,,ii ,calendar ,no4 #dcc #aaith ,,congress #b;d ,session ,s4 #dgdd ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,june #aj1 #bjbf,mr4 ,moran 7for himself1 ,mr4 ,boozman1 and ,mr4 ,cramer7 introduced the following bill2 which was read the first time ,june #aa1 #bjbf,read the second time and placed on the calendar ,a ,,bill ,to amend titles #aj and #ch1 ,united ,states ,code1 and other ,federal laws1 to improve benefits for veterans and the administration of the ,department of ,veterans ,affairs4 #a4 ,short title2 table of contents 7a7 ,short title ,this ,act may be cited as the ,take ,care of ,america's ,veterans ,act4 7b7 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents4,,title ,i--,compensation ,sec4 #aja4 ,major ,richard ,star ,act4,sec4 #ajb4 ,love ,lives ,on ,act4,sec4 #ajc4 ,extension of increased dependency and indemnity compensation to surviving spouses of veterans who die from amyotrophic lateral sclerosis4,sec4 #ajd4 ,sharri ,briley and ,eric ,edmundson ,veterans ,benefits ,expansion ,act of #bjbf4,sec4 #aje4 ,claims3 prohibition on denial solely for certain reason2 improved efficiency of adjudications and appeals4,sec4 #ajf4 ,annual report on causes of death among veterans4,sec4 #ajg4 ,plan for use of automation tools to process claims under laws administered by the ,secretary of ,veterans ,affairs4,sec4 #ajh4 ,reforms relating to ,department of ,veterans ,affairs disability ratings4,sec4 #aji4 ,improvements to temporary licensure requirements for contract health care professionals who perform medical disability examinations for the ,department of ,veterans ,affairs4,sec4 #aaj4 ,disability examinations3 study on access in rural areas2 review of training2 review of inadequate or unnecessary examinations4,sec4 #aaa4 ,improvements to processing and outreach regarding claims involving military sexual trauma4,sec4 #aab4 ,independent assessment of notices that the ,secretary of ,veterans ,affairs sends to claimants4,sec4 #aac4 ,independent assessment of forms that the ,secretary of ,veterans ,affairs sends to claimants4,,title ,,ii--,education and ,economic ,opportunity,sec4 #bja4 ,vets ,opportunity ,act4,sec4 #bjb4 ,improvements to process for making payments to automobile sellers for automobiles purchased for certain disabled veterans4,sec4 #bjc4 ,monthly housing stipend under the ,post-#i_/aa ,educational ,assistance ,program for individuals who pursue summer programs of education solely through distance learning4,sec4 #bjd4 ,clarification regarding inclusion of medically necessary automobile adaptations in ,department of ,veterans ,affairs definition of medical services4,sec4 #bje4 ,digital communications3 ,solid ,start program2 educational assistance4,sec4 #bjf4 ,improvements to ,transition ,assistance ,program and ,skillbridge4,sec4 #bjg4 ,transition ,assistance ,program3 presentation in preseparation counseling to promote benefits available to veterans4,sec4 #bjh4 ,elimination of requirement that on-campus educational and vocational counseling is provided by certain ,department of ,veterans ,affairs employees4,sec4 #bji4 ,expansion of entitlement for payment for licensing or certification tests for veterans entitled to educational assistance4,sec4 #baj4 ,increase of amount of educational assistance paid by the ,secretary of ,veterans ,affairs for first year of a full-time program of apprenticeship or other on-job training4,sec4 #baa4 ,improving emerging technology opportunities for veterans4,,title ,,iii--,health ,care,sec4 #cja4 ,extension and modification of transportation grant program of ,department of ,veterans ,affairs4,sec4 #cjb4 ,veteran ,caregiver ,reeducation1 ,reemployment1 and ,retirement ,act4,sec4 #cjc4 ,veterans ,,tbi ,breakthrough ,exploration of ,adaptive ,care ,opportunities ,nationwide ,act4,sec4 #cjd4 ,department of ,veterans ,affairs ,assignment of ,traveling ,physicians to ,serve ,territories1 ,possessions1 and ,freely ,associated ,states4,sec4 #cje4 ,inclusion of adaptive prostheses and terminal devices for sports and other recreational activities in medical services furnished to eligible veterans by the ,secretary of ,veterans ,affairs4,sec4 #cjf4 ,modifications to and reauthorization of ,staff ,sergeant ,parker ,gordon ,fox ,suicide ,prevention ,grant ,program of ,department of ,veterans ,affairs4,sec4 #cjg4 ,reports on the use of hyperbaric oxygen therapy4,sec4 #cjh4 ,department of ,veterans ,affairs pilot program to provide grants to mental health care providers for the provision of mental health care for veterans4,sec4 #cji4 ,furnishing of certain health services to veterans in the ,freely ,associated ,states4,sec4 #caj4 ,modification of ,precision ,medicine for ,veterans ,initiative2 reporting on suicide by veterans and members of the ,armed ,forces4,sec4 #caa4 ,establishment of the ,blast ,overpressure ,task ,force of the ,department of ,veterans ,affairs4,sec4 #cab4 ,extension of sharing of ,department of ,veterans ,affairs and ,department of ,defense ,health ,care ,resources2 resource sharing oversight and implementation plan4,sec4 #cac4 ,timely reporting of the death of a veteran4,sec4 #cad4 ,expansion of access by veterans to critical access hospitals and affiliated clinics under the ,veterans ,community ,care ,program4,sec4 #cae4 ,pilot platform for services for veterans2 collection from veterans of information related to social determinants of health4,sec4 #caf4 ,improvements to ,department of ,veterans ,affairs prosthetic and rehabilitative items and service4,sec4 #cag4 ,improvement of submission of medical documentation to the ,secretary of ,veterans ,affairs by community care providers4,sec4 #cah4 ,implementation of and report on efforts of ,department of ,veterans ,affairs to improve health care appointment scheduling4,sec4 #cai4 ,pilot program on coordination of care between ,department of ,veterans ,affairs and ,medicare program4,sec4 #cbj4 ,fisher ,house availability4,sec4 #cba4 ,agreements between medical facilities of ,department of ,veterans ,affairs and rural medical facilities4,sec4 #cbb4 ,study on quality of care difference between mental health and addiction therapy care provided by health care providers of ,department of ,veterans ,affairs compared to non-,department providers4,sec4 #cbc4 ,lactation spaces in medical centers of the ,department of ,veterans ,affairs4,sec4 #cbd4 ,research related to menopause1 perimenopause1 and mid-life women's health3 report2 plan4,sec4 #cbe4 ,pilot program on provision of opioid rescue medications to veterans4,sec4 #cbf4 ,establishment of ,veterans ,health ,administration ,policy ,advisory ,commission4,sec4 #cbg4 ,access to health care4,sec4 #cbh4 ,research on health conditions of descendants of toxic-exposed veterans4,sec4 #cbi4 ,veterans ,spinal ,trauma ,access to ,new ,devices ,act4,sec4 #ccj4 ,department of ,veterans ,affairs pilot program to award grants for the provision of service dogs to veterans4,sec4 #cca4 ,authorization of major medical facility project of ,department of ,veterans ,affairs for fiscal year #bjbg in ,manchester1 ,new ,hampshire4,sec4 #ccb4 ,bowel and bladder care program of ,department of ,veterans ,affairs4,,title ,,iv--,organization ,sec4 #dja4 ,authorization of appropriations to the ,office of ,information and ,technology of the ,department of ,veterans ,affairs for certain purposes4,sec4 #djb4 ,establishment of ,under ,secretary for ,management and ,chief ,financial ,officer4,sec4 #djc4 ,department of ,veterans ,affairs acquisition reform and cost assessment4,sec4 #djd4 ,improvement of telephone communication by ,department of ,veterans ,affairs4,sec4 #dje4 ,advancing ,department of ,veterans ,affairs emergency response to crisis4,sec4 #djf4 ,membership of ,department of ,veterans ,affairs ,geriatrics and ,gerontology ,advisory ,committee4,sec4 #djg4 ,scheduling of appointments under the ,veterans ,community ,care ,program4,,title ,v--,memorial ,affairs ,sec4 #eja4 ,expansion of eligibility for ,department of ,veterans ,affairs memorial headstone or marker for certain individuals4,sec4 #ejb4 ,department of ,veterans ,affairs provision of additional burial benefits when an urn or commemorative plaque is furnished4,sec4 #ejc4 ,fallen ,servicemembers ,religious ,heritage ,restoration ,program4,,title ,,vi--,veterans' ,assuring ,critical ,care ,expansions to ,support ,servicemembers,subtitle ,a--,improvement of ,veterans ,community ,care ,program,sec4 #fja4 ,codification of requirements for eligibility standards for access to community care from ,department of ,veterans ,affairs4,sec4 #fjb4 ,requirement that ,secretary notify veterans of eligibility for care or denial of request for care under ,veterans ,community ,care ,program4,sec4 #fjc4 ,consideration under ,veterans ,community ,care ,program of continuity of care and need for caregiver or attendant4,sec4 #fjd4 ,discussion of telehealth options under ,veterans ,community ,care ,program4,sec4 #fje4 ,extension of deadline for submittal of claims by health care entities and providers under prompt payment standard4,sec4 #fjf4 ,audit of representative sample of veterans receiving care and services under ,veterans ,community ,care ,program4,sec4 #fjg4 ,information on wait time and drive time options for receipt of care by veterans4,sec4 #fjh4 ,establishment of period during which a referral under ,veterans ,community ,care ,program remains valid4,sec4 #fji4 ,updates to contracting requirements under ,veterans ,community ,care ,program4,sec4 #faj4 ,publication of community care network sufficiency and payment waiver requests and approvals4,sec4 #faa4 ,requirements relating to quality of community care providers4,sec4 #fab4 ,provider training4,sec4 #fac4 ,oversight authority over community care4,subtitle ,b--,mental ,health ,treatment ,programs,sec4 #fba4 ,veteran participation in certain mental health programs4,sec4 #fbb4 ,access to mental health residential rehabilitation treatment programs for veterans with spinal cord injury or disorder4,subtitle ,c--,staffing ,matters,sec4 #fca4 ,treatment of psychologists4,sec4 #fcb4 ,mentorship program for executive leadership teams at medical centers of the ,department of ,veterans ,affairs4,sec4 #fcc4 ,requirement for equivalent role postings for vacant positions at ,department of ,veterans ,affairs4,sec4 #fcd4 ,improvements to ,department of ,veterans ,affairs hiring processes4,sec4 #fce4 ,department of ,veterans ,affairs telework policy4,sec4 #fcf4 ,expansion of reimbursement of continuing professional education expenses4,sec4 #fcg4 ,department of ,veterans ,affairs personnel transparency4,sec4 #fch4 ,modification of authority of licensure of health care professionals providing treatment via telemedicine4,sec4 #fci4 ,provision of data on educational assistance programs of ,veterans ,health ,administration4,subtitle ,d--,optimization of ,workforce,sec4 #fda4 ,department of ,veterans ,affairs strategic human capital plan4,sec4 #fdb4 ,department of ,veterans ,affairs reduction in force notice requirement4,sec4 #fdc4 ,detailed plans and justifications for reorganization of offices4,sec4 #fdd4 ,rule of construction4,subtitle ,e--,veterans ,infrastructure and ,transformation,sec4 #fea4 ,short title4,sec4 #feb4 ,modification of authority for sharing of health-care resources of ,department of ,veterans ,affairs to include flexible space utilization and streamlined service agreements4,sec4 #fec4 ,use of commercial construction and facilities code and standards4,sec4 #fed4 ,feasibility study for full-service hospital of ,department of ,veterans ,affairs in certain ,states4,sec4 #fee4 ,report on strategic plan for infrastructure and capital assets of ,department of ,veterans ,affairs4,sec4 #fef4 ,permanent extension of pilot program on acceptance by the ,department of ,veterans affairs of donated facilities and related improvements4,sec4 #feg4 ,authority to accept donations of construction services1 minor construction or nonrecurring maintenance projects1 and targeted contributions4,sec4 #feh4 ,report on use of additional authorities relating to recruitment and retention of personnel4,sec4 #fei4 ,reports on key capital asset investments1 activities1 and performance of ,department of ,veterans ,affairs4,sec4 #ffj4 ,development of streamlined procurement model2 report4,sec4 #ffa4 ,submission and notification of cost estimates for medical facility leases4,sec4 #ffb4 ,report on capital asset and information technology needs of the research and development program of ,department of ,veterans ,affairs4,sec4 #ffc4 ,improving prevention1 detection1 and reporting of waste1 fraud1 and abuse in ,department of ,veterans ,affairs capital asset projects and activities4,sec4 #ffd4 ,report on long-term care physical infrastructure needs of ,department of ,veterans ,affairs4,subtitle ,f--,other ,health ,care ,matters,sec4 #fga4 ,prescription1 delivery1 distribution1 and dispensation of controlled substance medications by covered health care professionals of ,department of ,veterans ,affairs via telemedicine4,sec4 #fgb4 ,copayments for limited supplies of medications4,sec4 #fgc4 ,plan on establishment of interactive1 online self-service module for care4,sec4 #fgd4 ,modification of requirements for ,center for ,innovation for ,care and ,payment of the ,department of ,veterans ,affairs and transfer of authority4,sec4 #fge4 ,report on improvements to clinical appeals process4,sec4 #fgf4 ,plan on increasing accessibility of care for veterans with spinal cord injury or disorder4 ,i ,compensation #aja4 ,major ,richard ,star ,act 7a7 ,concurrent receipt generally ,section #adad7;b7 of title #aj1 ,united ,states ,code1 is amended by striking paragraph 7#b7 and inserting the following new paragraphs3 7#b7 ,combat-related disability retirees 7,a7 ,in general ,a member retired under chapter #fa of this title with a combat-related disability who is entitled for any month to retired pay under chapter #fa of this title and is also entitled for that month to veterans' disability compensation under title #ch1 is entitled to be paid both without regard to sections #ecjd and #ecje of title #ch1 as provided by subparagraphs 7,b7 and 7,c74 7,b7 ,career retirees ,in the case of a member retired under chapter #fa of this title who has a combat-related disability that is not a qualifying service-connected disability 7as defined in subsection 7a77#b77 and who1 at the time of the member's retirement1 had #bj years or more of service otherwise creditable under section #adje of this title or at least #bj years of service computed under section #abgcb of this title1 the member may receive1 without regard to sections #ecjd and #ecje of title #ch1 both-- 7i7 the amount of retired pay to which the member would have been entitled under any other provision of law based on the member's service in the uniformed services if the member had not been retired under chapter #fa of this title2 and 7ii7 veterans' disability compensation under title #ch4 7,c7 ,disability retirees with less than #bj years of service ,in the case of a member retired under chapter #fa of this title with a combat-related disability and who1 at the time of the member's retirement1 had less than #bj years of service otherwise creditable under section #adje of this title or less than #bj years of service computed under section #abgcb of this title1 the member may receive1 without regard to sections #ecjd and #ecje of title #ch1 the lesser of-- 7i7 both-- 7,i7 the retired pay for which the member is eligible under chapter #fa of this title2 and 7,,ii7 veterans' disability compensation under title #ch2 or 7ii7 both-- 7,i7 an amount equal to the product of the retired pay base computed under section #adjf7;b7 or #adjg of this title and the retired pay multiplier determined under section #adji of this title1 as such base pay and multiplier would be computed if the member had #bj years of service creditable under section #adje of this title2 and 7,,ii7 veterans' disability compensation under title #ch4 7,d7 ,combat-related disability defined ,in this paragraph1 the term combat-related disability has the meaning given that term in subsection 7e7 of section #adac;a of this title and as determined under the criteria and procedures used for purposes of such section4 7#c7 ,exclusion of other retirees ,subsection 7a7 does not apply to a member retired under chapter #fa of this title if the member is not covered by paragraph 7#a7 or 7#b74 4 7b7 ,technical and conforming amendments 7#a7 ,coordination with combat-related special compensation program ,section #adad7;d7 of title #aj1 ,united ,states ,code1 is amended by striking qualified retiree under this section and inserting qualified retiree under subsection 7a7 or is entitled to a payment under subsection 7b77#b74 7#b7 ,amendments reflecting end of concurrent receipt phase-in period ,section #adad of title #aj1 ,united ,states ,code1 is further amended-- 7,a7 in subsection 7a77#a7-- 7i7 by striking the second sentence2 and 7ii7 by striking subparagraphs 7,a7 and 7,b72 7,b7 by striking subsection 7c7 and redesignating subsections 7d7 and 7e7 as subsections 7c7 and 7d71 respectively2 and 7,c7 in subsection 7d71 as redesignated1 by striking paragraphs 7#c7 and 7#d74 7#c7 ,section heading ,the heading of section #adad of such title is amended to read as follows3 #adad4 ,members eligible for retired pay who are also eligible for veterans' disability compensation3 concurrent receipt 4 7#d7 ,conforming amendment ,section #adac;a7f7 of such title is amended by striking ,subsection 7d7 and inserting ,subsection 7c74 7c7 ,effective date ,the amendments made by this section shall take effect on ,january #a1 #bjbg1 and shall apply to payments for months beginning on or after that date4 #ajb4 ,love ,lives ,on ,act 7a7 ,modification of entitlement to veterans dependency and indemnity compensation for surviving spouses who remarry ,section #ajc7;d7 of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in paragraph 7#b77;,b7-- 7,a7 by inserting 7i7 before ,the remarriage2 7,b7 in clause 7i71 as designated by subparagraph 7,a71 by striking ,notwithstanding the previous sentence and inserting the following3 7ii7 ,notwithstanding clause 7i7 2 and 7,c7 by adding at the end the following new clause3 7iii7 ,notwithstanding clause 7ii71 the remarriage of a surviving spouse shall not bar the furnishing of benefits under section #acaa or #aefb of this title to the surviving spouse of a veteran4 2 and 7#b7 in paragraph 7#e7-- 7,a7 by striking subparagraph 7,a72 and 7,b7 by renumbering subparagraphs 7,b7 through 7,e7 as subparagraphs 7,a7 through 7,d71 respectively4 7b7 ,continued eligibility for survivor benefit plan for certain surviving spouses who remarry ,section #adej7;b77#b7 of title #aj1 ,united ,states ,code1 is amended-- 7#a7 by striking ,an annuity and inserting the following3 7,a7 ,in general 7,a7 ,subject to subparagraph 7,b71 an annuity 2 and 7#b7 by adding at the end the following new subparagraph3 7,b7 ,treatment of survivors of members who die on active duty ,the ,secretary may not terminate payment of an annuity for a surviving spouse described in subparagraph 7,a7 or 7,b7 of section #addh7;d77#a7 solely because that surviving spouse remarries4 ,in the case of a surviving spouse who remarried before reaching age #ee and before the date of the enactment of ,take ,care of ,america's ,veterans ,act1 the ,secretary shall resume payment of the annuity to that surviving spouse-- 7i7 except as provided by clause 7ii71 for each month that begins on or after the date that is one year after such date of enactment2 or 7ii7 on the first day of the first month beginning after such date of enactment1 in the case of a surviving spouse who elected to transfer payment of that annuity to a surviving child or children under the provisions of section #addh7;d77#b77;,b7 of title #aj1 ,united ,states ,code1 as in effect on ,december #ca1 #bjai4 4 7c7 ,expansion of definition of dependent under ,,tricare program to include a remarried widow or widower whose subsequent marriage has ended ,section #ajgb7b7 of title #aj1 ,united ,states ,code1 is amended-- 7#a7 in subparagraph 7,h71 by striking 2 and and inserting a semicolon2 7#b7 in subparagraph 7,i77v71 by striking the period at the end and inserting 2 and2 and 7#c7 by adding at the end the following new subparagraph3 7,j7 a remarried widow or widower whose subsequent marriage has ended due to death1 divorce1 or annulment4 4 #ajc4 ,extension of increased dependency and indemnity compensation to surviving spouses of veterans who die from amyotrophic lateral sclerosis 7a7 ,extension ,section #acaa7;a77#b7 of title #ch1 ,united ,states ,code1 is amended-- 7#a7 by inserting 7,a7 before ,the rate2 and 7#b7 by adding at the end the following new subparagraph3 7,b7 ,a veteran whom the ,secretary determines died from amyotrophic lateral sclerosis shall be treated as a veteran described in subparagraph 7,a7 without regard for how long the veteran had such disease prior to death4 4 7b7 ,applicability ,subparagraph 7,b7 of section #acaa7;a77#b7 of title #ch1 ,united ,states ,code1 as added by subsection 7a71 shall apply to a veteran who dies from amyotrophic lateral sclerosis on or after ,october #a1 #bjbb4 #ajd4 ,sharri ,briley and ,eric ,edmundson ,veterans ,benefits ,expansion ,act of #bjbf 7a7 ,increase in rates of certain disability compensation and dependency and indemnity compensation under laws administered by ,secretary of ,veterans ,affairs 7#a7 ,increase to rates of wartime disability compensation 7,a7 ,in general ,section #aaad of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new subsection3 7u7 ,in the case of a veteran eligible for a monthly aid and attendance allowance under subsection 7r7 or subsection 7t7 of this section1 the ,secretary shall1 in addition to the total amount of compensation for which the veteran is eligible under this section1 pay the veteran a supplemental monthly allowance at the rate of #hcc4cc4 4 7,b7 ,effective date2 applicability ,subsection 7u7 of such section 7as added by subparagraph 7,a77 shall take effect on ,december #a1 #bjbf1 and shall apply to months beginning on or after such date4 7#b7 ,increase to rates of dependency and indemnity compensation ,section #ecab of such title is amended by adding at the end the following new subsection3 7d7 7#a7 ,whenever there is an increase in benefit amounts payable under title ,,ii of the ,social ,security ,act 7#db ,u4,s4,c4 #dja et seq47 as a result of a determination made under section #bae7;i7 of such ,act 7#db ,u4,s4,c4 #dae7;i771 the ,secretary shall1 except as provided in paragraph 7#b71 effective on the date of such increase in benefit amounts1 increase the dollar amounts in effect for the payment of dependency and indemnity compensation by the ,secretary under paragraph 7#a7 and paragraph 7#c7 of section #acaa7;a7 of this title1 as such amounts were in effect immediately before the date of such increase in benefit amounts payable under title ,,ii of the ,social ,security ,act1 by a percentage equal to the sum of-- 7,a7 the percentage by which such benefit amounts are increased2 and 7,b7 one percent4 7#b7 ,whenever there is an increase under paragraph 7#a7 in amounts in effect for the payment of dependency and indemnity compensation1 the ,secretary shall publish such amounts1 as increased pursuant to such paragraph1 in the ,federal ,register at the same time as the material required by section #bae7;i77#b77;,d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #dae7;i77#b77;,d77 is published by reason of a determination under section #bae7;i7 of such ,act 7#db ,u4,s4,c4 #dae7;i774 7#c7 ,the requirement to increase1 pursuant to paragraph 7#a71 the amounts in effect for the payment of dependency and indemnity compensation under paragraph 7#a7 and paragraph 7#c7 of section #acaa 7a7 of this title by the ,secretary shall-- 7,a7 take effect on ,december #a1 #bjbf1 and shall apply with respect to months beginning on or after such date2 and 7,b7 terminate after the date on which the third increase to such amounts pursuant to such paragraph occurs4 4 7b7 ,modification of waivers of fees collected for housing loans guaranteed1 insured1 or made by the ,secretary of ,veterans ,affairs ,section #cgbi7;b77#b7 of such title is amended1 in the loan fee table-- 7#a7 in subparagraph 7,e71 by striking #j4ej both places it appears and inserting #a4db2 and 7#b7 in subparagraph 7,i71 by striking #j4ej each place it appears and inserting #a4j4 7c7 ,home affordability for ,guard and ,reserve 7#a7 ,eligibility of certain members of the reserve components and the ,national ,guard for guaranteed housing loans 7,a7 ,expanded definition of active duty for purposes of housing loans ,section #cgja7;b7 of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new paragraph3 7#i7 ,the term active duty has the meanings as follows3 7,a7 ,in the case of members of the regular components of the ,armed ,forces1 the meaning given such term in section #aja7ba77;,a74 7,b7 ,in the case of members of the reserve components of the ,armed ,forces-- 7i7 service on active duty 7as defined in section #aja7;d7 of title #aj71 inactive-duty training 7as defined in section #aja7;d7 of title #aj71 or annual training duty2 or 7ii7 service on active duty under a call or order to active duty under section #fhh1 #abcja7;a71 #abcja7;d71 #abcja7;g71 #abcja7;h71 #abcjb1 #abcjd1 #abcjd;a1 or #abcjd;b of title #aj or section #gac of title #ad1 but not including inactive duty training 7as defined in section #aja7;d7 of title #aj7 or annual training duty4 7,c7 ,in the case of a member of the ,army ,national ,guard of the ,united ,states or ,air ,national ,guard of the ,united ,states1 in addition to service described in subparagraph 7,b71 full-time service-- 7i7 in the ,national ,guard of a ,state for the purpose of organizing1 administering1 recruiting1 instructing1 or training the ,national ,guard2 7ii7 in the ,national ,guard when performing full-time ,national ,guard duty 7as defined in section #aja of title #cb72 or 7iii7 in the ,national ,guard when performing active duty 7as defined in section #aja of title #cb74 4 7,b7 ,retroactive applicability to service performed ,the amendments made by this subsection shall apply with respect to any service performed on or after ,september #aa1 #bjja4 7#b7 ,expansion of eligibility for guaranteed housing loans to certain additional personnel upon payment of additional loan fee 7,a7 ,expansion to individuals with at least #ad days of service ,section #cgja7;b7 of title #ch1 ,united ,states ,code1 is amended by inserting after paragraph 7#g7 the following new paragraph3 7#h7 ,the term veteran also includes1 for purposes of home loans 7subject to the additional loan fee in section #cgbi7;b77#d77;,j7 of this title71 an individual who-- 7,a7 is not otherwise eligible for the benefits of this chapter2 7,b7 has completed a total service of at least #ad days on active duty under paragraph 7,b7 or 7,c7 of paragraph 7#i72 and 7,c7 following completion of such service1 continued to serve until the completion of entry level and skill training 7as defined in section #ccja7c7 of this title74 4 7,b7 ,basic entitlement ,section #cgjb7;a77#b7 of title #ch1 ,united ,states ,code1 is amended by adding at the end the following3 7,h7 ,each individual described in section #cgja7;b77#h7 of this title4 4 7,c7 ,additional loan fee for such individuals ,section #cgbi7;b77#d7 of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new subparagraph3 7,j7 ,in the case of a housing loan in which the veteran has eligibility under section #cgja7;b77#h7 of this title and does not otherwise have eligibility1 the loan fee table in paragraph 7#b7 shall be applied to the veteran or other obligor 7as applicable7 by adding #a4jj to the percentage in the table4 4 7,d7 ,notification to personnel ,the ,secretary of ,veterans ,affairs shall provide information about this benefit to the ,secretary of ,defense to ensure that each member of a reserve component or a member of the ,army ,national ,guard of the ,united ,states or ,air ,national ,guard of the ,united ,states who completes entry level and skill training 7as defined in section #ccja7c7 of title #ch1 ,united ,states ,code7 after the date of the enactment of this ,act is notified of their eligibility for housing loan benefits under chapter #cg of such title1 including eligibility 7subject to the additional loan fee7 under section #cgja7;b77#h7 of such title4 #aje4 ,claims3 prohibition on denial solely for certain reason2 improved efficiency of adjudications and appeals 7a7 ,prohibition on denial of claims for benefits under laws administered by ,secretary of ,veterans ,affairs on sole basis that veteran failed to appear for certain medical examination ,subsection 7d7 of section #eajc;,a of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in the heading1 by striking compensation claims and inserting claims for benefits2 7#b7 in paragraph 7#b71 by striking treat an examination or opinion as being necessary to make a decision on a claim for purposes of and inserting provide for a medical examination or obtain a medical opinion under2 and 7#c7 by adding at the end the following new paragraph3 7#c7 ,if a veteran fails to appear for a medical examination provided by the ,secretary in conjunction with a claim for a benefit under a law administered by the ,secretary1 the ,secretary may not deny such claim on the sole basis that such veteran failed to appear for such medical examination4 4 7b7 ,improvements to efficiency of adjudications and appeals of claims for benefits under laws administered by ,secretary of ,veterans ,affairs 7#a7 ,annual report on length of adjudications 7,a7 ,in general ,section #eaji;,b of title #ch1 ,united ,states ,code1 is amended-- 7i7 by striking ,the ,secretary and inserting 7a7 ,in general4--,the ,secretary2 and 7ii7 by adding at the end the following new subsection3 7b7 ,annual report ,the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate an annual report that includes1 with respect to the period covered by the report-- 7#a7 the average length of time a claim 7or an issue within a claim7 that was remanded by the ,board of ,veterans' ,appeals was or has been pending before the ,secretary after such remand2 7#b7 the number of cases that advanced on the docket by reason of a motion that was filed under section #gajg7;b7 of this title and on which the ,board ruled1 disaggregated by-- 7,a7 whether a motion was granted or denied2 and 7,b7 the reason provided for the motion2 and 7#c7 the number of appeals dismissed by the ,board1 disaggregated by-- 7,a7 whether or not the dismissal was by reason of the death of the appellant2 and 7,b7 in the case of a dismissal by reason of the death of the appellant1 whether or not such death was a result of suicide4 4 7,b7 ,deadline ,the ,secretary of ,veterans ,affairs shall submit the first report required by subsection 7b7 of section #eaji;,b of such title 7as added by subparagraph 7,a77 by not later than one year after the date of the enactment of this ,act4 7#b7 ,guidelines for advancement of cases on docket of ,board ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs1 in consultation with the ,board of ,veterans' ,appeals and the ,general ,counsel of the ,department of ,veterans ,affairs1 shall prescribe guidelines for the advancement of a case on the docket of the ,board on a motion for earlier consideration and determination under section #gajg7;b77#c7 of title #ch1 ,united ,states ,code4 ,such guidelines shall include the type of evidence that may be submitted with the motion for the advancement of the case to show grounds for such a motion4 7#c7 ,requirement ,to track certain claims for benefits 7,a7 ,in general ,chapter #ea of title #ch1 ,united ,states ,code1 is amended by inserting after section #eaji;,b the following new section3 #eaji;,c4 ,requirement to track and maintain information on certain claims for benefits2 notice of certain assignments 7a7 ,in general ,the ,secretary shall use technology to track and maintain information 7including information with respect to timeliness7 on-- 7#a7 claims for benefits under the laws administered by the ,secretary 7including issues within such claims7 that are-- 7,a7 continuously pursued in accordance with-- 7i7 sections #eajd;,c7a7 and #eaaj7;a77#b7 of this title2 or 7ii7 any other policy established by the ,secretary2 7,b7 filed in the ,national ,work ,queue 7or any successor system7 but have not been assigned to an office of the ,veterans ,benefits ,administration for adjudication2 7,c7 afforded expeditious treatment by the ,veterans ,benefits ,administration pursuant to section #eaji;,b of this title or any other policy established by the ,secretary2 7,d7 remanded by the ,board of ,veterans' ,appeals to the ,secretary pursuant to section #gajd of this title2 or 7,e7 pending a hearing by the ,board of ,veterans' ,appeals under section #gajg of this title2 7#b7 instances in which an adjudicator of the ,veterans ,benefits ,administration does not comply with a relevant decision of the ,board of ,veterans' ,appeals to remand a claim for benefits under the laws administered by the ,secretary 7or an issue within such a claim71 including any such instance in which the relevant decision concerned a failure on the part of the agency of original jurisdiction to satisfy the duty of the ,secretary to assist under section #eajc;,a of this title2 7#c7 supplemental claims under section #eajh of this title that are filed-- 7,a7 in accordance with section #eajd;,c7a7 and section #eaaj7;a77#b7 of this title2 and 7,b7 after the date of the applicable final decision of the ,secretary with respect to a claim for benefits under the laws administered by the ,secretary 7or an issue within such a claim72 and 7#d7 first notices submitted to the ,secretary of the death of individuals in receipt of benefits under the laws administered by the ,secretary1 disaggregated by such individuals who were-- 7,a7 assigned a fiduciary2 and 7,b7 not assigned a fiduciary4 7b7 ,annual report 7#a7 ,the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate an annual report that includes all information maintained and tracked pursuant to subsection 7a74 7#b7 ,the first report required by paragraph 7#a7 shall be submitted by not later than one year after the date of the enactment of the ,take ,care of ,america's ,veterans ,act4 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 #eaji;,b the following new item3 #eaji;,c4 ,requirement to track and maintain information on certain claims for benefits2 notice of certain assignments4 4 7#d7 ,improvements to ,board of ,veterans' ,appeals 7,a7 ,authority to aggregate certain claims 7i7 ,in general ,section #gajd7;a7 of such title is amended by inserting after the second sentence the following new sentence3 ,if the ,chairman of the ,board determines that more than one appeal involves common questions of law or fact1 the ,chairman may aggregate such appeals to decide such questions of law or fact44 7ii7 ,effective date ,the amendment made by clause 7i7 shall take effect on the date of the enactment of this ,act and apply beginning on the date #ij days after the date on which the ,secretary of ,veterans ,affairs submits to the ,committees on ,veterans' ,affairs of the ,senate and ,house of ,representatives a copy of the policies and procedures required under paragraph 7#g77;,d77i77,,ii74 7iii7 ,sunset ,the authority to aggregate appeals pursuant to clause 7i7 shall expire on the date that is three years after the date on which the ,secretary of ,veterans ,affairs completes the development of the policies and procedures required under paragraph 7#g77;,d77i77,,ii74 7,b7 ,requirement to ensure substantial compliance with certain decisions ,such section is further amended-- 7i7 by redesignating subsection 7f7 as subsection 7g72 and 7ii7 by inserting after subsection 7e7 the following new subsection 7f73 7f7 7#a7 ,the ,secretary1 acting through a member of the ,board1 shall ensure substantial compliance with any decision of the ,board to remand a claim4 7#b7 ,the agency of original adjudication may waive the requirement under paragraph 7#a7 with respect to a decision of the ,board to remand a claim to the ,secretary1 if a member of the ,board determines-- 7,a7 evidence added to the evidentiary record after the date of such decision is sufficient to resolve the issues underlying such decision2 or 7,b7 such decision was unnecessary4 7#c7 ,if the ,secretary waives such requirement1 the applicable member of the ,board shall include1 pursuant to subsection 7d71 a determination of such waiver in the decision of the ,board4 4 7,c7 ,definition of aggregate2 report ,such section is further amended by adding at the end the following new subsections3 7h7 ,not later than three years after the date on which the ,secretary of ,veterans ,affairs completes the development of the policies and procedures required under paragraph 7#g77;,d77i77,,ii71 and every five years thereafter1 the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,senate and ,house of ,representatives a report on the aggregation of claims by the ,board under subsection 7a74 ,each such report shall include-- 7#a7 an identification of each instance in which the ,board aggregated appeals during the period covered by the report1 including1 for each such instance1 the number of appeals that were aggregated2 7#b7 an assessment of whether the aggregation of appeals has contributed to improved efficiency at the ,board with issuing decisions on appeals2 and 7#c7 such other matters as the ,secretary determines appropriate4 7i7 ,in this section1 the term aggregate-- 7#a7 means any practice or procedure to collect common issues1 claims1 or appeals by multiple parties for the purposes of resolving such issues1 claims1 or appeals2 and 7#b7 includes the use of joinder1 consolidation1 intervention1 class actions1 and any other multiparty proceedings4 4 7#e7 ,expansion of jurisdiction of ,court of ,appeals for ,veterans ,claims ,section #gbeb of title #ch1 ,united ,states ,code1 is amended-- 7,a7 by redesignating subsections 7b7 and 7c7 as subsections 7d7 and 7e71 respectively2 and 7,b7 by inserting after subsection 7a7 the following new subsections3 7b7 7#a7 ,in an appeal over which the ,court has jurisdiction pursuant to section #gbff of this title1 if the appellant files a request for class certification pursuant to the rules prescribed by the ,court pursuant to section #gbfd of this title1 the ,court shall have supplemental jurisdiction over any claim for benefits under the laws administered by the ,secretary-- 7,a7 filed by a claimant who satisfies the definition of the class contained in such request 7including a claimant who has filed a claim for benefits under such laws that are specified in such request72 and 7,b7 regarding which-- 7i7 the agency of original jurisdiction has issued a nonfinal decision2 and 7ii7 the claimant has filed a notice of disagreement under section #eajd;,c7a7 or section #gaje of this title1 including any case in which a claimant has filed a supplemental claim within one year of a ,board decision under section #eaaj7;a77#b77;,d7 and #eajh of this title following a notice of disagreement and decision of the ,board4 7#b7 ,a claimant may submit a request for administrative review of such a claim under section #eajd;,c7a7 of this title during the period beginning on the date on which the named claimant of the motion for class action review submits to the ,court a motion for class action review and ending on the date that is #fj days after the later of the following dates3 7,a7 ,the date on which the ,court issues a final decision with respect to such claim4 7,b7 ,the date on which the ,court issues a final decision with respect to such motion for class action review4 7#c7 ,in the case of a claimant whose claim is decided by the ,board during the period when the ,court is reviewing the motion for class action review the deadline for such claimant to file an appeal to the ,court with respect to the decision of the ,board shall be tolled if the ,court denies the motion for class action review4 7c7 7#a7 ,in the case of a claim for benefits under the laws administered by the ,secretary1 the ,court may remand a matter to the ,board of ,veterans' ,appeals for the limited purpose of ordering the ,board to address a question of law or fact if the ,court determines the ,board failed to-- 7,a7 address1 in the relevant decision of the ,board1 an issue that-- 7i7 the claimant or the representative of the claimant raised2 or 7ii7 was reasonably raised by the evidentiary record of the claim2 or 7,b7 provide adequate reasons or bases for the decision of the ,board with respect to such question4 7#b7 ,the ,court shall issue ,rules that provide for each of the following3 7,a7 ,when and how a party to an appeal 7either the appellant or the ,secretary7 may request that the ,court issue a limited remand4 7,b7 ,the period of time within which the ,board is required to issue a decision on the relevant question identified in a limited remand4 7,c7 ,guidelines for when the ,court may grant a request for a limited remand4 7,d7 ,guidelines for when the ,court may decide sua sponte to issue a limited remand without a request from any party4 7,e7 ,a requirement that the parties to an appeal for which a limited remand is issued provide notice to the ,court when the ,board issues its decision on the relevant question identified in the limited remand4 7#c7 ,with respect to any matter remanded to the ,board pursuant to paragraph 7#a71 the ,court shall-- 7,a7 retain jurisdiction over such matter2 and 7,b7 stay the proceedings of the ,court on such matter until the date on which the ,board issues the decision required by such remand4 4 7#f7 ,study and report on common questions of law or fact before ,board of ,veterans' ,appeals 7,a7 ,study ,the ,chairman of the ,board of ,veterans' ,appeals shall carry out a study to identify questions of law or fact the ,board commonly considers when reviewing appeals pursuant to section #gajd of title #ch1 ,united ,states ,code1 for which precedential guidance would assist the ,board in issuing final decisions on such appeals4 ,the ,chairman may use artificial intelligence and other technology in carrying out such study4 7,b7 ,report ,not later than one year after the date of the enactment of this ,act1 the ,chairman of the ,board of ,veterans ,appeals shall submit to the ,committees on ,veterans ,affairs of the ,house of ,representatives and the ,senate a report that includes the findings of the study required by subparagraph 7,a74 7#g7 ,independent assessment of potential modifications to authority of ,board of ,veterans' ,appeals 7,a7 ,agreement ,not later than #cj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall seek to enter into an agreement with an ,,ffrdc under which the ,,ffrdc shall conduct an assessment of the feasibility of modifying the authority of the ,board of ,veterans' ,appeals established under chapter #ga of title #ch1 ,united ,states ,code1 to permit the ,board to issue precedential decisions with respect to questions of law or fact arising in matters before the ,board4 7,b7 ,report2 briefings ,if the ,secretary fails to finalize an agreement with an ,,ffrdc under subparagraph 7,a7 before the date that is #ahj days after the date on which the ,secretary enters negotiations with respect to such agreement1 the ,secretary shall-- 7i7 submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a report that includes-- 7,i7 an explanation of the reasons the ,secretary failed to satisfy such requirement2 and 7,,ii7 an estimate of the date on which the ,secretary will finalize the agreement under subparagraph 7,a72 and 7ii7 not less frequently than once every #fj days after the date on which the ,secretary failed to satisfy such requirement1 provide to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a briefing on the progress of the ,secretary toward finalizing such agreement4 7,c7 ,assessment ,an ,,ffrdc that enters into an agreement under subparagraph 7,a7 shall1 in consultation with veterans service organizations1 veterans' and survivors' advocate groups1 relevant legal experts1 and the ,chair of the ,administrative ,conference of the ,united ,states 7or the designee or designees of such ,chair7 submit to the ,secretary a written assessment that includes the following3 7i7 ,the determination of the ,,ffrdc of whether modifying the authority of the ,board to permit the ,board to issue precedential decisions with respect to questions of law or fact arising in matters before the ,board is feasible4 7ii7 ,an assessment of the authority of the ,board of ,veterans' ,appeals to aggregate1 for review1 more than one appeal under chapter #ga of such title that involves common questions of law or fact pursuant to section #gajd of such title1 as amended by paragraph 7#d77;,a74 7iii7 7,i7 ,the recommendations of the ,,ffrdc with respect to rules or principles to which the ,board should adhere when aggregating appeals for review pursuant to section #gajd7;a7 of title #ch1 ,united ,states ,code1 as so amended1 including-- 7aa7 whether the use of an opt-out system is appropriate in a class certification described in section #gajd7;a7 of title #ch1 ,united ,states ,code1 as amended2 7bb7 whether aggregation described in clause 7ii7 is better carried out by one member1 or a panel of members1 of the ,board2 7cc7 whether such aggregation may be accomplished in accordance with section #gajg of title #ch1 ,united ,states ,code2 and 7dd7 how an accredited representative1 attorney1 or authorized agent may be selected to represent a class before the ,board4 7,,ii7 ,the recommendations shall include1 but not be limited to1 the following3 7aa7 ,how the ,board should provide notice to claimants of the ,board's intent to aggregate their claim4 7bb7 ,this shall include standards for ensuring that information provided to claimants regarding aggregation is written in plain language and clearly explains the potential effects of aggregation on adjudication timelines1 appeal rights1 and participation options4 7cc7 ,the options the ,board should provide to claimants to opt out of participation in aggregation of their claim4 7dd7 ,the rights of the claimants to appeal decisions that arise out of aggregation of claims1 and whether or not such rights may be limited by existing statute1 regulation1 or judicial decisions4 7ee7 ,safeguards to ensure that aggregation of appeals does not diminish the requirement that each appeal be decided based on the individual facts1 evidence1 and circumstances specific to the claimant4 7ff7 ,recommendations regarding quality review procedures and oversight mechanisms to monitor the impact of aggregation on claim accuracy1 consistency1 timeliness1 and claimant outcomes4 7,d7 ,report2 implementation 7i7 ,in general ,not later than #ij days after the ,secretary receives the assessment under subparagraph 7,c71 the ,secretary shall-- 7,i7 submit to the ,committees on ,veterans' ,affairs of the ,senate and ,house of ,representatives a copy of such assessment2 and 7,,ii7 begin developing policies and procedures to implement the recommendations in the assessment with respect to the authority of the ,board of ,veterans' ,appeals referred to in subparagraph 7,c74 7ii7 ,deadline ,the ,secretary shall complete the development of the policies and procedures required under clause 7i77,,ii7 and submit to the ,committees on ,veterans' ,affairs of the ,senate and ,house of ,representatives a copy of such policies and procedures not later than six months after the date on which the ,secretary begins developing such policies and procedures4 7,e7 ,definitions ,in this paragraph3 7i7 ,the term ,,ffrdc means a federally funded research and development center4 7ii7 ,the term veterans service organization means an organization recognized by the ,secretary for the representation of veterans under section #eijb of title #ch1 ,united ,states ,code4 7c7 ,improvements to system for adjudication of claims for benefits under laws administered by ,secretary of ,veterans ,affairs 7#a7 ,program for quality assurance in decisions of ,board of ,veterans' ,appeals2 performance reviews 7,a7 ,in general ,section #gaja of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new subsection3 7f7 7#a7 ,the ,chairman shall carry out a program to ensure quality in the decisions of the ,board4 ,under such program1 the ,chairman shall-- 7,a7 develop policies and procedures for-- 7i7 measuring quality in such decisions2 7ii7 maintaining data and identifying trends with respect to-- 7,i7 errors in such decisions2 7,,ii7 errors in decisions remanded or returned to the ,board by the ,court of ,appeals for ,veterans ,claims2 and 7,,iii7 specific members of the ,board that issued decisions that were subsequently vacated by the ,court of ,appeals for ,veterans ,claims2 and 7iii7 ensuring any such decision of the ,board to remand a claim for a benefit under a law administered by the ,secretary is necessary under any applicable law or regulation2 7,b7 with respect to a claim for such a benefit that is remanded to the ,board by the ,court of ,appeals for ,veterans ,claims-- 7i7 inform any employee of the ,board responsible for drafting the decision of the ,board with respect to such claim that such decision was remanded2 7ii7 provide any such employee with a copy of the relevant order of the ,court of ,appeals for ,veterans ,claims 7including a copy of any accompanying joint motion for remand72 and 7iii7 provide incentives to such employees to review such relevant orders and joint motions for remand2 and 7,c7 ensure1 to the maximum extent practicable1 that any error identified by the ,board under such program is corrected before the date on which the ,board issues the final decision associated with such error4 7#b7 ,in developing policies and procedures to measure quality in decisions of the ,board pursuant to clause 7i7 of subparagraph 7,a7 of paragraph 7#a71 the ,chairman shall consider the data and trends maintained and identified pursuant to clause 7ii7 of such subparagraph4 7#c7 ,the ,chairman may use technology1 including artificial intelligence1 to maintain such data and identify such trends4 7#d7 ,the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate an annual report on the program required by this subsection that includes1 with respect to the period covered by the report1 an identification of-- 7,a7 elements1 if any of the process of the ,board for reviewing an appeal under this chapter that lead to errors in decisions of the ,board2 and 7,b7 the most common reasons that a claim for a benefit under a law administered by the ,secretary was remanded to such ,board by the ,court of ,appeals for ,veterans ,claims4 4 7,b7 ,deadline ,the ,secretary shall submit the first report required by paragraph 7#b7 of such section 7as added by subparagraph 7,a77 by not later than one year after the date of the enactment of this ,act4 7#b7 ,training program for certain employees of ,board of ,veterans' ,appeals2 performance reviews 7,a7 ,training program 7i7 ,in general ,chapter #ga of such title 7as amended by paragraph 7#a77 is further amended by inserting after section #gaja;,a the following new section3 #gaja;,b4 ,training program for members of ,board on timely and correct adjudication of appeals 7a7 ,in general ,the ,secretary1 in conjunction with the ,chairman of the ,board of ,veterans' ,appeals1 shall develop and carry out a program to provide ,members of the ,board training on timely and correct adjudication of appeals under this chapter4 7b7 ,required considerations ,in carrying out the program required by subsection 7a71 the ,secretary shall consider the following3 7#a7 ,feedback1 if any1 from members of the ,board and covered employees with respect to such program4 7#b7 ,data on errors in decisions of the ,board maintained pursuant to the program for quality assurance required by subsection 7f7 of section #gaja of this title4 7#c7 ,any decision of the ,court of ,appeals for ,veterans ,claims to remand a claim for benefits under the laws administered by the ,secretary to the ,board for further action1 including a joint motion to remand such claim4 7c7 ,assessments of effectiveness ,the ,secretary1 in conjunction with the ,chairman of the ,board of ,veterans' ,appeals1 shall develop a method to assess1 on an annual basis1 the effectiveness of the training program under this section4 ,in developing such method1 the ,secretary shall consider best practices for assessing the effectiveness of training programs1 including the ,kirkpatrick evaluation model4 7d7 ,report ,the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate an annual report on the program required by subsection 7a7 that includes1 with respect to the period covered by the report-- 7#a7 a statement of the topics of the training provided pursuant to this section1 disaggregated by-- 7,a7 mandatory training2 and 7,b7 non-mandatory training2 and 7#b7 the results of the assessment of the effectiveness of such program required under subsection 7c74 7e7 ,covered employee defined ,in this section1 the term covered employee means an employee of the ,board who is-- 7#a7 not a member of the ,board2 and 7#b7 responsible for drafting decisions of the ,board4 4 7ii7 ,clerical amendment ,the table of sections at the beginning of such chapter is amended by inserting after the item relating to section #gaja;,a the following new item3 #gaja;,b4 ,training program for ,members of ,board on timely and correct adjudication of appeals4 4 7,b7 ,performance reviews of members of the ,board ,section #gaja;,a of such title is amended-- 7i7 in subparagraph 7,b7 of subsection 7c77#a7 by striking not less often than once every three years and inserting not less often than annually2 and 7ii7 by adding at the end the following new subsection3 7h7 7#a7 ,with respect to any performance review of a covered employee1 the ,secretary may not consider the timeliness or quality of work of any ,member of the ,board4 7#b7 ,in this subsection1 the term covered employee has the meaning given such term in section #gaja;,b of this title4 4 7#c7 ,decisions of ,board to remand 7,a7 ,information relating to decisions to remand ,section #gajd of such title is amended in subsection 7d7-- 7i7 by redesignating paragraphs 7#a7 through 7#c7 as paragraphs 7#b7 through 7#d71 respectively2 and 7ii7 by inserting before paragraph 7#b7 7as so redesignated71 the following new paragraph3 7#a7 with respect to a claim that the ,board remands for further action1 a statement of the specific reasons such claim was remanded1 including any failure on the part of the ,secretary to comply with-- 7,a7 the ,secretary's duty to assist under section #eajc;,a of this title2 and 7,b7 the ,secretary's duty to notify under section #eajc of this title2 4 7,b7 ,notice of remanded decision for certain employees ,such section is further amended in-- 7i7 subsection 7e7-- 7,i7 by redesignating paragraphs 7#a7 through 7#c7 as subparagraphs 7,a7 through 7,c71 respectively2 7,,ii7 by striking ,after and inserting 7#a7 ,after2 and 7,,iii7 by adding at the end the following new paragraph3 7#b7 ,if1 pursuant to a decision on an appeal1 the ,board remands a claim for a benefit under a law administered by the ,secretary for further action1 the ,secretary shall1 to the maximum extent practicable1 issue a copy of such decision to each employee of the ,veterans ,benefits ,administration who committed the error resulting in the decision of the ,board to remand1 when applicable4 2 and 7ii7 in subsection 7g71 as redesignated by section #c7;d77#b77;,a71 by striking under subsection 7e7 and inserting under paragraph 7#a7 of subsection 7e74 7#d7 ,annual reports for ,board of ,veterans' ,appeals 7,a7 ,in general ,chapter #ga of title #ch1 ,united ,states ,code1 is amended by inserting after section #gaad the following new section3 #gaae4 ,annual report on ,board of ,veterans' ,appeals ,the ,chairman of the ,board shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate an annual report that includes1 for each decision of the ,board to remand a claim for a benefit under a law administered by the ,secretary to the ,secretary for further adjudication during the period covered by the report1 a statement of the reasons for such decision of the ,board1 disaggregated by decisions on-- 7#a7 claims with a rating decision dated on or after ,february #ai1 #bjai2 and 7#b7 claims with a rating decision dated before such date4 4 7,b7 ,deadlines ,the ,secretary shall submit the first reports required by subsections 7a7 and 7b7 of section #gaae of such title 7as added by paragraph 7#a77 by not later than one year after the date of the enactment of this ,act4 7,c7 ,clerical amendment ,the table of sections at the beginning of such chapter is amended by inserting after the item relating to section #gaad the following new item3 #gaae4 ,annual report on ,board of ,veterans' ,appeals 4 7#e7 ,plan for improvements to quality in decisions of ,board 7,a7 ,in general ,not later than six months after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs1 in consultation with the ,chairman of the ,board of ,veterans' ,appeals and the head of the ,office of ,administrative ,review of the ,veterans ,benefits ,administration1 shall develop a plan to-- 7i7 improve the quality of decisions of the ,board to remand1 pursuant to section #gajd of title #ch1 ,united ,states ,code1 claims for a benefit under a law administered by the ,secretary to the ,secretary for further action2 and 7ii7 mitigate the number of such decisions that are unnecessary under any applicable law or regulation4 7,b7 ,report ,the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a report on such plan by not later than six months after the date of the enactment of this ,act4 7d7 ,notice of avoidable deferrals of claims for benefits under laws administered by the ,secretary of ,veterans ,affairs2 study and report on certain opinions of ,department of ,veterans ,affairs ,office of ,general ,counsel 7#a7 ,notice of avoidable deferrals ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall develop policies1 procedures1 and technological capabilities to ensure that each employee of the ,veterans ,benefits ,administration that commits an avoidable deferral with respect to a claim for benefits under the laws administered by the ,secretary of ,veterans ,affairs in the ,national ,work ,queue is notified of any avoidable deferrals that such employee commits with respect to the same claim4 7#b7 ,study and report on certain ,,ogc opinions 7,a7 ,study ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs1 in consultation with the ,office of the ,general ,counsel of the ,department of ,veterans ,affairs and the ,chairman of the ,board of ,veterans' ,appeals1 shall complete a study to identify-- 7i7 issues about which an opinion from the ,office of the ,general ,counsel of the ,department would foster consistency in the decisions of the ,secretary with respect to claims for benefits under the laws administered by the ,secretary2 and 7ii7 issues raised in appeals of such decisions to the ,united ,states ,court of ,appeals for ,veterans ,claims before the date of the enactment of this ,act about which the ,office of the ,general ,counsel has had inconsistent opinions in matters involving substantially similar questions of law or fact4 7,b7 ,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 ,house of ,representatives a report that includes-- 7i7 the findings of the study required by subparagraph 7,a72 7ii7 a statement of which issues identified pursuant to such study about which the ,office of the ,general ,counsel of the ,department intends to publish an opinion2 and 7iii7 a timeline for the publication of any such opinion4 #ajf4 ,annual report on causes of death among veterans 7a7 ,in general ,subchapter ,,ii of chapter #e of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new section3 #ecd4 ,annual report on causes of death among veterans 7a7 ,in general ,the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate an annual report that contains data and information on causes of death among veterans4 7b7 ,elements ,such report shall include-- 7#a7 for each veteran that died during the period covered by the report an identification of-- 7,a7 whether such veteran had a service-connected disability rated as total2 7,b7 the primary cause of death2 7,c7 the secondary cause of death1 if applicable2 and 7,d7 the manner of death2 7#b7 for each primary cause of death identified pursuant to paragraph 7#a71 a statement of the total number of veterans that died from such primary cause of death during the period covered by the report2 and 7#c7 for each manner of death identified pursuant to paragraph 7#a71 a statement of the total number of veterans that died in such manner during the period covered by the report4 7c7 ,sunset ,this section shall terminate on the date that is five years after the date of the enactment of the ,take ,care of ,america's ,veterans ,act4 4 7b7 ,clerical amendment ,the table of sections at the beginning of chapter #e of such title is amended by inserting after the item relating to section #ecc the following new item3 #ecd4 ,annual report on causes of death among veterans 4 #ajg4 ,plan for use of automation tools to process claims under laws administered by the ,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 submit to the ,committees on ,veterans' ,affairs of the ,senate and ,house of ,representatives the plan of the ,secretary to make available1 to the maximum extent practicable1 an automation tool described in subsection 7b7 to elements of the ,department of ,veterans ,affairs for the purpose of processing claims under laws administered by the ,secretary4 7b7 ,automation tool described ,an automation tool described in this subsection is a technology developed for the ,compensation ,service of the ,veterans ,benefits ,administration that-- 7#a7 automates the retrieval of the service record or health records of a veteran2 7#b7 compiles evidence relevant to the determination of a claim for benefits under laws administered by the ,secretary2 7#c7 provides automated decision support relevant to such a determination2 7#d7 automates information sharing between ,federal agencies2 and 7#e7 assists in generating correspondence regarding such a claim4 7c7 ,analysis ,in developing the plan required under subsection 7a71 the ,secretary shall conduct an analysis of each of the following3 7#a7 ,the feasibility and benefits of the use of an automation tool described in subsection 7b7 by elements of the ,department for the purpose of processing claims under laws administered by the ,secretary4 7#b7 ,any modification to an existing automation tool that could render such tool usable for such purpose by such an element4 7#c7 ,any requirement of any such element pertaining to such purpose that cannot be addressed by using an automation tool4 7#d7 ,the extent to which the technology offices of such elements may need to collaborate with the technology office responsible for developing an automation tool in the course of the development and use of the tool by the element for such purpose4 7#e7 ,a timeline for modifying and implementing any automation tool for use by such elements for such purpose4 7d7 ,priority ,in providing or expanding an automation tool described in subsection 7b7 to elements of the ,department pursuant to the plan required under subsection 7a71 the ,secretary shall give priority to the following elements3 7#a7 ,the ,compensation ,service4 7#b7 ,the ,pension and ,fiduciary ,service of the ,veterans ,benefits ,administration4 7#c7 ,the ,education ,service of the ,veterans ,benefits ,administration4 7#d7 ,program offices of the ,veterans ,benefits ,administration1 as determined by the ,secretary4 7#e7 ,the ,debt ,management ,center4 7#f7 ,the ,board of ,veterans' ,appeals4 7e7 ,other requirements relating to technology at ,department of ,veterans ,affairs 7#a7 ,automatic notices regarding benefits for certain children of veterans 7,a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall implement policies1 processes1 and technological capabilities1 including in the ,national ,work ,queue 7or successor system71 to ensure that1 in the case of any covered situation1 a claims processors is made aware of1 and assigned to address1 such covered situation4 7,b7 ,definitions ,in this subsection3 7i7 ,the term covered situation means-- 7,i7 any increase in the amount of dependency compensation paid to a beneficiary for a child under the laws administered by the ,secretary2 and 7,,ii7 any educational assistance paid to the child of a veteran under the laws administered by the ,secretary4 7ii7 ,the term child has the meaning given such term in section #aja7d77;,a77iii7 of title #ch1 ,united ,states ,code4 7#b7 ,correct labeling of documents ,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 ,senate and ,house of ,representatives a plan to ensure that documents in the ,veterans ,benefits ,management ,system 7or any successor system7 are correctly labeled when such documents are uploaded1 including when such documents are labeled using automation tools4 #ajh4 ,reforms relating to ,department of ,veterans ,affairs disability ratings 7a7 ,ratings for sleep apnea 7#a7 ,in general ,the ,secretary of ,veterans ,affairs shall revise the schedule for rating disabilities adopted and applied under section #aaee of title #ch1 ,united ,states ,code1 as follows3 7,a7 ,a grade of disability of #j percent shall be assigned for sleep apnea syndrome when the syndrome is asymptomatic1 with or without treatment4 7,b7 ,a grade of disability of #aj percent shall be assigned for sleep apnea syndrome when treatment yields incomplete relief4 7,c7 ,a grade of disability of #ej percent shall be assigned for sleep apnea syndrome only if-- 7i7 treatment is either ineffective or the veteran is unable to use the prescribed treatment due to comorbid conditions2 and 7ii7 there is no end-organ damage4 7,d7 ,a grade of disability of #ajj percent shall be assigned for sleep apnea syndrome only if there is also end-organ damage4 7#b7 ,qualifying comorbid conditions ,for purposes of paragraph 7#a77;,c77i71 a comorbid condition is a condition that1 in the opinion of a qualified medical provider1 directly impedes or prevents the use of1 or implementation of1 a recognized form of treatment intervention normally shown to be effective4 7b7 ,ratings for tinnitus ,the ,secretary of ,veterans ,affairs shall revise the schedule for rating disabilities adopted and applied under section #aaee of title #ch1 ,united ,states ,code1 as follows3 7#a7 ,except as provided in paragraph 7#b71 tinnitus may not be assigned a separate compensable disability rating4 7#b7 ,a grade of disability of #aj percent shall be assigned for tinnitus only when tinnitus is diagnosed as associated with service-connected 7as defined in section #aja7af7 of title #ch1 ,united ,states ,code7 hearing loss that is otherwise noncompensable under the laws administered by the ,secretary4 7c7 ,applicability 7#a7 ,in general ,the revisions to the schedule for rating disabilities adopted and applied under section #aaee of title #ch1 ,united ,states ,code1 made pursuant to this section shall apply with respect to claims filed after the date of the enactment of this ,act4 7#b7 ,protection of existing ratings ,the revisions to the schedule for rating disabilities made pursuant to this section may not serve as the basis for reducing1 discontinuing1 or otherwise adversely affecting compensation that was in effect on the day before the date of the enactment of this ,act4 #aji4 ,improvements to temporary licensure requirements for contract health care professionals who perform medical disability examinations for the ,department of ,veterans ,affairs 7a7 ,expansion ,section #ejd of the ,veterans' ,benefits ,improvements ,act of #aiif 7,public ,law #ajd-bge2 #ch ,u4,s4,c4 #eaja note71 as amended by paragraph 7#a7 of subsection 7a7 of section #bjjb of the ,johnny ,isakson and ,david ,p4 ,roe1 ,m4,d4 ,veterans ,health ,care and ,benefits ,improvement ,act of #bjbj 7,public ,law #aaf-cae2 #ch ,u4,s4,c4 #eaja note71 is further amended1 subject to the sunset in paragraph 7#d7 of such subsection1 by striking paragraph 7#b7 of subsection 7c7 and inserting the following3 7#b7 ,health care professional described ,a health care professional described in this paragraph is a person who is eligible for appointment to a position in the ,veterans ,health ,administration covered by section #gdjb7;b7 of title #ch1 ,united ,states ,code1 who-- 7,a7 has a current and unrestricted license to practice the health care profession for which they are licensed2 7,b7 is not barred from practicing such health care profession in any ,state1 the ,district of ,columbia1 or a ,commonwealth1 territory1 or possession of the ,united ,states2 and 7,c7 is performing authorized duties for the ,department pursuant to a contract entered into under subsection 7a74 7#c7 ,source of funds ,expenses of carrying out this section1 including payments for examination travel and incidental expenses under the terms and conditions set forth by section #aaa of this title1 shall be reimbursed to the accounts available for the general operating expenses of the ,veterans ,benefits ,administration and information technology systems from amounts available to the ,secretary for payment of compensation and pensions4 7#d7 ,mechanism for transmittal of evidence introduced by applicants during examinations ,the ,secretary shall establish a mechanism whereby a health care professional