional standards as may be required to comply with the criteria under section #cfgf7;c77#ad7 and 7#ae7 of this title2 or 7,b7 an online high technology program of education 7as defined in subsection 7h77#b7 of section #cfii;,c of this title7-- 7i7 the provider of which has entered into a contract with the ,secretary under subsection 7c7 of such section2 7ii7 that has been provided to covered individuals 7as defined in subsection 7h77#a7 of such section7 under such contract for a period of at least five years2 7iii7 regarding which the ,secretary has determined that the average employment rate of covered individuals who graduated from such program of education is #fe percent or higher for the year preceding such determination2 and 7iv7 that satisfies the requirements of subsection 7e7 of such section4 2 and 7#b7 in subsection 7d71 by adding at the end the following3 7#h7 ,paragraph 7#a7 shall not apply to the enrollment of a veteran in an online high technology program described in subsection 7a77#d77;,b74 4 #bac4 ,notice of changes to ,department of ,veterans ,affairs policies and guidance affecting the educational assistance programs of the ,department 7a7 ,in general ,subchapter ,,iii of chapter #cf of title #ch1 ,united ,states ,code1 as amended by sections #baj and #bab1 is further amended by adding at the end the following new section3 #cfii;,d4 ,notice of changes to policies and guidance relating to educational assistance programs ,in the case of any change to any policy or guidance provided by the ,secretary that relates to any educational assistance program of the ,department1 the ,secretary may not implement the change before the date that is #ij days after the date on which the ,secretary makes available to students1 educational institutions1 and the ,committees on ,veterans' ,affairs of the ,senate and ,house of ,representatives notice of1 and justification for1 the change4 4 7b7 ,clerical amendment ,the table of sections at the beginning of such chapter is amended by inserting after the item relating to section #cfii;,b the following new item3 #cfii;,d4 ,notice of changes to policies and guidance relating to educational assistance programs4 4 #bad4 ,payment of ,,va educational assistance via electronic fund transfer to a foreign institution of higher education ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall update the payment system of the ,department of ,veterans ,affairs to allow for electronic fund transfer of educational assistance1 administered by the ,secretary1 to a foreign institution of higher education that-- 7#a7 provides an approved course of education to an eligible recipient of such assistance2 and 7#b7 does not have-- 7,a7 an employer identification number2 or 7,b7 an account with a domestic bank4 #bae4 ,improving transparency and accountability of educational institutions for purposes of veterans educational assistance 7a7 ,requirement relating to ,g4,i4 ,bill comparison tool 7#a7 ,requirement to maintain tool ,the ,secretary of ,veterans ,affairs shall maintain the ,g4,i4 ,bill ,comparison ,tool that was established pursuant to ,executive ,order #acfjg 7#gg ,fed4 ,reg4 #behfa2 relating to establishing principles of excellence for educational institutions serving service members1 veterans1 spouses1 and other family members7 and in effect on the day before the date of enactment of this ,act1 or a successor tool1 to provide relevant and timely information about programs of education approved under chapter #cf of title #ch1 ,united ,states ,code1 and the educational institutions that offer such programs4 7#b7 ,data retention ,the ,secretary shall ensure that historical data that is reported via the tool maintained under paragraph 7#a7 remains easily and prominently accessible on the benefits4va4gov website1 or a successor website1 for a period of not less than six years from the date of initial publication4 7b7 ,providing timely and relevant education information to veterans1 members of the ,armed ,forces1 and other individuals 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 ,secretary of ,education1 the ,secretary of the ,treasury1 and the heads of other relevant ,federal agencies1 shall make such changes to the tool maintained under subsection 7a7 as the ,secretary of ,veterans ,affairs determines appropriate to ensure that such tool is an effective and efficient method for providing information pursuant to section #cfih7;b77#e7 of title #ch1 ,united ,states ,code4 7#b7 ,memorandum of understanding required ,not later than two years after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall seek to enter into a memorandum of understanding with the ,secretary of ,education and the heads other relevant ,federal agencies1 as the ,secretary of ,veterans ,affairs determines appropriate1 to obtain information on outcomes with respect to individuals who are entitled to educational assistance under the laws administered by the ,secretary of ,veterans ,affairs and who are attending educational institutions4 ,such memorandum of understanding may include data sharing or computer matching agreements4 7#c7 ,modification of scope of comprehensive policy on providing education information ,section #cfih of title #ch1 ,united ,states ,code1 is amended-- 7,a7 in subsection 7a71 by striking veterans and members of the ,armed ,forces and inserting individuals entitled to educational assistance under laws administered by the ,secretary of ,veterans ,affairs2 and 7,b7 in subsection 7b77#e7-- 7i7 by striking veterans and members of the ,armed ,forces and inserting individuals described in subsection 7a72 and 7ii7 by striking the veteran or member and inserting the individual4 7#d7 ,g4,i4 ,bill comparison tool required disclosures ,paragraph 7#a7 of subsection 7c7 of such section is amended-- 7,a7 by striking subparagraph 7,b7 and inserting the following3 7,b7 for each individual described in subsection 7a7 seeking information provided under subsection 7b77#e71 the name of each ,federal student aid program1 and a description of each such program1 from which the individual may receive educational assistance2 and 2 7,b7 in subparagraph 7,c7-- 7i7 in clause 7i71 by inserting and a definition of each type of institution before the semicolon2 7ii7 in clause 7iv71 by inserting and if so1 which programs before the semicolon2 7iii7 by striking clause 7v7 and inserting the following3 7v7 the average annual cost and the total cost to earn an associate's degree and a bachelor's degree1 with available cost information on any other degree or credential the institution awards2 2 7iv7 in clause 7vi71 by inserting before the semicolon the following3 disaggregated by-- 7,i7 the type of beneficiary of educational assistance2 7,,ii7 individuals who received a credential and individuals who did not2 and 7,,iii7 individuals using educational assistance under laws administered by the ,secretary and individuals who are not2 2 7v7 in clause 7xiv71 by striking and at the end2 7vi7 in clause 7xv71 by striking the period at the end and inserting a semicolon2 and 7vii7 by adding at the end the following new clauses3 7xvi7 the number of veterans or members who completed covered education at the institution leading to-- 7,i7 a degree1 disaggregated by type of program1 including-- 7aa7 an associate degree2 7bb7 a bachelor's degree2 and 7cc7 a postbaccalaureate degree2 and 7,,ii7 a certificate or professional license1 disaggregated by type of certificate or professional license2 7xvii7 programs available and the average time for completion of each program2 7xviii7 employment rate and median income of graduates of the institution in general two and five years after graduation1 disaggregated by-- 7,i7 specific program2 and 7,,ii7 individuals using educational assistance under laws administered by the ,secretary and individuals who are not2 and 7xix7 the number of individuals using educational assistance under laws administered by the ,secretary who are enrolled in the both the institution and specific program per year4 4 7#e7 ,clarity and anonymity of information provided ,paragraph 7#b7 of such subsection is amended-- 7,a7 by inserting 7,a7 before ,to the extent2 and 7,b7 by adding at the end the following new subparagraph3 7,b7 ,the ,secretary shall ensure that information provided pursuant to subsection 7b77#e7 is provided in a manner that is easy for1 and accessible to1 individuals described in subsection 7a74 7,c7 ,in providing information pursuant to subsection 7b77#e71 the ,secretary shall maintain the anonymity of individuals described in subsection 7a7 and1 to the extent that a portion of any data would undermine such anonymity1 ensure that such data is not made available pursuant to such subsection4 4 7c7 ,improvements for student feedback 7#a7 ,in general ,subsection 7b77#b7 of such section is amended-- 7,a7 by amending subparagraph 7,a7 to read as follows3 7,a7 provides institutions of higher learning-- 7i7 up to #cj days to review and respond to feedback from individuals described in subsection 7a7 and address issues regarding the feedback before the feedback is published2 and 7ii7 if an institution of higher learning contests the accuracy of the feedback1 the opportunity to challenge the inclusion of such data with an