S. 4744

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 4744 Placed on Calendar Senate (PCS)]

<DOC>

Calendar No. 433
119th CONGRESS
2d Session
S. 4744

To amend titles 10 and 38, United States Code, and other Federal laws, 
to improve benefits for veterans and the administration of the 
Department of Veterans Affairs.

_______________________________________________________________________

IN THE SENATE OF THE UNITED STATES

June 10, 2026

Mr. Moran (for himself, Mr. Boozman, and Mr. Cramer) introduced the 
following bill; which was read the first time

June 11, 2026

Read the second time and placed on the calendar

_______________________________________________________________________

A BILL

To amend titles 10 and 38, United States Code, and other Federal laws, 
to improve benefits for veterans and the administration of the 
Department of Veterans Affairs.

Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

(a) Short Title.--This Act may be cited as the ``Take Care of 
America's Veterans Act''.
(b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
TITLE I--COMPENSATION

Sec. 101. Major Richard Star Act.
Sec. 102. Love Lives On Act.
Sec. 103. Extension of increased dependency and indemnity compensation 
to surviving spouses of veterans who die 
from amyotrophic lateral sclerosis.
Sec. 104. Sharri Briley and Eric Edmundson Veterans Benefits Expansion 
Act of 2026.
Sec. 105. Claims: prohibition on denial solely for certain reason; 
improved efficiency of adjudications and 
appeals.
Sec. 106. Annual report on causes of death among veterans.
Sec. 107. Plan for use of automation tools to process claims under laws 
administered by the Secretary of Veterans 
Affairs.
Sec. 108. Reforms relating to Department of Veterans Affairs disability 
ratings.
Sec. 109. Improvements to temporary licensure requirements for contract 
health care professionals who perform 
medical disability examinations for the 
Department of Veterans Affairs.
Sec. 110. Disability examinations: study on access in rural areas; 
review of training; review of inadequate or 
unnecessary examinations.
Sec. 111. Improvements to processing and outreach regarding claims 
involving military sexual trauma.
Sec. 112. Independent assessment of notices that the Secretary of 
Veterans Affairs sends to claimants.
Sec. 113. Independent assessment of forms that the Secretary of 
Veterans Affairs sends to claimants.
TITLE II--EDUCATION AND ECONOMIC OPPORTUNITY

Sec. 201. Vets Opportunity Act.
Sec. 202. Improvements to process for making payments to automobile 
sellers for automobiles purchased for 
certain disabled veterans.
Sec. 203. Monthly housing stipend under the Post-9/11 Educational 
Assistance Program for individuals who 
pursue summer programs of education solely 
through distance learning.
Sec. 204. Clarification regarding inclusion of medically necessary 
automobile adaptations in Department of 
Veterans Affairs definition of ``medical 
services''.
Sec. 205. Digital communications: Solid Start program; educational 
assistance.
Sec. 206. Improvements to Transition Assistance Program and 
Skillbridge.
Sec. 207. Transition Assistance Program: presentation in preseparation 
counseling to promote benefits available to 
veterans.
Sec. 208. Elimination of requirement that on-campus educational and 
vocational counseling is provided by 
certain Department of Veterans Affairs 
employees.
Sec. 209. Expansion of entitlement for payment for licensing or 
certification tests for veterans entitled 
to educational assistance.
Sec. 210. 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.
Sec. 211. Improving emerging technology opportunities for veterans.
TITLE III--HEALTH CARE

Sec. 301. Extension and modification of transportation grant program of 
Department of Veterans Affairs.
Sec. 302. Veteran Caregiver Reeducation, Reemployment, and Retirement 
Act.
Sec. 303. Veterans TBI Breakthrough Exploration of Adaptive Care 
Opportunities Nationwide Act.
Sec. 304. Department of Veterans Affairs Assignment of Traveling 
Physicians to Serve Territories, 
Possessions, and Freely Associated States.
Sec. 305. 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.
Sec. 306. Modifications to and reauthorization of Staff Sergeant Parker 
Gordon Fox Suicide Prevention Grant Program 
of Department of Veterans Affairs.
Sec. 307. Reports on the use of hyperbaric oxygen therapy.
Sec. 308. Department of Veterans Affairs pilot program to provide 
grants to mental health care providers for 
the provision of mental health care for 
veterans.
Sec. 309. Furnishing of certain health services to veterans in the 
Freely Associated States.
Sec. 310. Modification of Precision Medicine for Veterans Initiative; 
reporting on suicide by veterans and 
members of the Armed Forces.
Sec. 311. Establishment of the Blast Overpressure Task Force of the 
Department of Veterans Affairs.
Sec. 312. Extension of sharing of Department of Veterans Affairs and 
Department of Defense Health Care 
Resources; resource sharing oversight and 
implementation plan.
Sec. 313. Timely reporting of the death of a veteran.
Sec. 314. Expansion of access by veterans to critical access hospitals 
and affiliated clinics under the Veterans 
Community Care Program.
Sec. 315. Pilot platform for services for veterans; collection from 
veterans of information related to social 
determinants of health.
Sec. 316. Improvements to Department of Veterans Affairs prosthetic and 
rehabilitative items and service.
Sec. 317. Improvement of submission of medical documentation to the 
Secretary of Veterans Affairs by community 
care providers.
Sec. 318. Implementation of and report on efforts of Department of 
Veterans Affairs to improve health care 
appointment scheduling.
Sec. 319. Pilot program on coordination of care between Department of 
Veterans Affairs and Medicare program.
Sec. 320. Fisher House availability.
Sec. 321. Agreements between medical facilities of Department of 
Veterans Affairs and rural medical 
facilities.
Sec. 322. 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.
Sec. 323. Lactation spaces in medical centers of the Department of 
Veterans Affairs.
Sec. 324. Research related to menopause, perimenopause, and mid-life 
women's health: report; plan.
Sec. 325. Pilot program on provision of opioid rescue medications to 
veterans.
Sec. 326. Establishment of Veterans Health Administration Policy 
Advisory Commission.
Sec. 327. Access to health care.
Sec. 328. Research on health conditions of descendants of toxic-exposed 
veterans.
Sec. 329. Veterans Spinal Trauma Access to New Devices Act.
Sec. 330. Department of Veterans Affairs pilot program to award grants 
for the provision of service dogs to 
veterans.
Sec. 331. Authorization of major medical facility project of Department 
of Veterans Affairs for fiscal year 2027 in 
Manchester, New Hampshire.
Sec. 332. Bowel and bladder care program of Department of Veterans 
Affairs.
TITLE IV--ORGANIZATION

Sec. 401. Authorization of appropriations to the Office of Information 
and Technology of the Department of 
Veterans Affairs for certain purposes.
Sec. 402. Establishment of Under Secretary for Management and Chief 
Financial Officer.
Sec. 403. Department of Veterans Affairs acquisition reform and cost 
assessment.
Sec. 404. Improvement of telephone communication by Department of 
Veterans Affairs.
Sec. 405. Advancing Department of Veterans Affairs emergency response 
to crisis.
Sec. 406. Membership of Department of Veterans Affairs Geriatrics and 
Gerontology Advisory Committee.
Sec. 407. Scheduling of appointments under the Veterans Community Care 
Program.
TITLE V--MEMORIAL AFFAIRS

Sec. 501. Expansion of eligibility for Department of Veterans Affairs 
memorial headstone or marker for certain 
individuals.
Sec. 502. Department of Veterans Affairs provision of additional burial 
benefits when an urn or commemorative 
plaque is furnished.
Sec. 503. Fallen Servicemembers Religious Heritage Restoration Program.
TITLE VI--VETERANS' ASSURING CRITICAL CARE EXPANSIONS TO SUPPORT 
SERVICEMEMBERS

Subtitle A--Improvement of Veterans Community Care Program

Sec. 601. Codification of requirements for eligibility standards for 
access to community care from Department of 
Veterans Affairs.
Sec. 602. Requirement that Secretary notify veterans of eligibility for 
care or denial of request for care under 
Veterans Community Care Program.
Sec. 603. Consideration under Veterans Community Care Program of 
continuity of care and need for caregiver 
or attendant.
Sec. 604. Discussion of telehealth options under Veterans Community 
Care Program.
Sec. 605. Extension of deadline for submittal of claims by health care 
entities and providers under prompt payment 
standard.
Sec. 606. Audit of representative sample of veterans receiving care and 
services under Veterans Community Care 
Program.
Sec. 607. Information on wait time and drive time options for receipt 
of care by veterans.
Sec. 608. Establishment of period during which a referral under 
Veterans Community Care Program remains 
valid.
Sec. 609. Updates to contracting requirements under Veterans Community 
Care Program.
Sec. 610. Publication of community care network sufficiency and payment 
waiver requests and approvals.
Sec. 611. Requirements relating to quality of community care providers.
Sec. 612. Provider training.
Sec. 613. Oversight authority over community care.
Subtitle B--Mental Health Treatment Programs

Sec. 621. Veteran participation in certain mental health programs.
Sec. 622. Access to mental health residential rehabilitation treatment 
programs for veterans with spinal cord 
injury or disorder.
Subtitle C--Staffing Matters

Sec. 631. Treatment of psychologists.
Sec. 632. Mentorship program for executive leadership teams at medical 
centers of the Department of Veterans 
Affairs.
Sec. 633. Requirement for equivalent role postings for vacant positions 
at Department of Veterans Affairs.
Sec. 634. Improvements to Department of Veterans Affairs hiring 
processes.
Sec. 635. Department of Veterans Affairs telework policy.
Sec. 636. Expansion of reimbursement of continuing professional 
education expenses.
Sec. 637. Department of Veterans Affairs personnel transparency.
Sec. 638. Modification of authority of licensure of health care 
professionals providing treatment via 
telemedicine.
Sec. 639. Provision of data on educational assistance programs of 
Veterans Health Administration.
Subtitle D--Optimization of Workforce

Sec. 641. Department of Veterans Affairs strategic human capital plan.
Sec. 642. Department of Veterans Affairs reduction in force notice 
requirement.
Sec. 643. Detailed plans and justifications for reorganization of 
offices.
Sec. 644. Rule of construction.
Subtitle E--Veterans Infrastructure and Transformation

Sec. 651. Short title.
Sec. 652. Modification of authority for sharing of health-care 
resources of Department of Veterans Affairs 
to include flexible space utilization and 
streamlined service agreements.
Sec. 653. Use of commercial construction and facilities code and 
standards.
Sec. 654. Feasibility study for full-service hospital of Department of 
Veterans Affairs in certain States.
Sec. 655. Report on strategic plan for infrastructure and capital 
assets of Department of Veterans Affairs.
Sec. 656. Permanent extension of pilot program on acceptance by the 
Department of Veterans affairs of donated 
facilities and related improvements.
Sec. 657. Authority to accept donations of construction services, minor 
construction or nonrecurring maintenance 
projects, and targeted contributions.
Sec. 658. Report on use of additional authorities relating to 
recruitment and retention of personnel.
Sec. 659. Reports on key capital asset investments, activities, and 
performance of Department of Veterans 
Affairs.
Sec. 660. Development of streamlined procurement model; report.
Sec. 661. Submission and notification of cost estimates for medical 
facility leases.
Sec. 662. Report on capital asset and information technology needs of 
the research and development program of 
Department of Veterans Affairs.
Sec. 663. Improving prevention, detection, and reporting of waste, 
fraud, and abuse in Department of Veterans 
Affairs capital asset projects and 
activities.
Sec. 664. Report on long-term care physical infrastructure needs of 
Department of Veterans Affairs.
Subtitle F--Other Health Care Matters

Sec. 671. Prescription, delivery, distribution, and dispensation of 
controlled substance medications by covered 
health care professionals of Department of 
Veterans Affairs via telemedicine.
Sec. 672. Copayments for limited supplies of medications.
Sec. 673. Plan on establishment of interactive, online self-service 
module for care.
Sec. 674. Modification of requirements for Center for Innovation for 
Care and Payment of the Department of 
Veterans Affairs and transfer of authority.
Sec. 675. Report on improvements to clinical appeals process.
Sec. 676. Plan on increasing accessibility of care for veterans with 
spinal cord injury or disorder.

TITLE I--COMPENSATION

SEC. 101. MAJOR RICHARD STAR ACT.

(a) Concurrent Receipt Generally.--Section 1414(b) of title 10, 
United States Code, is amended by striking paragraph (2) and inserting 
the following new paragraphs:
``(2) Combat-related disability retirees.--
``(A) In general.--A member retired under chapter 
61 of this title with a combat-related disability who 
is entitled for any month to retired pay under chapter 
61 of this title and is also entitled for that month to 
veterans' disability compensation under title 38, is 
entitled to be paid both without regard to sections 
5304 and 5305 of title 38, as provided by subparagraphs 
(B) and (C).
``(B) Career retirees.--In the case of a member 
retired under chapter 61 of this title who has a 
combat-related disability that is not a qualifying 
service-connected disability (as defined in subsection 
(a)(2)) and who, at the time of the member's 
retirement, had 20 years or more of service otherwise 
creditable under section 1405 of this title or at least 
20 years of service computed under section 12732 of 
this title, the member may receive, without regard to 
sections 5304 and 5305 of title 38, both--
``(i) 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 61 of this 
title; and
``(ii) veterans' disability compensation 
under title 38.
``(C) Disability retirees with less than 20 years 
of service.--In the case of a member retired under 
chapter 61 of this title with a combat-related 
disability and who, at the time of the member's 
retirement, had less than 20 years of service otherwise 
creditable under section 1405 of this title or less 
than 20 years of service computed under section 12732 
of this title, the member may receive, without regard 
to sections 5304 and 5305 of title 38, the lesser of--
``(i) both--
``(I) the retired pay for which the 
member is eligible under chapter 61 of 
this title; and
``(II) veterans' disability 
compensation under title 38; or
``(ii) both--
``(I) an amount equal to the 
product of the retired pay base 
computed under section 1406(b) or 1407 
of this title and the retired pay 
multiplier determined under section 
1409 of this title, as such base pay 
and multiplier would be computed if the 
member had 20 years of service 
creditable under section 1405 of this 
title; and
``(II) veterans' disability 
compensation under title 38.
``(D) Combat-related disability defined.--In this 
paragraph, the term `combat-related disability' has the 
meaning given that term in subsection (e) of section 
1413a of this title and as determined under the 
criteria and procedures used for purposes of such 
section.
``(3) Exclusion of other retirees.--Subsection (a) does not 
apply to a member retired under chapter 61 of this title if the 
member is not covered by paragraph (1) or (2).''.
(b) Technical and Conforming Amendments.--
(1) Coordination with combat-related special compensation 
program.--Section 1414(d) of title 10, United States Code, is 
amended by striking ``qualified retiree under this section'' 
and inserting ``qualified retiree under subsection (a) or is 
entitled to a payment under subsection (b)(2)''.
(2) Amendments reflecting end of concurrent receipt phase-
in period.--Section 1414 of title 10, United States Code, is 
further amended--
(A) in subsection (a)(1)--
(i) by striking the second sentence; and
(ii) by striking subparagraphs (A) and (B);
(B) by striking subsection (c) and redesignating 
subsections (d) and (e) as subsections (c) and (d), 
respectively; and
(C) in subsection (d), as redesignated, by striking 
paragraphs (3) and (4).
(3) Section heading.--The heading of section 1414 of such 
title is amended to read as follows:
``Sec. 1414. Members eligible for retired pay who are also eligible for 
veterans' disability compensation: concurrent receipt''.
(4) Conforming amendment.--Section 1413a(f) of such title 
is amended by striking ``Subsection (d)'' and inserting 
``Subsection (c)''.
(c) Effective Date.--The amendments made by this section shall take 
effect on January 1, 2027, and shall apply to payments for months 
beginning on or after that date.

SEC. 102. LOVE LIVES ON ACT.

(a) Modification of Entitlement to Veterans Dependency and 
Indemnity Compensation for Surviving Spouses Who Remarry.--Section 
103(d) of title 38, United States Code, is amended--
(1) in paragraph (2)(B)--
(A) by inserting ``(i)'' before ``The remarriage'';
(B) in clause (i), as designated by subparagraph 
(A), by striking ``Notwithstanding the previous 
sentence'' and inserting the following:
``(ii) Notwithstanding clause (i)''; and
(C) by adding at the end the following new clause:
``(iii) Notwithstanding clause (ii), the remarriage of a surviving 
spouse shall not bar the furnishing of benefits under section 1311 or 
1562 of this title to the surviving spouse of a veteran.''; and
(2) in paragraph (5)--
(A) by striking subparagraph (A); and
(B) by renumbering subparagraphs (B) through (E) as 
subparagraphs (A) through (D), respectively.
(b) Continued Eligibility for Survivor Benefit Plan for Certain 
Surviving Spouses Who Remarry.--Section 1450(b)(2) of title 10, United 
States Code, is amended--
(1) by striking ``An annuity'' and inserting the following:
``(A) In general.--(A) Subject to subparagraph (B), 
an annuity''; and
(2) by adding at the end the following new subparagraph:
``(B) 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 (A) or (B) of section 1448(d)(1) solely 
because that surviving spouse remarries. In the case of 
a surviving spouse who remarried before reaching age 55 
and before the date of the enactment of Take Care of 
America's Veterans Act, the Secretary shall resume 
payment of the annuity to that surviving spouse--
``(i) except as provided by clause (ii), 
for each month that begins on or after the date 
that is one year after such date of enactment; 
or
``(ii) on the first day of the first month 
beginning after such date of enactment, 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 1448(d)(2)(B) of title 10, United 
States Code, as in effect on December 31, 
2019.''.
(c) Expansion of Definition of Dependent Under TRICARE Program to 
Include a Remarried Widow or Widower Whose Subsequent Marriage Has 
Ended.--Section 1072(2) of title 10, United States Code, is amended--
(1) in subparagraph (H), by striking ``; and'' and 
inserting a semicolon;
(2) in subparagraph (I)(v), by striking the period at the 
end and inserting ``; and''; and
(3) by adding at the end the following new subparagraph:
``(J) a remarried widow or widower whose subsequent 
marriage has ended due to death, divorce, or 
annulment.''.

SEC. 103. EXTENSION OF INCREASED DEPENDENCY AND INDEMNITY COMPENSATION 
TO SURVIVING SPOUSES OF VETERANS WHO DIE FROM AMYOTROPHIC 
LATERAL SCLEROSIS.

(a) Extension.--Section 1311(a)(2) of title 38, United States Code, 
is amended--
(1) by inserting ``(A)'' before ``The rate''; and
(2) by adding at the end the following new subparagraph:
``(B) A veteran whom the Secretary determines died from amyotrophic 
lateral sclerosis shall be treated as a veteran described in 
subparagraph (A) without regard for how long the veteran had such 
disease prior to death.''.
(b) Applicability.--Subparagraph (B) of section 1311(a)(2) of title 
38, United States Code, as added by subsection (a), shall apply to a 
veteran who dies from amyotrophic lateral sclerosis on or after October 
1, 2022.

SEC. 104. SHARRI BRILEY AND ERIC EDMUNDSON VETERANS BENEFITS EXPANSION 
ACT OF 2026.

(a) Increase in Rates of Certain Disability Compensation and 
Dependency and Indemnity Compensation Under Laws Administered by 
Secretary of Veterans Affairs.--
(1) Increase to rates of wartime disability compensation.--
(A) In general.--Section 1114 of title 38, United 
States Code, is amended by adding at the end the 
following new subsection:
``(u) In the case of a veteran eligible for a monthly aid and 
attendance allowance under subsection (r) or subsection (t) of this 
section, the Secretary shall, in addition to the total amount of 
compensation for which the veteran is eligible under this section, pay 
the veteran a supplemental monthly allowance at the rate of $833.33.''.
(B) Effective date; applicability.--Subsection (u) 
of such section (as added by subparagraph (A)) shall 
take effect on December 1, 2026, and shall apply to 
months beginning on or after such date.
(2) Increase to rates of dependency and indemnity 
compensation.--Section 5312 of such title is amended by adding 
at the end the following new subsection:
``(d)(1) Whenever there is an increase in benefit amounts payable 
under title II of the Social Security Act (42 U.S.C. 401 et seq.) as a 
result of a determination made under section 215(i) of such Act (42 
U.S.C. 415(i)), the Secretary shall, except as provided in paragraph 
(2), effective on the date of such increase in benefit amounts, 
increase the dollar amounts in effect for the payment of dependency and 
indemnity compensation by the Secretary under paragraph (1) and 
paragraph (3) of section 1311(a) of this title, as such amounts were in 
effect immediately before the date of such increase in benefit amounts 
payable under title II of the Social Security Act, by a percentage 
equal to the sum of--
``(A) the percentage by which such benefit amounts are 
increased; and
``(B) one percent.
``(2) Whenever there is an increase under paragraph (1) in amounts 
in effect for the payment of dependency and indemnity compensation, the 
Secretary shall publish such amounts, as increased pursuant to such 
paragraph, in the Federal Register at the same time as the material 
required by section 215(i)(2)(D) of the Social Security Act (42 U.S.C. 
415(i)(2)(D)) is published by reason of a determination under section 
215(i) of such Act (42 U.S.C. 415(i)).
``(3) The requirement to increase, pursuant to paragraph (1), the 
amounts in effect for the payment of dependency and indemnity 
compensation under paragraph (1) and paragraph (3) of section 1311 (a) 
of this title by the Secretary shall--
``(A) take effect on December 1, 2026, and shall apply with 
respect to months beginning on or after such date; and
``(B) terminate after the date on which the third increase 
to such amounts pursuant to such paragraph occurs.''.
(b) Modification of Waivers of Fees Collected for Housing Loans 
Guaranteed, Insured, or Made by the Secretary of Veterans Affairs.--
Section 3729(b)(2) of such title is amended, in the loan fee table--
(1) in subparagraph (E), by striking ``0.50'' both places 
it appears and inserting ``1.42''; and
(2) in subparagraph (I), by striking ``0.50'' each place it 
appears and inserting ``1.0''.
(c) Home Affordability for Guard and Reserve.--
(1) Eligibility of certain members of the reserve 
components and the national guard for guaranteed housing 
loans.--
(A) Expanded definition of ``active duty'' for 
purposes of housing loans.--Section 3701(b) of title 
38, United States Code, is amended by adding at the end 
the following new paragraph:
``(9) The term `active duty' has the meanings as follows:
``(A) In the case of members of the regular 
components of the Armed Forces, the meaning given such 
term in section 101(21)(A).
``(B) In the case of members of the reserve 
components of the Armed Forces--
``(i) service on active duty (as defined in 
section 101(d) of title 10), inactive-duty 
training (as defined in section 101(d) of title 
10), or annual training duty; or
``(ii) service on active duty under a call 
or order to active duty under section 688, 
12301(a), 12301(d), 12301(g), 12301(h), 12302, 
12304, 12304a, or 12304b of title 10 or section 
713 of title 14, but not including inactive 
duty training (as defined in section 101(d) of 
title 10) or annual training duty.
``(C) In the case of a member of the Army National 
Guard of the United States or Air National Guard of the 
United States, in addition to service described in 
subparagraph (B), full-time service--
``(i) in the National Guard of a State for 
the purpose of organizing, administering, 
recruiting, instructing, or training the 
National Guard;
``(ii) in the National Guard when 
performing full-time National Guard duty (as 
defined in section 101 of title 32); or
``(iii) in the National Guard when 
performing active duty (as defined in section 
101 of title 32).''.
(B) Retroactive applicability to service 
performed.--The amendments made by this subsection 
shall apply with respect to any service performed on or 
after September 11, 2001.
(2) Expansion of eligibility for guaranteed housing loans 
to certain additional personnel upon payment of additional loan 
fee.--
(A) Expansion to individuals with at least 14 days 
of service.--Section 3701(b) of title 38, United States 
Code, is amended by inserting after paragraph (7) the 
following new paragraph:
``(8) The term `veteran' also includes, for purposes of 
home loans (subject to the additional loan fee in section 
3729(b)(4)(J) of this title), an individual who--
``(A) is not otherwise eligible for the benefits of 
this chapter;
``(B) has completed a total service of at least 14 
days on active duty under paragraph (B) or (C) of 
paragraph (9); and
``(C) following completion of such service, 
continued to serve until the completion of entry level 
and skill training (as defined in section 3301(3) of 
this title).''.
(B) Basic entitlement.--Section 3702(a)(2) of title 
38, United States Code, is amended by adding at the end 
the following:
``(H) Each individual described in section 3701(b)(8) of 
this title.''.
(C) Additional loan fee for such individuals.--
Section 3729(b)(4) of title 38, United States Code, is 
amended by adding at the end the following new 
subparagraph:
``(J) In the case of a housing loan in which the veteran 
has eligibility under section 3701(b)(8) of this title and does 
not otherwise have eligibility, the loan fee table in paragraph 
(2) shall be applied to the veteran or other obligor (as 
applicable) by adding 1.00 to the percentage in the table.''.
(D) 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 (as defined in section 3301(3) of 
title 38, United States Code) after the date of the 
enactment of this Act is notified of their eligibility 
for housing loan benefits under chapter 37 of such 
title, including eligibility (subject to the additional 
loan fee) under section 3701(b)(8) of such title.

SEC. 105. CLAIMS: PROHIBITION ON DENIAL SOLELY FOR CERTAIN REASON; 
IMPROVED EFFICIENCY OF ADJUDICATIONS AND APPEALS.