who conducts medical examinations or opinions under section #eajc;,a7d7 of this title may transmit to a veteran's claims file1 evidence introduced by the applicant during a medical examination or in conjunction with a medical opinion that examiner used to inform such medical examination or opinion4 4 7b7 ,delayed sunset of amendment ,paragraph 7#d7 of subsection 7a7 of section #bjjb of the ,johnny ,isakson and ,david ,p4 ,roe1 ,m4,d4 ,veterans ,health ,care and ,benefits ,improvement ,act of #bjbj 7,public ,law #aaf-cae2 #ch ,u4,s4,c4 #eaja note7 is amended by striking ,on the date that is five years after the date of the enactment of this ,act and inserting ,on ,september #cj1 #bjcc4 7c7 ,conforming amendment ,paragraph 7#b7 of such subsection is amended by striking physicians assistants1 nurse practitioners1 audiologists1 and psychologists and inserting health care professionals4 7d7 ,report ,not later than #ae 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 regarding the use of the authority under section #ejd of the ,veterans' ,benefits ,improvements ,act of #aiif 7,public ,law #ajd-bge2 #ch ,u4,s4,c4 #eaja note71 as temporarily amended by section #bjjb7;a77#a7 of the ,johnny ,isakson and ,david ,p4 ,roe1 ,m4,d4 ,veterans ,health ,care and ,benefits ,improvement ,act of #bjbj 7,public ,law #aaf-cae2 #ch ,u4,s4,c4 #eaja note7 and this section4 ,such report shall include1 with respect to the one-year period after the date of the enactment of this ,act1 the following elements3 7#a7 ,the number of examinations conducted pursuant to a contract under such authority4 7#b7 ,the cost1 timeliness1 and legal adequacy of such examinations1 disaggregated by-- 7,a7 health care professional2 and 7,b7 contract4 7#c7 ,the number of such examinations conducted in each ,state1 the ,district of ,columbia1 or a ,commonwealth1 territory1 or possession of the ,united ,states4 7#d7 ,the numbers of each kind of health care professionals who conducted such examinations4 7#e7 ,the number of examinations that were erroneously conducted by a health care professional-- 7,a7 without such a contract2 or 7,b7 unauthorized to enter into such a contract4 7#f7 ,the plan of the ,secretary to correct errors in the use of such authority4 #aaj4 ,disability examinations3 study on access in rural areas2 review of training2 review of inadequate or unnecessary examinations 7a7 ,study on improvements to ,department of ,veterans ,affairs covered medical disability examinations in rural areas 7#a7 ,study required ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall complete a study on access by veterans who reside in rural and highly rural areas to covered medical disability examinations4 7#b7 ,elements 7,a7 ,in general ,the study conducted under paragraph 7#a7 shall include the following3 7i7 ,a comparison of the average number of days to complete covered medical disability examinations1 disaggregated by type of examination1 for veterans who reside in rural and highly rural areas compared to an average time for veterans who reside in other areas to complete a covered medical disability examination1 by either contractors or employees of the ,department4 7ii7 ,a root cause analysis of differences identified pursuant to clause 7i74 7iii7 ,the plan of the ,secretary for the following year to improve access described in paragraph 7#a71 which shall include a plan for the pursuit of a commercial or industry-standard solution or technology that could enable housebound veterans or veterans who live in rural areas to receive examinations without traveling long distances4 7,b7 ,number of days to complete defined ,for purposes of subparagraph 7,a77i71 the term number of days to complete means the number of days in the period-- 7i7 beginning on the date on which a contractor or employee of the ,department received a request from the ,secretary to conduct a covered medical disability examination2 and 7ii7 ending on the date on which the examination was completed4 7#c7 ,report on study ,not later than one year after the date of the enactment of this ,act1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report on the findings of the ,secretary with respect to the study completed under paragraph 7#a74 7#d7 ,definitions ,in this subsection3 7,a7 ,the term covered medical disability examination means a medical nexus examination or medical opinion for the purposes of adjudicating a claim for a benefit under chapter #aa or #ae of title #ch1 ,united ,states ,code1 regardless of whether conducted by an employee or a contractor of the ,department4 7,b7 ,the terms rural and highly rural have the meanings given those terms under the rural-urban commuting areas coding system of the ,department of ,agriculture4 7b7 ,review of training for veterans service representatives and rating veterans service representatives 7#a7 ,review required ,the ,secretary of ,veterans ,affairs shall conduct a comprehensive review of the training provided to ,veterans ,service ,representatives 7,v,s,rs7 and ,rating ,veterans ,service ,representatives 7,r,v,s,rs7 regarding covered medical disability examinations for the purpose of claims adjudication4 7#b7 ,scope of review ,the review shall include1 at minimum1 an evaluation of training and policies relating to-- 7,a7 assessing the adequacy of covered medical disability examinations for claims adjudication2 7,b7 determining the necessity of medical disability examinations where claims can be adjudicated based on existing evidence without ordering additional examinations2 7,c7 relevant statutes1 judicial decisions1 regulations1 and ,department policies1 including-- 7i7 the duty to assist claimants2 7ii7 evidentiary standards regarding causation2 7iii7 required elements and standards for covered medical disability examinations1 including the need for reasoned medical opinions2 and 7iv7 the absence of statutory or regulatory presumptions of service connection in covered medical disability examinations2 and 7,d7 input from impacted ,department employees1 including duly appointed labor representatives4 7#c7 ,second-level review for new employees ,the ,secretary shall evaluate the effectiveness of current policies requiring a second level of review of claims decisions made by new ,veterans ,service ,representatives and ,rating ,veterans ,service ,representatives before such employees are authorized to order covered medical disability examinations1 including any applicable accuracy thresholds4 7#d7 ,report to ,congress ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report detailing the findings of the ,secretary with respect to the review conducted under paragraph 7#a71 the data used by the ,secretary to support such findings1 and such recommendations as the ,secretary may have for improvements to training or policies4 7#e7 ,comptroller ,general of the ,united ,states review of findings ,not later than #ahj days after the date on which the ,secretary submits the report under paragraph 7#d71 the ,comptroller ,general of the ,united ,states shall conduct a review of the findings and recommendations contained in the report4 7#f7 ,modification of reports by the ,board of ,veterans' ,appeals and ,united ,states ,court of ,appeals for ,veterans ,claims 7,a7 ,board of ,veterans' ,appeals ,section #gaja7;d77#b7 of title #ch1 ,united ,states ,code1 is amended-- 7i7 in subparagraph 7,f71 by striking 2 and and inserting a semicolon2 7ii7 in subparagraph 7,g71 by striking the period at the end and inserting 2 and2 and 7iii7 by adding at the end the following new subparagraph3 7,h7 a summary of recurring issues that result in the ,board remanding appeals back to the agency of original jurisdiction4 4 7,b7 ,united ,states ,court of ,appeals for ,veterans ,claims ,section #gbhh7;b7 of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new paragraph3 7#af7 ,a summary of recurring issues that result in remands4 4 7#g7 ,definition of covered medical disability examination ,in this subsection1 the term covered medical disability examination means a medical examination or medical opinion that the ,secretary determines necessary for the purposes of adjudicating a claim for a benefit under chapter #aa or #ae of title #ch1 ,united ,states ,code1 regardless of whether conducted by an employee or a contractor of the ,department4 7c7 ,review and priority processing of claims with inadequate or unnecessary examinations 7#a7 ,review ,not later than #a year after the date of the enactment of this ,act and not less frequently than once every three months thereafter1 the ,secretary of ,veterans ,affairs shall review a random and representative sample of all covered medical disability examinations completed during the previous three-month period4 7#b7 ,further sample requirements ,under each review required by paragraph 7#a71 the ,secretary shall ensure the review includes-- 7,a7 a statistically significant sample of covered medical disability examinations completed by employees of the ,department of ,veterans ,affairs2 and 7,b7 a statistically significant sample of covered medical disability examinations completed by each contractor that provides such examinations for the ,department4 7#c7 ,analysis ,under each review required by paragraph 7#a71 the ,secretary shall-- 7,a7 analyze the samples specified in paragraph 7#b72 and 7,b7 pursuant to such analysis1 identify-- 7i7 the percentage of examinations that were adequate for purposes of adjudicating the particular claim for a benefit under chapter #aa or #ae of title #ch1 ,united ,states ,code1 for which the examination was ordered by the ,department2 and 7ii7 the percentage of examinations considered overdeveloped for purposes of adjudicating claims for a benefit under chapter #aa or #ae of title #ch1 ,united ,states ,code1 for which the examination was ordered by the ,department4 7#d7 ,priority processing 7,a7 ,in general ,except as provided for in subparagraph 7,b71 if during a review under paragraph 7#a7 the ,secretary finds any covered medical disability examination to be not adequate for adjudicating a claim1 the ,secretary shall ensure the claimant examined by that examination-- 7i7 receives another examination1 if necessary1 on a priority basis2 and 7ii7 receives priority processing for the entirety of impacted claim4 7,b7 ,exception ,the ,secretary is not required to furnish an additional examination under subparagraph 7,a7 if the ,secretary determines such an examination to be unnecessary for purposes of adjudicating the claim4 7#e7 ,comptroller ,general of the ,united ,states study ,the ,comptroller ,general of the ,united ,states shall conduct a review of the methodology and effectiveness of the ,departments review required in paragraph 7#a74 7#f7 ,covered medical disability examination defined ,in this subsection1 the term covered medical disability examination means a medical examination or opinion for the purposes of adjudicating a claim for a benefit under chapter #aa or #ae of title #ch1 ,united ,states ,code1 regardless of whether conducted by an employee or a contractor of the ,department4 7d7 ,review and plan regarding department of veterans affairs scheduling of medical examinations 7#a7 ,review required ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall complete a review of scheduling request tools1 contracts1 and systems used by employees and contractors of the ,department of ,veterans ,affairs to order and conduct medical disability examinations4 7#b7 ,plan required ,not later than one year after the date of the enactment of this ,act1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a plan to ensure the following3 7,a7 ,systems and processes used by the ,department enable seamless and clear communication of requirements between the claims processors who request medical disability examinations and the persons who conduct such examinations1 including through a contract4 7,b7 ,medical disability examiners1 including through a contract1 have access to the medical records and claims information they need to conduct exams that are adequate for purposes of rating claims for benefits under laws administered by the ,secretary4 7,c7 ,claimants or appellants for whom a medical disability examination is requested of the ,department have agency in determining when and where the examination is conducted4 7,d7 ,claimants or appellants for whom a medical disability examination is requested of the ,department have a seamless experience when scheduling their examinations without regard to who conducts the examinations4 7,e7 ,the ,department conducts customer satisfaction and experience surveys of claimants or appellants who attend medical disability examinations provided under laws administered by the ,secretary4 #aaa4 ,improvements to processing and outreach regarding claims involving military sexual trauma 7a7 ,evaluation of claims involving military sexual trauma 7#a7 ,in general ,subchapter ,,vi of chapter #aa of such title is amended by inserting after section #aaff the following new section3 #aaff;,a4 ,evaluation of claims involving military sexual trauma 7a7 ,notice and opportunity to supply evidence ,the ,secretary may not deny a claim of a veteran for compensation under this chapter for military sexual trauma without first-- 7#a7 advising the veteran of the evidence that would constitute credible corroborating evidence of the military sexual trauma2 and 7#b7 allowing the veteran an opportunity to furnish such corroborating evidence4 7b7 ,point of contact ,the ,secretary shall ensure that each document provided to a veteran relating to a claim for compensation under this chapter for a military sexual trauma includes contact information for an appropriate point of contact with the ,department4 7c7 ,specialized teams ,the ,secretary shall ensure that all claims for compensation under this chapter for a military sexual trauma are reviewed and processed by a specialized team established under section #aaff of this title4 7#a7 ,the ,secretary shall ensure that not less than annually1 the policies and procedures employed by the specialized team established under section #aaff of this title are reviewed by medical or mental health professionals as the ,secretary considers appropriate to determine whether the current standard of evidentiary review for acceptable documentation adequately evaluates the likelihood a military sexual trauma occurred4 7#b7 ,the ,secretary shall also conduct periodic quality reviews of claims processed by the specialized teams established under section #aaff to identify inconsistencies1 training deficiencies1 or procedural shortcomings and implement corrective actions as appropriate4 4 7#b7 ,outreach 7,a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall implement1 with input from the veteran community1 an informative outreach program for veterans regarding the standard of proof for evaluation of claims relating to military sexual trauma1 including requirements for a medical examination and opinion4 7,b7 ,targeted outreach ,in implementing the program under subparagraph 7,a71 the ,secretary shall1 to the extent practicable1 target outreach to veterans who submitted a claim relating to military sexual trauma that was denied4 7#c7 ,clerical amendment ,the table of sections at the beginning of chapter #aa of such title is amended by inserting after the item relating to section #aaff the following new item3 #aaff;,a4 ,evaluation of claims involving military sexual trauma4 4 7b7 ,communications from the ,department of ,veterans ,affairs to individuals who have experienced military sexual trauma 7#a7 ,review working group 7,a7 ,in general ,the ,secretary of ,veterans ,affairs shall establish a working group to review correspondence relating to military sexual trauma4 7,b7 ,membership ,the working group established under subparagraph 7,a7 shall be composed of members who shall be appointed by the ,secretary from among employees of the ,department of ,veterans ,affairs who are experts in military sexual trauma and mental health1 of whom-- 7i7 one or more shall be appointed from among mental health providers of the ,veterans ,health ,administration2 7ii7 one or more shall be appointed from among experts on sexual assault and sexual harassment of the ,veterans ,benefits ,administration2 and 7iii7 one or more shall be appointed from among experts on sexual assault and sexual harassment of the ,board of ,veterans' ,appeals4 7,c7 ,duties ,the working group established under subparagraph 7,a7 shall-- 7i7 review standard correspondence1 which may include templates for notices under sections #eajc1 #eajd1 #eajd;,b1 and #gajd of title #ch1 ,united ,states ,code1 from the ,department to individuals who have experienced military sexual trauma for sensitivity2 and 7ii7 ensure that the correspondence-- 7,i7 treats such individuals with dignity and respect2 and 7,,ii7 does not re-traumatize such individuals4 7,d7 ,individual who has experienced military sexual trauma defined ,in this subsection1 the term individual who has experienced military sexual trauma means-- 7i7 an individual who has filed a claim for compensation under chapter of title #ch1 ,united ,states ,code1 relating to military sexual trauma2 7ii7 a veteran who has been awarded compensation under such chapter relating to military sexual trauma2 or 7iii7 a member of the ,armed ,forces 7including a member of the ,national ,guard or ,reserves71 a former member of the ,armed ,forces1 or a veteran who is receiving care from the ,department relating to military sexual trauma4 7#b7 ,contents of certain written communications to individuals who have experienced military sexual trauma 7,a7 ,notice to claimants of required information and evidence ,section #eajc of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new subsection3 7c7 ,written communications to individuals who have experienced military sexual trauma 7#a7 ,the ,secretary shall ensure that any written communication under this section from the ,department to an individual who has experienced military sexual trauma includes each of the following3 7,a7 ,contact information for each of the following3 7i7 ,the military sexual trauma coordinator of the ,veterans ,benefits ,administration4 7ii7 ,the military sexual trauma coordinator of the ,veterans ,health ,administration4 7iii7 ,the ,veterans ,crisis ,line4 7iv7 ,the facility of the ,veterans ,health ,administration closest to where the individual resides4 7v7 ,the ,readjustment ,counseling ,service location closest to where the individual resides4 7,b7 ,information on the eligibility of the individual for services provided through the ,readjustment ,counseling ,service location described in subparagraph 7,a77v74 7#b7 ,in this subsection3 7,a7 ,the term individual who has experienced military sexual trauma means-- 7i7 an individual who has filed a claim for compensation under chapter #aa of this title relating to military sexual trauma2 7ii7 a veteran who has been awarded compensation under such chapter relating to military sexual trauma2 or 7iii7 a member of the ,armed ,forces 7including a member of the ,national ,guard or ,reserves71 a former member of the ,armed ,forces1 or a veteran who is receiving care from the ,department relating to military sexual trauma4 7,b7 ,the term military sexual trauma has the meaning given that term in section #aaff7;d77#b7 of this title4 7,c7 ,the term ,veterans ,crisis ,line means the toll-free hotline for veterans established under section #agbj;,f7h7 of this title4 4 7,b7 ,decisions and notices of decisions ,section #eajd of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new subsection3 7e7 7#a7 ,the ,secretary shall ensure that any written communication under this section from the ,department to an individual who has experienced military sexual trauma includes each of the following3 7,a7 ,contact information for each of the following3 7i7 ,the military sexual trauma coordinator of the ,veterans ,health ,administration4 7ii7 ,the ,veterans ,crisis ,line4 7iii7 ,the facility of the ,veterans ,health ,administration closest to where the individual resides4 7iv7 ,the ,readjustment ,counseling ,service location closest to where the individual resides4 7,b7 ,information on the eligibility of the individual for services provided through the ,readjustment ,counseling ,service location described in subparagraph 7,a77iv74 7#b7 ,the ,secretary shall ensure that any written communication under this section from the ,department to an individual who has experienced military sexual trauma that includes notification of an award of compensation under chapter #aa of this title relating to military sexual trauma includes-- 7,a7 the contact information described in paragraph 7#a72 and 7,b7 the contact information for the military sexual trauma coordinator of the ,veterans ,benefits ,administration4 7#c7 ,in this subsection3 7,a7 ,the term individual who has experienced military sexual trauma means-- 7i7 an individual who has filed a claim for compensation under chapter #aa of this title relating to military sexual trauma2 7ii7 a veteran who has been awarded compensation under such chapter relating to military sexual trauma2 or 7iii7 a member of the ,armed ,forces 7including a member of the ,national ,guard or ,reserves71 a former member of the ,armed ,forces1 or a veteran who is receiving care from the ,department relating to military sexual trauma4 7,b7 ,the term military sexual trauma has the meaning given that term in section #aaff7;d77#b7 of this title4 7,c7 ,the term ,veterans ,crisis ,line means the toll-free hotline for veterans established under section #agbj;,f7h7 of this title4 4 7,c7 ,higher-level review by the agency of original jurisdiction ,section #eajd;,b of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new subsection3 7f7 ,written communications to individuals who have experienced military sexual trauma 7#a7 ,the ,secretary shall ensure that any written communication under this section from the ,department to an individual who has experienced military sexual trauma includes each of the following3 7,a7 ,contact information for each of the following3 7i7 ,the military sexual trauma coordinator of the ,veterans ,health ,administration4 7ii7 ,the ,veterans ,crisis ,line4 7iii7 ,the facility of the ,veterans ,health ,administration closest to where the individual resides4 7iv7 ,the ,readjustment ,counseling ,service location closest to where the individual resides4 7,b7 ,information on the eligibility of the individual for services provided through the ,readjustment ,counseling ,service location described in subparagraph 7,a77iv74 7#b7 ,the ,secretary shall ensure that any written communication under this section from the ,department to an individual who has experienced military sexual trauma that includes notification of an award of compensation under chapter #aa of this title relating to military sexual trauma includes-- 7,a7 the contact information described in paragraph 7#a72 and 7,b7 the contact information for the military sexual trauma coordinator of the ,veterans ,benefits ,administration4 7#c7 ,in this subsection3 7,a7 ,the term individual who has experienced military sexual trauma means-- 7i7 an individual who has filed a claim for compensation under chapter #aa of this title relating to military sexual trauma2 7ii7 a veteran who has been awarded compensation under such chapter relating to military sexual trauma2 or 7iii7 a member of the ,armed ,forces 7including a member of the ,national ,guard or ,reserves71 a former member of the ,armed ,forces1 or a veteran who is receiving care from the ,department relating to military sexual trauma4 7,b7 ,the term military sexual trauma has the meaning given that term in section #aaff7;d77#b7 of this title4 7,c7 ,the term ,veterans ,crisis ,line means the toll-free hotline for veterans established under section #agbj;,f7h7 of this title4 4 7,d7 ,board of ,veterans' ,appeals ,section #gajd of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new subsection3 7g7 7#a7 ,the ,secretary shall ensure that any written communication under this section from the ,department to an individual who has experienced military sexual trauma include each of the following3 7,a7 ,contact information for each of the following3 7i7 ,the military sexual trauma coordinator of the ,veterans ,health ,administration4 7ii7 ,the ,veterans ,crisis ,line4 7iii7 ,the facility of the ,veterans ,health ,administration closest to where the individual resides4 7iv7 ,the ,readjustment ,counseling ,service location closest to where the individual resides4 7,b7 ,information on the eligibility of the individual for services provided through the ,readjustment ,counseling ,service location described in subparagraph 7,a77iv74 7#b7 ,the ,secretary shall ensure that any written communication under this section from the ,department to an individual who has experienced military sexual trauma that includes notification of an award of compensation under chapter #aa of this title relating to military sexual trauma includes-- 7,a7 the contact information described in paragraph 7#a72 and 7,b7 the contact information for the military sexual trauma coordinator of the ,veterans ,benefits ,administration4 7#c7 ,in this subsection3 7,a7 ,the term individual who has experienced military sexual trauma means-- 7i7 an individual who has filed a claim for compensation under chapter #aa of this title relating to military sexual trauma2 7ii7 a veteran who has been awarded compensation under such chapter relating to military sexual trauma2 or 7iii7 a member of the ,armed ,forces 7including a member of the ,national ,guard or ,reserves71 a former member of the ,armed ,forces1 or a veteran who is receiving care from the ,department relating to military sexual trauma4 7,b7 ,the term military sexual trauma has the meaning given that term in section #aaff7;d77#b7 of this title4 7,c7 ,the term ,veterans ,crisis ,line means the toll-free hotline for veterans established under section #agbj;,f7h7 of this title4 4 7c7 ,study on training and processing relating to claims for disability compensation relating to military sexual trauma 7#a7 ,study required ,the ,secretary of ,veterans ,affairs shall conduct a study on-- 7,a7 the quality of training provided to personnel of the ,department of ,veterans ,affairs who review claims for disability compensation under chapter #aa of title #ch1 ,united ,states ,code1 for disabilities relating to military sexual trauma2 and 7,b7 the quality of the procedures of the ,department for reviewing the accuracy of the processing of such claims4 7#b7 ,elements ,the study required by subsection 7a7 shall include the following3 7,a7 ,with respect to the quality of training described in paragraph 7#a7 of such subsection3 7i7 ,whether the ,department ensures personnel complete such training on time4 7ii7 ,whether the training has resulted in improvements to the processing of claims described in such subsection and issue-based accuracy4 7iii7 ,such recommendations as the ,secretary may have for improving the training4 7,b7 ,with respect to the quality of procedures described in paragraph 7#b7 of such subsection3 7i7 ,whether the procedures of the ,department for reviewing the accuracy of the processing of claims described in such subsection comport with generally accepted statistical methodologies to ensure reasonable accuracy of such reviews4 7ii7 ,whether such procedures adequately include mechanisms to correct errors found in such reviews4 7iii7 ,a summary of quality assurance reviews and reports conducted as part of such procedures4 7iv7 ,such recommendations as the ,secretary may have for improving such procedures4 7#c7 ,report required ,not later than one year after the date of the enactment of this ,act1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report detailing the findings of the ,secretary with respect to the study conducted under paragraph 7#a74 7d7 ,annual special focus review of claims for disability compensation for disabilities relating to military sexual trauma 7#a7 ,annual special focus review 7,a7 ,in general ,each year1 the ,under ,secretary for ,benefits of the ,department of ,veterans ,affairs shall conduct a special focus review on the accuracy of the processing of claims for disability compensation under chapter #aa of title #ch1 ,united ,states ,code1 for disabilities relating to military sexual trauma4 7,b7 ,elements ,each review conducted under subparagraph 7,a7 shall include a review of the following3 7i7 ,a statistically significant1 nationally representative sample of all claims for benefits under the laws administered by the ,secretary of ,veterans ,affairs relating to military sexual trauma filed during the fiscal year preceding the fiscal year in which the report is submitted4 7ii7 ,the accuracy of each decision made with respect to each claim described in clause 7i74 7iii7 ,the types of benefit entitlement errors found1 disaggregated by category4 7iv7 ,trends from year to year4 7v7 ,training completion rates for personnel of the ,department who process claims described in subparagraph 7,a74 7#b7 ,reprocessing of claims ,if the ,under ,secretary finds1 pursuant to a special focus review conducted under paragraph 7#a77;,a71 that an error was made with respect to the entitlement of a veteran to a benefit under the laws administered by the ,secretary1 the ,secretary shall return the relevant claim of the veteran to the appropriate office of the ,department for reprocessing to ensure that the veteran receives an accurate decision with respect to the claim4 7#c7 ,report ,section #eeja7;b7 of the ,johnny ,isakson and ,david ,p4 ,roe1 ,m4,d4 ,veterans ,health ,care and ,benefits ,improvement ,act of #bjbj 7,public ,law #aaf-cae2 #acd ,stat4 #ejdh7 is amended-- 7,a7 in paragraph 7#a71 by striking through #bjbg and inserting until the date described in section #aji7;d77#d7 of the ,take ,care of ,america's ,veterans ,act2 and 7,b7 in paragraph 7#b71 by adding at the end the following new subparagraph3 7,i7 ,the findings of the most recent special focus review conducted under subsection 7d77#a77;,a7 of section #aji of the ,take ,care of ,america's ,veterans ,act1 including-- 7i7 the elements under subsection 7d77#a77;,b7 of such section2 7ii7 the number of claims returned for reprocessing under subsection 7d77#b7 of such section2 and 7iii7 the number of claims described in clause 7ii7 for which the decision relating to service-connection or entitlement to compensation changed as a result of reprocessing the claim4 4 7#d7 ,sunset ,on the date that is #e years after the enactment of this ,act1 paragraph 7#a77;,a7 shall cease to be in effect4 7e7 ,working group on medical examinations for claims for disability compensation for disabilities relating to military sexual trauma 7#a7 ,in general ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall establish a working group on medical examinations for claims for disability compensation under chapter #aa of title #ch1 ,united ,states ,code1 for disabilities relating to military sexual trauma 7in this section referred to as the working group74 7#b7 ,membership ,the working group shall be composed of the following3 7,a7 ,staff of the operations center for military sexual trauma of the ,department of ,veterans ,affairs who have experience reviewing the quality of medical examinations in support of claims for disability compensation under chapter #aa of title #ch1 ,united ,states ,code4 7,b7 ,staff of the ,medical ,disability ,examination ,office of the ,department4 7,c7 ,veterans service officers who have experience with claims described in paragraph 7#a74 7,d7 ,medical examiners who have experience with such claims4 7,e7 ,staff of the ,veterans ,experience ,office of the ,department4 7,f7 ,such other individuals as the ,secretary considers appropriate4 7#c7 ,duties ,not later than #ahj days after the date of the enactment of this ,act1 the working group shall-- 7,a7 review the quality of medical examinations described in paragraph 7#a72 7,b7 review the feasibility of minimizing re-examinations for conditions relating to military sexual trauma2 and 7,c7 submit to the ,under ,secretary for ,benefits of the ,department and the ,secretary recommendations on how to-- 7i7 eliminate re-traumatization of individuals who file claims described in paragraph 7#a72 and 7ii7 reduce the overdevelopment of such claims4 7#d7 ,report ,not later than one year after the date of the enactment of this ,act1 the ,secretary shall submit to ,congress a report that includes the following3 7,a7 ,the views of the working group on efforts by the ,department to eliminate re-traumatization of individuals who file claims described in subsection 7a74 7,b7 ,legislative proposals to improve the experience of such individuals in pursuing such claims4 7,c7 ,the recommendations submitted under paragraph 7#c77;,c74 7,d7 ,the plan of the ,under ,secretary for ,benefits of the ,department and the ,secretary to implement such recommendations4 7#e7 ,review and implementation ,not later than one year after the date of the enactment of this ,act1 the ,under ,secretary for ,benefits of the ,department and the ,secretary shall-- 7,a7 review the recommendations submitted under paragraph 7#c77;,c72 and 7,b7 implement the recommendations that1 as determined by the ,under ,secretary and the ,secretary1 would improve the claims process for individuals who file claims described in paragraph 7#a74 7f7 ,military sexual trauma claims performance dashboard 7#a7 ,establishment ,the ,secretary of ,veterans ,affairs shall establish an interactive performance dashboard displaying information about claims relating to military sexual trauma submitted to the ,secretary for benefits under laws administered by the ,secretary4 7#b7 ,elements ,the dashboard established pursuant to paragraph 7#a7 shall cover the following3 7,a7 ,claims relating to military sexual trauma submitted to the ,secretary for benefits under laws administered by the ,secretary that have been submitted1 completed1 or appealed1 including appeals pending at the agency of jurisdiction and at the ,board of ,veterans' ,appeals4 7,b7 ,for comparison purposes with subparagraph 7,a71 claims not relating to military sexual trauma submitted to the ,secretary for benefits under laws administered by the ,secretary that have been submitted1 completed1 or appealed4 7,c7 ,overall1 cumulative information relating to claims relating to military sexual trauma submitted to the ,secretary for benefits under laws administered by the ,secretary1 including the following3 7i7 ,average number of days a claim is pending review4 7ii7 ,average number of days for completed adjudication4 7iii7 ,total number of pending claims1 disaggregated by whether the claims have been partially adjudicated or not adjudicated at all4 7iv7 ,total number of claims completely adjudicated4 7v7 ,of the number specified in clause 7iv71 the percentage that were approved1 denied1 or appealed4 7,d7 ,the total number of claims relating to military sexual trauma submitted to the ,secretary for benefits under laws administered by the ,secretary4 7,e7 ,the methods used for submittal of claims relating to military sexual trauma to the ,secretary for benefits under laws administered by the ,secretary4 7,f7 ,the most frequent reasons the ,secretary denies a claim relating to military sexual trauma submitted to the ,secretary for a benefit under a law administered by the ,secretary4 7,g7 ,the most frequent conditions or disabilities for which a claim relating to military sexual trauma is denied4 7,h7 ,the most frequent conditions or disabilities for which a claim relating to military sexual trauma is submitted to the ,secretary for disability compensation under chapter #aa of title #ch1 ,united ,states ,code1 including the grant rate for such contentions4 7#c7 ,additional resource information ,the ,secretary shall make available via the performance dashboard established pursuant to subsection 7a7 the following information3 7,a7 ,veterans ,crisis ,line contact information4 7,b7 ,information regarding the availability of services from military sexual trauma coordinators of the ,veterans ,health ,administration4 7,c7 ,information regarding the availability of services from military sexual trauma coordinators of the ,veterans ,benefits ,administration4 7,d7 ,information on availability of specialized care1 services1 and benefits from the ,department for individuals who have experienced military sexual trauma4 7,e7 ,such additional information as the ,secretary considers appropriate4 7#d7 ,availability ,the ,secretary shall ensure that the dashboard established pursuant to paragraph 7#a7 is available to the public from the website of the ,department of ,veterans ,affairs and is updated not less frequently than once every #cj days4 7#e7 ,reporting requirements 7,a7 ,not later than #b years after the date of the enactment of this ,act1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report detailing-- 7i7 the annual cost to implement the dashboard required by paragraph 7#b72 7ii7 areas for improvement of the dashboard2 and 7iii7 such additional information as the ,secretary considers appropriate4 7,b7 ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary shall commence providing1 on a quarterly basis1 to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a quarterly briefing on the ,department's processing of military sexual trauma-related claims4 7#f7 ,definition ,in this section1 the term military sexual trauma has the meaning given such term in section #aaff7;d77#b7 of title #ch1 ,united ,states ,code4 #aab4 ,independent assessment of notices that the ,secretary of ,veterans ,affairs sends to claimants 7a7 ,agreement ,not later than #cj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall seek to enter into an agreement with an ,,ffrdc for an assessment of notices that the ,secretary sends to claimants4 7b7 ,assessment ,an ,,ffrdc that enters into an agreement under subsection 7a7 shall submit to the ,secretary a written assessment of such notices4 ,the assessment shall include the following3 7#a7 ,the determination of the ,,ffrdc1 made in consultation with covered entities1 whether each such notice may be feasibly altered to reduce paper consumption by1 and costs to1 the ,federal ,government4 7#b7 ,the recommendations of the ,,ffrdc regarding how the ,secretary may make such notices clearer to claimants1 better organized1 and more concise4 7c7 ,report2 implementation ,not later than #ij days after the ,secretary receives the assessment under subsection 7b71 the ,secretary shall-- 7#a7 submit to the ,committees on ,veterans' ,affairs of the ,senate and ,house of ,representatives a copy of such assessment2 and 7#b7 implement the recommendations in the assessment that are in compliance with the laws administered by the ,secretary4 7d7 ,deadline for implementation ,the ,secretary shall complete the implementation of such recommendations pursuant to subsection 7c77#b7 by not later than one year after the date on which the ,secretary commences such implementation4 7e7 ,definitions ,in this section3 7#a7 ,the term ,,ffrdc means a federally funded research and development center4 7#b7 ,the term covered entities includes-- 7,a7 the ,secretary of ,veterans ,affairs2 7,b7 an expert in laws administered by the ,secretary of ,veterans ,affairs2 7,c7 a veterans service organization recognized under section #eijb of title #ch1 ,united ,states ,code2 7,d7 an entity that advocates for veterans2 and 7,e7 an entity that advocates for the survivors of veterans4 7#c7 ,the terms claimant and notice have the meanings given such terms in section #eajj of title #ch1 ,united ,states ,code4 #aac4 ,independent assessment of forms that the ,secretary of ,veterans ,affairs sends to claimants 7a7 ,agreement ,not later than #cj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall seek to enter into an agreement with an ,,ffrdc for an assessment of forms that the ,secretary sends to claimants4 7b7 ,assessment ,an ,,ffrdc that enters into an agreement under subsection 7a7 shall submit to the ,secretary a written assessment1 made in consultation with covered entities1 of such forms4 ,the assessment shall include the recommendations of the ,,ffrdc regarding how the ,secretary may make such forms clearer to claimants and better organized4 7c7 ,report2 implementation ,not later than #ij days after the ,secretary receives the assessment under subsection 7b71 the ,secretary shall-- 7#a7 submit to the ,committees on ,veterans' ,affairs of the ,senate and ,house of ,representatives a copy of such assessment2 and 7#b7 implement the recommendations in the assessment that are in compliance with the laws administered by the ,secretary4 7d7 ,deadline for implementation ,the ,secretary shall complete the implementation of such recommendations pursuant to subsection 7c77#b7 by not later than two years after the date on which the ,secretary commences such implementation4 7e7 ,definitions ,in this section3 7#a7 ,the term ,,ffrdc means a federally funded research and development center4 7#b7 ,the term covered entities includes-- 7,a7 the ,secretary of ,veterans ,affairs2 7,b7 an expert in laws administered by the ,secretary of ,veterans ,affairs2 7,c7 a veterans service organization recognized under section #eijb of title #ch1 ,united ,states ,code2 7,d7 an entity that advocates for veterans2 and 7,e7 an entity that advocates for survivors of veterans4 7#c7 ,the term claimant has the meaning given such term in section #eajj of title #ch1 ,united ,states ,code4 ,,ii ,education and ,economic ,opportunity #bja4 ,vets ,opportunity ,act 7a7 ,repayment of members of the ,armed ,forces for contributions towards ,post-#i_/aa ,educational ,assistance3 timing2 mechanism for individuals not eligible for a monthly housing stipend 7#a7 ,in general ,subsection 7f7 of section #ccbg of title #ch1 ,united ,states ,code1 is amended-- 7,a7 in paragraph 7#c71 by striking together and all that follows through before and inserting not later than #fj days after2 and 7,b7 by adding at the end the following new paragraph3 7#d7 ,additional assistance for an individual not eligible for a monthly housing stipend ,in the case of an individual making an election under subsection 7a7 who is described by subparagraph 7,a71 7,c71 or 7,e7 of paragraph 7#a7 of that subsection1 and who is not eligible for a monthly stipend payable under section #ccac7;c7 of this title1 the educational assistance payable to the individual under this chapter shall be paid-- 7,a7 in a lump sum calculated by multiplying-- 7i7 the total amount of contributions described in paragraph 7#a77;,a7 with regards to such individual2 and 7ii7 the sum of the number of months described in subclauses 7,i7 and 7,,ii7 of paragraph 7#a77;,b77i7 with regards to such individual2 and 7,b7 to the individual not later than #fj days after the exhaustion of the individual's entitlement to educational assistance under this chapter4 4 7#b7 ,technical corrections and conforming amendment ,such subsection is further amended-- 7,a7 by striking paragraphs 7#b7 through 7#g7 and inserting paragraphs 7#b7 through 7#f72 and 7,b7 in paragraph 7#a71 in the heading1 by inserting for an individual eligible for a monthly housing stipend after ,additional assistance4 7#c7 ,effective date ,the amendments made by this section shall take effect on ,august #a1 #bjbg4 7b7 ,treatment of certain independent study programs under educational assistance programs of ,department of ,veterans ,affairs 7#a7 ,in general ,section #cfhj;,a7a77#d77;,a77ii77,,iii7 of such title is amended-- 7,a7 by inserting that requires regular and substantive interaction between students and instructors after course of study2 7,b7 in item 7aa71 by striking 2 or and inserting a semicolon2 7,c7 in item 7bb71 by striking 2 and and inserting 2 or2 and 7,d7 by adding at the end by following new item3 7cc7 an institution of higher education1 as such term is defined in section #ajb of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajjb71 that is approved to participate or is participating in the student financial assistance programs authorized by title ,,iv of that ,act2 and 4 7#b7 ,applicability ,the amendment made by paragraph 7#a7 shall apply with respect to a quarter1 semester1 or term1 as applicable1 that begins on or after ,august #a1 #bjbg4 7#c7 ,oversight ,during the first six years beginning on the date of enactment of this ,act1 the ,secretary1 in coordination with ,state approving agencies1 shall1 every two years1 conduct risk-based surveys or reviews of institutions approved pursuant to section #cfhj;,a7a77#d77;,a77ii77,,iii77cc7 of title #ch1 ,united ,states ,code1 as added by paragraph 7#a74 7#d7 ,,gao report ,not later than #c years after the date of enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall submit to the ,committees on ,veterans' ,affairs of the ,senate and ,house of ,representatives a report on the oversight and implementation of the amendments made by paragraph 7#a71 including-- 7,a7 the effectiveness of oversight activities conducted by the ,department of ,veterans ,affairs and ,state approving agencies2 7,b7 institutional compliance with applicable requirements under chapter #cf of title #ch1 ,united ,states ,code2 7,c7 participation and outcomes of veterans enrolled in programs approved pursuant to section #cfhj;,a7a77#d77;,a77ii77,,iii77cc7 of such title1 as added by paragraph 7#a72 and 7,d7 any recommendations to improve oversight1 program integrity1 or educational outcomes for veterans4 7#e7 ,applicability ,to the extent practicable for any program requiring practical1 laboratory1 clinical1 shop1 or hands on competencies1 the online portion of instruction may not substitute for the supervised in person training necessary to demonstrate such competencies4 7c7 ,absence from certain education due to certain service 7#a7 ,options ,section #cfia;,a of such title is amended by striking paragraph 7#a7 of subsection 7a7 and inserting the following3 7#a7 ,a covered member may1 after receiving orders to enter a period of covered service-- 7,a7 withdraw from covered education2 7,b7 take a leave of absence from covered education2 or 7,c7 subject to subsection 7d71 enter into an agreement with the institution concerned to complete a course of covered education to the satisfaction of such institution concerned4 4 7#b7 ,conforming amendment ,such subsection is further amended1 in paragraph 7#b77;,a71 by striking or takes a leave of absence and inserting 1 takes a leave of absence1 or enters into an agreement4 7#c7 ,agreement ,such section is further amended-- 7,a7 by redesignating subsection 7d7 as subsection 7e72 and 7,b7 by inserting1 after subsection 7c71 the following new subsection 7d73 7d7 ,agreement with institution concerned ,a covered member may enter into an agreement under subsection 7a7 only if the covered member has completed at least half of a course of covered education4 4 7#d7 ,section heading ,such section is further amended by striking the heading and inserting ,absence from certain education due to certain service4 7#e7 ,table of sections ,the table of sections at the beginning of chapter #cf of such title is amended by striking the item relating to section #cfia;,a and inserting the following new item3 #cfia;,a4 ,absence from certain education due to certain service4 4 7d7 ,department of ,veterans ,affairs compliance surveys ,section #cfic of such title is amended-- 7#a7 in subsection 7c7-- 7,a7 by striking not more than #aj business days of notice2 7,b7 by striking this section4 and inserting this section--2 and 7,c7 by adding at the end the following new paragraphs3 7#a7 in the case of an educational institution or training establishment with a time stamp database collection feature1 not fewer than #aj1 and not more than #ae1 business days of notice2 and 7#b7 in the case of any other educational institution or training establishment1 not more than #aj business days of notice4 2 and 7#b7 by striking subsection 7d7 and inserting the following new subsection 7d73 7d7 ,definitions ,in this section3 7#a7 ,the terms educational institution and training establishment have the meanings given such terms in section #cdeb of this title4 7#b7 ,the term school certifying official means an employee of an educational institution with primary responsibility for certifying veteran enrollment at the educational institution4 4 7e7 ,notification of school certifying officials of handbook updates 7#a7 ,in general ,not later than #ad business days after updating the school certifying official handbook of the ,department of ,veterans ,affairs1 the ,secretary of ,veterans ,affairs shall provide notice to all school certifying officials of such update4 7#b7 ,school certifying official defined ,the term school certifying official means an employee of an educational institution with primary responsibility for certifying veteran enrollment at the educational institution4 #bjb4 ,improvements to process for making payments to automobile sellers for automobiles purchased for certain disabled veterans 7a7 ,timeliness of payments ,section #cijb of title #ch1 ,united ,states ,code1 is amended1 in subsection 7a7-- 7#a7 by inserting 7#a7 before ,the ,secretary2 and 7#b7 by adding at the end the following new paragraph3 7#b7 ,the ,secretary shall-- 7,a7 make payments under this section in compliance with regulations prescribed under section #cijc7;a7 of title #ca1 except that no interest penalties shall be required to be paid under this section2 and 7,b7 in the case of any payment under this section that is not processed during the period of #cj days following receipt by the ,secretary of the final invoice for such payment1 the ,secretary shall publish in the ,federal ,register the number of days required to process the payment4 4 7b7 ,centralization of process for making payments ,such section is amended by adding at the end the following new subsection3 7f7 7#a7 ,the ,secretary shall process payments under this section through one office of the ,department that the ,secretary determines has the capacity and expertise to make such payments in compliance with regulations described in subsection 7a77#b74 7#b7 ,the ,secretary shall accurately track and resolve payments due to sellers under this section that are more than #ij days overdue4 4 7c7 ,reporting ,the ,secretary of ,veterans ,affairs shall submit to the ,committees on ,veterans' ,affairs of the ,senate and ,house of ,representatives1 and publish on a publicly accessible website of the ,department of ,veterans ,affairs1 four semiannual reports after the date of the enactment of this ,act1 regarding the administration of section #cijb of title #ch1 ,united ,states ,code1 as amended by this section4 ,each such report shall include1 with respect to the period of six months preceding the date of the report1 the following elements3 7#a7 ,the average and median number of days between receipt of a invoice for payment under such section by the ,claims ,intake ,center of the ,department and the day when the ,secretary makes such payment1 disaggregated by whether the claim was under review or being processed by-- 7,a7 the ,veterans ,health ,administration2 7,b7 the ,veterans ,benefits ,administration2 or 7,c7 the seller4 7#b7 ,improvements to information technology of the ,department that the ,secretary determines would reduce the time required for such review or processing4 7d7 ,,gao report2 briefing 7#a7 ,report ,not later than #ahj days after the day the ,secretary completes centralization under subsection 7f7 of section #cijb of title #ch1 ,united ,states ,code1 as added by this section1 the ,comptroller ,general of the ,united ,states shall review such centralization and publish a report containing the results of such review4 ,such report shall include the determinations of the ,comptroller ,general regarding the following3 7,a7 ,the capacity of the office determined by the ,secretary under such subsection1 to carry out processing described in such subsection1 including-- 7i7 a comprehensive assessment of employees of the ,department who carry out chapter #ci of such title2 7ii7 a comprehensive skills assessment indicating what resources the ,secretary requires to otherwise improve such centralization1 including additional funds1 employees1 or contractors2 and 7iii7 a review of systems of information technology1 including systems in use or to be acquired1 to carry out such centralization4 7,b7 ,recommendations to improve such processing4 7,c7 ,estimated costs to the ,united ,states to implement such recommendations4 7#b7 ,briefing ,not later than #cj days after publishing the report under paragraph 7#a71 the ,comptroller ,general shall provide to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and ,senate a briefing on such report4 ,such briefing shall include any response from the ,secretary to the ,comptroller ,general regarding the recommendations in the report4 #bjc4 ,monthly housing stipend under the ,post-#i_/aa ,educational ,assistance ,program for individuals who pursue summer programs of education solely through distance learning 7a7 ,in general ,section #ccac7;c77#a77;,b7 of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in clause 7i71 by striking and 7iii7 and inserting 1 7iii71 and 7iv72 7#b7 by redesignating clause 7iv7 as clause 7v72 and 7#c7 by inserting after clause 7iii7 the following new clause 7iv73 7iv7 ,in the case of an individual pursuing1 solely through distance learning1 a program of education that is shorter than #ab weeks during the summer1 for each month the individual pursues the program of education1 a monthly housing stipend equal to the product of-- 7,i7 the national average of the monthly amount of the basic allowance for housing payable under section #djc of title #cg for a member with dependents in pay grade ,e-#e1 multiplied by 7,,ii7 the lesser of-- 7aa7 #a4j and 7bb7 the number of course hours borne by the individual in pursuit of the program of education1 divided by the minimum number of course hours required for full-time pursuit of the program of education1 rounded to the nearest multiple of #aj4 4 7b7 ,effective date ,the amendments made by subsection 7a7 shall apply to a program of education beginning on or after ,august #a1 #bjbg4 #bjd4 ,clarification regarding inclusion of medically necessary automobile adaptations in ,department of ,veterans ,affairs definition of medical services ,section #agja7f77;,i7 of title #ch1 ,united ,states ,code1 is amended to read as follows3 7,i7 ,the provision of any medically necessary automobile adaptations for driver or passenger use1 including-- 7i7 ramp and kneeling systems2 7ii7 raised doors or lowered floors2 7iii7 raised roofs2 7iv7 air conditioning2 7v7 occupied and unoccupied mobility lifts2 7vi7 ingress or egress accessibility modifications2 7vii7 wheelchair tiedowns2 and 7viii7 adapted seating4 4 #bje4 ,digital communications3 ,solid ,start program2 educational assistance 7a7 ,improvement to certain outreach under ,solid ,start program of ,department of ,veterans ,affairs ,section #fcbj7;b7 of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in paragraph 7#a77;,b7-- 7,a7 by striking calling and inserting communicating with2 and 7,b7 by inserting through the use of tailored lines of communication1 including mailings1 text messaging1 virtual chatting1 and other electronic forms of messaging after ,armed ,forces2 and 7#b7 in paragraph 7#b71 by striking tailored mailings and inserting tailored lines of communication1 including mailings1 text messaging1 virtual chatting1 and other electronic forms of messaging14 7b7 ,department of ,veterans ,affairs use of tailored lines of communication for correspondence relating to educational assistance benefits ,section #cfhj of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new subsection3 7i7 7#a7 ,the ,secretary shall provide a mechanism by which an eligible veteran or eligible person may use tailored lines of communication to send and receive correspondence with the ,department of ,veterans related to entitlement to and use of educational assistance benefits under the laws administered by the ,secretary4 ,the ,secretary shall ensure that an eligible veteran or eligible person is provided with an opportunity to opt into sending and receiving such correspondence using such lines of communication rather than by mail4 7#b7 ,the ,secretary shall provide to eligible veterans and eligible persons who are enrolled in a course or program of education or training notice of the opportunity to opt in to sending and receiving correspondence using tailored lines of communication pursuant to paragraph 7#a74 7#c7 ,in this subsection1 the term tailored lines of communication includes mailings1 text messaging1 virtual chatting1 and other electronic forms of messaging4 4 #bjf4 ,improvements to ,transition ,assistance ,program and ,skillbridge 7a7 ,transition ,assistance ,program3 amendments2 pilot program2 reports 7#a7 ,special operations forces ,subsection 7a7 of section #aadb of title #aj1 ,united ,states ,code1 is amended1 in paragraph 7#a71 by inserting 7including each member of the special operations forces7 after armed forces4 7#b7 ,requirement of preseparation counseling3 number of days ,such subsection is further amended1 in paragraph 7#a7-- 7,a7 by inserting 7,a7 before ,within2 and 7,b7 by adding at the end the following new subparagraph3 7,b7 ,the ,secretary concerned shall ensure that a member described in subparagraph 7,a7 receives preseparation counseling in the following amounts3 7i7 ,in the case of a member who has accepted an offer of full-time employment1 or has enrolled in a program of education or vocational training1 that shall commence after the member separates1 retires1 or is discharged1 not fewer than three days4 7ii7 ,in the case of a member other than a member described in clause 7i71 not fewer than five days4 4 7#c7 ,repeat attendance ,such subsection is further amended by adding at the end the following new paragraph3 7#f7 ,a member who received preseparation counseling under this section may1 before separation1 retirement1 or discharge1 request to receive1 on a space-available basis1 such preseparation counseling a second time4 4 7#d7 ,pathways3 standardization2 establishment of pathway for members of the reserve components ,such section is further amended1 in paragraph 7#a7 of subsection 7c71 in the matter preceding subparagraph 7,a77#a7-- 7,a7 by striking ,each ,secretary concerned and inserting ,the ,secretaries of ,defense and ,homeland ,security2 and 7,b7 by striking pathways for members of the military department concerned and inserting pathways1 standardized across the armed forces4 7#e7 ,pathways3 record of pathway assignment ,such subsection is further amended by adding at the end the following new paragraph3 7#d7 ,the ,secretary concerned shall ensure that the pathway in which a member is placed1 and the reasons for such placement1 are noted in the service record of such member4 4 7#f7 ,coordination between ,departments of ,defense1 ,veterans ,affairs1 and ,labor ,such section is further amended1 in subsection 7d7-- 7,a7 by striking the heading and inserting ,transmission of ,certain ,information to ,other ,departments2 7,b7 by inserting 7#a7 before ,in the case2 and 7,c7 by adding at the end the following new paragraphs3 7#b7 ,before a member described in subsection 7a7 separates1 retires1 or is discharged1 the ,secretary concerned shall transmit to the ,secretary of ,veterans ,affairs the ,department of ,defense ,form ,,dd-#bfdh regarding such member4 7#c7 7,a7 ,in the case of a member described in subsection 7a7 whom the ,secretary determined as tier #c status the ,secretary concerned shall1 before the member separates1 retires1 or is discharged1 provide such member with the contact information of an employee of the ,department of ,veterans ,affairs and an employee of the ,department of ,labor2 and 7,b7 ,each employee described in subparagraph 7,a7 shall contact the member described in such subparagraph not later than #fj days after such member separates1 retires1 or is discharged4 7,c7 ,the ,secretary of ,veterans ,affairs and the ,secretary of ,labor shall each submit to the ,committees on ,armed ,services and on ,veterans' ,affairs of the ,senate and ,house of ,representatives an annual report that identifies the number of times1 and reasons why1 an employee of the department under the jurisdiction of such ,secretary failed to carry out subparagraph 7,b7 in the year preceding the date of the report4 7,d7 ,the ,secretary of ,defense and ,secretary of ,homeland ,security shall prescribe regulations to ensure that1 for purposes of this paragraph1 each ,secretary concerned uses the same definition of the term at risk for a difficult transition to civilian life4 4 7#g7 ,report ,not later than two years after the date of the enactment of this ,act and annually thereafter for four years1 the ,secretary of ,defense shall submit to the ,committees on ,armed ,services1 and the ,committees on ,veterans' ,affairs1 of the ,senate and ,house of ,representatives1 a report on data recorded with such tracking system during the year preceding the date of such report4 ,such a report shall include a list of the seven military installations located inside the continental ,united ,states1 and three military installations located outside the continental ,united ,states1 where members are least likely to receive preseparation counseling in accordance with such time periods4 7,a7 ,the number of members who1 in the course of such preseparation counseling1 were referred to another ,federal agency or department4 7,b7 ,the ,federal agencies or departments to which members were so referred4 7,c7 ,the number of members who should have been1 but were not1 so referred1 and reasons why such referrals did not occur4 7,d7 ,the number of members who receive such preseparation counseling and apply for unemployment compensation under subchapter ,,ii of chapter #he of title #e1 ,united ,states ,code4 7,e7 ,the total amount of such unemployment compensation paid to members separating from the ,armed ,forces4 7,f7 ,the frequency with which the commander of the military installation received a briefing regarding attendance of members in accordance with statutory requirements of the ,transition ,assistance ,program4 7#h7 ,contracting3 standardization ,such section is further amended by adding at the end the following new subsection3 7f7 ,contracting ,a ,secretary concerned may enter into an agreement with an entity under which such entity shall provide preseparation counseling under this section4 ,if more than one ,secretary seeks to enter into such an agreement1 such ,secretaries concerned shall1 to the extent practicable1 seek to enter into such agreements with the same entity4 4 7#i7 ,annual report on ,,tap participation ,the frequency with which the commander of the military installation received a briefing regarding attendance of members in accordance with statutory requirements of the ,transition ,assistance ,program4 7b7 ,skillbridge3 ,,gao study 7#a7 ,study required ,the ,comptroller ,general of the ,united ,states shall conduct a study of the ,skillbridge programs under section #aadc7;e7 of title #aj1 ,united ,states ,code4 7#b7 ,report ,not later than two years after the date of the enactment of this ,act1 the ,comptroller ,general shall submit to the ,committees on ,armed ,services1 and the ,committees on ,veterans' ,affairs1 of the ,senate and ,house of ,representatives1 a report regarding such study4 ,such report shall include observations and recommendations of the ,comptroller regarding1 with respect to members and employers who participate in ,skillbridge-- 7,a7 differences in criteria for participation between the ,armed ,forces2 7,b7 other differences in ,skillbridge programs between the ,armed ,forces2 7,c7 best practices in ,skillbridge programs across the ,armed ,forces1 including-- 7i7 the selection of employers2 and 7ii7 the development of contracts2 and 7,d7 the feasibility of making ,skillbridge programs uniform across the ,armed ,forces4 #bjg4 ,transition ,assistance ,program3 presentation in preseparation counseling to promote benefits available to veterans 7a7 ,in general ,section #aadb7;b7 of title #aj1 ,united ,states ,code1 is amended by adding at the end the following new paragraph3 7#bj7 ,a presentation that promotes the benefits available to veterans under the laws administered by the ,secretary of ,veterans ,affairs4 ,such presentation-- 7,a7 shall be standardized2 7,b7 shall1 before implementation1 be reviewed and approved by the ,secretary of ,veterans ,affairs and ,secretary of ,defense in collaboration with veterans service organizations that provide claims assistance under the benefits delivery at discharge program of the ,department of ,veterans ,affairs2 7,c7 shall be submitted by the ,secretary of ,veterans ,affairs to the ,committees on ,veterans' ,affairs and ,armed ,services of the ,senate and the ,house of ,representatives for review at least #ij days before implementation2 7,d7 where available1 shall be presented with the participation of-- 7i7 an employee or representative of the ,department of ,veterans ,affairs assisted by a representative of a veterans service organization recognized under section #eijb of title #ch2 or 7ii7 an employee or representative of the ,department of ,veterans ,affairs assisted by an individual recognized under section #eijc of such title and authorized by the ,secretary concerned to so participate2 7,e7 shall include information on how a veterans service organization may assist the member in filing a claim described in paragraph 7#ai72 7,f7 may not encourage the member to join a particular veterans service organization2 and 7,g7 may not be longer than one hour4 4 7b7 ,annual report ,not less frequently than once each year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall submit1 to the ,committees on ,armed ,services of the ,senate and ,house of ,representatives1 and to the ,committees on ,veterans' ,affairs of the ,senate and ,house of ,representatives1 a report that-- 7#a7 identifies each veterans service organization that participated in a presentation under paragraph 7#bj7 of section #aadb7;b7 of title #aj1 ,united ,states ,code1 as added by subsection 7a72 7#b7 contains the number of members of the ,armed ,forces who attended such presentations2 and 7#c7 includes any recommendations of the ,secretary regarding changes to such presentation or to such paragraph4 #bjh4 ,elimination of requirement that on-campus educational and vocational counseling is provided by certain ,department of ,veterans ,affairs employees 7a7 ,in general ,section #cfig;,b7a7 of title #ch1 ,united ,states ,code1 is amended-- 7#a7 by striking the second sentence2 7#b7 by inserting 7#a7 before ,the ,secretary2 and 7#c7 by adding at the end the following new paragraph3 7#b7 ,any individual providing services under paragraph 7#a7 on behalf of the ,department who is not an employee of the ,department shall be subject to the same oversight1 training1 and accountability standards applicable to ,department employees providing such services4 4 7b7 ,expansion of ,vet,success on ,campus program to at least one location in each ,state 7#a7 ,in general ,the ,secretary of ,veterans ,affairs shall ensure that the ,vet,success on ,campus program of the ,department of ,veterans ,affairs is located in every ,state4 7#b7 ,counselors ,in carrying out paragraph 7#a71 the ,secretary shall ensure that at least one counselor of the ,vet,success on ,campus program is located in each ,state1 notwithstanding the number of individuals in a ,state or at an educational institution who may qualify to participate in the program4 7#c7 ,preference ,in carrying out this section1 the ,secretary shall give preference to educational institutions that have the largest populations of students who are pursuing programs of education at such institutions with educational assistance provided under laws administered by the ,secretary4 7#d7 ,state defined ,in this section1 the term ,state has the meaning given such term in section #aja of title #ch1 ,united ,states ,code4 #bji4 ,expansion of entitlement for payment for licensing or certification tests for veterans entitled to educational assistance ,section #ccae of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in subsection 7a71 by striking educational assistance under this chapter and inserting covered assistance2 7#b7 in subsection 7b77#c71 by striking under this chapter and inserting with respect to covered assistance2 7#c7 in subsection 7c71 in the matter preceding paragraph 7#a71 by striking under this chapter and inserting with respect to covered assistance2 and 7#d7 by adding at the end the following new subsection3 7d7 ,warnings ,before providing any payment to or on behalf of an individual described in subsection 7a71 the ,secretary shall provide notice to the individual a warning that use of entitlement under this section for a licensing or certification test may not lead to a license or certification4 7e7 ,covered assistance defined ,in this section1 the term covered assistance means educational assistance available under-- 7#a7 this chapter1 chapter #cj of this title1 chapter #ce of this title1 or chapter #afjf of title #aj2 or 7#b7 any other provision of law providing educational assistance to a veteran1 or to another individual in connection with the service of a veteran in the ,armed ,forces4 4 #baj4 ,increase of amount of educational assistance paid by the ,secretary of ,veterans ,affairs for first year of a