official appointed by the ,secretary2 2 7,b7 in subparagraph 7,b71 by striking and at the end2 7,c7 in subparagraph 7,c71 by striking that conforms with criteria for relevancy that the ,secretary shall determine4 and inserting 1 and responses from institutions of higher learning to such feedback1 that conform with criteria for relevancy that the ,secretary shall determine22 and 7,d7 by adding at the end the following new subparagraphs3 7,d7 for each institution of higher learning that is approved under this chapter1 retains1 maintains1 and publishes all of such feedback for not less than six years2 and 7,e7 is easily accessible to individuals described in subsection 7a7 and to the general public4 4 7#b7 ,accessibility from ,g4,i4 ,bill comparison tool ,the ,secretary shall ensure that-- 7,a7 the feedback tracked and published under subsection 7b77#b7 of such section1 as amended by paragraph 7#a71 is prominently displayed in the tool maintained under subsection 7a7 of this section2 and 7,b7 when such tool displays information for an institution of higher learning1 the applicable feedback is also displayed for such institution of higher learning4 7d7 ,training for provision of education counseling services 7#a7 ,in general ,not less than one year after the date of the enactment of this ,act1 the ,secretary shall ensure that personnel employed by the ,department of ,veteran ,affairs1 or a contractor of the ,department1 to provide education benefits counseling1 vocational or transition assistance1 or similar functions1 including employees or contractors of the ,department who provide such counseling or assistance as part of the ,transition ,assistance ,program1 are trained on how-- 7,a7 to use properly the tool maintained under subsection 7a72 and 7,b7 to provide appropriate educational counseling services to individuals described in section #cfih7;a7 of such title1 as amended by subsection 7b77#c77;,a74 7#b7 ,transition assistance program defined ,in this subsection1 the term ,transition ,assistance ,program means the program of counseling1 information1 and services under section #aadb of title #aj1 ,united ,states ,code4 ,b ,employment and ,training #bba4 ,improvements to reemployment rights of members of the ,armed ,forces 7a7 ,,userra purposes ,section #dcja7;a77#a7 of title #ch1 ,united ,states ,code1 is amended by striking encourage noncareer service in the uniformed services and inserting encourage service in the uniformed services4 7b7 ,prohibition of retaliation ,subsection 7b7 of section #dcaa of title #ch1 ,united ,states ,code1 is amended by inserting or other retaliatory action after employment action4 7c7 ,expansion of injunctive relief ,subsection 7e7 of section #dcbc of such title is amended-- 7#a7 by striking ,the court shall use and inserting 7#a7 ,the court shall use2 and 7#b7 by adding at the end the following new paragraphs3 7#b7 ,a person bringing an action to enforce a provision of this chapter pursuant to subsection 7a7 shall be entitled to an injunction under paragraph 7#a7 if such person demonstrates-- 7,a7 a violation-- 7i7 of the provisions of this chapter2 or 7ii7 of the provisions of this chapter is threatened or is imminent2 7,b7 the harm to the person outweighs the injury to the employer2 7,c7 a likelihood of success on the merits of such action2 and 7,d7 awarding such relief is in the public interest4 7#c7 ,the court may not deny a motion for injunctive relief on the basis that a party bringing an action to enforce a provision of this chapter may be awarded wages unearned due to an unlawful termination or denial of employment at the conclusion of such action4 4 7d7 ,damages against a ,state or private employer ,section #dcbc of such title is further amended1 in paragraph 7#a7 of subsection 7d71 by striking subparagraph 7,c7 and inserting the following new subparagraphs3 7,c7 ,the court may require the employer to pay the person the amount referred to in subparagraph 7,b7 and interest on such amount1 calculated at a rate of #c percent per year4 7,d7 ,the court may require the employer to pay the person the greater of #ej1jjj or the amount equal to the amounts referred to in subparagraphs 7,b7 and 7,c7 as liquidated damages1 if the court determines that the employer knowingly failed to comply with the provisions of this chapter4 4 7e7 ,mandatory attorney fees award in successful actions for reemployment 7#a7 ,,mspb actions ,paragraph 7#d7 of subsection 7c7 of section #dcbd of such title is amended-- 7,a7 by striking may1 in its discretion1 and inserting shall2 and 7,b7 by adding at the end the following new sentence3 ,the ,board may1 in its discretion1 award reasonable attorney fees in a case settled before the issuance of an order if the person can demonstrate that significant attorney fees were incurred and that justice requires such an award44 7#b7 ,federal ,circuit actions ,subsection 7d7 of such section is amended by adding at the end the following new paragraph3 7#c7 ,in such ,federal ,circuit proceeding1 the court shall award such person reasonable attorney fees1 expert witness fees1 and other litigation expenses if such person-- 7,a7 prevails in such ,federal ,circuit proceeding2 and 7,b7 is not represented by the ,special ,counsel in such ,federal ,circuit proceeding4 4 7#c7 ,actions against a ,state or private employer ,paragraph 7#b7 of section #dcbc7;h7 of such title is amended-- 7,a7 by striking subsection 7a77#b7 and inserting subsection 7a77#c72 and 7,b7 by striking the court may award any such person who prevails in such action or proceeding reasonable attorney fees and inserting the court shall award any such person who prevails in such action or proceeding reasonable attorney fees4 7f7 ,,gao review and report on ,,userra 7#a7 ,review ,the ,comptroller ,general of the ,united ,states shall review the methods through which the ,secretary of ,labor1 acting through the ,veterans' ,employment and ,training ,service1 processes actions for relief under chapter #dc of title #ch1 ,united ,states ,code4 7#b7 ,elements ,not later than one year after the date of the enactment of this ,act1 the ,comptroller ,general shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a report that includes-- 7,a7 the findings of the review required under paragraph 7#a72 7,b7 an identification of the number of actions for relief under chapter #dc of title #ch1 ,united ,states ,code1 initiated during the period covered by the report1 disaggregated by size of employer and geographic region2 7,c7 an identification of the number of such actions for relief that were erroneously dismissed1 as determined by the ,comptroller ,general2 7,d7 an identification of the number of such actions for relief that were referred to the ,department of ,justice2 and 7,e7 an assessment of trends1 if any1 in such actions for relief initiated during such period4 7g7 ,,gao review of protections for members of the uniformed services by ,federal intelligence agencies 7#a7 ,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 appropriate congressional committees a report on the processes and procedures adopted and used by the intelligence community to provide the protections for members of the uniformed services otherwise established under chapter #dc of title #ch1 ,united ,states ,code4 7#b7 ,definitions ,in this subsection3 7,a7 ,the term appropriate congressional committees means the ,committees on ,veterans' ,affairs of the ,house of ,representatives and ,senate1 the ,permanent ,select ,committee on ,intelligence of the ,house of ,representatives1 and the ,select ,committee on ,intelligence of the ,senate4 7,b7 ,the term intelligence community has the meaning given such term in section #c7d7 of the ,national ,security ,act of #aidg 7#ej ,u4,s4,c4 #cjjc7d774 #bbb4 ,review of investigations manual of ,veterans' ,employment and ,training ,service 7a7 ,in general ,not later than one year after the date of the enactment of this ,act1 and once every two years thereafter for the period of five years beginning on such date1 the ,secretary of ,labor1 shall review the manual of the ,department of ,labor titled ,veterans' ,employment and ,training ,service ,investigations ,manual3 ,,userra1 ,,veoa1 and ,,vp 7or a successor manual7 and make such revisions to such manual as the ,secretary determines appropriate4 7b7 ,report ,not later than #ij days after any date on which the ,secretary completes a review required under subsection 7a71 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate-- 7#a7 a report that includes a description of any revision to such manual made pursuant to such review2 and 7#b7 a copy of the entire such manual which-- 7,a7 shall be provided to the ,chairman and ,ranking ,member of each such committee2 and 7,b7 may contain a separate addendum for portions of the manual that contain law enforcement sensitive materials4 #bbc4 ,warrior ,training ,advancement ,course 7a7 ,reports required 7#a7 ,initial report ,not later than six months after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall submit to the ,committees on ,veterans' ,affairs of the ,senate and ,house of ,representatives a report on ,,wartac4 7#b7 ,annual report ,one year after the submission of the report required under paragraph 7#a7 and annually thereafter1 