(a) 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 
(d) of section 5103A of title 38, United States Code, is amended--
(1) in the heading, by striking ``Compensation Claims'' and 
inserting ``Claims for Benefits'';
(2) in paragraph (2), 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 under''; and
(3) by adding at the end the following new paragraph:
``(3) 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 Secretary, the Secretary may not deny 
such claim on the sole basis that such veteran failed to appear for 
such medical examination.''.
(b) Improvements to Efficiency of Adjudications and Appeals of 
Claims for Benefits Under Laws Administered by Secretary of Veterans 
Affairs.--
(1) Annual report on length of adjudications.--
(A) In general.--Section 5109B of title 38, United 
States Code, is amended--
(i) by striking ``The Secretary'' and 
inserting ``(a) In General.--The Secretary''; 
and
(ii) by adding at the end the following new 
subsection:
``(b) Annual Report.--The Secretary shall submit to the Committees 
on Veterans' Affairs of the House of Representatives and the Senate an 
annual report that includes, with respect to the period covered by the 
report--
``(1) the average length of time a claim (or an issue 
within a claim) that was remanded by the Board of Veterans' 
Appeals was or has been pending before the Secretary after such 
remand;
``(2) the number of cases that advanced on the docket by 
reason of a motion that was filed under section 7107(b) of this 
title and on which the Board ruled, disaggregated by--
``(A) whether a motion was granted or denied; and
``(B) the reason provided for the motion; and
``(3) the number of appeals dismissed by the Board, 
disaggregated by--
``(A) whether or not the dismissal was by reason of 
the death of the appellant; and
``(B) in the case of a dismissal by reason of the 
death of the appellant, whether or not such death was a 
result of suicide.''.
(B) Deadline.--The Secretary of Veterans Affairs 
shall submit the first report required by subsection 
(b) of section 5109B of such title (as added by 
subparagraph (A)) by not later than one year after the 
date of the enactment of this Act.
(2) Guidelines for advancement of cases on docket of 
board.--Not later than one year after the date of the enactment 
of this Act, the Secretary of Veterans Affairs, in consultation 
with the Board of Veterans' Appeals and the General Counsel of 
the Department of Veterans Affairs, 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 7107(b)(3) of title 38, United States Code. 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 motion.
(3) Requirement to track certain claims for benefits.--
(A) In general.--Chapter 51 of title 38, United 
States Code, is amended by inserting after section 
5109B the following new section:
``Sec. 5109C. Requirement to track and maintain information on certain 
claims for benefits; notice of certain assignments
``(a) In General.--The Secretary shall use technology to track and 
maintain information (including information with respect to timeliness) 
on--
``(1) claims for benefits under the laws administered by 
the Secretary (including issues within such claims) that are--
``(A) continuously pursued in accordance with--
``(i) sections 5104C(a) and 5110(a)(2) of 
this title; or
``(ii) any other policy established by the 
Secretary;
``(B) filed in the National Work Queue (or any 
successor system) but have not been assigned to an 
office of the Veterans Benefits Administration for 
adjudication;
``(C) afforded expeditious treatment by the 
Veterans Benefits Administration pursuant to section 
5109B of this title or any other policy established by 
the Secretary;
``(D) remanded by the Board of Veterans' Appeals to 
the Secretary pursuant to section 7104 of this title; 
or
``(E) pending a hearing by the Board of Veterans' 
Appeals under section 7107 of this title;
``(2) 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 (or 
an issue within such a claim), 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 5103A of this title;
``(3) supplemental claims under section 5108 of this title 
that are filed--
``(A) in accordance with section 5104C(a) and 
section 5110(a)(2) of this title; and
``(B) 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 
(or an issue within such a claim); and
``(4) first notices submitted to the Secretary of the death 
of individuals in receipt of benefits under the laws 
administered by the Secretary, disaggregated by such 
individuals who were--
``(A) assigned a fiduciary; and
``(B) not assigned a fiduciary.
``(b) Annual Report.--(1) 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 (a).
``(2) The first report required by paragraph (1) shall be submitted 
by not later than one year after the date of the enactment of the Take 
Care of America's Veterans Act.''.
(B) Clerical amendment.--The table of sections at 
the beginning of such chapter is amended by inserting 
after the item relating to section 5109B the following 
new item:

``5109C. Requirement to track and maintain information on certain 
claims for benefits; notice of certain 
assignments.''.
(4) Improvements to board of veterans' appeals.--
(A) Authority to aggregate certain claims.--
(i) In general.--Section 7104(a) of such 
title is amended by inserting after the second 
sentence the following new sentence: ``If the 
Chairman of the Board determines that more than 
one appeal involves common questions of law or 
fact, the Chairman may aggregate such appeals 
to decide such questions of law or fact.''.
(ii) Effective date.--The amendment made by 
clause (i) shall take effect on the date of the 
enactment of this Act and apply beginning on 
the date 90 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)(D)(i)(II).
(iii) Sunset.--The authority to aggregate 
appeals pursuant to clause (i) 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)(D)(i)(II).
(B) Requirement to ensure substantial compliance 
with certain decisions.--Such section is further 
amended--
(i) by redesignating subsection (f) as 
subsection (g); and
(ii) by inserting after subsection (e) the 
following new subsection (f):
``(f)(1) The Secretary, acting through a member of the Board, shall 
ensure substantial compliance with any decision of the Board to remand 
a claim.
``(2) The agency of original adjudication may waive the requirement 
under paragraph (1) with respect to a decision of the Board to remand a 
claim to the Secretary, if a member of the Board determines--
``(A) evidence added to the evidentiary record after the 
date of such decision is sufficient to resolve the issues 
underlying such decision; or
``(B) such decision was unnecessary.
``(3) If the Secretary waives such requirement, the applicable 
member of the Board shall include, pursuant to subsection (d), a 
determination of such waiver in the decision of the Board.''.
(C) Definition of aggregate; report.--Such section 
is further amended by adding at the end the following 
new subsections:
``(h) 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)(D)(i)(II), and every five 
years thereafter, 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 (a). Each 
such report shall include--
``(1) an identification of each instance in which the Board 
aggregated appeals during the period covered by the report, 
including, for each such instance, the number of appeals that 
were aggregated;
``(2) an assessment of whether the aggregation of appeals 
has contributed to improved efficiency at the Board with 
issuing decisions on appeals; and
``(3) such other matters as the Secretary determines 
appropriate.
``(i) In this section, the term `aggregate'--
``(1) means any practice or procedure to collect common 
issues, claims, or appeals by multiple parties for the purposes 
of resolving such issues, claims, or appeals; and
``(2) includes the use of joinder, consolidation, 
intervention, class actions, and any other multiparty 
proceedings.''.
(5) Expansion of jurisdiction of court of appeals for 
veterans claims.--Section 7252 of title 38, United States Code, 
is amended--
(A) by redesignating subsections (b) and (c) as 
subsections (d) and (e), respectively; and
(B) by inserting after subsection (a) the following 
new subsections:
``(b)(1) In an appeal over which the Court has jurisdiction 
pursuant to section 7266 of this title, if the appellant files a 
request for class certification pursuant to the rules prescribed by the 
Court pursuant to section 7264 of this title, the Court shall have 
supplemental jurisdiction over any claim for benefits under the laws 
administered by the Secretary--
``(A) filed by a claimant who satisfies the definition of 
the class contained in such request (including a claimant who 
has filed a claim for benefits under such laws that are 
specified in such request); and
``(B) regarding which--
``(i) the agency of original jurisdiction has 
issued a nonfinal decision; and
``(ii) the claimant has filed a notice of 
disagreement under section 5104C(a) or section 7105 of 
this title, including any case in which a claimant has 
filed a supplemental claim within one year of a Board 
decision under section 5110(a)(2)(D) and 5108 of this 
title following a notice of disagreement and decision 
of the Board.
``(2) A claimant may submit a request for administrative review of 
such a claim under section 5104C(a) 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 60 days after the later of the 
following dates:
``(A) The date on which the Court issues a final decision 
with respect to such claim.
``(B) The date on which the Court issues a final decision 
with respect to such motion for class action review.
``(3) 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 review.
``(c)(1) In the case of a claim for benefits under the laws 
administered by the Secretary, 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--
``(A) address, in the relevant decision of the Board, an 
issue that--
``(i) the claimant or the representative of the 
claimant raised; or
``(ii) was reasonably raised by the evidentiary 
record of the claim; or
``(B) provide adequate reasons or bases for the decision of 
the Board with respect to such question.
``(2) The Court shall issue Rules that provide for each of the 
following:
``(A) When and how a party to an appeal (either the 
appellant or the Secretary) may request that the Court issue a 
limited remand.
``(B) The period of time within which the Board is required 
to issue a decision on the relevant question identified in a 
limited remand.
``(C) Guidelines for when the Court may grant a request for 
a limited remand.
``(D) Guidelines for when the Court may decide sua sponte 
to issue a limited remand without a request from any party.
``(E) 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 remand.
``(3) With respect to any matter remanded to the Board pursuant to 
paragraph (1), the Court shall--
``(A) retain jurisdiction over such matter; and
``(B) stay the proceedings of the Court on such matter 
until the date on which the Board issues the decision required 
by such remand.''.
(6) Study and report on common questions of law or fact 
before board of veterans' appeals.--
(A) 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 7104 of title 38, 
United States Code, for which precedential guidance 
would assist the Board in issuing final decisions on 
such appeals. The Chairman may use artificial 
intelligence and other technology in carrying out such 
study.
(B) Report.--Not later than one year after the date 
of the enactment of this Act, 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 (A).
(7) Independent assessment of potential modifications to 
authority of board of veterans' appeals.--
(A) Agreement.--Not later than 30 days after the 
date of the enactment of this Act, 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 71 of title 38, United States Code, to 
permit the Board to issue precedential decisions with 
respect to questions of law or fact arising in matters 
before the Board.
(B) Report; briefings.--If the Secretary fails to 
finalize an agreement with an FFRDC under subparagraph 
(A) before the date that is 180 days after the date on 
which the Secretary enters negotiations with respect to 
such agreement, the Secretary shall--
(i) submit to the Committees on Veterans' 
Affairs of the House of Representatives and the 
Senate a report that includes--
(I) an explanation of the reasons 
the Secretary failed to satisfy such 
requirement; and
(II) an estimate of the date on 
which the Secretary will finalize the 
agreement under subparagraph (A); and
(ii) not less frequently than once every 60 
days after the date on which the Secretary 
failed to satisfy such requirement, 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 agreement.
(C) Assessment.--An FFRDC that enters into an 
agreement under subparagraph (A) shall, in consultation 
with veterans service organizations, veterans' and 
survivors' advocate groups, relevant legal experts, and 
the Chair of the Administrative Conference of the 
United States (or the designee or designees of such 
Chair) submit to the Secretary a written assessment 
that includes the following:
(i) 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 
feasible.
(ii) An assessment of the authority of the 
Board of Veterans' Appeals to aggregate, for 
review, more than one appeal under chapter 71 
of such title that involves common questions of 
law or fact pursuant to section 7104 of such 
title, as amended by paragraph (4)(A).
(iii)(I) 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 7104(a) 
of title 38, United States Code, as so amended, 
including--
(aa) whether the use of an opt-out 
system is appropriate in a class 
certification described in section 
7104(a) of title 38, United States 
Code, as amended;
(bb) whether aggregation described 
in clause (ii) is better carried out by 
one member, or a panel of members, of 
the Board;
(cc) whether such aggregation may 
be accomplished in accordance with 
section 7107 of title 38, United States 
Code; and
(dd) how an accredited 
representative, attorney, or authorized 
agent may be selected to represent a 
class before the Board.
(II) The recommendations shall include, but 
not be limited to, the following:
(aa) How the Board should provide 
notice to claimants of the Board's 
intent to aggregate their claim.
(bb) 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 timelines, 
appeal rights, and participation 
options.
(cc) The options the Board should 
provide to claimants to opt out of 
participation in aggregation of their 
claim.
(dd) The rights of the claimants to 
appeal decisions that arise out of 
aggregation of claims, and whether or 
not such rights may be limited by 
existing statute, regulation, or 
judicial decisions.
(ee) Safeguards to ensure that 
aggregation of appeals does not 
diminish the requirement that each 
appeal be decided based on the 
individual facts, evidence, and 
circumstances specific to the claimant.
(ff) Recommendations regarding 
quality review procedures and oversight 
mechanisms to monitor the impact of 
aggregation on claim accuracy, 
consistency, timeliness, and claimant 
outcomes.
(D) Report; implementation.--
(i) In general.--Not later than 90 days 
after the Secretary receives the assessment 
under subparagraph (C), the Secretary shall--
(I) submit to the Committees on 
Veterans' Affairs of the Senate and 
House of Representatives a copy of such 
assessment; and
(II) 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 (C).
(ii) Deadline.--The Secretary shall 
complete the development of the policies and 
procedures required under clause (i)(II) 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 
procedures.
(E) Definitions.--In this paragraph:
(i) The term ``FFRDC'' means a federally 
funded research and development center.
(ii) The term ``veterans service 
organization'' means an organization recognized 
by the Secretary for the representation of 
veterans under section 5902 of title 38, United 
States Code.
(c) Improvements to System for Adjudication of Claims for Benefits 
Under Laws Administered by Secretary of Veterans Affairs.--
(1) Program for quality assurance in decisions of board of 
veterans' appeals; performance reviews.--
(A) In general.--Section 7101 of title 38, United 
States Code, is amended by adding at the end the 
following new subsection:
``(f)(1) The Chairman shall carry out a program to ensure quality 
in the decisions of the Board. Under such program, the Chairman shall--
``(A) develop policies and procedures for--
``(i) measuring quality in such decisions;
``(ii) maintaining data and identifying trends with 
respect to--
``(I) errors in such decisions;
``(II) errors in decisions remanded or 
returned to the Board by the Court of Appeals 
for Veterans Claims; and
``(III) specific members of the Board that 
issued decisions that were subsequently vacated 
by the Court of Appeals for Veterans Claims; 
and
``(iii) 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 regulation;
``(B) with respect to a claim for such a benefit that is 
remanded to the Board by the Court of Appeals for Veterans 
Claims--
``(i) inform any employee of the Board responsible 
for drafting the decision of the Board with respect to 
such claim that such decision was remanded;
``(ii) provide any such employee with a copy of the 
relevant order of the Court of Appeals for Veterans 
Claims (including a copy of any accompanying joint 
motion for remand); and
``(iii) provide incentives to such employees to 
review such relevant orders and joint motions for 
remand; and
``(C) ensure, to the maximum extent practicable, 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 error.
``(2) In developing policies and procedures to measure quality in 
decisions of the Board pursuant to clause (i) of subparagraph (A) of 
paragraph (1), the Chairman shall consider the data and trends 
maintained and identified pursuant to clause (ii) of such subparagraph.
``(3) The Chairman may use technology, including artificial 
intelligence, to maintain such data and identify such trends.
``(4) 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 includes, with respect 
to the period covered by the report, an identification of--
``(A) elements, if any of the process of the Board for 
reviewing an appeal under this chapter that lead to errors in 
decisions of the Board; and
``(B) 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 Claims.''.
(B) Deadline.--The Secretary shall submit the first 
report required by paragraph (2) of such section (as 
added by subparagraph (A)) by not later than one year 
after the date of the enactment of this Act.
(2) Training program for certain employees of board of 
veterans' appeals; performance reviews.--
(A) Training program.--
(i) In general.--Chapter 71 of such title 
(as amended by paragraph (1)) is further 
amended by inserting after section 7101A the 
following new section:
``Sec. 7101B. Training program for members of Board on timely and 
correct adjudication of appeals
``(a) In General.--The Secretary, in conjunction with the Chairman 
of the Board of Veterans' Appeals, shall develop and carry out a 
program to provide Members of the Board training on timely and correct 
adjudication of appeals under this chapter.
``(b) Required Considerations.--In carrying out the program 
required by subsection (a), the Secretary shall consider the following:
``(1) Feedback, if any, from members of the Board and 
covered employees with respect to such program.
``(2) Data on errors in decisions of the Board maintained 
pursuant to the program for quality assurance required by 
subsection (f) of section 7101 of this title.
``(3) 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 action, 
including a joint motion to remand such claim.
``(c) Assessments of Effectiveness.--The Secretary, in conjunction 
with the Chairman of the Board of Veterans' Appeals, shall develop a 
method to assess, on an annual basis, the effectiveness of the training 
program under this section. In developing such method, the Secretary 
shall consider best practices for assessing the effectiveness of 
training programs, including the Kirkpatrick evaluation model.
``(d) 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 (a) that includes, 
with respect to the period covered by the report--
``(1) a statement of the topics of the training provided 
pursuant to this section, disaggregated by--
``(A) mandatory training; and
``(B) non-mandatory training; and
``(2) the results of the assessment of the effectiveness of 
such program required under subsection (c).
``(e) Covered Employee Defined.--In this section, the term `covered 
employee' means an employee of the Board who is--
``(1) not a member of the Board; and
``(2) responsible for drafting decisions of the Board.''.
(ii) Clerical amendment.--The table of 
sections at the beginning of such chapter is 
amended by inserting after the item relating to 
section 7101A the following new item:

``7101B. Training program for Members of Board on timely and 
correct adjudication of appeals.''.
(B) Performance reviews of members of the board.--
Section 7101A of such title is amended--
(i) in subparagraph (B) of subsection 
(c)(1) by striking ``not less often than once 
every three years'' and inserting ``not less 
often than annually''; and
(ii) by adding at the end the following new 
subsection:
``(h)(1) With respect to any performance review of a covered 
employee, the Secretary may not consider the timeliness or quality of 
work of any Member of the Board.
``(2) In this subsection, the term `covered employee' has the 
meaning given such term in section 7101B of this title.''.
(3) Decisions of board to remand.--
(A) Information relating to decisions to remand.--
Section 7104 of such title is amended in subsection 
(d)--
(i) by redesignating paragraphs (1) through 
(3) as paragraphs (2) through (4), 
respectively; and
(ii) by inserting before paragraph (2) (as 
so redesignated), the following new paragraph:
``(1) with respect to a claim that the Board remands for 
further action, a statement of the specific reasons such claim 
was remanded, including any failure on the part of the 
Secretary to comply with--
``(A) the Secretary's duty to assist under section 
5103A of this title; and
``(B) the Secretary's duty to notify under section 
5103 of this title;''.
(B) Notice of remanded decision for certain 
employees.--Such section is further amended in--
(i) subsection (e)--
(I) by redesignating paragraphs (1) 
through (3) as subparagraphs (A) 
through (C), respectively;
(II) by striking ``After'' and 
inserting ``(1) After''; and
(III) by adding at the end the 
following new paragraph:
``(2) If, pursuant to a decision on an appeal, the Board remands a 
claim for a benefit under a law administered by the Secretary for 
further action, the Secretary shall, to the maximum extent practicable, 
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 remand, when applicable.''; and
(ii) in subsection (g), as redesignated by 
section 3(d)(2)(A), by striking ``under 
subsection (e)'' and inserting ``under 
paragraph (1) of subsection (e)''.
(4) Annual reports for board of veterans' appeals.--
(A) In general.--Chapter 71 of title 38, United 
States Code, is amended by inserting after section 7114 
the following new section:
``Sec. 7115. 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 includes, 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 
report, a statement of the reasons for such decision of the Board, 
disaggregated by decisions on--
``(1) claims with a rating decision dated on or after 
February 19, 2019; and
``(2) claims with a rating decision dated before such 
date.''.
(B) Deadlines.--The Secretary shall submit the 
first reports required by subsections (a) and (b) of 
section 7115 of such title (as added by paragraph (1)) 
by not later than one year after the date of the 
enactment of this Act.
(C) Clerical amendment.--The table of sections at 
the beginning of such chapter is amended by inserting 
after the item relating to section 7114 the following 
new item:

``7115. Annual report on Board of Veterans' Appeals''.
(5) Plan for improvements to quality in decisions of 
board.--
(A) In general.--Not later than six months after 
the date of the enactment of this Act, the Secretary of 
Veterans Affairs, in consultation with the Chairman of 
the Board of Veterans' Appeals and the head of the 
Office of Administrative Review of the Veterans 
Benefits Administration, shall develop a plan to--
(i) improve the quality of decisions of the 
Board to remand, pursuant to section 7104 of 
title 38, United States Code, claims for a 
benefit under a law administered by the 
Secretary to the Secretary for further action; 
and
(ii) mitigate the number of such decisions 
that are unnecessary under any applicable law 
or regulation.
(B) 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 Act.
(d) Notice of Avoidable Deferrals of Claims for Benefits Under Laws 
Administered by the Secretary of Veterans Affairs; Study and Report on 
Certain Opinions of Department of Veterans Affairs Office of General 
Counsel.--
(1) Notice of avoidable deferrals.--Not later than one year 
after the date of the enactment of this Act, the Secretary of 
Veterans Affairs shall develop policies, procedures, 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 claim.
(2) Study and report on certain ogc opinions.--
(A) Study.--Not later than one year after the date 
of the enactment of this Act, the Secretary of Veterans 
Affairs, in consultation with the Office of the General 
Counsel of the Department of Veterans Affairs and the 
Chairman of the Board of Veterans' Appeals, shall 
complete a study to identify--
(i) 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 
Secretary; and
(ii) 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 fact.
(B) Report.--Not later than one year after the date 
of the enactment of this Act, the Secretary of Veterans 
Affairs shall submit to the Committees on Veterans' 
Affairs of the Senate and House of Representatives a 
report that includes--
(i) the findings of the study required by 
subparagraph (A);
(ii) 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 opinion; and
(iii) a timeline for the publication of any 
such opinion.

SEC. 106. ANNUAL REPORT ON CAUSES OF DEATH AMONG VETERANS.

(a) In General.--Subchapter II of chapter 5 of title 38, United 
States Code, is amended by adding at the end the following new section:
``Sec. 534. Annual report on causes of death among veterans
``(a) 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 veterans.
``(b) Elements.--Such report shall include--
``(1) for each veteran that died during the period covered 
by the report an identification of--
``(A) whether such veteran had a service-connected 
disability rated as total;
``(B) the primary cause of death;
``(C) the secondary cause of death, if applicable; 
and
``(D) the manner of death;
``(2) for each primary cause of death identified pursuant 
to paragraph (1), a statement of the total number of veterans 
that died from such primary cause of death during the period 
covered by the report; and
``(3) for each manner of death identified pursuant to 
paragraph (1), a statement of the total number of veterans that 
died in such manner during the period covered by the report.
``(c) 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 Act.''.
(b) Clerical Amendment.--The table of sections at the beginning of 
chapter 5 of such title is amended by inserting after the item relating 
to section 533 the following new item:

``534. Annual report on causes of death among veterans''.

SEC. 107. PLAN FOR USE OF AUTOMATION TOOLS TO PROCESS CLAIMS UNDER LAWS 
ADMINISTERED BY THE SECRETARY OF VETERANS AFFAIRS.

(a) In General.--Not later than one year after the date of the 
enactment of this Act, 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 available, to the 
maximum extent practicable, an automation tool described in subsection 
(b) to elements of the Department of Veterans Affairs for the purpose 
of processing claims under laws administered by the Secretary.
(b) Automation Tool Described.--An automation tool described in 
this subsection is a technology developed for the Compensation Service 
of the Veterans Benefits Administration that--
(1) automates the retrieval of the service record or health 
records of a veteran;
(2) compiles evidence relevant to the determination of a 
claim for benefits under laws administered by the Secretary;
(3) provides automated decision support relevant to such a 
determination;
(4) automates information sharing between Federal agencies; 
and
(5) assists in generating correspondence regarding such a 
claim.
(c) Analysis.--In developing the plan required under subsection 
(a), the Secretary shall conduct an analysis of each of the following:
(1) The feasibility and benefits of the use of an 
automation tool described in subsection (b) by elements of the 
Department for the purpose of processing claims under laws 
administered by the Secretary.
(2) Any modification to an existing automation tool that 
could render such tool usable for such purpose by such an 
element.
(3) Any requirement of any such element pertaining to such 
purpose that cannot be addressed by using an automation tool.
(4) 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 
purpose.
(5) A timeline for modifying and implementing any 
automation tool for use by such elements for such purpose.
(d) Priority.--In providing or expanding an automation tool 
described in subsection (b) to elements of the Department pursuant to 
the plan required under subsection (a), the Secretary shall give 
priority to the following elements:
(1) The Compensation Service.
(2) The Pension and Fiduciary Service of the Veterans 
Benefits Administration.
(3) The Education Service of the Veterans Benefits 
Administration.
(4) Program offices of the Veterans Benefits 
Administration, as determined by the Secretary.
(5) The Debt Management Center.
(6) The Board of Veterans' Appeals.
(e) Other Requirements Relating to Technology at Department of 
Veterans Affairs.--
(1) Automatic notices regarding benefits for certain 
children of veterans.--
(A) In general.--Not later than one year after the 
date of the enactment of this Act, the Secretary of 
Veterans Affairs shall implement policies, processes, 
and technological capabilities, including in the 
National Work Queue (or successor system), to ensure 
that, in the case of any covered situation, a claims 
processors is made aware of, and assigned to address, 
such covered situation.
(B) Definitions.--In this subsection:
(i) The term ``covered situation'' means--
(I) any increase in the amount of 
dependency compensation paid to a 
beneficiary for a child under the laws 
administered by the Secretary; and
(II) any educational assistance 
paid to the child of a veteran under 
the laws administered by the Secretary.
(ii) The term ``child'' has the meaning 
given such term in section 101(4)(A)(iii) of 
title 38, United States Code.
(2) Correct labeling of documents.--Not later than one year 
after the date of the enactment of this Act, 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 (or any 
successor system) are correctly labeled when such documents are 
uploaded, including when such documents are labeled using 
automation tools.

SEC. 108. REFORMS RELATING TO DEPARTMENT OF VETERANS AFFAIRS DISABILITY 
RATINGS.

(a) Ratings for Sleep Apnea.--
(1) In general.--The Secretary of Veterans Affairs shall 
revise the schedule for rating disabilities adopted and applied 
under section 1155 of title 38, United States Code, as follows:
(A) A grade of disability of 0 percent shall be 
assigned for sleep apnea syndrome when the syndrome is 
asymptomatic, with or without treatment.
(B) A grade of disability of 10 percent shall be 
assigned for sleep apnea syndrome when treatment yields 
incomplete relief.
(C) A grade of disability of 50 percent shall be 
assigned for sleep apnea syndrome only if--
(i) treatment is either ineffective or the 
veteran is unable to use the prescribed 
treatment due to comorbid conditions; and
(ii) there is no end-organ damage.
(D) A grade of disability of 100 percent shall be 
assigned for sleep apnea syndrome only if there is also 
end-organ damage.
(2) Qualifying comorbid conditions.--For purposes of 
paragraph (1)(C)(i), a comorbid condition is a condition that, 
in the opinion of a qualified medical provider, directly 
impedes or prevents the use of, or implementation of, a 
recognized form of treatment intervention normally shown to be 
effective.
(b) Ratings for Tinnitus.--The Secretary of Veterans Affairs shall 
revise the schedule for rating disabilities adopted and applied under 
section 1155 of title 38, United States Code, as follows:
(1) Except as provided in paragraph (2), tinnitus may not 
be assigned a separate compensable disability rating.
(2) A grade of disability of 10 percent shall be assigned 
for tinnitus only when tinnitus is diagnosed as associated with 
service-connected (as defined in section 101(16) of title 38, 
United States Code) hearing loss that is otherwise 
noncompensable under the laws administered by the Secretary.
(c) Applicability.--
(1) In general.--The revisions to the schedule for rating 
disabilities adopted and applied under section 1155 of title 
38, United States Code, made pursuant to this section shall 
apply with respect to claims filed after the date of the 
enactment of this Act.
(2) Protection of existing ratings.--The revisions to the 
schedule for rating disabilities made pursuant to this section 
may not serve as the basis for reducing, discontinuing, or 
otherwise adversely affecting compensation that was in effect 
on the day before the date of the enactment of this Act.