full-time program of apprenticeship or other on-job training ,section #ccac7;g77#c77;,b7 of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in the matter preceding clause 7i71 by inserting using educational assistance under this chapter2 and 7#b7 in clause 7i77,,ii71 by striking #hj percent and inserting #ajj percent4 #baa4 ,improving emerging technology opportunities for veterans 7a7 ,inclusion of emerging technologies in high technology program 7#a7 ,in general ,section #cfii;,c of title #ch1 ,united ,states ,code1 is amended-- 7,a7 in the section heading by striking ,high technology and inserting ,high technology and emerging technology2 7,b7 by striking high technology and inserting high technology or emerging technology each place such term appears2 and 7,c7 in subsection 7c77#d7 by adding at the end the following new subparagraph3 7,e7 ,such criteria shall also identify which technologies of critical importance1 such as artificial intelligence and semiconductor manufacturing1 shall be treated as emerging technologies for purposes of this section4 4 7#b7 ,clerical amendment ,the table of sections at the beginning of chapter #cf of such title is amended by striking the item relating to section #cfii;,c and inserting the following new item3 #cfii;,c4 ,high technology and emerging technology program4 4 7#c7 ,conforming amendments ,section #cfhj;,a of title #ch1 ,united ,states ,code1 is amended in subsections 7a77#d77;,b7 and 7d77#h7 by striking high technology each place such term appears and inserting high technology or emerging technology4 7b7 ,employment rate calculation for ,,vet-,,tec high technology and emerging technology program ,section #cfii;,c of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in subsection 7f7-- 7,a7 in the matter preceding paragraph 7#a7 by inserting after ,house of ,representatives the following3 1 and make available to the public12 and 7,b7 in paragraph 7#c7 by adding at the end the following3 ,such rate shall be calculated as a fraction1 the denominator of which is the number of covered individuals who completed such a program during such year and the numerator of which is the number of individuals counted in the denominator who are employed on the date that is #ahj days after the date on which the individual completed the program1 and expressed as a percentage4 ,notwithstanding the previous sentence1 the numerator shall not count a case in which the individual is employed by the same organization that was the provider of the individual's program of education or a case in which the individual is employed1 by a parent or affiliate of such organization1 as an instructor for a substantially similar program of education4 ,to the maximum extent practicable1 the ,secretary shall also report the rates of full-time employment1 part-time employment1 and self-employment42 and 7#b7 in subsection 7g7 by adding at the end the following new paragraph3 7#c7 ,the ,secretary on an ongoing basis shall solicit1 collect1 and analyze feedback about the program from covered individuals who participate in the program and from the ,,gi ,bill ,school ,feedback ,tool4 ,the ,secretary shall use such feedback to evaluate and improve the implementation of the program4 4 ,,iii ,health ,care #cja4 ,extension and modification of transportation grant program of ,department of ,veterans ,affairs ,section #cjg of the ,caregivers and ,veterans ,omnibus ,health ,services ,act of #bjaj 7,public ,law #aaa-afc2 #ch ,u4,s4,c4 #agaj note7 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#b71 by adding at the end the following new subparagraphs3 7,c7 ,indian tribes4 7,d7 ,tribal organizations4 7,e7 ,native ,hawaiian organizations4 7,f7 ,county veterans service organizations4 2 7,b7 in paragraph 7#c71 in the matter preceding subparagraph 7,a71 by striking ,state veterans service agency or veterans service organization awarded and inserting recipient of2 and 7,c7 by amending paragraph 7#d7 to read as follows3 7#d7 ,maximum amount 7,a7 ,in general ,except as provided in subparagraphs 7,b7 and 7,c71 the amount of a grant under this section may not exceed #ej1jjj4 7,b7 ,off-road communities ,in the case of a county that has more than five communities that are off the road system1 the amount of a grant awarded with respect to that county under this section may be increased by an amount not to exceed #ej percent of the amount specified in subparagraph 7,a74 7,c7 ,purchasing a vehicle 7i7 ,amount ,the amount of a grant awarded under this section to a recipient may be increased by not more than #hj1jjj if the recipient is purchasing a vehicle to comply with requirements under the ,americans with ,disabilities ,act of #aiij 7#db ,u4,s4,c4 #abaja et seq47 in carrying out this section4 7ii7 ,limitations ,the ,secretary may prescribe limitations on the number of vehicles purchased by each recipient under this section4 2 7#b7 by striking subsection 7d72 7#c7 by redesignating subsections 7b7 and 7c7 as subsections 7d7 and 7e71 respectively2 7#d7 by inserting after subsection 7a7 the following new subsections3 7b7 ,additional services 7#a7 ,nearby rural areas ,in addition to providing innovative transportation options to veterans in highly rural areas1 a recipient of a grant under this section may use amounts provided under the grant to provide innovative transportation options to veterans in nearby rural areas4 7#b7 ,priority ,a recipient of a grant under this section shall prioritize the provision of innovative transportation options to veterans in highly rural areas1 and shall demonstrate to the ,secretary such priority1 and may only provide services under paragraph 7#a7 to veterans in nearby rural areas if-- 7,a7 it does not impede the services provided to veterans in highly rural areas2 and 7,b7 the grantee has excess capacity and resources available to provide such services to veterans in nearby rural areas4 7c7 ,eligibility of previous areas ,areas eligible for assistance under the grant program under this section on the day before the date of the enactment of the ,supporting ,rural ,veterans ,access to ,healthcare ,services ,act shall remain eligible for such assistance on and after such date of enactment4 2 and 7#e7 in subsection 7e71 as redesignated by paragraph 7#b7-- 7,a7 by redesignating paragraph 7#b7 as paragraph 7#e72 and 7,b7 by striking paragraph 7#a7 and inserting the following3 7#a7 ,indian tribe2 ,tribal organization ,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#b7 ,native ,hawaiian organization ,the term ,native ,hawaiian organization has the meaning given that term in section #fbjg of the ,elementary and ,secondary ,education ,act f #aife 7#bj ,u4,s4,c4 #geag74 7#c7 ,nearby ,the term nearby1 with respect to a rural area1 includes rural areas adjacent to a highly rural area and rural areas geographically between the highly rural area and the nearest ,department of ,veterans ,affairs medical center4 7#d7 ,rural2 highly rural ,the terms rural and highly rural have the meanings given those terms under the ,rural-,urban ,commuting ,areas 7,,ruca7 coding system of the ,department of ,agriculture4 4 #cjb4 ,veteran ,caregiver ,reeducation1 ,reemployment1 and ,retirement ,act 7a7 ,extension of period of medical care coverage for caregivers designated as primary providers of personal care services for veterans ,section #agha7;a77#d7 of title #ch1 ,united ,states ,code1 is amended by inserting before the comma at the end the following3 1 including during the #ahj-;day period following discharge from the program under section #agbj;,g7a7 of this title unless the designation of the individual was revoked due to fraud1 abuse1 mistreatment1 or other misconduct4 7b7 ,employment and other benefits for caregivers designated as primary providers of personal care services for veterans 7#a7 ,employment assistance ,section #agbj;,g of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new subsection3 7e7 ,employment assistance 7#a7 ,the ,secretary shall1 subject to paragraph 7#b71 provide to an individual designated as a primary provider of personal care services under subsection 7a77#g77;,a7 employment assistance as follows3 7,a7 ,reimbursement of fees associated with certifications or relicensure necessary for such employment4 7,b7 ,for purposes of gaining credit for continuing professional education requirements1 access to training modules of the ,department at no cost4 7,c7 ,in consultation with the ,secretary of ,defense and the ,secretary of ,labor1 access to existing employment assistance resources and programs as considered appropriate4 7#b7 ,an individual described in paragraph 7#a7 shall have access to assistance described in such paragraph-- 7,a7 while participating in the program established under subsection 7a77#a72 and 7,b7 during the #ahj-;day period following the date on which the individual is no longer participating in such program unless the designation of such individual under subsection 7a77#g77;,a7 was revoked for fraud1 abuse1 mistreatment1 or other misconduct4 7#c7 ,the maximum lifetime amount that may be reimbursed for an individual under paragraph 7#a77;,a7 is #a1jjj4 4 7#b7 ,expansion of available services ,subsection 7a77#c77;,a77ii7 of such section is amended-- 7,a7 in subclause 7,v71 by striking 2 and and inserting a semicolon2 7,b7 in subclause 7,,vi7-- 7i7 in the matter preceding item 7aa71 by inserting or agreements after contracts2 7ii7 in item 7aa71 by inserting 1 including retirement planning services1 after services2 and 7iii7 in item 7bb71 by striking the period at the end and inserting 2 and2 and 7,c7 by adding at the end the following new subclause3 7,,vii7 such instruction1 preparation1 training1 and support as the ,secretary considers appropriate to assist in transitioning away from caregiving during the #ahj-;day period following the date on which the family caregiver is no longer participating in the program required by paragraph 7#a71 unless such designation was revoked for fraud1 abuse1 or mistreatment1 or other misconduct4 4 7#c7 ,assistance returning to workforce ,subclause 7,,vi7 of such subsection is further amended-- 7,a7 in item 7aa71 by striking 2 and and inserting a semicolon2 and 7,b7 by adding at the end the following new item3 7cc7 assistance returning to the workforce upon discharge or dismissal from the program required by paragraph 7#a7 unless such designation was revoked for fraud1 abuse1 mistreatment1 or other misconduct2 and 4 7#d7 ,bereavement counseling and support ,subsection 7a77#c77;,a77i77,,iii7 of such section is amended by inserting before the semicolon the following3 1 including bereavement counseling and support following the death of the eligible veteran4 7#e7 ,study on provision of returnship program 7,a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs1 in partnership with the ,secretary of ,labor1 shall complete a study on the feasibility and advisability of conducting a returnship program to assist individuals who are designated as a primary provider of personal care services under section #agbj;,g7a77#g77;,a7 of title #ch1 ,united ,states ,code1 or who were discharged from such program1 in returning to the workforce4 7,b7 ,report ,not later than #ahj days after completion of the study 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 the study4 7#f7 ,study on incorporating former caregivers into workforce of ,department of ,veterans ,affairs 7,a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall complete a study on barriers and incentives to hiring individuals who were designated as a primary provider of personal care services under section #agbj;,g7a77#g77;,a7 of title #ch1 ,united ,states ,code1 at facilities of the ,department of ,veterans ,affairs to address staffing needs4 7,b7 ,report ,not later than #ahj days after completion of the study 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 the study1 which shall include-- 7i7 a plan for increasing employment opportunities at facilities of the ,department for individuals who were designated as a primary provider of personal care services under section #agbj;,g7a77#g77;,a7 of title #ch1 ,united ,states ,code2 and 7ii7 such recommendations for legislative or administrative action as the ,secretary considers appropriate4 7c7 ,comptroller ,general report on efforts of ,department of ,veterans ,affairs in supporting family caregivers transitioning away from caregiving ,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 assessing the efforts of the ,secretary of ,veterans ,affairs to support individuals serving as family caregivers under section #agbj;,g7a7 of title #ch1 ,united ,states ,code1 in transitioning away from caregiving1 either by assisting those individuals with retirement planning or returning to work4 7d7 ,report on feasibility and advisability of establishing a retirement plan or retirement savings for family caregivers of certain veterans ,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 the ,treasury and the heads of such other relevant entities as the ,secretary of ,veterans ,affairs determines necessary1 shall submit to ,congress a report on the feasibility and advisability of1 for individuals serving as family caregivers under section #agbj;,g7a7 of title #ch1 ,united ,states ,code-- 7#a7 establishing an individual retirement plan 7as defined in section #ggja7;a77#cg7 of the ,internal ,revenue ,code of #aihf 7#bf ,u4,s4,c4 #ggja7;a77#cg777 or similar retirement plan2 or 7#b7 permitting such individuals to join an already established pathway to retirement savings4 #cjc4 ,veterans ,,tbi ,breakthrough ,exploration of ,adaptive ,care ,opportunities ,nationwide ,act 7a7 ,department of ,veterans ,affairs grant program for supplemental neurorehabilitation approaches to chronic mild ,,tbi treatment 7#a7 ,grant program 7,a7 ,in general ,the ,secretary of ,veterans ,affairs shall carry out a three-year program 7to be known as the ,,tbi ,innovation ,grant ,program7 under which the ,secretary shall award grants to eligible entities described in paragraph 7#b7 for the development1 implementation1 and evaluation of approaches and methodologies for prospective randomized control trials for neurorehabilitation treatments for the treatment of chronic mild traumatic brain injury 7in this ,act referred to as m,t,b,i7 in veterans4 7,b7 ,relationship to other ,department activities ,the grant program required under subparagraph 7,a7 shall be carried out in a manner that-- 7i7 supplements1 and does not supplant1 other clinical care and research of the ,department of ,veterans ,affairs relating to m,t,b,i2 and 7ii7 facilitates1 as practicable1 coordination with ,veterans ,health ,administration facilities for referral1 continuity of care1 and dissemination of findings4 7#b7 ,eligible entities described ,an eligible entity described in this paragraph is any of the following3 7,a7 ,a nonprofit organization with demonstrated capability to conduct clinical trials and to deliver or research effective neurorehabilitation treatments for m,t,b,i1 including through patient care delivery4 7,b7 ,an academic institution that conducts significant research on m,t,b,i and has demonstrated capability to conduct clinical trials relating to neurorehabilitation treatments4 7,c7 ,a non-,department health care provider with expertise in neurorehabilitative therapies and demonstrated capability to conduct clinical trials and to evaluate m,t,b,i treatments through patient care delivery4 7,d7 ,a partnership or consortium of two or more entities described in subparagraphs 7,a7 through 7,c74 7#c7 ,use of funds ,an eligible entity in receipt of a grant under this subsection shall use such grant to support activities that include-- 7,a7 designing and testing novel or integrative treatments for m,t,b,i that prioritize patient-centered care1 including non-pharmacological therapies2 7,b7 conducting clinical studies and assessments to measure the effectiveness of funded approaches to-- 7i7 improve mental health outcomes among veterans2 7ii7 reduce suicidality1 and common risk factors for completing suicide1 including depression and substance use disorders among veterans2 and 7iii7 mitigate long-term effects of m,t,b,i and1 to the extent outcomes are collected under the applicable clinical protocol1 measure durability of outcomes at approximately six months following completion of treatment2 7,c7 providing training for clinicians and outreach to veterans and their families to improve awareness and accessibility of innovative m,t,b,i treatments1 including information on available ,department resources and pathways to access such resources2 and 7,d7 establishing partnerships with community organizations1 academic institutions1 and health care facilities1 including1 as practicable1 coordination with ,veterans ,health ,administration facilities to facilitate referral of eligible veterans1 continuity of care1 and dissemination of aggregate findings4 7#d7 ,limitation on grant amount ,the ,secretary may not award an eligible entity a grant under this section in an amount that exceeds #e1jjj1jjj for any fiscal year4 7#e7 ,program administration 7,a7 ,applications ,an eligible entity desiring a grant under this subsection shall submit to the ,secretary an application in such form1 at such time1 and containing such information and assurances as the ,secretary determines appropriate1 including a detailed description of-- 7i7 activities proposed to be conducted using the grant2 7ii7 expected outcomes of such activities2 7iii7 plans for evaluating the effectiveness of such activities2 7iv7 how the eligible entity will coordinate1 as practicable1 with ,veterans ,health ,administration facilities for referral and continuity of care for veterans who participate in activities carried out using grant funds1 and for dissemination of aggregate findings2 7v7 the budget of the entity for the use of the grant1 including a narrative justification and an identification of the estimated amount of grant funds to be used for administrative or overhead costs2 and 7vi7 assurances of compliance with applicable ,federal laws and regulations relating to human subjects protections and patient safety4 7,b7 ,priority ,in awarding grants under this subsection1 the ,secretary shall give priority to eligible entities that have demonstrated the capacity to coordinate with the ,department to facilitate referral and continuity of care for veterans who participate in activities carried out using grant funds4 7,c7 ,periodic reports ,as a condition of receiving a grant under this section1 an eligible entity shall1 not less frequently than annually during the grant period and not later than #ahj days after the end of the grant period1 submit to the ,secretary a report that includes1 with respect to the period covered by the report-- 7i7 a description of how the eligible entity used such grant2 7ii7 a summary of the progress of activities funded with amounts from such grant2 7iii7 measured outcomes relating to such activities2 7iv7 a detailed accounting of expenditures of grant funds1 including administrative or overhead costs2 7v7 to the extent collected under the applicable clinical protocol or in the ordinary course of care1 a description of any adverse events and serious adverse events1 including self-harm or suicide-related events2 and 7vi7 a description of actions taken pursuant to the coordination plan described in subparagraph 7,a77iv74 7,d7 ,oversight2 annual evaluations ,the ,secretary shall-- 7i7 ensure rigorous oversight of the grant program under this section1 including by monitoring financial compliance and timely receipt of the reports required under subparagraph 7,b72 and 7ii7 on an annual basis until the termination date specified in paragraph 7#i77;,a71 evaluate the efficacy of activities carried out using grant funds based on the reports submitted under subparagraph 7,b7 and other appropriate information4 7,e7 ,rule of construction ,nothing in this section shall be construed to authorize the ,secretary to require prior approval of1 or changes to1 any clinical protocol1 study design1 outcome measures1 or follow-up schedule of an eligible entity that receives a grant under this section1 except as necessary to ensure compliance with applicable ,federal laws and regulations relating to human subjects protections and patient safety4 7,f7 ,enforcement authority ,the ,secretary may suspend1 modify1 or terminate a grant awarded under this section1 if the ,secretary determines that the recipient of such grant has failed to comply with reporting requirements under subparagraph 7,b7 or other applicable terms and conditions of the grant4 7#f7 ,available amounts2 authorization of appropriations 7,a7 ,available amounts ,the ,secretary may carry out the program under this section using amounts available to the ,secretary for general mental health care programs1 if the use of such amounts supplements1 and does not supplant1 amounts otherwise available for ,department mental health and traumatic brain injury programs4 7,b7 ,authorization of appropriations ,there is authorized to be appropriated to the ,secretary #aj1jjj1jjj for each of fiscal years #bjbf through #bjbh to carry out this section4 7#g7 ,duration2 annual review 7,a7 ,duration ,the authority of the ,secretary to carry out the grant program under this section shall terminate on the date that is three years after the date of the enactment of this ,act1 except that the ,secretary may continue to use amounts made available to carry out this section after such date solely for the purpose of administering activities and obligations incurred before such termination date4 7,b7 ,annual review ,during such three-year period1 the ,secretary shall1 on an annual basis1 review the effectiveness of the grant program to determine the potential of such grant program for continuation or expansion4 7b7 ,department of ,veterans ,affairs grant program for independent third-party research studies and treatment with respect to supplemental neurorehabilitation treatments for m,t,b,i 7#a7 ,establishment ,the ,secretary of ,veterans ,affairs shall establish and carry out a research grant program to award grants to eligible entities described in paragraph 7#b7 to be used to carry out studies and applied programs on approaches and methodologies for the treatment of m,t,b,i in veterans4 7#b7 ,eligible entities described ,an eligible entity described in this paragraph is any of the following3 7,a7 ,a nonprofit organization that has demonstrated the capability to conduct clinical trials and to evaluate traumatic brain injury treatments through patient care delivery4 7,b7 ,an academic institution that conducts significant research on traumatic brain injury and has demonstrated the capability to conduct clinical trials relating to neurorehabilitation treatments4 7,c7 ,a partnership or consortium of two or more entities described in subparagraphs 7,a7 and 7,b74 7#c7 ,applications ,an eligible entity desiring a grant under this section shall submit to the ,secretary an application in such form1 at such time1 and containing such information and assurances as the ,secretary determines appropriate1 including a summary of-- 7,a7 the research and treatment activities proposed to be carried out using grant funds2 7,b7 the methodology to be used for such activities2 7,c7 the expected outcomes of such activities2 7,d7 how the eligible entity will coordinate1 as practicable1 with ,veterans ,health ,administration facilities for referral and continuity of care for veterans who participate in activities carried out using grant funds1 and for dissemination of aggregate findings2 7,e7 the budget of the entity for the use of the grant1 including a narrative justification and an identification of the estimated amount of grant funds to be used for administrative or overhead costs2 and 7,f7 assurances of compliance with applicable ,federal laws and regulations relating to human subjects protections and patient safety4 7#d7 ,administration 7,a7 ,grant categories ,in carrying out the grant program under this subsection1 each fiscal year the ,secretary shall-- 7i7 subject to the requirement under subparagraph 7,b71 award four grants for exploratory or pilot research and treatment projects1 each of which shall be in an amount of not more than #fbe1jjj2 and 7ii7 award five grants for collaborative or multidisciplinary research and treatment initiatives1 each of which shall be in an amount of not more than #a1ejj1jjj4 7,b7 ,priority ,of the grants awarded under subparagraph 7,a77i71 the ,secretary shall award not fewer than three to nonprofit organizations4 7,c7 ,enforcement authority ,the ,secretary may suspend1 modify1 or terminate a grant awarded under this subsection1 if the ,secretary determines that the recipient of such grant has failed to comply with the applicable terms and conditions of the grant4 7#e7 ,agreement with independent organization 7,a7 ,in general ,the ,secretary shall seek to enter into an agreement with an independent organization that is not a component of the ,department and that has demonstrated expertise in randomized controlled trials1 neurorehabilitation outcomes evaluation1 and research integrity1 under which the organization agrees to-- 7i7 administer the research grant program under this subsection2 7ii7 carry out studies and implement efforts that include-- 7,i7 analyzing data from m,t,b,i treatment methodologies developed pursuant to the research grant program to assess the effect1 among veterans1 of such methodologies on enhanced brain health outcomes1 mental health1 and long-term recovery1 including1 to the extent outcomes are collected under the applicable clinical protocol1 durability of outcomes at approximately six months following completion of treatment2 7,,ii7 identifying data-driven best practices and providing recommendations for further research or clinical application1 including recommendations for dissemination to ,veterans ,health ,administration clinicians and facilities 7as appropriate72 and 7,,iii7 randomized1 controlled clinical trials to-- 7aa7 validate and deliver treatments2 7bb7 establish a standard of care2 and 7cc7 improve access to such treatments for veterans2 7iii7 submit to the ,secretary not less frequently than annually a report describing activities carried out under this section1 including outcome data and methodology2 and 7iv7 make available to the ,secretary all data and findings from the grants made under this section1 consistent with applicable ,federal law1 regulation1 and ,department policies relating to patient protections1 data security1 and privacy4 7,b7 ,rule of construction ,nothing in this section shall be construed to authorize the ,secretary1 or an independent organization that enters into an agreement with the ,secretary under subparagraph 7,a71 to require prior approval of1 or changes to1 any clinical protocol1 study design1 outcome measures1 or follow-up schedule established by an eligible entity that receives a grant under this section1 except as necessary to ensure compliance with applicable ,federal laws and regulations relating to human subjects protections and patient safety4 7,c7 ,report ,an agreement under subparagraph 7,a7 shall include a requirement that the independent organization submits to ,congress and the ,secretary a comprehensive report that includes-- 7i7 the findings of the studies required under such agreement2 7ii7 recommendations with respect to the expansion of successful ,,tbi treatment methodologies and standard of care recommendations1 if any1 developed pursuant to the research grant program2 and 7iii7 to the extent available from the reports and study materials of grant recipients1 a summary of-- 7,i7 the durability of outcomes at approximately six months following completion of treatment1 if collected under the applicable clinical protocol2 7,,ii7 adverse events and serious adverse events1 including self-harm or suicide-related events1 if collected under the applicable clinical protocol or in the ordinary course of care2 and 7,,iii7 aggregate expenditures of grant funds1 including administrative or overhead costs4 7,d7 ,surveys ,the ,secretary may conduct surveys of any independent organization that enters into an agreement with the ,secretary under subparagraph 7,a7 in order to assess the effectiveness of such organization in administering the research grant program under this subsection4 7#f7 ,available amounts2 authorization of appropriations 7,a7 ,available amounts ,the ,secretary may use amounts available to the ,secretary for the operating budget of the ,national ,center for ,posttraumatic ,stress ,disorder to carry out the research grant program under this subsection1 if the use of such amounts supplements1 and does not supplant1 amounts otherwise available for ,department programs and services4 7,b7 ,authorization of appropriations ,there is authorized to be appropriated to the ,secretary #aj1jjj1jjj for each of fiscal years #bjbf through #bjbh to carry out this subsection4 7#g7 ,termination date ,the authority of the ,secretary to carry out the research grant program under this section shall terminate on the date that is three years after the date of the enactment of this ,act4 7c7 ,reports to ,congress ,not later than two years after the date on which the ,secretary commences the research grant program under subsection 7a71 and on an annual basis thereafter until the termination date specified in paragraph 7#h7 of such subsection1 the ,secretary shall submit to ,congress a report on the grant programs under subsections 7a7 and 7b74 ,each such report shall include-- 7#a7 the findings of the studies under subsection 7a77#f77;,b72 7#b7 a description of any agreement entered into by the ,secretary under subsection 7b77#e77;,a72 7#c7 recommendations of the ,secretary with respect to policy and programmatic improvements to services of the ,department to treat m,t,b,i among veterans2 7#d7 any findings derived from surveys conducted under subsection 7b77#e77;,d71 including any recommendations of the ,secretary for improvements to the structure1 oversight1 administration1 or performance of the independent organization that enters into an agreement with the ,secretary under subsection 7b77#e77;,a72 and 7#e7 such other matters as the ,secretary determines appropriate4 7d7 ,definitions ,in this section3 7#a7 ,the terms chronic mild traumatic brain injury and m,t,b,i mean a mild traumatic brain injury with symptoms that persist for not fewer than six months after the inciting injury1 as determined using validated clinical criteria4 7#b7 ,the term nonprofit organization-- 7,a7 means an organization described in section #eja7;c77#c7 of the ,internal ,revenue ,code of #aihf and exempt from taxation under section #eja7;a7 of such ,code2 and 7,b7 includes such an organization that is a hospital1 nonprofit health system1 academic medical center1 or clinic that delivers neurorehabilitation care or conducts clinical research relating to m,t,b,i4 7#c7 ,the term veteran has the meaning given such term in section #aja of title #ch1 ,united ,states ,code4 #cjd4 ,department of ,veterans ,affairs ,assignment of ,traveling ,physicians to ,serve ,territories1 ,possessions1 and ,freely ,associated ,states 7a7 ,in general ,subchapter ,i of chapter #gd of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new section3 #gdae4 ,traveling physicians 7a7 ,in general 7#a7 ,the ,secretary may assign a physician appointed under section #gdja or section #gdca of this title to serve as a traveling physician for a period of not more than one year at a time4 ,a physician assigned to serve as a traveling physician under this section may be assigned to provide health care to veterans residing in ,american ,samoa1 ,guam1 the ,commonwealth of the ,northern ,mariana ,islands1 the ,commonwealth of ,puerto ,rico1 the ,virgin ,islands of the ,united ,states1 the ,freely ,associated ,states 7as defined in section #agbd7;f7 of this title71 or any other territory or possession of the ,united ,states at ,department facilities or other approved facilities located in such territory1 possession1 or ,freely ,associated ,state4 7#b7 ,the ,secretary may assign multiple physicians to serve as traveling physicians under this section and may assign each such physician to serve in a specific territory1 possession1 or ,freely ,associated ,state4 7b7 ,coordination of care ,in providing care under this section1 traveling physicians shall coordinate with non-,department medical providers to the extent practicable and necessary to ensure high quality and coordinated care for veterans receiving hospital care and medical services4 7c7 ,pay ,in addition to pay under section #gdca of this title1 the ,secretary shall provide a relocation or retention bonus to traveling physicians under this section4 ,such relocation or retention bonus shall be substantially similar to a relocation or retention bonus offered under section #gdaj7;a7 of this title1 as the ,secretary considers appropriate4 4 7b7 ,clerical amendment ,the table of sections at the beginning of such chapter is amended by inserting after the item relating to section #gdad the following new item3 #gdae4 ,traveling physicians4 4 7c7 ,technical and conforming amendments ,title #ch1 ,united ,states ,code1 is further amended as follows3 7#a7 ,in section #gdaj7;a77#a71 by-- 7,a7 by striking retention allowances and inserting retention bonuses2 and 7,b7 by striking the second comma after section #gdja7a7 of this title2 and 7#b7 ,in section #gdca7;e77#e77;,b71 by striking retention allowances and inserting retention bonuses4 #cje4 ,inclusion of adaptive prostheses and terminal devices for sports and other recreational activities in medical services furnished to eligible veterans by the ,secretary of ,veterans ,affairs ,section #agja of title #ch1 ,united ,states ,code1 is amended1 in paragraph 7#f77;,f77i71 by inserting 7including adaptive prostheses and terminal devices for sports and other recreational activities that are determined to be clinically appropriate by the ,secretary7 after artificial limbs4 #cjf4 ,modifications to and reauthorization of ,staff ,sergeant ,parker ,gordon ,fox ,suicide ,prevention ,grant ,program of ,department of ,veterans ,affairs 7a7 ,coordination by ,secretary ,subsection 7b7 of section #bja of the ,commander ,john ,scott ,hannon ,veterans ,mental ,health ,care ,improvement ,act of #bjai 7,public ,law #aaf-aga2 #ch ,u4,s4,c4 #agbj;,f note7 is amended by striking the second sentence4 7b7 ,use of grant funds ,subsection 7c7 of such section is amended-- 7#a7 in the subsection heading1 by inserting 2 ,use of ,grant ,funds after ,grants2 and 7#b7 by adding at the end the following new paragraphs3 7#c7 ,renewal of grant amounts 7,a7 ,in general ,in determining whether to renew a grant awarded under this section to an eligible entity1 the ,secretary shall consider1 among such other factors as the ,secretary may consider appropriate-- 7i7 the compliance by the eligible entity in administering pre- and post-intervention assessments required under subsection 7e77#f72 and 7ii7 any demonstrated improvements in participant outcomes4 7,b7 ,additional amounts ,based on a consideration of the factors described in subparagraph 7,a71 the ,secretary may award amounts1 not to exceed #bej1jjj per grantee per fiscal year1 to a grantee in addition to the maximum amount under paragraph 7#b77;,a7 based on a performance-based metric established by the ,secretary4 4 7c7 ,priority for new recipients ,subsection 7d7 of such section is amended-- 7#a7 in the subsection heading1 by striking and ,preference and inserting 1 ,preference1 and ,priority2 7#b7 in paragraph 7#a77;,a7-- 7,a7 in clause 7iv71 by striking the semi-colon at the end and inserting 2 and2 7,b7 by striking clause 7v72 and 7,c7 by redesignating clause 7vi7 as clause 7v72 and 7#c7 by adding at the end the following new paragraph3 7#c7 ,priority for new recipients ,to the maximum extent practicable1 the ,secretary shall prioritize grants for eligible entities that have satisfied the requirements provided under subsection 7f7 and are located in ,states in which a grant has not been awarded under this section4 4 7d7 ,requirements for receipt of grants ,subsection 7e7 of such section is amended-- 7#a7 in paragraph 7#c7-- 7,a7 by redesignating subparagraphs 7,b7 and 7,c7 as subparagraphs 7,c7 and 7,d71 respectively2 and 7,b7 by inserting after subparagraph 7,a7 the following new subparagraph 7,b73 7,b7 coordinate with the ,secretary to develop a plan for communication between the entity and local mental health providers of the ,department regarding whether veterans receiving assistance under this section from the entity are attending appointments to ensure continuity of care2 2 and 7#b7 by adding at the end the following new paragraph3 7#f7 ,assessments ,an eligible entity receiving a grant under this section shall conduct a pre- and post-intervention assessment with respect to each eligible individual who receives suicide prevention services pursuant to such grant across all relevant metrics1 as determined by the ,secretary4 7#g7 ,metrics and outcomes ,an eligible entity receiving a grant under this section shall collect and submit to the ,secretary such metrics and outcome data as the ,secretary may require1 including-- 7,a7 throughput measures1 including the number of veterans screened1 referred1 connected to care1 and retained in services under the grant program2 7,b7 reductions in severity scale measurements1 including reductions in suicidality identified through applicable inventories or assessments2 and 7,c7 such other quantifiable metrics as the ,secretary determines appropriate4 4 7e7 ,training and technical assistance ,subsection 7g7 of such section is amended-- 7#a7 in paragraph 7#a7-- 7,a7 in the matter preceding subparagraph 7,a71 by inserting 1 or interested in receiving such grants1 after this section2 and 7,b7 in subparagraph 7,a71 by inserting 1 including training on how to properly use the ,columbia ,protocol 7also known as the ,columbia-,suicide ,severity ,rating ,scale 7,c-,,ssrs77 and other screening tools selected by the ,secretary after management2 and 7#b7 by adding at the end the following new paragraphs3 7#c7 ,training for department employees ,the ,secretary shall provide training to employees of the ,department as the ,secretary considers appropriate on the grant program under this section4 4 7f7 ,briefing for local ,,vamcs ,subsection 7h7 of such section is amended by adding at the end the following new paragraph3 7#e7 ,briefing for local ,,vamcs ,not less frequently than once per year1 unless the ,secretary determines that such frequency is not advisable1 the ,secretary shall provide1 to the appropriate personnel of each medical center of the ,department identified on the grantee's application under this section1 a briefing about the grant program under this section in order to improve coordination between such recipient and personnel4 4 7g7 ,duration ,subsection 7j7 of such section is amended by striking ,september #cj1 #bjbf and inserting ,september #cj1 #bjbi4 7h7 ,reports ,subsection 7k77#b7 is amended-- 7#a7 in the paragraph heading1 by striking ,final report and inserting ,annual reports2 and 7#b7 in subparagraph 7,b7-- 7,a7 by redesignating clauses 7iii7 and 7iv7 as 7v7 and 7vi71 respectively2 and 7,b7 by adding the following new clauses 7iii7 and 7iv73 7iii7 ,a description of the ,secretary's compliance with the requirement to train employees of the ,department under subsection 7g77#c74 7iv7 ,an optional description and inclusion of subjective or narrative stories of community or individual impact to allow grant recipients to share meaningful accomplishments4 4 7i7 ,referral for care ,subsection 7m7 of such section is amended by adding at the end the following new paragraph3 7#d7 ,required response or action 7,a7 ,if the ,secretary receives a referral under paragraph 7#a7 for additional care1 the ,secretary shall review such referral and contact the veteran not later than #gb-;hours following the referral4 7,b7 ,if the ,secretary receives a referral under paragraph 7#b7 for emergent suicide care1 the ,secretary shall review such referral and contact the veteran not later than #bd hours following the referral by such entity under subsection 7m77#a74 4 7j7 ,reauthorization ,subsection 7p7 of such section is amended-- 7#a7 by striking section a total and inserting section-- 7#a7 a total 2 7#b7 by striking the period at the end and inserting 2 and2 and 7#c7 by adding at the end the following new paragraph3 7#b7 a total of #bjj1jjj1jjj for fiscal years #bjbg through #bjbi4 4 7k7 ,technical correction to definitions ,subsection 7q77#e7 of such section is amended1 in the first sentence-- 7#a7 by striking ,medical services and inserting ,the term emergency treatment means medical services2 and 7#b7 by striking was rendered and inserting rendered4 7l7 ,identification of demand for other services and support ,subsection 7e7 of such section1 as amended1 is further amended-- 7#a7 by redesignating paragraphs 7#e7 and 7#f7 as 7#f7 and 7#g71 respectively2 and 7#b7 by adding after paragraph 7#d7 the following new paragraph3 7#e7 ,demand for other services and support ,an entity receiving a grant under this section shall submit to the ,secretary information concerning-- 7,a7 the number of individuals seeking services from the entity who are not eligible individuals and the most common reason such individuals are not eligible individuals2 7,b7 a description of the types of services that eligible individuals or individuals described in subparagraph 7,a7 require based on any screening conducted by the entity2 and 7,c7 any actions taken by the entity to provide the services described in subparagraph 7,b7 or to refer the individual or eligible individual to another entity for the receipt of such services4 4 7m7 ,suicide prevention services 7#a7 ,required use of certain screening protocol ,subsection 7q77#aa77;,a77ii7 of such section is amended by adding at the end the following new sentence3 ,in the case of a recipient of a grant awarded under this section on or after the date of the enactment of the ,take ,care of ,america's ,veterans ,act1 such screening shall be ,columbia ,protocol 7also known as the ,columbia-,suicide ,severity ,rating ,scale 7,c-,,ssrs77 or the ,patient ,health ,questionnaire-#i 7,,phq#i71 or a successor screening tool selected by the ,secretary42 7#b7 ,transportation ,subsection 7q77#aa77;,a7 of such section is amended-- 7,a7 by redesignating clause 7xi7 as clause 7xii72 and 7,b7 by inserting after clause 7x7 the following new clause3 7xi7 ,transportation and rideshare services for eligible individuals to use for appointments4 4 7n7 ,eligible individuals ,subsection 7q77#d77;,c7 of such section is amended by striking clauses 7i7 through 7iv7 and inserting clauses 7i7 through 7vi74 7o7 ,effective date ,the amendments made by this section shall take effect on-- 7#a7 the effective date of award following the date the ,secretary publishes a notice of funding opportunity for the program required by section #bja7;a7 of the ,commander ,john ,scott ,hannon ,veterans ,mental ,health ,care ,improvement ,act of #bjai 7,public ,law #aaf-aga2 7#ch ,u4,s4,c4 #agbj;,f771 if the ,secretary determines such amendments do not require rulemaking2 or 7#b7 the effective date of award following the date the ,secretary publishes a notice of funding opportunity following the effective date of subsequent rulemaking1 if the ,secretary determines such amendments do require rulemaking4 #cjg4 ,reports on the use of hyperbaric oxygen therapy 7a7 ,,gao report on the use of hyperbaric oxygen therapy to treat traumatic brain injury and post-traumatic stress disorder ,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 ,house of ,representatives an update to the report titled ,research on ,hyperbaric ,oxygen ,therapy to ,treat ,traumatic ,brain ,injury and ,post-,traumatic ,stress ,disorder 7,,gao-#af-aed74 ,such report shall include the assessment of the ,comptroller ,general of clinical trials conducted1 since the publication of such report-- 7#a7 regarding the use of hyperbaric oxygen therapy to treat traumatic brain injury and post-traumatic stress disorder2 and 7#b7 by-- 7,a7 the ,secretary of ,veterans ,affairs2 7,b7 the ,secretary of ,defense2 and 7,c7 private entities4 7b7 ,follow-up study 7#a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary shall conduct a systematic review of published research literature on the off-label use of hyperbaric oxygen therapy to treat post-traumatic stress disorder and traumatic brain injury among veterans and nonveterans4 7#b7 ,elements ,the review conducted under paragraph 7#a7 shall include the following3 7,a7 ,an analysis of available research literature published after the review completed pursuant to section #gjb of the ,commander ,john ,scott ,hannon ,veterans ,mental ,health ,care ,improvement ,act 7,public ,law #aaf-aga72 7,b7 ,an assessment of the current parameters for research on the use by the ,department of ,veterans ,affairs of hyperbaric oxygen therapy1 including-- 7i7 tests and questionnaires used to determine the efficacy of such therapy2 and 7ii7 metrics for determining the success of such therapy4 7,c7 ,a comparative analysis of tests and questionnaires used to study post-traumatic stress disorder and traumatic brain injury in other research conducted by the ,department of ,veterans ,affairs1 other ,federal agencies1 and entities outside the ,federal ,government4 7,d7 ,a market assessment of available hyperbaric oxygen therapy facilities or units within facilities to assess the most effective locations and practices1 including-- 7i7 an analysis of whether multi-person chambers could reduce per-veteran costs2 7ii7 an analysis of areas with lower prices compared to a national average2 and 7iii7 an identification of not fewer than two ,v,i,s,ns in which the provision or furnishing of hyperbaric oxygen therapy would benefit the most number of veterans at the lowest cost to the ,department4 #cjh4 ,department of ,veterans ,affairs pilot program to provide grants to mental health care providers for the provision of mental health care for veterans 7a7 ,establishment ,the ,secretary of ,veterans ,affairs shall carry out a three-year pilot program under which the ,secretary shall make grants to eligible mental health care providers for the provision of mental health care1 including evidence-based mental health care delivered in person or via telehealth4 7b7 ,eligibility ,to be eligible to receive a grant under the pilot program1 a mental health care provider shall-- 7#a7 be a non-profit organization2 7#b7 have operated at least one outpatient mental health facility in the ,united ,states for a continuous period of at least three years2 7#c7 be licensed or certified under applicable state law to provide outpatient mental health services2 7#d7 be accredited by-- 7,a7 the ,joint ,commission on ,accreditation of ,healthcare ,organizations2 7,b7 the ,commission on ,accreditation of ,rehabilitation ,facilities2 or 7,c7 any other nationally recognized accrediting body the ,secretary determines appropriate2 and 7#e7 submit to the ,secretary an application that includes such information and assurances as the ,secretary may require1 including-- 7,a7 an identification of the outpatient facility or facilities where the mental health care services will be provided2 7,b7 a plan for providing clinicians at each facility in receipt of grant funds with units of continuing education with respect to veterans issues2 and 7,c7 an identification of the percentage of the operating budget for each such facility that was provided through ,federal grants during the fiscal year preceding the year during which the application is submitted4 7c7 ,use of funds 7#a7 ,in general ,the recipient of a grant under the pilot program shall use the grant-- 7,a7 to deliver evidence-based mental health care for veterans in person or via telehealth4 7,b7 to operate or expand an existing outpatient mental health facility or establish a new outpatient mental health facility for the purpose of providing such care2 7,c7 to encourage veterans who are eligible for enrollment in the patient enrollment system under section #agje of title #ch1 ,united ,states ,code1 to enroll in such system and to receive medical services furnished by the ,department of ,veterans ,affairs2 7,d7 to support activities necessary to deliver or sustain care1 including-- 7i7 outreach2 7ii7 care coordination2 7iii7 veteran engagement2 7iv7 clinician training2 7v7 implementation support2 and 7vi7 program evaluation2 and 7,e7 to support continuous quality improvement and outcomes measurement activities1 including the collection and reporting of clinical outcomes and operational metrics2 and 7,f7 to support activities of the program that are not billable1 reimbursable1 or otherwise authorized by law1 including-- 7i7 outreach2 7ii7 care coordination2 7iii7 engagement2 7iv7 implementation support2 and 7v7 program evaluation2 and 7,g7 to provide services to individuals for which reimbursement is not otherwise available1 including such individuals who are-- 7i7 uninsured2 7ii7 ineligible for health care furnished by the ,department of ,veterans ,affairs2 or 7iii7 in receipt of health care that is not reimbursable as of the date of the enactment of this ,act4 7#b7 ,limitations on use of grant funds ,the recipient of a grant under the pilot program may not-- 7,a7 charge an eligible veteran a fee associated with the receipt of mental health care funded by such grant2 7,b7 refuse to provide mental health care to an eligible veteran on the basis that the veteran is not eligible for reimbursement for such care under another payer source2 or 7,c7 use grant funds to-- 7i7 duplicate payments made under any contract or agreement to which the ,department is a party as of the date of the enactment of this ,act2 or 7ii7 pay for the same clinical services or service units that are otherwise billable to a ,federal payer1 including the ,veterans ,community ,care ,program under section #agjc of title #ch1 ,united ,states ,code1 or any other public or private health plan4 7#c7 ,rules of construction ,nothing in this subsection may be construed to-- 7,a7 prohibit a grant recipient from seeking reimbursement from non-,department payers for mental health services provided by the grant recipient1 except that grant funds shall not be used to supplant or duplicate a reimbursement otherwise available under ,federal law2 or 7,b7 authorize double billing or duplicate payments for the same clinical service or unit of service4 7#d7 ,spouse and dependent care ,a recipient may use grant funds to provide care to spouses and dependent children of a veteran when such services are integral to achieving a successful clinical outcome4 ,permissible services include-- 7,a7 family therapy2 7,b7 couples therapy2 7,c7 group therapy2 7,d7 family psychoeducation2 and 7,e7 other counseling services the ,secretary determines are clinically necessary4 7d7 ,selection of facilities ,in awarding grants under the pilot program1 the ,secretary-- 7#a7 shall ensure that grants are distributed geographically evenly among rural and urban areas2 7#b7 may consider the proportion of veterans historically served by the grant recipient2 and 7#c7 may prioritize outpatient mental health facilities located in areas that the ,secretary determines-- 7,a7 are medically underserved2 7,b7 have large veteran populations2 7,c7 are located near military installations2 or 7,d7 have large numbers of veterans at high risk of suicide4 7e7 ,amount of grant 7#a7 ,in general 7,a7 ,in general ,except as provided in subparagraph 7,b71 no grant under the pilot program for a facility for any fiscal year may exceed #a1ejj1jjj4 7,b7 ,limitation ,in the case of an outpatient mental health facility for which at least #ej percent of the operating budget of the facility for the preceding fiscal year was provided through ,federal grants1 no grant under the pilot program for the facility for any fiscal year may exceed the lesser of-- 7i7 #ej percent of the operating budget of the facility2 or 7ii7 #a1ejj1jjj4 7#b7 ,multiple grants ,the recipient of a grant under the pilot program-- 7,a7 may apply for1 and receive1 grants for more than one facility of the recipient for any fiscal year2 and 7,b7 may apply for1 and receive1 a grant for a facility that has already received a grant under the pilot program4 7f7 ,regulations2 accountability ,the ,secretary shall prescribe regulations to carry out this section1 which shall include a requirement that each recipient of a grant under the pilot program shall-- 7#a7 demonstrate the capacity to provide accountability2 7#b7 demonstrate clinical outcomes2 7#c7 justify the effective use of any private investment funds or ,federal grant funds through data collection and reporting metrics2 and 7#d7 collect standardized outcome measures including symptom improvement and program completion4 7g7 ,continuity of care ,a recipient of a grant under the pilot program shall adhere to the continuity of care model established by the ,secretary to the ,veterans ,community ,care ,program4 7h7 ,report ,not later than #ahj days after the completion of the pilot program under this section1 the ,secretary shall submit to ,congress a report on the pilot program that includes the following3 7#a7 ,the number of veterans who received mental health care under the program4 7#b7 ,an identification of the types of mental health care provided and the time period for which such care was provided4 7#c7 ,an identification and summary of program outcomes4 7#d7 ,the number of veterans who received mental health care under the program and subsequently enrolled in the patient enrollment system under section #agje of title #ch1 ,united ,states ,code4 7#e7 ,an identification of any obstacles faced by grant recipients in providing mental health care under the program4 7#f7 ,a summary of clinical outcomes based on pre- and post-client functioning-- 7,a7 the number of veterans who improved clinically based on relevant clinical evaluation metrics that the ,secretary determines appropriate2 7,b7 the degree of clinical improvement based on such relevant clinical evaluation metrics2 7,c7 the total number of veterans participating in the program2 and 7,d7 any other outcome metrics as the ,secretary determines appropriate4 7#g7 ,findings with respect to the sustainability of the program4 7i7 ,authorization of appropriations ,there is authorized to be appropriated to the ,secretary to carry out the pilot program under this section #bj1jjj1jjj for each of fiscal years #bjbg through #bjbi4 #cji4 ,furnishing of certain health services to veterans in the ,freely ,associated ,states 7a7 ,agreements required ,consistent with section #agbd7;f7 of title #ch1 ,united ,states ,code1 and section #bji7;a77#d77;,a7 of the ,compact of ,free ,association ,amendments ,act of #bjbd 7#dh ,u4,s4,c4 #aihh7;a77#d77;,a771 the ,secretary of ,veterans ,affairs shall work expeditiously with the governments of the ,freely ,associated ,states to enter into the agreements described in such sections4 7b7 ,inclusion of telehealth and mail order pharmacy services required ,consistent with such sections and with the agreements required by subsection 7a71 the ,secretary shall furnish to veterans in the ,freely ,associated ,states services that include1 at a minimum-- 7#a7 medical services authorized to be provided under chapter #ag of title #ch1 ,united ,states ,code1 which can be administered through telehealth2 and 7#b7 pharmaceutical products authorized to be provided under such chapter1 delivered by mail4 7c7 ,implementation dates ,in carrying out subsections 7a7 and 7b71 the ,secretary shall-- 7#a7 initiate outreach to each such government not later than #cj days after the date of the enactment of this ,act2 7#b7 enter into each agreement required by subsection 7a7 not later than one year after the date of the enactment of this ,act2 and 7#c7 begin furnishing the services required by paragraphs 7#a7 and 7#b7 of subsection 7b7 not later than one year after the date of the enactment of this ,act4 7d7 ,beneficiary travel ,section #aaa7;h77#a7 of title #ch1 ,united ,states ,code1 is amended by striking the ,secretary may make payments and inserting beginning not later than one year after the date of the enactment of the ,take ,care of ,america's ,veterans ,act1 the ,secretary shall make payments4 7e7 ,reports ,not less frequently than quarterly1 the ,secretary shall submit to the appropriate committees of ,congress a report on the implementation of this section and the cost of such implementation4 ,until the ,secretary has entered into the agreements required by paragraph 7#a7 and begun furnishing the services required by subparagraphs 7,a7 and 7,b7 of paragraph 7#b71 the report shall also describe the technical and logistical factors that have prevented or impeded the ,secretary from doing so4 7f7 ,definitions ,in this subsection3 7#a7 ,appropriate committees of ,congress ,the term appropriate committees of ,congress means-- 7,a7 the ,committee on ,veterans' ,affairs and the ,committee on ,appropriations of the ,senate2 and 7,b7 the ,committee on ,veterans' ,affairs and the ,committee on ,appropriations of the ,house of ,representatives4 7#b7 ,freely ,associated ,states ,the term ,freely ,associated ,states has the meaning given such term in section #agbd7;f7 of title #ch1 ,united ,states ,code4 #caj4 ,modification of ,precision ,medicine for ,veterans ,initiative2 reporting on suicide by veterans and members of the ,armed ,forces 7a7 ,modification of ,precision ,medicine for ,veterans ,initiative ,section #cje of the ,commander ,john ,scott ,hannon ,veterans ,mental ,health ,care ,improvement ,act of #bjai 7,public ,law #aaf-aga2 #ch ,u4,s4,c4 #agab;,a note7 is amended-- 7#a7 in subsection 7a71 by striking and such other mental health conditions and inserting repetitive low-level blast exposure1 dementia1 and such other brain and mental health conditions2 7#b7 in subsection 7d77#d71 by adding at the end the following new subparagraph3 7,e7 ,data-sharing partnership 7i7 ,in general ,the ,secretary shall work with the ,secretary of ,defense to establish a data-sharing partnership between the ,department of ,veterans ,affairs and the ,department of ,defense4 7ii7 ,storage ,the partnership established under clause 7i7 shall be stored in the open platform made available under this paragraph4 7iii7 ,data ,the data supplied by the ,secretary of ,defense under the partnership established under clause 7i7 shall include relevant data throughout the ,department of ,defense relating to low-level repetitive blast exposure and traumatic brain injury collected by the ,armed ,forces and other appropriate entities1 as determined jointly by the ,secretary of ,defense and the ,secretary of ,veterans ,affairs4 2 and 7#c7 by adding at the end the following new subsections3 7f7 ,repetitive low-level blast exposure research ,in carrying out the initiative under subsection 7a71 the ,secretary shall prioritize research-- 7#a7 to identify and validate biomarkers associated with repetitive low-level blast exposure and traumatic brain injury2 7#b7 to evaluate clinical and non-clinical interventions that improve cognitive function1 quality of life1 and mental health outcomes among veterans with symptoms associated with repetitive low-level blast exposure2 7#c7 to improve the diagnosis1 treatment1 and care coordination for veterans with a history of low-level repetitive blast exposure or traumatic brain injury1 including veterans who performed duties or tasks associated with increased risk of low-level repetitive blast exposure2 and 7#d7 to develop evidence-based strategies to reduce suicide risk among veterans with a history of low-level repetitive blast exposure or traumatic brain injury4 7g7 ,assistance and report by national academies of sciences1 engineering1 and medicine ,not later than #ahj days after the date of the enactment of the ,take ,care of ,america's ,veterans ,act1 the ,secretary of ,veterans ,affairs shall seek to enter into a contract with the ,national ,academies of ,sciences1 ,engineering1 and ,medicine under which the ,national ,academies shall-- 7#a7 work in tandem with the initiative under subsection 7a7 on validation of brain and mental health biomarkers among veterans2 and 7#b7 not less frequently than once every two years1 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 work completed under paragraph 7#a74 7h7 ,assessment 7#a7 ,in general ,the ,secretary of ,veterans ,affairs shall conduct an assessment of all translational research studies in progress and planned under the initiative under subsection 7a71 including research under subsection 7f74 7#b7 ,report ,not later than #fj days after completion of the assessment conducted under paragraph 7#a71 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report on the assessment4 7i7 ,reports 7#a7 ,in general ,not less frequently than once every two years1 the ,secretary of ,veterans ,affairs shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report on the initiative under subsection 7a74 7#b7 ,recommendations ,each report required by paragraph 7#a7 may include recommendations for immediate administrative and legislative action to improve the initiative under subsection 7a74 7j7 ,authorization of appropriations ,there is authorized to be appropriated to the ,secretary of ,veterans ,affairs #e1jjj1jjj to carry out the initiative under subsection 7a7 for each of fiscal years #bjbg through #bjcb4 4 7b7 ,inclusion of information in reports on suicide prevention among veterans and members of the ,armed ,forces 7#a7 ,inclusion of information in national veteran suicide prevention annual report ,section #adi7;a77#d77;,b7 of the ,senator ,elizabeth ,dole #bast ,century ,veterans ,healthcare and ,benefits ,improvement ,act 7,public ,law #aah-baj2 #ch ,u4,s4,c4 #agji;,b note7 is amended by adding at the end the following3 7iv7 ,military occupation data of veterans who attempt or commit suicide4 4 7#b7 ,inclusion of information in ,department of ,defense annual report ,the ,secretary of ,defense shall include in the annual report of the ,defense ,suicide ,prevention ,office1 or successor office1 information on-- 7,a7 occupational data of members of the ,armed ,forces who attempt suicide2 and 7,b7 outcomes of suicide prevention interventions among members of the ,armed ,forces4 #caa4 ,establishment of the ,blast ,overpressure ,task ,force of the ,department of ,veterans ,affairs 7a7 ,establishment ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall appoint1 through the ,department of ,veterans ,affairs-,department of ,defense ,joint ,executive ,committee under section #cbj of title #ch1 ,united ,states ,code1 the ,blast ,overpressure ,task ,force of the ,department of ,veterans ,affairs 7in this section referred to as the ,task ,force74 7b7 ,membership ,each member of the ,task ,force appointed under subsection 7a7 shall be a member of the ,health ,executive ,committee under subsection 7b77#b7 of such section who1 at the time of appointment1 is involved in research regarding the mitigation and treatment of blast overpressure or blast exposure4 7c7 ,duties ,the duties of the ,task ,force are the following3 7#a7 ,to improve how the ,secretary of ,veterans ,affairs1 in consultation with the ,secretary of ,defense1 provides health care and other benefits to veterans or members of the ,armed ,forces diagnosed with traumatic brain injury1 post-traumatic stress disorder1 or other symptoms1 from blast overpressure or blast exposure4 7#b7 ,to align research agendas and acquisition strategies of the ,department regarding such health care4 7#c7 ,to establish physiological and cognitive performance baselines for such veterans and members4 7#d7 ,to prioritize translational research regarding such veterans and members1 including research regarding-- 7,a7 sleep therapy2 7,b7 blast-related gut health2 7,c7 mobile diagnostics2 7,d7 vestibular dysfunction and balance impairment2 7,e7 autonomic nervous system dysregulation2 7,f7 cumulative mild traumatic brain injury2 7,g7 neuroinflammation and glial activation2 and 7,h7 any other issue determined appropriate by the ,secretary4 7#e7 ,to monitor sensory decline 7including with regards to vision1 hearing1 and vestibular function7 and stress-related impairments among such veterans and members4 7#f7 ,to support continuity of such care by integrating mobile and longitudinal diagnostic tools4 7d7 ,reports ,the ,task ,force shall issue annual reports to the ,committees on ,veterans' ,affairs and on ,armed ,services of the ,senate and ,house of ,representatives4 ,each such report shall include the following elements3 7#a7 ,details of research initiatives1 coordination outcomes1 and clinical advancements of the ,task ,force4 7#b7 ,recommendations of the ,task ,force regarding-- 7,a7 how claims processors of the ,department of ,veterans ,affairs should evaluate evidence that links such conditions to active military1 naval1 air1 or space service2 and 7,b7 best practices regarding the evaluation of neurological injuries in examinations for benefits under chapters #aa or #ae of title #ch1 ,united ,states ,code4 7e7 ,sunset ,the ,task ,force shall terminate on ,september #cj1 #bjbi4 #cab4 ,extension of sharing of ,department of ,veterans ,affairs and ,department of ,defense ,health ,care ,resources2 resource sharing oversight and implementation plan 7a7 ,extension ,section #haaa7;d77#c7 of title #ch1 ,united ,states ,code1 is amended by striking ,september #cj1 #bjbf and inserting ,september #cj1 #bjbg4 7b7 ,oversight 7#a7 ,justification ,such section is further amended in subsection 7a7-- 7,a7 by inserting 7#a7 before ,to the maximum extent practicable1 the ,secretary2 and 7,b7 by adding at the end the following new paragraph3 7#b7 ,if the ,secretary of ,veterans ,affairs elects not to enter into such an agreement or contract1 notwithstanding paragraph 7#a71 the ,secretary and the ,department of ,veterans ,affairs-,department of ,defense ,joint ,executive ,committee shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a written justification for such election4 4 7#b7 ,form of information ,if the ,committee on ,veterans' ,affairs of the ,house of ,representatives or the ,senate requests information from the ,secretary of ,veterans ,affairs regarding section #haaa of title #ch1 ,united ,states ,code1 the ,secretary shall provide such information in the form requested by such committee1 including underlying records1 datasets1 methodologies1 contracts1 and communications1 and may not be limited to summaries or briefing materials in lieu of original source documents unless authorized by the requesting committee4 7#c7 ,interference with transmission of information ,in response to such a request1 no official or employee of the ,department of ,veterans ,affairs shall-- 7,a7 withhold1 screen1 or alter responsive information2 7,b7 delay or condition production on initial clearance or political review2 7,c7 require a nondisclosure agreement unless required by law2 7,d7 substitute summaries for requested #b records2 or 7,e7 otherwise impede or interfere with direct transmission of information to the ,committee on ,veterans' ,affairs of the ,house of ,representatives or the ,senate4 7#d7 ,classified information ,if the ,secretary of ,veterans' ,affairs determines that any information regarding such section requested by the ,committee on ,veterans' ,affairs of the ,house of ,representatives or the ,senate is classified1 the ,secretary shall make arrangements to present such information to the ,chair and ,ranking ,member of the such committee using appropriate security measures4 7c7 ,implementation plan and report 7#a7 ,joint resource sharing implementation plan ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs1 in coordination with the ,secretary of ,defense1 shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a ,joint ,resource ,sharing ,implementation ,plan4 ,such plan shall include-- 7,a7 a comprehensive inventory of all agreements under section #haaa of title #ch1 ,united ,states ,code2 7,b7 a standardized reimbursement methodology2 7,c7 capacity assessments of ,department of ,veterans ,affairs and ,department of ,defense facilities2 and 7,d7 identification of priority regions for expansion4 7#b7 ,report ,not later than #b years after date of the enactment of this ,act1 the ,comptroller ,general shall submit a report to ,congress on the implementation of section #haaa of title #ch1 ,united ,states ,code4 ,such report shall include-- 7,a7 a description of use and effectiveness of agreements under such section2 7,b7 a description of the role and output of the ,joint ,executive ,committee under such section2 7,c7 an evaluation of the effectiveness of coordination of care and sharing of resources by the ,department of ,veterans ,affairs and the ,department of ,defense under such section2 and 7,d7 a description of any statutory1 operational1 or cultural barriers to the implementation of such section4 #cac4 ,timely reporting of the death of a veteran 7a7 ,findings ,congress finds the following3 7#a7 ,states and counties have reported significant delays in the signing of death certificates for veterans who pass away from natural causes4 7#b7 ,such delays1 caused by the refusal of1 or postponement by1 physicians of the ,department of ,veterans ,affairs have1 in some cases1 lasted as long as eight weeks4 7#c7 ,such delays prevent the timely burial of deceased veterans and access to survivor benefits4 7b7 ,timely certification