the ,secretary shall submit to such ,committees a report that contains the elements under paragraphs 7#a7 and 7#c7 of subsection 7b7 with regards to the preceding year4 7#c7 ,elements ,except as provided in subsection 7a77#b71 the reports under this subsection shall include the following elements3 7,a7 ,best practices ,with regards to best practices of ,,wartac-- 7i7 how many covered members have applied to participate in ,,wartac2 7ii7 how many covered members have participated in ,,wartac2 7iii7 how the ,secretary provides training to covered members during ,,tap2 7iv7 how many covered members have completed ,,wartac2 and 7v7 any other information the ,secretary determines appropriate4 7,b7 ,cost savings ,with regards to cost savings of ,,wartac-- 7i7 how much money the ,secretary determines ,,wartac saves the ,united ,states each fiscal year2 7ii7 how much money the ,secretary determines ,,wartac has saved the ,united ,states since its establishment2 and 7iii7 the determination of the ,secretary whether other ,federal agencies may save money by establishing a program similar to ,,wartac4 7,c7 ,hiring ,with regards to hiring covered members who complete ,,wartac-- 7i7 how the ,secretary identifies positions in the ,department of ,veterans ,affairs for which such covered members may qualify2 7ii7 the grades of such positions on the ,general ,schedule under section #eccb of title #e1 ,united ,states ,code2 and 7iii7 how many such covered members the ,secretary has hired to such positions4 7#d7 ,distribution ,not later than #cj days after submitting the report under paragraph 7#a71 the ,secretary of ,veterans ,affairs shall transmit a copy of such report to the head of each ,federal agency4 7#e7 ,definitions ,in this subsection3 7,a7 ,the term covered member means members of the ,armed ,forces participating in ,,tap4 7,b7 ,the term ,,tap means the ,transition ,assistance ,program under sections #aadb and #aadd of title #aj1 ,united ,states ,code4 7,c7 ,the term ,,wartac means the ,warrior ,training ,advancement ,course of the ,veterans ,benefit ,administration1 in which the ,secretary provides training to covered members so such covered members may qualify for certain employment in the ,veterans ,benefit ,administration4 7b7 ,best practices for other departments ,the ,assistant ,secretary of ,labor for ,veterans' ,employment and ,training shall1 in consultation with the ,secretary of ,veterans ,affairs1 establish guidelines containing best practices for departments and agencies of the ,federal ,government that carry out programs to employ veterans who are transitioning from service in the ,armed ,forces4 ,such guidelines shall include the findings of the initial report required under subsection 7a77#a74 7c7 ,pilot program 7#a7 ,establishment ,the ,secretary of the ,interior shall1 in consultation with the ,secretary of ,labor and the ,secretary of ,veterans ,affairs1 establish a pilot program to proactively inform veterans of available employment positions that relate to the conservation and resource management activities of the ,department of the ,interior4 7#b7 ,positions ,the ,secretary of the ,interior shall-- 7,a7 identify vacant positions in the ,department of the ,interior that are appropriate to fill using the pilot program2 and 7,b7 to the maximum extent practicable1 provide assistance to veterans in selecting one or more vacant positions to apply to1 for which that veteran may be best qualified4 7#c7 ,reports 7,a7 ,implementation report ,not later than one year after the date on which the pilot program under paragraph 7#a7 commences1 the ,secretary of the ,interior1 the ,secretary of ,veterans ,affairs1 and the ,secretary of ,labor shall jointly provide to the appropriate congressional committees a report on the implementation of the pilot program4 7,b7 ,final report ,not later than #cj days after the date on which the pilot program under paragraph 7#a7 terminates under paragraph 7#d71 the ,secretary of the ,interior1 the ,secretary of ,veterans ,affairs1 and the ,secretary of ,labor shall jointly submit to the appropriate congressional committees a report on the pilot program that includes the following3 7i7 ,the number of veterans who applied to participate in the pilot program4 7ii7 ,the number of such veterans employed under the pilot program4 7iii7 ,the number of veterans identified in clause 7ii7 who transitioned to full-time positions with the ,federal ,government after participating in the pilot program4 7iv7 ,any other information the ,secretary of the ,interior1 the ,secretary of ,veterans ,affairs1 and the ,secretary of ,labor determine appropriate with respect to measuring the effectiveness of the pilot program4 7#d7 ,termination ,the authority to carry out the pilot program under this subsection shall terminate on the date that is two years after the date on which the pilot program commences4 7#e7 ,appropriate congressional committees defined ,in this subsection1 the term appropriate congressional committees means-- 7,a7 the ,committee on ,veterans' ,affairs and the ,committee on ,energy and ,natural ,resources of the ,senate2 and 7,b7 the ,committee on ,veterans' ,affairs and the ,committee on ,natural ,resources of the ,house of ,representatives4 7d7 ,outdoor recreation program attendance ,the ,secretary of the ,interior and the ,secretary of ,agriculture are encouraged to work with the ,secretary of ,defense and the ,secretary of ,veterans ,affairs to ensure members of the ,armed ,forces and veterans have access to outdoor recreation and outdoor-related volunteer and wellness programs as part of the basic services provided to such members and veterans4 ,c ,home ,loans #bca4 ,improvements to program for direct housing loans made to ,native ,american veterans by the ,secretary of ,veterans ,affairs 7a7 ,general authorities and requirements 7#a7 ,direct housing loans to ,native ,american veterans ,section #cgfb7;a7 of title #ch1 ,united ,states ,code1 is amended to read as follows3 7a7 ,the ,secretary may make a direct housing loan to a ,native ,american veteran under this subchapter if the ,secretary ensures the following3 7#a7 ,that each ,native ,american veteran to whom the ,secretary makes a direct housing loan under this subchapter-- 7,a7 holds1 possesses1 or purchases using the proceeds of the loan a meaningful interest in a lot or dwelling 7or both7 that is located on trust land2 and 7,b7 will purchase1 construct1 or improve 7as the case may be7 a dwelling on the lot using the proceeds of the loan4 7#b7 ,that each such ,native ,american veteran will convey to the ,secretary by an appropriate instrument the interest referred to in paragraph 7#a77;,a7 as security for a direct housing loan under this subchapter4 7#c7 ,that the ,secretary1 including the ,secretary's employees or agents1 may enter upon the trust land for the purposes of carrying out such actions as the ,secretary determines are necessary1 including-- 7,a7 to evaluate the advisability of the loan2 7,b7 to monitor any purchase1 construction1 or improvements carried out using the proceeds of the loan2 and 7,c7 to manage any servicing or post-foreclosure activities1 including acquisition1 property inspections1 and property management4 7#d7 ,that there are established standards and procedures that apply to the foreclosure of the interest conveyed by a ,native ,american veteran pursuant to paragraph 7#b71 including-- 7,a7 procedures for foreclosing the interest2 and 7,b7 procedures for the resale of the lot or dwelling 7or both7 purchased1 constructed1 or improved using the proceeds of the loan4 7#e7 ,that the loan is made in a responsible and prudent manner1 subject to standards and procedures as are necessary for the reasonable protection of the financial interests of the ,united ,states4 4 7#b7 ,memorandums of understanding1 agreements1 and determinations ,section #cgfb7;b7 of such title is amended to read as follows3 7b7 7#a7 ,to carry out the purpose of subsection 7a71 the ,secretary may-- 7,a7 enter into a memorandum of understanding with a tribal organization1 other entity1 or individual2 7,b7 rely on agreements or determinations of other ,federal agencies to guarantee1 insure1 or make loans on trust land2 and 7,c7 enter into other agreements or take such other actions as the ,secretary determines necessary4 7#b7 ,if the ,secretary determines that the requirements under subsection 7a7 are not being enforced by a tribal organization1 other entity1 or individual that is a party to any memorandum of understanding1 agreement1 or determination described in paragraph 7#a71 the ,secretary may cease making new direct housing loans to ,native ,american veterans under this subchapter within the area of the authority of the tribal organization1 other entity1 or individual 7as the case may be74 4 7b7 ,direct loans to ,native ,american veterans ,to refinance existing mortgage loans ,section #cgfb7;h7 of such title is amended to read as follows3 7h7 ,the ,secretary may make direct loans to ,native ,american veterans in order to enable such veterans to refinance existing mortgage loans for any of the following purposes3 7#a7 ,to refinance an existing loan made under this section1 if the loan-- 7,a7 meets the requirements set forth in subparagraphs 