SEC. 109. IMPROVEMENTS TO TEMPORARY LICENSURE REQUIREMENTS FOR CONTRACT 
HEALTH CARE PROFESSIONALS WHO PERFORM MEDICAL DISABILITY 
EXAMINATIONS FOR THE DEPARTMENT OF VETERANS AFFAIRS.

(a) Expansion.--Section 504 of the Veterans' Benefits Improvements 
Act of 1996 (Public Law 104-275; 38 U.S.C. 5101 note), as amended by 
paragraph (1) of subsection (a) of section 2002 of the Johnny Isakson 
and David P. Roe, M.D. Veterans Health Care and Benefits Improvement 
Act of 2020 (Public Law 116-315; 38 U.S.C. 5101 note), is further 
amended, subject to the sunset in paragraph (4) of such subsection, by 
striking paragraph (2) of subsection (c) and inserting the following:
``(2) 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 7402(b) of title 38, United 
States Code, who--
``(A) has a current and unrestricted license to 
practice the health care profession for which they are 
licensed;
``(B) is not barred from practicing such health 
care profession in any State, the District of Columbia, 
or a Commonwealth, territory, or possession of the 
United States; and
``(C) is performing authorized duties for the 
Department pursuant to a contract entered into under 
subsection (a).
``(3) Source of funds.--Expenses of carrying out this 
section, including payments for examination travel and 
incidental expenses under the terms and conditions set forth by 
section 111 of this title, 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 pensions.
``(4) 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 5103A(d) of this 
title may transmit to a veteran's claims file, 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 opinion.''.
(b) Delayed Sunset of Amendment.--Paragraph (4) of subsection (a) 
of section 2002 of the Johnny Isakson and David P. Roe, M.D. Veterans 
Health Care and Benefits Improvement Act of 2020 (Public Law 116-315; 
38 U.S.C. 5101 note) is amended by striking ``On the date that is five 
years after the date of the enactment of this Act'' and inserting ``On 
September 30, 2033''.
(c) Conforming Amendment.--Paragraph (2) of such subsection is 
amended by striking ``physicians assistants, nurse practitioners, 
audiologists, and psychologists'' and inserting ``health care 
professionals''.
(d) Report.--Not later than 15 months after the date of the 
enactment of this Act, 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 504 of the Veterans' Benefits Improvements Act of 1996 (Public 
Law 104-275; 38 U.S.C. 5101 note), as temporarily amended by section 
2002(a)(1) of the Johnny Isakson and David P. Roe, M.D. Veterans Health 
Care and Benefits Improvement Act of 2020 (Public Law 116-315; 38 
U.S.C. 5101 note) and this section. Such report shall include, with 
respect to the one-year period after the date of the enactment of this 
Act, the following elements:
(1) The number of examinations conducted pursuant to a 
contract under such authority.
(2) The cost, timeliness, and legal adequacy of such 
examinations, disaggregated by--
(A) health care professional; and
(B) contract.
(3) The number of such examinations conducted in each 
State, the District of Columbia, or a Commonwealth, territory, 
or possession of the United States.
(4) The numbers of each kind of health care professionals 
who conducted such examinations.
(5) The number of examinations that were erroneously 
conducted by a health care professional--
(A) without such a contract; or
(B) unauthorized to enter into such a contract.
(6) The plan of the Secretary to correct errors in the use 
of such authority.

SEC. 110. DISABILITY EXAMINATIONS: STUDY ON ACCESS IN RURAL AREAS; 
REVIEW OF TRAINING; REVIEW OF INADEQUATE OR UNNECESSARY 
EXAMINATIONS.

(a) Study on Improvements to Department of Veterans Affairs Covered 
Medical Disability Examinations in Rural Areas.--
(1) Study required.--Not later than one year after the date 
of the enactment of this Act, 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 
examinations.
(2) Elements.--
(A) In general.--The study conducted under 
paragraph (1) shall include the following:
(i) A comparison of the average number of 
days to complete covered medical disability 
examinations, disaggregated by type of 
examination, 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 
examination, by either contractors or employees 
of the Department.
(ii) A root cause analysis of differences 
identified pursuant to clause (i).
(iii) The plan of the Secretary for the 
following year to improve access described in 
paragraph (1), 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 distances.
(B) Number of days to complete defined.--For 
purposes of subparagraph (A)(i), the term ``number of 
days to complete'' means the number of days in the 
period--
(i) 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 
examination; and
(ii) ending on the date on which the 
examination was completed.
(3) Report on study.--Not later than one year after the 
date of the enactment of this Act, 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 (1).
(4) Definitions.--In this subsection:
(A) 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 11 or 15 of title 38, 
United States Code, regardless of whether conducted by 
an employee or a contractor of the Department.
(B) The terms ``rural'' and ``highly rural'' have 
the meanings given those terms under the rural-urban 
commuting areas coding system of the Department of 
Agriculture.
(b) Review of Training for Veterans Service Representatives and 
Rating Veterans Service Representatives.--
(1) Review required.--The Secretary of Veterans Affairs 
shall conduct a comprehensive review of the training provided 
to Veterans Service Representatives (VSRs) and Rating Veterans 
Service Representatives (RVSRs) regarding covered medical 
disability examinations for the purpose of claims adjudication.
(2) Scope of review.--The review shall include, at minimum, 
an evaluation of training and policies relating to--
(A) assessing the adequacy of covered medical 
disability examinations for claims adjudication;
(B) determining the necessity of medical disability 
examinations where claims can be adjudicated based on 
existing evidence without ordering additional 
examinations;
(C) relevant statutes, judicial decisions, 
regulations, and Department policies, including--
(i) the duty to assist claimants;
(ii) evidentiary standards regarding 
causation;
(iii) required elements and standards for 
covered medical disability examinations, 
including the need for reasoned medical 
opinions; and
(iv) the absence of statutory or regulatory 
presumptions of service connection in covered 
medical disability examinations; and
(D) input from impacted Department employees, 
including duly appointed labor representatives.
(3) 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 examinations, including any 
applicable accuracy thresholds.
(4) Report to congress.--Not later than 180 days after the 
date of the enactment of this Act, 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 (1), the data used by 
the Secretary to support such findings, and such 
recommendations as the Secretary may have for improvements to 
training or policies.
(5) Comptroller general of the united states review of 
findings.--Not later than 180 days after the date on which the 
Secretary submits the report under paragraph (4), the 
Comptroller General of the United States shall conduct a review 
of the findings and recommendations contained in the report.
(6) Modification of reports by the board of veterans' 
appeals and united states court of appeals for veterans 
claims.--
(A) Board of veterans' appeals.--Section 7101(d)(2) 
of title 38, United States Code, is amended--
(i) in subparagraph (F), by striking ``; 
and'' and inserting a semicolon;
(ii) in subparagraph (G), by striking the 
period at the end and inserting ``; and''; and
(iii) by adding at the end the following 
new subparagraph:
``(H) a summary of recurring issues that result in 
the Board remanding appeals back to the agency of 
original jurisdiction.''.
(B) United states court of appeals for veterans 
claims.--Section 7288(b) of title 38, United States 
Code, is amended by adding at the end the following new 
paragraph:
``(16) A summary of recurring issues that result in 
remands.''.
(7) Definition of covered medical disability examination.--
In this subsection, 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 11 or 15 of 
title 38, United States Code, regardless of whether conducted 
by an employee or a contractor of the Department.
(c) Review and Priority Processing of Claims With Inadequate or 
Unnecessary Examinations.--
(1) Review.--Not later than 1 year after the date of the 
enactment of this Act and not less frequently than once every 
three months thereafter, the Secretary of Veterans Affairs 
shall review a random and representative sample of all covered 
medical disability examinations completed during the previous 
three-month period.
(2) Further sample requirements.--Under each review 
required by paragraph (1), the Secretary shall ensure the 
review includes--
(A) a statistically significant sample of covered 
medical disability examinations completed by employees 
of the Department of Veterans Affairs; and
(B) a statistically significant sample of covered 
medical disability examinations completed by each 
contractor that provides such examinations for the 
Department.
(3) Analysis.--Under each review required by paragraph (1), 
the Secretary shall--
(A) analyze the samples specified in paragraph (2); 
and
(B) pursuant to such analysis, identify--
(i) the percentage of examinations that 
were adequate for purposes of adjudicating the 
particular claim for a benefit under chapter 11 
or 15 of title 38, United States Code, for 
which the examination was ordered by the 
Department; and
(ii) the percentage of examinations 
considered overdeveloped for purposes of 
adjudicating claims for a benefit under chapter 
11 or 15 of title 38, United States Code, for 
which the examination was ordered by the 
Department.
(4) Priority processing.--
(A) In general.--Except as provided for in 
subparagraph (B), if during a review under paragraph 
(1) the Secretary finds any covered medical disability 
examination to be not adequate for adjudicating a 
claim, the Secretary shall ensure the claimant examined 
by that examination--
(i) receives another examination, if 
necessary, on a priority basis; and
(ii) receives priority processing for the 
entirety of impacted claim.
(B) Exception.--The Secretary is not required to 
furnish an additional examination under subparagraph 
(A) if the Secretary determines such an examination to 
be unnecessary for purposes of adjudicating the claim.
(5) 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 (1).
(6) Covered medical disability examination defined.--In 
this subsection, the term ``covered medical disability 
examination'' means a medical examination or opinion for the 
purposes of adjudicating a claim for a benefit under chapter 11 
or 15 of title 38, United States Code, regardless of whether 
conducted by an employee or a contractor of the Department.
(d) Review and Plan Regarding Department of Veterans Affairs 
Scheduling of Medical Examinations.--
(1) Review required.--Not later than one year after the 
date of the enactment of this Act, the Secretary of Veterans 
Affairs shall complete a review of scheduling request tools, 
contracts, and systems used by employees and contractors of the 
Department of Veterans Affairs to order and conduct medical 
disability examinations.
(2) Plan required.--Not later than one year after the date 
of the enactment of this Act, 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 following:
(A) 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 examinations, including through a contract.
(B) Medical disability examiners, including through 
a contract, 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 Secretary.
(C) Claimants or appellants for whom a medical 
disability examination is requested of the Department 
have agency in determining when and where the 
examination is conducted.
(D) 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 
examinations.
(E) The Department conducts customer satisfaction 
and experience surveys of claimants or appellants who 
attend medical disability examinations provided under 
laws administered by the Secretary.

SEC. 111. IMPROVEMENTS TO PROCESSING AND OUTREACH REGARDING CLAIMS 
INVOLVING MILITARY SEXUAL TRAUMA.

(a) Evaluation of Claims Involving Military Sexual Trauma.--
(1) In general.--Subchapter VI of chapter 11 of such title 
is amended by inserting after section 1166 the following new 
section:
``Sec. 1166A. Evaluation of claims involving military sexual trauma
``(a) 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--
``(1) advising the veteran of the evidence that would 
constitute credible corroborating evidence of the military 
sexual trauma; and
``(2) allowing the veteran an opportunity to furnish such 
corroborating evidence.
``(b) 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 Department.
``(c) 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 1166 of this title.
``(1) The Secretary shall ensure that not less than 
annually, the policies and procedures employed by the 
specialized team established under section 1166 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 occurred.
``(2) The Secretary shall also conduct periodic quality 
reviews of claims processed by the specialized teams 
established under section 1166 to identify inconsistencies, 
training deficiencies, or procedural shortcomings and implement 
corrective actions as appropriate.''.
(2) Outreach.--
(A) In general.--Not later than 180 days after the 
date of the enactment of this Act, the Secretary of 
Veterans Affairs shall implement, with input from the 
veteran community, an informative outreach program for 
veterans regarding the standard of proof for evaluation 
of claims relating to military sexual trauma, including 
requirements for a medical examination and opinion.
(B) Targeted outreach.--In implementing the program 
under subparagraph (A), the Secretary shall, to the 
extent practicable, target outreach to veterans who 
submitted a claim relating to military sexual trauma 
that was denied.
(3) Clerical amendment.--The table of sections at the 
beginning of chapter 11 of such title is amended by inserting 
after the item relating to section 1166 the following new item:

``1166A. Evaluation of claims involving military sexual trauma.''.
(b) Communications From the Department of Veterans Affairs to 
Individuals Who Have Experienced Military Sexual Trauma.--
(1) Review working group.--
(A) In general.--The Secretary of Veterans Affairs 
shall establish a working group to review 
correspondence relating to military sexual trauma.
(B) Membership.--The working group established 
under subparagraph (A) 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 health, of 
whom--
(i) one or more shall be appointed from 
among mental health providers of the Veterans 
Health Administration;
(ii) one or more shall be appointed from 
among experts on sexual assault and sexual 
harassment of the Veterans Benefits 
Administration; and
(iii) one or more shall be appointed from 
among experts on sexual assault and sexual 
harassment of the Board of Veterans' Appeals.
(C) Duties.--The working group established under 
subparagraph (A) shall--
(i) review standard correspondence, which 
may include templates for notices under 
sections 5103, 5104, 5104B, and 7104 of title 
38, United States Code, from the Department to 
individuals who have experienced military 
sexual trauma for sensitivity; and
(ii) ensure that the correspondence--
(I) treats such individuals with 
dignity and respect; and
(II) does not re-traumatize such 
individuals.
(D) Individual who has experienced military sexual 
trauma defined.--In this subsection, the term 
``individual who has experienced military sexual 
trauma'' means--
(i) an individual who has filed a claim for 
compensation under chapter of title 38, United 
States Code, relating to military sexual 
trauma;
(ii) a veteran who has been awarded 
compensation under such chapter relating to 
military sexual trauma; or
(iii) a member of the Armed Forces 
(including a member of the National Guard or 
Reserves), a former member of the Armed Forces, 
or a veteran who is receiving care from the 
Department relating to military sexual trauma.
(2) Contents of certain written communications to 
individuals who have experienced military sexual trauma.--
(A) Notice to claimants of required information and 
evidence.--Section 5103 of title 38, United States 
Code, is amended by adding at the end the following new 
subsection:
``(c) Written Communications to Individuals Who Have Experienced 
Military Sexual Trauma.--
``(1) 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 following:
``(A) Contact information for each of the 
following:
``(i) The military sexual trauma 
coordinator of the Veterans Benefits 
Administration.
``(ii) The military sexual trauma 
coordinator of the Veterans Health 
Administration.
``(iii) The Veterans Crisis Line.
``(iv) The facility of the Veterans Health 
Administration closest to where the individual 
resides.
``(v) The Readjustment Counseling Service 
location closest to where the individual 
resides.
``(B) Information on the eligibility of the 
individual for services provided through the 
Readjustment Counseling Service location described in 
subparagraph (A)(v).
``(2) In this subsection:
``(A) The term `individual who has experienced 
military sexual trauma' means--
``(i) an individual who has filed a claim 
for compensation under chapter 11 of this title 
relating to military sexual trauma;
``(ii) a veteran who has been awarded 
compensation under such chapter relating to 
military sexual trauma; or
``(iii) a member of the Armed Forces 
(including a member of the National Guard or 
Reserves), a former member of the Armed Forces, 
or a veteran who is receiving care from the 
Department relating to military sexual trauma.
``(B) The term `military sexual trauma' has the 
meaning given that term in section 1166(d)(2) of this 
title.
``(C) The term `Veterans Crisis Line' means the 
toll-free hotline for veterans established under 
section 1720F(h) of this title.''.
(B) Decisions and notices of decisions.--Section 
5104 of title 38, United States Code, is amended by 
adding at the end the following new subsection:
``(e)(1) 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 following:
``(A) Contact information for each of the following:
``(i) The military sexual trauma coordinator of the 
Veterans Health Administration.
``(ii) The Veterans Crisis Line.
``(iii) The facility of the Veterans Health 
Administration closest to where the individual resides.
``(iv) The Readjustment Counseling Service location 
closest to where the individual resides.
``(B) Information on the eligibility of the individual for 
services provided through the Readjustment Counseling Service 
location described in subparagraph (A)(iv).
``(2) 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 11 of this title relating to 
military sexual trauma includes--
``(A) the contact information described in paragraph (1); 
and
``(B) the contact information for the military sexual 
trauma coordinator of the Veterans Benefits Administration.
``(3) In this subsection:
``(A) The term `individual who has experienced military 
sexual trauma' means--
``(i) an individual who has filed a claim for 
compensation under chapter 11 of this title relating to 
military sexual trauma;
``(ii) a veteran who has been awarded compensation 
under such chapter relating to military sexual trauma; 
or
``(iii) a member of the Armed Forces (including a 
member of the National Guard or Reserves), a former 
member of the Armed Forces, or a veteran who is 
receiving care from the Department relating to military 
sexual trauma.
``(B) The term `military sexual trauma' has the meaning 
given that term in section 1166(d)(2) of this title.
``(C) The term `Veterans Crisis Line' means the toll-free 
hotline for veterans established under section 1720F(h) of this 
title.''.
(C) Higher-level review by the agency of original 
jurisdiction.--Section 5104B of title 38, United States 
Code, is amended by adding at the end the following new 
subsection:
``(f) Written Communications to Individuals Who Have Experienced 
Military Sexual Trauma.--
``(1) 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 following:
``(A) Contact information for each of the 
following:
``(i) The military sexual trauma 
coordinator of the Veterans Health 
Administration.
``(ii) The Veterans Crisis Line.
``(iii) The facility of the Veterans Health 
Administration closest to where the individual 
resides.
``(iv) The Readjustment Counseling Service 
location closest to where the individual 
resides.
``(B) Information on the eligibility of the 
individual for services provided through the 
Readjustment Counseling Service location described in 
subparagraph (A)(iv).
``(2) 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 
11 of this title relating to military sexual trauma includes--
``(A) the contact information described in 
paragraph (1); and
``(B) the contact information for the military 
sexual trauma coordinator of the Veterans Benefits 
Administration.
``(3) In this subsection:
``(A) The term `individual who has experienced 
military sexual trauma' means--
``(i) an individual who has filed a claim 
for compensation under chapter 11 of this title 
relating to military sexual trauma;
``(ii) a veteran who has been awarded 
compensation under such chapter relating to 
military sexual trauma; or
``(iii) a member of the Armed Forces 
(including a member of the National Guard or 
Reserves), a former member of the Armed Forces, 
or a veteran who is receiving care from the 
Department relating to military sexual trauma.
``(B) The term `military sexual trauma' has the 
meaning given that term in section 1166(d)(2) of this 
title.
``(C) The term `Veterans Crisis Line' means the 
toll-free hotline for veterans established under 
section 1720F(h) of this title.''.
(D) Board of veterans' appeals.--Section 7104 of 
title 38, United States Code, is amended by adding at 
the end the following new subsection:
``(g)(1) 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 following:
``(A) Contact information for each of the following:
``(i) The military sexual trauma coordinator of the 
Veterans Health Administration.
``(ii) The Veterans Crisis Line.
``(iii) The facility of the Veterans Health 
Administration closest to where the individual resides.
``(iv) The Readjustment Counseling Service location 
closest to where the individual resides.
``(B) Information on the eligibility of the individual for 
services provided through the Readjustment Counseling Service 
location described in subparagraph (A)(iv).
``(2) 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 11 of this title relating to 
military sexual trauma includes--
``(A) the contact information described in paragraph (1); 
and
``(B) the contact information for the military sexual 
trauma coordinator of the Veterans Benefits Administration.
``(3) In this subsection:
``(A) The term `individual who has experienced military 
sexual trauma' means--
``(i) an individual who has filed a claim for 
compensation under chapter 11 of this title relating to 
military sexual trauma;
``(ii) a veteran who has been awarded compensation 
under such chapter relating to military sexual trauma; 
or
``(iii) a member of the Armed Forces (including a 
member of the National Guard or Reserves), a former 
member of the Armed Forces, or a veteran who is 
receiving care from the Department relating to military 
sexual trauma.
``(B) The term `military sexual trauma' has the meaning 
given that term in section 1166(d)(2) of this title.
``(C) The term `Veterans Crisis Line' means the toll-free 
hotline for veterans established under section 1720F(h) of this 
title.''.
(c) Study on Training and Processing Relating to Claims for 
Disability Compensation Relating to Military Sexual Trauma.--
(1) Study required.--The Secretary of Veterans Affairs 
shall conduct a study on--
(A) the quality of training provided to personnel 
of the Department of Veterans Affairs who review claims 
for disability compensation under chapter 11 of title 
38, United States Code, for disabilities relating to 
military sexual trauma; and
(B) the quality of the procedures of the Department 
for reviewing the accuracy of the processing of such 
claims.
(2) Elements.--The study required by subsection (a) shall 
include the following:
(A) With respect to the quality of training 
described in paragraph (1) of such subsection:
(i) Whether the Department ensures 
personnel complete such training on time.
(ii) Whether the training has resulted in 
improvements to the processing of claims 
described in such subsection and issue-based 
accuracy.
(iii) Such recommendations as the Secretary 
may have for improving the training.
(B) With respect to the quality of procedures 
described in paragraph (2) of such subsection:
(i) 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 reviews.
(ii) Whether such procedures adequately 
include mechanisms to correct errors found in 
such reviews.
(iii) A summary of quality assurance 
reviews and reports conducted as part of such 
procedures.
(iv) Such recommendations as the Secretary 
may have for improving such procedures.
(3) Report required.--Not later than one year after the 
date of the enactment of this Act, 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 (1).
(d) Annual Special Focus Review of Claims for Disability 
Compensation for Disabilities Relating to Military Sexual Trauma.--
(1) Annual special focus review.--
(A) In general.--Each year, 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 11 of title 38, United States Code, for 
disabilities relating to military sexual trauma.
(B) Elements.--Each review conducted under 
subparagraph (A) shall include a review of the 
following:
(i) A statistically significant, 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 submitted.
(ii) The accuracy of each decision made 
with respect to each claim described in clause 
(i).
(iii) The types of benefit entitlement 
errors found, disaggregated by category.
(iv) Trends from year to year.
(v) Training completion rates for personnel 
of the Department who process claims described 
in subparagraph (A).
(2) Reprocessing of claims.--If the Under Secretary finds, 
pursuant to a special focus review conducted under paragraph 
(1)(A), that an error was made with respect to the entitlement 
of a veteran to a benefit under the laws administered by the 
Secretary, 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 claim.
(3) Report.--Section 5501(b) of the Johnny Isakson and 
David P. Roe, M.D. Veterans Health Care and Benefits 
Improvement Act of 2020 (Public Law 116-315; 134 Stat. 5048) is 
amended--
(A) in paragraph (1), by striking ``through 2027'' 
and inserting ``until the date described in section 
109(d)(4) of the Take Care of America's Veterans Act''; 
and
(B) in paragraph (2), by adding at the end the 
following new subparagraph:
``(I) The findings of the most recent special focus 
review conducted under subsection (d)(1)(A) of section 
109 of the Take Care of America's Veterans Act, 
including--
``(i) the elements under subsection 
(d)(1)(B) of such section;
``(ii) the number of claims returned for 
reprocessing under subsection (d)(2) of such 
section; and
``(iii) the number of claims described in 
clause (ii) for which the decision relating to 
service-connection or entitlement to 
compensation changed as a result of 
reprocessing the claim.''.
(4) Sunset.--On the date that is 5 years after the 
enactment of this Act, paragraph (1)(A) shall cease to be in 
effect.
(e) Working Group on Medical Examinations for Claims for Disability 
Compensation for Disabilities Relating to Military Sexual Trauma.--
(1) In general.--Not later than 90 days after the date of 
the enactment of this Act, the Secretary of Veterans Affairs 
shall establish a working group on medical examinations for 
claims for disability compensation under chapter 11 of title 
38, United States Code, for disabilities relating to military 
sexual trauma (in this section referred to as the ``working 
group'').
(2) Membership.--The working group shall be composed of the 
following:
(A) 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 11 of title 38, United 
States Code.
(B) Staff of the Medical Disability Examination 
Office of the Department.
(C) Veterans service officers who have experience 
with claims described in paragraph (1).
(D) Medical examiners who have experience with such 
claims.
(E) Staff of the Veterans Experience Office of the 
Department.
(F) Such other individuals as the Secretary 
considers appropriate.
(3) Duties.--Not later than 180 days after the date of the 
enactment of this Act, the working group shall--
(A) review the quality of medical examinations 
described in paragraph (1);
(B) review the feasibility of minimizing re-
examinations for conditions relating to military sexual 
trauma; and
(C) submit to the Under Secretary for Benefits of 
the Department and the Secretary recommendations on how 
to--
(i) eliminate re-traumatization of 
individuals who file claims described in 
paragraph (1); and
(ii) reduce the overdevelopment of such 
claims.
(4) Report.--Not later than one year after the date of the 
enactment of this Act, the Secretary shall submit to Congress a 
report that includes the following:
(A) The views of the working group on efforts by 
the Department to eliminate re-traumatization of 
individuals who file claims described in subsection 
(a).
(B) Legislative proposals to improve the experience 
of such individuals in pursuing such claims.
(C) The recommendations submitted under paragraph 
(3)(C).
(D) The plan of the Under Secretary for Benefits of 
the Department and the Secretary to implement such 
recommendations.
(5) Review and implementation.--Not later than one year 
after the date of the enactment of this Act, the Under 
Secretary for Benefits of the Department and the Secretary 
shall--
(A) review the recommendations submitted under 
paragraph (3)(C); and
(B) implement the recommendations that, as 
determined by the Under Secretary and the Secretary, 
would improve the claims process for individuals who 
file claims described in paragraph (1).
(f) Military Sexual Trauma Claims Performance Dashboard.--
(1) 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 Secretary.
(2) Elements.--The dashboard established pursuant to 
paragraph (1) shall cover the following:
(A) Claims relating to military sexual trauma 
submitted to the Secretary for benefits under laws 
administered by the Secretary that have been submitted, 
completed, or appealed, including appeals pending at 
the agency of jurisdiction and at the Board of 
Veterans' Appeals.
(B) For comparison purposes with subparagraph (A), 
claims not relating to military sexual trauma submitted 
to the Secretary for benefits under laws administered 
by the Secretary that have been submitted, completed, 
or appealed.
(C) Overall, cumulative information relating to 
claims relating to military sexual trauma submitted to 
the Secretary for benefits under laws administered by 
the Secretary, including the following:
(i) Average number of days a claim is 
pending review.
(ii) Average number of days for completed 
adjudication.
(iii) Total number of pending claims, 
disaggregated by whether the claims have been 
partially adjudicated or not adjudicated at 
all.
(iv) Total number of claims completely 
adjudicated.
(v) Of the number specified in clause (iv), 
the percentage that were approved, denied, or 
appealed.
(D) The total number of claims relating to military 
sexual trauma submitted to the Secretary for benefits 
under laws administered by the Secretary.
(E) The methods used for submittal of claims 
relating to military sexual trauma to the Secretary for 
benefits under laws administered by the Secretary.
(F) 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 Secretary.
(G) The most frequent conditions or disabilities 
for which a claim relating to military sexual trauma is 
denied.
(H) 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 11 of title 38, United States Code, 
including the grant rate for such contentions.
(3) Additional resource information.--The Secretary shall 
make available via the performance dashboard established 
pursuant to subsection (a) the following information:
(A) Veterans Crisis Line contact information.
(B) Information regarding the availability of 
services from military sexual trauma coordinators of 
the Veterans Health Administration.
(C) Information regarding the availability of 
services from military sexual trauma coordinators of 
the Veterans Benefits Administration.
(D) Information on availability of specialized 
care, services, and benefits from the Department for 
individuals who have experienced military sexual 
trauma.
(E) Such additional information as the Secretary 
considers appropriate.
(4) Availability.--The Secretary shall ensure that the 
dashboard established pursuant to paragraph (1) is available to 
the public from the website of the Department of Veterans 
Affairs and is updated not less frequently than once every 30 
days.
(5) Reporting requirements.--(A) Not later than 2 years 
after the date of the enactment of this Act, 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--
(i) the annual cost to implement the dashboard 
required by paragraph (2);
(ii) areas for improvement of the dashboard; and
(iii) such additional information as the Secretary 
considers appropriate.
(B) Not later than 180 days after the date of the enactment 
of this Act, the Secretary shall commence providing, on a 
quarterly basis, 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 claims.
(6) Definition.--In this section, the term ``military 
sexual trauma'' has the meaning given such term in section 
1166(d)(2) of title 38, United States Code.