of the death of a veteran 7#a7 ,in general 7,a7 ,,va physician1 nurse practitioner1 or physician assistant ,subject to subparagraph 7,b71 a physician1 nurse practitioner1 or physician assistant employed by the ,secretary of ,veterans ,affairs who is the primary care provider of a veteran who dies of natural causes shall certify the death of such veteran not later than two business days after such physician1 nurse practitioner1 or physician assistant learns of such death4 7,b7 ,coroner or medical examiner ,if a physician1 nurse practitioner1 or physician assistant described in subparagraph 7,a7 cannot comply with such paragraph with respect to a death described in such paragraph1 a coroner or medical examiner in the jurisdiction where such death occurred may certify such death4 7#b7 ,report 7,a7 ,in general ,not later than one year after the date of the enactment of this ,act1 and annually thereafter for the following five years1 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 regarding compliance with paragraph 7#a74 7,b7 ,elements ,each report required under subparagraph 7,a7 shall include1 with respect to the year preceding the date of the report1 the following elements3 7i7 ,the percentage of cases in which a physician1 nurse practitioner1 or physician assistant employed by the ,secretary complied with paragraph 7#a77;,a74 7ii7 ,the number of cases in which such a physician1 nurse practitioner1 or physician assistant could not so comply4 7iii7 ,an identification of the most common reasons why such a physician1 nurse practitioner1 or physician assistant could not so comply4 7#c7 ,rule of construction ,nothing in this section shall be construed to authorize a physician assistant or nurse practitioner to certify a death in any ,state in which such authority is not permitted under ,state or local law4 #cad4 ,expansion of access by veterans to critical access hospitals and affiliated clinics under the ,veterans ,community ,care ,program 7a7 ,pilot program to improve care coordination for veterans from critical access hospitals and affiliated clinics 7#a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall commence a five-year pilot program to improve care coordination for eligible veterans who receive care from a critical access hospital or a provider-based rural health clinic affiliated with such hospital 7in this section referred to as the pilot program74 7#b7 ,contracts1 agreements1 or other arrangements 7,a7 ,in general ,in carrying out the pilot program1 the ,secretary shall enter into contracts1 agreements1 or other arrangements with facilities participating in the pilot program to reimburse critical access hospitals and affiliated clinics for outpatient health care and medical services provided to eligible veterans4 7,b7 ,elements ,the ,secretary1 in coordination with participating critical access hospitals1 shall ensure that any contract1 agreement1 or other arrangement entered into under subparagraph 7,a7 establishes criteria1 as the ,secretary considers appropriate1 to ensure-- 7i7 the provision of timely1 safe1 and high-quality health care services to participants in the pilot program1 including through timely sharing of pertinent medical record and other information between medical facilities participating in the pilot program and medical facilities of the ,department of ,veterans ,affairs2 7ii7 the provision of health care services through the pilot program is in accordance with the medical benefits package of the ,department2 7iii7 no additional charges are imposed on veterans participating in the pilot program or the health care insurer of such veterans for any medical service for which payment is made by the ,secretary2 7iv7 appropriate reimbursement rates1 including through the consideration of cost-based reimbursements2 and 7v7 such other considerations as the ,secretary considers appropriate4 7#c7 ,locations ,the ,secretary shall ensure participation in the pilot program is open to all qualified facilities located in ,states that are designated by the ,centers for ,medicare ,medicaid ,services as frontier ,states4 7#d7 ,authorization for care ,the ,secretary shall provide eligible veterans opting to participate in the pilot program a one-year authorization from the ,department to receive outpatient services at facilities participating in the pilot program4 7#e7 ,outreach 7,a7 ,eligible veterans ,not less frequently than annually during each year in which the pilot program is carried out1 the ,secretary shall conduct direct outreach to eligible veterans in areas in which the pilot program is carried out to notify such veterans of their ability to participate in the pilot program4 7,b7 ,hospitals ,the ,secretary shall conduct direct outreach to critical access hospitals in areas in which the pilot program is carried out to notify those hospitals of their ability to participate in the pilot program4 7#f7 ,staff ,the ,secretary shall ensure that each medical facility of the ,department within the catchment area of a location in which the pilot program is carried out has sufficient dedicated staff to handle-- 7,a7 administrative and technical challenges that arise from the pilot program2 7,b7 care coordination and follow up with the veteran and the facility participating in the pilot program after an episode of care2 and 7,c7 timely records return following an episode of care4 7#g7 ,limitation ,the ,secretary may not extend the pilot program beyond the five-year period specified under subsection 7a7 or expand the pilot program to additional ,states or convert the pilot program into a permanent authority unless expressly authorized by a subsequent ,act of ,congress4 7#h7 ,report 7,a7 ,in general ,not later than one year after the date of the enactment of this ,act1 and annually thereafter for the duration of the pilot program1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans ,affairs of the ,house of ,representatives a report on the pilot program4 7,b7 ,elements 7i7 ,in general ,each report required under subparagraph 7,a7 shall contain the recommendation of the ,secretary for the expansion or continuation of the pilot program4 7ii7 ,initial report ,the initial report required under clause 7i7 shall contain-- 7,i7 a description of the outreach conducted to critical access hospitals concerning the pilot program2 7,,ii7 a list of facilities that have opted to participate in the pilot program2 7,,iii7 information1 by facility1 regarding total obligations and expenditures1 utilization average time from authorization to care1 timeliness regarding medical records return and claim payment1 emergency department utilization1 veteran satisfaction1 and any effect on care furnished by ,department facilities2 and 7,,iv7 a list of the barriers1 if any1 cited by facilities that opted not to participate in the pilot program4 7iii7 ,subsequent reports ,each report required under clause 7i7 after the initial report shall contain-- 7,i7 an updated list of facilities participating in the pilot program2 7,,ii7 the number of veterans participating in the pilot program1 disaggregated by facility2 7,,iii7 an overview of the types of care received through the pilot program2 7,,iv7 feedback from the facilities participating in the pilot program1 with identifying information removed1 regarding the status of the pilot program1 challenges in participating in the pilot program1 and the interest of the facility in continued participation in such a program2 and 7,v7 any additional information that the ,secretary determines relevant or necessary4 7#i7 ,definitions ,in this subsection3 7,a7 ,critical access hospital ,the term critical access hospital has the meaning given that term in section #ahfa7mm7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7mm774 7,b7 ,eligible veteran ,the term eligible veteran means a veteran-- 7i7 enrolled in the patient enrollment system of the ,department of ,veterans ,affairs established and operated under section #agje7;a7 of title #ch1 ,united ,states ,code2 7ii7 who has received care at a facility of the ,department or in-network provider under the ,veterans ,community ,care ,program under section #agjc of such title during the previous two-year period2 7iii7 who lives within #ce miles of a critical access hospital2 and 7iv7 who would be eligible for care or services under the ,veterans ,community ,care ,program4 7b7 ,action plan to address barriers to care for veterans living in rural areas 7#a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall develop and submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a comprehensive action plan to identify1 address1 and eliminate barriers to accessing care for veterans residing in rural1 highly rural1 and frontier areas4 7#b7 ,elements ,in developing the action plan required under paragraph 7#a71 the ,secretary shall-- 7,a7 consult with health care providers that provide care in the community under the laws administered by the ,secretary1 ,state ,offices of ,rural ,health1 ,tribal health authorities1 and other relevant stakeholders in rural1 highly rural1 and frontier areas as the ,secretary determines appropriate2 7,b7 assess barriers to care in the community for veterans residing in rural and highly rural areas1 including challenges with respect to-- 7i7 network adequacy2 7ii7 provider participation2 7iii7 geographic distance2 7iv7 transportation2 7v7 information technology2 7vi7 physical infrastructure2 7vii7 outreach and understanding of eligibility for such care2 7viii7 timeliness of referrals1 authorization1 and medical documentation exchange2 and 7ix7 any other matter the ,secretary determines appropriate2 7,c7 list specific and measurable strategies and actions to address the barriers and challenges assessed under subparagraph 7,b71 to include the consideration of-- 7i7 expanding participation in the ,veterans ,community ,care ,program under section #agjc of title #ch1 ,united ,states ,code1 among providers in rural1 highly rural1 and frontier areas2 7ii7 physically locating health care facilities of the ,department of ,veterans ,affairs within the same building or on the campuses of other health care facilities located in rural1 highly rural1 or frontier areas2 7iii7 enhancing transportation assistance2 7iv7 increasing reimbursement rates1 including through cost-based reimbursements2 and 7v7 improving coordination with ,state1 ,tribal1 and local partners2 and 7,d7 assess legislative and regulatory barriers1 if any1 to addressing the barriers assessed under subparagraph 7,b74 7#c7 ,implementation ,not later than #ij days after submitting the action plan under paragraph 7#a71 the ,secretary shall begin implementation of the plan and shall ensure full implementation not later than two years after the date of the enactment of this ,act4 7c7 ,outreach 7#a7 ,outreach to veterans ,not later than one year after the date of the enactment of this ,act1 and annually thereafter1 the ,secretary of ,veterans ,affairs1 through the ,office of ,rural ,health 7or successor office7 and the ,office of ,integrated ,veteran ,care 7or successor office71 shall conduct outreach to veterans residing in rural1 highly rural1 and frontier areas regarding-- 7,a7 opportunities to seek care through facilities and programs of the ,department of ,veterans ,affairs1 including via telehealth1 existing programs provided through grantees or contractors of the ,department1 ,vet ,centers 7as defined in section #agab;,a of title #ch1 ,united ,states ,code71 and volunteer programs and services for transportation2 7,b7 opportunities to seek care though the ,veterans ,community ,care ,program under section #agjc of title #ch1 ,united ,states ,code2 7,c7 opportunities to seek care at critical access hospitals with contracts1 partnerships1 or agreements with the ,department of ,veterans ,affairs2 and 7,d7 any other matters the ,secretary considers appropriate4 7#b7 ,outreach to providers ,not later than one year after the date of the enactment of this ,act1 and annually thereafter1 the ,secretary of ,veterans ,affairs1 through the ,office of ,rural ,health 7or successor office7 and the ,office of ,integrated ,veteran ,care 7or successor office71 shall-- 7,a7 conduct outreach to health care facilities and critical access hospitals in rural areas regarding-- 7i7 the ,veterans ,community ,care program under section #agjc of title #ch1 ,united ,states ,code1 and the pilot program under subsection 7a7 of this section2 and 7ii7 any other matters the ,secretary considers appropriate2 and 7,b7 seek to enter into contracts1 partnerships1 agreements1 or other arrangements with health care facilities and critical access hospitals in rural areas4 7#c7 ,critical access hospital defined ,in this section1 the term critical access hospital has the meaning given that term in section #ahfa7mm7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7mm774 #cae4 ,pilot platform for services for veterans2 collection from veterans of information related to social determinants of health 7a7 ,pilot program on establishment or enhancement of community integration platform for veterans 7#a7 ,in general ,commencing not later than #ah months after the date of the enactment of this ,act1 the ,secretary1 acting through the ,center for ,innovation for ,care and ,payment of the ,department of ,veterans ,affairs1 shall carry out a pilot program under which the ,secretary shall establish a new1 or enhance an existing1 interoperable community integration platform to coordinate local support services for veterans through other governmental and nongovernmental organizations 7in this section referred to as the pilot program74 7#b7 ,elements of pilot program ,in carrying out the pilot program1 the ,secretary shall ensure that the community integration platform established or enhanced under the pilot program-- 7,a7 permits veterans to identify and connect with covered entities that furnish covered services2 7,b7 permits covered entities to identify and connect with veterans in need of covered services2 7,c7 utilizes1 to the extent practicable1 existing interoperable technology networks2 7,d7 prioritizes connectivity with appropriate existing technology networks developed by public or private organizations that comply with1 as applicable1 standards adopted by the ,secretary of ,health and ,human ,services under section #cjjd of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;jj-#ad71 for the provision of covered services2 7,e7 ensures that-- 7i7 reasonable measures are taken to promote connectivity and interoperable exchange among covered entities and between covered entities and veterans2 and 7ii7 appropriate privacy and security protections are in place1 in accordance with applicable ,federal and ,state privacy law2 7,f7 is accessible by employees of the ,department1 covered entities1 and veterans2 7,g7 connects covered entities and veterans for purposes of communication1 service coordination1 and consumer assistance1 referral and capacity management1 outcome tracking and reporting1 and related services2 and 7,h7 is accessible via a web-based platform for all veterans and via a non-web-based alternative platform or process for veterans who are unable to easily and reliably access the web-based platform4 7#c7 ,locations 7,a7 ,initial locations ,the ,secretary shall carry out the pilot program at not fewer than five medical facilities of the ,department of ,veterans ,affairs selected by the ,secretary for purposes of the pilot program4 7,b7 ,expansion ,the ,secretary may expand beyond initial sites for the pilot program selected under paragraph 7#a7 not before two years after the date of enactment1 not before thirty days after briefing the ,committees on ,veterans' ,affairs of the ,senate and the ,house of the expansion plan1 and after demonstrated success4 7,c7 ,variety of facilities ,in selecting facilities under subparagraph 7,a71 the ,secretary shall ensure the selection of a variety of different types of facilities1 including-- 7i7 frontier facilities2 7ii7 under-resourced facilities2 7iii7 facilities at which there are existing efforts to coordinate with community resources2 and 7iv7 facilities located in communities with an established community-based veteran service coordination network capable of integration with the pilot program4 7#d7 ,procurement of technology ,in carrying out the pilot program1 the ,secretary shall ensure full and open competition in the procurement of any services or technology and shall not enter into an exclusive national contract for the operation of the community integration platform under the pilot program4 ,in procuring technology under this section1 the ,secretary may prioritize1 to the maximum extent practicable1 technologies1 platforms1 or capabilities that are already deployed1 validated1 interoperable1 or otherwise in operational use within medical centers or other components of the ,department1 unless the ,secretary determines and documents that an alternative solution would better achieve the purposes of this section4 7#e7 ,application process 7,a7 ,in general ,the ,secretary may require covered entities that seek to participate in the pilot program to submit to the ,secretary an application therefore in such form1 in such manner1 and containing such commitments and information as the ,secretary considers necessary to carry out this section4 7,b7 ,review 7i7 ,in general ,the ,secretary shall review the applications of covered entities submitted under subparagraph 7,a7 to ensure that the participation of such entities would be safe and appropriate for veterans participating in the pilot program4 7ii7 ,due diligence ,in reviewing applications under clause 7i71 the ,secretary shall conduct due diligence consistent with how the ,secretary conducts due diligence for public-private partnerships under other laws administered by the ,secretary4 7#f7 ,screening and tracking of participants 7,a7 ,in general ,the ,secretary shall require veterans participating in the community integration platform under the pilot program to provide information regarding social determinants of health using the ,,icd-#aj diagnostic codes ,z#ee through ,z#fc and ,z#ge 7as in effect on the date of the enactment of this ,act7 in a standardized risk assessment or screening tool and such other information as the ,secretary considers necessary to administer the pilot program4 7,b7 ,informed consent ,information collected under the pilot program with respect to a veteran shall be obtained with the informed consent of the veteran and used solely for purposes of care coordination1 service delivery1 or program evaluation under the pilot program4 7,c7 ,tracking of information 7i7 ,in general ,the ,secretary shall track-- 7,i7 the number of referrals of veterans to covered entities through the community integration platform under the pilot program2 7,,ii7 the response time of covered entities to which such veterans are referred2 and 7,,iii7 the outcome of the initial meeting by a veteran and a covered entity to which the veteran is referred1 including a description of the services that are provided to the veteran by such entity4 7ii7 ,tracking by entities ,the ,secretary may require covered entities participating in the pilot program to track the information required under clause 7i7 in a medium determined appropriate by the ,secretary4 7#g7 ,coordination and integration of programs 7,a7 ,coordination with existing networks ,in carrying out the pilot program1 the ,secretary shall coordinate with existing community networks4 7,b7 ,coordination and integration with ,state medicaid programs ,the ,secretary may consult and coordinate with the ,secretary of ,health and ,human ,services and with ,states regarding existing ,federal and ,state programs1 but nothing in this section shall be construed to authorize the ,secretary of ,veterans ,affairs to administer1 direct1 or modify a ,state ,medicaid program or waiver4 7#h7 ,performance benchmarks ,the ,secretary shall establish performance benchmarks for the pilot program1 including measures of referral completion1 timeliness of service connection1 and veteran-reported satisfaction4 7#i7 ,report and briefings 7,a7 ,report ,not later than three years after the commencement of the pilot program1 the ,secretary shall submit to the appropriate committees of ,congress a report analyzing the needs of veterans for covered services reflected by the use of such services under the community integration platform under the pilot program1 including an assessment of-- 7i7 the need for such services that is being met through such platform2 and 7ii7 the need for such services that is not being met through such platform4 7,b7 ,briefing on entities not selected ,not later than #ahj days after the commencement of the pilot program1 and not less frequently than once every #ahj days thereafter until the conclusion of the pilot program1 the ,secretary shall brief the appropriate committees of ,congress on the covered entities that submitted an application to participate in the pilot program but were not selected for participation and the reason those entities were not selected4 7#aj7 ,comptroller ,general evaluation1 report1 and recommendations 7,a7 ,evaluation ,the ,comptroller ,general of the ,united ,states shall conduct an evaluation that measures the overall impact of the community integration platform established or enhanced under the pilot program with respect to-- 7i7 changes in individual and population health outcomes among veterans2 7ii7 changes in access to health care or social services among veterans2 and 7iii7 such other factors as the ,comptroller ,general considers appropriate4 7,b7 ,report and recommendations 7i7 ,in general ,not later than four years after the commencement of the pilot program1 the ,comptroller ,general shall-- 7,i7 submit to ,congress a report on the evaluation conducted under subparagraph 7,a72 7,,ii7 make such report publicly available2 and 7,,iii7 based on such evaluation1 make recommendations to the ,secretary on how to improve and sustain the community integration platform established or enhanced under the pilot program4 7ii7 ,elements of report ,the report under clause 7i77,i7 shall include data on-- 7,i7 what covered sources under the pilot program are being utilized the most2 7,,ii7 what requests for services under the pilot program cannot be met2 and 7,,iii7 the impact of the provision of services under the pilot program on health outcomes of veterans4 7#aa7 ,limitations 7,a7 ,the ,secretary may not use the pilot program established under subsection 7a7 to supplant services otherwise required to be furnished by the ,department under title #ch1 ,united ,states ,code4 7,b7 ,no covered entity participating in the pilot program established under subsection 7a7 may receive access to personally identifiable information1 protected health information1 or social determinants information of a veteran without the veteran's informed written consent1 and such information may be used only for the specific referral or service authorized by the veteran4 7#ab7 ,definitions ,in this subsection3 7,a7 ,appropriate committees of ,congress ,the term appropriate committees of ,congress means the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives4 7,b7 ,community integration platform ,the term community integration platform means an interoperable platform or network of interoperable systems used to enable the coordination1 alignment1 and connection of covered entities and veterans at the local level for purposes of communication1 service coordination1 and referral management of covered services4 7,c7 ,covered entity ,the term covered entity means any of the following entities or providers that have entered into an agreement with the ,secretary to participate in the pilot program3 7i7 ,a community-based organization that-- 7,i7 accepts referrals from health care organizations2 and 7,,ii7 provides covered services4 7ii7 ,a public or private health care provider organization4 7iii7 ,a public or private funded payor of health care services1 including home- or community-based services4 7iv7 ,a ,state1 local1 territorial1 or ,tribal health or social services agency4 7v7 ,a ,state public housing authority or housing finance agency4 7vi7 ,a public health information exchange or public health information network1 as defined by the ,secretary4 7vii7 ,a faith-based service provider4 7viii7 ,any other similar entity1 as determined by the ,secretary4 7,d7 ,covered services ,the term covered services means any of the following3 7i7 ,nutritional assistance4 7ii7 ,housing4 7iii7 ,health care1 including preventive health intervention1 chronic disease management1 and behavioral health care4 7iv7 ,transportation4 7v7 ,job training and employment4 7vi7 ,child development or care4 7vii7 ,caregiving and respite care4 7viii7 ,disability assistance4 7ix7 ,suicide prevention4 7x7 ,sexual assault services4 7xi7 ,legal aid4 7xii7 ,transition assistance for veterans newly separated or discharged from active military1 naval1 air1 or space service 7as defined in section #aja7bd7 of title #ch1 ,united ,states ,code74 7xiii7 ,assistance with utilities necessary for safe habitation4 7xiv7 ,other services directly related to health care access1 suicide prevention1 homelessness prevention1 food insecurity1 transportation to health care1 or assistance separating from military service and reentering civilian life1 as expressly authorized under laws administered by the ,secretary4 7,e7 ,secretary ,the term ,secretary means the ,secretary of ,veterans ,affairs4 7,f7 ,state ,the term ,state has the meaning given that term in section #aja of title #ch1 ,united ,states ,code4 7b7 ,collection of information from veterans related to social determinants of health 7#a7 ,in general ,the ,secretary of ,veterans ,affairs shall collect from 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 as part of routine screenings of such veterans under the laws administered by the ,secretary1 information related to social determinants that may factor into the health of such veterans4 7#b7 ,social determinants of health 7,a7 ,in general ,the information collected under subsection 7a7 shall include standardized definitions for identifying social determinants of health needs identified in the ,,icd-#aj diagnostic codes ,z#ee through ,z#fc and ,z#ge 7as in effect on the date of enactment of this ,act74 7,b7 ,incorporation of measures ,definitions included under subparagraph 7,a7 with respect to identifying social determinants of health needs shall incorporate measures for quantifying the relative severity of any such social determinant of health need identified in an individual4 #caf4 ,improvements to ,department of ,veterans ,affairs prosthetic and rehabilitative items and service 7a7 ,prosthetic and ,rehabilitative ,items and ,services ,formulary 7#a7 ,in general ,chapter #ag of title #ch1 ,united ,states ,code1 is amended by inserting after section #agji;,c the following new section3 #agji;,d4 ,prosthetic and ,rehabilitative ,items and ,services ,formulary 7a7 ,in general ,the ,secretary shall establish a list of prosthetic and rehabilitative items and services1 which may be referred to as the ,prosthetic and ,rehabilitative ,items and ,services ,formulary or the ,formulary1 for purposes of furnishing medical services under section #agja7f77;,f7 of this title pursuant to section #agaj of this title4 7b7 ,requirements 7#a7 ,input ,in developing the ,formulary1 the ,secretary shall solicit input from veterans and the public4 7#b7 ,availability of items ,the ,secretary shall ensure that all items and services included in the ,formulary are available at or through all facilities of the ,department4 7#c7 ,items ,to be included ,in developing the ,formulary1 the ,secretary shall rely on the best available evidence to identify which items and services should be included on the ,formulary4 7c7 ,publication and communication 7#a7 ,publication and update ,the ,secretary shall publish the ,formulary on a website of the ,department and shall update the ,formulary periodically4 7#b7 ,communication ,the ,secretary shall communicate to veterans the contents of the ,formulary and information about how to appeal decisions regarding the provision of items and services on the ,formulary4 7d7 ,contracts ,the ,secretary shall enter into such contracts as the ,secretary considers necessary to support the availability of items and services included in the ,formulary4 7e7 ,training ,the ,secretary shall ensure the availability of training on the ,formulary for clinicians and other staff of the ,department4 7f7 ,exceptions 7#a7 ,in general ,the ,secretary shall establish a process for clinicians of the ,department to request1 prescribe1 and furnish prosthetic and rehabilitative items and services that are not included on the ,formulary when medically necessary4 7#b7 ,monitoring of non-,formulary items and services ,the ,secretary shall monitor requests and prescriptions for and the furnishing of prosthetic and rehabilitative items and services under paragraph 7#a7-- 7,a7 to ensure that such items and services are being consistently and appropriately prescribed at all facilities of the ,department2 and 7,b7 to determine whether such items or services should be added to the ,formulary4 7#c7 ,prior authorization for non-formulary procurement ,the ,secretary shall establish a prior authorization process for the procurement of prosthetic and rehabilitative items that are not included on the ,formulary or available through a national contract4 7#d7 ,open market procurement ,the ,secretary shall ensure that procurement of items that are not included on the ,formulary or available through a national contract is permitted only if a clinician determines the item is medically necessary4 7g7 ,consideration ,in developing the ,formulary1 the ,secretary shall consider how the approach of the ,pharmacy ,benefits ,management ,services of the ,department for formulary management and medication safety can be adapted to support the efficient and effective administration of the ,formulary4 7h7 ,enterprise procurement and ordering system 7#a7 ,in general ,the ,secretary shall implement an enterprise electronic ordering system for prosthetic and rehabilitative items and services furnished under this section4 7#b7 ,systems elements ,the system required under paragraph 7#a7 shall-- 7,a7 enable the automated ordering of items included on the ,formulary2 7,b7 provide visibility of contract pricing and availability across all facilities of the ,department2 7,c7 allow enterprise loading of nationally contracted products2 7,d7 provide procurement analytics to monitor compliance with national contracts and reduce open market purchasing2 and 7,e7 contain all data elements required for the ,federal ,electronic ,healthcare ,record in a searchable format4 7#c7 ,implementation ,the ,secretary shall ensure that the system required under paragraph 7#a7 is implemented across all medical centers of the ,department by not later than three years after the date of the enactment of this section4 7i7 ,program management 7#a7 ,in general ,the ,secretary shall ensure that the ,prosthetic and ,sensory ,aids ,service of the ,department maintains adequate staffing to administer the ,formulary and associated procurement programs4 7#b7 ,staffing included ,staffing required under paragraph 7#a7 shall include-- 7,a7 dedicated program managers for major prosthetic product categories2 and 7,b7 full-time clinical staff responsible for clinical evaluations and practice recommendations4 7j7 ,report to ,congress ,not later than two years after the date of the enactment of this section1 and annually thereafter1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report describing-- 7#a7 rates of compliance by the ,department with national prosthetic contracts2 7#b7 open market purchasing trends of the ,department2 7#c7 utilization of the ,formulary across facilities of the ,department2 and 7#d7 steps taken by the ,department to improve enterprise procurement efficiency4 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 #agji;,c the following new item3 #agji;,d4 ,prosthetic and rehabilitative items and services formulary4 7b7 ,report 7#a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report containing a comprehensive operational and technology assessment of the ,prosthetic and ,rehabilitative ,items and ,services ,formulary established under section #agji;,d of title #ch1 ,united ,states ,code1 as added by subsection 7a74 7#b7 ,elements ,the report required by paragraph 7#a7 shall identify potential impacts of the ,prosthetic and ,rehabilitative ,items and ,services ,formulary on-- 7,a7 access by veterans to prosthetic and rehabilitative items and services2 7,b7 clinician workload2 7,c7 procurement timelines2 and 7,d7 innovation adoption4 #cag4 ,improvement of submission of medical documentation to the ,secretary of ,veterans ,affairs by community care providers 7a7 ,in general ,the ,secretary of ,veterans ,affairs shall ensure that each contract1 agreement1 or other arrangement through which the ,secretary furnishes hospital care1 medical services1 or extended care services to eligible veterans through non-,department of ,veterans ,affairs entities or providers includes clear requirements1 including requirements regarding timeliness1 regarding the submission of medical documentation to the ,secretary after a veteran receives such care or services from the non-,department entity or provider4 7b7 ,internal ,measures ,the ,secretary shall establish such goals and related performance measures for medical centers of the ,department as the ,secretary determines appropriate in obtaining medical documentation from non-,department entities or providers under subsection 7a74 7c7 ,training ,the ,secretary may establish goals and related performance measures for the completion by non-,department entities or providers of core training related to the submission to the ,secretary of medical documentation under subsection 7a7 and may monitor the completion of such training4 7d7 ,outreach ,the ,secretary shall ensure that communications by the ,secretary with non-,department entities or providers contain clear and accurate information regarding requirements for submitting medical documentation under subsection 7a7 and completing the core training described in subsection 7c74 7e7 ,submission of goals1 measures1 and materials ,not later than one year after the date of the enactment of this ,act1 and not less frequently than annually thereafter for the following five years1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives copies of any goals1 performance measures1 training materials1 or outreach materials pertaining to the submission of medical documentation under this section4 #cah4 ,implementation of and report on efforts of ,department of ,veterans ,affairs to improve health care appointment scheduling 7a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall submit to the appropriate committees of ,congress a plan to improve the process for scheduling appointments for health care from the ,department of ,veterans ,affairs1 including improvements for both patients and employees of the ,department responsible for scheduling such appointments4 7b7 ,elements of plan 7#a7 ,in general ,the plan required by subsection 7a7 shall include-- 7,a7 such actions1 resources1 technology1 and process improvements as the ,secretary determines necessary to ensure the ,department achieves1 in a timely manner1 improved delivery of health care1 access to health care1 customer experience and service relating to the receipt of health care1 and efficiency with respect to the delivery of health care2 and 7,b7 a proposed schedule and timeline to carry out such plan4 7#b7 ,objectives 7,a7 ,in general ,the ,secretary shall ensure that the plan required by subsection 7a7 addresses the following objectives3 7i7 ,to develop or continue the development of a scheduling system that enables both personnel and patients of the ,department to view available appointments for care furnished by the ,department1 including primary care1 mental health care1 and all forms of specialty care4 7ii7 ,to develop or continue the development of a self-service scheduling platform1 available for use by all patients of the ,department1 which shall-- 7,i7 enable such patients to view available appointments and1 subject to the process described in clause 7iii71 fully schedule appointments for all care furnished by the ,department2 7,,ii7 if a referral is required for an appointment1 provide a method for the patient to request a referral and subsequently book an appointment if the referral is approved2 and 7,,iii7 provide such patients with the ability to cancel or reschedule appointments4 7iii7 ,to create a process through which all patients of the ,department can telephonically speak with a scheduler who can assist the patient to determine appointment availability and can fully schedule appointments on behalf of the patient for all care furnished by the ,department4 7iv7 ,to carry out such other functions1 oversight1 metric development and tracking1 change management1 cross-,department coordination1 and other related matters1 including improvements to employee-facing information technology1 training1 and processes1 as the ,secretary determines appropriate as it relates to scheduling tools1 functions1 and operations with respect to health care appointments furnished by the ,department4 7,b7 ,explanation of inability to implement certain objectives1 features1 or services ,if the ,secretary determines that an objective under subparagraph 7,a71 or any feature or service in connection with that objective1 cannot be implemented or otherwise incorporated into a final product pursuant to the plan required by subsection 7a71 the ,secretary shall include with the plan submitted under such subsection a report containing-- 7i7 an explanation as to why that objective1 feature1 or service cannot be implemented or incorporated1 as the case may be2 and 7ii7 a plan for implementing the plan required by subsection 7a7 without that objective1 feature1 or service4 7c7 ,implementation ,not later than two years after submitting to the appropriate committees of ,congress the plan required by subsection 7a71 the ,secretary shall fully implement the plan4 7d7 ,coordination with ,electronic ,health ,record ,modernization ,program ,in developing the plan required by subsection 7a71 the ,secretary shall ensure that the elements and objectives of such plan set forth under subsection 7b7 are developed in consideration of the deployment schedule and capabilities of the ,electronic ,health ,record ,modernization ,program of the ,department to ensure a smooth transition to using the tools and features under such plan as relevant and appropriate4 7e7 ,implementation reports ,not later than each of one year and two years after the date on which the ,secretary submits the plan required by subsection 7a71 the ,secretary shall submit to the appropriate committees of ,congress a report on the progress of the ,secretary in implementing such plan1 including-- 7#a7 the costs incurred to implement the plan as of the date of the report2 7#b7 the expected costs to complete implementation of the plan 7including costs for management and technology72 7#c7 the schedule for deployment of any capabilities developed pursuant to the plan2 and 7#d7 the goals and metrics achieved1 challenges1 and lessons learned in implementing the plan4 7f7 ,rule of construction ,nothing in this section shall be construed to require the ,secretary to include in the plan required by subsection 7a7 any technology or process that would preclude or impede the ability of a veteran to contact or schedule an appointment directly with a facility or provider through a non-online scheduling process1 should the veteran choose to do so4 7g7 ,definitions ,in this section3 7#a7 ,appropriate committees of ,congress ,the term appropriate committees of ,congress means the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives4 7#b7 ,fully schedule ,the term fully schedule1 with respect to an appointment for health care1 means that the appointment booking is completed1 rather than simply requested4 #cai4 ,pilot program on coordination of care between ,department of ,veterans ,affairs and ,medicare program 7a7 ,in general ,the ,secretary1 in consultation with the ,secretary of ,health and ,human ,services1 shall carry out a pilot program 7in this section referred to as the pilot program7 to coordinate1 navigate1 and manage care and benefits for covered veterans4 7b7 ,purposes of pilot program ,the purposes of the pilot program are as follows3 7#a7 ,to improve access to health care services for covered veterans from the ,department of ,veterans ,affairs and under the ,medicare program under title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq474 7#b7 ,to improve satisfaction with care received by covered veterans4 7#c7 ,to improve quality of care received by covered veterans4 7#d7 ,to lower costs to the ,federal ,government for care received by covered veterans4 7#e7 ,to reduce gaps in care and duplication of services and expenses for covered veterans4 7#f7 ,to improve care coordination for covered veterans1 including coordination of patient information and medical records between providers and between the ,department and the ,centers for ,medicare ,medicaid ,services4 7c7 ,locations ,the ,secretary shall carry out the pilot program in not fewer than three but not more than five ,veterans ,integrated ,service ,networks with a significant number of covered veterans and geographic diversity1 including-- 7#a7 locations that are in rural or highly rural areas1 as determined through the use of the ,rural-,urban ,continuum codes of the ,department of ,agriculture2 and 7#b7 locations that are in medically underserved communities 7as defined in section #gii;,b of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #biep774 7d7 ,case manager ,in carrying out the pilot program1 the ,secretary shall assign each covered veteran participating in the pilot program a case manager responsible for-- 7#a7 coordinating with the veteran1 the primary care team of the veteran1 and any relevant care coordinators already assisting the veteran to develop an individualized needs assessment for the veteran and1 based on such assessment1 a care coordination plan with defined treatment goals2 and 7#b7 navigating the systems of care under the laws administered by the ,secretary and under the ,medicare program under title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq474 7e7 ,use of existing models ,in designing the pilot program1 the ,secretary may use existing models used by commercial health care programs to improve access1 health outcomes1 quality1 and customer experience and lower per capita costs4 7f7 ,contracting with private sector entities 7#a7 ,in general ,the ,secretary1 to the extent practicable1 shall consider entering into contracts or agreements with private sector entities carrying out commercial health care programs for assistance in designing1 implementing1 and managing care and benefits under the pilot program1 to include providing care coordination4 7#b7 ,notification ,if the ,secretary determines that entering into contracts or agreements with private sector entities under paragraph 7#a7 is not necessary or practicable1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives-- 7,a7 a notification of that determination2 7,b7 a description of the steps1 if any1 the ,secretary has taken to attempt to enter into a contract or an agreement with a private sector entity2 7,c7 a justification for why the ,secretary has determined that such contract or agreement is not necessary or practicable2 and 7,d7 a plan for how the ,secretary will carry out the pilot program without entering into a contract or an agreement with a private sector entity1 including through the use of employees of the ,department of ,veterans ,affairs or other government agencies1 nonprofit organizations1 or other entities4 7g7 ,metrics 7#a7 ,in general ,the ,secretary shall track metrics under the pilot program1 including the following3 7,a7 ,the number of veterans participating in the pilot program1 disaggregated by ,veterans ,integrated ,service ,network4 7,b7 ,reliance on health care services administered by the ,secretary4 7,c7 ,reliance on health care services administered under the ,medicare program under title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq474 7,d7 ,quality of care1 including patient outcomes4 7,e7 ,cost of care4 7,f7 ,access to care1 including under the designated access standards developed by the ,secretary under section #agjc;,b of title #ch1 ,united ,states ,code4 7,g7 ,patient satisfaction4 7,h7 ,provider satisfaction4 7,i7 ,care coordination1 including timely information sharing and medical documentation return4 7#b7 ,elements ,in tracking metrics under paragraph 7#a71 the ,secretary shall track information relating to-- 7,a7 whether care received by a covered veteran is related to a service-connected disability 7as defined in section #aja of title #ch1 ,united ,states ,code72 7,b7 the priority group under section #agje7;a7 of title #ch1 ,united ,states ,code1 through which each covered veteran was enrolled in the system of annual patient enrollment of the ,department of ,veterans ,affairs under such section2 7,c7 the type of care and services provided to covered veterans2 and 7,d7 the demographics of covered veterans participating in the pilot program1 including age4 7h7 ,supplement not supplant ,the services provided under the pilot program shall supplement1 not supplant1 the services provided under the education program under section #aba of the ,,va ,,mission ,act of #bjah 7,public ,law #aae-ahb2 #ch ,u4,s4,c4 #agja note74 7i7 ,duration ,the ,secretary shall carry out the pilot program for a three-year period beginning on the commencement of the pilot program4 7j7 ,reports 7#a7 ,development1 implementation1 results1 and design of pilot program 7,a7 ,in general ,not less frequently than biannually during the two-year period beginning on the date of the enactment of this ,act1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report on the development1 implementation1 results1 and design of the pilot program1 including information on the metrics tracked under subsection 7g74 7,b7 ,final design ,one of the reports required under subparagraph 7,a7 shall contain a description of the final design of the pilot program4 7#b7 ,results of pilot program 7,a7 ,in general ,not later than one year after the submission of the final report under paragraph 7#a71 and not less frequently than annually thereafter during the duration of the pilot program1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report on the results of the pilot program4 7,b7 ,final report ,in the final report submitted under subparagraph 7,a71 the ,secretary shall include the recommendation of the ,secretary for whether the pilot program should be extended or made permanent4 7k7 ,definitions ,in this section3 7#a7 ,covered veteran ,the term covered veteran means a veteran who is enrolled in both the ,medicare program under title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq47 and the system of annual patient enrollment of the ,department of ,veterans ,affairs under section #agje7;a7 of title #ch1 ,united ,states ,code4 7#b7 ,secretary ,the term ,secretary means the ,secretary of ,veterans ,affairs4 #cbj4 ,fisher ,house availability ,section #agjh of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in subsection 7a71 by striking in connection with and all that follows through the period at the end and inserting in accordance with this section42 7#b7 in subsection 7b7-- 7,a7 in paragraph 7#b7-- 7i7 by inserting described in paragraph 7#a7 after family of a veteran2 and 7ii7 by inserting such after accompany2 and 7,b7 by adding at the end the following new paragraphs3 7#c7 ,on a space-available basis1 a covered beneficiary who must travel a significant distance to receive care or services at a ,department or non-,department facility4 7#d7 ,on a space-available basis1 a member of the family of a covered beneficiary described in paragraph 7#c7 and others who accompany such a covered beneficiary who is receiving care or services and provide the equivalent of familial support for such beneficiary when the covered beneficiary or the family member is traveling to receive care or services at a ,department or non-,department facility4 7#e7 ,on a space-available basis1 a veteran and a member of the family of a veteran and others who must travel a significant distance for a member of the veteran's family to receive care or services at a ,department or non-,department facility4 7#f7 ,on a space available basis1 a covered beneficiary and a member of the family of a covered beneficiary and others who must travel a significant distance for a member of the covered beneficiary's family to receive care or services at a ,department or non-,department facility4 2 7#c7 by striking subsection 7c7 and redesignating subsections 7d7 and 7e7 as subsections 7c7 and 7d71 respectively2 7#d7 in subsection 7d71 as so redesignated-- 7,a7 in paragraph 7#b71 by striking subsection 7d7 and inserting subsection 7c72 7,b7 in paragraph 7#c71 by striking under subsection 7b77#b7 and inserting or a covered beneficiary under subsection 7b72 7,c7 in paragraph 7#d71 by striking and after the semicolon2 7,d7 by redesignating paragraph 7#e7 as paragraph 7#f72 and 7,e7 by inserting after paragraph 7#d7 the following new paragraph 7#e73 7#e7 establishing criteria for providing access to temporary lodging facilities on a space-available basis under paragraphs 7#c7 through 7#f7 of subsection 7b72 and 2 and 7#e7 by adding at the end the following new subsection3 7e7 ,in this section3 7#a7 ,the term covered beneficiary means a member of the uniformed services1 including members of the armed services regardless of duty status4 7#b7 ,the term ,fisher house means a housing facility that-- 7,a7 is located at1 or in proximity to1 a ,department medical facility2 7,b7 is available for residential use on a temporary basis by patients of that facility and others described in subsection 7b72 and 7,c7 is constructed by1 and donated to the ,secretary by1 the ,zachary and ,elizabeth ,m4 ,fisher ,armed ,services ,foundation or the ,fisher ,house ,foundation1 ,inc4 4 #cba4 ,agreements between medical facilities of ,department of ,veterans ,affairs and rural medical facilities 7a7 ,in general ,not later than one year after the date of enactment of this ,act1 the ,secretary of ,veterans ,affairs shall commence a #e-year pilot program to provide greater access to care for eligible veterans in rural areas and reduce the initial or long-term costs to the ,department or the eligible entity of providing such care for eligible veterans4 7b7 ,pilot program ,in carrying out the pilot program1 the ,secretary shall ensure that each medical center of the ,department participating in the pilot enters into or provides material support to an agreement with an eligible entity related to one or more of the following3 7#a7 ,co-location of ,department and non- ,department health care resources4 7#b7 ,the provision of telehealth to eligible veterans by health care providers of the ,department4 7#c7 ,leasing of space or equipment by or from the ,department4 7#d7 ,training by health care providers of the ,department of non-,department health care providers1 subject to paragraph 7#d74 7#e7 ,care coordination for authorized care furnished by the eligible entity for eligible veterans4 7#f7 ,care coordination1 including transportation coordination1 for emergency treatment 7as defined in section #agbe7;h7 of title #ch1 ,united ,states ,code4 7#g7 ,the provision by the eligible entity of hospital care1 medical services1 or extended care services under section #agjc of this title4 7#h7 ,such other conditions or services directly related to health care as expressly authorized under laws administered by the ,secretary4 7c7 ,types of arrangements ,an agreement under subsection 7b7 may include a lease or co-location agreement1 a memorandum of understanding1 a partnership agreement1 a contract or agreement for the mutual use or exchange of use of health-care resources1 or any other similar agreement or arrangement4 7d7 ,report ,for each year of the pilot1 the ,secretary shall submit to the appropriate committees of ,congress a report on the operation and performance of agreements entered into under subsection 7a7 including-- 7#a7 new agreements entered into1 in the case of the initial report1 since the date of the enactment of the ,take ,care of ,america's ,veterans ,act1 and1 in the case of any subsequent report1 during the period following the previous report2 7#b7 an assessment of the success of all agreements entered into pursuant to this ,act in delivering services to eligible veterans1 including-- 7,a7 the number of eligible veterans1 by region1 who received services under an agreement compared to the previous five-year period2 7,b7 an evaluation of accessibility to services for eligible veterans as compared to the accessibility of services for those veterans prior to the implementation of such agreements2 7,c7 an overview of best practices1 including new best practices1 developed for such agreements and the ,department more broadly2 7,d7 the number of veterans receiving compensation from the ,department for a service-connected disability1 disaggregated by region1 compared to the previous #e-year period2 and 7,e7 such other factors considered appropriate by the ,secretary of ,veterans ,affairs4 7e7 ,definitions ,in this section3 7#a7 ,appropriate committees of congress ,the term appropriate committees of ,congress means-- 7,a7 the ,committee on ,veterans' ,affairs and the ,committee on ,appropriations of the ,senate2 and 7,b7 the ,committee on ,veterans' ,affairs and the ,committee on ,appropriations of the ,house of ,representatives4 7#b7 ,eligible entity ,the term eligible entity means a non-,department entity or provider furnishing health care or health care services in a rural area4 7#c7 ,eligible veteran ,the term eligible veteran means a covered veteran under section #agjc7;b7#af of this title4 7#d7 ,material support ,the term material support means support provided by a health care provider or other staff of the ,department to further the purpose or purposes of an agreement under subsection 7a77#a7 and may include-- 7,a7 the use of time or resources of health care providers of the ,department2 7,b7 the obligation or receipt of funds2 and 7,c7 such other support as the ,secretary determines appropriate4 7#e7 ,rural ,the term rural1 with respect to an area1 means the area has a code other than #a or #a4a in the ,rural-,urban ,commuting ,areas 7,,ruca7 coding system of the ,department of ,agriculture4 #cbb4 ,study on quality of care difference between mental health and addiction therapy care provided by health care providers of ,department of ,veterans ,affairs compared to non-,department providers 7a7 ,in general ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall seek to enter into an agreement with an independent and objective organization outside the ,department of ,veterans ,affairs under which that organization shall-- 7#a7 conduct a study on the quality of care difference between mental health and addiction therapy care under the laws administered by the ,secretary provided by health care providers of the ,department compared to non-,department providers across various modalities1 such as telehealth1 in-patient1 intensive out-patient1 out-patient1 and residential treatment2 and 7#b7 submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives and publish on a publicly available website a report containing the final results of such study4 7b7 ,timing ,the ,secretary shall ensure that the organization with which the ,secretary enters into an agreement pursuant to subsection 7a7 is able to complete the requirements under such subsection by not later than #ah months after the date on which the agreement is entered into4 7c7 ,elements ,the report submitted pursuant to subsection 7a77#b7 shall include an assessment of the following3 7#a7 ,the amount of improvement in health outcomes from start of treatment to completion1 including symptom scores and suicide risk using evidence-based scales1 including the ,columbia-,suicide ,severity ,rating ,scale4 7#b7 ,whether providers of the ,department and non-,department providers are using evidence-based practices in the treatment of mental health and addiction therapy care1 including criteria set forth by the ,american ,society of ,addiction ,medicine4 7#c7 ,potential gaps in coordination between providers of the ,department and non-,department providers in responding to individuals seeking mental health or addiction therapy care1 including the sharing of patient health records4 7#d7 ,implementation of veteran-centric care1 including the level of satisfaction of patients with care and the competency of providers with the unique experiences and needs of the military and veteran population4 7#e7 ,whether veterans with co-occurring conditions receive integrated care to holistically address their needs4 7#f7 ,whether providers monitor health outcomes continually throughout treatment and at regular intervals for up to three years after treatment4 7#g7 ,the average length of time to initiate services1 which shall include a comparison of the average length of time between the initial point of contact after patient outreach to the point of initial service1 as measured or determined by the ,secretary4 #cbc4 ,lactation spaces in medical centers of the ,department of ,veterans ,affairs 7a7 ,in general ,subchapter ,,ii of chapter #ag of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new section3 #agbj,m4 ,lactation spaces in medical centers of the ,department 7a7 ,lactation space required ,the ,secretary shall ensure that each medical center of the ,department contains a lactation space4 7b7 ,no unauthorized entry ,nothing in this section shall be construed to authorize an individual to enter a medical center of the ,department or portion thereof that the individual is not otherwise authorized to enter4 7c7 ,lactation space defined ,in this section1 the term lactation space means a hygienic place1 other than a bathroom1 that-- 7#a7 is shielded from view2 7#b7 is free from intrusion2 7#c7 is accessible to disabled individuals 7including such individuals who use wheelchairs72 7#d7 contains a chair and a working surface2 7#e7 is easy to locate2 7#f7 is clearly identified with signage2 and 7#g7 is available for use by women veterans and members of the public to express breast milk4 4 7b7 ,clerical amendment ,the table of sections at the beginning of such chapter is amended by inserting after the item related to section #agbj,l the following new item3 #agbj,m4 ,lactation spaces in medical centers of the ,department4 4 7c7 ,implementation ,the ,secretary of ,veterans ,affairs shall ensure that-- 7#a7 not later than two years after the date of the enactment of this ,act1 not fewer than #hj percent of medical centers of the ,department of ,veterans ,affairs are in compliance with section #agbj,m of title #ch1 ,united ,states ,code1 as added by subsection 7a72 and 7#b7 not later than three years after such date of enactment1 all medical centers of the ,department are in compliance with such section4 7d7 ,report 7#a7 ,in general ,not later than one year after the date of the enactment of this ,act1 and annually thereafter1 the ,secretary of ,veterans ,affairs shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report on the progress of the ,secretary in meeting the requirements under section #agbj,m of title #ch1 ,united ,states ,code1 as added by subsection 7a71 including-- 7,a7 a list of which medical centers of the ,department of ,veterans ,affairs currently have a lactation space2 7,b7 a list of which medical centers of the ,department do not have a lactation space2 and 7,c7 for each medical center listed under subparagraph 7,b71 a description of actions the ,department has taken to design and plan a lactation space and a timeline for such lactation space to be fully functional and open for use within the time periods specified under subsection 7c74 7#b7 ,termination ,the ,secretary is not required to submit a report under paragraph 7#a7 on or after the date on which the ,secretary confirms in a report submitted under such paragraph that each medical center of the ,department contains a lactation space4 #cbd4 ,research related to menopause1 perimenopause1 and mid-life women's health3 report2 plan 7a7 ,definitions ,in this section3 7#a7 ,covered provider ,the term covered provider means a health care provider employed by the ,department of ,veterans ,affairs4 7#b7 ,menopause ,the term menopause means the stage of a woman's life-- 7,a7 when menstrual periods stop permanently and she can no longer get pregnant2 and 7,b7 that is not a disease state1 but a normal part of aging for women4 7#c7 ,mid-life ,the term mid-life means a life stage that-- 7,a7 coincides with the menopausal transition in women1 which may be physical or emotional2 7,b7 encompasses the late reproductive age1 which can begin at approximately #ce years of age1 to the late postmenopausal stages of reproductive aging1 which can extend to approximately #fe years of age2 and 7,c7 often marks the onset of many chronic diseases4 7#d7 ,perimenopause ,the term perimenopause means the time during a woman's life when levels of the hormone estrogen fall unevenly in a woman's body and is also called the menopausal transition4 7#e7 ,postmenopausal ,the term postmenopausal means the stage of a woman's life after a woman has been without a menstrual period for #ab months that lasts for the rest of a woman's life and reflects a time when women are at increased risk for osteoporosis and heart disease4 7b7 ,evaluation of certain research related to menopause1 perimenopause1 or mid-life women's health 7#a7 ,in general ,the ,secretary of ,veterans ,affairs1 shall evaluate-- 7,a7 the results of completed research related to menopause1 perimenopause1 or mid-life women's health among women who are members of the uniformed services or veterans2 7,b7 the status of such research that is ongoing2 7,c7 any gaps in knowledge and research on-- 7i7 treatments for menopause-related symptoms1 including hormone and non-hormone treatments2 7ii7 the safety and effectiveness of treatments for menopause-related symptoms2 7iii7 the impact of perimenopause and menopause on the mental health of women who are members of the uniformed services or veterans2 7,d7 the availability of and uptake of professional training resources for covered providers relating to mid-life women's health with respect to the care1 treatment1 and management of perimenopause and menopausal symptoms1 and related support services2 and 7,e7 the availability of and uptake of treatments for women who are members of the uniformed services or veterans who are experiencing perimenopause or menopause4 7#b7 ,report2 strategic plan ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall submit to ,congress a report containing-- 7,a7 the findings of the evaluation conducted under paragraph 7#a72 7,b7 recommendations for improving professional training resources described in paragraph 7#a77;,d7 for covered providers2 and 7,c7 a strategic plan that-- 7i7 resolves the gaps in knowledge and research identified in the report2 and 7ii7 identifies topics in need of further research relating to potential treatments for menopause-related symptoms of women who are members of the uniformed services or veterans4 7#c7 ,nonduplication and supplementation of efforts ,in carrying out activities under this section1 the ,secretary of ,veterans ,affairs shall ensure that such activities minimize duplication and supplement1 not supplant1 existing information-sharing efforts of the ,department of ,health and ,human ,services4 7c7 ,sense of ,congress on additional research related to menopause1 perimenopause1 or mid-life women's health ,it is the sense of ,congress that the ,secretary of ,defense and the ,secretary of ,veterans ,affairs should each conduct research related to menopause1 perimenopause1 or mid-life health regarding women who are members of the uniformed services or veterans4 #cbe4 ,pilot program on provision of opioid rescue medications to veterans 7a7 ,in general ,commencing not later than #abj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall carry out a one-year pilot program under which the ,secretary shall make covered medications available to any veteran at no charge 7in this section referred to as the pilot program74 7b7 ,provision of medication prior to confirmation of status ,the ,secretary may provide covered medication to an individual under the pilot program prior to confirming the status of the individual as a veteran if the individual provides contact information for the individual and a written self-attestation of veteran status4 7c7 ,site selection ,the ,secretary shall prioritize carrying out the pilot program in geographical areas where data indicates a disproportionately high risk of overdose among the veteran population4 7d7 ,limitation on use of information 7#a7 ,in general ,in carrying out this section1 the ,secretary may only collect the personally identifiable information needed for prescribing covered medication under the pilot program1 and any personally identifiable information collected under this section may be used solely for the purpose of delivering1 evaluating1 and enhancing the quality of health care4 7#b7 ,exclusion ,the ,secretary may not use any personally identifiable information collected under this section-- 7,a7 for the purpose of preventing a veteran from employment2 7,b7 as evidence of a history of drug use2 or 7,c7 as evidence that an individual is an unlawful user of or addicted to any controlled substance4 7e7 ,provision of information ,the ,secretary shall ensure that any individual who receives covered medication under the pilot program also receives-- 7#a7 information about addiction services1 suicide prevention services1 mental health services1 and other related services provided by the ,department of ,veterans ,affairs2 and 7#b7 information on the use and application of covered medications4 7f7 ,report 7#a7 ,in general ,not later than #cj days before the completion of the pilot program under this section1 the ,secretary shall submit to ,congress a report on the pilot program4 7#b7 ,elements ,the report required by paragraph 7#a7 shall include the following3 7,a7 ,the number of veterans who received a covered medication under the pilot program1 disaggregated by those enrolled in the system of annual patient enrollment of the ,department of ,veterans ,affairs under section #agje7;a7 of title #ch1 ,united ,states ,code1 and those not enrolled in such system4 7,b7 ,an assessment of the feasibility of expanding the pilot program to provide covered medications to immediate family members of veterans4 7,c7 ,any considerations associated with continuing1 expanding1 or making permanent the pilot program4 7,d7 ,any other recommendations of the ,secretary with respect to modifying or continuing the pilot program4 7g7 ,definitions ,in this section3 7#a7 ,covered medication ,the term covered medication means any opioid overdose rescue medication1 such as naloxone4 7#b7 ,veteran ,the term veteran has the meaning given that term in section #aja of title #ch1 ,united ,states ,code4 #cbf4 ,establishment of ,veterans ,health ,administration ,policy ,advisory ,commission 7a7 ,in general ,chapter #a of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new section3 #abj4 ,veterans ,health ,administration ,policy ,advisory ,commission 7a7 ,establishment ,there is established the ,veterans ,health ,administration ,policy ,advisory ,commission 7in this section referred to as the ,commission74 7b7 ,membership 7#a7 ,composition ,the ,commission shall be composed of #ag members appointed by the ,comptroller ,general of the ,united ,states1 of which not fewer than #b shall be veterans4 7#b7 ,qualifications 7,a7 ,in general ,an individual is eligible for appointment to the ,commission under paragraph 7#a7 if the individual has significant expertise in operating or advising large medical systems1 including expertise in quality of care1 staffing issues1 health information technology1 artificial intelligence in health care1 medical research1 and managed care plans and networks4 7,b7 ,experience of members ,in appointing members under paragraph 7#a71 the ,comptroller ,general shall select individuals from backgrounds that reflect the broad diversity of health care received by veterans1 including nonprofit health systems1 public and private health systems1 care furnished by the ,veterans ,health ,administration1 and care furnished by the ,department of ,defense4 7#c7 ,ethical disclosure ,a member of the ,commission shall be considered an employee of ,congress whose compensation is disbursed by the ,secretary of the ,senate for purposes of applying subchapter ,i of chapter #aca of title #e1 ,united ,states ,code1 except that a member of the ,commission is required to file public financial disclosure reports without regard to their number of days of service or rate of pay4 7c7 ,period of appointment2 vacancies 7#a7 ,vacancies 7,a7 ,in general ,a vacancy on the ,commission shall be filled in the manner in which the original appointment was made and