7,b71 7,c71 and 7,e7 of paragraph 7#a7 of section #cgaj7;e7 of this title2 7,b7 will bear an interest rate at least one percentage point less than the interest rate borne by the loan being refinanced2 and 7,c7 complies with paragraphs 7#b7 and 7#c7 of section #cgaj7;e7 of this title1 except that for the purposes of this subsection the reference to subsection 7a77#h7 of section #cgaj of this title in such paragraphs 7#b7 and 7#c7 shall be deemed to be a reference to this subsection4 7#b7 ,to refinance an existing mortgage loan not made under this section on a dwelling owned and occupied by the veteran as the veteran's home1 if all of the following requirements are met3 7,a7 ,the loan will be secured by the same dwelling as was the loan being refinanced4 7,b7 ,the loan will provide the veteran with a net tangible benefit4 7,c7 ,the nature and condition of the property is such as to be suitable for dwelling purposes4 7,d7 ,the amount of the loan does not exceed either of the following3 7i7 #ajj percent of the reasonable value of the dwelling1 with such reasonable value determined under the procedures established by the ,secretary under subsection 7d77#b74 7ii7 ,an amount equal to the sum of the balance of the loan being refinanced and such closing costs 7including any discount points7 as may be authorized by the ,secretary to be included in the loan4 7,e7 ,notwithstanding subparagraph 7,d71 if a loan is made for both the purpose of this paragraph and to make energy efficiency improvements1 the loan must not exceed either of the following3 7i7 #ajj percent of the reasonable value of the dwelling as improved for energy efficiency1 with such reasonable value determined under the procedures established by the ,secretary under subsection 7d77#b74 7ii7 ,the amount referred to under subparagraph 7,d77ii71 plus the applicable amount specified under section #cgaj7;d77#b7 of this title4 7,f7 ,the loan meets all other requirements the ,secretary may establish under this subchapter4 7,g7 ,the existing mortgage being refinanced is a first lien on the property and secured of record4 7#c7 ,to refinance an existing mortgage loan to repair1 alter1 or improve a dwelling owned by the veteran and occupied by the veteran as the veteran's home1 if all of the following requirements are met3 7,a7 ,the loan will be secured by the same dwelling as was the loan being refinanced4 7,b7 ,the nature and condition of the property is such as to be suitable for dwelling purposes1 and the repair1 alteration1 or improvement substantially protects or improves the basic livability or utility of such property4 7,c7 ,the amount of the loan1 including the costs of repairs1 alterations1 and improvements1 does not exceed either of the following3 7i7 #ajj percent of the reasonable value of the dwelling as repaired1 altered1 or improved1 with such reasonable value determined under the procedures established by the ,secretary under subsection 7d77#b74 7ii7 ,an amount equal to the sum of-- 7,i7 the balance of the loan being refinanced2 7,,ii7 the actual cost of repairs1 alterations1 or improvements2 and 7,,iii7 such closing costs 7including any discount points7 as may be authorized by the ,secretary to be included in the loan4 7,d7 ,the loan meets all other requirements the ,secretary may establish under this subchapter4 7,e7 ,the existing mortgage loan being refinanced is a first lien on the property and secured of record4 4 7c7 ,expansion of outreach program on availability of direct housing loans for ,native ,american veterans ,section #cgfb7;i77#b7 of such title is amended by adding at the end the following new subparagraph3 7,g7 ,pursuant to subsection 7g77#d71 assisting ,native ,american veterans in qualifying for mortgage financing by-- 7i7 partnering with local service providers1 such as tribal organizations1 tribally designated housing entities1 ,native community development financial institutions1 and nonprofit organizations1 for conducting outreach1 homebuyer education1 housing counseling1 and post-purchase education2 and 7ii7 providing other technical assistance as needed4 7,h7 ,attending conferences and conventions conducted by the network of ,native community development financial institutions and other ,native ,american homeownership organizations to provide information and training to ,native community development financial institutions about the availability of the relending program under section #cgfb;,a of this title4 4 7d7 ,adequate personnel ,section #cgfb of such title is amended by adding at the end the following new subsection3 7k7 ,the ,secretary shall assign a sufficient number of personnel of the ,department dedicated to carrying out the authority of the ,secretary under this subchapter1 including construction and valuation specialists to assist with issues unique to new construction and renovations on trust land4 4 7e7 ,definitions ,section #cgfe of such title is amended-- 7#a7 in paragraph 7#a7-- 7,a7 by amending subparagraph 7,c7 to read as follows3 7,c7 is located in the ,state of ,alaska within a region established under section #g7;a7 of the ,alaska ,native ,claims ,settlement ,act 7#dc ,u4,s4,c4 #afjf7;a772 2 7,b7 in subparagraph 7,d71 by striking the period at the end and inserting a semicolon2 and 7,c7 by adding at the end the following new subparagraphs3 7,e7 is defined by the ,secretary of the ,interior and recognized by the ,united ,states as land over which an ,indian ,tribe has governmental dominion2 or 7,f7 is on any land that the ,secretary determines is provided to ,native ,american veterans because of their status as ,native ,americans4 2 and 7#b7 by adding at the end the following new paragraphs3 7#f7 ,the term community development financial institution has the meaning given that term in section #ajc of the ,community ,development ,banking and ,financial ,institutions ,act of #aiid 7#ab ,u4,s4,c4 #dgjb74 7#g7 ,the term ,indian ,tribe means any ,indian tribe1 band1 nation1 or other organized group or community1 including any ,alaska ,native village or regional or village corporation as defined in or established pursuant to the ,alaska ,native ,claims ,settlement ,act 7#dc ,u4,s4,c4 #afja et seq471 which is recognized as eligible for the special programs and services provided by the ,united ,states to ,indians because of their status as ,indians4 7#h7 ,the term ,native community development financial institution means any entity-- 7,a7 that has been certified as a community development financial institution by the ,secretary of the ,treasury2 7,b7 that is not less than #ea percent owned or controlled by ,native ,americans2 and 7,c7 for which not less than #ea percent of the activities of the entity serve ,native ,americans4 7#i7 ,the term net tangible benefit shall have such meaning as the ,secretary determines appropriate1 but shall include the refinance of an interim construction loan4 7#aj7 ,the term other technical assistance means services to assist a ,native ,american veteran to navigate the steps necessary for securing a mortgage loan on trust land1 including pre-development activities related to utilities1 identifying appropriate residential construction services1 and obtaining lease clearances and title status reports from the applicable tribal organization or the ,bureau of ,indian ,affairs4 7#aa7 ,the term tribally designated housing entity has the meaning given that term in section #d of the ,native ,american ,housing ,assistance and ,self-,determination ,act of #aiif 7#be ,u4,s4,c4 #dajc74 4 7f7 ,interest rate reduction financing loan ,section #cgbi7;b77#d77;,f7 of such title is amended by striking #cgfb7;h7 and inserting #cgfb7;h77#a74 7g7 ,regulations ,section #cgfa of such title is amended by adding at the end the following new subsection3 7c7 ,the ,secretary shall prescribe such regulations as may be necessary to carry out this subchapter4 4 #bcb4 ,native community development financial institution relending program 7a7 ,in general ,subchapter ,v of chapter #cg of title #ch1 ,united ,states ,code1 is amended by inserting after section #cgfb the following new section3 #cgfb;,a4 ,native community development financial institution relending program 7a7 ,purpose ,the ,secretary may make a loan to a ,native community development financial institution for the purpose of allowing the institution to relend loan amounts to qualified ,native ,american veterans1 subject to the requirements of this section4 7b7 ,standards 7#a7 ,the ,secretary shall establish standards to be used in evaluating whether to make a loan to a ,native community development financial institution under this section4 7#b7 ,in establishing standards under paragraph 7#a71 the ,secretary shall ensure that a ,native community development financial institution-- 7,a7 is able to originate and service loans for single-family homes2 7,b7 is able to operate the relending program in a manner consistent with the mission of the ,department to serve veterans2 and 7,c7 uses loan amounts received under this section only for the purpose of relending1 as described in subsection 7c71 to ,native ,american veterans4 7c7 ,relending requirements 7#a7 ,a ,native community development financial institution that receives a loan under this section shall use the loan amounts