SEC. 112. INDEPENDENT ASSESSMENT OF NOTICES THAT THE SECRETARY OF 
VETERANS AFFAIRS SENDS TO CLAIMANTS.

(a) Agreement.--Not later than 30 days after the date of the 
enactment of this Act, 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 claimants.
(b) Assessment.--An FFRDC that enters into an agreement under 
subsection (a) shall submit to the Secretary a written assessment of 
such notices. The assessment shall include the following:
(1) The determination of the FFRDC, made in consultation 
with covered entities, whether each such notice may be feasibly 
altered to reduce paper consumption by, and costs to, the 
Federal Government.
(2) The recommendations of the FFRDC regarding how the 
Secretary may make such notices clearer to claimants, better 
organized, and more concise.
(c) Report; Implementation.--Not later than 90 days after the 
Secretary receives the assessment under subsection (b), the Secretary 
shall--
(1) submit to the Committees on Veterans' Affairs of the 
Senate and House of Representatives a copy of such assessment; 
and
(2) implement the recommendations in the assessment that 
are in compliance with the laws administered by the Secretary.
(d) Deadline for Implementation.--The Secretary shall complete the 
implementation of such recommendations pursuant to subsection (c)(2) by 
not later than one year after the date on which the Secretary commences 
such implementation.
(e) Definitions.--In this section:
(1) The term ``FFRDC'' means a federally funded research 
and development center.
(2) The term ``covered entities'' includes--
(A) the Secretary of Veterans Affairs;
(B) an expert in laws administered by the Secretary 
of Veterans Affairs;
(C) a veterans service organization recognized 
under section 5902 of title 38, United States Code;
(D) an entity that advocates for veterans; and
(E) an entity that advocates for the survivors of 
veterans.
(3) The terms ``claimant'' and ``notice'' have the meanings 
given such terms in section 5100 of title 38, United States 
Code.

SEC. 113. INDEPENDENT ASSESSMENT OF FORMS THAT THE SECRETARY OF 
VETERANS AFFAIRS SENDS TO CLAIMANTS.

(a) Agreement.--Not later than 30 days after the date of the 
enactment of this Act, 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 claimants.
(b) Assessment.--An FFRDC that enters into an agreement under 
subsection (a) shall submit to the Secretary a written assessment, made 
in consultation with covered entities, of such forms. The assessment 
shall include the recommendations of the FFRDC regarding how the 
Secretary may make such forms clearer to claimants and better 
organized.
(c) Report; Implementation.--Not later than 90 days after the 
Secretary receives the assessment under subsection (b), the Secretary 
shall--
(1) submit to the Committees on Veterans' Affairs of the 
Senate and House of Representatives a copy of such assessment; 
and
(2) implement the recommendations in the assessment that 
are in compliance with the laws administered by the Secretary.
(d) Deadline for Implementation.--The Secretary shall complete the 
implementation of such recommendations pursuant to subsection (c)(2) by 
not later than two years after the date on which the Secretary 
commences such implementation.
(e) Definitions.--In this section:
(1) The term ``FFRDC'' means a federally funded research 
and development center.
(2) The term ``covered entities'' includes--
(A) the Secretary of Veterans Affairs;
(B) an expert in laws administered by the Secretary 
of Veterans Affairs;
(C) a veterans service organization recognized 
under section 5902 of title 38, United States Code;
(D) an entity that advocates for veterans; and
(E) an entity that advocates for survivors of 
veterans.
(3) The term ``claimant'' has the meaning given such term 
in section 5100 of title 38, United States Code.

TITLE II--EDUCATION AND ECONOMIC OPPORTUNITY

SEC. 201. VETS OPPORTUNITY ACT.

(a) Repayment of Members of the Armed Forces for Contributions 
Towards Post-9/11 Educational Assistance: Timing; Mechanism for 
Individuals Not Eligible for a Monthly Housing Stipend.--
(1) In general.--Subsection (f) of section 3327 of title 
38, United States Code, is amended--
(A) in paragraph (3), by striking ``together'' and 
all that follows through ``before'' and inserting ``not 
later than 60 days after''; and
(B) by adding at the end the following new 
paragraph:
``(4) Additional assistance for an individual not eligible 
for a monthly housing stipend.--In the case of an individual 
making an election under subsection (a) who is described by 
subparagraph (A), (C), or (E) of paragraph (1) of that 
subsection, and who is not eligible for a monthly stipend 
payable under section 3313(c) of this title, the educational 
assistance payable to the individual under this chapter shall 
be paid--
``(A) in a lump sum calculated by multiplying--
``(i) the total amount of contributions 
described in paragraph (1)(A) with regards to 
such individual; and
``(ii) the sum of the number of months 
described in subclauses (I) and (II) of 
paragraph (1)(B)(i) with regards to such 
individual; and
``(B) to the individual not later than 60 days 
after the exhaustion of the individual's entitlement to 
educational assistance under this chapter.''.
(2) Technical corrections and conforming amendment.--Such 
subsection is further amended--
(A) by striking ``paragraphs (2) through (7)'' and 
inserting ``paragraphs (2) through (6)''; and
(B) in paragraph (1), in the heading, by inserting 
``for an individual eligible for a monthly housing 
stipend'' after ``Additional assistance''.
(3) Effective date.--The amendments made by this section 
shall take effect on August 1, 2027.
(b) Treatment of Certain Independent Study Programs Under 
Educational Assistance Programs of Department of Veterans Affairs.--
(1) In general.--Section 3680A(a)(4)(A)(ii)(III) of such 
title is amended--
(A) by inserting ``that requires regular and 
substantive interaction between students and 
instructors'' after ``course of study'';
(B) in item (aa), by striking ``; or'' and 
inserting a semicolon;
(C) in item (bb), by striking ``; and'' and 
inserting ``; or''; and
(D) by adding at the end by following new item:
``(cc) an institution of 
higher education, as such term 
is defined in section 102 of 
the Higher Education Act of 
1965 (20 U.S.C. 1002), that is 
approved to participate or is 
participating in the student 
financial assistance programs 
authorized by title IV of that 
Act; and''.
(2) Applicability.--The amendment made by paragraph (1) 
shall apply with respect to a quarter, semester, or term, as 
applicable, that begins on or after August 1, 2027.
(3) Oversight.--During the first six years beginning on the 
date of enactment of this Act, the Secretary, in coordination 
with State approving agencies, shall, every two years, conduct 
risk-based surveys or reviews of institutions approved pursuant 
to section 3680A(a)(4)(A)(ii)(III)(cc) of title 38, United 
States Code, as added by paragraph (1).
(4) GAO report.--Not later than 3 years after the date of 
enactment of this Act, 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 (1), including--
(A) the effectiveness of oversight activities 
conducted by the Department of Veterans Affairs and 
State approving agencies;
(B) institutional compliance with applicable 
requirements under chapter 36 of title 38, United 
States Code;
(C) participation and outcomes of veterans enrolled 
in programs approved pursuant to section 
3680A(a)(4)(A)(ii)(III)(cc) of such title, as added by 
paragraph (1); and
(D) any recommendations to improve oversight, 
program integrity, or educational outcomes for 
veterans.
(5) Applicability.--To the extent practicable for any 
program requiring practical, laboratory, clinical, shop, or 
hands on competencies, the online portion of instruction may 
not substitute for the supervised in person training necessary 
to demonstrate such competencies.
(c) Absence From Certain Education Due to Certain Service.--
(1) Options.--Section 3691A of such title is amended by 
striking paragraph (1) of subsection (a) and inserting the 
following:
``(1) A covered member may, after receiving orders to enter a 
period of covered service--
``(A) withdraw from covered education;
``(B) take a leave of absence from covered education; or
``(C) subject to subsection (d), enter into an agreement 
with the institution concerned to complete a course of covered 
education to the satisfaction of such institution concerned.''.
(2) Conforming amendment.--Such subsection is further 
amended, in paragraph (2)(A), by striking ``or takes a leave of 
absence'' and inserting ``, takes a leave of absence, or enters 
into an agreement''.
(3) Agreement.--Such section is further amended--
(A) by redesignating subsection (d) as subsection 
(e); and
(B) by inserting, after subsection (c), the 
following new subsection (d):
``(d) Agreement With Institution Concerned.--A covered member may 
enter into an agreement under subsection (a) only if the covered member 
has completed at least half of a course of covered education.''.
(4) Section heading.--Such section is further amended by 
striking the heading and inserting ``Absence from certain 
education due to certain service''.
(5) Table of sections.--The table of sections at the 
beginning of chapter 36 of such title is amended by striking 
the item relating to section 3691A and inserting the following 
new item:

``3691A. Absence from certain education due to certain service.''.
(d) Department of Veterans Affairs Compliance Surveys.--Section 
3693 of such title is amended--
(1) in subsection (c)--
(A) by striking ``not more than 10 business days of 
notice'';
(B) by striking ``this section.'' and inserting 
``this section--''; and
(C) by adding at the end the following new 
paragraphs:
``(1) in the case of an educational institution or training 
establishment with a time stamp database collection feature, 
not fewer than 10, and not more than 15, business days of 
notice; and
``(2) in the case of any other educational institution or 
training establishment, not more than 10 business days of 
notice.''; and
(2) by striking subsection (d) and inserting the following 
new subsection (d):
``(d) Definitions.--In this section:
``(1) The terms `educational institution' and `training 
establishment' have the meanings given such terms in section 
3452 of this title.
``(2) The term `school certifying official' means an 
employee of an educational institution with primary 
responsibility for certifying veteran enrollment at the 
educational institution.''.
(e) Notification of School Certifying Officials of Handbook 
Updates.--
(1) In general.--Not later than 14 business days after 
updating the school certifying official handbook of the 
Department of Veterans Affairs, the Secretary of Veterans 
Affairs shall provide notice to all school certifying officials 
of such update.
(2) 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 institution.

SEC. 202. IMPROVEMENTS TO PROCESS FOR MAKING PAYMENTS TO AUTOMOBILE 
SELLERS FOR AUTOMOBILES PURCHASED FOR CERTAIN DISABLED 
VETERANS.

(a) Timeliness of Payments.--Section 3902 of title 38, United 
States Code, is amended, in subsection (a)--
(1) by inserting ``(1)'' before ``The Secretary''; and
(2) by adding at the end the following new paragraph:
``(2) The Secretary shall--
``(A) make payments under this section in compliance with 
regulations prescribed under section 3903(a) of title 31, 
except that no interest penalties shall be required to be paid 
under this section; and
``(B) in the case of any payment under this section that is 
not processed during the period of 30 days following receipt by 
the Secretary of the final invoice for such payment, the 
Secretary shall publish in the Federal Register the number of 
days required to process the payment.''.
(b) Centralization of Process for Making Payments.--Such section is 
amended by adding at the end the following new subsection:
``(f)(1) 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 (a)(2).
``(2) The Secretary shall accurately track and resolve payments due 
to sellers under this section that are more than 90 days overdue.''.
(c) Reporting.--The Secretary of Veterans Affairs shall submit to 
the Committees on Veterans' Affairs of the Senate and House of 
Representatives, and publish on a publicly accessible website of the 
Department of Veterans Affairs, four semiannual reports after the date 
of the enactment of this Act, regarding the administration of section 
3902 of title 38, United States Code, as amended by this section. Each 
such report shall include, with respect to the period of six months 
preceding the date of the report, the following elements:
(1) 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 payment, disaggregated by whether the claim was 
under review or being processed by--
(A) the Veterans Health Administration;
(B) the Veterans Benefits Administration; or
(C) the seller.
(2) Improvements to information technology of the 
Department that the Secretary determines would reduce the time 
required for such review or processing.
(d) GAO Report; Briefing.--
(1) Report.--Not later than 180 days after the day the 
Secretary completes centralization under subsection (f) of 
section 3902 of title 38, United States Code, as added by this 
section, the Comptroller General of the United States shall 
review such centralization and publish a report containing the 
results of such review. Such report shall include the 
determinations of the Comptroller General regarding the 
following:
(A) The capacity of the office determined by the 
Secretary under such subsection, to carry out 
processing described in such subsection, including--
(i) a comprehensive assessment of employees 
of the Department who carry out chapter 39 of 
such title;
(ii) a comprehensive skills assessment 
indicating what resources the Secretary 
requires to otherwise improve such 
centralization, including additional funds, 
employees, or contractors; and
(iii) a review of systems of information 
technology, including systems in use or to be 
acquired, to carry out such centralization.
(B) Recommendations to improve such processing.
(C) Estimated costs to the United States to 
implement such recommendations.
(2) Briefing.--Not later than 30 days after publishing the 
report under paragraph (1), the Comptroller General shall 
provide to the Committees on Veterans' Affairs of the House of 
Representatives and Senate a briefing on such report. Such 
briefing shall include any response from the Secretary to the 
Comptroller General regarding the recommendations in the 
report.

SEC. 203. MONTHLY HOUSING STIPEND UNDER THE POST-9/11 EDUCATIONAL 
ASSISTANCE PROGRAM FOR INDIVIDUALS WHO PURSUE SUMMER 
PROGRAMS OF EDUCATION SOLELY THROUGH DISTANCE LEARNING.

(a) In General.--Section 3313(c)(1)(B) of title 38, United States 
Code, is amended--
(1) in clause (i), by striking ``and (iii)'' and inserting 
``, (iii), and (iv)'';
(2) by redesignating clause (iv) as clause (v); and
(3) by inserting after clause (iii) the following new 
clause (iv):
``(iv) In the case of an individual 
pursuing, solely through distance learning, a 
program of education that is shorter than 12 
weeks during the summer, for each month the 
individual pursues the program of education, a 
monthly housing stipend equal to the product 
of--
``(I) the national average of the 
monthly amount of the basic allowance 
for housing payable under section 403 
of title 37 for a member with 
dependents in pay grade E-5, multiplied 
by
``(II) the lesser of--
``(aa) 1.0 and
``(bb) the number of course 
hours borne by the individual 
in pursuit of the program of 
education, divided by the 
minimum number of course hours 
required for full-time pursuit 
of the program of education, 
rounded to the nearest multiple 
of 10.''.
(b) Effective Date.--The amendments made by subsection (a) shall 
apply to a program of education beginning on or after August 1, 2027.

SEC. 204. CLARIFICATION REGARDING INCLUSION OF MEDICALLY NECESSARY 
AUTOMOBILE ADAPTATIONS IN DEPARTMENT OF VETERANS AFFAIRS 
DEFINITION OF ``MEDICAL SERVICES''.

Section 1701(6)(I) of title 38, United States Code, is amended to 
read as follows:
``(I) The provision of any medically necessary automobile 
adaptations for driver or passenger use, including--
``(i) ramp and kneeling systems;
``(ii) raised doors or lowered floors;
``(iii) raised roofs;
``(iv) air conditioning;
``(v) occupied and unoccupied mobility lifts;
``(vi) ingress or egress accessibility 
modifications;
``(vii) wheelchair tiedowns; and
``(viii) adapted seating.''.

SEC. 205. DIGITAL COMMUNICATIONS: SOLID START PROGRAM; EDUCATIONAL 
ASSISTANCE.

(a) Improvement to Certain Outreach Under Solid Start Program of 
Department of Veterans Affairs.--Section 6320(b) of title 38, United 
States Code, is amended--
(1) in paragraph (1)(B)--
(A) by striking ``calling'' and inserting 
``communicating with''; and
(B) by inserting ``through the use of tailored 
lines of communication, including mailings, text 
messaging, virtual chatting, and other electronic forms 
of messaging'' after ``Armed Forces''; and
(2) in paragraph (2), by striking ``tailored mailings'' and 
inserting ``tailored lines of communication, including 
mailings, text messaging, virtual chatting, and other 
electronic forms of messaging,''.
(b) Department of Veterans Affairs Use of Tailored Lines of 
Communication for Correspondence Relating to Educational Assistance 
Benefits.--Section 3680 of title 38, United States Code, is amended by 
adding at the end the following new subsection:
``(i)(1) 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 Secretary. 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 mail.
``(2) 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 (1).
``(3) In this subsection, the term `tailored lines of 
communication' includes mailings, text messaging, virtual chatting, and 
other electronic forms of messaging.''.

SEC. 206. IMPROVEMENTS TO TRANSITION ASSISTANCE PROGRAM AND 
SKILLBRIDGE.

(a) Transition Assistance Program: Amendments; Pilot Program; 
Reports.--
(1) Special operations forces.--Subsection (a) of section 
1142 of title 10, United States Code, is amended, in paragraph 
(1), by inserting ``(including each member of the special 
operations forces)'' after ``armed forces''.
(2) Requirement of preseparation counseling: number of 
days.--Such subsection is further amended, in paragraph (1)--
(A) by inserting ``(A)'' before ``Within''; and
(B) by adding at the end the following new 
subparagraph:
``(B) The Secretary concerned shall ensure that a member 
described in subparagraph (A) receives preseparation counseling 
in the following amounts:
``(i) In the case of a member who has accepted an 
offer of full-time employment, or has enrolled in a 
program of education or vocational training, that shall 
commence after the member separates, retires, or is 
discharged, not fewer than three days.
``(ii) In the case of a member other than a member 
described in clause (i), not fewer than five days.''.
(3) Repeat attendance.--Such subsection is further amended 
by adding at the end the following new paragraph:
``(6) A member who received preseparation counseling under 
this section may, before separation, retirement, or discharge, 
request to receive, on a space-available basis, such 
preseparation counseling a second time.''.
(4) Pathways: standardization; establishment of pathway for 
members of the reserve components.--Such section is further 
amended, in paragraph (1) of subsection (c), in the matter 
preceding subparagraph (A)(1)--
(A) by striking ``Each Secretary concerned'' and 
inserting ``The Secretaries of Defense and Homeland 
Security''; and
(B) by striking ``pathways for members of the 
military department concerned'' and inserting 
``pathways, standardized across the armed forces''.
(5) Pathways: record of pathway assignment.--Such 
subsection is further amended by adding at the end the 
following new paragraph:
``(4) The Secretary concerned shall ensure that the pathway 
in which a member is placed, and the reasons for such 
placement, are noted in the service record of such member.''.
(6) Coordination between departments of defense, veterans 
affairs, and labor.--Such section is further amended, in 
subsection (d)--
(A) by striking the heading and inserting 
``Transmission of Certain Information to Other 
Departments'';
(B) by inserting ``(1)'' before ``In the case''; 
and
(C) by adding at the end the following new 
paragraphs:
``(2) Before a member described in subsection (a) 
separates, retires, or is discharged, the Secretary concerned 
shall transmit to the Secretary of Veterans Affairs the 
Department of Defense Form DD-2648 regarding such member.
``(3)(A) In the case of a member described in subsection 
(a) whom the Secretary determined as tier 3 status the 
Secretary concerned shall, before the member separates, 
retires, or is discharged, provide such member with the contact 
information of an employee of the Department of Veterans 
Affairs and an employee of the Department of Labor; and
``(B) Each employee described in subparagraph (A) shall 
contact the member described in such subparagraph not later 
than 60 days after such member separates, retires, or is 
discharged.
``(C) 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 
times, and reasons why, an employee of the department under the 
jurisdiction of such Secretary failed to carry out subparagraph 
(B) in the year preceding the date of the report.
``(D) The Secretary of Defense and Secretary of Homeland 
Security shall prescribe regulations to ensure that, for 
purposes of this paragraph, each Secretary concerned uses the 
same definition of the term `at risk for a difficult transition 
to civilian life'.''.
(7) Report.--Not later than two years after the date of the 
enactment of this Act and annually thereafter for four years, 
the Secretary of Defense shall submit to the Committees on 
Armed Services, and the Committees on Veterans' Affairs, of the 
Senate and House of Representatives, a report on data recorded 
with such tracking system during the year preceding the date of 
such report. Such a report shall include a list of the seven 
military installations located inside the continental United 
States, and three military installations located outside the 
continental United States, where members are least likely to 
receive preseparation counseling in accordance with such time 
periods.
(A) The number of members who, in the course of 
such preseparation counseling, were referred to another 
Federal agency or department.
(B) The Federal agencies or departments to which 
members were so referred.
(C) The number of members who should have been, but 
were not, so referred, and reasons why such referrals 
did not occur.
(D) The number of members who receive such 
preseparation counseling and apply for unemployment 
compensation under subchapter II of chapter 85 of title 
5, United States Code.
(E) The total amount of such unemployment 
compensation paid to members separating from the Armed 
Forces.
(F) 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 Program.
(8) Contracting: standardization.--Such section is further 
amended by adding at the end the following new subsection:
``(f) Contracting.--A Secretary concerned may enter into an 
agreement with an entity under which such entity shall provide 
preseparation counseling under this section. If more than one Secretary 
seeks to enter into such an agreement, such Secretaries concerned 
shall, to the extent practicable, seek to enter into such agreements 
with the same entity.''.
(9) 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 Program.
(b) Skillbridge: GAO Study.--
(1) Study required.--The Comptroller General of the United 
States shall conduct a study of the Skillbridge programs under 
section 1143(e) of title 10, United States Code.
(2) Report.--Not later than two years after the date of the 
enactment of this Act, the Comptroller General shall submit to 
the Committees on Armed Services, and the Committees on 
Veterans' Affairs, of the Senate and House of Representatives, 
a report regarding such study. Such report shall include 
observations and recommendations of the Comptroller regarding, 
with respect to members and employers who participate in 
Skillbridge--
(A) differences in criteria for participation 
between the Armed Forces;
(B) other differences in Skillbridge programs 
between the Armed Forces;
(C) best practices in Skillbridge programs across 
the Armed Forces, including--
(i) the selection of employers; and
(ii) the development of contracts; and
(D) the feasibility of making Skillbridge programs 
uniform across the Armed Forces.

SEC. 207. TRANSITION ASSISTANCE PROGRAM: PRESENTATION IN PRESEPARATION 
COUNSELING TO PROMOTE BENEFITS AVAILABLE TO VETERANS.

(a) In General.--Section 1142(b) of title 10, United States Code, 
is amended by adding at the end the following new paragraph:
``(20) A presentation that promotes the benefits available 
to veterans under the laws administered by the Secretary of 
Veterans Affairs. Such presentation--
``(A) shall be standardized;
``(B) shall, before implementation, 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 Affairs;
``(C) 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 90 days before 
implementation;
``(D) where available, shall be presented with the 
participation of--
``(i) an employee or representative of the 
Department of Veterans Affairs assisted by a 
representative of a veterans service 
organization recognized under section 5902 of 
title 38; or
``(ii) an employee or representative of the 
Department of Veterans Affairs assisted by an 
individual recognized under section 5903 of 
such title and authorized by the Secretary 
concerned to so participate;
``(E) shall include information on how a veterans 
service organization may assist the member in filing a 
claim described in paragraph (19);
``(F) may not encourage the member to join a 
particular veterans service organization; and
``(G) may not be longer than one hour.''.
(b) Annual Report.--Not less frequently than once each year after 
the date of the enactment of this Act, the Secretary of Veterans 
Affairs shall submit, to the Committees on Armed Services of the Senate 
and House of Representatives, and to the Committees on Veterans' 
Affairs of the Senate and House of Representatives, a report that--
(1) identifies each veterans service organization that 
participated in a presentation under paragraph (20) of section 
1142(b) of title 10, United States Code, as added by subsection 
(a);
(2) contains the number of members of the Armed Forces who 
attended such presentations; and
(3) includes any recommendations of the Secretary regarding 
changes to such presentation or to such paragraph.

SEC. 208. ELIMINATION OF REQUIREMENT THAT ON-CAMPUS EDUCATIONAL AND 
VOCATIONAL COUNSELING IS PROVIDED BY CERTAIN DEPARTMENT 
OF VETERANS AFFAIRS EMPLOYEES.

(a) In General.--Section 3697B(a) of title 38, United States Code, 
is amended--
(1) by striking the second sentence;
(2) by inserting ``(1)'' before ``The Secretary''; and
(3) by adding at the end the following new paragraph:
``(2) Any individual providing services under paragraph (1) on 
behalf of the Department who is not an employee of the Department shall 
be subject to the same oversight, training, and accountability 
standards applicable to Department employees providing such 
services.''.
(b) Expansion of VetSuccess on Campus Program to at Least One 
Location in Each State.--
(1) In general.--The Secretary of Veterans Affairs shall 
ensure that the VetSuccess on Campus program of the Department 
of Veterans Affairs is located in every State.
(2) Counselors.--In carrying out paragraph (1), the 
Secretary shall ensure that at least one counselor of the 
VetSuccess on Campus program is located in each State, 
notwithstanding the number of individuals in a State or at an 
educational institution who may qualify to participate in the 
program.
(3) Preference.--In carrying out this section, 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 Secretary.
(4) State defined.--In this section, the term ``State'' has 
the meaning given such term in section 101 of title 38, United 
States Code.

SEC. 209. EXPANSION OF ENTITLEMENT FOR PAYMENT FOR LICENSING OR 
CERTIFICATION TESTS FOR VETERANS ENTITLED TO EDUCATIONAL 
ASSISTANCE.