shall be subject to any conditions that applied with respect to the original appointment4 7,b7 ,filling unexpired term ,an individual chosen to fill a vacancy shall be appointed for the unexpired term of the member replaced4 7#b7 ,expiration of terms ,the term of any member shall not expire before the date on which the member's successor takes office4 7d7 ,meetings 7#a7 ,frequency ,the ,commission shall meet at the call of the ,chairman1 but not less frequently than once per year4 7#b7 ,quorum ,a majority of the members of the ,commission shall constitute a quorum1 but a lesser number of members may hold meetings4 7e7 ,chairman and ,vice ,chairman ,the ,comptroller ,general shall designate one member of the ,commission as ,chairman and one member of the ,commission as ,vice ,chairman1 at the time of appointment of such member and for the term of appointment of such member1 except that in the case of vacancy of the ,chairmanship or ,vice ,chairmanship1 the ,comptroller ,general may designate another member for the remainder of that member's term4 7f7 ,duties of the ,commission 7#a7 ,review ,the ,commission shall-- 7,a7 review operations at the ,veterans ,health ,administration2 and 7,b7 prepare reports for ,congress based on such review1 including recommendations to ,congress4 7#b7 ,topics to be reviewed ,in conducting a review under paragraph 7#a77;,a71 the ,commission shall include periodic reviews of the following1 taking into consideration other independent assessments in selecting topics to limit duplicative efforts3 7,a7 ,information technology infrastructure at medical facilities of the ,department1 including with respect to electronic health record systems4 7,b7 ,referrals to care at facilities of the ,department and under the ,veterans ,community ,care ,program under section #agjc of this title1 and factors impacting those referrals4 7,c7 ,access and wait times at medical facilities of the ,department and under the ,veterans ,community ,care ,program1 including both primary and specialty care1 and factors impacting those wait times4 7,d7 ,the quality of health care furnished by the ,department and through the ,veterans ,community ,care ,program4 7,e7 ,workforce issues1 including workforce performance1 recruitment1 and retention factors4 7,f7 ,patient satisfaction and customer service at medical facilities of the ,department and through the ,veterans ,community ,care ,program4 7,g7 ,the training of health care providers and the standards of care at facilities of the ,department and in the ,veterans ,community ,care ,program4 7,h7 ,the long-term budgetary outlook of the ,veterans ,health ,administration1 as well as key components driving budgetary changes over time4 7,i7 ,the research program of the ,department1 including both internal and external research4 7,j7 ,the interaction of care under the ,medicare program under title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq471 the ,medicaid program under title ,,xix of such ,act 7#db ,u4,s4,c4 #acif et seq471 the ,,tricare program under chapter #ee of title #aj1 and commercial health care plans with care furnished by the ,veterans ,health ,administration4 7#c7 ,use of existing data ,in carrying out the requirements of this subsection1 the ,commission1 to the extent practicable1 shall use existing data that has been compiled by the ,department1 compiled for the ,department1 or purchased by the ,department1 including-- 7,a7 data described in subsection 7c77#a7 of section #agjd;,a of this title2 and 7,b7 the results of the independent assessments conducted under such section4 7#d7 ,issues regarding veteran health care delivery generally ,in carrying out the requirements of this subsection1 the ,commission shall review the effect of policies under this title on the delivery of health care services to veterans and assess the implications of changes in health care delivery for veterans under the laws administered by the ,secretary4 7#e7 ,transmittal of certain reports ,if the ,secretary or the ,inspector ,general of the ,department of ,veterans ,affairs submits to ,congress 7or a committee of ,congress7 a report that is required by law and that relates to policies for health care furnished under the laws administered by the ,secretary1 the ,secretary shall transmit a copy of that report to the ,commission4 7#f7 ,consultation and additional reviews and studies 7,a7 ,consultation ,in carrying out the requirements of this subsection1 the ,commission shall consult periodically with the chairmen and ranking members of the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives regarding the agenda of the ,commission and progress towards achieving that agenda4 7,b7 ,additional reviews and reports ,the ,commission may conduct additional reviews1 and may submit additional reports to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives1 from time to time on such topics relating to the activities of the ,commission as may be requested by the ,chairman and members and as the ,commission determines appropriate4 7,c7 ,special studies ,the ,commission may conduct special studies requested by the chairman or ranking member of the ,committee on ,veterans' ,affairs of the ,senate or the ,committee on ,veterans' ,affairs of the ,house of ,representatives and as the ,commission determines appropriate4 7#g7 ,coordination ,in carrying out reviews1 preparing reports1 and conducting studies under this section1 the ,commission shall1 to the extent practicable1 coordinate with the ,inspector ,general of the ,department to ensure the work of the ,commission does not interfere with investigations or remediations underway by the ,inspector ,general4 7#h7 ,budgetary considerations ,before making any recommendations to ,congress1 the ,commission shall examine the budget consequences of such recommendations1 directly or through consultation with appropriate expert entities4 7#i7 ,report 7,a7 ,in general ,by not later than ,march #ae of each year1 the ,commission shall submit to ,congress a report containing the results and recommendations from the review conducted under paragraph 7#a74 7,b7 ,inclusion of recommendations ,a recommendation may be included in a report under subparagraph 7,a7 if a simple majority of the members of the ,commission vote to include the recommendation in the report4 7#aj7 ,limitation ,nothing in this section shall be construed to authorize the ,commission to direct1 control1 approve1 suspend1 delay1 or administer any program1 policy1 contract1 personnel action1 budgetary decision1 clinical decision1 or operational activity of the ,department4 ,the ,commission shall serve solely in an advisory capacity to ,congress and to the ,department on matters expressly authorized under laws administered by the ,secretary4 7g7 ,powers of ,commission 7#a7 ,in general ,the ,commission may-- 7,a7 employ and fix the compensation3 7i7 of an ,executive ,director 7at a rate of pay not greater than that provided for level ,,iii of the ,executive ,schedule under section #ecad of title #e7 who is confirmed by two thirds vote by members of the ,commission2 and 7ii7 other such personnel as may be necessary to carry out the duties of the ,commission1 without regard to the provisions of title #e governing appointments in the competitive service2 7,b7 seek such assistance and support as may be required in the performance of its duties from appropriate departments and agencies of the ,united ,states or departments or agencies of a ,state2 7,c7 enter into a contract or conduct original research only upon a written determination by the ,chair and ,vice ,chair that comparable information is unavailable1 insufficient1 or outdated2 7,d7 make advance1 progress1 and other payments that relate to the work of the ,commission2 7,e7 provide transportation and subsistence for individuals serving the ,commission without compensation2 and 7,f7 prescribe such rules and regulations as the ,commission determines necessary with respect to the internal organization and operation of the ,commission4 7#b7 ,data collection ,in order to carry out its functions1 the ,commission shall-- 7,a7 utilize existing information1 both published and unpublished1 if possible1 collected and assessed either by its own staff or under other arrangements made in accordance with this section2 7,b7 to the maximum extent practicable1 rely on existing data1 reports1 audits1 evaluations1 and assessments prepared by the ,department1 the ,inspector ,general of the ,department1 the ,government ,accountability ,office1 the ,congressional ,research ,service1 the ,congressional ,budget ,office1 and other relevant ,federal entities before entering into any contract or conducting original research2 and 7,c7 adopt procedures allowing any interested party to submit information for use by the ,commission in making reports and recommendations4 7#c7 ,information from ,federal agencies 7,a7 ,in general ,the ,commission may secure directly from any relevant department or agency of the ,united ,states health care information the ,chairman determines would be helpful to enable the ,commission to carry out this section4 7,b7 ,timing ,upon request of the ,chairman1 the head of a department or agency of the ,united ,states shall furnish information requested under subparagraph 7,a7 to the ,commission on an agreed upon schedule or not later than #ahj days after the date of the request4 7h7 ,compensation 7#a7 ,members 7,a7 ,in general ,while conducting the business of the ,commission 7including travel time71 a member of the ,commission shall be entitled to compensation at the per diem equivalent of the rate provided for level ,,iv of the ,executive ,schedule under section #ecae of title #e4 7,b7 ,travel expenses ,while conducting the business of the ,commission away from home and the regular place of business of the member1 a member may be allowed travel expenses1 as authorized by the ,chairman4 7#b7 ,physician comparability allowance for personnel ,the ,commission may provide a physician comparability allowance to physicians serving as personnel of the ,commission in the same manner as physicians of the ,federal ,government may be provided such an allowance by an agency under section #eidh of title #e1 and for such purpose1 subsection 7i7 of such section shall apply to the ,commission in the same manner as it applies to the ,tennessee ,valley ,authority4 7#c7 ,treatment of personnel ,for purposes of pay 7other than pay of members of the ,commission7 and employment benefits1 rights1 and privileges1 all personnel of the ,commission shall be treated as if they were employees of the ,united ,states ,senate4 7i7 ,detail of ,federal employees ,an employee of the ,federal ,government may be detailed to the ,commission without reimbursement and without interruption or loss of civil service status or privileges4 7j7 ,access of congressional support agencies to information ,the ,commission shall provide to the ,comptroller ,general1 the ,congressional ,research ,service1 and the ,congressional ,budget ,office unrestricted access to all deliberations1 records1 and nonproprietary data of the ,commission not later than #cj days after such access is requested4 7k7 ,authorization of appropriations ,the ,commission shall submit requests for appropriations in the same manner as the ,comptroller ,general submits requests for appropriations1 but amounts appropriated for the ,commission shall be separate from amounts appropriated for the ,comptroller ,general4 7l7 ,termination 7#a7 ,the ,commission shall terminate on ,september #cj1 #bjcb4 7#b7 ,not later than #a year before the date of termination under paragraph 7#a71 the ,commission shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a final assessment on whether the ,commission should be continued1 modified1 or allowed to terminate4 7#c7 ,a member of the ,commission shall be appointed under subsection 7b77#a7 for a term of #e years1 except that the ,comptroller ,general shall designate staggered terms for the members first appointed4 7#d7 ,no funds may be obligated by the ,commission after the date of termination under paragraph 7#a71 except for activities necessary to close out the operations of the ,commission4 4 7b7 ,clerical amendment ,the table of sections at the beginning of such chapter is amended by inserting after the item relating to section #aai the following new item3 #abj4 ,veterans ,health ,administration ,policy ,advisory ,commission4 4 7c7 ,initial appointment ,not later than #bhj days after the date on which amounts are first appropriated to the ,veterans ,health ,administration ,policy ,advisory ,commission established under section #abj of title #ch1 ,united ,states ,code1 as added by subsection 7a71 the ,comptroller ,general of the ,united ,states shall make initial appointments of members to the ,commission under subsection 7b77#a7 of such section4 #cbg4 ,access to health care 7a7 ,connection to ,veterans ,health ,administration when a disability claim related to military sexual trauma is submitted to ,veterans ,benefits ,administration ,section #b of the ,,mst ,claims ,coordination ,act 7,public ,law #aag-cjc2 #ch ,u4,s4,c4 #aaff note7 is amended-- 7#a7 in subsection 7a77#a7-- 7,a7 in subparagraph 7,c71 by striking 2 and and inserting a semicolon2 and 7,b7 by striking subparagraph 7,d7 and inserting the following3 7,d7 the contact information for the nearest military sexual trauma coordinator for the veteran at the ,veterans ,benefits ,administration and a description of the assistance such coordinator can provide2 7,e7 the contact information for the nearest military sexual trauma coordinator for the veteran at the ,veterans ,health ,administration and a description of the assistance such coordinator can provide2 7,f7 the types of services that individuals who have experienced military sexual trauma are eligible to receive from the ,department of ,veterans ,affairs1 such as mental health counseling from providers trained in military sexual trauma issues and peer support services1 including the nearest locations where such services are furnished1 including the nearest ,readjustment ,counseling ,service location1 and the contact information for the providers of such services2 and 7,g7 such other information on services1 care1 or resources for military sexual trauma as the ,secretary determines appropriate4 2 and 7#b7 in subsection 7d7-- 7,a7 in paragraph 7#c7-- 7i7 in subparagraph 7,b71 by striking 2 and and inserting a semicolon2 7ii7 in subparagraph 7,c71 by striking the period and inserting 2 and2 and 7iii7 by adding at the end the following3 7,d7 submitting a claim for disability compensation to the ,veterans ,benefits ,administration for a disability relating to military sexual trauma4 2 and 7,b7 by amending paragraph 7#e7 to read as follows3 7#e7 ,the term military sexual trauma with respect to eligibility for health care1 has the meaning given such term in section #aaff7;d77#b7 of title #ch1 ,united ,states ,code4 4 7b7 ,care relating to military sexual trauma for individuals who withdraw from or otherwise do not complete service at service academies 7#a7 ,in general ,the ,secretary of ,veterans ,affairs1 in coordination with the ,secretary of ,defense1 the ,secretary of ,homeland ,security1 and the ,secretary of ,transportation1 shall ensure that each individual who withdraws from1 or otherwise does not complete service at1 a service academy is provided-- 7,a7 information on the potential eligibility of such individual for care and counseling relating to military sexual trauma provided through the ,department of ,veterans ,affairs2 and 7,b7 the option to receive copies of-- 7i7 the individual's service treatment records or military personnel records that document military sexual trauma2 7ii7 reporting forms of the ,department of ,defense1 the ,department of ,homeland ,security1 or the ,department of ,transportation on sexual assault or sexual harassment for which the individual was the victim2 and 7iii7 any investigative reports into military sexual trauma that occurred during the individual's service in the ,armed ,forces and for which the individual was the victim1 which are in the possession of the ,department of ,defense1 the ,department of ,homeland ,security1 or the ,department of ,transportation4 7#b7 ,definitions ,in this subsection3 7,a7 ,military sexual trauma ,the term military sexual trauma has the meaning given such term in section #aaff7;d77#b7 of title #ch1 ,united ,states ,code4-- 7,b7 ,service academy ,the term service academy means any of the following3 7i7 ,the ,united ,states ,military ,academy4 7ii7 ,the ,united ,states ,naval ,academy4 7iii7 ,the ,united ,states ,air ,force ,academy4 7iv7 ,the ,united ,states ,coast ,guard ,academy4 7v7 ,the ,united ,states ,merchant ,marine ,academy4 #cbh4 ,research on health conditions of descendants of toxic-exposed veterans 7a7 ,research on diagnosis and treatment of health conditions of descendants of individuals exposed to toxic substances while serving in ,armed ,forces 7#a7 ,contract or agreement ,the ,secretary of ,veterans ,affairs shall enter into a contract or interagency agreement with the ,agency for ,toxic ,substances and ,disease ,registry 7in this section referred to as the ,agency7 to perform the services covered by this section4 7#b7 ,services ,under a contract or agreement between the ,secretary and the ,agency under this section1 the ,agency shall-- 7,a7 conduct a literature review on the health effects on descendants of toxic-exposed veterans and toxic-exposed members of the ,armed ,forces from their toxic exposure and identify any gaps in knowledge or research on such topic2 7,b7 not later than #ahj days after completing the literature review under subparagraph 7,a7 establish and maintain a publicly available report with information on-- 7i7 the findings of the ,agency with respect to such literature review2 and 7ii7 the ongoing research and activities directed by the ,agency1 including a review of all relevant data to determine the strength of evidence for a positive association between a health condition researched and a toxic exposure based on the categories set forth under section #aagc7;c77#b7 of title #ch1 ,united ,states ,code2 and 7,c7 not later than #cj days after the date on which the first review is published under subparagraph 7,b7 and not less frequently than once every year thereafter1 publish a new report containing the information made available under clause 7ii7 of such subparagraph4 7#c7 ,sunset ,on the date that is #g years after the date of enactment of this ,act4 7#d7 ,literature review 7,a7 ,in general ,in carrying out the literature review under paragraph 7#b77;,a71 the ,agency shall review available literature to determine the association between military toxic exposures and the incidence or prevalence of birth defects among the descendants of toxic-exposed veterans and toxic-exposed members of the ,armed ,forces4 7,b7 ,report ,not later than one year after the date of the enactment of this ,act1 the ,agency 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 containing the findings of the ,agency with respect to the activities of the ,agency under paragraph 7#b77;,a74 7,c7 ,plan 7i7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 the ,agency shall submit to the ,secretary and to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a plan describing the ,agency's proposed approach to carrying out the literature review under paragraph 7#b77;,a74 7ii7 ,contents ,the plan submitted pursuant to clause 7i7 shall include-- 7,i7 the scope and key research questions to be addressed2 and 7,,ii7 the methodology to be used in identifying1 evaluating1 and synthesizing relevant scientific and medical literature4 7#e7 ,consultation ,the ,agency shall carry out the services covered by this subsection in consultation with such ,federal1 ,state1 and research partners as the ,agency and the ,secretary jointly consider appropriate4 7#f7 ,prohibition on expansion of services ,nothing in this section shall be construed to authorize the expansion of compensation or healthcare benefits furnished by the ,department to the descendants of members of the ,armed ,forces4 7b7 ,program for monitoring health of descendants of veterans and members of the ,armed ,forces subjected to toxic exposure in the ,armed ,forces 7#a7 ,in general ,the ,secretary of ,veterans ,affairs shall use the results of the literature review conducted under subsection 7a77#b77;,a7 to establish a health monitoring or screening program for descendants of toxic-exposed veterans and toxic-exposed members of the ,armed ,forces1 to assist in identifying potential patterns or signals1 supporting public health surveillance1 and facilitating epidemiologic and clinical research related to birth defects4 7#b7 ,requirements ,in carrying out the program required by paragraph 7#a71 the ,secretary shall-- 7,a7 leverage ,government data sets to improve the program2 7,b7 recruit additional descendants2 7,c7 consult with relevant stakeholders to develop a strategy to coordinate collection of information under the program2 and 7,d7 ensure data from the program is used to inform basic research1 translational research1 and epidemiological studies to help address data and knowledge gaps identified in the literature review conducted under subsection 7a77#b77;,a74 7#c7 ,mechanisms for administration ,the ,secretary may administer the program required by paragraph 7#a7 either directly or through such mechanisms as the ,secretary considers appropriate1 such as through the award of a grant or cooperative agreement4 7#d7 ,collection of information ,in administering the health monitoring program required by paragraph 7#a71 the ,secretary may collect1 process1 maintain1 and consolidate information on birth defects among descendants of toxic-exposed veterans and toxic-exposed members of the ,armed ,forces1 including biological samples1 environmental factors1 and personal and social factors4 7#e7 ,consultation ,the ,secretary shall carry out the services covered by this section in consultation with such ,federal1 ,state1 and research partners as the ,department considers appropriate4 7#f7 ,sunset ,on the date that is #g years after the date of enactment of this ,act4 7#g7 ,prohibition on expansion of services ,no information collected by this program shall be used to inform the expansion of compensation or healthcare benefits furnished by the ,department to the descendants of members of the ,armed ,forces1 unless otherwise authorized by another ,act of ,congress on a date after the passage of this legislation4 7c7 ,definitions ,in this subsection3 7#a7 ,active military1 naval1 air1 or space service ,the term active military1 naval1 air1 or space service has the meaning given such term in section #aja of title #ch1 ,united ,states ,code4 7#b7 ,relevant stakeholders ,the term relevant stakeholders means-- 7,a7 public health experts with experience in developing and maintaining registries2 7,b7 epidemiologists with experience in studying health effects of toxic exposure on the descendants of toxic-exposed veterans2 7,c7 descendants of toxic-exposed veterans2 and 7,d7 veterans service organizations4 7#c7 ,toxic-exposed member of the ,armed ,forces ,the term toxic-exposed member of the ,armed ,forces means a member of the ,armed ,forces who was subject to a toxic exposure in line of duty in the active military1 naval1 air1 or space service4 7#d7 ,toxic-exposed veteran ,the term toxic-exposed veteran means a veteran who was subject to a toxic exposure in line of duty in the active military1 naval1 air1 or space service4 7#e7 ,toxic exposure ,the terms toxic exposure and toxic-exposed veteran have the meanings given such terms in section #aja of title #ch1 ,united ,states ,code4 #cbi4 ,veterans ,spinal ,trauma ,access to ,new ,devices ,act ,section #agjf of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new subsection3 7d7 7#a7 ,in managing the provision of hospital care and medical services under section #agaj7;a7 of this title1 the ,secretary shall furnish 7through direct provision of service1 referral1 or a telehealth program operated by the ,department7 a preventative health evaluation annually to any veteran with a spinal cord injury or disorder who elects to undergo the evaluation4 7#b7 ,the evaluation described in paragraph 7#a7 shall include the following3 7,a7 ,an assessment of any circumstance or condition the veteran is experiencing that indicates a risk for any health complication related to the spinal cord injury or disorder1 including a risk of comorbidities4 7,b7 ,an assessment regarding chronic pain and1 if applicable1 the management of chronic pain4 7,c7 ,an assessment regarding dietary management and weight management4 7,d7 ,an assessment regarding prosthetic equipment1 including which prosthetic equipment the veteran needs1 how well any existing prosthetic equipment is functioning considering the needs of the veteran1 and any safety concerns regarding the prosthetic equipment in use by or recommended to the veteran4 7,e7 ,an assessment with respect to the provision of assistive technology1 including spinal cord neuromodulation technology 7such as non-invasive transcutaneous spinal stimulation71 that could help maximize the veteran's voluntary motor or autonomic function1 independence1 or mobility1 including suitability for home use and need for training1 programming1 and remote follow-up4 7#c7 7,a7 ,in maintaining1 prescribing1 or amending any guidance1 rules1 or regulations issued by the ,department regarding the requirements set out in this subsection1 the ,secretary shall consult with-- 7i7 the spinal cord injury and disorder program managers of the ,department2 7ii7 clinicians employed by the ,department as specialists in spinal cord injuries and disorders2 7iii7 clinicians and technologists with demonstrated expertise in spinal cord neuromodulation therapies1 including non-invasive transcutaneous approaches2 and 7iv7 representatives of organizations recognzied under section #eijb of this title4 7,b7 ,before issuing any guidance1 rules1 or regulations regarding the requirements set out in this subsection1 the ,secretary shall consult with manufacturers of assistive technologies and other entities relevant to the provision of assistive technologies if the guidance1 rules1 or regulations would directly affect such manufacturers or entities4 7,c7 ,the ,secretary shall ensure1 to the extent possible1 that any veteran known by the ,secretary to have a spinal cord injury or disorder receives information annually about the evaluation available under this subsection and the benefits to the veteran of choosing to undergo the evaluation4 7#d7 ,as the ,secretary determines clinically appropriate1 the ,secretary may provide training1 programming1 remote monitoring1 and follow-up for assistive technologies through telehealth4 7#e7 ,not later than one year after the date of the enactment of the ,take ,care of ,america's ,veterans ,act1 and every two years thereafter1 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 ,for the period covered by the report-- 7i7 the number of veterans who-- 7,i7 received medical care or hospital services from the ,department and used an assistive technology2 7,,ii7 received medical care or hospital services from the ,department and were assessed for the provision of an assistive technology2 and 7,,iii7 received medical care or hospital services from the ,department and were prescribed an assistive technology4 7ii7 for any assistive technology prescribed1 an identification of the category of such technology1 including spinal cord neuromodulation1 and a summary of functional outcomes associated with the prescription of such technology1 if available4 7,b7 ,the year-to-year change 7for the period covered by the report1 including the two years immediately prior to year the report is submitted7 in the percent of veterans with a spinal cord injury or disorder who received an evaluation under this subsection4 7#f7 ,in reviewing the performance metrics of a ,veterans ,integrated ,service ,network for any year beginning after the date that is one year after the date of the enactment of the ,veterans ,spinal ,trauma ,access to ,new ,devices ,act1 the ,secretary shall consider the provision of evaluations under paragraph 7#a74 7#g7 ,in this subsection1 the term assistive technology means a powered medical device or electronic tool used to treat or alleviate symptoms or conditions caused by a spinal cord injury or disorder1 including the following3 7,a7 ,a personal mobility device1 including a powered exoskeleton device4 7,b7 ,a speech generating device4 7,c7 ,a spinal cord neuromodulation technology1 including non-invasive transcutaneous spinal stimulation using sensory 7afferent7 pathways1 intended to improve voluntary motor function1 autonomic function1 independence1 or quality of life4 7,d7 ,where clinically appropriate1 and consistent with the prosthetic and sensory aids policies of the ,department1 an implantable spinal cord stimulation system that is approved by the ,food and ,drug ,administration4 4 #ccj4 ,department of ,veterans ,affairs pilot program to award grants for the provision of service dogs to veterans 7a7 ,in general 7#a7 ,pilot program required ,not later than #bd months after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall establish a pilot program under which the ,secretary shall award grants1 on a competitive basis based on the application elements listed in subsection 7b77#b71 to nonprofit entities to provide service dogs to eligible veterans4 7#b7 ,duration ,the ,secretary shall carry out the pilot program during the three-year period beginning on the date on which the first grant is awarded under this section4 7b7 ,applications 7#a7 ,in general ,to be eligible to receive a grant under this section1 a nonprofit entity shall submit an application to the ,secretary at such time and in such manner as the ,secretary may require4 7#b7 ,elements ,an application submitted by a nonprofit entity under paragraph 7#a7 shall include the following3 7,a7 ,a proposal for the provision of service dogs to eligible veterans1 including how the nonprofit entity will communicate with the ,secretary to ensure an increasing number of service dogs are provided to veterans4 7,b7 ,a description of the following services or commitments to be provided by the nonprofit entity3 7i7 ,the training that will be provided to eligible veterans4 7ii7 ,the training of dogs that will serve as service dogs4 7iii7 ,any additional support or services that will be provided for such dogs and eligible veterans4 7iv7 ,the plan for publicizing the availability of such service dogs through a marketing campaign that targets eligible veterans4 7v7 ,the commitment to have humane standards for animals4 7vi7 ,the demonstrated experience of the nonprofit entity in training service dogs in compliance with the requirements of the ,americans with ,disabilities ,act of #aiij 7#db ,u4,s4,c4 #abaja et seq474 7c7 ,award of grants 7#a7 ,in general ,the ,secretary shall award a grant to each nonprofit entity for which the ,secretary has approved an application submitted under subsection 7b77#a74 7#b7 ,agreement required ,before the provision of any grant amounts to a nonprofit entity selected to receive a grant under this section1 the ,secretary shall enter into an agreement1 containing such terms1 conditions1 and limitations as the ,secretary determines appropriate1 with such entity4 7#c7 ,maximum grant amount ,except as provided in subparagraph 7,b71 a grant awarded to a nonprofit entity under this section may not exceed #b1jjj1jjj in a fiscal year4 7#d7 ,payments ,the ,secretary shall establish intervals of payment for the administration of each grant awarded under this section4 7d7 ,use of funds 7#a7 ,in general 7,a7 ,requirement ,a recipient of a grant under this section shall use the grant amounts to plan1 develop1 implement1 and manage one or more covered programs4 7,b7 ,covered program defined ,in this paragraph1 the term covered program means a program under which-- 7i7 service dogs are provided to participants in the program2 and 7ii7 only eligible veterans are allowed to participate in the program4 7#b7 ,administrative expenses ,the ,secretary may establish a maximum amount for each grant awarded under this section that may be used by the recipient of the grant to cover administrative expenses4 7#c7 ,other conditions and limitations ,the ,secretary may establish other conditions or limitations on the use of grant amounts under this section4 7e7 ,requirements for grant recipients 7#a7 ,notifications and information ,a recipient of a grant under this section shall-- 7,a7 notify each veteran who receives a service dog through such grant that the service dog is being paid for1 in whole or in part1 by the ,department of ,veterans ,affairs2 and 7,b7 inform each such veteran of the benefits and services available from the ,secretary for the veteran and the service dog4 7#b7 ,prohibition on certain fees ,a recipient of a grant under this section may not charge a fee to a veteran receiving a service dog through such grant4 7f7 ,veterinary insurance 7#a7 ,in general ,the ,secretary shall provide to each veteran who receives a service dog through a grant under this section a commercially available veterinary insurance policy for the service dog4 7#b7 ,continuation ,if the ,secretary provides a veterinary insurance policy to a veteran under paragraph 7#a71 the ,secretary shall continue to provide the policy to the veteran without regard to the continuation or termination of the pilot program4 7g7 ,training and technical assistance ,the ,secretary may provide training and technical assistance regarding grant application and administration to recipients of grants under this section4 7h7 ,oversight and monitoring ,the ,secretary-- 7#a7 may require each recipient of a grant under this section to provide1 in such form as may be prescribed by the ,secretary1 such reports or answers in writing to specific questions1 surveys1 or questionnaires as the ,secretary determines necessary to carry out the pilot program2 7#b7 shall establish such oversight and monitoring requirement as the ,secretary determines appropriate to ensure that grant amounts awarded under this section are used appropriately2 and 7#c7 may take such actions as the ,secretary determines necessary and according to the terms of the grant agreement to address any issues identified through the enforcement of such requirements4 7i7 ,definitions ,in this section3 7#a7 ,eligible veteran ,the term eligible veteran means a veteran 7as defined in section #aja of title #ch1 ,united ,states ,code7 who-- 7,a7 as determined by a physician1 has one or more disabilities1 conditions1 or diagnoses described in paragraph 7#b72 and 7,b7 is 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 or is otherwise entitled to receive such care and services under subsection 7c77#b7 of such section4 7#b7 ,disability1 condition1 diagnosis described ,a disability1 condition1 or diagnosis described in this subparagraph is any of the following3 7,a7 ,blindness or visual impairment4 7,b7 ,loss of use of a limb1 paralysis1 or other significant mobility issue4 7,c7 ,loss of hearing4 7,d7 ,post-traumatic stress disorder4 7,e7 ,traumatic brain injury4 7,f7 ,any other disability1 condition1 or diagnosis for which the ,secretary determines1 based on medical judgment1 that it is optimal for the veteran to manage the disability1 condition1 or diagnosis and live independently through the assistance of a service dog4 7#c7 ,pilot program ,the term pilot program means the pilot program required by subsection 7a77#a74 7#d7 ,service dog ,the term service dog means any dog that is individually trained to do work or perform tasks that are-- 7,a7 for the benefit of a veteran with a disability1 condition1 or diagnosis described in paragraph 7#b72 and 7,b7 directly related to the disability1 condition1 or diagnosis of the veteran4 7j7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #aj1jjj1jjj for each of the three consecutive fiscal years beginning the fiscal year in which the pilot program is established under subsection 7a74 7k7 ,termination 7#a7 ,the authority to carry out a pilot program under this section shall terminate on ,september #cj1 #bjbi4 7#b7 ,no funds may be obligated by the ,secretary to carry out a pilot program under this section after the date of termination in paragraph 7#a71 except for activities necessary to close operations of such pilot program4 #cca4 ,authorization of major medical facility project of ,department of ,veterans ,affairs for fiscal year #bjbg in ,manchester1 ,new ,hampshire 7a7 ,authorization of major medical facility project of ,department of ,veterans ,affairs for fiscal year #bjbg in ,manchester1 ,new ,hampshire 7#a7 ,in general ,the ,secretary of ,veterans ,affairs shall carry out a major medical facility project for the replacement of a medical center1 a new central utility plant1 a community living center1 a residential rehabilitation treatment facility1 associated parking1 and demolition of existing buildings in ,manchester1 ,new ,hampshire4 7#b7 ,non-,department ,federal entity waiver ,in order to reduce cost and expedite timelines1 the ,secretary may waive the requirements under section #hajc7;e7 of title #ch1 ,united ,states ,code1 and section #ajif of the ,national ,defense ,authorization ,act for ,fiscal ,year #bjaf 7,public ,law #aad-ib2 #ch ,u4,s4,c4 #hajc note7 for a non-,department ,federal entity to be engaged in project management and other activities for the project under paragraph 7#a74 7#c7 ,notification ,not later than #fj days after making a waiver1 modification1 or substitution relating to the project under subsection 7a71 including a waiver under paragraph 7#b71 the ,secretary shall submit to the appropriate committees of ,congress a notification describing the waiver1 modification1 or substitution and the reason for such waiver1 modification1 or substitution4 7#d7 ,authorization of appropriations ,there is authorized to be appropriated to the ,secretary of ,veterans ,affairs for the ,construction1 ,major ,projects account #a1ahj1jjj1jjj for the project under paragraph 7#a71 to remain available until expended4 7#e7 ,appropriate committees of ,congress defined ,in this section the term appropriate committees of ,congress means-- 7,a7 the ,committee on ,veterans' ,affairs and the ,committee on ,appropriations of the ,senate2 and 7,b7 the ,committee on ,veterans' ,affairs and the ,committee on ,appropriations of the ,house of ,representatives4 7b7 ,access to information for medical facility construction projects and leases 7#a7 ,in general ,subchapter ,i of chapter #ha of title #ch1 ,united ,states ,code1 is amended by inserting after section #hajf the following3 #hajg4 ,access to information for medical facility construction projects and leases 7a7 ,in general ,for any major construction project1 lease1 or enhanced-use lease for a medical facility of the ,department1 the ,secretary shall ensure that the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives are provided timely access to all information1 records1 documents1 data1 analyses1 communications1 contracts1 agreements1 project schedules1 cost estimates1 memoranda1 briefings1 reports1 and other materials relating to the project or lease4 7b7 ,prohibition on withholding information ,the ,secretary may not withhold information under subsection 7a7 from the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives solely on the basis that the information is predecisional1 deliberative1 advisory1 procurement-sensitive1 or subject to an internal policy or directive of the ,department4 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 #hajf the following new item3 #hajg4 ,access to information for medical facility construction projects and leases4 4 #ccb4 ,bowel and bladder care program of ,department of ,veterans ,affairs 7a7 ,findings2 ,sense of ,congress 7#a7 ,findings ,congress finds the following3 7,a7 ,bowel care and bladder care are supportive and necessary medical services for veterans with spinal cord injuries and disorders when they are unable to manage their bowel and bladder functions independently4 7,b7 ,inadequate care will lead to complications and problems such as autonomic dysreflexia that can be potentially life-threatening and result in illness and hospitalization4 7,c7 ,bowel care and bladder care are essential to support veterans with spinal cord injuries and disorders in non-institutional settings1 improve quality of life1 optimize health1 and prevent complications from neurogenic bowel and bladder4 7,d7 ,family caregivers and individually employed caregivers provide life-sustaining care for the bowel and bladder care needs of veterans that allow them to live in their communities4 7#b7 ,sense of ,congress ,it is the sense of ,congress that-- 7,a7 family caregivers and individually employed caregivers should not be subjected to self-employment taxes and treated as vendors or contractors for the veterans to whom they provide care2 7,b7 veterans should not be forced to finish their bowel and bladder care needs in a set period of time that does not consider their individual needs2 and 7,c7 veterans should not be subjected to ongoing clinical determinations regarding their bowel and bladder care needs absent a decision by their medical care provider that such care is no longer needed4 7b7 ,in general ,the ,secretary of ,veterans ,affairs shall establish a program to address the bowel and bladder care needs of covered veterans 7in this section referred to as the program74 7c7 ,provision of care 7#a7 ,clinical need ,the ,secretary shall provide bowel and bladder care under the program to covered veterans based on clinical need1 which may include covered veterans receiving aid and attendance benefits from the ,department of ,veterans ,affairs4 7#b7 ,caregiver or agency ,a covered veteran may receive bowel and bladder care under the program through a qualified family member1 an individually employed caregiver1 or a contracted home health agency4 7#c7 ,individualized assessment ,the ,secretary shall conduct an individualized assessment with respect to a covered veteran to determine the number of hours of bowel and bladder care needed by such veteran under the program4 7#d7 ,denial of care ,before denying bowel and bladder care for any covered veteran under the program1 the ,secretary shall first obtain review of and concurrence with respect to such denial from a designated ,spinal ,cord ,injuries and ,disorders ,center of the ,department4 7d7 ,coordination of care and benefits ,the ,secretary shall ensure the program is coordinated with other programs and benefits of the ,department for which the covered veteran is eligible to ensure that covered veterans and caregivers receive appropriate support without duplicating benefits or services4 7e7 ,supportive medical training and qualifications 7#a7 ,in general ,the ,secretary shall provide to each family member or individually employed caregiver providing care to a covered veteran under the program necessary supportive medical training to participate in and receive payment by the ,secretary for the provision of such care4 7#b7 ,qualifications ,the ,secretary shall establish such requirements1 conditions1 and qualifications for providers of care under the program as necessary to provide clinically appropriate bowel and bladder care to covered veterans and to ensure the financial and administrative integrity of the program4 7f7 ,payment 7#a7 ,in general ,the ,secretary shall provide a monthly stipend to family members and individually employed caregivers and payment to contracted home health agencies for care provided to covered veterans under the program4 7#b7 ,limitation 7,a7 ,family members and individually employed caregivers ,the stipend for a family member or individually employed caregiver for care provided to a covered veteran under the program-- 7i7 shall be determined by the ,secretary2 7ii7 shall be based on the amount and degree of assistance provided2 and 7iii7 may not exceed the fifth step of the applicable grade of the ,general ,schedule hourly rate paid to nursing assistants who provide such care at the medical facility of the ,department that is nearest to the residence of such veteran4 7,b7 ,home health agencies ,payment to a home health agency for care provided to a covered veteran under the program may not exceed the payment rates of the ,department under section #ag4djce of title #ch1 ,code of ,federal ,regulations 7relating to payment rates and methodologies71 or successor regulations4 7g7 ,submission of documentation ,family members and individually employed caregivers providing care to covered veterans under the program shall provide such documentation and information in such format and under such terms as the ,secretary may require as a condition of receiving payment under the program4 7h7 ,continued participation in program ,if a covered veteran has been medically determined to require care under the program for a continuous period of three years or more1 the veteran is deemed to require such care for life or until such time as the medical provider for such veteran determines the service is no longer needed4 7i7 ,not vendors or contractors ,family members and individually employed caregivers providing care to covered veterans under the program shall not be considered vendors or contractors for purposes of the program4 7j7 ,limitation ,care may not be provided under the program to a veteran who can perform the bowel and bladder functions of the veteran without assistance4 7k7 ,covered veteran defined ,in this section1 the term covered veteran means a veteran who-- 7#a7 is 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 ,code2 7#b7 has a spinal cord injury or disorder2 and 7#c7 is dependent upon others for bowel and bladder care while residing in non-institutional settings4 ,,iv ,organization #dja4 ,authorization of appropriations to the ,office of ,information and ,technology of the ,department of ,veterans ,affairs for certain purposes 7a7 ,authorization of appropriations ,there is authorized to be appropriated1 and there is appropriated1 to the ,secretary of ,veterans ,affairs #ejj1jjj1jjj for fiscal year #bjbf1 to remain available until ,september #cj1 #bjca1 for deposit into the accounts of the ,office of ,information and ,technology of the ,department of ,veterans ,affairs for the purposes described in subsection 7b74 7b7 ,use of funds ,funds shall be allocated and expended only as follows3 7#a7 #aej1jjj1jjj for ,enterprise ,logistics and ,supply ,chain ,visibility -- ,to develop and deploy integrated1 real-time enterprise-wide logistics systems1 inventory visibility1 pharmaceutical tracking1 and medical supply chain resiliency capabilities4 ,these systems shall support both routine veteran care operations and #dth ,mission medical surge1 patient movement1 and emergency distribution requirements in consultation with ,do,d1 ,,fema1 and other agencies4 7#b7 #bjj1jjj1jjj for ,cybersecurity and ,operational ,resiliency -- ,for zero trust architecture implementation1 threat detection1 secure cloud hardening1 endpoint protection1 continuity of operations 7,,coop7 platforms1 and protection of mission-essential systems against cyber and physical disruptions4 ,funds shall prioritize high-risk legacy systems and medical device security4 7#c7 #aej1jjj1jjj for ,resilient ,communications and ,digital ,records ,modernization -- ,for interoperable1 survivable communications infrastructure and targeted digitization_/automation of high-volume paper-based workflows 7claims1 correspondence1 administrative records7 to reduce fraud risk and improve continuity during degraded or emergency environments4 ,funds shall not be used for broad ,electronic ,health ,record ,modernization expansion4 7c7 ,oversight and protection of sensitive information 7#a7 ,the ,secretary may obligate and expend amounts under this section in classified1 controlled1 or protected environments consistent with applicable law4 7#b7 ,not later than #ij days after the date of enactment of this ,act1 and annually thereafter until ,september #cj1 #bjca1 the ,secretary shall provide to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a briefing and report on-- 7,a7 activities carried out using funds made available under this section2 7,b7 progress on improving cybersecurity1 resiliency1 continuity1 logistics1 communications1 digitization1 and mission assurance capabilities2 and 7,c7 coordination with other ,federal agencies1 as appropriate4 ,such reports may include a classified annex4 7#c7 ,detailed implementation plan and quarterly briefings 7,a7 ,not later than #ij days after the date of enactment of this ,act1 the ,secretary1 acting through the ,office of ,information and ,technology1 shall submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a comprehensive implementation plan4 ,the plan shall include-- 7i7 specific milestones1 deliverables1 and performance metrics for each category of activities in subsection 7b72 7ii7 a zero trust architecture strategy with timelines and technical requirements2 7iii7 a detailed expenditure plan by fiscal quarter and by activity category2 and7iv7 any proposed interagency or private-sector partnerships4 7,b7 ,not later than #cj days after the end of each fiscal quarter through ,september #cj1 #bjca1 the ,secretary shall provide the ,committees a briefing and written report on-- 7i7 obligations and expenditures to date1 by category2 7ii7 progress against the implementation plan2 7iii7 any deviations from the plan and corrective actions2 and 7iv7 updated projections for remaining funds4 ,the initial briefing shall be in person2 subsequent briefings may be virtual unless otherwise requested by the ,committees4 ,reports may include a classified annex4 7d7 ,limitation ,funds made available under this section may not be used for any purpose unrelated to information technology modernization1 cybersecurity1 operational resilience1 logistics modernization1 communications modernization1 digitization1 or fraud prevention activities of the ,department4 7e7 ,supplement1 not supplant ,amounts made available under this section shall supplement and not supplant other amounts otherwise authorized to be appropriated for the ,office of ,information and ,technology of the ,department of ,veterans ,affairs4 7f7 ,rule of construction ,nothing in this section shall be construed to require the public disclosure of classified information1 controlled unclassified information1 operational details1 cybersecurity architecture1 contingency planning information1 mission-essential system design1 or information otherwise protected from disclosure under ,federal law or ,executive ,order4 7g7 ,reauthorization and sunset 7#a7 ,reauthorization required ,the authority provided under this section to obligate or expend amounts appropriated pursuant to subsection 7a7 shall terminate on ,september #cj1 #bjca1 unless subsequently reauthorized by law4 7#b7 ,limitation on new obligations after sunset ,beginning on ,october #a1 #bjca1 the ,secretary may not initiate1 award1 enter into1 renew1 extend1 or otherwise obligate funds for any new program1 project1 activity1 contract1 task order1 or operational capability carried out pursuant to this section unless expressly authorized by a subsequent ,act of ,congress4 7#c7 ,continuation of existing activities ,nothing in paragraph 7#b7 shall be construed to prohibit the ,secretary from-- 7,a7 maintaining1 sustaining1 securing1 operating1 completing1 or supporting any program1 project1 activity1 contract1 system1 platform1 infrastructure capability1 or operational activity lawfully initiated using amounts obligated before ,september #cj1 #bjca2 or 7,b7 carrying out similar information technology modernization1 cybersecurity1 continuity of operations1 logistics modernization1 communications modernization1 operational resiliency1 or mission assurance activities using amounts otherwise authorized and appropriated under any other provision of law4 7h7 ,use of existing contracting authorities ,the ,secretary shall carry out the activities authorized under this section1 to the maximum extent practicable1 through contracts1 task orders1 delivery orders1 interagency agreements1 cooperative agreements1 or other agreements entered into under existing authorities of title #ch1 ,united ,states ,code1 as applicable4 ,amounts made available under this section shall not be used to establish a new full-time equivalent position1 hire additional employees of the ,department1 or otherwise increase the number of full-time equivalent employees of the ,department1 except to the extent the ,secretary determines that such personnel are necessary for the oversight1 management1 cybersecurity supervision1 acquisition administration1 or operational integration of activities carried out under this section4 #djb4 ,establishment of ,under ,secretary for ,management and ,chief ,financial ,officer 7a7 ,chief ,financial ,officer2 ,office of ,budget ,section #cji of title #ch1 ,united ,states ,code1 is amended to read as follows3 #cji4 ,under ,secretary for ,management and ,chief ,financial ,officer 7a7 ,under ,secretary for ,management and ,chief ,financial ,officer 7#a7 ,the ,under ,secretary for ,management and ,chief ,financial ,officer shall be the principal management and financial officer of the ,department4 7#b7 ,the ,under ,secretary shall report directly to the ,secretary4 7#c7 ,the ,under ,secretary shall serve as the ,chief ,financial ,officer of the ,department for purposes of chapter #i of title #ca4 7#d7 ,the ,under ,secretary shall exercise authority1 direction1 and control over the ,office of ,budget and such other offices as may be assigned by law or by the ,secretary4 7b7 ,duties ,the duties of the ,under ,secretary include the following3 7#a7 ,to advise the ,secretary on financial management of the ,department4 7#b7 ,to formulate1 justify1 execute1 oversee1 and certify the budget of the ,department4 7#c7 ,to control1 account for1 audit1 and report on the finances of the ,department4 7#d7 ,to coordinate and assist the ,chief ,acquisition ,officer with the life cycle of major acquisition programs of the ,department4 7#e7 ,to exercise the authority and carry out the functions specified in section #ijb of title #ca4 7#f7 ,to ensure compliance with sections #acda1 #acdb1 #acdi1 #acej1 and #aeaa through #aeai of title #ca4 7#g7 ,to provide to ,congress1 or a congressional committee upon request1 information regarding the budget1 finances1 and fiscal condition of the ,department4 7#h7 ,to serve as the head of the ,office of ,budget of the ,department4 7#i7 ,to establish and oversee ,department-wide financial management policies1 accounting systems1 internal controls1 enterprise risk management programs1 strategic planning processes1 and capital planning activities4 7#aj7 ,to oversee infrastructure investment planning1 financial systems modernization1 and business transformation initiatives of the ,department4 7c7 ,deputy ,assistant ,secretary 7#a7 ,there is in the ,department a ,deputy ,assistant ,secretary for ,infrastructure and ,construction4 7#b7 ,such ,deputy ,assistant ,secretary shall be a career appointee 7as that term is defined in section #cacb7;a7 of title #e7 within the ,senior ,executive ,service of the ,department4 7d7 ,office of ,infrastructure and ,construction ,there is an ,office of ,infrastructure and ,construction in the ,department4 7e7 ,budget and ,appropriations ,affairs ,office 7#a7 ,there is within the ,office of ,management a ,budget and ,appropriations ,affairs ,office 7in this subsection referred to as the ,,baa office74 ,the ,undersecretary shall appoint a head of the ,,baa ,office who shall report exclusively to the ,undersecretary4 7#b7 ,the sole function of the ,,baa ,office is to provide to ,congress 7or a congressional committee71 accurate1 timely1 and certified information regarding the finances and budget of the ,department4 7#c7 ,congress or a congressional committee may submit a request for information described in paragraph 7#b7 directly to the ,,baa ,office4 7#d7 ,paragraphs 7#b7 and 7#c7 notwithstanding1 the ,assistant ,secretary for ,congressional and ,legislative ,affairs may facilitate and transmit responses to requests described in paragraph 7#c7 that are submitted to the ,,baa ,office4 ,any response containing information described in paragraph 7#b7 shall be prepared and certified by the ,,baa ,office and may not be altered1 delayed1 withheld1 edited1 or modified by any other officer or employee of the ,department prior to transmission to ,congress or a congressional committee4 7#e7 ,not more than six full-time equivalent employees1 including supervisors1 may be assigned to the ,,baa ,office4 7f7 ,limitation on authority to appoint ,the ,secretary may not establish an employee position-- 7#a7 that performs a function substantially similar to the function of the ,budget and ,appropriations ,affairs ,office established under section #cji7;e72 and 7#b7 that is not within the ,office of ,management4 7g7 ,transfer of functions 7#a7 ,all functions1 powers1 duties1 authorities1 responsibilities1 personnel1 property1 records1 contracts1 delegations1 directives1 regulations1 administrative actions1 and unobligated balances of appropriations relating to the ,chief ,financial ,officer of the ,department immediately before the effective date of this ,act are transferred to the ,under ,secretary for ,management and ,chief ,financial ,officer4 7#b7 ,any delegation1 determination1 rule1 regulation1 order1 permit1 contract1 agreement1 certification1 or other administrative action in effect immediately before the effective date of this ,act shall continue in effect according to its terms until modified1 superseded1 terminated1 or revoked4 7h7 ,references ,any reference in any law1 regulation1 rule1 directive1 delegation1 contract1 agreement1 determination1 record1 or other official document of the ,united ,states to the ,chief ,financial ,officer of the ,department shall be deemed to refer to the ,under ,secretary for ,management and ,chief ,financial ,officer4 4 7b7 ,technical and conforming amendments 7#a7 ,the table of sections for chapter #c of title #ch1 ,united ,states ,code1 is amended accordingly4 7#b7 ,the ,secretary shall make such additional technical and conforming amendments to regulations1 directives1 delegations1 organizational charters1 manuals1 and internal guidance as may be necessary to carry out this ,act4 #djc4 ,department of ,veterans ,affairs acquisition reform and cost assessment 7a7 ,department of ,veterans ,affairs acquisition organization 7#a7 ,definitions ,chapter #ha of title #ch1 ,united ,states ,code1 is amended by inserting after subchapter ,,vi the following new subchapter3 ,,vii ,acquisition ,organization1 ,cost ,assessment1 and ,program ,evaluation #haha4 ,definition of major acquisition program ,in this subchapter1 the term major acquisition program means a program of the ,department to acquire services1 supplies1 technology1 systems1 or a combination thereof1 with an estimated total program cost1 estimated by the ,secretary1 that exceeds-- 7#a7 #a1jjj1jjj1jjj 7adjusted pursuant to section #aijh of title #da7 for the total life cycle cost of the program2 or 7#b7 #bjj1jjj1jjj 7adjusted pursuant to section #aijh of title #da7 annually4 4 7#b7 ,assistant ,secretary for ,acquisition ,section #cjh of such title is amended-- 7,a7 in subsection 7a77#a71 by striking seven and inserting eight2 and 7,b7 in subsection 7b77#aj71 by striking ,procurement functions and inserting ,acquisition functions4 7#c7 ,acquisition organization ,subchapter ,,vii of chapter #ha of such title1 as added by paragraph 7#a71 is amended by adding at the end the following new section3 #hahb4 ,acquisition organization 7a7 ,assistant ,secretary for ,acquisition2 ,chief ,acquisition ,officer 7#a7 ,the ,secretary shall designate one of the ,assistant ,secretaries specified in subsection 7a77#a7 of section #cjh of this title as the ,assistant ,secretary of ,veterans ,affairs for ,acquisition1 who shall focus solely on the administration of functions specified in subsection 7b77#aj7 of such section4 7#b7 ,pursuant to section #agjb7;a7 of title #da1 the ,secretary shall designate the ,assistant ,secretary of ,veterans ,affairs for ,acquisition as the ,chief ,acquisition ,officer of the ,department4 7b7 ,office of ,acquisition 7#a7 ,there is in the ,department an ,office of ,acquisition4 7#b7 ,the head of the ,office of ,acquisition shall be the ,assistant ,secretary of ,veterans ,affairs for ,acquisition designated pursuant to subsection 7a74 7#c7 ,the ,secretary shall take such actions as may be necessary to ensure that major acquisition program offices of the ,department align under the ,office of ,acquisition and report directly to the ,assistant ,secretary of ,veterans ,affairs for ,acquisition4 7#d7 ,the budget of the ,office of ,acquisition1 including budgets for major acquisition programs1 shall be established in the budget justification materials submitted to ,congress in support of the budget of the ,department 7as submitted with the budget of the ,president under section #aaje7;a7 of title #ca74 7c7 ,deputy ,assistant ,secretary for ,logistics 7#a7 ,pursuant to section #cjh7;d7 of this title1 the ,secretary shall appoint a ,deputy ,assistant ,secretary of ,veterans ,affairs for ,logistics1 who shall report to the ,assistant ,secretary for ,acquisition4 7#b7 ,the ,deputy ,assistant ,secretary of ,veterans ,affairs for ,logistics shall be responsible for administration of logistics and supply chain operations of the ,department4 7d7 ,deputy ,assistant ,secretary for ,procurement 7#a7 ,pursuant to section #cjh7;d7 of this title1 the ,secretary shall appoint a ,deputy ,assistant ,secretary of ,veterans ,affairs for ,procurement1 who shall report to the ,assistant ,secretary for ,acquisition4 7#b7 ,the ,deputy ,assistant ,secretary of ,veterans ,affairs for ,procurement shall be responsible for all procurement and contracting organizations of the ,department4 7e7 ,deputy ,assistant ,secretary for ,acquisition1 ,program ,management1 and ,performance 7#a7 ,pursuant to section #cjh7;d7 of this title1 the ,secretary shall appoint a ,deputy ,assistant ,secretary of ,veterans ,affairs for ,acquisition1 ,program ,management1 and ,performance1 who shall report to the ,assistant ,secretary for ,acquisition4 7#b7 ,the ,deputy ,assistant ,secretary for ,acquisition1 ,program ,management1 and ,performance shall be responsible for the following3 7,a7 ,lifecycle management4 7,b7 ,requirements planning4 7,c7 ,programming and budgeting4 7,d7 ,policy4 7,e7 ,performance standards4 7,f7 ,governance4 7,g7 ,enhancing the capabilities of the acquisition workforce4 7f7 ,program ,executive ,officers 7#a7 ,the ,assistant ,secretary for ,acquisition shall appoint no fewer than four ,program ,executive ,officers1 each responsible for overseeing major acquisition programs in one of the following areas3 7,a7 ,medical4 7,b7 ,information technology4 7,c7 ,professional services4 7,d7 ,other areas not included in subparagraphs 7,a7 through 7,c74 7#b7 ,each ,program ,executive ,officer shall report directly to the ,assistant ,secretary for ,acquisition and shall supervise the managers of major acquisition programs within their respective area1 as appointed under section #hahc of this title4 7#c7 ,each ,program ,executive ,officer shall be-- 7,a7 certified in project management at level three by-- 7i7 the ,department2 7ii7 the ,federal ,acquisition ,institute pursuant to section #abja of title #da2 or 7iii7 the ,department of ,defense pursuant to section #agja;a of title #aj2 or 7,b7 hold an equivalent certification by a private sector project management certification organization1 as determined appropriate by the ,secretary4 4 7b7 ,department of ,veterans ,affairs major acquisition program managers ,subchapter ,,vii of chapter #ha of title #ch1 ,united ,states ,code1 as added by subsection 7a71 is amended by adding at the end the following new section3 #hahc4 ,major acquisition program managers 7a7 ,appointments ,not later than #cj days after any date on which the ,secretary approves a major acquisition program to commence1 the applicable ,program ,executive ,officer shall appoint a manager to be responsible for administering such program4 7b7 ,qualifications ,each manager appointed pursuant to subsection 7a7 shall be-- 7#a7 certified in project management at level three by-- 7,a7 the ,department2 7,b7 the ,federal ,acquisition ,institute pursuant to section #abja of title #da2 or 7,c7 the ,department of ,defense pursuant to section #agja;a of title #aj2 or 7#b7 hold an equivalent certification by a private sector project management certification organization1 as determined appropriate by the ,secretary4 7c7 ,duties ,each manager appointed pursuant to subsection 7a7 for a major acquisition program shall-- 7#a7 report to the ,assistant ,secretary for ,acquisition through the ,program ,executive ,officer responsible for the major acquisition program2 and 7#b7 shall be responsible for1 with respect to the major acquisition program-- 7,a7 developing1 in coordination with the ,program ,executive ,officer1 a plan to administer major acquisition program1 which shall be known as the program baseline for the major acquisition program1 that includes-- 7i7 a description of each acquisition phase of the major acquisition program2 7ii7 for each such acquisition phase1 requirements for advancing the major acquisition program to a subsequent acquisition phase2 and 7iii7 estimates of the cost1 schedule1 and performance of the major acquisition program that account for the entire life cycle of the major acquisition program2 7,b7 ensuring the major acquisition program is in compliance with such requirements and providing all program documentation1 including program baseline documentation1 cost1 schedule1 performance and risk assessments1 and other relevant materials1 to designated officials and relevant governance boards2 7,c7 developing resource requests and justifications necessary to satisfy such requirements2 and 7,d7 on a continuous basis1 assessing and managing risks to satisfying the requirements of such program baseline relating to cost and schedule4 7d7 ,program decision authority ,the ,secretary shall ensure that-- 7#a7 program decision authority for oversight of a major acquisition program is the ,assistant ,secretary for ,acquisition2 and 7#b7 program management offices for major acquisition programs are independent of the ,veterans ,benefits ,administration1 the ,veterans ,health ,administration1 the ,national ,cemetery ,administration1 and staff offices of the ,department by reporting directly to the ,assistant ,secretary for ,acquisition4 7e7 ,program decision authority notification required ,not later than #cj days after any date on which a major acquisition program concludes an acquisition phase1 the manager of such program appointed pursuant to subsection 7a7 shall notify the program decision authority under subsection 7c74 4 7c7 ,department of ,veterans ,affairs acquisition and procurement reorganization matters 7#a7 ,organizational consolidation ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall organizationally consolidate under the ,assistant ,secretary of ,veterans ,affairs for ,acquisition every activity of the ,department of ,veterans ,affairs1 including the ,veterans ,benefits ,administration1 the ,veterans ,health ,administration1 and the ,national ,cemetery ,administration1 that relates to-- 7,a7 acquisition2 7,b7 procurement and contracting2 or 7,c7 logistics and supply chain4 7#b7 ,relocation ,paragraph 7#a7 shall not be construed to require the physical relocation of employees of the ,department4 7#c7 ,plan and briefing 7,a7 ,in general ,not later than #ij days after commencing organizational consolidation under subsection 7a71 the ,secretary shall-- 7i7 submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a written plan to carry out such organizational consolidation2 and 7ii7 provide such committees a briefing on such plan4 7,b7 ,contents ,the plan submitted pursuant to subparagraph 7,a77i7 shall include the following3 7i7 ,a timeline4 7ii7 ,a plan for communication and training activities for relevant ,department personnel4 7iii7 ,a plan for modification of relevant ,department policy and guidance4 7iv7 ,such other matters as the ,secretary considers relevant and appropriate4 7d7 ,independent verification and validation of major acquisition programs of ,department of ,veterans ,affairs 7#a7 ,contracting authority ,not later than #abj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall seek to enter into one or more contracts using competitive procedures with one or more entities to carry out the functions described in paragraph 7#c74 7#b7 ,eligibility 7,a7 ,in general ,an entity is not eligible to be awarded a contract under this section unless the ,chief ,acquisition ,officer of the ,department of ,veterans ,affairs determines1 at the time of evaluation of offers submitted under paragraph 7#a71 that the entity is currently performing or has performed1 during the preceding three-year period1 not fewer than three prime contracts from either governmental or commercial health care organizations for-- 7i7 the independent verification and validation services or equivalent services1 including systems engineering and technical advisory 7,,seta7 support of major acquisition programs2 or 7ii7 the independent verification