to make loans to ,native ,american veterans residing on trust land4 7#b7 ,a loan to a ,native ,american veteran made by a ,native community development financial institution under paragraph 7#a7 shall-- 7,a7 be limited either to the purpose of purchase1 construction1 or improvement of a dwelling located on trust land or to the refinance of an existing mortgage loan for a dwelling on trust land1 consistent with the requirements of section #cgfb7;h7 of this title2 and 7,b7 comply with such terms and conditions as the ,secretary determines are necessary to protect against predatory lending1 including the interest rate charged on a loan to a ,native ,american veteran4 7d7 ,repayment ,a loan made to a ,native community development financial institution under this section shall-- 7#a7 be payable to the ,secretary upon such terms and conditions as are prescribed in regulations pursuant to this subchapter2 and 7#b7 bear interest at a rate of one percent4 7e7 ,oversight ,subject to notice and opportunity for a hearing1 whenever the ,secretary finds with respect to loans made under subsection 7a7 or 7c7 that any ,native community development financial institution has failed to maintain adequate loan accounting records1 to demonstrate proper ability to service loans adequately1 or to exercise proper credit judgment1 or that such ,native community development financial institution has willfully or negligently engaged in practices otherwise detrimental to the interest of veterans or of the ,government1 the ,secretary may take such actions as the ,secretary determines necessary to protect veterans or the ,government1 such as requiring immediate repayment of any loans made under subsection 7a7 and the assignment to the ,secretary of loans made under subsection 7c74 7f7 ,sunset ,the ,secretary may not make a loan under this section after ,september #cj1 #bjbg4 4 7b7 ,clerical amendment ,the table of sections at the beginning of chapter #cg of such title is amended by inserting after the item relating to section #cgfb the following new item3 #cgfb;,a4 ,native community development financial institution relending program44 7c7 ,native ,american veteran housing loan program account ,section #cgfc of such title is amended by adding at the end the following new subsection3 7c7 ,of amounts available in the ,account1 the ,secretary may use for loans made under section #cgfb;,a of this title-- 7#a7 in fiscal year #bjbe1 not more than #e1jjj1jjj2 and 7#b7 in any fiscal year after fiscal year #bjbe1 an amount determined necessary by the ,secretary to meet the demand for such loans4 4 ,,iii ,disability and ,memorial ,affairs ,matters #cja4 ,burial allowance for certain veterans who die at home while in receipt of hospice care furnished by ,department of ,veterans ,affairs 7a7 ,in general ,the ,secretary of ,veterans ,affairs shall treat a veteran described in subsection 7b7 as a veteran described in subparagraph 7,a7 of section #bcjc7;a77#b7 of title #ch1 ,united ,states ,code4 7b7 ,veteran described ,a veteran described in this subsection is a veteran who dies in a home or other setting at which the deceased veteran was1 at the time of death1 receiving hospice care pursuant to section #agag7;a7 of such title if such care was directly preceded by the ,secretary furnishing to the veteran hospital care or nursing home care described in clause 7ii7 of such subparagraph4 7c7 ,effective date2 applicability ,this section shall apply with respect to deaths that occur-- 7#a7 on or after the date that is #ahj days after the date of the enactment of this ,act2 and 7#b7 before ,october #a1 #bjbf4 #cjb4 ,authority for ,secretary of ,veterans ,affairs to award grants to ,states and ,indian ,tribes to improve outreach to veterans 7a7 ,in general ,chapter #fc of title #ch1 ,united ,states ,code1 is amended-- 7#a7 by redesignating sections #fcjg and #fcjh as sections #fcjh and #fcji1 respectively2 and 7#b7 by inserting after section #fcjf the following new section #fcjg3 #fcjg4 ,grants to ,states and ,indian ,tribes to improve outreach to veterans 7a7 ,purpose ,it is the purpose of this section to provide for assistance by the ,secretary to ,states and ,indian ,tribes to carry out programs that improve covered outreach and assistance to veterans and the spouses1 children1 and parents of veterans1 to ensure that such individuals are fully informed about1 and assisted in applying for1 any veterans and veterans-related benefits and programs 7including veterans programs of a ,state or ,indian ,tribe7 for which they may be eligible and facilitate opportunities for such individuals to receive competent1 qualified services in the preparation1 presentation and prosecution of veterans benefits claims4 7b7 ,authority ,the ,secretary may award grants to ,states and ,indian ,tribes-- 7#a7 to carry out1 coordinate1 improve1 or otherwise enhance-- 7,a7 covered outreach activities2 or 7,b7 activities to assist in the development and submittal of claims for veterans and veterans-related benefits2 or 7#b7 to increase the number of county or ,tribal veterans service officers serving in the ,state by hiring new1 additional such officers4 7c7 ,application 7#a7 ,to be eligible for a grant under this section1 a ,state or ,indian ,tribe shall submit to the ,secretary an application therefor at such time1 in such manner1 and containing such information as the ,secretary may require4 7#b7 ,each application submitted under paragraph 7#a7 shall include the following3 7,a7 ,a detailed plan for the use of the grant4 7,b7 ,a description of the programs through which the ,state or ,indian ,tribe will meet the outcome measures developed by the ,secretary under subsection 7j74 7,c7 ,a description of how the ,state or ,indian ,tribe will distribute grant amounts equitably among counties or ,tribal lands with varying levels of urbanization4 7,d7 ,a plan for how the grant will be used to meet the unique needs of ,american ,indian veterans1 ,alaska ,native veterans1 or ,native ,hawaiian veterans1 elderly veterans1 and veterans from other underserved communities4 7d7 ,distribution ,the ,secretary shall seek to ensure that grants awarded under this section are equitably distributed among ,states and ,indian ,tribes with varying levels of urbanization4 7e7 ,set-aside ,of the amounts authorized to be appropriated or otherwise made available for grants under this section for any fiscal year1 the ,secretary shall ensure that not less than five percent is used to make grants to ,indian ,tribes4 7f7 ,priority ,the ,secretary shall prioritize awarding grants under this section that will serve the following areas3 7#a7 ,areas with a critical shortage of county or ,tribal veterans service officers4 7#b7 ,areas with high rates of-- 7,a7 suicide among veterans2 or 7,b7 referrals to the ,veterans ,crisis ,line4 7g7 ,use of county or ,tribal veterans service officers ,a ,state or ,indian ,tribe that receives a grant under this section to carry out an activity described in subsection 7b77#a7 shall carry out the activity through-- 7#a7 a county or ,tribal veterans service officer of the ,state2 or 7#b7 if the ,state or ,indian ,tribe does not have a county or ,tribal veterans service officer1 or if the county or ,tribal veterans service officers of the ,state or ,indian ,tribe cover only a portion of that ,state or ,indian ,tribe1 an appropriate entity of a ,state1 local1 or ,tribal government1 as determined by the ,secretary4 7h7 ,required activities ,any grant awarded under this section shall be used-- 7#a7 to expand existing programs1 activities1 and services2 7#b7 to hire new1 additional county or ,tribal veterans service officers2 or 7#c7 for travel and transportation to facilitate carrying out paragraph 7#a7 or 7#b74 7i7 ,authorized activities ,a grant under this section may be used to provide education and training1 including on-the-job training1 for ,state1 county1 local1 and ,tribal government employees who provide 7or when trained will provide7 covered outreach services in order for those employees to obtain accreditation in accordance with procedures approved by the ,secretary4 7j7 ,outcome measures 7#a7 ,the ,secretary shall develop and provide to each ,state or ,indian ,tribe that receives a grant under this section written guidance on the following3 7,a7 ,outcome measures4 7,b7 ,policies of the ,department4 7#b7 ,in developing outcome measures under paragraph 7#a71 the ,secretary shall consider the following goals3 7,a7 ,increasing the use of veterans and veterans-related benefits1 particularly among vulnerable populations4 7,b7 ,increasing the number of county and ,tribal veterans service officers recognized by the ,secretary for the representation of veterans under chapter #ei of this title4 7k7 ,tracking requirements 7#a7 ,with respect to each grant awarded under this section1 the ,secretary shall track the use of veterans and veterans-related benefits among the population served by the grant1 including the average period of time between the date on which a veteran applies for such a benefit and the date on which the veteran receives the benefit1 disaggregated by type of benefit4 7#b7 ,not less frequently than annually during the life of the grant program established under this section1 the ,secretary