Section 3315 of title 38, United States Code, is amended--
(1) in subsection (a), by striking ``educational assistance 
under this chapter'' and inserting ``covered assistance'';
(2) in subsection (b)(3), by striking ``under this 
chapter'' and inserting ``with respect to covered assistance'';
(3) in subsection (c), in the matter preceding paragraph 
(1), by striking ``under this chapter'' and inserting ``with 
respect to covered assistance''; and
(4) by adding at the end the following new subsection:
``(d) Warnings.--Before providing any payment to or on behalf of an 
individual described in subsection (a), 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 certification.
``(e) Covered Assistance Defined.--In this section, the term 
`covered assistance' means educational assistance available under--
``(1) this chapter, chapter 30 of this title, chapter 35 of 
this title, or chapter 1606 of title 10; or
``(2) any other provision of law providing educational 
assistance to a veteran, or to another individual in connection 
with the service of a veteran in the Armed Forces.''.

SEC. 210. 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 3313(g)(3)(B) of title 38, United States Code, is amended--
(1) in the matter preceding clause (i), by inserting 
``using educational assistance under this chapter''; and
(2) in clause (i)(II), by striking ``80 percent'' and 
inserting ``100 percent''.

SEC. 211. IMPROVING EMERGING TECHNOLOGY OPPORTUNITIES FOR VETERANS.

(a) Inclusion of Emerging Technologies in High Technology 
Program.--
(1) In general.--Section 3699C of title 38, United States 
Code, is amended--
(A) in the section heading by striking ``High 
technology'' and inserting ``High technology and 
emerging technology'';
(B) by striking ``high technology'' and inserting 
``high technology or emerging technology'' each place 
such term appears; and
(C) in subsection (c)(4) by adding at the end the 
following new subparagraph:
``(E) Such criteria shall also identify which technologies of 
critical importance, such as artificial intelligence and semiconductor 
manufacturing, shall be treated as emerging technologies for purposes 
of this section.''.
(2) Clerical amendment.--The table of sections at the 
beginning of chapter 36 of such title is amended by striking 
the item relating to section 3699C and inserting the following 
new item:

``3699C. High technology and emerging technology program.''.
(3) Conforming amendments.--Section 3680A of title 38, 
United States Code, is amended in subsections (a)(4)(B) and 
(d)(8) by striking ``high technology'' each place such term 
appears and inserting ``high technology or emerging 
technology''.
(b) Employment Rate Calculation for VET-TEC High Technology and 
Emerging Technology Program.--Section 3699C of title 38, United States 
Code, is amended--
(1) in subsection (f)--
(A) in the matter preceding paragraph (1) by 
inserting after ``House of Representatives'' the 
following: ``, and make available to the public,''; and
(B) in paragraph (3) by adding at the end the 
following: ``Such rate shall be calculated as a 
fraction, 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 180 days after the date on which 
the individual completed the program, and expressed as 
a percentage. Notwithstanding the previous sentence, 
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 
employed, by a parent or affiliate of such 
organization, as an instructor for a substantially 
similar program of education. To the maximum extent 
practicable, the Secretary shall also report the rates 
of full-time employment, part-time employment, and 
self-employment.''; and
(2) in subsection (g) by adding at the end the following 
new paragraph:
``(3) The Secretary on an ongoing basis shall solicit, collect, and 
analyze feedback about the program from covered individuals who 
participate in the program and from the GI Bill School Feedback Tool. 
The Secretary shall use such feedback to evaluate and improve the 
implementation of the program.''.

TITLE III--HEALTH CARE

SEC. 301. EXTENSION AND MODIFICATION OF TRANSPORTATION GRANT PROGRAM OF 
DEPARTMENT OF VETERANS AFFAIRS.

Section 307 of the Caregivers and Veterans Omnibus Health Services 
Act of 2010 (Public Law 111-163; 38 U.S.C. 1710 note) is amended--
(1) in subsection (a)--
(A) in paragraph (2), by adding at the end the 
following new subparagraphs:
``(C) Indian tribes.
``(D) Tribal organizations.
``(E) Native Hawaiian organizations.
``(F) County veterans service organizations.'';
(B) in paragraph (3), in the matter preceding 
subparagraph (A), by striking ``State veterans service 
agency or veterans service organization awarded'' and 
inserting ``recipient of''; and
(C) by amending paragraph (4) to read as follows:
``(4) Maximum amount.--
``(A) In general.--Except as provided in 
subparagraphs (B) and (C), the amount of a grant under 
this section may not exceed $50,000.
``(B) Off-road communities.--In the case of a 
county that has more than five communities that are off 
the road system, the amount of a grant awarded with 
respect to that county under this section may be 
increased by an amount not to exceed 50 percent of the 
amount specified in subparagraph (A).
``(C) Purchasing a vehicle.--
``(i) Amount.--The amount of a grant 
awarded under this section to a recipient may 
be increased by not more than $80,000 if the 
recipient is purchasing a vehicle to comply 
with requirements under the Americans with 
Disabilities Act of 1990 (42 U.S.C. 12101 et 
seq.) in carrying out this section.
``(ii) Limitations.--The Secretary may 
prescribe limitations on the number of vehicles 
purchased by each recipient under this 
section.'';
(2) by striking subsection (d);
(3) by redesignating subsections (b) and (c) as subsections 
(d) and (e), respectively;
(4) by inserting after subsection (a) the following new 
subsections:
``(b) Additional Services.--
``(1) Nearby rural areas.--In addition to providing 
innovative transportation options to veterans in highly rural 
areas, 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 areas.
``(2) Priority.--A recipient of a grant under this section 
shall prioritize the provision of innovative transportation 
options to veterans in highly rural areas, and shall 
demonstrate to the Secretary such priority, and may only 
provide services under paragraph (1) to veterans in nearby 
rural areas if--
``(A) it does not impede the services provided to 
veterans in highly rural areas; and
``(B) the grantee has excess capacity and resources 
available to provide such services to veterans in 
nearby rural areas.
``(c) 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 enactment.''; and
(5) in subsection (e), as redesignated by paragraph (2)--
(A) by redesignating paragraph (2) as paragraph 
(5); and
(B) by striking paragraph (1) and inserting the 
following:
``(1) Indian tribe; tribal organization.--The terms `Indian 
tribe' and `Tribal organization' have the meanings given those 
terms in section 4 of the Indian Self-Determination and 
Education Assistance Act (25 U.S.C. 5304).
``(2) Native hawaiian organization.--The term `Native 
Hawaiian organization' has the meaning given that term in 
section 6207 of the Elementary and Secondary Education Act f 
1965 (20 U.S.C. 7517).
``(3) Nearby.--The term `nearby', with respect to a rural 
area, 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 center.
``(4) Rural; highly rural.--The terms `rural' and `highly 
rural' have the meanings given those terms under the Rural-
Urban Commuting Areas (RUCA) coding system of the Department of 
Agriculture.''.

SEC. 302. VETERAN CAREGIVER REEDUCATION, REEMPLOYMENT, AND RETIREMENT 
ACT.

(a) Extension of Period of Medical Care Coverage for Caregivers 
Designated as Primary Providers of Personal Care Services for 
Veterans.--Section 1781(a)(4) of title 38, United States Code, is 
amended by inserting before the comma at the end the following: ``, 
including during the 180-day period following discharge from the 
program under section 1720G(a) of this title unless the designation of 
the individual was revoked due to fraud, abuse, mistreatment, or other 
misconduct''.
(b) Employment and Other Benefits for Caregivers Designated as 
Primary Providers of Personal Care Services for Veterans.--
(1) Employment assistance.--Section 1720G of title 38, 
United States Code, is amended by adding at the end the 
following new subsection:
``(e) Employment Assistance.--(1) The Secretary shall, subject to 
paragraph (2), provide to an individual designated as a primary 
provider of personal care services under subsection (a)(7)(A) 
employment assistance as follows:
``(A) Reimbursement of fees associated with certifications 
or relicensure necessary for such employment.
``(B) For purposes of gaining credit for continuing 
professional education requirements, access to training modules 
of the Department at no cost.
``(C) In consultation with the Secretary of Defense and the 
Secretary of Labor, access to existing employment assistance 
resources and programs as considered appropriate.
``(2) An individual described in paragraph (1) shall have access to 
assistance described in such paragraph--
``(A) while participating in the program established under 
subsection (a)(1); and
``(B) during the 180-day period following the date on which 
the individual is no longer participating in such program 
unless the designation of such individual under subsection 
(a)(7)(A) was revoked for fraud, abuse, mistreatment, or other 
misconduct.
``(3) The maximum lifetime amount that may be reimbursed for an 
individual under paragraph (1)(A) is $1,000.''.
(2) Expansion of available services.--Subsection 
(a)(3)(A)(ii) of such section is amended--
(A) in subclause (V), by striking ``; and'' and 
inserting a semicolon;
(B) in subclause (VI)--
(i) in the matter preceding item (aa), by 
inserting ``or agreements'' after 
``contracts'';
(ii) in item (aa), by inserting ``, 
including retirement planning services,'' after 
``services''; and
(iii) in item (bb), by striking the period 
at the end and inserting ``; and''; and
(C) by adding at the end the following new 
subclause:
``(VII) such instruction, preparation, training, 
and support as the Secretary considers appropriate to 
assist in transitioning away from caregiving during the 
180-day period following the date on which the family 
caregiver is no longer participating in the program 
required by paragraph (1), unless such designation was 
revoked for fraud, abuse, or mistreatment, or other 
misconduct.''.
(3) Assistance returning to workforce.--Subclause (VI) of 
such subsection is further amended--
(A) in item (aa), by striking ``; and'' and 
inserting a semicolon; and
(B) by adding at the end the following new item:
``(cc) assistance returning to the 
workforce upon discharge or dismissal from the 
program required by paragraph (1) unless such 
designation was revoked for fraud, abuse, 
mistreatment, or other misconduct; and''.
(4) Bereavement counseling and support.--Subsection 
(a)(3)(A)(i)(III) of such section is amended by inserting 
before the semicolon the following: ``, including bereavement 
counseling and support following the death of the eligible 
veteran''.
(5) Study on provision of returnship program.--
(A) In general.--Not later than one year after the 
date of the enactment of this Act, the Secretary of 
Veterans Affairs, in partnership with the Secretary of 
Labor, 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 
1720G(a)(7)(A) of title 38, United States Code, or who 
were discharged from such program, in returning to the 
workforce.
(B) Report.--Not later than 180 days after 
completion of the study under subparagraph (A), the 
Secretary shall submit to the Committee on Veterans' 
Affairs of the Senate and the Committee on Veterans' 
Affairs of the House of Representatives a report on the 
study.
(6) Study on incorporating former caregivers into workforce 
of department of veterans affairs.--
(A) In general.--Not later than one year after the 
date of the enactment of this Act, 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 1720G(a)(7)(A) of title 38, United States Code, 
at facilities of the Department of Veterans Affairs to 
address staffing needs.
(B) Report.--Not later than 180 days after 
completion of the study under subparagraph (A), the 
Secretary shall submit to the Committee on Veterans' 
Affairs of the Senate and the Committee on Veterans' 
Affairs of the House of Representatives a report on the 
study, which shall include--
(i) 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 1720G(a)(7)(A) of title 38, 
United States Code; and
(ii) such recommendations for legislative 
or administrative action as the Secretary 
considers appropriate.
(c) 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 Act, 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 1720G(a) of title 38, United States Code, in transitioning away 
from caregiving, either by assisting those individuals with retirement 
planning or returning to work.
(d) 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 Act, the Secretary of Veterans Affairs, in consultation with the 
Secretary of the Treasury and the heads of such other relevant entities 
as the Secretary of Veterans Affairs determines necessary, shall submit 
to Congress a report on the feasibility and advisability of, for 
individuals serving as family caregivers under section 1720G(a) of 
title 38, United States Code--
(1) establishing an individual retirement plan (as defined 
in section 7701(a)(37) of the Internal Revenue Code of 1986 (26 
U.S.C. 7701(a)(37))) or similar retirement plan; or
(2) permitting such individuals to join an already 
established pathway to retirement savings.

SEC. 303. VETERANS TBI BREAKTHROUGH EXPLORATION OF ADAPTIVE CARE 
OPPORTUNITIES NATIONWIDE ACT.

(a) Department of Veterans Affairs Grant Program for Supplemental 
Neurorehabilitation Approaches to Chronic Mild TBI Treatment.--
(1) Grant program.--
(A) In general.--The Secretary of Veterans Affairs 
shall carry out a three-year program (to be known as 
the ``TBI Innovation Grant Program'') under which the 
Secretary shall award grants to eligible entities 
described in paragraph (2) for the development, 
implementation, and evaluation of approaches and 
methodologies for prospective randomized control trials 
for neurorehabilitation treatments for the treatment of 
chronic mild traumatic brain injury (in this Act 
referred to as ``mTBI'') in veterans.
(B) Relationship to other department activities.--
The grant program required under subparagraph (A) shall 
be carried out in a manner that--
(i) supplements, and does not supplant, 
other clinical care and research of the 
Department of Veterans Affairs relating to 
mTBI; and
(ii) facilitates, as practicable, 
coordination with Veterans Health 
Administration facilities for referral, 
continuity of care, and dissemination of 
findings.
(2) Eligible entities described.--An eligible entity 
described in this paragraph is any of the following:
(A) A nonprofit organization with demonstrated 
capability to conduct clinical trials and to deliver or 
research effective neurorehabilitation treatments for 
mTBI, including through patient care delivery.
(B) An academic institution that conducts 
significant research on mTBI and has demonstrated 
capability to conduct clinical trials relating to 
neurorehabilitation treatments.
(C) A non-Department health care provider with 
expertise in neurorehabilitative therapies and 
demonstrated capability to conduct clinical trials and 
to evaluate mTBI treatments through patient care 
delivery.
(D) A partnership or consortium of two or more 
entities described in subparagraphs (A) through (C).
(3) Use of funds.--An eligible entity in receipt of a grant 
under this subsection shall use such grant to support 
activities that include--
(A) designing and testing novel or integrative 
treatments for mTBI that prioritize patient-centered 
care, including non-pharmacological therapies;
(B) conducting clinical studies and assessments to 
measure the effectiveness of funded approaches to--
(i) improve mental health outcomes among 
veterans;
(ii) reduce suicidality, and common risk 
factors for completing suicide, including 
depression and substance use disorders among 
veterans; and
(iii) mitigate long-term effects of mTBI 
and, to the extent outcomes are collected under 
the applicable clinical protocol, measure 
durability of outcomes at approximately six 
months following completion of treatment;
(C) providing training for clinicians and outreach 
to veterans and their families to improve awareness and 
accessibility of innovative mTBI treatments, including 
information on available Department resources and 
pathways to access such resources; and
(D) establishing partnerships with community 
organizations, academic institutions, and health care 
facilities, including, as practicable, coordination 
with Veterans Health Administration facilities to 
facilitate referral of eligible veterans, continuity of 
care, and dissemination of aggregate findings.
(4) Limitation on grant amount.--The Secretary may not 
award an eligible entity a grant under this section in an 
amount that exceeds $5,000,000 for any fiscal year.
(5) Program administration.--
(A) Applications.--An eligible entity desiring a 
grant under this subsection shall submit to the 
Secretary an application in such form, at such time, 
and containing such information and assurances as the 
Secretary determines appropriate, including a detailed 
description of--
(i) activities proposed to be conducted 
using the grant;
(ii) expected outcomes of such activities;
(iii) plans for evaluating the 
effectiveness of such activities;
(iv) how the eligible entity will 
coordinate, as practicable, with Veterans 
Health Administration facilities for referral 
and continuity of care for veterans who 
participate in activities carried out using 
grant funds, and for dissemination of aggregate 
findings;
(v) the budget of the entity for the use of 
the grant, including a narrative justification 
and an identification of the estimated amount 
of grant funds to be used for administrative or 
overhead costs; and
(vi) assurances of compliance with 
applicable Federal laws and regulations 
relating to human subjects protections and 
patient safety.
(B) Priority.--In awarding grants under this 
subsection, 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 
funds.
(C) Periodic reports.--As a condition of receiving 
a grant under this section, an eligible entity shall, 
not less frequently than annually during the grant 
period and not later than 180 days after the end of the 
grant period, submit to the Secretary a report that 
includes, with respect to the period covered by the 
report--
(i) a description of how the eligible 
entity used such grant;
(ii) a summary of the progress of 
activities funded with amounts from such grant;
(iii) measured outcomes relating to such 
activities;
(iv) a detailed accounting of expenditures 
of grant funds, including administrative or 
overhead costs;
(v) to the extent collected under the 
applicable clinical protocol or in the ordinary 
course of care, a description of any adverse 
events and serious adverse events, including 
self-harm or suicide-related events; and
(vi) a description of actions taken 
pursuant to the coordination plan described in 
subparagraph (A)(iv).
(D) Oversight; annual evaluations.--The Secretary 
shall--
(i) ensure rigorous oversight of the grant 
program under this section, including by 
monitoring financial compliance and timely 
receipt of the reports required under 
subparagraph (B); and
(ii) on an annual basis until the 
termination date specified in paragraph (9)(A), 
evaluate the efficacy of activities carried out 
using grant funds based on the reports 
submitted under subparagraph (B) and other 
appropriate information.
(E) Rule of construction.--Nothing in this section 
shall be construed to authorize the Secretary to 
require prior approval of, or changes to, any clinical 
protocol, study design, outcome measures, or follow-up 
schedule of an eligible entity that receives a grant 
under this section, except as necessary to ensure 
compliance with applicable Federal laws and regulations 
relating to human subjects protections and patient 
safety.
(F) Enforcement authority.--The Secretary may 
suspend, modify, or terminate a grant awarded under 
this section, if the Secretary determines that the 
recipient of such grant has failed to comply with 
reporting requirements under subparagraph (B) or other 
applicable terms and conditions of the grant.
(6) Available amounts; authorization of appropriations.--
(A) Available amounts.--The Secretary may carry out 
the program under this section using amounts available 
to the Secretary for general mental health care 
programs, if the use of such amounts supplements, and 
does not supplant, amounts otherwise available for 
Department mental health and traumatic brain injury 
programs.
(B) Authorization of appropriations.--There is 
authorized to be appropriated to the Secretary 
$10,000,000 for each of fiscal years 2026 through 2028 
to carry out this section.
(7) Duration; annual review.--
(A) 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 Act, 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 date.
(B) Annual review.--During such three-year period, 
the Secretary shall, on an annual basis, review the 
effectiveness of the grant program to determine the 
potential of such grant program for continuation or 
expansion.
(b) Department of Veterans Affairs Grant Program for Independent 
Third-party Research Studies and Treatment With Respect to Supplemental 
Neurorehabilitation Treatments for MTBI.--
(1) Establishment.--The Secretary of Veterans Affairs shall 
establish and carry out a research grant program to award 
grants to eligible entities described in paragraph (2) to be 
used to carry out studies and applied programs on approaches 
and methodologies for the treatment of mTBI in veterans.
(2) Eligible entities described.--An eligible entity 
described in this paragraph is any of the following:
(A) A nonprofit organization that has demonstrated 
the capability to conduct clinical trials and to 
evaluate traumatic brain injury treatments through 
patient care delivery.
(B) An academic institution that conducts 
significant research on traumatic brain injury and has 
demonstrated the capability to conduct clinical trials 
relating to neurorehabilitation treatments.
(C) A partnership or consortium of two or more 
entities described in subparagraphs (A) and (B).
(3) Applications.--An eligible entity desiring a grant 
under this section shall submit to the Secretary an application 
in such form, at such time, and containing such information and 
assurances as the Secretary determines appropriate, including a 
summary of--
(A) the research and treatment activities proposed 
to be carried out using grant funds;
(B) the methodology to be used for such activities;
(C) the expected outcomes of such activities;
(D) how the eligible entity will coordinate, as 
practicable, with Veterans Health Administration 
facilities for referral and continuity of care for 
veterans who participate in activities carried out 
using grant funds, and for dissemination of aggregate 
findings;
(E) the budget of the entity for the use of the 
grant, including a narrative justification and an 
identification of the estimated amount of grant funds 
to be used for administrative or overhead costs; and
(F) assurances of compliance with applicable 
Federal laws and regulations relating to human subjects 
protections and patient safety.
(4) Administration.--
(A) Grant categories.--In carrying out the grant 
program under this subsection, each fiscal year the 
Secretary shall--
(i) subject to the requirement under 
subparagraph (B), award four grants for 
exploratory or pilot research and treatment 
projects, each of which shall be in an amount 
of not more than $625,000; and
(ii) award five grants for collaborative or 
multidisciplinary research and treatment 
initiatives, each of which shall be in an 
amount of not more than $1,500,000.
(B) Priority.--Of the grants awarded under 
subparagraph (A)(i), the Secretary shall award not 
fewer than three to nonprofit organizations.
(C) Enforcement authority.--The Secretary may 
suspend, modify, or terminate a grant awarded under 
this subsection, if the Secretary determines that the 
recipient of such grant has failed to comply with the 
applicable terms and conditions of the grant.
(5) Agreement with independent organization.--
(A) 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 trials, 
neurorehabilitation outcomes evaluation, and research 
integrity, under which the organization agrees to--
(i) administer the research grant program 
under this subsection;
(ii) carry out studies and implement 
efforts that include--
(I) analyzing data from mTBI 
treatment methodologies developed 
pursuant to the research grant program 
to assess the effect, among veterans, 
of such methodologies on enhanced brain 
health outcomes, mental health, and 
long-term recovery, including, to the 
extent outcomes are collected under the 
applicable clinical protocol, 
durability of outcomes at approximately 
six months following completion of 
treatment;
(II) identifying data-driven best 
practices and providing recommendations 
for further research or clinical 
application, including recommendations 
for dissemination to Veterans Health 
Administration clinicians and 
facilities (as appropriate); and
(III) randomized, controlled 
clinical trials to--
(aa) validate and deliver 
treatments;
(bb) establish a standard 
of care; and
(cc) improve access to such 
treatments for veterans;
(iii) submit to the Secretary not less 
frequently than annually a report describing 
activities carried out under this section, 
including outcome data and methodology; and
(iv) make available to the Secretary all 
data and findings from the grants made under 
this section, consistent with applicable 
Federal law, regulation, and Department 
policies relating to patient protections, data 
security, and privacy.
(B) Rule of construction.--Nothing in this section 
shall be construed to authorize the Secretary, or an 
independent organization that enters into an agreement 
with the Secretary under subparagraph (A), to require 
prior approval of, or changes to, any clinical 
protocol, study design, outcome measures, or follow-up 
schedule established by an eligible entity that 
receives a grant under this section, except as 
necessary to ensure compliance with applicable Federal 
laws and regulations relating to human subjects 
protections and patient safety.
(C) Report.--An agreement under subparagraph (A) 
shall include a requirement that the independent 
organization submits to Congress and the Secretary a 
comprehensive report that includes--
(i) the findings of the studies required 
under such agreement;
(ii) recommendations with respect to the 
expansion of successful TBI treatment 
methodologies and standard of care 
recommendations, if any, developed pursuant to 
the research grant program; and
(iii) to the extent available from the 
reports and study materials of grant 
recipients, a summary of--
(I) the durability of outcomes at 
approximately six months following 
completion of treatment, if collected 
under the applicable clinical protocol;
(II) adverse events and serious 
adverse events, including self-harm or 
suicide-related events, if collected 
under the applicable clinical protocol 
or in the ordinary course of care; and
(III) aggregate expenditures of 
grant funds, including administrative 
or overhead costs.
(D) Surveys.--The Secretary may conduct surveys of 
any independent organization that enters into an 
agreement with the Secretary under subparagraph (A) in 
order to assess the effectiveness of such organization 
in administering the research grant program under this 
subsection.
(6) Available amounts; authorization of appropriations.--
(A) 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 subsection, if the use of such amounts 
supplements, and does not supplant, amounts otherwise 
available for Department programs and services.
(B) Authorization of appropriations.--There is 
authorized to be appropriated to the Secretary 
$10,000,000 for each of fiscal years 2026 through 2028 
to carry out this subsection.
(7) 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 Act.
(c) Reports to Congress.--Not later than two years after the date 
on which the Secretary commences the research grant program under 
subsection (a), and on an annual basis thereafter until the termination 
date specified in paragraph (8) of such subsection, the Secretary shall 
submit to Congress a report on the grant programs under subsections (a) 
and (b). Each such report shall include--
(1) the findings of the studies under subsection (a)(6)(B);
(2) a description of any agreement entered into by the 
Secretary under subsection (b)(5)(A);
(3) recommendations of the Secretary with respect to policy 
and programmatic improvements to services of the Department to 
treat mTBI among veterans;
(4) any findings derived from surveys conducted under 
subsection (b)(5)(D), including any recommendations of the 
Secretary for improvements to the structure, oversight, 
administration, or performance of the independent organization 
that enters into an agreement with the Secretary under 
subsection (b)(5)(A); and
(5) such other matters as the Secretary determines 
appropriate.
(d) Definitions.--In this section:
(1) The terms ``chronic mild traumatic brain injury'' and 
``mTBI'' mean a mild traumatic brain injury with symptoms that 
persist for not fewer than six months after the inciting 
injury, as determined using validated clinical criteria.
(2) The term ``nonprofit organization''--
(A) means an organization described in section 
501(c)(3) of the Internal Revenue Code of 1986 and 
exempt from taxation under section 501(a) of such Code; 
and
(B) includes such an organization that is a 
hospital, nonprofit health system, academic medical 
center, or clinic that delivers neurorehabilitation 
care or conducts clinical research relating to mTBI.
(3) The term ``veteran'' has the meaning given such term in 
section 101 of title 38, United States Code.

SEC. 304. DEPARTMENT OF VETERANS AFFAIRS ASSIGNMENT OF TRAVELING 
PHYSICIANS TO SERVE TERRITORIES, POSSESSIONS, AND FREELY 
ASSOCIATED STATES.

(a) In General.--Subchapter I of chapter 74 of title 38, United 
States Code, is amended by adding at the end the following new section:
``Sec. 7415. Traveling physicians
``(a) In General.--(1) The Secretary may assign a physician 
appointed under section 7401 or section 7431 of this title to serve as 
a traveling physician for a period of not more than one year at a time. 
A physician assigned to serve as a traveling physician under this 
section may be assigned to provide health care to veterans residing in 
American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, 
the Commonwealth of Puerto Rico, the Virgin Islands of the United 
States, the Freely Associated States (as defined in section 1724(f) of 
this title), or any other territory or possession of the United States 
at Department facilities or other approved facilities located in such 
territory, possession, or Freely Associated State.
``(2) 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 territory, possession, or Freely 
Associated State.
``(b) Coordination of Care.--In providing care under this section, 
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 services.
``(c) Pay.--In addition to pay under section 7431 of this title, 
the Secretary shall provide a relocation or retention bonus to 
traveling physicians under this section. Such relocation or retention 
bonus shall be substantially similar to a relocation or retention bonus 
offered under section 7410(a) of this title, as the Secretary considers 
appropriate.''.
(b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by inserting after the item relating to section 
7414 the following new item:

``7415. Traveling physicians.''.
(c) Technical and Conforming Amendments.--Title 38, United States 
Code, is further amended as follows:
(1) In section 7410(a)(1), by--
(A) by striking ``retention allowances'' and 
inserting ``retention bonuses''; and
(B) by striking the second comma after ``section 
7401(1) of this title''; and
(2) In section 7431(e)(5)(B), by striking ``retention 
allowances'' and inserting ``retention bonuses''.