and validation or systems engineering and technical advisory 7,,seta7 support of the development or acquisition of major acquisition programs or defense systems1 in accordance with guidance of the ,department of ,defense relating to such acquisition programs or such business systems4 7,b7 ,past performance ,for any contract used to demonstrate eligibility under subparagraph 7,a71 an entity must have performed the work at a satisfactory or better level as indicated by the past performance information in the ,contractor ,performance ,assessment ,reporting ,system1 or successor system4 7,c7 ,demonstration of lack of conflict of interest ,the ,secretary shall revoke the eligibility of an entity under this subsection if an entity does not demonstrate clear and unmitigable evidence that the entity does not have a conflict of interest with respect to the effective performance of functions under paragraph 7#c74 7,d7 ,no mitigation plans acceptable ,the ,secretary may not accept from an entity a plan to mitigate a conflict of interest in order to ameliorate any limitation or prohibition under this subsection4 7#c7 ,functions ,the functions specified in this subsection are the following3 7,a7 ,the independent verification and validation of each major acquisition program project-- 7i7 when such major acquisition program is initiated1 with respect to its design and the development of its requirements and acquisition2 7ii7 at the conclusion of such program2 and 7iii7 at any other intervals during such program selected by the ,chief ,acquisition ,officer of the ,department4 7,b7 ,the independent verification and validation of other programs or projects of the ,department selected by the ,chief ,acquisition ,officer of the ,department1 at intervals selected by the ,chief ,acquisition ,officer4 7#d7 ,funding ,the ,chief ,financial ,officer of the ,department shall ensure that each organizational subdivision of the ,department that enters into a contract under paragraph 7#a7 proportionally contributes amounts to fund each such contract4 7#e7 ,definitions ,in this section3 7,a7 ,covered contract ,the term covered contract means any prime or subcontract with the ,department1 including-- 7i7 information technology support or software or system design1 development1 sustainment1 or maintenance services2 7ii7 professional or management consulting services2 or 7iii7 advisory and assistance services4 7,b7 ,independent verification validation ,the term independent verification and validation means a comprehensive inspection1 a review1 analysis1 and testing1 or an assessment of systems1 software1 or hardware1 as applicable1 performed by an entity awarded a contract under paragraph 7#a7-- 7i7 to verify that the requirements of a program1 project or system1 or a development phase of such a program or project1 are correctly defined2 and 7ii7 to validate cost1 schedule1 and performance baselines of current programs and measure program effectiveness4 7e7 ,department of ,veterans ,affairs cost assessment and program evaluation 7#a7 ,in general ,subchapter ,,vii of chapter #ha of title #ch1 ,united ,states ,code1 as added by subsection 7a7 and amended by subsection 7b71 is further amended by adding at the end the following new section3 #hahd4 ,cost assessment and program evaluation 7a7 ,director of ,cost ,assessment and ,program ,evaluation ,there is in the ,department a ,director of ,cost ,assessment and ,program ,evaluation1 who shall report directly to the ,secretary4 7b7 ,responsibilities ,the responsibilities of the ,director are as follows3 7#a7 ,to develop policies and procedures for cost estimation and analysis of major acquisition programs of the ,department4 7#b7 ,to conduct independent cost estimates and analyses for major acquisition programs to support acquisition decisions1 or any other acquisitions as directed by the ,secretary1 7#c7 ,to provide an independent cost estimate to the ,assistant ,secretary for ,acquisition in advance of a decision to proceed with full-scale acquisition for a major acquisition program or any other program as directed by the ,director4 7#d7 ,to evaluate the effectiveness of major acquisition programs in meeting ,department objectives4 7#e7 ,not less frequently than once each year1 to submit to the ,secretary and the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives an annual report on cost estimation and program evaluation activities1 including recommendations to improve acquisition efficiency4 ,such report shall include a list of all acquisitions where the independent cost estimate for a major acquisition program exceeded the budget request for the program by more than #e percent4 7c7 ,support and resources ,the ,chief ,financial ,officer of the ,department shall provide to the ,secretary such support and resources as may be necessary for the ,secretary to ensure the effective establishment and functioning of the ,director of ,cost ,assessment and ,program ,evaluation4 4 7#b7 ,report on monitoring of operating and support costs for major acquisition programs 7,a7 ,report to ,secretary of ,veterans ,affairs ,not later than one year after the date of the enactment of this ,act1 and not less frequently than once each year thereafter until ,december #ca1 #bjbh1 the ,director of ,cost ,assessment and ,program ,evaluation of the ,department of ,veterans ,affairs shall submit to the ,secretary of ,veterans ,affairs a report on systems and methods for tracking and assessing operating and support costs of major acquisition programs 7as defined in section #haha of title #ch1 ,united ,states ,code1 as added by subsection 7a771 including recommendations for establishing cost baselines4 7,b7 ,transmittal to ,congress ,not later than #cj days after receiving a report pursuant to 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 the report received by the ,secretary4 7f7 ,improvements to hiring of entry-level acquisition positions in ,department of ,veterans ,affairs 7#a7 ,priority use of internship programs for hiring into entry-level positions in acquisitions ,the ,secretary of ,veterans ,affairs shall prioritize the use of acquisition internship programs to hire employees to entry-level positions relating to acquisition in the ,department of ,veterans ,affairs4 7#b7 ,annual number of participants in acquisition internship programs 7,a7 ,in general ,not later than ,september #cj of the first fiscal year beginning after the date of the enactment of this ,act1 the ,secretary shall take such actions as may be necessary to ensure that the annual number of participants in acquisition internship programs of the ,department is-- 7i7 not fewer than twice the number of participants in such programs during fiscal year #bjbe2 and 7ii7 not more than #d times the number of participants in such programs during such fiscal year4 7,b7 ,termination ,the requirements of subparagraph 7,a7 shall terminate on the date on which the ,secretary certifies to the appropriate committees of ,congress that the projected number of graduates of acquisition internship programs is sufficient to satisfy the human capital needs of the ,department with respect to acquisition1 taking into account the rate of attrition and projected retirements of personnel4 7,c7 ,appropriate committees of ,congress defined ,in this subsection1 the term appropriate committees of ,congress means the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives4 7g7 ,independent analysis of acquisition process of ,department of ,veterans ,affairs 7#a7 ,systems engineering analysis ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans' ,affairs shall enter into a memorandum of understanding with the ,executive ,director of the ,acquisition ,research ,center of the ,department of ,defense to conduct a systems engineering analysis of the acquisition process of the ,department of ,veterans ,affairs4 7#b7 ,report ,not later than one year after the date in which the ,secretary enters into the memorandum of understanding required by paragraph 7#a71 the ,secretary shall submit to ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report on the findings of the ,executive ,director with respect to the analysis conducted under such subsection4 7h7 ,requirements development process 7#a7 ,in general ,subchapter ,,vii of chapter #ha of title #ch1 ,united ,states ,code1 as added by subsection 7a7 and amended by subsections 7b7 and 7e71 is further amended by adding at the end the following new section3 #hahe4 ,requirements development process 7a7 ,establishment of process 7#a7 ,the ,secretary shall establish a standardized requirements development process for major acquisition programs4 7#b7 ,the process established pursuant to paragraph 7#a7 shall-- 7,a7 define and validate mission-driven requirements for major acquisition programs exceeding #bjj1jjj1jjj annually or #a1jjj1jjj1jjj in lifecycle costs1 in coordination with the ,assistant ,secretary for ,acquisition2 7,b7 incorporate data-driven needs assessments1 stakeholder input from relevant administrations1 staff offices1 and other elements of the ,department1 and alignment with statutory mandates1 such as section #haba of this title2 and 7,c7 ensure iterative validation of requirements through independent verification and validation1 as described in section #hahe of this title1 to confirm cost1 schedule1 and performance baselines4 7b7 ,limitation on personnel ,the ,secretary shall implement the process established pursuant to subsection 7a7 using staff within the ,office of ,acquisition and other relevant offices of the ,department1 as established under section #hahb of this title1 without creating new positions1 unless a subsequent cost-benefit analysis1 validated by the ,director of ,cost ,assessment and ,program ,evaluation1 justifies additional resources4 4 7#b7 ,report ,not later than #ahj days after the enactment of this ,act1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report detailing the requirements process established pursuant to section #hahg of such title1 as added by paragraph 7#a7 and a plan for implementation of such process1 including timelines for integration with major acquisition program baselines4 7i7 ,conforming amendments ,subchapter ,,vi of chapter #ha of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in section #haga1 by striking paragraphs 7#e7 and 7#f72 and 7#b7 by striking section #hagb4 7j7 ,clerical amendments ,the table of sections at the beginning of chapter #ha of title #ch1 ,united ,states ,code1 is amended-- 7#a7 by striking the item relating to section #hagb2 and 7#b7 by adding at the end the following3 ,,subchapter ,,vii--,acquisition ,review1 ,cost ,assessment1 and ,program ,evaluation #haha4 ,definition of major acquisition program4 #hahb4 ,acquisition reorganization4 #hahc4 ,major acquisition program managers4 #hahd4 ,cost assessment and program evaluation4#hahe4 ,requirements development process4 4 #djd4 ,improvement of telephone communication by ,department of ,veterans ,affairs 7a7 ,in general ,chapter #fc of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new section3 #fcba4 ,telephone communication 7a7 ,calls associated with ,department ,not later than one year after the date of the enactment of the ,take ,care of ,america's ,veterans ,act1 the ,secretary shall ensure1 to the extent practicable and feasible1 that any call made to a veteran1 beneficiary1 claimant1 or other relevant individual by an employee or contractor of the ,department regarding services or benefits furnished by the ,department-- 7#a7 is made from a single1 well-known telephone number2 and 7#b7 uses caller identification branding that indicates to the individual that the call is from or on behalf of the ,department4 7b7 ,call centers for health care appointments and referrals 7#a7 ,in general ,not later than one year after the date of the enactment of the ,take ,care of ,america's ,veterans ,act1 the ,secretary shall ensure that the ,veterans ,health ,administration has at least one call center in each of the time zones specified in paragraph 7#c7 to address concerns regarding appointments and referrals for health care under the laws administered by the ,secretary4 7#b7 ,existing efforts and call centers ,in carrying out paragraph 7#a71 the ,secretary-- 7,a7 shall ensure coordination with existing efforts of the ,department to improve call center operations2 and 7,b7 may use existing call centers to meet the requirements of such paragraph4 7#c7 ,time zones specified ,the time zones specified in this paragraph are the following3 7,a7 ,eastern time4 7,b7 ,central time4 7,c7 ,mountain time4 7,d7 ,pacific time4 7,e7 ,alaska time4 7,f7 ,hawaii time4 7#d7 ,clarification ,the ,secretary is not required to ensure that the ,veterans ,health ,administration has a call center in any location generally within a time zone specified in paragraph 7#c7 that does not follow daylight saving time4 4 7b7 ,clerical amendment ,the table of sections at the beginning of chapter #fc of such title is amended by adding at the end the following new item3 #fcba4 ,telephone communication4 4 7c7 ,report ,not later than #ahj days after enactment1 and annually for three years thereafter1 the ,secretary shall submit to the ,committees on ,veterans' ,affairs a report on implementation1 including call-answer rates1 abandoned-call rates1 average wait times1 veteran complaints1 spoofing or fraud-prevention measures1 and any exceptions granted4 #dje4 ,advancing ,department of ,veterans ,affairs emergency response to crisis 7a7 ,report on emergency management roles for ,department of ,veterans ,affairs 7#a7 ,in general ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report outlining the roles and responsibilities of all offices of the ,department of ,veterans ,affairs involved with emergency management4 7#b7 ,consultation ,in preparing the report required by paragraph 7#a71 the ,secretary of ,veterans ,affairs shall consult with the ,comptroller ,general of the ,united ,states1 the ,inspector ,general of the ,department of ,veterans ,affairs1 the ,secretary of ,homeland ,security1 the ,secretary of ,defense1 and such other ,federal agencies as the ,secretary of ,veterans ,affairs considers relevant1 to obtain insights from their experience and trends that they have found1 and such recommendations as they may have with respect to the management by the ,department of ,veterans ,affairs of emergency management functions4 7#c7 ,contents ,the report submitted pursuant to paragraph 7#a7 shall include the following3 7,a7 ,a description of the organizational structure of each office1 both during normal operations and during emergency or disaster operations4 7,b7 ,the roles and responsibilities of each office4 7,c7 ,a detailed description of roles and responsibilities that are shared by both the ,office of ,emergency ,management of the ,department and the ,office of ,operations1 ,security1 and ,preparedness of the ,department1 including an analysis of how each office plays a part in emergency management functions4 7,d7 ,recommendations for improving the structure and alignment of relevant offices to better prepare the ,department for emergencies1 remove redundancies1 and improve accountability4 7,e7 ,an analysis of the feasibility and advisability of consolidating relevant offices into one centralized emergency management office to improve communication and streamline emergency preparedness and response efforts of the ,department4 7b7 ,plan to allow fuel sharing and increased coordination between the ,federal ,emergency ,management ,agency and the ,department of ,veterans ,affairs ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall1 after consulting with the ,administrator of the ,federal ,emergency ,management ,agency1 submit to the ,committee on ,veterans' ,affairs of the ,senate1 the ,committee on ,veterans' ,affairs of the ,house of ,representatives1 the ,committee on ,homeland ,security and ,government ,affairs of the ,senate1 and the ,committee on ,homeland ,security of the ,house of ,representatives a report regarding-- 7#a7 the current limitations preventing the ,federal ,emergency ,management ,agency from providing fuel or other resources to the ,department of ,veterans ,affairs during emergencies2 7#b7 whether the ,department requires action by ,congress to allow such resource provision to occur2 7#c7 whether the ,secretary has been unable to coordinate with the ,administrator during prior emergencies or ,fourth ,mission activations due to a lack of authority for such coordination2 7#d7 whether the ,secretary requires action by ,congress to address any of the issues mentioned under paragraph 7#c72 and 7#e7 whether the ,secretary requires action by ,congress to address the issue of ,department employees or responders being unable to use ,department-purchased fuel4 #djf4 ,membership of ,department of ,veterans ,affairs ,geriatrics and ,gerontology ,advisory ,committee ,section #gcae of title #ch1 ,united ,states ,code1 is amended1 in subsection 7a7-- 7#a7 in the second sentence1 by striking and at least one representative of a national veterans service organization and inserting 1 at least one individual who represents a national veterans service organization1 at least one individual who has served veterans or families of veterans in a ,state home1 and at least one individual who holds a professional license in nursing home administration2 and 7#b7 by designating the first1 second1 and third sentences as paragraphs 7#a7 through 7#c71 respectively 7and adjusting the margins accordingly74 #djg4 ,scheduling of appointments under the ,veterans ,community ,care ,program 7a7 ,in general 7#a7 ,electronic process ,subsection 7d7 of section #caja of the ,johnny ,isakson and ,david ,p4 ,roe1 ,m4,d4 ,veterans ,health ,care and ,benefits ,improvement ,act of #bjbj 7,public ,law #aaf-cae2 #ch ,u4,s4,c4 #agja note7 is amended to read as follows3 7d7 ,electronic process 7#a7 ,the ,secretary shall implement an electronic process through which a scheduler of the ,department1 using an information technology system1 may schedule an appointment for health care furnished by the ,department or through the ,veterans ,community ,care ,program1 under section #agjc of this title1 by a non-,department health care provider4 7#b7 ,the electronic process under this subsection shall allow a scheduler1 with regards to appointments described in-- 7,a7 either clause of subparagraph 7,a7 of subsection 7a77#a71 to view1 search1 and sort such appointments by type of care1 location1 and date2 and 7,b7 clause 7ii7 of such subparagraph-- 7i7 to schedule such an appointment2 7ii7 to provide referral and authorization documents directly to a non-,department provider2 and 7iii7 to perform any other function the ,secretary determines necessary4 7#c7 ,the ,secretary shall ensure that the electronic process allows a scheduler to schedule an appointment for health care furnished by the ,secretary through a health care provider of the ,department4 7#d7 ,the ,secretary shall implement the electronic process through an existing agreement if practicable4 7#e7 ,the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,senate and ,house of ,representatives the following regarding the electronic process3 7,a7 ,not later than #ij days after the ,secretary makes a determination under subparagraph 7,b77iii7 of paragraph 7#b71 a briefing regarding the functions the ,secretary has determined necessary4 7,b7 ,not later than six months after the date of the enactment of ,take ,care of ,america's ,veterans ,act1 and semiannually thereafter during the following three years1 a report regarding operation of the electronic process during both the semiannual period preceding the date of the report and the cumulative period since the date of the enactment of such ,act4 ,such a report shall include the following for each such period3 7i7 ,the number of non-,department health care providers that participated in such electronic process1 disaggregated by-- 7,i7 category of hospital care or medical services provided2 and 7,,ii7 medical center of the ,department2 7ii7 ,the number of appointments scheduled pursuant to the electronic process1 disaggregated by-- 7,i7 category of hospital care or medical services provided2 7,,ii7 medical center of the ,department2 and 7,,iii7 month4 7iii7 ,a comparison of the average wait time for appointments scheduled through the electronic process and through non-electronic methods1 disaggregated by medical center of the ,department4 7iv7 ,the rates at which veterans cancelled appointments scheduled through the electronic process4 7v7 ,the rates at which veterans did not appear for appointments scheduled through the electronic process4 4 7#b7 ,implementation 7,a7 ,date ,the ,secretary of ,veterans ,affairs shall implement the electronic process under subsection 7d7 of section #agjc;,h of such title1 as added by this section1 not later than two years after the date of the enactment of this ,act4 7,b7 ,guidelines ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall establish guidelines4 ,such guidelines shall include the following3 7i7 ,procedures for schedulers and other employees of the ,department involved in the scheduling of appointments described in such section4 7ii7 ,a directive that employees described in clause 7i7 use the electronic process to the extent practicable4 7iii7 ,a directive that employees described in clause 7i71 when scheduling an appointment for a covered veteran 7as such term is used in section #agjc of such title7 for health care furnished by the ,secretary1 inform such covered veteran of available appointments though providers of the ,department and through providers under the ,veterans ,community ,care ,program when eligible4 7iv7 ,procedures for engaging with non-,department health care providers in specialized cases4 7v7 ,standards regarding timeliness and accuracy4 7vi7 ,escalation protocols for scheduling failures or delays4 7,c7 ,training ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary shall implement a mandatory training program for employees described in subparagraph 7,b7 regarding the guidelines under subparagraph 7,b74 7,d7 ,evaluation ,not later than #fj days after the date of the enactment of this ,act1 the ,secretary shall prescribe performance benchmarks and outcome-based metrics for the electronic process under such section1 including-- 7i7 time between a referral and a scheduled appointment2 7ii7 patient satisfaction2 and 7iii7 the percentage of appointments scheduled exclusively through the electronic process4 7,e7 ,outreach ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary shall plan and carry out an outreach strategy to encourage non-,department of ,veterans ,affairs health care providers that participate in the ,veterans ,community ,care ,program to participate in the electronic process under such subsection4 ,such outreach shall-- 7i7 include contacting each such provider during such #ij days2 7ii7 include seeking to enter into an agreement with each such provider under which the provider shall participate in the electronic process2 7iii7 include collaborating with ,state hospital associations and rural health associations to promote such participation2 7iv7 focus on providers in specialties or underserved areas1 as determined by the ,secretary2 and 7v7 include the publication1 on a publicly accessible website of the ,department1 of information regarding-- 7,i7 details of the electronic process2 7,,ii7 how a provider may elect to participate in the electronic process2 and 7,,iii7 a point of contact in the ,department regarding the electronic process4 7,f7 ,oversight ,the ,secretary shall submit to the ,committees on ,veterans' ,affairs of the ,senate and ,house of ,representatives1 with regards to the electronic process under such subsection1 the following3 7i7 ,not later than #cj days after the ,secretary establishes guidelines under subparagraph 7,b7 of this paragraph1 a copy of such guidelines4 7ii7 ,not later than #cj days after the ,secretary formulates the plan under subparagraph 7,e7 of this paragraph1 a briefing on the outreach strategy under such paragraph4 7iii7 ,not later than #ahj days after the date of the enactment of this ,act1 the benchmarks and metrics prescribed under subparagraph 7,d74 7#c7 ,expansion ,not later than #ij 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 integrate the scheduling of appointments for health care furnished through health care providers of the ,department of ,veterans ,affairs into the electronic process under subsection 7d7 of section #agjc;,h of such title4 ,such plan shall include the following elements3 7,a7 ,a timeline to implement such plan4 7,b7 ,estimated costs to carry out such plan4 7,c7 ,changes to policies and procedures of the ,department the ,secretary determines necessary to implement such plan4 7#d7 ,codification 7,a7 ,in general ,section #caja of such ,act1 as amended by paragraph 7#a71 is transferred to subchapter ,i of chapter #ag of title #ch1 ,united ,states ,code1 inserted after section #agjc;,g1 and redesignated as section #agjc;,h4 7,b7 ,conforming amendments ,section #agjc;,h of such title1 as transferred and redesignated by this subsection1 is amended-- 7i7 by striking any heading that is not a section heading or subsection heading and conforming the margins accordingly2 7ii7 by striking of title #ch1 ,united ,states ,code both places it appears and inserting of this title2 7iii7 in subsection 7b77#a71 by striking ,not later than one year after the date of the enactment of this ,act1 the ,secretary and inserting ,the ,secretary2 7iv7 in subsection 7c7-- 7,i7 in paragraph 7#a71 in the matter preceding subparagraph 7,a71 by striking ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary and inserting ,the ,secretary2 and 7,,ii7 in paragraph 7#b71 by striking subparagraphs 7,a7 and 7,b7 and inserting ,the ,secretary shall require each medical facility of the ,department to use the method or tool described in paragraph 7#a742 7v7 in the section enumerator1 by striking ,sec4 and inserting 2 and 7vi7 in the section heading-- 7,i7 by striking ,process and requirements for scheduling appointments for health care from ,department of ,veterans ,affairs and non-,department health care4 and inserting ,scheduling of appointments2 and 7,,ii7 by conforming the typeface and typestyle1 including capitalization1 to the typeface and typestyle used in the section heading of section #agjc;,g of such title4 7,c7 ,table of sections ,the table of sections at the beginning of such chapter is amended by inserting1 after the item relating to section #agjc;,g1 the following new item3 #agjc;,h4 ,scheduling of appointments4 4 ,v ,memorial ,affairs #eja4 ,expansion of eligibility for ,department of ,veterans ,affairs memorial headstone or marker for certain individuals ,section #bcjf7;b77#b7 of title #ch1 ,united ,states ,code1 is amended in subparagraphs 7,b7 and 7,c7 by striking who dies on or after ,november #aa1 #aiih1 each place it appears4 #ejb4 ,department of ,veterans ,affairs provision of additional burial benefits when an urn or commemorative plaque is furnished 7a7 ,in general ,paragraph 7#b7 of section #bcjf7;h7 of title #ch1 ,united ,states ,code1 is amended to read as follows3 7#b7 ,if the ,secretary furnishes an urn or commemorative plaque for an individual under paragraph 7#a71 the ,secretary may not provide for such individual a headstone or marker under this section1 or any interment benefit under section #bdjb of this title1 unless-- 7,a7 in the case of a request for a headstone or marker under this section-- 7i7 such request is made at the same time as a request for placement of a headstone or marker for another individual who is eligible to have such a headstone or marker placed in a national cemetery1 a veterans' cemetery in receipt of a grant made under section #bdjh of this title1 or a post cemetery2 and 7ii7 the ,secretary furnishes one headstone or marker inscribed for both individuals2 or 7,b7 in the case of a request for interment1 the individual is interred at the same time and in the same gravesite as the interment of another individual eligible for interment in a national cemetery under section #bdjb7;a7 of this title4 4 7b7 ,applicability ,the amendment made by subsection 7a7 shall apply with respect to an individual who dies on or after ,january #e1 #bjba4 #ejc4 ,fallen ,servicemembers ,religious ,heritage ,restoration ,program 7a7 ,findings ,congress finds the following3 7#a7 ,an estimated #ijj ,american-,jewish servicemembers of the ,armed ,forces1 killed in ,world ,war ,i and ,world ,war ,,ii and buried overseas in ,united ,states military cemeteries were1 for various reasons1 mistakenly buried under ,latin ,crosses4 ,in most instances1 those mistakes were made inadvertently4 7#b7 ,in #bjbb1 more than #b1jjj1jjj people visited the ,united ,states ,world ,war ,i and ,world ,war ,,ii cemeteries in foreign countries4 7#c7 ,american-,jewish servicemembers played a vital role in the ,allied victories in ,world ,war ,i and ,world ,war ,,ii4 7#d7 ,american-,jewish servicemembers who fought and died for the ,united ,states must have their heritage properly recognized and honored4 7#e7 ,the ,united ,states ,government has a solemn responsibility to ensure that every ,american servicemember killed in action and buried overseas is properly honored4 7#f7 ,the work of properly identifying ,american-,jewish servicemembers buried overseas is vital and integral to the responsibility of the ,american ,battle ,monuments ,commission to ensure that past mistakes in honoring those servicemembers who died in the line of duty are corrected4 7b7 ,fallen servicemembers religious heritage restoration program 7#a7 ,establishment ,the ,american ,battle ,monuments ,commission shall establish a program to identify covered members and to contact survivors and descendants of such covered members4 ,such program shall be known as the ,fallen ,servicemembers ,religious ,heritage ,restoration ,program4 7#b7 ,duration ,the ,commission shall carry out the ,fallen ,servicemembers ,religious ,heritage ,restoration ,program during the first five fiscal years that begin after the date of the enactment of this ,act4 7#c7 ,contracts 7,a7 ,authority ,during each fiscal year described in subsection 7b71 the ,commission shall seek to enter into a contract with a nonprofit organization under which such nonprofit organization shall carry out the purpose described in subsection 7a74 7,b7 ,term2 amount ,each contract under this subsection shall be for one year and in the amount of #ejj1jjj to the nonprofit organization4 7,c7 ,priority ,in awarding a contract under this subsection1 the ,commission shall give priority to a nonprofit organization that has demonstrated capability and expertise in carrying out the purpose described in subsection 7a74 7#d7 ,definitions ,in this section3 7,a7 ,the term covered member means a deceased member of the ,armed ,forces who was ,jewish and buried-- 7i7 in a ,united ,states military cemetery located outside the ,united ,states2 and 7ii7 under a marker that indicates such member was not ,jewish4 7,b7 ,the term nonprofit organization means an organization described in section #eja7;c77#c7 of the ,internal ,revenue ,code of #aihf and exempt from taxation under section #eja7;a7 of such ,code4 ,,vi ,veterans' ,assuring ,critical ,care ,expansions to ,support ,servicemembers ,a ,improvement of ,veterans ,community ,care ,program #fja4 ,codification of requirements for eligibility standards for access to community care from ,department of ,veterans ,affairs 7a7 ,eligibility access standards ,section #agjc;,b of title #ch1 ,united ,states ,code1 is amended-- 7#a7 by striking subsections 7a7 through 7e7 and inserting the following3 7a7 ,access standards for community care 7#a7 ,for purposes of section #agjc7;d77#a77;,d7 of this title1 the eligibility access standards for hospital care1 medical services1 or non-institutional extended care services1 are as follows3 7,a7 ,with respect to primary care1 mental health care1 or non-institutional extended care services1 the ,secretary must schedule an appointment for the covered veteran with a health care provider of the ,department who can provide the needed service-- 7i7 within #cj minutes average driving time from the residence of the veteran unless a longer average driving time has been agreed to by the veteran in consultation with a health care provider of the veteran2 and 7ii7 within #bj days of either the date of request for such an appointment or a later date agreed to by the veteran in consultation with a health care provider of the veteran4 7,b7 ,with respect to specialty care1 the ,secretary must schedule an appointment for the covered veteran with a health care provider of the ,department who can provide the needed service-- 7i7 within #fj minutes average driving time from the residence of the veteran unless a longer average driving time has been agreed to by the veteran in consultation with a health care provider of the veteran2 and 7ii7 within #bh days of either the date of request for such an appointment or a later date agreed to by the veteran in consultation with a health care provider of the veteran4 7,c7 ,with respect to a covered treatment program1 the ,secretary must-- 7i7 provide to a covered veteran a screening not later than #dh hours after the date on which the veteran1 or a relevant health care provider1 makes a documented request for the veteran to be admitted to a covered treatment program2 and 7ii7 if the veteran is determined eligible for priority admission to a covered treatment program-- 7,i7 admit the veteran to a covered treatment program not later than #dh hours after the date of such determination or give the veteran the option of seeking care at a non-,department facility pursuant to section #agib7;e7 of this title2 or 7,,ii7 give the veteran the option of seeking care at a non-,department facility pursuant to section #agib7;e7 of this title4 7#b7 ,for the purposes of determining the ability of the ,secretary to schedule an appointment for a covered veteran with a health care provider of the ,department under paragraph 7#a71 the ,secretary shall not take into consideration the availability of telehealth appointments from the ,department4 7#c7 ,in the case of a covered veteran who has had an appointment with a health care provider of the ,department canceled by the ,department for a reason other than either the request of the veteran or the failure of the veteran to appear as scheduled1 in calculating a wait time for a subsequent appointment under the eligibility access standards established under paragraph 7#a71 the ,secretary shall calculate such wait time from the date of the request for the original1 canceled appointment4 7#d7 ,if a veteran agrees to a longer average drive time or a later date under paragraph 7#a71 the ,secretary shall document the agreement to such longer average drive time or later date in the electronic health record of the veteran and provide the veteran a copy of such documentation4 ,such copy may be provided electronically4 7#e7 ,paragraph 7#a77;,c7 shall not be construed to affect a covered veteran in a covered treatment program pursuant to a determination made on or before the date of the enactment of the ,take ,care of ,america's ,veterans ,act4 7#f7 7,a7 ,subject to the provisions of this paragraph1 subparagraphs 7,a7 and 7,b7 of paragraph 7#a7 shall terminate on the date that is eight years after the date of the enactment of the ,take ,care of ,america's ,veterans ,act4 7,b7 ,not later than seven years after the date of the enactment of the ,take ,care of ,america's ,veterans ,act1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report containing-- 7i7 an assessment of the effects of the codification of eligibility access standards for primary care1 mental health care1 non-institutional extended care services1 and specialty care under this subsection on the management and oversight of the ,veterans ,community ,care ,program under section #agjc of this title2 and 7ii7 the recommendation of the ,secretary for continued codification of such standards along with a justification for such recommendation4 7,c7 ,on and after the date that is eight years after the date of the enactment of the ,take ,care of ,america's ,veterans ,act1 the ,secretary may not establish access standards for care and services described in subparagraph 7,a7 or 7,b7 of paragraph 7#a7 that are different from the standards set forth in those subparagraphs unless1 not later than #ahj days before establishing such different standards-- 7i7 the ,secretary submits to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives notification of the intent of the ,secretary to establish such different standards1 including a description of the changes the ,secretary intends to make and the justification for such changes2 and 7ii7 a joint resolution of approval is enacted that approves such different standards4 7,d7 ,for purposes of this subsection1 the term joint resolution of approval means only a joint resolution the matter after the resolving clause of which is as follows3 ,that ,congress approves the access standards established by the ,secretary submitted on relating to 41 with the first blank space filled by the appropriate date and the second blank space filled with a description of the access standards4 7,e7 ,a joint resolution of approval shall be considered under the expedited procedures outlined in section #hjb of title #e to the same extent as a joint resolution described in subsection 7a7 of that section is considered4 7b7 ,application ,the ,secretary shall ensure that the eligibility access standards established under subsection 7a7 apply-- 7#a7 to all care and services within the medical benefits package of the ,department to which a covered veteran is eligible under section #agjc of this title2 and 7#b7 to all covered veterans1 regardless of whether a veteran is a new or established patient4 7c7 ,periodic review of access standards 7#a7 ,not later than three years after the date of the enactment of the ,take ,care of ,america's ,veterans ,act1 and not less frequently than once every three years thereafter1 the ,secretary shall-- 7,a7 conduct a review of the eligibility access standards under subsection 7a7 in consultation with-- 7i7 such ,federal entities as the ,secretary considers appropriate1 including the ,department of ,defense1 the ,department of ,health and ,human ,services1 and the ,centers for ,medicare ,medicaid ,services2 7ii7 entities and individuals in the private sector1 including-- 7,i7 veteran patients2 7,,ii7 representatives of veterans1 including individual veterans and participants from veteran stakeholder organizations selected through an open and transparent process2 and 7,,iii7 health care providers participating in the ,veterans ,community ,care ,program under section #agjc of this title2 and 7iii7 other entities that are not part of the ,federal ,government2 and 7,b7 submit to the appropriate committees of ,congress a report on-- 7i7 the findings of the ,secretary with respect to the review conducted under paragraph 7#a72 and 7ii7 such recommendations as the ,secretary may have with respect to the eligibility access standards under subsection 7a74 7#b7 ,chapter #aj of title #e shall not apply to the consultation required by paragraph 7#a77;,a74 2 7#b7 by striking subsection 7g72 7#c7 by redesignating subsections 7f71 7h71 and 7i7 as subsections 7d71 7e71 and 7f71 respectively2 7#d7 in subsection 7d71 as redesignated by paragraph 7#c7-- 7,a7 by striking established each place it appears2 and 7,b7 in paragraph 7#a71 by striking 7#a7 ,subject to and inserting ,compliance by ,community ,care ,providers ,with ,access ,standards4--7#a7 ,subject to2 7#e7 in subsection 7e71 as so redesignated-- 7,a7 in paragraph 7#a7-- 7i7 by striking 7#a7 ,consistent with and inserting ,determination ,regarding ,eligibility4--7#a7 ,consistent with2 and 7ii7 by striking designated access standards established under this section and inserting eligibility access standards under subsection 7a72 and 7,b7 in paragraph 7#b77;,b71 by striking designated access standards established under this section and inserting eligibility access standards under subsection 7a72 and 7#f7 in subsection 7f71 as redesignated by paragraph 7#b7-- 7,a7 in the matter preceding paragraph 7#a71 by striking ,in this section and inserting ,definitions4--,in this section2 and 7,b7 in paragraph 7#b7-- 7i7 by striking covered veterans and inserting covered veteran2 7ii7 by striking veterans described and inserting a veteran described2 7iii7 by redesignating paragraphs 7#c7 and 7#d7 as paragraphs 7#d7 and 7#e71 respectively2 and 7iv7 by inserting after paragraph 7#b7 the following new paragraph 7#c73 7#c7 ,the term covered treatment program has the meaning given such term in section #agia of this title4 4 7b7 ,conforming amendments ,section #agjc7;d7 of such title is amended-- 7#a7 in paragraph 7#a77;,d71 by striking designated access standards developed by the ,secretary under section #agjc;,b of this title and inserting eligibility access standards under section #agjc;,b7a7 of this title2 7#b7 in paragraph 7#c71 by striking designated access standards developed by the ,secretary under section #agjc;,b of this title and inserting eligibility access standards under section #agjc;,b7a7 of this title2 and 7#c7 in paragraph 7#d71 by striking designated access standards developed by the ,secretary under section #agjc;,b of this title and inserting eligibility access standards under section #agjc;,b7a7 of this title4 #fjb4 ,requirement that ,secretary notify veterans of eligibility for care or denial of request for care under ,veterans ,community ,care ,program 7a7 ,in general ,section #agjc7;a7 of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new paragraph3 7#e7 7,a7 7i7 ,except as provided in clause 7iii71 the ,secretary shall notify each covered veteran in writing of the eligibility of such veteran for care or services under this section as soon as possible but not later than five days after the date on which the ,secretary is aware that the veteran is seeking care or services and is eligible for such care or services under this section4 7ii7 ,the ,secretary is required to notify a covered veteran under clause 7i7 only at the start of an episode of care for such veteran4 7iii7 ,the ,secretary shall allow a covered veteran to opt out of receiving notification under clause 7i74 7,b7 ,with respect to each covered veteran eligible for care or services under subsection 7d71 and consistent with subparagraph 7,a71 the ,secretary shall provide such veteran periodic reminders1 as applicable and as the ,secretary determines appropriate1 of their ongoing eligibility under such subsection4 7,c7 ,any notification or reminder under this paragraph may be provided electronically4 7#f7 7,a7 ,if a request by a veteran for the ,secretary to authorize care or services under this section is denied1 except as provided in subparagraph 7,c71 the ,secretary shall notify the veteran in writing as soon as possible but not later than five days after the denial is made-- 7i7 of the reason for the denial2 and 7ii7 with instructions on how to appeal such denial using the clinical appeals process of the ,veterans ,health ,administration4 7,b7 ,if a denial under subparagraph 7,a7 is due to the ,secretary meeting the eligibility access standards under section #agjc;,b7a7 of this title1 notice under such subparagraph shall include an explanation of how the ,secretary met such standards4 7,c7 ,the ,secretary shall allow a covered veteran to opt out of receiving notification under subparagraph 7,a74 7,d7 ,any notification under this paragraph may be provided electronically4 4 7b7 ,reports to ,congress ,not later than one year after the date of the enactment of this ,act1 and not less frequently than annually thereafter for a period of five years1 the ,secretary of ,veterans ,affairs shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report on the implementation of the amendments made by subsection 7a71 including-- 7#a7 an assessment of the timeliness of the notifications required by those amendments2 7#b7 a description of barriers to increasing the timeliness of those notifications2 and 7#c7 the number of veterans who opt out of receiving those notifications4 #fjc4 ,consideration under ,veterans ,community ,care ,program of continuity of care and need for caregiver or attendant ,section #agjc7;d7 of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in paragraph 7#b71 by adding at the end the following new subparagraphs3 7,f7 ,the potential for improved continuity of care1 including if a veteran has an established relationship with a non-,department provider and the likelihood of the covered veteran to seek and complete recommended care1 including if the veteran would abstain from seeking such care if required to seek such care at a facility of the ,department4 7,g7 ,whether the covered veteran needs an attendant to provide required aid or assistance to the veteran1 including for the veteran to travel to a facility of the ,department4 2 and 7#b7 by adding at the end the following new paragraph3 7#e7 ,the ,secretary shall ensure that consideration of the factors specified in paragraph 7#b7 includes consideration of all relevant factors1 is driven by clinical need1 and that no single factor is required to be determinative when considering the best medical interest of a covered veteran4 4 #fjd4 ,discussion of telehealth options under ,veterans ,community ,care ,program ,section #agjc of title #ch1 ,united ,states ,code1 is amended-- 7#a7 by redesignating subsection 7q7 as subsection 7r72 and 7#b7 by inserting after subsection 7p7 the following new subsection 7q73 7q7 ,discussion of options for telehealth 7#a7 ,when discussing options for care or services for a covered veteran under this section1 the ,secretary shall ensure that the veteran is informed of the ability of the veteran to seek care or services via telehealth1 either through a medical facility of the ,department or through a non-,department provider1 if-- 7,a7 telehealth is-- 7i7 available to the veteran2 7ii7 appropriate for the type of care or services the veteran is seeking1 as determined by the ,secretary2 and 7iii7 is acceptable to the veteran2 or 7,b7 the care or services the veteran is seeking is only or primarily available through telehealth4 7#b7 ,nothing in paragraph 7#a7 shall be construed to prohibit a health care provider specified in subsection 7c7 from furnishing hospital care1 medical services1 or extended care services under this section via telehealth4 4 #fje4 ,extension of deadline for submittal of claims by health care entities and providers under prompt payment standard ,section #agjc;,d of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in subsection 7a77#b71 by striking the reason for denying the claim and what1 if any1 additional information is required to process the claim and inserting the reason for denying the claim and request additional missing information1 if any1 that is required to process the claim2 7#b7 by amending subsection 7b7 to read as follows3 7b7 ,submittal of claims by health care entities and providers 7#a7 ,a health care entity or provider that furnishes hospital care1 a medical service1 or an extended care services under this chapter pursuant to a contract1 agreement1 or other arrangement shall submit to the ,secretary a claim for payment for furnishing the hospital care1 medical service1 or extended care service not later than one year after the date on which the entity or provider furnished the hospital care1 medical service1 or extended care service4 7#b7 ,no health care entity or provider may seek payment from a patient if the health care entity or provider failed to comply with the timely filing requirement set forth in paragraph 7#a74 2 and 7#c7 in subsection 7c71 by adding at the end the following new paragraph3 7#c7 7,a7 ,if the ,secretary determines1 based on reliable evidence1 that a health care entity or provider has submitted or caused to be submitted a fraudulent claim for payment under this chapter1 the ,secretary may suspend such entity or provider from furnishing hospital care1 medical services1 or extended care services under this chapter4 7,b7 ,before imposing a suspension under subparagraph 7,a7 with respect to an entity or provider1 the ,secretary shall-- 7i7 provide written notice to the entity or provider identifying the basis for the proposed suspension2 7ii7 afford the entity or provider an opportunity to respond within a period of #cj days2 and 7iii7 consider any evidence or explanation submitted by the entity or provider4 7,c7 7i7 ,the ,secretary shall take all necessary actions to resolve a suspension under subparagraph 7,a7 as soon as possible but not longer than within one year of the date of the beginning of the suspension1 unless the ,secretary determines and provides a written determination that an extension beyond one year is strictly necessary to protect the interests of veterans and taxpayers and to preserve the integrity of the health care delivery system of the ,department4 7ii7 ,any extension under clause 7i7 of a suspension shall-- 7,i7 be for an additional period of not longer than one year2 and 7,,ii7 shall be reported to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives4 7,d7 ,the ,secretary shall establish procedures for reinstatement of an entity or provider suspended under subparagraph 7,a7 following the resolution of any fraud-related investigation or proceeding4 7,e7 ,the ,secretary shall coordinate actions under this paragraph with the ,office of ,inspector ,general of the ,department4 7,f7 ,the ,secretary shall prescribe regulations to carry out this paragraph1 including standards of evidence1 notice1 and appeal procedures4 7,g7 7i7 ,not less frequently than quarterly1 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 written notification of the suspensions entered into1 if any1 during the preceding quarter that includes-- 7,i7 the identity of the suspended entity or provider2 7,,ii7 the statutory or regulatory basis for the suspension2 7,,iii7 a summary of the factual findings or evidence supporting the action2 and 7,,iv7 the status of any related investigation of or referral to the ,office of ,inspector ,general of the ,department or any other appropriate ,federal agency4 7ii7 ,the ,secretary shall provide to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives1 upon request1 all records1 memoranda1 and communications relevant to any suspension or reinstatement action taken under this paragraph1 in accordance with applicable laws related to privacy1 ongoing investigations1 or sensitive law enforcement information4 7iii7 ,failure by the ,secretary to provide notice under clause 7i7 shall be treated as a failure to comply with a statutory reporting requirement4 4 #fjf4 ,audit of representative sample of veterans receiving care and services under ,veterans ,community ,care ,program ,not later than one year after the date of the enactment of this ,act1 and not less frequently than annually thereafter for the following five years1 the ,secretary of ,veterans ,affairs shall-- 7#a7 conduct an audit1 for the one-year period preceding the audit1 of-- 7,a7 the number of veterans eligible for care or services under section #agjc of title #ch1 ,united ,states ,code1 and the reasons for such eligibility1 including multiple such reasons for veterans eligible under more than one eligibility criteria2 7,b7 of those veterans eligible for care or services under section #agjc of title #ch1 ,united ,states ,code1 the number of veterans who are informed of such eligibility2 7,c7 the number of veterans who opt to seek care or services under such section2 7,d7 the number of veterans who do not opt to seek care or services under such section2 7,e7 the timeliness of referrals for care or services under such section and the timeliness of receipt of such care or services1 including whether care or services received by the veteran through a non-,department of ,veterans ,affairs provider had a shorter wait time than the average wait time for such care or services at a facility of the ,department2 7,f7 the number of requests for an appeal of a denial of care or services under such section using the clinical appeals process of the ,veterans ,health ,administration2 7,g7 the timeliness of each such appeal2 and 7,h7 the outcome of each such appeal2 and 7#b7 submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report on the audit conducted under paragraph 7#a74 #fjg4 ,information on wait time and drive time options for receipt of care by veterans 7a7 ,in general ,to the greatest extent practicable1 the ,secretary of ,veterans ,affairs shall ensure that veterans are informed in writing1 for each episode of care provided under the laws administered by the ,secretary1 of current wait time and average drive time options for such episode of care disaggregated by care provided-- 7#a7 in person at a facility of the ,department of ,veterans ,affairs2 7#b7 via telehealth through a provider of the ,department4 7#c7 in person through the nearest suitable non-,department facility with which the ,department has a provider agreement or other arrangement for non-,department care pursuant to section #agjc of title #ch1 ,united ,states ,code2 and 7#d7 via telehealth through a non-,department provider with which the ,department has a provider agreement or other arrangement for non-,department care pursuant to such section with the shortest wait time4 7b7 ,form of information ,information provided under subsection 7a7-- 7#a7 may be provided electronically2 and 7#b7 shall be documented in the health record of the veteran4 7c7 ,opt out ,the ,secretary shall permit a veteran to opt out of receiving information under subsection 7a74 #fjh4 ,establishment of period during which a referral under ,veterans ,community ,care ,program remains valid ,section #agjc7;a7 of title #ch1 ,united ,states ,code1 as amended by section #fjb7;a71 is further amended by adding at the end the following new paragraph3 7#g7 ,when authorizing care or services under this section1 the ,secretary shall ensure that the period during which such care or services may be performed by a health care provider specified in subsection 7c7 begins on the date that the covered veteran has the first appointment with such provider4 4 #fji4 ,updates to contracting requirements under ,veterans ,community ,care ,program ,section #agjc7;h7 of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in paragraph 7#c7-- 7,a7 by amending subparagraph 7,a7 to read as follows3 7,a7 ,the ,secretary may terminate a contract with an entity entered into under paragraph 7#a7 at such time and upon such notice to the entity as the ,secretary may specify for purposes of this section1 if the ,secretary notifies the appropriate committees of ,congress that1 at a minimum-- 7i7 the entity failed to comply substantially with the provisions of the contract or with the provisions of this section and the regulations prescribed under this section1 including with respect to access1 quality1 training1 and medical documentation2 7ii7 it is reasonable to terminate the contract based on the health care needs of veterans2 or 7iii7 it is reasonable to terminate the contract based on coverage provided by contracts or sharing agreements entered into under authorities other than this section4 2 7,b7 by redesignating subparagraph 7,b7 as subparagraph 7,d72 7,c7 by inserting after subparagraph 7,a7 the following new subparagraphs3 7,b7 7i7 ,the ,secretary shall terminate a contract with an entity entered into under paragraph 7#a7 at such a time and upon such notice to the entity as the ,secretary may specify for the purposes of this section1 if the entity-- 7,i7 is excluded from participation in a ,federal health care program 7as defined in section #aabh;,b7f7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g;b7f777 under section #aabh or #aabh;,a of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g and #acbj;a-#g;a72 7,,ii7 has been convicted of a felony or other serious offense under ,federal or ,state law and the continued participation of the entity would be detrimental to the best interests of veterans or the ,department2 or 7,,iii7 is identified as an excluded source on the list maintained in the ,system for ,award ,management1 or any successor system4 7ii7 ,the ,secretary may issue a waiver for entities subject to clause 7i7 for a one-year period1 and such a waiver shall be reported to ,congress not later than #cj days after such waiver is issued4 7,c7 ,any entities ineligible to enter into contracts with the ,department due to one or more reasons specified in this paragraph may be listed on a publicly available website of the ,department or appropriate third party administrator4 2 7,d7 in subparagraph 7,d71 as redesignated by subparagraph 7,b7 of this paragraph1 by striking in subparagraph 7,a7 and inserting in this paragraph2 and 7#b7 by adding at the end the following new paragraph3 7#g7 ,any contract or agreement between the ,department and a third party administrator or between a third party administrator and a health care provider specified in subsection 7c7 that is made with respect to care or services provided under this section shall include-- 7,a7 notice of obligations to comply with ,federal laws and the consequences for failure to comply with those laws1 including specific information regarding claims for payment and consequences for any false claims1 statements1 or documents1 or concealment of a material fact2 7,b7 confirmation by the health care provider that they are accredited to provide any specialized services subject to the contract or agreement and that they will only use qualified staff to provide those services2 and 7,c7 confirmation that the health care provider will identify any individuals providing specialized services or treatments included in the contract or agreement and provide proof of the licensure of those individuals to the ,department4 4 #faj4 ,publication of community care network sufficiency and payment waiver requests and approvals ,not later than one year after the date of the enactment of this ,act1 and not less frequently than annually thereafter1 the ,secretary of ,veterans ,affairs shall publish on a publicly available and user-friendly website-- 7#a7 the information contained in the most recent report required by section #agjc7p7 of title #ch1 ,united ,states ,code2 and 7#b7 an overview1 disaggregated by region1 of the waivers requested1 approved1 and denied under section #agjc;,b7f77#c7 of such title4 #faa4 ,requirements relating to quality of community care providers 7a7 ,monthly checks against list of excluded individuals or entities ,the ,secretary of ,veterans ,affairs shall ensure that third party administrators under the ,veterans ,community ,care ,program perform automated monthly checks for all community care providers against the list of excluded individuals or entities set forth by the ,office of ,inspector ,general of the ,department of ,health and ,human ,services using national provider identifier records or other unique identifiers4 7b7 ,revision of provider exclusion standard operating procedures ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary shall ensure that the ,office of ,integrated ,veteran ,care or successor office revises its provider exclusion standard operating procedures to require automated matching of community care providers in the provider profile management system of the ,department of ,veterans ,affairs to the system for award management exclusions of the ,general ,services ,administration using both taxpayer identification number and national provider identifier as identifiers4 7c7 ,process to identify department providers terminated or resigning from employment ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary shall ensure that the ,under ,secretary for ,health of the ,department of ,veterans ,affairs develops a process to identify health care providers that are terminated1 retire1 or resign from employment with the ,department for quality of care concerns or while under investigation for quality of care concerns so those health care providers can be prevented from participating in the ,veterans ,community ,care ,program4 7d7 ,update of information on providers ,not later than one year after the date of the enactment of this ,act1 the ,secretary1 through the ,office of ,integrated ,veteran ,care or successor office1 shall develop a process to ensure that third party administrators regularly1 not less frequently than quarterly-- 7#a7 update their lists of community care providers to reflect accurate provider contact information2 7#b7 annotate providers that are not currently accepting patients under the ,veterans ,community ,care ,program2 and 7#c7 remove providers from the provider profile management system that-- 7,a7 are on the list of excluded individuals or entities set forth by the ,office of ,inspector ,general of the ,department of ,health and ,human ,services2 7,b7 are in the system for award management exclusions of the ,general ,services ,administration2 or 7,c7 have been terminated from employment with the ,department of ,veterans ,affairs due to quality of care concerns or left such employment voluntarily1 through resignation1 or through retirement1 while under investigation for quality of care concerns4 7e7 ,definitions ,in this section3 7#a7 ,community care provider ,the term community care provider means a health care provider specified under section #agjc7;c7 of title #ch1 ,united ,states ,code4 7#b7 ,veterans ,community ,care ,program ,the term ,veterans ,community ,care ,program means the ,veterans ,community ,care ,program under section #agjc of title #ch1 ,united ,states ,code4 #fab4 ,provider training 7a7 ,development of plan ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall develop a comprehensive plan to better align training and incentive requirements applicable to community care providers participating in the ,veterans ,community ,care ,program and health care providers1 residents1 and trainees of the ,department of ,veterans ,affairs4 7b7 ,elements ,the plan required under subsection 7a7 shall-- 7#a7 identify existing training requirements or incentives applicable to health care providers of the ,department2 7#b7 identify existing training requirements or incentives applicable to health care trainees or residents of the ,department2 7#c7 identify existing training requirements or incentives applicable to community care providers2 7#d7 assess gaps between training requirements and incentives for health care providers of the ,department1 trainees or residents of the ,department1 and community care providers2 7#e7 establish standardized baseline training requirements to ensure consistency in the quality of care furnished through the ,department from health care providers of the ,department1 trainees or residents of the ,department1 and community care providers2 and 7#f7 provide a strategy1 assessment of barriers1 and timeline for implementing such baseline training requirements1 including-- 7,a7 through online modules and continuing medical education programs2 and 7,b7 within such strategy-- 7i7 metrics to measure the effectiveness of baseline training requirements in improving clinical quality1 satisfaction of veterans1 and health outcomes for veterans2 7ii7 a mechanism to account for non-,department training that is equivalent or substantially similar to the ,department training in length1 scope1 and content1 as determined by the ,secretary2 7iii7 a mechanism to regularly communicate1 including through direct outreach and publication online and in provider handbooks of third party administrators under the ,veterans ,community ,care ,program1 requirements and expectations with respect to training2 7iv7 a mechanism to track1 report1 and address non-compliance1 to include corrective actions1 which may include suspending or barring providers who are routinely non-compliant2 and 7v7 a mechanism to designate community care providers who routinely meet or exceed baseline training requirements as preferred providers or part of the high performing provider program of the ,department1 as the ,secretary considers appropriate4 7c7 ,implementation ,not later than one year after submission of the report required under subsection 7d71 the ,secretary shall begin implementing the plan required under subsection 7a74 7d7 ,report to ,congress ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report containing-- 7#a7 the plan required under subsection 7a72 7#b7 a description of identified gaps between training or incentives for providers of the ,department1 trainees or residents of the ,department1 and community care providers2 7#c7 the estimated costs associated with implementation of the plan2 and 7#d7 a description of any legislative or regulatory changes necessary to carry out the plan4 7e7 ,annual updates ,not later than one year after the submission of the report required by subsection 7d71 and annually thereafter for the following two years1 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-- 7#a7 describing progress in implementing the plan required under subsection 7a72 7#b7 assessing any measurable impacts of such implementation on quality of care2 and 7#c7 assessing any improvements in rates of compliance with training requirements among health care providers1 trainees1 and residents of the ,department and community care providers4 7f7 ,definitions ,in this section3 7#a7 ,community care provider ,the term community care provider means a health care provider specified under section #agjc7;c7 of title #ch1 ,united ,states ,code4 7#b7 ,training ,the term training includes training relating to-- 7,a7 veteran-specific cultural competency2 7,b7 health conditions related to military service1 including toxic exposures1 post-traumatic stress disorder1 traumatic brain injury1 and military sexual trauma2 7,c7 suicide prevention2 7,d7 pain management and opioid safety2 and 7,e7 any other matter the ,secretary determines appropriate4 7#c7 ,veterans ,community ,care ,program ,the term ,veterans ,community ,care ,program means the ,veterans ,community ,care ,program under section #agjc of title #ch1 ,united ,states ,code4 #fac4 ,oversight authority over community care 7a7 ,in general ,the ,secretary of ,veterans ,affairs shall include in each contract or agreement used to provide care or services through the ,veterans ,community ,care ,program provisions requiring the contractor and any subcontractor or participating provider to provide government officials1 including the ,office of the ,inspector ,general of the ,department of ,veterans ,affairs1 access1 within a reasonable time and manner1 to records1 materials1 documents1 data1 and personnel necessary to conduct audits1 inspections1 evaluations1 or investigations related to such care or services4 7b7 ,third party administrators 7#a7 ,requirement ,the ,secretary shall require third party administrators under the ,veterans ,community ,care ,program to include provisions in agreements with participating providers that are equivalent to the provisions required under subsection 7a74 7#b7 ,notification ,notification of the requirements under this section and any other related information as the ,secretary determines appropriate shall be included in the provider handbooks of third party administrators under the ,veterans ,community ,care ,program4 7c7 ,standard contract language ,the ,secretary shall establish standard contract language under this section in consultation with the ,inspector ,general of the ,department of ,veterans ,affairs4 7d7 ,veterans ,community ,care ,program defined ,in this section1 the term ,veterans ,community ,care ,program means the ,veterans ,community ,care ,program under section #agjc of title #ch1 ,united ,states ,code4 ,b ,mental ,health ,treatment ,programs #fba4 ,veteran participation in certain mental health programs 7a7 ,establishment ,chapter #ag of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new subchapter3 ,,ix ,participation by ,veterans in ,certain ,mental ,health ,treatment ,programs #agia4 ,definitions ,in this subchapter3 7#a7 ,activities of daily living ,the term activities of daily living means specific personal care activities that are required for basic daily maintenance and sustenance1 to include eating1 toileting1 bathing1 grooming1 dressing and undressing1 and mobility4 7#b7 ,covered treatment program 7,a7 ,in general ,the term covered treatment program-- 7i7 means-- 7,i7 a mental health residential rehabilitation treatment program of the ,department2 or 7,,ii7 a program of the ,department for residential care for mental health and substance use disorders2 7ii7 includes-- 7,i7 the programs designated as of the date of the enactment of the ,take ,care of ,america's ,veterans ,act as domiciliary residential rehabilitation treatment programs2 and 7,,ii7 any programs designated as domiciliary residential rehabilitation treatment programs on or after such date of enactment2 and 7iii7 does not include-- 7,i7 ,compensated ,work ,therapy ,transition ,residence programs of the ,department2 or 7,,ii7 ,department or non-,department programs in which more than #bj percent of the care provided is provided through telehealth4 7,b7 ,accreditation ,a program described in subparagraph 7,a7 must maintain accreditation by the ,commission on ,accreditation of ,rehabilitation ,facilities and the ,joint ,commission4 7#c7 ,covered veteran ,the term covered veteran means a veteran described in section #agjc7;b7 of this title4 7#d7 ,evidence-based treatment ,the term evidence-based treatment means treatment provided in accordance with the ,department of ,veterans ,affairs_/,department of ,defense ,clinical ,practice ,guidelines for ,mental ,health and ,substance ,use ,disorder1 or any successor similar guidelines4 7#e7 ,social support systems ,the term social support systems1 with respect to a covered veteran-- 7,a7 means-- 7i7 a member of the family of the covered veteran1 including a parent1 spouse1 child1 step-family member1 or extended family member2 or 7ii7 an individual who lives with the veteran but is not a member of the family of the veteran2 and 7,b7 does not include a facility-organized peer support program4 #agib4 ,standardized process to determine eligibility of covered veterans for participation in certain mental health treatment programs 7a7 ,standardized screening process ,not later than one year after the date of the enactment of the ,take ,care of ,america's ,veterans ,act1 the ,secretary shall establish a standardized screening process to determine1 based on clinical need1 whether a covered veteran satisfies criteria for priority or routine admission to a covered treatment program4 7b7 ,eligibility criteria for priority admission 7#a7 ,in general ,under the standardized screening process required by subsection 7a71 a covered veteran shall be eligible for priority admission to a covered treatment program if the covered veteran meets criteria established by the ,secretary that shall include any of the following3 7,a7 ,a clinical assessment of the symptoms of the veteran1 including symptoms that-- 7i7 significantly affect activities of daily life2 and 7ii7 increase the risk of adverse outcomes1 such as overdose1 suicide1 self-harm1 or an unsafe living situation4 7,b7 ,the lack of availability and applicability of other treatment options4 7,c7 ,whether the veteran has a recent suicide or overdose attempt4 7,d7 ,whether the veteran is determined to be a high risk for suicide or overdose4 7,e7 ,whether the veteran has a demonstrated history of non-responsiveness1 relapse1 or inability to find recovery from two other completed courses of treatment1 such as outpatient or intensive outpatient treatment1 through a program that-- 7i7 is licensed by a ,state2 7ii7 is accredited by the ,commission on ,accreditation of ,rehabilitation ,facilities or the ,joint ,commission2 and 7iii7 provides evidence-based treatment4 7,f7 ,such other criteria as the ,secretary determines appropriate1 in consultation with ,congress4 7#b7 ,consideration ,in making a determination that a covered veteran meets criteria established by the ,secretary under paragraph 7#a7 for priority admission to a covered treatment program1 the ,secretary shall-- 7,a7 consider any referral of a health care provider of a covered veteran2 and 7,b7 ensure that consideration of such criteria includes consideration of all relevant factors1 is driven by clinical need1 and that no single factor is required to be determinative when considering the best medical interest of a covered veteran4 7#c7 ,provision of higher-level care ,the ,secretary shall provide immediate and clinically necessary care under other authorities available to the ,secretary to any covered veteran who is not clinically recommended for admission to a covered treatment program based on the need for a higher level of care1 such as being at a high acute risk for suicide4 7c7 ,screening for traumatic brain injury ,under the standardized screening process required by subsection 7a71 the ,secretary shall ensure a covered veteran is screened at an appropriate time for potential mild1 moderate1 or severe traumatic brain injury4 7d7 ,considerations ,in making placement decisions in a covered treatment program for veterans who meet criteria for priority or routine admission1 the ,secretary shall-- 7#a7 consider the input of the covered veteran with respect to the-- 7,a7 program specialty1 subtype1 and treatment track offered to the covered veteran2 and 7,b7 geographic placement of the covered veteran1 including proximity to the current residence1 time zone1 or geographic region of the covered veteran2 7#b7 maximize the proximity of the covered veteran to social support systems2 and 7#c7 to the greatest extent practicable1 place the veteran in a covered treatment program located within the same time zone and geographic region as the residence of the veteran at the time of admission4 7e7 ,conditions under which care shall be furnished through non-,department providers 7#a7 ,priority admission ,if the ,secretary determines a covered veteran is eligible for priority admission to a covered treatment program pursuant to the standardized screening process required by subsection 7a7 and the ,secretary is unable to admit such covered veteran to a covered treatment program at a facility of the ,department in a manner that complies with the requirements under subsection 7d7 and section #agjc;,b7a77#a77;,c7 of this title1 the ,secretary shall offer the covered veteran the option to receive care at a non-,department facility that-- 7,a7 can admit the covered veteran within the period required by section #agjc;,b7a77#a77;,c77ii77,i7 of this title2 7,b7 is party to a contract or agreement with the ,department or enters into such a contract or agreement under which the ,department furnishes a program that is equivalent to a covered treatment program to a veteran through such non-,department facility2 7,c7 is licensed by a ,state2 7,d7 is accredited by the ,commission on ,accreditation of ,rehabilitation ,facilities or the ,joint ,commission2 and 7,e7 provides evidence-based treatment4 7#b7 ,routine admission ,if the ,secretary determines a covered veteran is eligible for routine admission to a covered treatment program pursuant to the standardized screening process required by subsection 7a7 and the ,secretary is unable to admit such covered veteran to a covered treatment program at a facility of the ,department in a manner that complies with the requirements under section #agjc;,b7a77#a77;,c7 of this title with respect to routine admission1 the ,secretary shall offer the covered veteran the option to receive care at a non-,department facility that-- 7,a7 is party to a contract or agreement with the ,department or enters into such a contract or agreement under which the ,department furnishes a program that is equivalent to a covered treatment program to a veteran through such non-,department facility2 7,b7 is licensed by a ,state2 7,c7 is accredited by the ,commission on ,accreditation of ,rehabilitation ,facilities or the ,joint ,commission2 and 7,d7 provides evidence-based treatment4 7#c7 ,rule of construction ,this subsection shall not be construed to affect a covered veteran in a covered treatment program pursuant to a determination made on or before the date of the ,take ,care of ,america's ,veterans ,act4 #agic4 ,improvements to ,department of ,veterans ,affairs mental health residential rehabilitation treatment program 7a7 ,performance metrics 7#a7 ,in general ,the ,secretary shall develop metrics to track1 and shall subsequently track1 the performance of medical facilities of the ,department1 ,veterans ,integrated ,service ,networks1 and non-,department facilities in meeting the requirements for-- 7,a7 screening1 under section #agib of this title1 for a covered treatment program2 7,b7 timely admission1 under section #agib of this title1 to a covered treatment program pursuant to such screening2 and 7,c7 adherence to evidence-based treatment standards developed by the ,secretary in consultation with appropriate governmental and non-governmental professional organizations with a demonstrated history of providing or accrediting programs that are substantially similar to covered treatment programs1 or made of professionals who provide for such programs1 including by-- 7i7 using placement criteria established by the ,american ,society of ,addiction ,medicine2 and 7ii7 maintaining standards to meet accreditation by the ,commission on ,accreditation of ,rehabilitation ,facilities or the ,joint ,commission4 7#b7 ,elements ,the metrics developed under paragraph 7#a7 shall include metrics for tracking the performance of medical facilities of the ,department1 ,veterans ,integrated ,service ,networks1 and non-,department facilities with respect to routine and priority admission under a covered treatment program as well as adherence to evidence-based treatment standards4 7#c7 ,consultation ,in developing metrics under paragraph 7#a71 the ,secretary shall consult with mental health and substance use disorder providers1 including providers employed by the ,department and those employed by non-,department entities1 and ensure adherence to industry standards4 7#d7 ,report ,not later than one year after the date of the enactment of the ,take ,care of ,america's ,veterans ,act1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house a report describing the consultation and performance metrics required under this subsection4 7b7 ,oversight 7#a7 ,in general ,the ,secretary shall develop a process for systematically assessing at the facility1 network1 and regional level1 as the ,secretary considers appropriate1 the quality of care delivered by facilities of the ,department and non-,department facilities treating covered veterans under this section as well as a process for rectifying any identified concerns4 7#b7 ,elements ,the processes required under paragraph 7#a7 shall include assessments of-- 7,a7 the extent to which providers at the facility deliver evidence-based treatments to covered veterans2 7,b7 clinical outcomes for covered veterans1 including those outcomes assessment pursuant to a subsequent clinical screening under subsection 7g77#c77;,e72 7,c7 the ratio of licensed independent practitioners per resident2 7,d7 the rate of completion of training under section #agie of this title by licensed independent practitioners2 7,e7 whether non-,department facilities and providers generally meet the criteria outlined in section #agib7;e7 of this title2 7,f7 the timeliness1 completeness1 and rate of transmission1 if applicable1 of medical records during and following treatment of covered veterans2 and 7,g7 potentially wasteful1 fraudulent1 or inappropriate referral or billing practices4 7#c7 ,consultation ,in developing the processes required under paragraph 7#a71 the ,secretary shall consult with relevant stakeholders1 including mental health and substance use disorder providers employed by the ,department and those employed by non-,department entities1 and ensure adherence to industry standards4 7#d7 ,report ,not later than one year after the date of the enactment of the ,take ,care of ,america's ,veterans ,act1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house a report describing the consultation and oversight processes required by this subsection4 7c7 ,placement2 transportation 7#a7 ,locations ,if the ,secretary determines that a covered veteran is in need of residential care under a covered treatment program1 the ,secretary shall provide to the covered veteran a list of locations at which such covered veteran can receive such residential care that meets-- 7,a7 the standards for screening under section #agib of this title2 and 7,b7 the care needs of the covered veteran1 including applicable treatment tracks4 7#b7 ,transportation coverage 7,a7 ,in general ,notwithstanding any other provision of law regarding the transportation of individuals under this title1 or any other law administered by the ,secretary1 and except as provided in subparagraph 7,b71 the ,secretary shall provide transportation1 pay for1 or reimburse the costs of transportation for any covered veteran who is admitted into a covered treatment program and needs transportation assistance-- 7i7 from the residence of the covered veteran or a facility of the ,department or authorized non-,department facility that does not provide such care to another ,department or non-,department facility that provides residential care covered under a covered treatment program2 and 7ii7 back to the residence of the covered veteran or to a facility of the ,department or an authorized non-,department facility after the conclusion of a covered treatment program1 if applicable4 7,b7 ,limitations 7i7 ,costs incurred by veterans ,the ,secretary shall provide reimbursement under subparagraph 7,a7 directly to a covered veteran only for costs directly incurred by the covered veteran and pre-approved by the ,department4 7ii7 ,no coverage of transportation provided by covered treatment program ,the ,secretary shall not reimburse a covered veteran for transportation provided to the covered veteran by a covered treatment program1 unless for a purpose and amount approved by the ,secretary4 7d7 ,appeals 7#a7 ,in general ,the ,secretary shall develop a national policy and associated procedures1 in accordance with the existing clinical appeals process of the ,veterans ,health ,administration1 under which a covered veteran1 a representative of a covered veteran1 or a provider who requests a covered veteran be admitted to a covered treatment program1 including a provider of the ,department or a non-,department provider1 may file a clinical appeal pursuant to this subsection if the covered veteran is-- 7,a7 denied admission into a covered treatment program2 or 7,b7 accepted into a covered treatment program but is not offered bed placement in a timely manner4 7#b7 ,timeliness standards for review 7,a7 ,in general ,the national policy and procedures developed under paragraph 7#a7 for appeals described in such paragraph shall include timeliness standards for the ,department to review and make a decision on such an appeal4 7,b7 ,decision ,the ,secretary shall review and respond to any appeal under paragraph 7#a7 not later than #gb hours after the ,secretary receives such appeal4 7#c7 ,public guidance ,the ,secretary shall develop1 and make available to the public1 guidance on how a covered veteran1 a representative of the covered veteran1 or a provider of the covered veteran can file a clinical appeal pursuant to this subsection-- 7,a7 if the covered veteran is denied admission into a covered treatment program2 7,b7 if the first date on which the covered veteran may enter a covered treatment program does not comply with the eligibility access standards under section #agjc;,b7a7 of this title for care at a covered treatment program2 or 7,c7 with respect to such other factors as the ,secretary may specify4 7#d7 ,rule of construction ,nothing in this subsection may be construed as granting a covered veteran1 a representative of a covered veteran1 or a provider who requests a covered veteran be admitted to a covered treatment program1 including a provider of the ,department or a non-,department provider1 the right to appeal a decision of the ,secretary with respect to admission to a covered treatment program to the ,board of ,veterans' ,appeals under chapter #ga of this title4 7e7 ,tracking of availability and wait times 7#a7 ,in general ,the ,secretary1 to the extent practicable1 shall create a method for tracking availability and wait times under a covered treatment program across all facilities of the ,department1 ,veterans ,integrated ,service ,networks1 and non-,department providers throughout the ,united ,states4 7#b7 ,availability of information ,the ,secretary shall make the information tracked under paragraph 7#a7 available1 in real time to-- 7,a7 the mental health treatment coordinators at each facility of the ,department2 7,b7 the leadership of each medical center of the ,department2 7,c7 the leadership of each ,veterans ,integrated ,service ,network2 and 7,d7 the ,office of the ,under ,secretary for ,health of the ,department4 7#c7 ,publication of information ,not less frequently than monthly1 the ,secretary shall publish the information tracked under paragraph 7#a7 on a publicly accessible website of the ,department4 7f7 ,staffing matters 7#a7 ,training 7,a7 ,in general ,the ,secretary shall update and implement training for staff of the ,department directly involved in a covered treatment program regarding referrals1 screening1 admission1 placement decisions1 and appeals for such program1 including all changes to processes and guidance under such program required by this section and section #agib4 7,b7 ,covered veterans awaiting admission ,the training under subparagraph 7,a7 shall include procedures for the care of covered veterans awaiting admission into a covered treatment program and communication with such covered veterans and the providers of such covered veterans4 7,c7 ,timing of training 7i7 ,in general ,the ,secretary shall require the training under subparagraph 7,a7 to be completed by staff required to complete such training-- 7,i7 not later than #fj days after beginning employment at the ,department in a position that includes work directly involving a covered treatment program2 and 7,,ii7 not less frequently than annually4 7ii7 ,tracking ,the ,secretary shall track completion of training required under clause 7i7 by staff required to complete such training4 7#b7 ,oversight standards ,the ,secretary shall review and revise oversight standards for the leadership of the ,veterans ,integrated ,service ,networks and the ,veterans ,health ,administration to ensure that facilities and staff of the ,department are adhering to the policy on access to care of each covered treatment program4 7#c7 ,staff coverage ,the ,secretary shall not require staff of a covered treatment program to act as coverage for any other team1 service1 or project unrelated to the covered treatment program for a period of greater than three days per month unless such coverage is for purposes of the fourth mission of the ,department or under an emergency declaration4 7g7 ,care coordination and follow-up care 7#a7 ,continuity of care ,the ,secretary shall ensure each covered veteran who is screened for admission to a covered treatment program is offered1 and provided if agreed upon1 care options during the period between screening of the covered veteran and admission of the covered veteran to such program to ensure the covered veteran does not experience any lapse in care4 7#b7 ,care coordination for substance use disorder ,for a covered veteran being treated for substance use disorder1 the ,secretary shall-- 7,a7 ensure there is a care plan in place during the period between any detoxification services or inpatient care received by the covered veteran and admission of the covered veteran to a covered treatment program2 and 7,b7 communicate that care plan to the covered veteran1 the primary care provider of the covered veteran1 and the facility where the covered veteran is or will be residing under such program4 7#c7 ,care planning and clinical screening 7,a7 ,in general ,a covered treatment program1 in consultation with the covered veteran and the treating providers of the covered veteran in the covered treatment program1 shall ensure the completion of a care plan and a clinical screening upon admittance to the covered treatment program and prior to discharge from the covered treatment program1 which shall include an assessment of1 with respect to the covered veteran-- 7i7 overall mental health2 7ii7 risk for suicide2 7iii7 risk for overdose2 7iv7 housing insecurity2 7v7 food insecurity2 7vi7 employment2 7vii7 complex medical needs and diagnoses2 and 7viii7 any other factors the ,secretary determines necessary4 7,b7 ,matters to be included ,the care plan required under subparagraph 7,a7 for a covered veteran shall include details on the course of treatment for the covered veteran following completion of treatment under the covered treatment program1 including recommended length of stay and any necessary follow-up care and the results of any screening conducted under such subparagraph4 7,c7 ,length of stay 7i7 ,in general ,covered treatment programs at non-,department facilities shall submit the care plan under subparagraph 7,a7 for a covered veteran1 including the requested or recommended length of stay for the covered veteran1 to the ,department not later than #gb hours after the veteran is admitted to the covered treatment program4 7ii7 ,approval required ,any length of stay of a covered veteran at a covered treatment program longer than #cj days or extensions of length of stay greater than a total of #cj days shall require approval by the ,secretary4 ,the ,secretary shall respond to any such requests for approval within #gb hours4 ,any such requests that have not received a response within #gb hours shall be automatically approved on a daily basis until the ,secretary responds4 7,d7 ,sharing of care plan ,the care plan required under subparagraph 7,a7 shall be shared with the covered veteran1 the primary care provider of the covered veteran1 and any other providers with which the covered veteran consents to sharing the plan4 7,e7 ,discharge from non-,department facility ,upon discharge of a covered veteran under a covered treatment program from a non-,department facility1 and not later than #cj days after discharge1 the facility shall share with the ,department all care records maintained by the facility with respect to the covered veteran and shall work in consultation with the ,department on the care plan of the covered veteran required under subparagraph 7,a74 7,f7 ,subsequent clinical screening ,not later than #ahj days after the end of treatment of a covered veteran in a covered treatment program1 the covered treatment program or a ,department or non-,department provider shall conduct a subsequent clinical screening1 which shall include an assessment of the factors specified in clauses 7i7 through 7viii7 of subparagraph 7,a7 and recommendations for follow-up care as the ,secretary considers appropriate4 7,g7 ,complex medical needs ,before1 during1 and after treatment in a covered treatment program1 the ,secretary shall provide greater engagement1 coordination1 and monitoring of care for covered veterans with-- 7i7 complex medical diagnoses1 including diagnoses of dementia1 spinal cord injury or disorder1 epilepsy1 ,parkinson's1 anemia1 severe mental illness1 multiple sclerosis1 incontinence of the bladder or bowel1 mobility limitations1 or impaired vision2 or 7ii7 complex medical needs1 including chemotherapy or other oncology care1 dialysis1 recurring blood transfusions1 or physical or occupational therapy4 7h7 ,data collection ,the ,secretary shall consult with the ,office of ,research and ,development of the ,department1 or any successor office1 regarding any data the ,department should consider requesting or requiring from non-,department facilities to assist with research studies and projects in which the ,department is participating relating to mental health residential rehabilitation treatment programs4 7i7 ,reports to ,congress 7#a7 ,report on modifications to programs 7,a7 ,in general ,not later than two years after the date of the enactment of the ,take ,care of ,america's ,veterans ,act1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report on modifications made to the guidance1 operation1 and oversight of covered treatment programs to fulfill the requirements of this section4 7,b7 ,elements ,the report required by subparagraph 7,a7 shall include-- 7i7 an assessment of whether costs of covered treatment programs1 including for residential care provided through facilities of the ,department and non-,department facilities1 serve as a disincentive to placement in the such a program2 7ii7 a description of actions taken by the ,department to address the findings and recommendations by the ,secretary contained in the report under section #ejc7;c7 of the ,,strong ,veterans ,act of #bjbb 7division ,v of ,public ,law #aag-cbh2 #acf ,stat4 #eeae71 including-- 7,i7 such actions with respect to-- 7aa7 any new locations added for covered treatment programs2 7bb7 any beds added at existing facilities of such programs2 and 7cc7 any additional treatment tracks or sex-specific programs created or added at facilities of the ,department2 and 7,,ii7 a breakdown of the number and percentage of covered veterans who are determined eligible for priority placement into a covered treatment program and the number and percentage of covered veterans who are determined eligible for routine placement into a covered treatment program2 and 7iii7 such recommendations as the ,secretary may have for legislative or administrative action to address any funding constraints or disincentives for use of a covered treatment program4 7#b7 ,annual report on operation of programs 7,a7 ,in general ,not later than one year after the submission of the report under paragraph 7#a71 and not less frequently than annually thereafter for the following five years1 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 operation of covered treatment programs4 7,b7 ,elements ,subject to subparagraph 7,c71 each report required by subparagraph 7,a7 shall include the following3 7i7 ,the number of covered veterans served by a covered treatment program1 disaggregated by-- 7,i7 ,veterans ,integrated ,service ,network in which the covered veteran receives care2 7,,ii7 facility1 including facilities of the ,department and non-,department facilities1 at which the covered veteran receives care2 7,,iii7 type of residential rehabilitation treatment care received by the covered veteran under such program2 7,,iv7 sex of the covered veteran2 and 7,v7 race or ethnicity of the covered veteran4 7ii7 ,wait times under a covered treatment program for the most recent year data is available1 disaggregated by-- 7,i7 treatment track or specificity of residential rehabilitation treatment care sought by the covered veteran2 7,,ii7 sex of the covered veteran2 7,,iii7 ,state or territory in which the covered veteran is located2 7,,iv7 ,veterans ,integrated ,service ,network in which the covered veteran is located2 and 7,v7 facility of the ,department at which the covered veteran seeks care4 7iii7 ,a list of all locations of a covered treatment program and number of bed spaces at each such location1 disaggregated by residential rehabilitation treatment care or treatment track provided under such program at such location4 7iv7 ,a list of any new locations of covered treatment programs added or removed and any bed spaces added or removed during the one-year period preceding the date of the report4 7v7 ,average cost of a stay under a covered treatment program1 including total stay average and daily average1 at facilities of the ,department compared to non-,department facilities4 7vi7 ,a review of staffing needs and gaps with respect to covered treatment programs that is data-driven and aligned with industry benchmarks and standards1 including-- 7,i7 a list of facilities that had unstaffed beds or closed beds due to lack of staffing at any point in the previous year2 7,,ii7 the number of additional staff needed to staff those beds2 7,,iii7 the number of beds at each facility2 7,,iv7 the average wait-times for the covered treatment program1 disaggregated by month1 during the periods of bed closures2 and 7,v7 a list of facilities that required staff of covered treatment programs to perform duties unrelated to covered treatment programs for a period of greater than three days4 7vii7 ,an overview of data collected pursuant to a subsequent clinical screening under subsection 7g77#c77;,f74 7viii7 ,a list of health care systems without a covered treatment program and an assessment of the feasibility and advisability of opening a covered treatment program at such health care system that is aligned and justified by patient demand and market factors4 7ix7 ,a list of health care systems that offer a covered treatment program aligned with patient demand and market factors and that have an average wait time of more than #bj days and an assessment of the feasibility and advisability of expanding such covered treatment program to lower such average wait time4 7x7 ,any recommendations for changes to the operation of covered treatment programs1 including any policy changes1 guidance changes1 training changes1 or other changes4 7,c7 ,anonymity ,to ensure that the data provided under this paragraph1 or some portion of that data1 will not undermine the anonymity of a veteran1 the ,secretary shall provide such data pursuant to applicable ,federal law and in a manner that is wholly consistent with applicable ,federal privacy and confidentiality laws1 including-- 7i7 section #eeb;a of title #e 7commonly known as the ,privacy ,act of #aigd72 7ii7 the ,health ,insurance ,portability and ,accountability ,act of #aiif 7,public ,law #ajd-aia72 7iii7 parts #afj and #afd of title #de1 ,code of ,federal ,regulations1 or successor regulations2 and 7iv7 sections #egja1 #egje1 and #gccb of this title4 7#c7 ,notification to ,congress of beds not available due to lack of staffing ,the ,secretary shall notify ,congress of any covered treatment programs of the ,department with more than five beds or more than ten percent of beds unavailable1 closed1 or reassigned due to lack of staffing1 including-- 7,a7 information on the staff needed to reopen beds that are closed2 7,b7 plans to recruit and retain staff2 7,c7 the total number of beds closed or expected to be closed2 7,d7 the estimated length of time until those closed beds are made available2 and 7,e7 the current wait time for access to those beds4 7j7 ,third-party assessment 7#a7 ,in general ,not later than two years after the date of the enactment of the ,take ,care of ,america's ,veterans ,act1 the ,secretary shall seek to enter into a contract with an appropriate entity to conduct a study of the care provided under covered treatment programs through facilities of the ,department and non-,department facilities4 7#b7 ,elements ,the study required under paragraph 7#a7 shall include a review of-- 7,a7 whether facilities are meeting requirements of the ,department pursuant to law1 regulation1 or policy2 7,b7 staffing models used by facilities and level of adherence to those models2 7,c7 success rates of covered treatment programs in preventing readmittance to a covered treatment program or death by suicide or overdose within a year of discharge from the program2 7,d7 adherence of non-,department facilities to timelines for claim submission and record returns to the ,department2 and 7,e7 any other factors the ,secretary or the appropriate entity determines relevant or appropriate to include4 7#c7 ,completion of study ,the contract sought under paragraph 7#a7 shall include a requirement that the appropriate entity1 not later than four years after the date of the enactment of the ,take ,care of ,america's ,veterans ,act1 complete the study required under such paragraph and submit to the ,secretary a report on the study4 7#d7 ,action plan and commentary ,not later than five years after the date of the enactment of the ,take ,care of ,america's ,veterans ,act1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives1 and publish on a publicly accessible website of the ,department1 a report containing-- 7,a7 the results of the study required under paragraph 7#a72 7,b7 action plans for improvement based on the results of the study2 and 7,c7 general commentary and feedback on the results of the study4 7#e7 ,appropriate entity defined ,in this subsection1 the term appropriate entity means-- 7,a7 a nongovernmental entity with experience in assessing programs that deliver services provided under covered treatment programs on a large scale2 or 7,b7 a federally funded research and development center4 7k7 ,revision of guidance ,the ,secretary shall update the guidance of the ,department on the operation of covered treatment programs to reflect each of the requirements under this section4 7l7 ,deadline ,unless otherwise specified1 the ,secretary shall carry out each requirement under this section by not later than one year after the date of the enactment of the ,take ,care of ,america's ,veterans ,act4 7m7 ,comptroller ,general review 7#a7 ,in general ,not later than two years after the date of the enactment of the ,take ,care of ,america's ,veterans ,act1 the ,comptroller ,general of the ,united ,states shall review access to care under a covered treatment program for covered veterans in need of residential mental health care and substance use disorder care4 7#b7 ,elements ,the review required by paragraph 7#a7 shall include the following3 7,a7 ,a review of wait times for covered veterans under a covered treatment program1 disaggregated by-- 7i7 treatment track or specificity of residential rehabilitation treatment care needed2 7ii7 sex of the covered veteran2 7iii7 home ,state of the covered veteran2 7iv7 home ,veterans ,integrated ,service ,network of the covered veteran2 and 7v7 wait times for-- 7,i7 facilities of the ,department2 and 7,,ii7 non-,department facilities4 7,b7 ,a review of policy and training of the ,department on screening1 admission1 and placement under a covered treatment program4 7,c7 ,a review of the rights of covered veterans and providers to appeal admission decisions under a covered treatment program and how the ,department adjudicates appeals4 7,d7 ,when determining the facility at which a covered veteran admitted to a covered treatment program will be placed in such program1 a review of how the input of the covered veteran is taken into consideration with respect to-- 7i7 program specialty1 subtype1 or treatment track offered to the covered veteran2 and 7ii7 the geographic placement of the covered veteran1 including family- or occupation-related preferences or circumstances4 7,e7 ,a review of staffing and staffing needs and gaps of covered treatment programs1 including with respect to-- 7i7 mental health providers and coordinators at the facility level2 7ii7 staff of facilities of such programs2 7iii7 staff of ,veterans ,integrated ,service ,networks2 and 7iv7 overall administration of such programs at the national level4 7,f7 ,a review of outcomes from ,department and non-,department covered treatment programs based at least in part on the subsequent clinical screenings required under subsection 7g77#c77;,e74 7,g7 ,recommendations for improvement of access by covered veterans to care under a covered treatment program1 including with respect to-- 7i7 any new sites or types of programs needed or in development2 7ii7 changes in training or policy2 7iii7 changes in communications with covered veterans2 and 7iv7 oversight of covered treatment programs by the ,department4 #agid4 ,fee schedule 7a7 ,in general ,not later than #ahj days after the date of the enactment of the ,take ,care of ,america's ,veterans ,act1 the ,secretary shall make publicly available on an appropriate website of the ,department a fee schedule for each covered treatment program provided by a non-,department provider through which the ,secretary furnishes care and services under section #agaj of this title4 7b7 ,elements ,the fee schedule required under subsection 7a7 for a covered treatment program shall-- 7#a7 reflect reasonable charges for the services provided2 7#b7 be based on the amounts customarily paid for similar services under the ,medicaid program under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 and by commercial health insurance providers2 7#c7 to the greatest extent practicable1 be consistent with payment rates under section #agjc7;i7 of this title2 7#d7 be comprehensive to include a variety of possible types of care1 services1 and charges2 and 7#e7 be sufficient to ensure a robust network of qualified community providers able to provide services under a covered treatment program to covered veterans4 7c7 ,coordination of payment rates ,after the date of the initial publication of the fee schedule under subsection 7a71 the rate paid by the ,department for residential substance use disorder treatment shall be the rate provided in the fee schedule required under such subsection4 7d7 ,recoupment of amounts 7#a7 ,in general ,the ,secretary shall recoup from a non-,department entity1 including a third party administrator1 any amount paid to such entity that exceeds the amount specified under the fee schedule under subsection 7a7 for the care or services provided4 7#b7 ,limitation ,a non-,department entity shall not bill a veteran for any charges recouped under paragraph 7#a74 #agie4 ,training 7a7 ,in general ,not later than one year after the date of the enactment of the ,take ,care of ,america's ,veterans ,act1 the ,secretary shall-- 7#a7 develop and implement a plan to ensure that health care providers caring for veterans under covered treatment programs receive and complete relevant training aligned with industry standards and practices2 and 7#b7 submit that plan to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives4 7b7 ,elements of training ,training required under subsection 7a7 shall-- 7#a7 be easily accessible1 no-cost1 and offered in such a manner as to qualify for or fulfill continuing education requirements for health care professionals2 7#b7 include course modules related to military culture1 post-traumatic stress disorder1 the evaluation and management of suicide1 traumatic brain injury1 and opioid safety1 or comparable course modules1 as determined by the ,secretary2 and 7#c7 be offered through ,department and non-,department entities or organizations4 7c7 ,elements of plan ,the plan required under subsection 7a7 shall-- 7#a7 allow for ,department or non-,department providers to receive credit for non-,department training that is equivalent or substantially similar to training required under subsection 7a72 and 7#b7 include details regarding consequences for non-compliance with training required under such plan1 which may include removal from a network of providers under the ,veterans ,community ,care ,program under section #agjc of this title for a specified period of time4 7d7 ,consultation ,the ,secretary shall consult with relevant professional organizations with respect to the content of relevant training required under subsection 7a74 4 7b7 ,clerical amendment ,the table of sections at the beginning of such chapter is amended by adding at the end the following new items3 ,,subchapter ,,ix--,participation by ,veterans in ,certain ,mental ,health ,treatment ,programs #agia4 ,definitions4 #agib4 ,standardized process to determine eligibility of covered veterans for participation in certain mental health treatment programs4 #agic4 ,improvements to ,department of ,veterans ,affairs mental health residential rehabilitation treatment program4 #agid4 ,fee schedule4 #agie4 ,training4 4 #fbb4 ,access to mental health residential rehabilitation treatment programs for veterans with spinal cord injury or disorder 7a7 ,plan 7#a7 ,in general ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a plan to ensure access to mental health residential treatment programs for veterans with a spinal cord injury or disorder4 7#b7 ,elements ,the plan required under paragraph 7#a7 shall include-- 7,a7 a staffing plan1 which shall include a plan for how the ,department will-- 7i7 incorporate staff from other facilities to support the pilot program required under subsection 7b72 and 7ii7 ensure adequate staffing to support the needs of veterans with a spinal cord injury or disorder2 7,b7 an assessment of medical equipment needs2 and 7,c7 an assessment of the best location to deliver treatment and health care under mental health residential treatment programs1 including through the use of spinal cord injury or disorder centers1 spinal cord injury or disorder spokes1 and community care providers4 7b7 ,pilot program 7#a7 ,in general ,commencing not later than #abj days after the date of the enactment of this ,act1 the ,secretary shall carry out a pilot program to provide improved access to mental health residential treatment programs of the ,department of ,veterans ,affairs for veterans with a spinal cord injury or disorder at not fewer than three medical facilities of the ,department4 7#b7 ,selection of locations ,in selecting sites for the pilot program under paragraph 7#a71 the ,secretary shall prioritize sites in the following areas3 7,a7 ,areas with geographic diversity1 including areas that serve veterans residing in rural or highly rural areas4 7,b7 ,areas with a significant number of veterans with spinal cord injury or disorder4 7c7 ,report ,not later than one year after the date of the enactment of this ,act1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report on-- 7#a7 the implementation of the plan required under subsection 7a72 7#b7 the initial results from the pilot program under subsection 7b71 including the number of unique veterans who participated in the pilot program1 the cost of the pilot program1 and an assessment of the effectiveness of the pilot program in increasing access to1 and improving outcomes for1 participants in the pilot program2 7#c7 plans1 if any1 to expand or extend the pilot program to address demand for the highly specialized treatment provided under the mental health residential treatment programs of the ,department for veterans with a spinal cord injury or disorder2 and 7#d7 ,such other matters as the ,secretary considers appropriate4 ,c ,staffing ,matters #fca4 ,treatment of psychologists 7a7 ,treatment as title #ch employees ,section #gdja of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in paragraph 7#a71 by inserting psychologists1 after chiropractors12 and 7#b7 in paragraph 7#c71 by striking psychologists14 7b7 ,inclusion in contracts for scarce medical specialist services ,section #gdji7;a7 of title #ch1 ,united ,states ,code1 is amended by inserting psychologists1 after chiropractors14 #fcb4 ,mentorship program for executive leadership teams at medical centers of the ,department of ,veterans ,affairs 7a7 ,in general ,the ,secretary of ,veterans ,affairs may establish a program to connect covered individuals 7in this section referred to as mentees7 with peer mentors to facilitate sharing of best practices and leadership experiences and to foster opportunities to develop knowledge and skills required to lead successfully at medical facilities of the ,department 7in this section referred to as the mentorship program74 7b7 ,covered individual defined ,in this section1 the term covered individual means-- 7#a7 an individual in the position of ,facility ,director1 ,chief of ,staff1 ,associate ,director of ,patient ,care ,services1 ,associate ,director1 ,assistant ,director1 or ,deputy ,director at a medical center of the ,department2 or 7#b7 any other employee of the ,department who is determined by the ,secretary to be an executive leader at a medical center of the ,department4 7c7 ,eligibility ,the following employees of the ,department are eligible for participation as mentees in the mentorship program3 7#a7 ,an employee appointed to a position as a covered individual who has been in that position for less than one year4 7#b7 ,a covered individual employed at a medical center of the ,department 7regardless of appointment commencement date7 that meets one or more of the following criteria3 7,a7 ,reports poor performance1 as defined by the ,secretary1 on the ,strategic ,analytics for ,improvement and ,learning ,value ,model of the ,department1 or successor similar model4 7,b7 ,reports data under section #agjc;,c7a77#c7 of title #ch1 ,united ,states ,code1 as published on the ,access to ,care website of the ,department1 or successor similar website1 that-- 7i7 does not consistently meet the level reported in the community surrounding such medical center1 as determined by the ,secretary2 or 7ii7 does not meet a threshold level determined by the ,secretary4 7,c7 ,has one or more recommendations from a report by the ,office of ,inspector ,general of the ,department of ,veterans ,affairs that is still open more than one year after the report was published4 7#c7 ,a covered individual employed at a medical center of the ,department 7regardless of appointment commencement date7 who is recommended by the regional leadership overseeing such medical center4 7d7 ,criteria for peer mentors ,each peer mentor to be paired with a mentee under subsection 7a7 shall meet each of the following criteria3 7#a7 ,previous or current employment in the same position title as the mentee4 7#b7 ,employment in that position for not less than two years4 7#c7 ,employment at a medical center of the ,department that reports-- 7,a7 above average performance1 as defined by the ,secretary1 on the ,strategic ,analytics for ,improvement and ,learning ,value ,model of the ,department1 or successor similar model2 and 7,b7 data under section #agjc;,c7a77#c7 of title #ch1 ,united ,states ,code1 as published on the ,access to ,care website of the ,department1 or successor similar website1 that exceeds the level reported in the community surrounding such medical center1 as determined by the ,secretary4 7e7 ,report ,not later than one year after the date of the enactment of this ,act1 and annually thereafter for an additional three years1 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 mentorship program1 including-- 7#a7 the number of mentees and peer mentors participating in the mentorship program1 disaggregated by medical center of the ,department2 7#b7 the number of mentor-mentee pairings initiated under each of the eligibility criteria outlined in paragraphs 7#a71 7#b71 and 7#c7 of subsection 7c71 including information on any circumstances in which multiple criteria under such paragraphs were met2 7#c7 a description of the actions taken by the ,department to encourage communication between mentees and peer mentors2 7#d7 aggregated feedback from participants in the mentorship program2 and 7#e7 the turnover rate for mentee participants in the mentorship program4 7f7 ,termination ,the authority under this section shall terminate on ,september #cj1 #bjcj4 #fcc4 ,requirement for equivalent role postings for vacant positions at ,department of ,veterans ,affairs 7a7 ,in general ,whenever possible and practicable1 if the ,secretary of ,veterans ,affairs is issuing a posting for vacant positions at the ,department of ,veterans ,affairs that may be filled by more than one type of professional or clinician1 the ,secretary shall issue postings for all possible clinicians or professionals who could fill the position4 7b7 ,application to certain positions ,the ,secretary shall consider the requirement under subsection 7a7 in particular with respect to hard-to-recruit1 hard-to-retain1 primary care1 and mental health care positions4 #fcd4 ,improvements to ,department of ,veterans ,affairs hiring processes 7a7 ,in general ,subchapter ,i of chapter #g of title #ch1 ,united ,states ,code1 is amended by inserting after section #gja the following new section3 #gjb4 ,hiring processes 7a7 ,standardized approval process for filling vacant positions 7#a7 ,process required 7,a7 ,in general ,the ,secretary shall establish a standardized1 nationwide approval process for filling vacant employment positions within the ,department4 7,b7 ,variability ,the process required by subparagraph 7,a7 may be different for each type of employment position in the ,department4 7,c7 ,approval windows ,the process required by subparagraph 7,a7 shall include a standardized approval window for each approval step4 7#b7 ,delegation ,if the approval authority for a step in the hiring process established under paragraph 7#a7 is vacant1 on leave1 or otherwise unable to respond to requests for approval in an appropriate timeframe1 such authority for approval shall be delegated to the extent practicable to the supervisor of such approval authority or such other designee as may be specified in the chain of command4 7#c7 ,time to fill goal ,each window of time allotted for each approval step under paragraph 7#a77;,c7 when added together shall not exceed the goal of the ,department to fill window for that employment position4 7b7 ,process for tentative offers of employment ,the ,secretary shall develop a standardized process for issuing tentative offers of employment with the ,department and such process shall require that each such offer includes a specified rate of basic pay when possible and practicable4 7c7 ,third-party contracts ,the ,secretary may conduct laboratory testing1 background clearances1 and other candidate approval and vetting procedures through a contract with a third party if the ,secretary determines that the contract would ensure equal or better quality or timeliness4 7d7 ,electronic signatures 7#a7 ,authority ,the ,secretary shall allow electronic signatures on any hiring1 recruitment1 retention1 or other employment documents once a standardized process for such signatures is developed and implemented under paragraph 7#b74 7#b7 ,standardized process ,the ,secretary shall develop a standardized process for use of electronic signatures as described in paragraph 7#a71 which shall include exceptions and limitations as the ,secretary considers appropriate and that allows for use of electronic signatures for employment documents1 including ,,sf #aaeb and related successor forms1 ,,sf #bhbc and related successor forms1 and ,,sf #cajb-;,,fers and related successor forms4 7e7 ,employee community building program ,the ,secretary shall1 to the extent practicable1 establish an employee community building program that connects employees in similar positions1 offices1 and programs to connect with each other nationwide4 4 7b7 ,clerical amendment ,the table of sections at the beginning of chapter #g of such title is amended by inserting after the item relating to section #gja the following new item3 #gjb4 ,hiring processes4 4 #fce4 ,department of ,veterans ,affairs telework policy 7a7 ,policy required ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall1 in accordance with the requirements of this section and the requirements of section #fejb of title #e1 ,united ,states ,code1 establish a policy for the use of telework within the ,department of ,veterans ,affairs4 7b7 ,locations ,the policy established under subsection 7a7 may be different for different locations1 specialties1 and categories of employees1 as determined appropriate by the ,secretary4 7c7 ,assessment ,in developing the policy required by subsection 7a71 the ,secretary shall assess the following for each category of employees at the ,department-- 7#a7 staffing levels and trends over the last #e years2 7#b7 exit survey data related to telework2 7#c7 the availability of dedicated work space at facilities of the ,department to enable onsite work at a duty station2 7#d7 a comparison of productivity levels when duties are performed on site or through telework2 7#e7 telework flexibilities for comparable categories of employees in the private sector and in other ,federal agencies2 and 7#f7 particular duties that necessitate on site work4 7d7 ,notice and reporting 7#a7 ,in general ,for any change made to the policy established pursuant to subsection 7a71 the ,secretary shall-- 7,a7 notify all affected employees of the ,department of the changes2 and 7,b7 submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report on the changes4 7#b7 ,report contents ,for each report submitted to ,congress under paragraph 7#a77;,b71 the ,secretary shall include the analyses for each category conducted in subsection 7c7 and the role of those analyses in the telework policy for each category4 7#c7 ,deadline ,a report submitted under paragraph 7#a77;,b7 regarding a change to the policy established under subsection 7a7 shall be made not fewer than #ij days before the change goes into effect4 7e7 ,report on budgetary impact ,not later than #a year after the date on which the policy established pursuant to subsection 7a7 goes into effect1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs and the ,committee on ,appropriations of the ,senate and the ,committee on ,veterans' ,affairs and the ,committee on ,appropriations of the ,house of ,representatives a report on the annual budgetary impact of such policy4 7f7 ,effective date and changes 7#a7 ,effective date of initial policy ,the initial policy established by pursuant to subsection 7a7 shall go into effect not later than #ahj days after the date on which the policy is established4 7#b7 ,effective date of subsequent changes ,any change made to the policy established pursuant to subsection 7a7 after the effective date set forth in paragraph 7#a7 shall take effect not less than #ij days after the date on which the change is made4 7#c7 ,notice ,for any change made to the policy established pursuant to subsection 7a7 after the effective date set forth in paragraph 7#a71 the ,secretary shall-- 7,a7 notify all affected employees of the ,department of the changes2 and 7,b7 submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report on the changes4 #fcf4 ,expansion of reimbursement of continuing professional education expenses 7a7 ,in general ,section #gdaa of title #ch1 ,united ,states ,code1 is amended to read as follows3 #gdaa4 ,reimbursement of continuing professional education expenses 7a7 ,required reimbursement ,the ,secretary shall reimburse any full-time physician1 dentist1 podiatrist1 chiropractor1 optometrist1 psychologist1 registered nurse 7including any advanced practice registered nurse71 or physician assistant appointed under section #gdja7a7 of this title not more than #a1jjj per year for each such individual for expenses incurred for continuing professional education directly related to the duties and responsibilities of the position of the employee or related to the duties and responsibilities of the position or positions of the employees overseen by the employee4 7b7 ,authorized reimbursement ,the ,secretary may reimburse any full-time licensed practical or vocational nurse 7including any nurse practitioner71 medical technologist1 pharmacist1 pharmacy technician1 diagnostic radiologic technologist1 or social worker appointed under section #gdja7c7 of this title1 not more than #a1jjj per year for each such individual for expenses incurred for continuing professional education directly related to the duties and responsibilities of the position of the employee or related to the duties and responsibilities of the position or positions of the employees overseen by the employee4 7c7 ,maximum number of individuals reimbursed ,the total number of individuals who may be reimbursed under this section may not exceed #ej1jjj per year4 7d7 ,priority reimbursements ,in providing reimbursement under subsection 7a71 the ,secretary shall prioritize reimbursement for individuals providing direct patient care or individuals who are decision-makers for direct patient care4 7e7 ,report required 7#a7 ,in general ,not less frequently than annually after the end of the first fiscal year following the date of the enactment of the ,take ,care of ,america's ,veterans ,act1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives information on utilization of reimbursement under this section1 including-- 7,a7 locations at which reimbursement is claimed2 7,b7 position title and specialty of the individual claiming reimbursement2 7,c7 average amount claimed per position and specialty2 and 7,d7 percent utilization by each position and specialty overall4 7#b7 ,authority to include in existing report ,the information required under paragraph 7#a7 may be submitted independently or included in another annual report to ,congress4 4 7b7 ,clerical amendment ,the table of sections at the beginning of subchapter ,i of chapter #gd of title #ch1 ,united ,states ,code1 is amended by striking the item relating to section #gdaa and inserting the following new item3 #gdaa4 ,reimbursement of continuing professional education expenses4 4 #fcg4 ,department of ,veterans ,affairs personnel transparency 7a7 ,in general ,section #eje of the ,john ,s4 ,mc,cain ,,iii1 ,daniel ,k4 ,akaka1 and ,samuel ,r4 ,johnson ,,va ,maintaining ,internal ,systems and ,strengthening ,integrated ,outside ,networks ,act of #bjah 7,public ,law #aae-ahb2 #ch ,u4,s4,c4 #cja note7 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#a7-- 7i7 in the matter before subparagraph 7,a71 by striking information1 and all that follows through facility3 and inserting information32 7ii7 in subparagraph 7,b7-- 7,i7 by inserting 7i7 before ,the number2 and 7,,ii7 by adding at the end the following new clause3 7ii7 ,information made available under this subparagraph shall be updated not less frequently than once each quarter to account for delays in data processing and shall reflect the most recently available data4 2 7iii7 in subparagraph 7,c71 by striking vacancies1 by occupation4 and inserting positions currently undergoing a recruitment action1 disaggregated by occupation and by stage of recruitment42 7iv7 in subparagraph 7,e77iii71 by striking potential hires or2 and 7v7 by adding at the end the following new subparagraph3 7,f7 ,the number of positions vacated during the quarter for which the ,department has not initiated a recruitment action or is not planning to initiate a recruitment action4 2 7,b7 by redesignating paragraph 7#e7 as paragraph 7#f72 7,c7 by inserting after paragraph 7#d7 the following new paragraph 7#e73 7#e7 ,display of information ,the display of information made publicly available on a website of the ,department pursuant to paragraph 7#a7 shall be disaggregated-- 7,a7 by departmental component2 7,b7 in the case of information relating to ,veterans ,health ,administration positions1 by medical facility2 and 7,c7 in the case of information relating to ,veterans ,benefits ,administration positions1 by regional office4 2 and 7,d7 in paragraph 7#f71 as redesignated by subparagraph 7,b71 by striking shall and all that follows and inserting the following3 8shall-- 7,a7 review the administration of the website required under paragraph 7#a72 7,b7 develop recommendations relating to the improvement of such administration2 and 7,c7 submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report containing-- 7i7 the findings of the ,inspector ,general with respect to the most recent review conducted under subparagraph 7,a72 and 7ii7 the recommendations most recently developed under subparagraph 7,b74 2 and 7#b7 by amending subsection 7b7 to read as follows3 7b7 ,annual report ,each year1 the ,secretary shall submit to ,congress an annual report that includes the following3 7#a7 ,a description of the steps the ,department is taking to achieve full staffing capacity4 7#b7 ,a description of the actions the ,department is taking to improve the onboard timeline for facilities of the ,department1 including-- 7,a7 in the case of facilities of the ,veterans ,health ,administration1 for facilities for which the duration of the onboarding process exceeds the metrics laid out in the ,time to ,hire ,model of the ,veterans ,health ,administration1 or successor model2 and 7,b7 in the case of the ,veterans ,benefits ,administration1 for regional offices that exceed the time-to-hire target of the ,office of ,personnel ,management4 7#c7 ,the amount of additional funds necessary to enable the ,department to reach full staffing capacity4 7#d7 ,such recommendations for legislative or administrative action as the ,secretary may have in order to achieve full staffing capacity at the ,department4 4 7b7 ,effective date ,the amendments made by subsection 7a7 shall take effect on the date of the enactment of this ,act and shall apply with respect to the second update under section #eje7;a77#c7 of such ,act beginning after the date of the enactment of this ,act and each update thereafter4 #fch4 ,modification of authority of licensure of health care professionals providing treatment via telemedicine ,section #agcj;,c of title #ch1 ,united ,states ,code1 is amended-- 7#a7 by amending subsection 7a7 to read as follows3 7a7 ,in general ,notwithstanding any provision of law regarding the licensure of health care professionals or the prescribing of controlled substances1 a covered health care professional may practice the health care profession of the health care professional and prescribe controlled substances at any location in any ,state or any of the ,freely ,associated ,states 7as defined in section #agbd7;f7 of this title71 regardless of where the covered health care professional or the patient is located1 if the covered health care professional is using telemedicine to provide treatment or prescribe controlled substances to an individual under this chapter4 2 7#b7 in subsection 7b71 by adding at the end the following new paragraph3 7#d7 ,a health care professional who is a contractor of the ,department acting in the scope of a contract with the ,department to furnish care in a facility or clinic of the ,department and who has an active1 current1 full1 and unrestricted license1 registration1 or certification in a ,state to practice the health care profession of the health care professional1 excluding the following3 7,a7 ,a health care professional located outside a facility or clinic of the ,department providing care through the ,veterans ,community ,care ,program under section #agjc of this title or a similar authority under the laws administered by the ,secretary4 7,b7 ,a health care professional conducting disability compensation evaluations pursuant to a contract with the ,department4 2 7#c7 in subsection 7d7-- 7,a7 by redesignating paragraph 7#b7 as paragraph 7#c72 and 7,b7 by inserting after paragraph 7#a7 the following new paragraph 7#b73 7#b7 ,state laws that may be inconsistent under paragraph 7#a7 include-- 7,a7 the laws of-- 7i7 the ,state of licensure1 certification1 or registration of the covered health care professional2 7ii7 the ,state of practice of the covered health care professional2 7iii7 the ,state in which the patient is located2 or 7iv7 the ,state of residence of the patient2 and 7,b7 such laws specified under subparagraph 7,a7 as incorporated by the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hja et seq474 2 and 7#d7 in subsection 7e71 striking ,nothing and inserting ,except as provided in subsections 7a7 and 7d71 nothing44 #fci4 ,provision of data on educational assistance programs of ,veterans ,health ,administration 7a7 ,in general ,beginning not later than #ahj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall provide to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives data on graduate medical education programs1 health profession scholarship programs1 and any other educational assistance programs within the ,veterans ,health ,administration4 7b7 ,elements ,the data required to be provided under subsection 7a7 shall include1 for each program1 the following3 7#a7 ,the number of active participants1 broken down by position or expected future position or licensure4 7#b7 ,the amount of funds spent each fiscal year4 7#c7 ,the number of participants who have completed their education and are currently completing their service requirements at the ,department of ,veterans ,affairs4 7#d7 ,the number of participants who were previously active in the program but left the program before completing their education or service requirement during the year preceding the date on which the data is provided4 7#e7 ,an overview of outreach by the ,department to prospective participants in the program4 7#f7 ,such other information as the ,secretary considers appropriate4 7c7 ,update and submittal of data ,the data required to be provided under subsection 7a7-- 7#a7 shall be updated not less frequently than annually2 and 7#b7 may be submitted to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives as part of another report required by law4 7d7 ,initial data ,with the first iteration of data provided under subsection 7a71 the ,secretary shall provide to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report on the implementation of the pilot program under section #bdf of the ,military ,construction1 ,veterans ,affairs1 and ,related ,agencies ,appropriations ,act1 #bjah 7division ,j of ,public ,law #aae-ada2 #ch ,u4,s4,c4 #gfja note71 including the current status of the pilot program and a timeline of the status of the pilot program since its initial implementation4 ,d ,optimization of ,workforce #fda4 ,department of ,veterans ,affairs strategic human capital plan 7a7 ,in general ,subchapter ,i of chapter #g of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new section3 #gbi4 ,strategic human capital plan 7a7 ,plan development 7#a7 ,not later than ,september #cj1 #bjbg1 the ,secretary shall develop and submit to the appropriate committees of ,congress a five-year strategic human capital plan to support the mission and responsibilities of the ,department1 disaggregated by the ,veterans ,health ,administration1 the ,veterans ,benefits ,administration1 the ,national ,cemetery ,administration1 and such other administrative components of the ,department as the ,secretary considers necessary to carry out the mission of the ,department4 7#b7 ,not later than ,september #cj1 #bjbh1 and each ,september #cj thereafter1 the ,secretary shall update the plan developed pursuant to paragraph 7#a7 and extend the plan so that it covers the next period of five fiscal years commencing immediately after the date of the update4 7b7 ,requirements 7#a7 ,in developing the plan required by subsection 7a71 the ,secretary shall take into account and document current and future projected demand for benefits and services administered by the ,department1 disaggregated for each component by facility location1 facility type1 region1 administration1 program office1 the type of benefit or service1 and such other categories as the ,secretary determines appropriate4 7#b7 ,the ,secretary shall develop and update the plan under subsection 7a7 in consultation with veterans service organizations and such other stakeholders as the ,secretary considers appropriate4 7c7 ,contents ,the strategic human capital plan required by subsection 7a7 shall incorporate leading practices1 including the following3 7#a7 ,a workforce gap analysis1 including an assessment of-- 7,a7 the staffing levels of each employee position needed to deliver high quality1 accessible1 and timely health care1 benefits1 and other services the ,secretary considers appropriate1 disaggregated by employee position1 facility location1 facility type1 region1 administration1 program office1 the type of benefit or service1 and such other categories as the ,secretary determines appropriate2 7,b7 how the staffing levels described in subparagraph 7,a7 align with industry best practices in each employee position for the anticipated demand for health care1 benefits1 and other services described in subsection 7b72 and 7,c7 core competencies1 as defined by the ,secretary1 and the staffing levels needed in each of these core competencies1 disaggregated by employee position1 facility location1 facility type1 region1 administration1 program office1 the type of benefit or service and such other categories as the ,secretary considers appropriate4 7#b7 ,an implementation plan that includes the following3 7,a7 ,specific recruitment and retention goals to fulfill the staffing needs identified in the strategic human capital plan and the strategy of the ,department to achieve such goals4 7,b7 ,specific strategies-- 7i7 to improve workforce productivity using technological1 organizational1 behavioral1 and such other approaches as the ,secretary determines appropriate and productivity measures that are specific to employee positions and the benefits or services they provide2 and 7ii7 that are informed by applicable industry best practices4 7,c7 ,specific strategies for recruiting and retaining veterans1 spouses of veterans and members of the ,armed ,forces1 family members of veterans and members of the ,armed ,forces1 caregivers of veterans1 and survivors of members of the ,armed ,forces as employees of the ,department4 7,d7 ,specific goals to reduce the time to hire and onboard employees of the ,department and a strategy to achieve such goals1 including draft legislative language for any legislative action necessary to achieve such goals1 without degradation of-- 7i7 necessary background checks2 and 7ii7 measures to protect ,department customer and employee safety4 7d7 ,annual updates ,not later than ,september #cj1 #bjbh1 and ,september #cj of each of year thereafter1 the ,secretary shall submit to the appropriate committees of ,congress an update on the implementation of the strategic human capital plan developed pursuant to subsection 7a71 including an assessment by the ,secretary of-- 7#a7 the progress of the ,department in implementing the strategic human capital plan2 7#b7 the progress of the ,department in improving outcomes for veterans and their spouses1 dependents1 and caregivers through the delivery of high quality1 accessible1 and timely health care1 benefits1 and other services the ,secretary considers appropriate using results based performance measures2 7#c7 changes to projected demand for benefits and services based on new legislative action or other factors1 disaggregated for each component by facility location1 facility type1 region1 administration1 program office and the type of benefit or service2 7#d7 changes to the staffing levels included in the strategic human capital plan1 including justifications for such changes1 disaggregated by employee position1 facility location1 facility type1 region1 administration1 program office1 the type of benefit or service and such other categories as the ,secretary determines appropriate2 7#e7 any differentiation between the staffing levels included in the strategic