shall submit to ,congress a report on-- 7,a7 the information tracked under paragraph 7#a72 7,b7 how the grants awarded under this section serve the unique needs of ,american ,indian veterans1 ,alaska ,native veterans1 or ,native ,hawaiian veterans1 elderly veterans1 and veterans from other underserved communities2 and 7,c7 other information provided by ,states and ,indian ,tribes pursuant to the grant reporting requirements4 7l7 ,performance review ,the ,secretary shall-- 7#a7 review the performance of each ,state or ,indian ,tribe that receives a grant under this section2 and 7#b7 make information regarding such performance publicly available4 7m7 ,remediation plan 7#a7 ,in the case of a ,state or ,indian ,tribe that receives a grant under this section and does not meet the outcome measures developed by the ,secretary under subsection 7j71 the ,secretary shall require the ,state or ,indian ,tribe to submit a remediation plan under which the ,state shall describe how and when it plans to meet such outcome measures4 7#b7 ,the ,secretary may not award a subsequent grant under this section to a ,state or ,indian ,tribe described in paragraph 7#a7 unless the ,secretary approves the remediation plan submitted by the ,state or ,indian ,tribe4 7n7 ,definitions ,in this section3 7#a7 ,the term county or ,tribal veterans service officer includes a local equivalent veterans service officer4 7#b7 ,the term covered outreach means outreach with respect to-- 7,a7 benefits administered by the ,under ,secretary for ,benefits2 or 7,b7 similar benefits administered by a ,state or ,indian ,tribe4 7#c7 ,the term ,indian ,tribe has the meaning given such term in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd74 7#d7 ,the term ,state includes the ,district of ,columbia1 the ,commonwealth of ,puerto ,rico1 the ,commonwealth of the ,northern ,mariana ,islands1 and any territory or possession of the ,united ,states4 7#e7 ,the term ,veterans ,crisis ,line means the toll-free hotline for veterans established under section #agbj;,f7h7 of this title4 4 7b7 ,clerical amendment ,the table of sections at the beginning of chapter #fc of such title is amended by striking the items relating to sections #fcjg and #fcjh and inserting the following new items3 #fcjg4 ,grants to ,states and ,indian ,tribes to improve outreach to veterans4#fcjh4 ,outreach for eligible dependents4#fcji4 ,biennial report to ,congress4 4 7c7 ,authorization of appropriations ,there is authorized to be appropriated to the ,secretary of ,veterans ,affairs for each of fiscal years #bjbf and #bjbg1 #aj1jjj1jjj to carry out section #fcjg of title #ch1 ,united ,states ,code1 as added by subsection 7a74 #cjc4 ,definition of surviving spouse ,paragraph 7#c7 of section #aja of title #ch1 ,united ,states ,code1 is amended to read as follows3 7#c7 ,the term surviving spouse means 7except for purposes of chapter #ai of this title7 a person who was the spouse of a veteran at the time of the veteran's death1 and who lived with the veteran continuously from the date of marriage to the date of the veteran's death 7except where there was a separation which was due to the misconduct of1 or procured by1 the veteran without the fault of the spouse7 and who has not remarried4 4 #cjd4 ,ensuring only licensed health care professionals perform medical disability examinations under certain ,department of ,veterans ,affairs pilot program 7a7 ,prohibition on use of certain health care professionals ,section #ejd7;c77#a7 of the ,veterans' ,benefits ,improvements ,act of #aiif 7,public ,law #ajd-bge2 #ch ,u4,s4,c4 #eaja note7 is amended by inserting only before a health care professional4 7b7 ,remedies ,the ,secretary of ,veterans ,affairs shall take such actions as the ,secretary considers appropriate to ensure compliance with section #ejd7;c7 of the ,veterans' ,benefits ,improvements ,act of #aiif 7,public ,law #ajd-bge2 #ch ,u4,s4,c4 #eaja note71 as amended by subsection 7a74 7c7 ,annual report ,not later than one year after the date of the enactment of this ,act and not less frequently than once each year 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-- 7#a7 the conduct of the pilot program established under section #ejd of the ,veterans' ,benefits ,improvements ,act of #aiif 7,public ,law #ajd-bge2 #ch ,u4,s4,c4 #eaja note72 and 7#b7 the actions of the ,secretary under subsection 7b74 7d7 ,technical corrections ,section #ejd of the ,veterans' ,benefits ,improvements ,act of #aiif 7,public ,law #ajd-bge2 #ch ,u4,s4,c4 #eaja note7 is amended1 in the section heading1 by striking physicians and inserting health care professionals4 #cje4 ,provision of information regarding an agent or attorney to a licensed health care professional who performs a medical disability examination under certain ,department of ,veterans ,affairs pilot program 7a7 ,in general ,section #ejd of the ,veterans' ,benefits ,improvements ,act of #aiif 7,public ,law #ajd-bge2 #ch ,u4,s4,c4 #eaja note71 as amended by section #cjd1 is further amended by adding at the end the following new subsection3 7f7 ,certain information provided to health care professional ,the ,secretary shall provide to a health care professional who performs an examination under subsection 7a71 or a contractor performing a contract under such subsection1 the contact information of any agent or attorney recognized by the ,secretary under chapter #ei of title #ch1 ,united ,states ,code1 with regards to a claim for benefits that gives rise to such examination4 4 7b7 ,applicability ,the amendment made by this section shall apply to an examination described in subsection 7a7 of such section that is performed on or after the date of the enactment of this ,act4 #cjf4 ,modernization of ,department of ,veterans ,affairs disability benefit questionnaires 7a7 ,requirement for transmission of certain information in machine-readable format 7#a7 ,requirement ,not later than #ahj days after enactment of this ,act1 the ,secretary of ,veterans ,affairs shall require all disability benefit questionnaire data collected in the course of medical disability examinations made by covered non-,department providers to be transmitted to the ,department in a machine-readable format4 7#b7 ,issuance of standards ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary shall issue standards for the transmission of disability benefit questionnaire data in a machine-readable format as required under paragraph 7#a74 7#c7 ,updates ,in making updates to disability benefit questionnaires after the date specified in paragraph 7#a71 the ,secretary shall-- 7,a7 ensure that the updates are made in a manner that allows for the data collected under the questionnaires to be in a machine-readable format as of the date on which the update goes into effect2 and 7,b7 not later than #cj days before an update goes into effect1 notify the covered non-,department providers 7or the contractor performing a contract under section #ejd of the ,veterans ,benefits ,improvement ,act of #aiif 7,public ,law #ajd-bge2 #ch ,u4,s4,c4 #eaja note77 described in such paragraph of such updates4 7b7 ,plan for information technology system modification ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,senate and ,house of ,representatives a plan to modify the information technology systems and processes of the ,department to enable a non-,department health care professional1 assigned to or selected by a claimant1 to transmit to the ,department1 in a machine-readable format1 disability benefit questionnaire data1 including complete disability benefit questionnaires rather than partial questionnaires or elements of medical evidence4 7c7 ,public availability of information ,the ,secretary shall make publicly available on the internet website of the ,department referred to in section #eaja7;d7 of title #ch1 ,united ,states ,code-- 7#a7 a description of the standards issued under subsection 7a77#b72 and 7#b7 the plan required under subsection 7b74 7d7 ,definitions ,in this section3 7#a7 ,the term claimant has the meaning given such term in section #eajj of title #ch1 ,united ,states ,code4 7#b7 ,the term covered non-,department provider means a health care provider who-- 7,a7 is not an employee of the ,department of ,veterans ,affairs2 and 7,b7 pursuant to a contract under section #ejd of the ,veterans ,benefits ,improvement ,act of #aiif 7,public ,law #ajd-bge2 #ch ,u4,s4,c4 #eaja note71 as amended by sections #cjd and #cje1 examines a claimant for a medical disability4 #cjg4 ,department of ,veterans ,affairs automatic processing of certain claims for temporary disability ratings 7a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall modify the information technology systems of the ,department of ,veterans ,affairs to use automation technology for claims for temporary disability ratings for veterans described in section #aaef7;a77#a77;,c7 of title #ch1 ,united ,states ,code4 7b7 ,additional requirements ,in carrying out subsection 7a71 the ,secretary shall ensure that-- 7#a7 medical evidence is obtained from the corporate data warehouse of the ,department or other sources of data1 the ,secretary determines appropriate2 7#b7 employees of the ,department continue to determine whether a veteran is entitled to a temporary