SEC. 305. 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 1701 of title 38, United States Code, is amended, in 
paragraph (6)(F)(i), by inserting ``(including adaptive prostheses and 
terminal devices for sports and other recreational activities that are 
determined to be clinically appropriate by the Secretary)'' after 
``artificial limbs''.

SEC. 306. MODIFICATIONS TO AND REAUTHORIZATION OF STAFF SERGEANT PARKER 
GORDON FOX SUICIDE PREVENTION GRANT PROGRAM OF DEPARTMENT 
OF VETERANS AFFAIRS.

(a) Coordination by Secretary.--Subsection (b) of section 201 of 
the Commander John Scott Hannon Veterans Mental Health Care Improvement 
Act of 2019 (Public Law 116-171; 38 U.S.C. 1720F note) is amended by 
striking the second sentence.
(b) Use of Grant Funds.--Subsection (c) of such section is 
amended--
(1) in the subsection heading, by inserting ``; Use of 
Grant Funds'' after ``Grants''; and
(2) by adding at the end the following new paragraphs:
``(3) Renewal of grant amounts.--
``(A) In general.--In determining whether to renew 
a grant awarded under this section to an eligible 
entity, the Secretary shall consider, among such other 
factors as the Secretary may consider appropriate--
``(i) the compliance by the eligible entity 
in administering pre- and post-intervention 
assessments required under subsection (e)(6); 
and
``(ii) any demonstrated improvements in 
participant outcomes.
``(B) Additional amounts.--Based on a consideration 
of the factors described in subparagraph (A), the 
Secretary may award amounts, not to exceed $250,000 per 
grantee per fiscal year, to a grantee in addition to 
the maximum amount under paragraph (2)(A) based on a 
performance-based metric established by the 
Secretary.''.
(c) Priority for New Recipients.--Subsection (d) of such section is 
amended--
(1) in the subsection heading, by striking ``and 
Preference'' and inserting ``, Preference, and Priority'';
(2) in paragraph (1)(A)--
(A) in clause (iv), by striking the semi-colon at 
the end and inserting ``; and'';
(B) by striking clause (v); and
(C) by redesignating clause (vi) as clause (v); and
(3) by adding at the end the following new paragraph:
``(3) Priority for new recipients.--To the maximum extent 
practicable, the Secretary shall prioritize grants for eligible 
entities that have satisfied the requirements provided under 
subsection (f) and are located in States in which a grant has 
not been awarded under this section.''.
(d) Requirements for Receipt of Grants.--Subsection (e) of such 
section is amended--
(1) in paragraph (3)--
(A) by redesignating subparagraphs (B) and (C) as 
subparagraphs (C) and (D), respectively; and
(B) by inserting after subparagraph (A) the 
following new subparagraph (B):
``(B) 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 care;''; and
(2) by adding at the end the following new paragraph:
``(6) 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 metrics, as determined by the Secretary.
``(7) 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 
require, including--
``(A) throughput measures, including the number of 
veterans screened, referred, connected to care, and 
retained in services under the grant program;
``(B) reductions in severity scale measurements, 
including reductions in suicidality identified through 
applicable inventories or assessments; and
``(C) such other quantifiable metrics as the 
Secretary determines appropriate.''.
(e) Training and Technical Assistance.--Subsection (g) of such 
section is amended--
(1) in paragraph (1)--
(A) in the matter preceding subparagraph (A), by 
inserting ``, or interested in receiving such grants,'' 
after ``this section''; and
(B) in subparagraph (A), by inserting ``, including 
training on how to properly use the Columbia Protocol 
(also known as the Columbia-Suicide Severity Rating 
Scale (C-SSRS)) and other screening tools selected by 
the Secretary'' after ``management''; and
(2) by adding at the end the following new paragraphs:
``(3) 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 
section.''.
(f) Briefing for Local VAMCS.--Subsection (h) of such section is 
amended by adding at the end the following new paragraph:
``(5) Briefing for local vamcs.--Not less frequently than 
once per year, unless the Secretary determines that such 
frequency is not advisable, the Secretary shall provide, to the 
appropriate personnel of each medical center of the Department 
identified on the grantee's application under this section, a 
briefing about the grant program under this section in order to 
improve coordination between such recipient and personnel.''.
(g) Duration.--Subsection (j) of such section is amended by 
striking ``September 30, 2026'' and inserting ``September 30, 2029''.
(h) Reports.--Subsection (k)(2) is amended--
(1) in the paragraph heading, by striking ``Final report'' 
and inserting ``Annual reports''; and
(2) in subparagraph (B)--
(A) by redesignating clauses (iii) and (iv) as (v) 
and (vi), respectively; and
(B) by adding the following new clauses (iii) and 
(iv):
``(iii) A description of the Secretary's 
compliance with the requirement to train 
employees of the Department under subsection 
(g)(3).
``(iv) An optional description and 
inclusion of subjective or narrative stories of 
community or individual impact to allow grant 
recipients to share meaningful 
accomplishments.''.
(i) Referral for Care.--Subsection (m) of such section is amended 
by adding at the end the following new paragraph:
``(4) Required response or action.--(A) If the Secretary 
receives a referral under paragraph (1) for additional care, 
the Secretary shall review such referral and contact the 
veteran not later than 72-hours following the referral.
``(B) If the Secretary receives a referral under paragraph 
(2) for emergent suicide care, the Secretary shall review such 
referral and contact the veteran not later than 24 hours 
following the referral by such entity under subsection 
(m)(1).''.
(j) Reauthorization.--Subsection (p) of such section is amended--
(1) by striking ``section a total'' and inserting 
``section--
``(1) a total'';
(2) by striking the period at the end and inserting ``; 
and''; and
(3) by adding at the end the following new paragraph:
``(2) a total of $200,000,000 for fiscal years 2027 through 
2029.''.
(k) Technical Correction to Definitions.--Subsection (q)(5) of such 
section is amended, in the first sentence--
(1) by striking ``Medical services'' and inserting ``The 
term `emergency treatment' means medical services''; and
(2) by striking ``was rendered'' and inserting 
``rendered''.
(l) Identification of Demand for Other Services and Support.--
Subsection (e) of such section, as amended, is further amended--
(1) by redesignating paragraphs (5) and (6) as (6) and (7), 
respectively; and
(2) by adding after paragraph (4) the following new 
paragraph:
``(5) Demand for other services and support.--An entity 
receiving a grant under this section shall submit to the 
Secretary information concerning--
``(A) the number of individuals seeking services 
from the entity who are not eligible individuals and 
the most common reason such individuals are not 
eligible individuals;
``(B) a description of the types of services that 
eligible individuals or individuals described in 
subparagraph (A) require based on any screening 
conducted by the entity; and
``(C) any actions taken by the entity to provide 
the services described in subparagraph (B) or to refer 
the individual or eligible individual to another entity 
for the receipt of such services.''.
(m) Suicide Prevention Services.--
(1) Required use of certain screening protocol.--Subsection 
(q)(11)(A)(ii) of such section is amended by adding at the end 
the following new sentence: ``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 Act, such 
screening shall be Columbia Protocol (also known as the 
Columbia-Suicide Severity Rating Scale (C-SSRS)) or the Patient 
Health Questionnaire-9 (PHQ9), or a successor screening tool 
selected by the Secretary.'';
(2) Transportation.--Subsection (q)(11)(A) of such section 
is amended--
(A) by redesignating clause (xi) as clause (xii); 
and
(B) by inserting after clause (x) the following new 
clause:
``(xi) Transportation and rideshare 
services for eligible individuals to use for 
appointments.''.
(n) Eligible Individuals.--Subsection (q)(4)(C) of such section is 
amended by striking ``clauses (i) through (iv)'' and inserting 
``clauses (i) through (vi)''.
(o) Effective Date.--The amendments made by this section shall take 
effect on--
(1) the effective date of award following the date the 
Secretary publishes a notice of funding opportunity for the 
program required by section 201(a) of the Commander John Scott 
Hannon Veterans Mental Health Care Improvement Act of 2019 
(Public Law 116-171; (38 U.S.C. 1720F)), if the Secretary 
determines such amendments do not require rulemaking; or
(2) the effective date of award following the date the 
Secretary publishes a notice of funding opportunity following 
the effective date of subsequent rulemaking, if the Secretary 
determines such amendments do require rulemaking.

SEC. 307. REPORTS ON THE USE OF HYPERBARIC OXYGEN THERAPY.

(a) 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 Act, 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'' (GAO-
16-154). Such report shall include the assessment of the Comptroller 
General of clinical trials conducted, since the publication of such 
report--
(1) regarding the use of hyperbaric oxygen therapy to treat 
traumatic brain injury and post-traumatic stress disorder; and
(2) by--
(A) the Secretary of Veterans Affairs;
(B) the Secretary of Defense; and
(C) private entities.
(b) Follow-up Study.--
(1) In general.--Not later than 180 days after the date of 
the enactment of this Act, 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 
nonveterans.
(2) Elements.--The review conducted under paragraph (1) 
shall include the following:
(A) An analysis of available research literature 
published after the review completed pursuant to 
section 702 of the Commander John Scott Hannon Veterans 
Mental Health Care Improvement Act (Public Law 116-
171);
(B) An assessment of the current parameters for 
research on the use by the Department of Veterans 
Affairs of hyperbaric oxygen therapy, including--
(i) tests and questionnaires used to 
determine the efficacy of such therapy; and
(ii) metrics for determining the success of 
such therapy.
(C) 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 Affairs, other 
Federal agencies, and entities outside the Federal 
Government.
(D) A market assessment of available hyperbaric 
oxygen therapy facilities or units within facilities to 
assess the most effective locations and practices, 
including--
(i) an analysis of whether multi-person 
chambers could reduce per-veteran costs;
(ii) an analysis of areas with lower prices 
compared to a national average; and
(iii) an identification of not fewer than 
two VISNs in which the provision or furnishing 
of hyperbaric oxygen therapy would benefit the 
most number of veterans at the lowest cost to 
the Department.

SEC. 308. DEPARTMENT OF VETERANS AFFAIRS PILOT PROGRAM TO PROVIDE 
GRANTS TO MENTAL HEALTH CARE PROVIDERS FOR THE PROVISION 
OF MENTAL HEALTH CARE FOR VETERANS.

(a) 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 care, including evidence-based mental health care 
delivered in person or via telehealth.
(b) Eligibility.--To be eligible to receive a grant under the pilot 
program, a mental health care provider shall--
(1) be a non-profit organization;
(2) have operated at least one outpatient mental health 
facility in the United States for a continuous period of at 
least three years;
(3) be licensed or certified under applicable state law to 
provide outpatient mental health services;
(4) be accredited by--
(A) the Joint Commission on Accreditation of 
Healthcare Organizations;
(B) the Commission on Accreditation of 
Rehabilitation Facilities; or
(C) any other nationally recognized accrediting 
body the Secretary determines appropriate; and
(5) submit to the Secretary an application that includes 
such information and assurances as the Secretary may require, 
including--
(A) an identification of the outpatient facility or 
facilities where the mental health care services will 
be provided;
(B) a plan for providing clinicians at each 
facility in receipt of grant funds with units of 
continuing education with respect to veterans issues; 
and
(C) 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 
submitted.
(c) Use of Funds.--
(1) In general.--The recipient of a grant under the pilot 
program shall use the grant--
(A) to deliver evidence-based mental health care 
for veterans in person or via telehealth.
(B) to operate or expand an existing outpatient 
mental health facility or establish a new outpatient 
mental health facility for the purpose of providing 
such care;
(C) to encourage veterans who are eligible for 
enrollment in the patient enrollment system under 
section 1705 of title 38, United States Code, to enroll 
in such system and to receive medical services 
furnished by the Department of Veterans Affairs;
(D) to support activities necessary to deliver or 
sustain care, including--
(i) outreach;
(ii) care coordination;
(iii) veteran engagement;
(iv) clinician training;
(v) implementation support; and
(vi) program evaluation; and
(E) to support continuous quality improvement and 
outcomes measurement activities, including the 
collection and reporting of clinical outcomes and 
operational metrics; and
(F) to support activities of the program that are 
not billable, reimbursable, or otherwise authorized by 
law, including--
(i) outreach;
(ii) care coordination;
(iii) engagement;
(iv) implementation support; and
(v) program evaluation; and
(G) to provide services to individuals for which 
reimbursement is not otherwise available, including 
such individuals who are--
(i) uninsured;
(ii) ineligible for health care furnished 
by the Department of Veterans Affairs; or
(iii) in receipt of health care that is not 
reimbursable as of the date of the enactment of 
this Act.
(2) Limitations on use of grant funds.--The recipient of a 
grant under the pilot program may not--
(A) charge an eligible veteran a fee associated 
with the receipt of mental health care funded by such 
grant;
(B) 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 source; or
(C) use grant funds to--
(i) duplicate payments made under any 
contract or agreement to which the Department 
is a party as of the date of the enactment of 
this Act; or
(ii) pay for the same clinical services or 
service units that are otherwise billable to a 
Federal payer, including the Veterans Community 
Care Program under section 1703 of title 38, 
United States Code, or any other public or 
private health plan.
(3) Rules of construction.--Nothing in this subsection may 
be construed to--
(A) prohibit a grant recipient from seeking 
reimbursement from non-Department payers for mental 
health services provided by the grant recipient, except 
that grant funds shall not be used to supplant or 
duplicate a reimbursement otherwise available under 
Federal law; or
(B) authorize double billing or duplicate payments 
for the same clinical service or unit of service.
(4) 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 outcome. Permissible services include--
(A) family therapy;
(B) couples therapy;
(C) group therapy;
(D) family psychoeducation; and
(E) other counseling services the Secretary 
determines are clinically necessary.
(d) Selection of Facilities.--In awarding grants under the pilot 
program, the Secretary--
(1) shall ensure that grants are distributed geographically 
evenly among rural and urban areas;
(2) may consider the proportion of veterans historically 
served by the grant recipient; and
(3) may prioritize outpatient mental health facilities 
located in areas that the Secretary determines--
(A) are medically underserved;
(B) have large veteran populations;
(C) are located near military installations; or
(D) have large numbers of veterans at high risk of 
suicide.
(e) Amount of Grant.--
(1) In general.--
(A) In general.--Except as provided in subparagraph 
(B), no grant under the pilot program for a facility 
for any fiscal year may exceed $1,500,000.
(B) Limitation.--In the case of an outpatient 
mental health facility for which at least 50 percent of 
the operating budget of the facility for the preceding 
fiscal year was provided through Federal grants, no 
grant under the pilot program for the facility for any 
fiscal year may exceed the lesser of--
(i) 50 percent of the operating budget of 
the facility; or
(ii) $1,500,000.
(2) Multiple grants.--The recipient of a grant under the 
pilot program--
(A) may apply for, and receive, grants for more 
than one facility of the recipient for any fiscal year; 
and
(B) may apply for, and receive, a grant for a 
facility that has already received a grant under the 
pilot program.
(f) Regulations; Accountability.--The Secretary shall prescribe 
regulations to carry out this section, which shall include a 
requirement that each recipient of a grant under the pilot program 
shall--
(1) demonstrate the capacity to provide accountability;
(2) demonstrate clinical outcomes;
(3) justify the effective use of any private investment 
funds or Federal grant funds through data collection and 
reporting metrics; and
(4) collect standardized outcome measures including symptom 
improvement and program completion.
(g) 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 Program.
(h) Report.--Not later than 180 days after the completion of the 
pilot program under this section, the Secretary shall submit to 
Congress a report on the pilot program that includes the following:
(1) The number of veterans who received mental health care 
under the program.
(2) An identification of the types of mental health care 
provided and the time period for which such care was provided.
(3) An identification and summary of program outcomes.
(4) The number of veterans who received mental health care 
under the program and subsequently enrolled in the patient 
enrollment system under section 1705 of title 38, United States 
Code.
(5) An identification of any obstacles faced by grant 
recipients in providing mental health care under the program.
(6) A summary of clinical outcomes based on pre- and post-
client functioning--
(A) the number of veterans who improved clinically 
based on relevant clinical evaluation metrics that the 
Secretary determines appropriate;
(B) the degree of clinical improvement based on 
such relevant clinical evaluation metrics;
(C) the total number of veterans participating in 
the program; and
(D) any other outcome metrics as the Secretary 
determines appropriate.
(7) Findings with respect to the sustainability of the 
program.
(i) Authorization of Appropriations.--There is authorized to be 
appropriated to the Secretary to carry out the pilot program under this 
section $20,000,000 for each of fiscal years 2027 through 2029.

SEC. 309. FURNISHING OF CERTAIN HEALTH SERVICES TO VETERANS IN THE 
FREELY ASSOCIATED STATES.

(a) Agreements Required.--Consistent with section 1724(f) of title 
38, United States Code, and section 209(a)(4)(A) of the Compact of Free 
Association Amendments Act of 2024 (48 U.S.C. 1988(a)(4)(A)), the 
Secretary of Veterans Affairs shall work expeditiously with the 
governments of the Freely Associated States to enter into the 
agreements described in such sections.
(b) Inclusion of Telehealth and Mail Order Pharmacy Services 
Required.--Consistent with such sections and with the agreements 
required by subsection (a), the Secretary shall furnish to veterans in 
the Freely Associated States services that include, at a minimum--
(1) medical services authorized to be provided under 
chapter 17 of title 38, United States Code, which can be 
administered through telehealth; and
(2) pharmaceutical products authorized to be provided under 
such chapter, delivered by mail.
(c) Implementation Dates.--In carrying out subsections (a) and (b), 
the Secretary shall--
(1) initiate outreach to each such government not later 
than 30 days after the date of the enactment of this Act;
(2) enter into each agreement required by subsection (a) 
not later than one year after the date of the enactment of this 
Act; and
(3) begin furnishing the services required by paragraphs 
(1) and (2) of subsection (b) not later than one year after the 
date of the enactment of this Act.
(d) Beneficiary Travel.--Section 111(h)(1) of title 38, United 
States Code, 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 Act, the Secretary 
shall make payments''.
(e) Reports.--Not less frequently than quarterly, the Secretary 
shall submit to the appropriate committees of Congress a report on the 
implementation of this section and the cost of such implementation. 
Until the Secretary has entered into the agreements required by 
paragraph (1) and begun furnishing the services required by 
subparagraphs (A) and (B) of paragraph (2), the report shall also 
describe the technical and logistical factors that have prevented or 
impeded the Secretary from doing so.
(f) Definitions.--In this subsection:
(1) Appropriate committees of congress.--The term 
``appropriate committees of Congress'' means--
(A) the Committee on Veterans' Affairs and the 
Committee on Appropriations of the Senate; and
(B) the Committee on Veterans' Affairs and the 
Committee on Appropriations of the House of 
Representatives.
(2) Freely associated states.--The term ``Freely Associated 
States'' has the meaning given such term in section 1724(f) of 
title 38, United States Code.

SEC. 310. MODIFICATION OF PRECISION MEDICINE FOR VETERANS INITIATIVE; 
REPORTING ON SUICIDE BY VETERANS AND MEMBERS OF THE ARMED 
FORCES.

(a) Modification of Precision Medicine for Veterans Initiative.--
Section 305 of the Commander John Scott Hannon Veterans Mental Health 
Care Improvement Act of 2019 (Public Law 116-171; 38 U.S.C. 1712A note) 
is amended--
(1) in subsection (a), by striking ``and such other mental 
health conditions'' and inserting ``repetitive low-level blast 
exposure, dementia, and such other brain and mental health 
conditions'';
(2) in subsection (d)(4), by adding at the end the 
following new subparagraph:
``(E) Data-sharing partnership.--
``(i) 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 
Defense.
``(ii) Storage.--The partnership 
established under clause (i) shall be stored in 
the open platform made available under this 
paragraph.
``(iii) Data.--The data supplied by the 
Secretary of Defense under the partnership 
established under clause (i) 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 
entities, as determined jointly by the 
Secretary of Defense and the Secretary of 
Veterans Affairs.''; and
(3) by adding at the end the following new subsections:
``(f) Repetitive Low-level Blast Exposure Research.--In carrying 
out the initiative under subsection (a), the Secretary shall prioritize 
research--
``(1) to identify and validate biomarkers associated with 
repetitive low-level blast exposure and traumatic brain injury;
``(2) to evaluate clinical and non-clinical interventions 
that improve cognitive function, quality of life, and mental 
health outcomes among veterans with symptoms associated with 
repetitive low-level blast exposure;
``(3) to improve the diagnosis, treatment, and care 
coordination for veterans with a history of low-level 
repetitive blast exposure or traumatic brain injury, including 
veterans who performed duties or tasks associated with 
increased risk of low-level repetitive blast exposure; and
``(4) to develop evidence-based strategies to reduce 
suicide risk among veterans with a history of low-level 
repetitive blast exposure or traumatic brain injury.
``(g) Assistance and Report by National Academies of Sciences, 
Engineering, and Medicine.--Not later than 180 days after the date of 
the enactment of the Take Care of America's Veterans Act, the Secretary 
of Veterans Affairs shall seek to enter into a contract with the 
National Academies of Sciences, Engineering, and Medicine under which 
the National Academies shall--
``(1) work in tandem with the initiative under subsection 
(a) on validation of brain and mental health biomarkers among 
veterans; and
``(2) not less frequently than once every two years, 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 (1).
``(h) Assessment.--
``(1) 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 (a), 
including research under subsection (f).
``(2) Report.--Not later than 60 days after completion of 
the assessment conducted under paragraph (1), 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 assessment.
``(i) Reports.--
``(1) In general.--Not less frequently than once every two 
years, 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 (a).
``(2) Recommendations.--Each report required by paragraph 
(1) may include recommendations for immediate administrative 
and legislative action to improve the initiative under 
subsection (a).
``(j) Authorization of Appropriations.--There is authorized to be 
appropriated to the Secretary of Veterans Affairs $5,000,000 to carry 
out the initiative under subsection (a) for each of fiscal years 2027 
through 2032.''.
(b) Inclusion of Information in Reports on Suicide Prevention Among 
Veterans and Members of the Armed Forces.--
(1) Inclusion of information in national veteran suicide 
prevention annual report.--Section 149(a)(4)(B) of the Senator 
Elizabeth Dole 21st Century Veterans Healthcare and Benefits 
Improvement Act (Public Law 118-210; 38 U.S.C. 1709B note) is 
amended by adding at the end the following:
``(iv) Military occupation data of veterans 
who attempt or commit suicide.''.
(2) Inclusion of information in department of defense 
annual report.--The Secretary of Defense shall include in the 
annual report of the Defense Suicide Prevention Office, or 
successor office, information on--
(A) occupational data of members of the Armed 
Forces who attempt suicide; and
(B) outcomes of suicide prevention interventions 
among members of the Armed Forces.

SEC. 311. ESTABLISHMENT OF THE BLAST OVERPRESSURE TASK FORCE OF THE 
DEPARTMENT OF VETERANS AFFAIRS.

(a) Establishment.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall appoint, 
through the Department of Veterans Affairs-Department of Defense Joint 
Executive Committee under section 320 of title 38, United States Code, 
the Blast Overpressure Task Force of the Department of Veterans Affairs 
(in this section referred to as the ``Task Force'').
(b) Membership.--Each member of the Task Force appointed under 
subsection (a) shall be a member of the Health Executive Committee 
under subsection (b)(2) of such section who, at the time of 
appointment, is involved in research regarding the mitigation and 
treatment of blast overpressure or blast exposure.
(c) Duties.--The duties of the Task Force are the following:
(1) To improve how the Secretary of Veterans Affairs, in 
consultation with the Secretary of Defense, provides health 
care and other benefits to veterans or members of the Armed 
Forces diagnosed with traumatic brain injury, post-traumatic 
stress disorder, or other symptoms, from blast overpressure or 
blast exposure.
(2) To align research agendas and acquisition strategies of 
the Department regarding such health care.
(3) To establish physiological and cognitive performance 
baselines for such veterans and members.
(4) To prioritize translational research regarding such 
veterans and members, including research regarding--
(A) sleep therapy;
(B) blast-related gut health;
(C) mobile diagnostics;
(D) vestibular dysfunction and balance impairment;
(E) autonomic nervous system dysregulation;
(F) cumulative mild traumatic brain injury;
(G) neuroinflammation and glial activation; and
(H) any other issue determined appropriate by the 
Secretary.
(5) To monitor sensory decline (including with regards to 
vision, hearing, and vestibular function) and stress-related 
impairments among such veterans and members.
(6) To support continuity of such care by integrating 
mobile and longitudinal diagnostic tools.
(d) Reports.--The Task Force shall issue annual reports to the 
Committees on Veterans' Affairs and on Armed Services of the Senate and 
House of Representatives. Each such report shall include the following 
elements:
(1) Details of research initiatives, coordination outcomes, 
and clinical advancements of the Task Force.
(2) Recommendations of the Task Force regarding--
(A) how claims processors of the Department of 
Veterans Affairs should evaluate evidence that links 
such conditions to active military, naval, air, or 
space service; and
(B) best practices regarding the evaluation of 
neurological injuries in examinations for benefits 
under chapters 11 or 15 of title 38, United States 
Code.
(e) Sunset.--The Task Force shall terminate on September 30, 2029.

SEC. 312. EXTENSION OF SHARING OF DEPARTMENT OF VETERANS AFFAIRS AND 
DEPARTMENT OF DEFENSE HEALTH CARE RESOURCES; RESOURCE 
SHARING OVERSIGHT AND IMPLEMENTATION PLAN.