human capital plan and those included in the budget justification materials most recently submitted to ,congress in support of the budget of the ,department 7as submitted with the budget of the ,president under section #aaje7;a7 of title #ca72 and 7#f7 any differentiation from the ,quadrennial ,veterans ,health ,administration review required by section #gccj;,c of this title4 7e7 ,comptroller ,general of the ,united ,states biennial reviews ,not later than #ahj days after the date on which the human capital plan is submitted to the appropriate committees of ,congress pursuant to subsection 7a71 and not less frequently than once every #b years thereafter1 the ,comptroller ,general of the ,united ,states shall-- 7#a7 review the strategic human capital plan developed pursuant to subsection 7a7 and updated pursuant to subsection 7d71 as the case may be1 particularly with respect to the adequacy of the plan to fulfill the mission and responsibilities of the ,department2 and 7#b7 submit to ,congress the findings of the ,comptroller ,general with respect to the review conducted pursuant to paragraph 7#a74 7f7 ,definitions ,in this section3 7#a7 ,the term appropriate committees of ,congress means-- 7,a7 the ,committee on ,veterans' ,affairs and the ,committee on ,appropriations of the ,senate2 and 7,b7 the ,committee on ,veterans' ,affairs and the ,committee on ,appropriations of the ,house of ,representatives4 7#b7 ,the term veterans service organization means any organization recognized by the ,secretary under section #eijb of this title4 4 7b7 ,clerical amendment ,the table of sections at the beginning of chapter #g of such title is amended by inserting after the item relating to section #gbh the following new item3 #gbi4 ,strategic human capital plan4 4 #fdb4 ,department of ,veterans ,affairs reduction in force notice requirement 7a7 ,in general ,subchapter ,i of chapter #g of title #ch1 ,united ,states ,code1 as amended by section #fda7;a71 is further amended by inserting after section #gbi the following new section3 #gbi;,a4 ,reductions in force 7a7 ,notice required ,in any case in which the ,secretary plans to carry out a reduction in force1 the ,secretary shall1 not later than the date that is #fj days before the date on which the ,secretary commences carrying out such reduction in force1 submit to the appropriate committees of ,congress and the employees of the ,department who will be affected by the reduction in force notice of the intention of the ,secretary to carry out such reduction in force4 7b7 ,limitation ,notwithstanding any other provision of law1 the ,secretary may not carry out any reduction in force with respect to any employee who has not received the notice required under subsection 7a7 in the manner and within the time required by such subsection4 7c7 ,contents ,notice regarding plans to carry out a reduction in force submitted pursuant to subsection 7a7 shall include the following3 7#a7 ,the total number of employees of the ,department who will be affected by the reduction4 7#b7 ,the offices of the ,department that will be affected by the reduction1 including1 for each such office1 the following3 7,a7 ,the location of the office4 7,b7 ,the program of the ,department carried out by the office4 7,c7 ,the total number of employees of the office before and after the reduction in force4 7,d7 ,the services provided by the office4 7#c7 ,a justification for the reduction in force1 including how-- 7,a7 the new staffing levels resulting from the reduction in force align with the current and future projected demand for benefits and services administered by the ,department1 disaggregated for each component by facility location1 facility type1 region1 administration1 program office1 the type of benefit or service1 and such other categories as the ,secretary determines appropriate2 and 7,b7 the reduction in force aligns with the strategic human capital plan required by section #gbi of this title4 7#d7 ,budgetary effects of the reduction in force4 7#e7 ,an assessment of the anticipated impact of the reduction in force on the delivery of benefits and services furnished by the ,department and the actions the ,secretary plans to take to mitigate any adverse impacts4 7d7 ,equal content ,a notice regarding a reduction in force sent to an employee pursuant to subsection 7a7 shall be the same as the notice submitted under such subsection to ,congress for the same reduction in force4 7e7 ,administrative remedy ,effect of ,noncompliance4 ,a reduction in force carried out with respect to an employee in violation of subsection 7b7 shall have no force or effect with respect to such employee until the ,secretary complies with subsection 7a74 7f7 ,definitions ,in this section3 7#a7 ,the term appropriate committees of ,congress means-- 7,a7 the ,committee on ,veterans' ,affairs and the ,committee on ,appropriations of the ,senate2 and 7,b7 the ,committee on ,veterans' ,affairs and the ,committee on ,appropriations of the ,house of ,representatives4 7#b7 ,the term reduction in force means any action that would have required notice under part #cea of title #e1 ,code of ,federal ,regulations1 as in effect on ,january #a1bjbf4 4 7b7 ,clerical amendment ,the table of sections at the beginning of chapter #g of such title1 as amended by section #b7;b71 is further amended by inserting after the item relating to section #gbi the following new item3 #gbi;,a4 ,reductions in force4 4 #fdc4 ,detailed plans and justifications for reorganization of offices ,section #eaj of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in subsection 7f77#b7-- 7,a7 in subparagraph 7,d71 by inserting in improving outcomes for veterans and their spouses1 dependents1 and caregivers through the delivery of high quality1 accessible1 and timely health care1 benefits1 and other services the ,secretary considers appropriate before the period at the end2 and 7,b7 by adding at the end the following new subparagraphs3 7,g7 ,a description of how the ,secretary will analyze success of the reorganization using results based performance metrics that are derived from the justification for the reorganization4 7,h7 ,a risk mitigation plan identifying significant operational1 workforce1 financial1 information technology1 patient care1 and service-delivery risks reasonably anticipated by the ,secretary and the actions planned to mitigate such risks4 2 7#b7 by redesignating subsections 7e7 and 7f7 as subsections 7f7 and 7g71 respectively2 and 7#c7 by inserting after subsection 7d7 the following new subsection 7e73 7e7 ,not later than #ahj days after the date on which the ,secretary completes an administrative reorganization for which the ,secretary submitted under subsection 7b7 a report containing a detailed plan and justification for the administrative reorganization1 and not less frequently than once every #ahj days thereafter until the date that is two years after the date of the completion of such administrative reorganization1 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 assessing the administrative reorganization using the performance metrics described in the detailed plan and justification pursuant to subsection 7g77#b77;,g74 4 #fdd4 ,rule of construction ,nothing in this subtitle or an amendment made by this subtitle shall be construed to have any effect on any provision of law in effect before the date of the enactment of this ,act4 ,e ,veterans ,infrastructure and ,transformation #fea4 ,short title ,this subtitle may be cited as the ,veterans ,infrastructure and ,transformation ,act of #bjbf or the ,,vital ,act of #bjbf4 #feb4 ,modification of authority for sharing of health-care resources of ,department of ,veterans ,affairs to include flexible space utilization and streamlined service agreements ,section #haec of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in subsection 7a77#c7-- 7,a7 in subparagraph 7,a71 by inserting physical before space2 7,b7 in subparagraph 7,b77i71 by inserting physical before space2 7,c7 by striking subparagraph 7,e72 7,d7 by redesignating subparagraphs 7,c7 and 7,d7 as subparagraphs 7,d7 and 7,e71 respectively2 7,e7 by inserting after subparagraph 7,b7 the following new subparagraph 7,c73 7,c7 ,if the health-care resource required is physical space or common services with respect to existing buildings and is to be acquired from an institution affiliated with the ,department in accordance with section #gcjb of this title or another entity1 the ,secretary may enter into contracts or agreements for the acquisition of the space or service-- 7i7 without regard to any law or regulation 7including any ,executive order1 circular1 or other administrative policy7 that would otherwise require the use of competitive procedures for acquiring the resource2 and 7ii7 if all obligations are funded through available appropriations or borne by the institution or entity1 without regard to any limitations applicable to leases of the ,department1 if1 in the case of a multi-year space-sharing agreement1 the agreement-- 7,i7 requires that payments for each fiscal year be made only from appropriated funds and available that year2 and 7,,ii7 includes a provision that the ,government's obligations for future years is contingent upon availability of appropriations4 2 7,f7 in subparagraph 7,d71 as redesignated by subparagraph 7,d7 of this paragraph1 by striking subparagraph 7,a7 or 7,b7 and inserting subparagraph 7,a71 7,b71 or 7,c72 7#b7 by adding at the end the following3 7h7 ,in this section3 7#a7 ,the term commercial service means a service that is offered and sold competitively in the commercial marketplace1 is performed under standard commercial terms and conditions1 and is procured using firm-fixed price contracts4 7#b7 ,the term common service means a commercial service necessary to maintain or operate existing physical space1 including maintenance1 heating1 ventilation1 air conditioning1 electricity1 energy1 water1 wastewater1 landscaping1 security1 laundry1 or any other service as determined by the ,secretary4 7#c7 ,the term physical space means a portion of a building or parking facilities4 4 #fec4 ,use of commercial construction and facilities code and standards 7a7 ,in general ,the ,secretary of ,veterans ,affairs may use commercial codes and standards instead of or in addition to ,federal codes and standards in the construction or alteration of facilities of the ,department of ,veterans ,affairs1 where such commercial codes and standards do not conflict with statutory and regulatory requirements4 7b7 ,pilot projects ,the ,secretary shall under take not fewer than three pilot projects during each of fiscal years #bjbg1 #bjbh1 #bjbi1 #bjcj1 and #bjca utilizing commercial codes and standards instead of ,federal codes and standards to lease or construct facilities of the ,department for major construction1 minor construction1 or major lease projects4 7c7 ,reports ,the ,secretary shall submit a report to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives not later than #ij days after the end of each of fiscal years #bjbg1 #bjbh1 #bjbi1 #bjcj1 and #bjca detailing the use by the ,secretary of the authority provided by subsection 7a7 and conduct of each pilot project required by subsection 7b7 that was initiated1 ongoing1 or completed during the fiscal year4 7d7 ,definitions ,in this section3 7#a7 ,commercial codes and standards ,the term commercial codes and standards means building codes or standards of the following3 7,a7 ,the ,national ,fire ,protection ,association4 7,b7 ,the ,international ,code ,council4 7,c7 ,the ,american ,society for ,testing and ,materials4 7,d7 ,the ,american ,society of ,civil ,engineers4 7,e7 ,any other building code or standard1 other than those described in 7#b71 determined by the ,secretary4 7#b7 ,federal codes and standards ,the term ,federal codes and standards means the following3 7,a7 ,building codes or standards specific to one or more ,federal agencies4 7,b7 ,building codes or standards specific to the ,department1 including the ,technical ,information ,library4 7,c7 ,standards of the ,federal ,guidelines ,institute4 #fed4 ,feasibility study for full-service hospital of ,department of ,veterans ,affairs in certain ,states 7a7 ,in general ,the ,secretary of ,veterans ,affairs shall conduct a study on the feasibility of establishing a full-service hospital of the ,department of ,veterans ,affairs in ,alaska and ,hawaii4 7b7 ,publication ,not later than one year after the date of the enactment of this title1 the ,secretary shall publish on a publicly available website of the ,department the findings of the ,secretary with respect to the study conducted under subsection 7a74 #fee4 ,report on strategic plan for infrastructure and capital assets of ,department of ,veterans ,affairs 7a7 ,report ,not later than one year after the date of the enactment of this title1 the ,secretary of ,veterans ,affairs shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report on the strategic plan for infrastructure and capital assets of the ,department of ,veterans ,affairs1 which summarizes a facility lifecycle strategy targeting modernization of owned and leased facilities and infrastructure required to mitigate increasing systemic failures1 veteran and staff safety1 benefits delivery interruptions1 and funding associated to address emergency repairs4 7b7 ,elements ,the report required by subsection 7a7 shall cover known and projected requirements over a period of not less than #aj years for the following3 7#a7 ,land acquisition4 7#b7 ,operations and maintenance of facilities of the existing capital asset portfolio of the ,department4 7#c7 ,operations and maintenance of the planned future capital asset portfolio of the ,department4 7#d7 ,new construction1 disaggregated by type of new construction1 including the following types of construction3 7,a7 ,major construction4 7,b7 ,minor construction4 7,c7 ,nonrecurring maintenance4 7#e7 ,leasing4 7#f7 ,alternative acquisition methods1 such as partnerships and donations4 7#g7 ,activation of space4 7#h7 ,disposal1 reuse1 and remediation4 7#i7 ,facility lifecycle strategy process supporting the planning1 programming delivery1 management1 and maintenance of the current and future capital asset portfolio of the ,department4 7#aj7 ,a discussion of the negative effect of the lack of stable and predictable capital asset funding on the ability of the ,department to plan1 staff1 and execute effective capital asset management4 7#aa7 ,overview of the strategy being utilized in the approach of the ,secretary to capital investment1 across all the capital and leasing programs1 including the approach of repair versus recapitalization1 use of leasing1 and other relevant strategies as deemed appropriate by the ,secretary4 7#ab7 ,such other matters as the ,secretary considers appropriate1 including with respect to legislative or administrative action1 if such actions are subject to the availability of appropriated funds4 7c7 ,rule of construction ,nothing in this section or a report submitted under this section shall be construed to create or imply any financial or operational obligation beyond the availability of appropriated funds4 #fef4 ,permanent extension of pilot program on acceptance by the ,department of ,veterans affairs of donated facilities and related improvements 7a7 ,in general ,section #b of the ,communities ,helping ,invest through ,property and ,improvements ,needed for ,veterans ,act of #bjaf 7,public ,law #aad-bid2 #ch ,u4,s4,c4 #hajc note7 is amended-- 7#a7 in the section heading1 by striking ,pilot2 7#b7 in subsection 7a71 in the subsection heading1 by striking ,pilot2 7#c7 by striking pilot each place it appears2 7#d7 by striking subsection 7i72 and 7#e7 by redesignating subsection 7j7 as subsection 7i74 7b7 ,modification of acceptance of property ,paragraph 7#a7 of subsection 7b7 of such section is amended to read as follows3 7#a7 the donation aligns with-- 7,a7 a need identified in a ,strategic ,capital ,investment ,planning process priority list1 a five-year development plan1 a facility master plan1 or an annual capital needs inventory of the ,department2 or 7,b7 any component or phase of a need described in paragraph 7#a72 and 4 #feg4 ,authority to accept donations of construction services1 minor construction or nonrecurring maintenance projects1 and targeted contributions 7a7 ,authority ,notwithstanding any other provision of law1 the ,secretary of ,veterans ,affairs may accept donations comprising the total cost or a portion of the cost of-- 7#a7 minor construction projects2 7#b7 nonrecurring maintenance projects2 or 7#c7 construction services relating-- 7,a7 to minor construction projects2 7,b7 to nonrecurring maintenance projects2 7,c7 to an existing facility of the ,department2 or 7,d7 to a new facility or portion thereof of the ,department4 7b7 ,alignment to needs ,the ,secretary may accept a donation under this section only if-- 7#a7 the donation aligns with-- 7,a7 a need identified in a ,strategic ,capital ,investment ,planning process priority list1 a five-year development plan1 a facility master plan1 or an annual capital needs inventory of the ,department2 or 7,b7 any component or phase of a need described in subparagraph 7,a72 7#b7 the donation is from an entity described in section #b7;a77#b7 of the ,communities ,helping ,invest through ,property and ,improvements ,needed for ,veterans ,act of #bjaf 7,public ,law #aad-bid2 #ch ,u4,s4,c4 #hajc note72 7#c7 the ,secretary determines such donation would-- 7,a7 accelerate project completion2 7,b7 reduce the expense to the ,department2 7,c7 improve facility condition2 or 7,d7 otherwise benefit veterans2 7#d7 the donor enters into a formal agreement with the ,secretary that includes-- 7,a7 provisions for the ,department's oversight during performance2 7,b7 compliance with applicable construction codes and standards1 and applicable laws and regulations2 7,c7 donor-provided insurance1 warranties1 and liability protections2 7,d7 the amount of the donation and the amount of the ,department's funding contribution1 if any2 7,e7 that the donation shall not increase the cost to the ,federal ,government of completing such project described in subsection 7a7 7excluding activation and sustainment of such facility72 and 7,f7 such other terms as the ,secretary determines necessary4 7c7 ,streamlined requirements ,for donations under this section that do not involve transfer of real property title-- 7#a7 the donor shall enter into an agreement with the ,department that determines who is responsible to ensure environmental or historic preservation due diligence is completed2 7#b7 the donor shall obtain all federally required construction and facility related permits2 and 7#c7 agreements may be simplified relative to those under section #b of the ,communities ,helping ,invest through ,property and ,improvements ,needed for ,veterans ,act of #bjaf 7,public ,law #aad-bid2 #ch ,u4,s4,c4 #hajc note7 to reflect the nature of services or targeted contributions4 7d7 ,reporting ,the ,secretary shall include information on donations accepted under this section in the reports required under section #b7;g7 of the ,communities ,helping ,invest through ,property and ,improvements ,needed for ,veterans ,act of #bjaf 7,public ,law #aad-bid2 #ch ,u4,s4,c4 #hajc note71 with separate tracking for donations under this section4 #feh4 ,report on use of additional authorities relating to recruitment and retention of personnel 7a7 ,report required ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall submit to the appropriate committees of ,congress a report detailing how the ,secretary will use the authorities of section #gjf of title #ch1 ,united ,states ,code1 to increase the size and performance of the acquisition workforce of the ,department of ,veterans ,affairs4 7b7 ,definitions ,in this section3 7#a7 ,acquisition workforce of the ,department ,the term acquisition workforce of the ,department of ,veterans ,affairs means personnel of the ,department of ,veterans ,affairs occupying positions within occupational series1 as defined by the ,director of the ,office of ,personnel ,management1 responsible for acquisition functions1 as determined by the ,secretary4 7#b7 ,appropriate committees of ,congress ,the term appropriate committees of ,congress means the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives4 #fei4 ,reports on key capital asset investments1 activities1 and performance of ,department of ,veterans ,affairs 7a7 ,in general ,section #habj of title #ch1 ,united ,states ,code1 is amended to read as follows3 #habj4 ,reports on key capital asset investments1 activities1 and performance 7a7 ,capital asset investment1 activities1 and performance 7#a7 ,in general ,not later than #cj days after the end of each fiscal year1 and every #fj days thereafter until the end of the subsequent fiscal year1 the ,secretary shall submit to the appropriate committees of ,congress a report on key capital asset investments1 activities1 and performance of the ,department4 7#b7 ,elements 7,a7 ,first report in each fiscal year ,the first report under paragraph 7#a7 in each fiscal year shall include the following3 7i7 ,a brief summary of work that was completed on each capital asset project that was completed in the previous fiscal year4 7ii7 ,a brief summary of the accomplishments1 impediments1 and challenges experienced by the ,department with respect to capital asset projects in the previous fiscal year and a description of efforts made to address any such impediments and challenges4 7iii7 ,with respect to each capital asset project completed in such year1 the following3 7,i7 ,the type of project 7major construction1 minor construction1 nonrecurring maintenance1 leases1 or other category1 including disposals74 7,,ii7 ,the estimated total cost and the actual total cost of the project4 7,,iii7 ,a description of the project4 7,,iv7 ,the location and facility with respect to which the project was carried out4 7,v7 ,the fiscal quarter the project was expected to begin1 the fiscal quarter the project began1 the month and year the project was completed1 and the fiscal quarter the facility in connection to such project was in use by veterans1 employees of the ,department1 or other relevant users1 as the case may be4 7iv7 ,in the case of any capital asset project completed during the previous fiscal year with respect to which the final cost of the project 7or any increment of the project7 was more than #aj percent greater than the estimated cost of the project 7or increment7 or the completion of such project 7or increment7 was more than #ahj days later than the planned schedule for such project 7or increment7-- 7,i7 the reason for any such overage or delay2 and 7,,ii7 actions being taken to prevent any such overage or delay in future projects4 7v7 ,a list of any capital asset projects cancelled during the previous fiscal year1 including any projects in the design phase and including the reason for the cancellation4 7vi7 ,a summary of total actual obligations for capital asset projects for the previous fiscal year1 broken out by major construction1 minor construction1 nonrecurring maintenance1 and leases from the medical facilities appropriation account of the ,department4 7vii7 ,a projected list of capital asset projects1 broken out by type of project under subclause 7,i71 that are expected to be initiated during the current fiscal year and those that are expected to be completed during the current fiscal year1 which shall include the following3 7,i7 ,the type of project 7major construction1 minor construction1 nonrecurring maintenance1 leases1 or other category1 including disposals74 7,,ii7 ,the estimated total cost of the project4 7,,iii7 ,a description of the project4 7,,iv7 ,the location and facility with respect to which the project was carried out or is expected to be carried out4 7,v7 ,the fiscal quarter the project is expected to begin1 the fiscal quarter the project is expected to be completed1 and the fiscal quarter the facility in connection to such project is expected to be in use by veterans1 employees of the ,department1 or other relevant users1 as the case may be4 7viii7 ,projected total obligations for capital asset projects for the current fiscal year1 broken out by major construction1 minor construction1 nonrecurring maintenance1 and leases1 from the medical facilities appropriation account of the ,department4 7ix7 ,such observations of best practices1 impediments1 and accomplishments related to the capital asset management and performance of the ,department1 including any legislative or administrative action1 as the ,secretary considers appropriate with respect to such practices1 impediments1 and accomplishments4 7x7 ,meaningful metrics that show the progress of the ,department toward meeting relevant goals of the ,department relating to capital asset management4 7xi7 ,such other matters as the ,secretary considers appropriate4 7,b7 ,subsequent reports ,each report in a fiscal year after the first report shall include1 at a minimum1 relevant updates on any capital asset projects that are ongoing during that fiscal year1 including any updates to information provided with respect to such projects under subparagraph 7,a74 7#c7 ,matters relating to reporting costs ,in each report under paragraph 7#a71 when reporting on costs for capital asset projects1 the ,secretary may include information regarding ,federal requirements1 including those specific to the ,department1 that may not exist in the non-,federal construction sector that may increase costs for capital asset projects4 7b7 ,super construction projects 7#a7 ,in general ,not later than #cj days after the end of each fiscal year1 and every #fj days thereafter until the end of that fiscal year1 the ,secretary shall submit to the appropriate committees of ,congress a report on the super construction projects carried out by the appropriate non-,department ,federal entity described in section #hajc7;e77#a7 of this title during such year4 7#b7 ,elements ,each report required under paragraph 7#a7 shall include1 for each project described in such paragraph-- 7,a7 the budgetary and scheduling status of the project1 as of the last day of the most recent fiscal quarter ending before the date on which the report is required to be submitted2 and 7,b7 the actual cost and schedule variances of the project1 as of such day1 compared to the planned cost and schedules for the project4 7c7 ,definitions ,in this section3 7#a7 ,appropriate committees of ,congress ,the term appropriate committees of ,congress means-- 7,a7 the ,committee on ,appropriations and the ,committee on ,veterans' ,affairs of the ,senate2 and 7,b7 the ,committee on ,appropriations and the ,committee on ,veterans' ,affairs of the ,house of ,representatives4 7#b7 ,capital asset project ,the term capital asset project means a capital asset investment or activity of the ,department4 7#c7 ,super construction project ,the term super construction project has the meaning given such term in section #hajc7;e77#c7 of this title4 4 7b7 ,clerical amendment ,the table of sections at the beginning of chapter #ha of title #ch1 ,united ,states ,code1 is amended by striking the item relating to section #habj and inserting the following new item3 #habj4 ,reports on key capital asset investments1 activities1 and performance4 4 #ffj4 ,development of streamlined procurement model2 report ,not later than #ahj days after the date of enactment of this ,act1 the ,secretary of ,veterans ,affairs1 in consultation with the ,comptroller ,general of the ,united ,states1 the ,director of the ,office of ,management and ,budget1 and private sector stakeholders1 shall develop a revised process for the procurement of major medical facility leases under chapter #ha of title #ch1 ,united ,states ,code1 and submit to the ,committees on ,veterans' ,affairs of the ,house of ,representatives and the ,senate a report that includes a description of such revised process4 #ffa4 ,submission and notification of cost estimates for medical facility leases 7a7 ,submission of cost estimates for major medical facility leases with presidential budget request ,subchapter ,i of chapter #ha of title #ch1 ,united ,states ,code1 is amended by inserting after section #hajd the following new section3 #hajd;,a4 ,submission of cost estimates for major medical facility leases with president's budget request 7a7 ,in general ,for each major medical facility lease or prospectus-level lease for which the ,secretary seeks authorization1 appropriations1 or prospectus approval1 the ,secretary shall include in the budget justification materials submitted to ,congress in connection with the budget of the ,department for the applicable fiscal year 7as submitted with the budget of the ,president under section #aaje7;a7 of title #ca7 a market-based cost estimate and full life-cycle cost estimate for such lease4 7b7 ,market-based cost estimate ,each market-based cost estimate required under subsection 7a7 shall include an evaluation of-- 7#a7 local land values2 7#b7 applicable construction costs2 and 7#c7 other cost factors the ,secretary determines relevant to build-to-suit facilities4 7c7 ,standardized methodology 7#a7 ,in general ,the ,secretary shall adopt and apply a standardized methodology for estimating under subsection 7a7 the full life-cycle cost of major medical facility leases and prospectus-level leases4 7#b7 ,required elements ,the methodology required under paragraph 7#a7 shall include1 at a minimum-- 7,a7 base rent projections over the full lease term2 7,b7 tenant improvement and buildout costs based on current medical facility standards2 7,c7 estimated operating expenses1 including utilities1 maintenance1 and security2 7,d7 annual escalation factors tied to construction cost indices1 labor rates1 and market trends2 7,e7 cost assumptions for option periods or potential renewal terms2 and 7,f7 geographic adjustments using current regional market data to reflect location-specific construction and leasing conditions4 7d7 ,annual adjustment 7#a7 ,in general ,to reflect inflation and market escalation1 the ,secretary shall annually adjust each cost estimate for a lease submitted to ,congress for authorization1 appropriations1 or prospectus approval during the period beginning on the date on which the ,secretary first includes such cost estimate in the budget justification materials described in subsection 7a7 and ending on the projected award date for the lease4 7#b7 ,indices ,in adjusting a cost estimate under paragraph 7#a71 the ,secretary shall use such medical construction or real estate indices as the ,secretary determines appropriate4 7e7 ,rules of construction 7#a7 ,budgetary treatment ,nothing in this section shall be construed to alter1 supersede1 waive1 or otherwise affect the application of the scorekeeping guidelines1 including the budgetary treatment of leases under ,office of ,management and ,budget ,circular ,a-#aa or any successor guidance4 7#b7 ,preservation of existing budget authority requirements ,nothing in this section shall be construed to authorize the ,secretary to enter into a lease1 incur an obligation1 or make an expenditure except to the extent and in the amount provided in advance in appropriations ,acts4 7f7 ,definitions ,in this section1 the term major medical facility lease has the meaning given that term in section #hajd7;a77#c77;,b7 of this title4 4 7b7 ,congressional notification and plan required for cost estimates exceeding approved prospectus amounts ,subchapter ,i of such chapter is further amended by inserting after section #hajd;,a the following new section3 #hajd;,b4 ,congressional notification and plan required for cost estimates exceeding approved prospectus amounts 7a7 ,price estimates required during solicitation phase ,as part of the request for lease proposals 7or equivalent formal solicitation7 for a major medical facility lease1 the ,secretary shall require offerors to provide detailed price proposals1 including the cost of land 7if applicable71 to enable evaluation against the authorized prospectus amount4 7b7 ,notification required ,if the lowest responsive offer for a major medical facility lease exceeds the unserviced shell rent authorized in the approved prospectus by more than #aj percent1 the ,secretary shall notify the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives not later than #de days after the date on which the ,secretary determines that such offer exceeds such authorized amount4 7c7 ,plan required 7#a7 ,in general ,not later than #fj days after notification under subsection 7b7 with respect to a major medical facility lease1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a plan to address the cost discrepancy for such lease1 which may include scope adjustment1 value engineering1 requesting additional authority1 or other appropriate measures4 7#b7 ,limitation on award ,the ,secretary shall not award a major medical facility lease until the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives have received the plan required under paragraph 7#a7 with respect to such lease4 7d7 ,limitation on further action ,if the ,secretary is required to submit a notification under subsection 7b71 the ,secretary may not issue a request for lease proposals for the applicable major medical facility lease until the date on which the ,secretary submits the plan required under subsection 7c74 7e7 ,rule of construction ,nothing in this section shall be construed to authorize the ,secretary to exceed any amount authorized in an approved prospectus or any amount provided in advance in an appropriations ,act4 4 7c7 ,clerical amendment ,the table of sections at the beginning of such chapter is amended by inserting after the item relating to section #hajd the following new items3 #hajd;,a4 ,submission of cost estimates for major medical facility leases with ,president's budget request#hajd;,b4 ,congressional notification and plan required for cost estimates exceeding approved prospectus amounts 4 #ffb4 ,report on capital asset and information technology needs of the research and development program of ,department of ,veterans ,affairs 7a7 ,report required ,not later than two years after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall submit to ,congress a report on the capital asset and information technology needs of the research and development program of the ,department of ,veterans ,affairs4 7b7 ,contents 7#a7 ,in general ,the report required by subsection 7a7 shall include the following3 7,a7 ,a comprehensive summary of new facilities1 renovations of existing facilities1 leasing of facilities1 and any other such facilities or physical infrastructure the ,department requires to effectively perform its research and development functions1 including projected functions4 7,b7 ,detailed information on the information technology resources1 projects1 equipment1 and related information technology needs1 disaggregated by type of information technology funding categories1 such as development or operations and maintenance1 the ,department requires in order to make the research and development program and activities of the ,department functional and high-performing in the short-1 medium-1 and long-term1 and those needed to enable employees of the ,department to perform their research and development activities in an effective and efficient manner4 7,c7 ,such matters as the ,secretary determines relevant to maintain and further improve and advance the research and development functions of the ,department through improved capital asset and information technology support4 7#b7 ,requirements 7,a7 ,facilities 7i7 ,summaries by project ,in providing information under paragraph 7#a77;,a71 the ,secretary shall provide estimated summaries for each project with cost data as well as a realistic multi-year plan to design and deliver the capital asset projects1 assuming required funding is provided4 7ii7 ,identification of projects ,the ,secretary shall identify each project under paragraph 7#a77;,a7 by its project type1 such as major construction1 minor construction1 nonrecurring maintenance1 major lease1 minor lease1 or such other category as the ,secretary determines may be appropriate4 7,b7 ,information technology ,in providing information under paragraph 7#a77;,b71 the ,secretary shall provide estimated summaries for each project or investment with individual and total cost data as well as a realistic multi-year plan to develop relevant requirements and acquire and deploy the relevant information technology services1 projects1 equipment1 and related matters4 7,c7 ,scope ,the scope of the report submitted under subsection 7a7 is on the capital asset1 information technology1 and other related critical support functions1 excluding human capital related needs1 needed for the ,department to perform research and development in an effective and efficient manner4 7c7 ,considerations ,in preparing the report required by subsection 7a71 the ,secretary may consider the following3 7#a7 ,the findings of the #bjab final report of the ,research ,infrastructure ,program of the ,department4 7#b7 ,current and updated data providing the most accurate and holistic presentation of the physical infrastructure1 information technology1 and other relevant support function needs of the research and development program of the ,department4 7#c7 ,such other matters as the ,secretary considers appropriate4 #ffc4 ,improving prevention1 detection1 and reporting of waste1 fraud1 and abuse in ,department of ,veterans ,affairs capital asset projects and activities 7a7 ,report required ,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 actions the ,department of ,veterans ,affairs is taking or plans to take to enhance the ability of the ,department to prevent1 detect1 and report waste1 fraud1 and abuse occurring in capital asset projects of the ,department1 whether by employees1 contractors1 or other relevant persons or entities involved with the ,department4 7b7 ,elements ,the report required by subsection 7a7 shall include the following3 7#a7 ,an assessment of whether new training or enhancements to existing training should be undertaken to improve the prevention1 detection1 and reporting of waste1 fraud1 and abuse4 7#b7 ,recommendations for such legislative and administrative action as the ,secretary determines appropriate to improve the prevention1 detection1 and reporting of waste1 fraud1 and abuse4 7#c7 ,such other matters as the ,secretary considers appropriate4 7c7 ,consultation ,in carrying out subsection 7a71 the ,secretary-- 7#a7 shall consult with the ,inspector ,general of the ,department of ,veterans ,affairs and the ,comptroller ,general of the ,united ,states on matters relating to best practices and strategies to improve detection and prevention by the ,department of waste1 fraud1 and abuse in capital asset projects and management2 and 7#b7 may consult with such other persons and entities on such matters as the ,secretary considers appropriate4 #ffd4 ,report on long-term care physical infrastructure needs of ,department of ,veterans ,affairs 7a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall submit to the appropriate committees of ,congress a report1 disaggregated by medical center or other relevant health care facility of the ,department of ,veterans ,affairs1 identifying the physical infrastructure needs of the ,department to support current and future anticipated long-term care needs and models of care for veterans1 including-- 7#a7 infrastructure needed to support the delivery of long-term care for women veterans1 veterans with spinal cord injuries and diseases1 veterans with traumatic brain injury1 veterans with unique behavioral health needs1 veterans with memory loss1 and other population groups with unique needs or projected future needs2 7#b7 information regarding the plans of the ,department to provide such care as the ,department builds internal capacity but space is not yet available to meet the demand for such care2 and 7#c7 with respect to any projects needed to provide the infrastructure specified under paragraph 7#a7-- 7,a7 the estimated individual project cost and total cost to accomplish those projects2 and 7,b7 the estimated individual project timeline to accomplish each such project upon receipt of appropriate funding4 7b7 ,inclusion of information regarding prioritization of certain projects ,the ,secretary shall include in the report required under subsection 7a7 information regarding how the infrastructure prioritization processes of the ,department1 such as the ,strategic ,capital ,investment ,planning process1 or successor process1 could be modified to include higher prioritization of projects that support the provision of a health care service that is not widely available1 or is not available in compliance with appropriate quality or access standards1 from non-,department providers4 7c7 ,development of report ,in developing the report required under subsection 7a71 the ,secretary shall consult with relevant regional and national program offices of the ,veterans ,health ,administration with responsibility for managing the various health care services covered by the report1 including long-term care and care relating to spinal cord injuries and diseases1 to ensure that the report contains a holistic1 comprehensive1 and integrated plan to address the capital asset and other space needs for the population of veterans who require those services4 7d7 ,indication of types of projects ,in the report required under subsection 7a71 the ,secretary shall indicate the projects that can be most efficiently and effectively accomplished through smaller individual infrastructure projects or through a larger medical facility replacement or new site of care1 as determined by the ,secretary4 ,f ,other ,health ,care ,matters #fga4 ,prescription1 delivery1 distribution1 and dispensation of controlled substance medications by covered health care professionals of ,department of ,veterans ,affairs via telemedicine 7a7 ,in general ,subchapter ,,iii of chapter #ag of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new section3 #agcj;,d4 ,prescription1 delivery1 distribution1 and dispensation of controlled substance medications via telemedicine 7a7 ,in general ,notwithstanding sections #ajb7ed7 and #cji7;e7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hjb7ed7 and #hbi7;e771 a covered health care professional may prescribe1 deliver1 distribute1 and dispense a controlled substance if the covered health care professional is using telemedicine through the use of an interactive telecommunications system1 including an audio-only telecommunications system when necessary1 to prescribe1 deliver1 distribute1 or dispense to a patient eligible to receive hospital care or medical services under this chapter a controlled substance that is a prescription drug as determined under the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cja et seq471 regardless of whether such covered health care professional has conducted an in-person medical examination of such patient1 if-- 7#a7 such covered health care professional-- 7,a7 is acting in the usual course of professional practice2 7,b7 is registered pursuant to section #cjc7;g7 of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbc7;g77 in any ,state or is utilizing the registration of a facility of the ,department registered pursuant to section #cjc7;f7 of such ,act 7#ba ,u4,s4,c4 #hbc7;f772 7,c7 has access to medical documentation from an in-person medical evaluation of such patient in the past two years by-- 7i7 a covered health care professional2 7ii7 a health care professional who furnished care and services under the ,veterans ,community ,care ,program under section #agjc of this title2 or 7iii7 a health care professional of the ,department of ,defense2 and 7,d7 at the time of the telemedicine visit of the patient-- 7i7 has reviewed the prescription data of the individual from the electronic health record database of the ,department and data from the prescription drug monitoring program for the ,state in which the patient is located at the time of the telemedicine encounter 7if such a program exists7 for at least the one-year period preceding the date of the visit or1 if less than one year of data is available1 for the entire period available2 and 7ii7 provides documentation of-- 7,i7 such review2 7,,ii7 all successful attempts to access such databases and program2 and 7,,iii7 all unsuccessful attempts to access such databases and program that resulted in the prescription of a limited supply under subsection 7b72 and 7#b7 such substance is delivered1 distributed1 or dispensed for a legitimate medical purpose4 7b7 ,authority for limited supply 7#a7 ,in general ,if the databases and program described in subsection 7a77#a77;,d7 are unavailable or inaccessible at the time of a telemedicine encounter conducted by a covered health care professional1 the covered health care professional may not prescribe1 deliver1 distribute1 or dispense more than a seven-day supply of a controlled substance until the covered health care professional is able to review such databases and program4 7#b7 ,databases unavailable or inaccessible ,if a database or program required to be reviewed under subsection 7a77#a77;,d7 is unavailable or inaccessible for an extended period1 as determined by the ,secretary1 a covered health care professional may provide additional seven-day supplies of a controlled substance until such database or program is accessible4 7c7 ,maximum supply ,the authority under this section may be used to supply a controlled substance for not more than a six-month period4 7d7 ,use of authority ,the ,secretary shall ensure that the authority under this section is used to prevent interruptions to patient care and not as a replacement for routine in-person patient care4 7e7 ,regulations 7#a7 ,in general ,the ,secretary shall establish in regulations guidelines and a process for the prescription1 delivery1 distribution1 and dispensation of a controlled substance pursuant to subsection 7a74 7#b7 ,elements ,the ,secretary shall ensure the guidelines and process described in paragraph 7#a7-- 7,a7 do not restrict access of a patient to in-person care2 and 7,b7 provide for the collection and analysis of data to determine if an individual has evidence of a prior in-person medical evaluation by a health care professional described in subsection 7a77#a77;,c7 who would reasonably be expected to have prescribing authority based on their credential or organizational role4 7#c7 ,initiating treatment 7,a7 ,in general ,the guidelines established by paragraph 7#a7 shall prohibit a covered health care professional from initiating treatment with an opioid medication listed in schedule ,,ii or ,,iii under section #bjb of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hab7 unless the covered health care professional is providing treatment-- 7i7 for opioid use disorder2 7ii7 for a patient receiving palliative care or enrolled in hospice care2 or 7iii7 for a patient who is physically located in a medical facility where the patient is receiving in-person care4 7,b7 ,exception ,the prohibition under subparagraph 7,a7 shall not apply to renewal or maintenance of a previously prescribed medication described in such subparagraph4 7f7 ,reporting 7#a7 ,in general ,not later than one year after the date of the enactment of the ,take ,care of ,america's ,veterans ,act1 and not less frequently than annually thereafter until the termination date under subsection 7g71 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report that addresses the use of the authority under this section during the fiscal year preceding the date of submission of the report in each ,veterans ,integrated ,service ,network4 7#b7 ,elements ,each report under paragraph 7#a7 shall indicate1 at a minimum-- 7,a7 how many patients received prescriptions for controlled substance medications through telemedicine under this section2 7,b7 which controlled substances are being prescribed under this section and how many prescriptions were written for each such substance2 7,c7 the number of individuals who received a controlled substance medication that was prescribed1 delivered1 distributed1 or dispensed under this section without evidence of an in-person medical evaluation within the previous two years by a health care professional described in subsection 7a77#a77;,c72 and 7,d7 the barriers that exist to reviewing prescription drug monitoring programs of ,states and how often those barriers occur4 7g7 ,duration ,the authority under this section shall terminate on ,september #cj1 #bjca4 7h7 ,definitions ,in this section3 7#a7 ,the terms controlled substance1 deliver1 dispense1 and distribute have the meanings given those terms in section #ajb of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hjb74 7#b7 ,the term covered health care professional means-- 7,a7 a health care professional who-- 7i7 is-- 7,i7 an employee of the ,department appointed under section #gcjf1 #gdja1 #gdje1 #gdjf1 or #gdjh of this title or under title #e2 or 7,,ii7 operating from a facility of the ,department1 including a clinic of the ,department2 7ii7 is authorized by the ,secretary to provide health care under this chapter2 7iii7 is required to adhere to all standards for quality relating to the provision of health care in accordance with applicable policies of the ,department2 7iv7 has an active1 current1 full1 and unrestricted license1 registration1 or certification or meets qualification standards set forth by the ,secretary within a specified time frame2 and 7v7 with respect to a health care profession listed under section #gdjb7;b7 of this title1 has the qualifications for such profession as set forth by the ,secretary2 and 7,b7 a health professions trainee who-- 7i7 is appointed under section #gdje of this title2 and 7ii7 is under the clinical supervision of a health care professional described in subparagraph 7,a74 4 7b7 ,clerical amendment ,the table of sections at the beginning of such chapter is amended by inserting after the item relating to section #agcj;,c the following new item3 #agcj;,d4 ,prescription1 delivery1 distribution1 and dispensation of controlled substance medications via telemedicine4 4 #fgb4 ,copayments for limited supplies of medications ,paragraph 7#d7 of section #agbb;,a7a7 of title #ch1 ,united ,states ,code1 is amended to read as follows3 7#d7 ,paragraph 7#a7 does not apply-- 7,a7 to opioid antagonists furnished under this chapter to a veteran who is at high risk for overdose of a specific medication or substance in order to reverse the effect of such an overdose2 and 7,b7 to any limited supply prescription for medication1 up to a #cj-;day supply of such medication1 under section #agcj;,d7b7 of this title if the covered health care professional would have prescribed1 delivered1 distributed1 or dispensed a supply for more than seven days if not for the restrictions under such section4 4 #fgc4 ,plan on establishment of interactive1 online self-service module for care 7a7 ,in general ,the ,secretary of ,veterans ,affairs shall develop and implement a plan to establish1 to the greatest extent practicable1 an interactive1 online self-service module-- 7#a7 to allow 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 ,code-- 7,a7 to request appointments1 track referrals for health care under the laws administered by the ,secretary1 whether at a facility of the ,department of ,veterans ,affairs or through a non-,department provider1 and receive appointment reminders2 7,b7 to appeal and track decisions relating to-- 7i7 denials of requests for authorization for care or services under section #agjc of title #ch1 ,united ,states ,code2 or 7ii7 denials of requests for care or services at facilities of the ,department1 including under section #agaj of such title2 7,c7 to compare the average wait times for appointments for the type of care sought by the veteran at facilities of the ,department and with non-,department facilities and providers through which the ,secretary furnishes care and services under section #agjc of such title2 7,d7 to compare average driving times between their residence and the nearest facility of the ,department that provides the care they are seeking and between their residence and the closest non-,department provider that provides the care they are seeking and through which the ,secretary furnishes care and services under section #agjc of such title2 and 7,e7 to view a provider directory1 information regarding pending medical claims1 and explanations of benefits2 and 7#b7 to implement such other matters as determined appropriate by the ,secretary4 7b7 ,submittal of plan 7#a7 ,initial plan ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives the plan developed under subsection 7a74 7#b7 ,biannual update ,not less frequently than once every #ahj days during the two-year period beginning on the submittal of the plan under paragraph 7#a71 the ,secretary shall brief the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives on any updates on the implementation of such plan4 #fgd4 ,modification of requirements for ,center for ,innovation for ,care and ,payment of the ,department of ,veterans ,affairs and transfer of authority 7a7 ,in general ,chapter #c of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new section3 #cbf4 ,center for ,innovation 7a7 ,establishment ,there is established within the ,department a ,center for ,innovation 7in this section referred to as the ,center74 7b7 ,purpose ,the purpose of the ,center is to test innovative payment and service delivery models to reduce program expenditures of the ,department under chapter #ag of this title while preserving or enhancing the quality of care furnished to veterans and other eligible individuals4 7c7 ,identification and testing of models 7#a7 ,in general ,the ,center shall-- 7,a7 identify and test health care payment and service delivery models under this title1 including care from non-,department providers under subchapter ,i of chapter #ag of this title1 that have the potential to-- 7i7 reduce program expenditures2 and 7ii7 preserve or enhance the quality of care furnished to veterans2 7,b7 give preference to models that improve the coordination1 quality1 and efficiency of health care services furnished under this title2 and 7,c7 evaluate the effect of applying such models on program expenditures and quality outcomes under this title4 7#b7 ,included models ,the models identified and tested under paragraph 7#a7 may include the following3 7,a7 ,bundled payment arrangements4 7,b7 ,preventive care initiatives4 7,c7 ,chronic care coordination models4 7d7 ,selection of models 7#a7 ,in general ,the ,secretary1 acting through the ,center1 shall select models to be tested under subsection 7b7 from among those that-- 7,a7 address a defined population for which there are demonstrated deficits in care leading to poor clinical outcomes or potentially avoidable expenditures2 and 7,b7 are expected to reduce program costs while preserving or enhancing the quality of care furnished to veterans4 7#b7 ,criteria ,in selecting models under paragraph 7#a71 the ,secretary shall apply criteria consistent with the model selection framework used in evidence-based criteria that the ,secretary determines appropriate4 7e7 ,testing and evaluation 7#a7 ,in general ,the ,secretary shall design and test each model under this section in a manner that allows for the evaluation of-- 7,a7 changes in program expenditures2 7,b7 changes in quality and outcomes of care for veterans2 and 7,c7 other factors the ,secretary determines relevant to care coordination1 access1 and equity4 7#b7 ,evaluation ,the ,secretary shall evaluate each model under this section using scientifically valid methodologies1 including control or comparison groups if practicable4 7f7 ,reporting 7#a7 ,annual report ,not less frequently than annually1 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 models being tested under this section and their preliminary results1 including-- 7,a7 a brief narrative description of the model explaining its intent and the proposed manner in which it is supposed to reduce expenditures and increase quality of or access to care for veterans2 7,b7 the number of veterans and providers participating in the model1 broken down by demographics such as age1 race or ethnicity1 geographic location1 and other characteristics as chosen by the ,secretary2 7,c7 gross and net savings or increases to the medical services account of the ,department1 including in comparison to baseline budgetary assumptions in the absence of the model2 7,d7 an assessment of the utilization of the model1 including the proportion of providers choosing to participate in the model and the proportion of veterans choosing to participate in the model1 as the case may be2 7,e7 an assessment of quality of care and patient outcome as measured by discrete objective metrics1 including changes to morbidity and mortality1 changes to admission rates1 changes to readmission rates1 changes to population health metrics such as average blood pressure1 ,a#a;,c levels1 body mass index1 or other relevant health metrics1 or other relevant clinical outcome metrics2 7,f7 a description of provider1 stakeholder1 and veteran experiences2 and 7,g7 such other matters as the ,secretary may consider relevant4 7#b7 ,final report on models ,not later than #ahj days after completing each model under this section1 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a final report on such model1 including-- 7,a7 findings from the evaluation of such model2 7,b7 updated findings under paragraph 7#a7 with respect to such model2 7,c7 an assessment of the fiscal impact of such model2 and 7,d7 recommendations for expansion or termination of the use of such model4 7g7 ,expansion of successful models 7#a7 ,in general ,except as provided in paragraph 7#b71 the ,secretary may1 through rulemaking1 expand the duration and scope of a model tested under this section to the extent that-- 7,a7 the ,secretary determines such expansion is expected to-- 7i7 reduce program expenditures without reducing quality of care2 or 7ii7 improve quality of care without increasing program expenditures2 and 7,b7 the ,chief ,financial ,officer of the ,department certifies that such expansion will maintain budget neutrality4 7#b7 ,limitation ,the ,secretary shall not expand a model unless the results of the evaluation of the model under subsection 7e7 demonstrate that the requirements of paragraph 7#a7 are satisfied4 7h7 ,cost neutrality and funding 7#a7 ,in general ,implementation or expansion of any model under this section shall be conducted in a manner that is cost-neutral to the ,department over the duration of the use of the model1 including administrative costs4 7#b7 ,use of available amounts ,the ,secretary shall ensure that expenditures under this section are made from amounts otherwise available to the ,department for medical services1 community care1 or medical support and compliance4 7i7 ,rule of construction ,nothing in this section shall be construed to authorize the ,secretary to reduce the scope or amount of benefits under this title1 or to impose additional eligibility requirements1 except as may be necessary to carry out an approved model under this section4 4 7b7 ,conforming and clerical amendments 7#a7 ,conforming repeal ,section #agjc;,e of title #ch1 ,united ,states ,code1 is repealed4 7#b7 ,conforming amendments 7,a7 ,pilot program to improve administration of care under ,veterans ,community ,care ,program ,section #aje7;a7 of the ,senator ,elizabeth ,dole #bast ,century ,veterans ,healthcare and ,benefits ,improvement ,act 7,public ,law #aah-baj2 #ch ,u4,s4,c4 #agjc note7 is amended1 in the matter preceding paragraph 7#a71 by striking ,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 and inserting ,pursuant to section #cbf of title #ch1 ,united ,states ,code1 the ,secretary of ,veterans ,affairs1 acting through the ,center for ,innovation4 7,b7 ,pilot program on consolidating approval process of ,department of ,veterans ,affairs for covered dental care ,section #ajf7;a7 of the ,senator ,elizabeth ,dole #bast ,century ,veterans ,healthcare and ,benefits ,improvement ,act 7,public ,law #aah-baj2 #ch ,u4,s4,c4 #agjc note7 is amended1 in the matter preceding paragraph 7#a71 by striking the ,center for ,innovation for ,care and ,payment established under section #agjc;,e of title #ch1 ,united ,states ,code and inserting the ,center for ,innovation established under section #cbf of title #ch1 ,united ,states ,code4 7,c7 ,strategic plan on value-based health care system for ,veterans ,health ,administration2 pilot program ,section #ajg of the ,senator ,elizabeth ,dole #bast ,century ,veterans ,healthcare and ,benefits ,improvement ,act 7,public ,law #aah-baj2 #ch ,u4,s4,c4 #agja note7 is amended-- 7i7 in subsection 7a77#b77;,a77viii71 by striking the ,center for ,innovation for ,care and ,payment of the ,department under section #agjc;,e of title #ch1 ,united ,states ,code and inserting the ,center for ,innovation under section #cbf of title #ch1 ,united ,states ,code2 and 7ii7 in subsection 7c77#a71 by striking the ,center for ,innovation for ,care and ,payment established under section #agjc;,e of title #ch1 ,united ,states ,code and inserting 8the ,center for ,innovation under section #cbf of title #ch1 ,united ,states ,code4 7#c7 ,clerical amendments 7,a7 ,chapter #ag ,the table of sections at the beginning of chapter #ag of title #ch1 ,united ,states ,code1 is amended by striking the item relating to section #agjc;,e4 7,b7 ,chapter #c ,the table of sections at the beginning of chapter #c of such title is amended by adding at the end the following new item3 #cbf4 ,center for ,innovation4 4 7c7 ,comptroller ,general report ,not later than #ah months after the date of the enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall submit to ,congress a report-- 7#a7 on the efforts of the ,center for ,innovation of the ,department of ,veterans ,affairs in fulfilling the objectives and requirements under section #cbf of title #ch1 ,united ,states ,code1 as added by subsection 7a72 and 7#b7 containing such recommendations as the ,comptroller ,general considers appropriate4 7d7 ,review of ,veterans ,community ,care ,program 7#a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs1 acting through the ,office of ,management of the ,department of ,veterans ,affairs1 shall conduct a review of all aspects of the ,veterans ,community ,care ,program4 7#b7 ,elements ,the review required by paragraph 7#a7 shall-- 7,a7 identify proven management and payment best practices of the ,federal ,government used under the ,medicare program under title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq471 the ,medicaid program under title ,,xix of such ,act 7#db ,u4,s4,c4 #acif et seq471 and the ,,tricare program 7as defined in section #ajgb of title #aj1 ,united ,states ,code72 7,b7 determine what best practices1 if any1 identified under subparagraph 7,a7 should be adopted and implemented by the ,secretary1 including those practices that would require legislative action before adoption and implementation2 7,c7 determine how the ,secretary can improve access to care through the ,veterans ,community ,care ,program for veterans eligible for such care2 7,d7 identify solutions to ease administrative1 legislative1 and regulatory burdens and improve efficiency in the ,veterans ,community ,care ,program2 7,e7 identify improvements to the ,veterans ,community ,care ,program that can enhance the experience of veterans and participating entities and providers furnishing hospital care1 medical services1 and extended care services under the ,veterans ,community ,care ,program2 7,f7 review how the ,secretary-- 7i7 identifies eligibility for and reviews1 processes1 and approves referrals for care under the ,veterans ,community ,care ,program2 7ii7 authorizes the furnishing of services under the ,veterans ,community ,care ,program2 and 7iii7 receives1 reviews1 processes1 and approves requests for payment from participating entities and providers furnishing services under the ,veterans ,community ,care ,program4 7,g7 assess such other factors as determined appropriate by the ,secretary in consultation with ,congress4 7#c7 ,briefing and report 7,a7 ,briefing ,periodically throughout the duration of the review required under paragraph 7#a71 but not less frequently than quarterly1 the ,secretary shall brief the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives on the status and preliminary findings of such review4 7,b7 ,report ,not later than #cj days after the conclusion of the review required under paragraph 7#a71 the ,secretary shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a written report containing-- 7i7 a complete and unredacted list of all findings and recommendations from the review2 and 7ii7 any legislative1 administrative1 regulatory1 policy1 or other changes sought by the ,secretary as a result of such findings4 7#d7 ,veterans ,community ,care ,program defined ,in this subsection1 the term ,veterans ,community ,care ,program means the ,veterans ,community ,care ,program under section #agjc of title #ch1 ,united ,states ,code4 7e7 ,pilot programs 7#a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall commence carrying out the pilot programs described in paragraph 7#b7 through the ,center for ,innovation established by section #cbf of title #ch1 ,united ,states ,code1 as added by subsection 7a71 and the ,office of ,management of the ,department of ,veterans ,affairs4 7#b7 ,pilot programs described ,the ,secretary shall carry out the following pilot programs3 7,a7 ,a pilot program to test innovative payment models for the furnishing of preventive health services1 as such term is defined in section #agja of title #ch1 ,united ,states ,code4 7,b7 ,a pilot program to test innovative payment models involving payment bundling for integrated care during an episode of care authorized under the ,veterans ,community ,care ,program under section #agjc of title #ch1 ,united ,states ,code1 to improve the coordination1 quality1 and efficiency of health care delivery under such program4 7f7 ,modification of independent assessments of health care delivery systems and management processes ,subsection #agjd;,a of title #ch1 ,united ,states ,code1 is amended-- 7#a7 in subsection 7a77#b77;,i71 by adding at the end the following new clause3 7vi7 ,to identify proven management and payment best practices of the ,federal ,government used under the ,medicare program under title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq471 the ,medicaid program under title ,,xix of such ,act 7#db ,u4,s4,c4 #acif et seq471 and the ,,tricare program 7as defined in section #ajgb of title #aj74 2 and 7#b7 in subsection 7d71 by inserting or federally funded research and development center after private entity4 #fge4 ,report on improvements to clinical appeals process 7a7 ,in general ,not later than two years after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs1 in consultation with veterans service organizations1 veterans1 caregivers of veterans1 employees of the ,department of ,veterans ,affairs1 and other stakeholders as determined by the ,secretary1 shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a report containing recommendations for legislative or administrative action to improve the clinical appeals process of the ,department with respect to timeliness1 transparency1 objectivity1 consistency1 and fairness4 7b7 ,inapplicability of requirements relating to ,federal advisory committees ,chapter #aj of title #e1 ,united ,states ,code1 shall not apply to the consultation required by subsection 7a74 7c7 ,veterans service organization defined ,in this section1 the term veterans service organization means any organization recognized by the ,secretary under section #eijb of title #ch1 ,united ,states ,code4 #fgf4 ,plan on increasing accessibility of care for veterans with spinal cord injury or disorder 7a7 ,in general ,not later than one year after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall submit to the ,committee on ,veterans' ,affairs of the ,senate and the ,committee on ,veterans' ,affairs of the ,house of ,representatives a plan on improving disability-related access to care from facilities of the ,department and from non-,department facilities and providers through which the ,secretary furnishes care and services under section #agjc of title #ch1 ,united ,states ,code1 for veterans with spinal cord injury or disorder4 7b7 ,consultation ,in developing the plan required under subsection 7a71 the ,secretary shall consult with relevant stakeholders1 including veterans service organizations who serve veterans with spinal cord injury or disorder4 7c7 ,elements ,the plan required under subsection 7a7 shall include an assessment of disability-related barriers to care at medical facilities of the ,department of ,veterans ,affairs and through community care networks of non-,department providers for veterans with spinal cord injury or disorder and a description of the actions needed to overcome such barriers1 including cost estimates1 timelines for corrective action1 and requests for legislative action1 if any4 7d7 ,veterans service organization defined ,in this section1 the term veterans service organization means any organization recognized by the ,secretary under section #eijb of title #ch1 ,united ,states ,code4 ,june #aa1 #bjbf,read the second time and placed on the calendar