disability rating under section #aaef7;a77#a77;,c7 of title #ch1 ,united ,states ,code2 and 7#c7 claims may be processed manually if the evidence of record is not sufficient to decide the claim or if the medical evidence is provided in a format that is not compatible with the system developed under subsection 7a74 ,,iv ,homelessness ,matters #dja4 ,short title ,this title may be cited as the ,housing our ,military ,veterans ,effectively ,act of #bjbd or the ,,home ,act of #bjbd4 #djb4 ,per diem payments provided by the ,secretary of ,veterans ,affairs for services furnished to homeless veterans 7a7 ,in general ,section #bjab of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#b77;,b7-- 7i7 in clause 7i77,,ii77aa77,,bb71 by striking #aae percent and inserting #aae percent 7or1 during the period beginning on the date of the enactment of the ,housing our ,military ,veterans ,effectively ,act of #bjbd and ending on ,september #cj1 #bjbg1 #acc percent72 and 7ii7 by adding at the end the following3 7iii7 ,for each of fiscal years #bjbe through #bjbg1 the ,secretary may waive the maximum rate for per diem payments under clause 7i77,,ii77aa77,,bb7 or 7ii7 and1 subject to the availability of appropriations1 provide such payments at a rate that does not exceed #bjj percent of the rate authorized for ,state homes for domiciliary care under subsection 7a77#a77;,a7 of section #agda of this title1 as the ,secretary may increase from time to time under subsection 7c7 of that section1 if the ,secretary notifies ,congress of such waiver4 7iv7 ,the ,secretary may not1 pursuant to clause 7iii71 waive the maximum rate described in such clause for more than #ej percent of all grant recipients and eligible entities for a fiscal year4 2 and 7,b7 by adding at the end the following new paragraph3 7#d7 ,the ,secretary may not provide more than #ab1jjj per diem payments under this section for a fiscal year4 2 and 7#b7 by adding at the end the following new subsection3 7f7 ,reports required ,not later than #ij days after the date of the enactment of the ,,home ,act of #bjbd1 and not less frequently than twice each year 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 rate for per diem payments under this section that includes1 for each ,veterans ,integrated ,service ,network of the ,department1 the following data3 7#a7 ,the average rate for such a payment4 7#b7 ,a list of locations where the rate for such a payment is within #aj percent of the maximum rate for such a payment authorized under this section4 7#c7 ,the average length of stay by a veteran participating in a program described in section #bjab7;a7 of this title4 4 7b7 ,regulatory authority ,the ,secretary of ,veterans ,affairs may carry out the amendments made by subsection 7a7 through interim guidance in advance of the issuance of regulations for such purpose4 7c7 ,strategic plan 7#a7 ,in general ,not later than ,september #cj1 #bjbe1 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 strategic plan for the provision of grants and per diem payments for services furnished to homeless veterans under sections #bjaa and #bjab of title #ch1 ,united ,states ,code4 7#b7 ,elements ,the plan required by paragraph 7#a7 shall include the following3 7,a7 ,a method for administering grant funding equitably without using the rate authorized for ,state homes for domiciliary care under subsection 7a77#a77;,a7 of section #agda of title #ch1 ,united ,states ,code1 as the ,secretary may increase from time to time under subsection 7c7 of that section1 that takes into account-- 7i7 the wide variety of services furnished by grant recipients and eligible entities under sections #bjaa and #bjab of title #ch1 ,united ,states ,code2 7ii7 varying costs of living across different geographic locations2 7iii7 varying availability of affordable housing in different geographic locations2 7iv7 circumstances of housing insecurity in rural and ,tribal communities2 7v7 veterans with significant medical care needs2 and 7vi7 the changing dynamic of the veteran population nationwide4 7,b7 ,a plan and timeline for implementation of the method included under subparagraph 7,a74 7,c7 ,an estimate of increased costs or savings per year under the plan4 7,d7 ,an overview of the different grants that will be available once the plan is implemented4 #djc4 ,authorization for ,secretary of ,veterans ,affairs to use certain funds for improved flexibility in assistance to homeless veterans 7a7 ,use of funds ,during the period beginning on the date of the enactment of this ,act and ending on the termination date specified in subsection 7d71 the ,secretary of ,veterans ,affairs may provide to a covered veteran1 as the ,secretary determines necessary-- 7#a7 food1 shelter1 clothing1 blankets1 and hygiene items required for the safety and survival of the veteran2 7#b7 transportation required to support the stability and health of the veteran for appointments with service providers1 the conduct of housing and employment searches1 and the obtainment of food and supplies2 and 7#c7 tablets1 smartphones1 disposable phones and other technology1 and related service plans required to support the stability and health of the veteran through the maintenance of contact with service providers1 prospective landlords1 and family members4 7b7 ,homeless veterans on ,department of ,veterans ,affairs land 7#a7 ,in general ,the ,secretary may collaborate1 to the extent practicable1 with one or more organizations to manage the use of land of the ,department of ,veterans ,affairs for homeless veterans for living and sleeping4 7#b7 ,forms of collaboration ,collaboration under paragraph 7#a7 may include the provision by either the ,secretary or the head of the organization concerned of food services and security for property1 buildings1 and other facilities owned or controlled by the ,department of ,veterans ,affairs4 7c7 ,report required ,not later than six months after the date of the enactment of this ,act1 and annually thereafter until the date specified in subsection 7d71 the ,secretary shall submit to ,congress a report that includes1 with respect to the period covered by such report-- 7#a7 a statement1 disaggregated by each medical center of the ,department of ,veterans ,affairs1 of the amount of funds under this section-- 7,a7 each such medical center requested from the ,secretary2 and 7,b7 to which the ,secretary provided each such medical center2 7#b7 data1 disaggregated by each such medical center1 relating to how each such medical center used amounts provided by the ,secretary under this section2 7#c7 the number of covered veterans to which the ,secretary provided assistance under this section2 7#d7 the total amount of assistance the ,secretary provided to covered veterans pursuant to subsection 7a77#c7 for communications equipment1 broken down by the type of equipment provided2 7#e7 the total amount of assistance the ,secretary provided covered veterans pursuant to subsection 7a77#b7 for ridesharing2 7#f7 the number of covered veterans who received such assistance2 and 7#g7 a description1 for each rideshare used by a covered veteran with such assistance1 of the reasons such covered veteran used such rideshare4 7#h7 the number of covered veterans who lived or slept on ,department land2 7#i7 the amount of funds used to make available ,department land for covered veterans to live and sleep2 7#aj7 the number of ,department employees whose primary responsibilities involved providing services for covered veterans living or sleeping on ,department land2 7#aa7 the average length of time a covered veteran lived or slept on ,department land1 and 7#ab7 the period of time the ,secretary expects ,department land will be made available for covered veterans to live and sleep4 7d7 ,termination date ,the termination date specified in this subsection is ,september #cj1 #bjbg4 7e7 ,definitions ,in this section1 the term covered veteran means-- 7#a7 a homeless veteran1 as such term is defined in section #bjjb of title #ch1 ,united ,states ,code2 and 7#b7 a veteran participating in the program carried out under section #h7o77#ai7 of the ,united ,states ,housing ,act of #aicg 7#db ,u4,s4,c4 #adcg;f7o77#ai774 #djd4 ,access to ,department of ,veterans ,affairs telehealth services 7a7 ,in general ,subtitle ,,vii of chapter #bj of title #ch1 ,united ,states ,code is amended by adding at the end the following new section3 #bjfi4 ,access to telehealth services ,to the extent practicable1 the ,secretary shall ensure that veterans participating in or receiving services from a program under this chapter have access to telehealth services to which such veterans are eligible under the laws administered by the ,secretary1 including by ensuring that telehealth capabilities are available to-- 7#a7 such veterans2 7#b7 case managers of the ,department of programs for homeless veterans authorized under this chapter2 and 7#c7 community-based service providers for homeless veterans receiving funds from the ,department through grants or contracts4 4 7b7 ,clerical amendment ,the table of sections at the beginning of chapter #bj of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new item3 #bjfi4 ,access to telehealth services4 4 ,v ,oversight and ,investigations ,matters #eja4 ,department