(a) Extension.--Section 8111(d)(3) of title 38, United States Code, 
is amended by striking ``September 30, 2026'' and inserting ``September 
30, 2027''.
(b) Oversight.--
(1) Justification.--Such section is further amended in 
subsection (a)--
(A) by inserting ``(1)'' before ``To the maximum 
extent practicable, the Secretary''; and
(B) by adding at the end the following new 
paragraph:
``(2) If the Secretary of Veterans Affairs elects not to 
enter into such an agreement or contract, notwithstanding 
paragraph (1), 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 
election.''.
(2) 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 8111 of title 38, United States Code, the Secretary 
shall provide such information in the form requested by such 
committee, including underlying records, datasets, 
methodologies, contracts, and communications, and may not be 
limited to summaries or briefing materials in lieu of original 
source documents unless authorized by the requesting committee.
(3) Interference with transmission of information.--In 
response to such a request, no official or employee of the 
Department of Veterans Affairs shall--
(A) withhold, screen, or alter responsive 
information;
(B) delay or condition production on initial 
clearance or political review;
(C) require a nondisclosure agreement unless 
required by law;
(D) substitute summaries for requested 2 records; 
or
(E) otherwise impede or interfere with direct 
transmission of information to the Committee on 
Veterans' Affairs of the House of Representatives or 
the Senate.
(4) 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 classified, the Secretary 
shall make arrangements to present such information to the 
Chair and Ranking Member of the such committee using 
appropriate security measures.
(c) Implementation Plan and Report.--
(1) Joint resource sharing implementation plan.--Not later 
than 90 days after the date of the enactment of this Act, the 
Secretary of Veterans Affairs, in coordination with the 
Secretary of Defense, shall submit to the Committees on 
Veterans' Affairs of the House of Representatives and the 
Senate a Joint Resource Sharing Implementation Plan. Such plan 
shall include--
(A) a comprehensive inventory of all agreements 
under section 8111 of title 38, United States Code;
(B) a standardized reimbursement methodology;
(C) capacity assessments of Department of Veterans 
Affairs and Department of Defense facilities; and
(D) identification of priority regions for 
expansion.
(2) Report.--Not later than 2 years after date of the 
enactment of this Act, the Comptroller General shall submit a 
report to Congress on the implementation of section 8111 of 
title 38, United States Code. Such report shall include--
(A) a description of use and effectiveness of 
agreements under such section;
(B) a description of the role and output of the 
Joint Executive Committee under such section;
(C) 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 section; and
(D) a description of any statutory, operational, or 
cultural barriers to the implementation of such 
section.

SEC. 313. TIMELY REPORTING OF THE DEATH OF A VETERAN.

(a) Findings.--Congress finds the following:
(1) States and counties have reported significant delays in 
the signing of death certificates for veterans who pass away 
from natural causes.
(2) Such delays, caused by the refusal of, or postponement 
by, physicians of the Department of Veterans Affairs have, in 
some cases, lasted as long as eight weeks.
(3) Such delays prevent the timely burial of deceased 
veterans and access to survivor benefits.
(b) Timely Certification of the Death of a Veteran.--
(1) In general.--
(A) VA physician, nurse practitioner, or physician 
assistant.--Subject to subparagraph (B), a physician, 
nurse practitioner, 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 physician, nurse 
practitioner, or physician assistant learns of such 
death.
(B) Coroner or medical examiner.--If a physician, 
nurse practitioner, or physician assistant described in 
subparagraph (A) cannot comply with such paragraph with 
respect to a death described in such paragraph, a 
coroner or medical examiner in the jurisdiction where 
such death occurred may certify such death.
(2) Report.--
(A) In general.--Not later than one year after the 
date of the enactment of this Act, and annually 
thereafter for the following five years, 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 (1).
(B) Elements.--Each report required under 
subparagraph (A) shall include, with respect to the 
year preceding the date of the report, the following 
elements:
(i) The percentage of cases in which a 
physician, nurse practitioner, or physician 
assistant employed by the Secretary complied 
with paragraph (1)(A).
(ii) The number of cases in which such a 
physician, nurse practitioner, or physician 
assistant could not so comply.
(iii) An identification of the most common 
reasons why such a physician, nurse 
practitioner, or physician assistant could not 
so comply.
(3) 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 law.

SEC. 314. EXPANSION OF ACCESS BY VETERANS TO CRITICAL ACCESS HOSPITALS 
AND AFFILIATED CLINICS UNDER THE VETERANS COMMUNITY CARE 
PROGRAM.

(a) Pilot Program to Improve Care Coordination for Veterans From 
Critical Access Hospitals and Affiliated Clinics.--
(1) In general.--Not later than one year after the date of 
the enactment of this Act, 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 (in this section referred 
to as the ``pilot program'').
(2) Contracts, agreements, or other arrangements.--
(A) In general.--In carrying out the pilot program, 
the Secretary shall enter into contracts, agreements, 
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 
veterans.
(B) Elements.--The Secretary, in coordination with 
participating critical access hospitals, shall ensure 
that any contract, agreement, or other arrangement 
entered into under subparagraph (A) establishes 
criteria, as the Secretary considers appropriate, to 
ensure--
(i) the provision of timely, safe, and 
high-quality health care services to 
participants in the pilot program, 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 Affairs;
(ii) the provision of health care services 
through the pilot program is in accordance with 
the medical benefits package of the Department;
(iii) 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 Secretary;
(iv) appropriate reimbursement rates, 
including through the consideration of cost-
based reimbursements; and
(v) such other considerations as the 
Secretary considers appropriate.
(3) 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 States.
(4) 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 
program.
(5) Outreach.--
(A) Eligible veterans.--Not less frequently than 
annually during each year in which the pilot program is 
carried out, 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 program.
(B) 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 
program.
(6) 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--
(A) administrative and technical challenges that 
arise from the pilot program;
(B) care coordination and follow up with the 
veteran and the facility participating in the pilot 
program after an episode of care; and
(C) timely records return following an episode of 
care.
(7) Limitation.--The Secretary may not extend the pilot 
program beyond the five-year period specified under subsection 
(a) 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 Congress.
(8) Report.--
(A) In general.--Not later than one year after the 
date of the enactment of this Act, and annually 
thereafter for the duration of the pilot program, the 
Secretary shall submit to the Committee on Veterans' 
Affairs of the Senate and the Committee on Veterans 
Affairs of the House of Representatives a report on the 
pilot program.
(B) Elements.--
(i) In general.--Each report required under 
subparagraph (A) shall contain the 
recommendation of the Secretary for the 
expansion or continuation of the pilot program.
(ii) Initial report.--The initial report 
required under clause (i) shall contain--
(I) a description of the outreach 
conducted to critical access hospitals 
concerning the pilot program;
(II) a list of facilities that have 
opted to participate in the pilot 
program;
(III) information, by facility, 
regarding total obligations and 
expenditures, utilization average time 
from authorization to care, timeliness 
regarding medical records return and 
claim payment, emergency department 
utilization, veteran satisfaction, and 
any effect on care furnished by 
Department facilities; and
(IV) a list of the barriers, if 
any, cited by facilities that opted not 
to participate in the pilot program.
(iii) Subsequent reports.--Each report 
required under clause (i) after the initial 
report shall contain--
(I) an updated list of facilities 
participating in the pilot program;
(II) the number of veterans 
participating in the pilot program, 
disaggregated by facility;
(III) an overview of the types of 
care received through the pilot 
program;
(IV) feedback from the facilities 
participating in the pilot program, 
with identifying information removed, 
regarding the status of the pilot 
program, challenges in participating in 
the pilot program, and the interest of 
the facility in continued participation 
in such a program; and
(V) any additional information that 
the Secretary determines relevant or 
necessary.
(9) Definitions.--In this subsection:
(A) Critical access hospital.--The term ``critical 
access hospital'' has the meaning given that term in 
section 1861(mm) of the Social Security Act (42 U.S.C. 
1395x(mm)).
(B) Eligible veteran.--The term ``eligible 
veteran'' means a veteran--
(i) enrolled in the patient enrollment 
system of the Department of Veterans Affairs 
established and operated under section 1705(a) 
of title 38, United States Code;
(ii) who has received care at a facility of 
the Department or in-network provider under the 
Veterans Community Care Program under section 
1703 of such title during the previous two-year 
period;
(iii) who lives within 35 miles of a 
critical access hospital; and
(iv) who would be eligible for care or 
services under the Veterans Community Care 
Program.
(b) Action Plan to Address Barriers to Care for Veterans Living in 
Rural Areas.--
(1) In general.--Not later than one year after the date of 
the enactment of this Act, 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 
identify, address, and eliminate barriers to accessing care for 
veterans residing in rural, highly rural, and frontier areas.
(2) Elements.--In developing the action plan required under 
paragraph (1), the Secretary shall--
(A) consult with health care providers that provide 
care in the community under the laws administered by 
the Secretary, State Offices of Rural Health, Tribal 
health authorities, and other relevant stakeholders in 
rural, highly rural, and frontier areas as the 
Secretary determines appropriate;
(B) assess barriers to care in the community for 
veterans residing in rural and highly rural areas, 
including challenges with respect to--
(i) network adequacy;
(ii) provider participation;
(iii) geographic distance;
(iv) transportation;
(v) information technology;
(vi) physical infrastructure;
(vii) outreach and understanding of 
eligibility for such care;
(viii) timeliness of referrals, 
authorization, and medical documentation 
exchange; and
(ix) any other matter the Secretary 
determines appropriate;
(C) list specific and measurable strategies and 
actions to address the barriers and challenges assessed 
under subparagraph (B), to include the consideration 
of--
(i) expanding participation in the Veterans 
Community Care Program under section 1703 of 
title 38, United States Code, among providers 
in rural, highly rural, and frontier areas;
(ii) 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 rural, highly rural, or frontier 
areas;
(iii) enhancing transportation assistance;
(iv) increasing reimbursement rates, 
including through cost-based reimbursements; 
and
(v) improving coordination with State, 
Tribal, and local partners; and
(D) assess legislative and regulatory barriers, if 
any, to addressing the barriers assessed under 
subparagraph (B).
(3) Implementation.--Not later than 90 days after 
submitting the action plan under paragraph (1), 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 Act.
(c) Outreach.--
(1) Outreach to veterans.--Not later than one year after 
the date of the enactment of this Act, and annually thereafter, 
the Secretary of Veterans Affairs, through the Office of Rural 
Health (or successor office) and the Office of Integrated 
Veteran Care (or successor office), shall conduct outreach to 
veterans residing in rural, highly rural, and frontier areas 
regarding--
(A) opportunities to seek care through facilities 
and programs of the Department of Veterans Affairs, 
including via telehealth, existing programs provided 
through grantees or contractors of the Department, Vet 
Centers (as defined in section 1712A of title 38, 
United States Code), and volunteer programs and 
services for transportation;
(B) opportunities to seek care though the Veterans 
Community Care Program under section 1703 of title 38, 
United States Code;
(C) opportunities to seek care at critical access 
hospitals with contracts, partnerships, or agreements 
with the Department of Veterans Affairs; and
(D) any other matters the Secretary considers 
appropriate.
(2) Outreach to providers.--Not later than one year after 
the date of the enactment of this Act, and annually thereafter, 
the Secretary of Veterans Affairs, through the Office of Rural 
Health (or successor office) and the Office of Integrated 
Veteran Care (or successor office), shall--
(A) conduct outreach to health care facilities and 
critical access hospitals in rural areas regarding--
(i) the Veterans Community Care program 
under section 1703 of title 38, United States 
Code, and the pilot program under subsection 
(a) of this section; and
(ii) any other matters the Secretary 
considers appropriate; and
(B) seek to enter into contracts, partnerships, 
agreements, or other arrangements with health care 
facilities and critical access hospitals in rural 
areas.
(3) Critical access hospital defined.--In this section, the 
term ``critical access hospital'' has the meaning given that 
term in section 1861(mm) of the Social Security Act (42 U.S.C. 
1395x(mm)).

SEC. 315. PILOT PLATFORM FOR SERVICES FOR VETERANS; COLLECTION FROM 
VETERANS OF INFORMATION RELATED TO SOCIAL DETERMINANTS OF 
HEALTH.

(a) Pilot Program on Establishment or Enhancement of Community 
Integration Platform for Veterans.--
(1) In general.--Commencing not later than 18 months after 
the date of the enactment of this Act, the Secretary, acting 
through the Center for Innovation for Care and Payment of the 
Department of Veterans Affairs, shall carry out a pilot program 
under which the Secretary shall establish a new, or enhance an 
existing, interoperable community integration platform to 
coordinate local support services for veterans through other 
governmental and nongovernmental organizations (in this section 
referred to as the ``pilot program'').
(2) Elements of pilot program.--In carrying out the pilot 
program, the Secretary shall ensure that the community 
integration platform established or enhanced under the pilot 
program--
(A) permits veterans to identify and connect with 
covered entities that furnish covered services;
(B) permits covered entities to identify and 
connect with veterans in need of covered services;
(C) utilizes, to the extent practicable, existing 
interoperable technology networks;
(D) prioritizes connectivity with appropriate 
existing technology networks developed by public or 
private organizations that comply with, as applicable, 
standards adopted by the Secretary of Health and Human 
Services under section 3004 of the Public Health 
Service Act (42 U.S.C. 300jj-14), for the provision of 
covered services;
(E) ensures that--
(i) reasonable measures are taken to 
promote connectivity and interoperable exchange 
among covered entities and between covered 
entities and veterans; and
(ii) appropriate privacy and security 
protections are in place, in accordance with 
applicable Federal and State privacy law;
(F) is accessible by employees of the Department, 
covered entities, and veterans;
(G) connects covered entities and veterans for 
purposes of communication, service coordination, and 
consumer assistance, referral and capacity management, 
outcome tracking and reporting, and related services; 
and
(H) 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 platform.
(3) Locations.--
(A) 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 
program.
(B) Expansion.--The Secretary may expand beyond 
initial sites for the pilot program selected under 
paragraph (1) not before two years after the date of 
enactment, not before thirty days after briefing the 
Committees on Veterans' Affairs of the Senate and the 
House of the expansion plan, and after demonstrated 
success.
(C) Variety of facilities.--In selecting facilities 
under subparagraph (A), the Secretary shall ensure the 
selection of a variety of different types of 
facilities, including--
(i) frontier facilities;
(ii) under-resourced facilities;
(iii) facilities at which there are 
existing efforts to coordinate with community 
resources; and
(iv) facilities located in communities with 
an established community-based veteran service 
coordination network capable of integration 
with the pilot program.
(4) Procurement of technology.--In carrying out the pilot 
program, 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 program. In 
procuring technology under this section, the Secretary may 
prioritize, to the maximum extent practicable, technologies, 
platforms, or capabilities that are already deployed, 
validated, interoperable, or otherwise in operational use 
within medical centers or other components of the Department, 
unless the Secretary determines and documents that an 
alternative solution would better achieve the purposes of this 
section.
(5) Application process.--
(A) 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 form, in such manner, and containing such 
commitments and information as the Secretary considers 
necessary to carry out this section.
(B) Review.--
(i) In general.--The Secretary shall review 
the applications of covered entities submitted 
under subparagraph (A) to ensure that the 
participation of such entities would be safe 
and appropriate for veterans participating in 
the pilot program.
(ii) Due diligence.--In reviewing 
applications under clause (i), the Secretary 
shall conduct due diligence consistent with how 
the Secretary conducts due diligence for 
public-private partnerships under other laws 
administered by the Secretary.
(6) Screening and tracking of participants.--
(A) 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-
10 diagnostic codes Z55 through Z63 and Z75 (as in 
effect on the date of the enactment of this Act) in a 
standardized risk assessment or screening tool and such 
other information as the Secretary considers necessary 
to administer the pilot program.
(B) 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 coordination, service 
delivery, or program evaluation under the pilot 
program.
(C) Tracking of information.--
(i) In general.--The Secretary shall 
track--
(I) the number of referrals of 
veterans to covered entities through 
the community integration platform 
under the pilot program;
(II) the response time of covered 
entities to which such veterans are 
referred; and
(III) the outcome of the initial 
meeting by a veteran and a covered 
entity to which the veteran is 
referred, including a description of 
the services that are provided to the 
veteran by such entity.
(ii) Tracking by entities.--The Secretary 
may require covered entities participating in 
the pilot program to track the information 
required under clause (i) in a medium 
determined appropriate by the Secretary.
(7) Coordination and integration of programs.--
(A) Coordination with existing networks.--In 
carrying out the pilot program, the Secretary shall 
coordinate with existing community networks.
(B) 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 programs, but nothing in this section shall be 
construed to authorize the Secretary of Veterans 
Affairs to administer, direct, or modify a State 
Medicaid program or waiver.
(8) Performance benchmarks.--The Secretary shall establish 
performance benchmarks for the pilot program, including 
measures of referral completion, timeliness of service 
connection, and veteran-reported satisfaction.
(9) Report and briefings.--
(A) Report.--Not later than three years after the 
commencement of the pilot program, 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 
program, including an assessment of--
(i) the need for such services that is 
being met through such platform; and
(ii) the need for such services that is not 
being met through such platform.
(B) Briefing on entities not selected.--Not later 
than 180 days after the commencement of the pilot 
program, and not less frequently than once every 180 
days thereafter until the conclusion of the pilot 
program, 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 selected.
(10) Comptroller general evaluation, report, and 
recommendations.--
(A) 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--
(i) changes in individual and population 
health outcomes among veterans;
(ii) changes in access to health care or 
social services among veterans; and
(iii) such other factors as the Comptroller 
General considers appropriate.
(B) Report and recommendations.--
(i) In general.--Not later than four years 
after the commencement of the pilot program, 
the Comptroller General shall--
(I) submit to Congress a report on 
the evaluation conducted under 
subparagraph (A);
(II) make such report publicly 
available; and
(III) based on such evaluation, 
make recommendations to the Secretary 
on how to improve and sustain the 
community integration platform 
established or enhanced under the pilot 
program.
(ii) Elements of report.--The report under 
clause (i)(I) shall include data on--
(I) what covered sources under the 
pilot program are being utilized the 
most;
(II) what requests for services 
under the pilot program cannot be met; 
and
(III) the impact of the provision 
of services under the pilot program on 
health outcomes of veterans.
(11) Limitations.--(A) The Secretary may not use the pilot 
program established under subsection (a) to supplant services 
otherwise required to be furnished by the Department under 
title 38, United States Code.
(B) No covered entity participating in the pilot program 
established under subsection (a) may receive access to 
personally identifiable information, protected health 
information, or social determinants information of a veteran 
without the veteran's informed written consent, and such 
information may be used only for the specific referral or 
service authorized by the veteran.
(12) Definitions.--In this subsection:
(A) 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 
Representatives.
(B) Community integration platform.--The term 
``community integration platform'' means an 
interoperable platform or network of interoperable 
systems used to enable the coordination, alignment, and 
connection of covered entities and veterans at the 
local level for purposes of communication, service 
coordination, and referral management of covered 
services.
(C) 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 program:
(i) A community-based organization that--
(I) accepts referrals from health 
care organizations; and
(II) provides covered services.
(ii) A public or private health care 
provider organization.
(iii) A public or private funded payor of 
health care services, including home- or 
community-based services.
(iv) A State, local, territorial, or Tribal 
health or social services agency.
(v) A State public housing authority or 
housing finance agency.
(vi) A public health information exchange 
or public health information network, as 
defined by the Secretary.
(vii) A faith-based service provider.
(viii) Any other similar entity, as 
determined by the Secretary.
(D) Covered services.--The term ``covered 
services'' means any of the following:
(i) Nutritional assistance.
(ii) Housing.
(iii) Health care, including preventive 
health intervention, chronic disease 
management, and behavioral health care.
(iv) Transportation.
(v) Job training and employment.
(vi) Child development or care.
(vii) Caregiving and respite care.
(viii) Disability assistance.
(ix) Suicide prevention.
(x) Sexual assault services.
(xi) Legal aid.
(xii) Transition assistance for veterans 
newly separated or discharged from active 
military, naval, air, or space service (as 
defined in section 101(24) of title 38, United 
States Code).
(xiii) Assistance with utilities necessary 
for safe habitation.
(xiv) Other services directly related to 
health care access, suicide prevention, 
homelessness prevention, food insecurity, 
transportation to health care, or assistance 
separating from military service and reentering 
civilian life, as expressly authorized under 
laws administered by the Secretary.
(E) Secretary.--The term ``Secretary'' means the 
Secretary of Veterans Affairs.
(F) State.--The term ``State'' has the meaning 
given that term in section 101 of title 38, United 
States Code.
(b) Collection of Information From Veterans Related to Social 
Determinants of Health.--
(1) 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 1705(a) of title 38, United States 
Code, as part of routine screenings of such veterans under the 
laws administered by the Secretary, information related to 
social determinants that may factor into the health of such 
veterans.
(2) Social determinants of health.--
(A) In general.--The information collected under 
subsection (a) shall include standardized definitions 
for identifying social determinants of health needs 
identified in the ICD-10 diagnostic codes Z55 through 
Z63 and Z75 (as in effect on the date of enactment of 
this Act).
(B) Incorporation of measures.--Definitions 
included under subparagraph (A) 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 individual.

SEC. 316. IMPROVEMENTS TO DEPARTMENT OF VETERANS AFFAIRS PROSTHETIC AND 
REHABILITATIVE ITEMS AND SERVICE.

(a) Prosthetic and Rehabilitative Items and Services Formulary.--
(1) In general.--Chapter 17 of title 38, United States 
Code, is amended by inserting after section 1709C the following 
new section:
``Sec. 1709D. Prosthetic and Rehabilitative Items and Services 
Formulary
``(a) In General.--The Secretary shall establish a list of 
prosthetic and rehabilitative items and services, which may be referred 
to as the `Prosthetic and Rehabilitative Items and Services Formulary' 
or the `Formulary', for purposes of furnishing medical services under 
section 1701(6)(F) of this title pursuant to section 1710 of this 
title.
``(b) Requirements.--
``(1) Input.--In developing the Formulary, the Secretary 
shall solicit input from veterans and the public.
``(2) 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 Department.
``(3) Items to be included.--In developing the Formulary, 
the Secretary shall rely on the best available evidence to 
identify which items and services should be included on the 
Formulary.
``(c) Publication and Communication.--
``(1) Publication and update.--The Secretary shall publish 
the Formulary on a website of the Department and shall update 
the Formulary periodically.
``(2) 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 Formulary.
``(d) Contracts.--The Secretary shall enter into such contracts as 
the Secretary considers necessary to support the availability of items 
and services included in the Formulary.
``(e) Training.--The Secretary shall ensure the availability of 
training on the Formulary for clinicians and other staff of the 
Department.
``(f) Exceptions.--
``(1) In general.--The Secretary shall establish a process 
for clinicians of the Department to request, prescribe, and 
furnish prosthetic and rehabilitative items and services that 
are not included on the Formulary when medically necessary.
``(2) 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 (1)--
``(A) to ensure that such items and services are 
being consistently and appropriately prescribed at all 
facilities of the Department; and
``(B) to determine whether such items or services 
should be added to the Formulary.
``(3) 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 
contract.
``(4) 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 necessary.
``(g) Consideration.--In developing the Formulary, 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 Formulary.
``(h) Enterprise Procurement and Ordering System.--
``(1) In general.--The Secretary shall implement an 
enterprise electronic ordering system for prosthetic and 
rehabilitative items and services furnished under this section.
``(2) Systems elements.--The system required under 
paragraph (1) shall--
``(A) enable the automated ordering of items 
included on the Formulary;
``(B) provide visibility of contract pricing and 
availability across all facilities of the Department;
``(C) allow enterprise loading of nationally 
contracted products;
``(D) provide procurement analytics to monitor 
compliance with national contracts and reduce open 
market purchasing; and
``(E) contain all data elements required for the 
Federal Electronic Healthcare Record in a searchable 
format.
``(3) Implementation.--The Secretary shall ensure that the 
system required under paragraph (1) is implemented across all 
medical centers of the Department by not later than three years 
after the date of the enactment of this section.
``(i) Program Management.--
``(1) 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 programs.
``(2) Staffing included.--Staffing required under paragraph 
(1) shall include--
``(A) dedicated program managers for major 
prosthetic product categories; and
``(B) full-time clinical staff responsible for 
clinical evaluations and practice recommendations.
``(j) Report to Congress.--Not later than two years after the date 
of the enactment of this section, and annually thereafter, 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--
``(1) rates of compliance by the Department with national 
prosthetic contracts;
``(2) open market purchasing trends of the Department;
``(3) utilization of the Formulary across facilities of the 
Department; and
``(4) steps taken by the Department to improve enterprise 
procurement efficiency.''.
(2) Clerical amendment.--The table of sections at the 
beginning of such chapter is amended by inserting after the 
item relating to section 1709C the following new item:

``1709D. Prosthetic and rehabilitative items and services formulary''.
(b) Report.--
(1) In general.--Not later than one year after the date of 
the enactment of this Act, 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 1709D of 
title 38, United States Code, as added by subsection (a).
(2) Elements.--The report required by paragraph (1) shall 
identify potential impacts of the Prosthetic and Rehabilitative 
Items and Services Formulary on--
(A) access by veterans to prosthetic and 
rehabilitative items and services;
(B) clinician workload;
(C) procurement timelines; and
(D) innovation adoption.

SEC. 317. IMPROVEMENT OF SUBMISSION OF MEDICAL DOCUMENTATION TO THE 
SECRETARY OF VETERANS AFFAIRS BY COMMUNITY CARE 
PROVIDERS.

(a) In General.--The Secretary of Veterans Affairs shall ensure 
that each contract, agreement, or other arrangement through which the 
Secretary furnishes hospital care, medical services, or extended care 
services to eligible veterans through non-Department of Veterans 
Affairs entities or providers includes clear requirements, including 
requirements regarding timeliness, regarding the submission of medical 
documentation to the Secretary after a veteran receives such care or 
services from the non-Department entity or provider.
(b) 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 (a).
(c) 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 (a) and may monitor the 
completion of such training.
(d) 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 (a) and completing the core training 
described in subsection (c).
(e) Submission of Goals, Measures, and Materials.--Not later than 
one year after the date of the enactment of this Act, and not less 
frequently than annually thereafter for the following five years, 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 goals, performance measures, training 
materials, or outreach materials pertaining to the submission of 
medical documentation under this section.

SEC. 318. IMPLEMENTATION OF AND REPORT ON EFFORTS OF DEPARTMENT OF 
VETERANS AFFAIRS TO IMPROVE HEALTH CARE APPOINTMENT 
SCHEDULING.