of ,veterans ,affairs employee training regarding ,office of ,inspector ,general 7a7 ,training ,the ,secretary of ,veterans ,affairs shall require each employee of the ,department of ,veterans ,affairs who begins employment with the ,department on or after the date of the enactment of this ,act to receive training that the ,inspector ,general of the ,department shall develop on the reporting of wrongdoing to1 responding to requests from1 and the duty of cooperating with the ,office of ,inspector ,general of the ,department4 7b7 ,timing of training ,in carrying out subsection 7a71 the ,secretary shall require each employee of the ,department covered under such subsection to undergo the training required by such subsection not later than one year after the date on which the employee begins employment with the ,department4 7c7 ,elements ,training developed and required under subsection 7a7 shall include the following3 7#a7 ,definition of the role1 responsibilities1 and legal authority of the ,inspector ,general of the ,department and the duties of employees of the ,department for engaging with the ,office of ,inspector ,general4 7#b7 ,identification of ,federal whistleblower protection rights1 including the right to report fraud1 waste1 abuse1 and other wrongdoing to ,congress4 7#c7 ,identification of the circumstances and mechanisms for reporting fraud1 waste1 abuse1 and other wrongdoing to the ,inspector ,general1 including making confidential complaints to the ,inspector ,general4 7#d7 ,identification of the prohibitions and remedies that help to protect employees of the ,department from retaliation when reporting wrongdoing to the ,inspector ,general4 7#e7 ,recognition of opportunities to engage with staff of the ,office of ,inspector ,general to improve programs1 operations1 and services of the ,department4 7#f7 ,notification of the authority of the ,inspector ,general to subpoena the attendance and testimony of witnesses1 including former employees of the ,department1 as necessary to carry out the duties of the ,office of ,inspector ,general under section #cab of title #ch1 ,united ,states ,code4 7d7 ,design and update ,the ,inspector ,general of the ,department shall design1 and update as the ,inspector ,general considers appropriate1 the training developed and required by subsection 7a74 7e7 ,system ,the ,secretary shall provide1 via the talent management system of the ,department1 or successor system1 the training developed and required under subsection 7a74 7f7 ,relation to certain training ,the ,secretary shall ensure that training developed and required under subsection 7a7 is separate and distinct from training provided under section #gcc of title #ch1 ,united ,states ,code4 7g7 ,notice to employees ,the ,secretary shall ensure that the ,inspector ,general is afforded the opportunity1 not less frequently than twice each year and more frequently if the ,inspector ,general considers appropriate under extraordinary circumstances1 to use the electronic mail system of the ,department to notify all authorized users of such system of the following3 7#a7 ,the roles and responsibilities of the employees of the ,department when engaging with the ,office of ,inspector ,general4 7#b7 ,the availability of training provided under subsection 7a74 7#c7 ,how to access training provided under subsection 7a74 7#d7 ,information about how to contact the ,office of ,inspector ,general1 including a link to any website-based reporting form of the ,office4 #ejb4 ,annual review of security at covered facilities of the ,department of ,veterans ,affairs 7a7 ,annual survey ,not later than one year after the date of the enactment of this ,act1 and annually thereafter for each of the following five fiscal years1 the ,secretary of ,veterans ,affairs1 in coordination with the ,director of the ,office of ,security and ,law ,enforcement of the ,department of ,veterans ,affairs1 shall conduct a survey of the covered employees at each covered facility to collect information regarding security4 ,each annual survey shall include questions about-- 7#a7 the type and frequency of criminal activity experienced at the covered facility during the fiscal year which most recently concluded including whether or not the criminal activity was related to residents at the facility or campus such as those in a residential rehabilitation treatment program or enhanced-use lease facility2 7#b7 the number of vacancies and number of days vacant for ,department police officers at the covered facility at the time of the survey delineated by recruitment status and stage2 7#c7 the availability and adequacy of covered equipment2 7#d7 the availability and adequacy of resources1 classes1 or other time set aside for training ,department police officers who work at each covered facility about any skill or tactic related to law enforcement1 including the proper use of force1 firearms qualifications and training1 procedures for responding to an active threat1 and any other training required for ,department police officers2 7#e7 any security weakness at covered facilities2 7#f7 the relationship between the covered facility 7including the ,department police officers who work at the covered facility7 and local1 state1 and federal law enforcement agencies including what agreements or memorandums of understanding exist between each covered facility and external law enforcement agencies2 7#g7 efforts by the personnel of the covered facility to address and reduce criminal activity at1 or in close proximity to1 the covered facility2 and 7#h7 recommendations for the ,secretary to better address and reduce criminal activity at1 or in close proximity to1 covered facilities so as to improve the safety of veterans1 employees1 visitors1 other authorized personnel1 and the surrounding community4 7b7 ,report ,not later than #cj days after the end of the next full ,fiscal ,year after the enactment of this ,act and for each of the following five fiscal years1 the ,secretary shall submit to each of the ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives a report regarding the results of the surveys conducted under subsection 7a7 during the previous fiscal year4 ,the report shall include-- 7#a7 the results of the annual survey described under subsection 7a7 for the year covered by the report2 7#b7 an analysis1 made in coordination with the ,director of the ,office of ,security and ,law ,enforcement of such ,department1 each director and police chief of a ,veterans ,integrated ,service ,network1 and the directors and police chiefs of the medical centers within the ,veterans ,integrated ,service ,network of the results of the triannual security inspections conducted in prior fiscal year1 to include a plan of action that describes how the ,secretary plans to address any security weakness identified in the results of the triannual security inspections and includes clearly-stated goals with measurable benchmarks for each goal and deadlines for each benchmark2 and 7#c7 a list of all vacant positions for police chief or deputy police chief at each covered facility during the prior fiscal year1 the number of individuals who filled those positions over the two years prior to the date of the survey1 the number of days the positions were vacant without someone serving in an acting capacity1 and the number of days the positions were filled by individuals serving in an acting capacity4 7c7 ,definitions ,in this section3 7#a7 ,the term covered equipment means any item issued by the ,secretary of ,veterans ,affairs to a ,department police officer 7including firearms1 weapons detecting technology1 ballistic vests1 body-worn cameras1 and radios7 for use in the provision of services under section #ijb of title #ch1 ,united ,states ,code4 7#b7 ,the term covered employee means an employee of the ,department of ,veterans ,affairs who is employed and responsible for security operations at a covered facility including a covered facility's police chief1 facility emergency management leader1 facility director1 or person carrying out the responsibilities of one of these positions in an acting capacity4 7#c7 ,the term covered facility means any facility of the ,department of ,veterans ,affairs where ,department police officers have jurisdiction4 7#d7 ,the term ,department police officer is used as such term as used in section #ijb of title #ch1 ,united ,states ,code4 7#e7 ,the term security weakness means a deficiency in the facilities1 staffing1 or covered equipment at a covered facility that a covered employee of the covered facility determines presents a risk to the safety of visitors or staff1 including an unsecured door1 inoperable security camera1 unsecured police operations room1 a lack of security presence at an entrance to the covered facility1 and a lack of security presence in an area of the covered facility or the grounds of the covered facility that the director of the covered facility determines requires an increased security presence4 #ejc4 ,modification of certain housing loan fees ,the loan fee table in section #cgbi7;b77#b7 of title #ch1 ,united ,states ,code1 is amended by striking ,november #bi1 #bjca each place it appears and inserting ,june #i1 #bjcd4 ,passed the ,senate ,december #ab1 #bjbd4,secretary