(a) In General.--Not later than one year after the date of the 
enactment of this Act, 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 Affairs, including improvements for both patients and 
employees of the Department responsible for scheduling such 
appointments.
(b) Elements of Plan.--
(1) In general.--The plan required by subsection (a) shall 
include--
(A) such actions, resources, technology, and 
process improvements as the Secretary determines 
necessary to ensure the Department achieves, in a 
timely manner, improved delivery of health care, access 
to health care, customer experience and service 
relating to the receipt of health care, and efficiency 
with respect to the delivery of health care; and
(B) a proposed schedule and timeline to carry out 
such plan.
(2) Objectives.--
(A) In general.--The Secretary shall ensure that 
the plan required by subsection (a) addresses the 
following objectives:
(i) 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 Department, including primary care, 
mental health care, and all forms of specialty 
care.
(ii) To develop or continue the development 
of a self-service scheduling platform, 
available for use by all patients of the 
Department, which shall--
(I) enable such patients to view 
available appointments and, subject to 
the process described in clause (iii), 
fully schedule appointments for all 
care furnished by the Department;
(II) if a referral is required for 
an appointment, provide a method for 
the patient to request a referral and 
subsequently book an appointment if the 
referral is approved; and
(III) provide such patients with 
the ability to cancel or reschedule 
appointments.
(iii) 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 
Department.
(iv) To carry out such other functions, 
oversight, metric development and tracking, 
change management, cross-Department 
coordination, and other related matters, 
including improvements to employee-facing 
information technology, training, and 
processes, as the Secretary determines 
appropriate as it relates to scheduling tools, 
functions, and operations with respect to 
health care appointments furnished by the 
Department.
(B) Explanation of inability to implement certain 
objectives, features, or services.--If the Secretary 
determines that an objective under subparagraph (A), or 
any feature or service in connection with that 
objective, cannot be implemented or otherwise 
incorporated into a final product pursuant to the plan 
required by subsection (a), the Secretary shall include 
with the plan submitted under such subsection a report 
containing--
(i) an explanation as to why that 
objective, feature, or service cannot be 
implemented or incorporated, as the case may 
be; and
(ii) a plan for implementing the plan 
required by subsection (a) without that 
objective, feature, or service.
(c) Implementation.--Not later than two years after submitting to 
the appropriate committees of Congress the plan required by subsection 
(a), the Secretary shall fully implement the plan.
(d) Coordination With Electronic Health Record Modernization 
Program.--In developing the plan required by subsection (a), the 
Secretary shall ensure that the elements and objectives of such plan 
set forth under subsection (b) 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 
appropriate.
(e) 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 (a), the Secretary shall submit to the 
appropriate committees of Congress a report on the progress of the 
Secretary in implementing such plan, including--
(1) the costs incurred to implement the plan as of the date 
of the report;
(2) the expected costs to complete implementation of the 
plan (including costs for management and technology);
(3) the schedule for deployment of any capabilities 
developed pursuant to the plan; and
(4) the goals and metrics achieved, challenges, and lessons 
learned in implementing the plan.
(f) Rule of Construction.--Nothing in this section shall be 
construed to require the Secretary to include in the plan required by 
subsection (a) 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 process, 
should the veteran choose to do so.
(g) Definitions.--In this section:
(1) 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 Representatives.
(2) Fully schedule.--The term ``fully schedule'', with 
respect to an appointment for health care, means that the 
appointment booking is completed, rather than simply requested.

SEC. 319. PILOT PROGRAM ON COORDINATION OF CARE BETWEEN DEPARTMENT OF 
VETERANS AFFAIRS AND MEDICARE PROGRAM.

(a) In General.--The Secretary, in consultation with the Secretary 
of Health and Human Services, shall carry out a pilot program (in this 
section referred to as the ``pilot program'') to coordinate, navigate, 
and manage care and benefits for covered veterans.
(b) Purposes of Pilot Program.--The purposes of the pilot program 
are as follows:
(1) 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 
(42 U.S.C. 1395 et seq.).
(2) To improve satisfaction with care received by covered 
veterans.
(3) To improve quality of care received by covered 
veterans.
(4) To lower costs to the Federal Government for care 
received by covered veterans.
(5) To reduce gaps in care and duplication of services and 
expenses for covered veterans.
(6) To improve care coordination for covered veterans, 
including coordination of patient information and medical 
records between providers and between the Department and the 
Centers for Medicare & Medicaid Services.
(c) 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 
diversity, including--
(1) locations that are in rural or highly rural areas, as 
determined through the use of the Rural-Urban Continuum codes 
of the Department of Agriculture; and
(2) locations that are in medically underserved communities 
(as defined in section 799B of the Public Health Service Act 
(42 U.S.C. 295p)).
(d) Case Manager.--In carrying out the pilot program, the Secretary 
shall assign each covered veteran participating in the pilot program a 
case manager responsible for--
(1) coordinating with the veteran, the primary care team of 
the veteran, and any relevant care coordinators already 
assisting the veteran to develop an individualized needs 
assessment for the veteran and, based on such assessment, a 
care coordination plan with defined treatment goals; and
(2) 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 (42 U.S.C. 1395 et 
seq.).
(e) Use of Existing Models.--In designing the pilot program, the 
Secretary may use existing models used by commercial health care 
programs to improve access, health outcomes, quality, and customer 
experience and lower per capita costs.
(f) Contracting With Private Sector Entities.--
(1) In general.--The Secretary, to the extent practicable, 
shall consider entering into contracts or agreements with 
private sector entities carrying out commercial health care 
programs for assistance in designing, implementing, and 
managing care and benefits under the pilot program, to include 
providing care coordination.
(2) Notification.--If the Secretary determines that 
entering into contracts or agreements with private sector 
entities under paragraph (1) is not necessary or practicable, 
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) a notification of that determination;
(B) a description of the steps, if any, the 
Secretary has taken to attempt to enter into a contract 
or an agreement with a private sector entity;
(C) a justification for why the Secretary has 
determined that such contract or agreement is not 
necessary or practicable; and
(D) a plan for how the Secretary will carry out the 
pilot program without entering into a contract or an 
agreement with a private sector entity, including 
through the use of employees of the Department of 
Veterans Affairs or other government agencies, 
nonprofit organizations, or other entities.
(g) Metrics.--
(1) In general.--The Secretary shall track metrics under 
the pilot program, including the following:
(A) The number of veterans participating in the 
pilot program, disaggregated by Veterans Integrated 
Service Network.
(B) Reliance on health care services administered 
by the Secretary.
(C) Reliance on health care services administered 
under the Medicare program under title XVIII of the 
Social Security Act (42 U.S.C. 1395 et seq.).
(D) Quality of care, including patient outcomes.
(E) Cost of care.
(F) Access to care, including under the designated 
access standards developed by the Secretary under 
section 1703B of title 38, United States Code.
(G) Patient satisfaction.
(H) Provider satisfaction.
(I) Care coordination, including timely information 
sharing and medical documentation return.
(2) Elements.--In tracking metrics under paragraph (1), the 
Secretary shall track information relating to--
(A) whether care received by a covered veteran is 
related to a service-connected disability (as defined 
in section 101 of title 38, United States Code);
(B) the priority group under section 1705(a) of 
title 38, United States Code, through which each 
covered veteran was enrolled in the system of annual 
patient enrollment of the Department of Veterans 
Affairs under such section;
(C) the type of care and services provided to 
covered veterans; and
(D) the demographics of covered veterans 
participating in the pilot program, including age.
(h) Supplement Not Supplant.--The services provided under the pilot 
program shall supplement, not supplant, the services provided under the 
education program under section 121 of the VA MISSION Act of 2018 
(Public Law 115-182; 38 U.S.C. 1701 note).
(i) Duration.--The Secretary shall carry out the pilot program for 
a three-year period beginning on the commencement of the pilot program.
(j) Reports.--
(1) Development, implementation, results, and design of 
pilot program.--
(A) In general.--Not less frequently than 
biannually during the two-year period beginning on the 
date of the enactment of this Act, 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 development, 
implementation, results, and design of the pilot 
program, including information on the metrics tracked 
under subsection (g).
(B) Final design.--One of the reports required 
under subparagraph (A) shall contain a description of 
the final design of the pilot program.
(2) Results of pilot program.--
(A) In general.--Not later than one year after the 
submission of the final report under paragraph (1), and 
not less frequently than annually thereafter during the 
duration of the pilot program, 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 program.
(B) Final report.--In the final report submitted 
under subparagraph (A), the Secretary shall include the 
recommendation of the Secretary for whether the pilot 
program should be extended or made permanent.
(k) Definitions.--In this section:
(1) 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 (42 U.S.C. 1395 et seq.) 
and the system of annual patient enrollment of the Department 
of Veterans Affairs under section 1705(a) of title 38, United 
States Code.
(2) Secretary.--The term ``Secretary'' means the Secretary 
of Veterans Affairs.

SEC. 320. FISHER HOUSE AVAILABILITY.

Section 1708 of title 38, United States Code, is amended--
(1) in subsection (a), by striking ``in connection with'' 
and all that follows through the period at the end and 
inserting ``in accordance with this section.'';
(2) in subsection (b)--
(A) in paragraph (2)--
(i) by inserting ``described in paragraph 
(1)'' after ``family of a veteran''; and
(ii) by inserting ``such'' after 
``accompany''; and
(B) by adding at the end the following new 
paragraphs:
``(3) On a space-available basis, a covered beneficiary who 
must travel a significant distance to receive care or services 
at a Department or non-Department facility.
``(4) On a space-available basis, a member of the family of 
a covered beneficiary described in paragraph (3) 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 facility.
``(5) On a space-available basis, 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 
facility.
``(6) On a space available basis, 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 facility.'';
(3) by striking subsection (c) and redesignating 
subsections (d) and (e) as subsections (c) and (d), 
respectively;
(4) in subsection (d), as so redesignated--
(A) in paragraph (2), by striking ``subsection 
(d)'' and inserting ``subsection (c)'';
(B) in paragraph (3), by striking ``under 
subsection (b)(2)'' and inserting ``or a covered 
beneficiary under subsection (b)'';
(C) in paragraph (4), by striking ``and'' after the 
semicolon;
(D) by redesignating paragraph (5) as paragraph 
(6); and
(E) by inserting after paragraph (4) the following 
new paragraph (5):
``(5) establishing criteria for providing access to 
temporary lodging facilities on a space-available basis under 
paragraphs (3) through (6) of subsection (b); and''; and
(5) by adding at the end the following new subsection:
``(e) In this section:
``(1) The term `covered beneficiary' means a member of the 
uniformed services, including members of the armed services 
regardless of duty status.
``(2) The term `Fisher house' means a housing facility 
that--
``(A) is located at, or in proximity to, a 
Department medical facility;
``(B) is available for residential use on a 
temporary basis by patients of that facility and others 
described in subsection (b); and
``(C) is constructed by, and donated to the 
Secretary by, the Zachary and Elizabeth M. Fisher Armed 
Services Foundation or the Fisher House Foundation, 
Inc.''.

SEC. 321. AGREEMENTS BETWEEN MEDICAL FACILITIES OF DEPARTMENT OF 
VETERANS AFFAIRS AND RURAL MEDICAL FACILITIES.

(a) In General.--Not later than one year after the date of 
enactment of this Act, the Secretary of Veterans Affairs shall commence 
a 5-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 veterans.
(b) Pilot Program.--In carrying out the pilot program, 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 
following:
(1) Co-location of Department and non- Department health 
care resources.
(2) The provision of telehealth to eligible veterans by 
health care providers of the Department.
(3) Leasing of space or equipment by or from the 
Department.
(4) Training by health care providers of the Department of 
non-Department health care providers, subject to paragraph (4).
(5) Care coordination for authorized care furnished by the 
eligible entity for eligible veterans.
(6) Care coordination, including transportation 
coordination, for emergency treatment (as defined in section 
1725(h) of title 38, United States Code.
(7) The provision by the eligible entity of hospital care, 
medical services, or extended care services under section 1703 
of this title.
(8) Such other conditions or services directly related to 
health care as expressly authorized under laws administered by 
the Secretary.
(c) Types of Arrangements.--An agreement under subsection (b) may 
include a lease or co-location agreement, a memorandum of 
understanding, a partnership agreement, a contract or agreement for the 
mutual use or exchange of use of health-care resources, or any other 
similar agreement or arrangement.
(d) Report.--For each year of the pilot, the Secretary shall submit 
to the appropriate committees of Congress a report on the operation and 
performance of agreements entered into under subsection (a) including--
(1) new agreements entered into, in the case of the initial 
report, since the date of the enactment of the Take Care of 
America's Veterans Act, and, in the case of any subsequent 
report, during the period following the previous report;
(2) an assessment of the success of all agreements entered 
into pursuant to this Act in delivering services to eligible 
veterans, including--
(A) the number of eligible veterans, by region, who 
received services under an agreement compared to the 
previous five-year period;
(B) 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 agreements;
(C) an overview of best practices, including new 
best practices, developed for such agreements and the 
Department more broadly;
(D) the number of veterans receiving compensation 
from the Department for a service-connected disability, 
disaggregated by region, compared to the previous 5-
year period; and
(E) such other factors considered appropriate by 
the Secretary of Veterans Affairs.
(e) Definitions.--In this section:
(1) Appropriate committees of congress.--The term 
``appropriate committees of Congress'' means--
(A) the Committee on Veterans' Affairs and the 
Committee on Appropriations of the Senate; and
(B) the Committee on Veterans' Affairs and the 
Committee on Appropriations of the House of 
Representatives.
(2) Eligible entity.--The term ``eligible entity'' means a 
non-Department entity or provider furnishing health care or 
health care services in a rural area.
(3) Eligible veteran.--The term ``eligible veteran'' means 
a covered veteran under section 1703(b)16 of this title.
(4) 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 (a)(1) and may include--
(A) the use of time or resources of health care 
providers of the Department;
(B) the obligation or receipt of funds; and
(C) such other support as the Secretary determines 
appropriate.
(5) Rural.--The term ``rural'', with respect to an area, 
means the area has a code other than 1 or 1.1 in the Rural-
Urban Commuting Areas (RUCA) coding system of the Department of 
Agriculture.

SEC. 322. 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.

(a) In General.--Not later than 90 days after the date of the 
enactment of this Act, 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--
(1) 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 modalities, such as telehealth, in-patient, intensive 
out-patient, out-patient, and residential treatment; and
(2) 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 study.
(b) Timing.--The Secretary shall ensure that the organization with 
which the Secretary enters into an agreement pursuant to subsection (a) 
is able to complete the requirements under such subsection by not later 
than 18 months after the date on which the agreement is entered into.
(c) Elements.--The report submitted pursuant to subsection (a)(2) 
shall include an assessment of the following:
(1) The amount of improvement in health outcomes from start 
of treatment to completion, including symptom scores and 
suicide risk using evidence-based scales, including the 
Columbia-Suicide Severity Rating Scale.
(2) Whether providers of the Department and non-Department 
providers are using evidence-based practices in the treatment 
of mental health and addiction therapy care, including criteria 
set forth by the American Society of Addiction Medicine.
(3) Potential gaps in coordination between providers of the 
Department and non-Department providers in responding to 
individuals seeking mental health or addiction therapy care, 
including the sharing of patient health records.
(4) Implementation of veteran-centric care, 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 population.
(5) Whether veterans with co-occurring conditions receive 
integrated care to holistically address their needs.
(6) Whether providers monitor health outcomes continually 
throughout treatment and at regular intervals for up to three 
years after treatment.
(7) The average length of time to initiate services, 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 service, as measured or determined by the 
Secretary.

SEC. 323. LACTATION SPACES IN MEDICAL CENTERS OF THE DEPARTMENT OF 
VETERANS AFFAIRS.

(a) In General.--Subchapter II of chapter 17 of title 38, United 
States Code, is amended by adding at the end the following new section:
``Sec. 1720M. Lactation spaces in medical centers of the Department
``(a) Lactation Space Required.--The Secretary shall ensure that 
each medical center of the Department contains a lactation space.
``(b) 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 enter.
``(c) Lactation Space Defined.--In this section, the term 
`lactation space' means a hygienic place, other than a bathroom, that--
``(1) is shielded from view;
``(2) is free from intrusion;
``(3) is accessible to disabled individuals (including such 
individuals who use wheelchairs);
``(4) contains a chair and a working surface;
``(5) is easy to locate;
``(6) is clearly identified with signage; and
``(7) is available for use by women veterans and members of 
the public to express breast milk.''.
(b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by inserting after the item related to section 
1720L the following new item:

``1720M. Lactation spaces in medical centers of the Department.''.
(c) Implementation.--The Secretary of Veterans Affairs shall ensure 
that--
(1) not later than two years after the date of the 
enactment of this Act, not fewer than 80 percent of medical 
centers of the Department of Veterans Affairs are in compliance 
with section 1720M of title 38, United States Code, as added by 
subsection (a); and
(2) not later than three years after such date of 
enactment, all medical centers of the Department are in 
compliance with such section.
(d) Report.--
(1) In general.--Not later than one year after the date of 
the enactment of this Act, and annually thereafter, 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 1720M of title 38, United States Code, as added by 
subsection (a), including--
(A) a list of which medical centers of the 
Department of Veterans Affairs currently have a 
lactation space;
(B) a list of which medical centers of the 
Department do not have a lactation space; and
(C) for each medical center listed under 
subparagraph (B), 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 (c).
(2) Termination.--The Secretary is not required to submit a 
report under paragraph (1) 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 
space.

SEC. 324. RESEARCH RELATED TO MENOPAUSE, PERIMENOPAUSE, AND MID-LIFE 
WOMEN'S HEALTH: REPORT; PLAN.

(a) Definitions.--In this section:
(1) Covered provider.--The term ``covered provider'' means 
a health care provider employed by the Department of Veterans 
Affairs.
(2) Menopause.--The term ``menopause'' means the stage of a 
woman's life--
(A) when menstrual periods stop permanently and she 
can no longer get pregnant; and
(B) that is not a disease state, but a normal part 
of aging for women.
(3) Mid-life.--The term ``mid-life'' means a life stage 
that--
(A) coincides with the menopausal transition in 
women, which may be physical or emotional;
(B) encompasses the late reproductive age, which 
can begin at approximately 35 years of age, to the late 
postmenopausal stages of reproductive aging, which can 
extend to approximately 65 years of age; and
(C) often marks the onset of many chronic diseases.
(4) 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 transition.
(5) Postmenopausal.--The term ``postmenopausal'' means the 
stage of a woman's life after a woman has been without a 
menstrual period for 12 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 disease.
(b) Evaluation of Certain Research Related to Menopause, 
Perimenopause, or Mid-life Women's Health.--
(1) In general.--The Secretary of Veterans Affairs, shall 
evaluate--
(A) the results of completed research related to 
menopause, perimenopause, or mid-life women's health 
among women who are members of the uniformed services 
or veterans;
(B) the status of such research that is ongoing;
(C) any gaps in knowledge and research on--
(i) treatments for menopause-related 
symptoms, including hormone and non-hormone 
treatments;
(ii) the safety and effectiveness of 
treatments for menopause-related symptoms;
(iii) the impact of perimenopause and 
menopause on the mental health of women who are 
members of the uniformed services or veterans;
(D) the availability of and uptake of professional 
training resources for covered providers relating to 
mid-life women's health with respect to the care, 
treatment, and management of perimenopause and 
menopausal symptoms, and related support services; and
(E) the availability of and uptake of treatments 
for women who are members of the uniformed services or 
veterans who are experiencing perimenopause or 
menopause.
(2) Report; strategic plan.--Not later than 180 days after 
the date of the enactment of this Act, the Secretary of 
Veterans Affairs shall submit to Congress a report containing--
(A) the findings of the evaluation conducted under 
paragraph (1);
(B) recommendations for improving professional 
training resources described in paragraph (1)(D) for 
covered providers; and
(C) a strategic plan that--
(i) resolves the gaps in knowledge and 
research identified in the report; and
(ii) 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 veterans.
(3) Nonduplication and supplementation of efforts.--In 
carrying out activities under this section, the Secretary of 
Veterans Affairs shall ensure that such activities minimize 
duplication and supplement, not supplant, existing information-
sharing efforts of the Department of Health and Human Services.
(c) Sense of Congress on Additional Research Related to Menopause, 
Perimenopause, 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 menopause, perimenopause, or 
mid-life health regarding women who are members of the uniformed 
services or veterans.

SEC. 325. PILOT PROGRAM ON PROVISION OF OPIOID RESCUE MEDICATIONS TO 
VETERANS.

(a) In General.--Commencing not later than 120 days after the date 
of the enactment of this Act, 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 (in this 
section referred to as the ``pilot program'').
(b) 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 status.
(c) 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 population.
(d) Limitation on Use of Information.--
(1) In general.--In carrying out this section, the 
Secretary may only collect the personally identifiable 
information needed for prescribing covered medication under the 
pilot program, and any personally identifiable information 
collected under this section may be used solely for the purpose 
of delivering, evaluating, and enhancing the quality of health 
care.
(2) Exclusion.--The Secretary may not use any personally 
identifiable information collected under this section--
(A) for the purpose of preventing a veteran from 
employment;
(B) as evidence of a history of drug use; or
(C) as evidence that an individual is an unlawful 
user of or addicted to any controlled substance.
(e) Provision of Information.--The Secretary shall ensure that any 
individual who receives covered medication under the pilot program also 
receives--
(1) information about addiction services, suicide 
prevention services, mental health services, and other related 
services provided by the Department of Veterans Affairs; and
(2) information on the use and application of covered 
medications.
(f) Report.--
(1) In general.--Not later than 30 days before the 
completion of the pilot program under this section, the 
Secretary shall submit to Congress a report on the pilot 
program.
(2) Elements.--The report required by paragraph (1) shall 
include the following:
(A) The number of veterans who received a covered 
medication under the pilot program, disaggregated by 
those enrolled in the system of annual patient 
enrollment of the Department of Veterans Affairs under 
section 1705(a) of title 38, United States Code, and 
those not enrolled in such system.
(B) An assessment of the feasibility of expanding 
the pilot program to provide covered medications to 
immediate family members of veterans.
(C) Any considerations associated with continuing, 
expanding, or making permanent the pilot program.
(D) Any other recommendations of the Secretary with 
respect to modifying or continuing the pilot program.
(g) Definitions.--In this section:
(1) Covered medication.--The term ``covered medication'' 
means any opioid overdose rescue medication, such as naloxone.
(2) Veteran.--The term ``veteran'' has the meaning given 
that term in section 101 of title 38, United States Code.

SEC. 326. ESTABLISHMENT OF VETERANS HEALTH ADMINISTRATION POLICY 
ADVISORY COMMISSION.

(a) In General.--Chapter 1 of title 38, United States Code, is 
amended by adding at the end the following new section:
``Sec. 120. Veterans Health Administration Policy Advisory Commission
``(a) Establishment.--There is established the Veterans Health 
Administration Policy Advisory Commission (in this section referred to 
as the `Commission').
``(b) Membership.--
``(1) Composition.--The Commission shall be composed of 17 
members appointed by the Comptroller General of the United 
States, of which not fewer than 2 shall be veterans.
``(2) Qualifications.--
``(A) In general.--An individual is eligible for 
appointment to the Commission under paragraph (1) if 
the individual has significant expertise in operating 
or advising large medical systems, including expertise 
in quality of care, staffing issues, health information 
technology, artificial intelligence in health care, 
medical research, and managed care plans and networks.
``(B) Experience of members.--In appointing members 
under paragraph (1), the Comptroller General shall 
select individuals from backgrounds that reflect the 
broad diversity of health care received by veterans, 
including nonprofit health systems, public and private 
health systems, care furnished by the Veterans Health 
Administration, and care furnished by the Department of 
Defense.
``(3) 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 131 of title 5, United States 
Code, 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 pay.
``(c) Period of Appointment; Vacancies.--
``(1) Vacancies.--
``(A) 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 
appointment.
``(B) Filling unexpired term.--An individual chosen 
to fill a vacancy shall be appointed for the unexpired 
term of the member replaced.
``(2) Expiration of terms.--The term of any member shall 
not expire before the date on which the member's successor 
takes office.
``(d) Meetings.--
``(1) Frequency.--The Commission shall meet at the call of 
the Chairman, but not less frequently than once per year.
``(2) Quorum.--A majority of the members of the Commission 
shall constitute a quorum, but a lesser number of members may 
hold meetings.
``(e) Chairman and Vice Chairman.--The Comptroller General shall 
designate one member of the Commission as Chairman and one member of 
the Commission as Vice Chairman, at the time of appointment of such 
member and for the term of appointment of such member, except that in 
the case of vacancy of the Chairmanship or Vice Chairmanship, the 
Comptroller General may designate another member for the remainder of 
that member's term.
``(f) Duties of the Commission.--
``(1) Review.--The Commission shall--
``(A) review operations at the Veterans Health 
Administration; and
``(B) prepare reports for Congress based on such 
review, including recommendations to Congress.
``(2) Topics to be reviewed.--In conducting a review under 
paragraph (1)(A), the Commission shall include periodic reviews 
of the following, taking into consideration other independent 
assessments in selecting topics to limit duplicative efforts:
``(A) Information technology infrastructure at 
medical facilities of the Department, including with 
respect to electronic health record systems.
``(B) Referrals to care at facilities of the 
Department and under the Veterans Community Care 
Program under section 1703 of this title, and factors 
impacting those referrals.
``(C) Access and wait times at medical facilities 
of the Department and under the Veterans Community Care 
Program, including both primary and specialty care, and 
factors impacting those wait times.
``(D) The quality of health care furnished by the 
Department and through the Veterans Community Care 
Program.
``(E) Workforce issues, including workforce 
performance, recruitment, and retention factors.
``(F) Patient satisfaction and customer service at 
medical facilities of the Department and through the 
Veterans Community Care Program.
``(G) The training of health care providers and the 
standards of care at facilities of the Department and 
in the Veterans Community Care Program.
``(H) The long-term budgetary outlook of the 
Veterans Health Administration, as well as key 
components driving budgetary changes over time.
``(I) The research program of the Department, 
including both internal and external research.
``(J) The interaction of care under the Medicare 
program under title XVIII of the Social Security Act 
(42 U.S.C. 1395 et seq.), the Medicaid program under 
title XIX of such Act (42 U.S.C. 1396 et seq.), the 
TRICARE program under chapter 55 of title 10, and 
commercial health care plans with care furnished by the 
Veterans Health Administration.
``(3) Use of existing data.--In carrying out the 
requirements of this subsection, the Commission, to the extent 
practicable, shall use existing data that has been compiled by 
the Department, compiled for the Department, or purchased by 
the Department, including--
``(A) data described in subsection (c)(1) of 
section 1704A of this title; and
``(B) the results of the independent assessments 
conducted under such section.
``(4) Issues regarding veteran health care delivery 
generally.--In carrying out the requirements of this 
subsection, 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 
Secretary.
``(5) Transmittal of certain reports.--If the Secretary or 
the Inspector General of the Department of Veterans Affairs 
submits to Congress (or a committee of Congress) a report that 
is required by law and that relates to policies for health care 
furnished under the laws administered by the Secretary, the 
Secretary shall transmit a copy of that report to the 
Commission.
``(6) Consultation and additional reviews and studies.--
``(A) Consultation.--In carrying out the 
requirements of this subsection, 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 agenda.
``(B) Additional reviews and reports.--The 
Commission may conduct additional reviews, and may 
submit additional reports to the Committee on Veterans' 
Affairs of the Senate and the Committee on Veterans' 
Affairs of the House of Representatives, 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 appropriate.
``(C) 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 appropriate.
``(7) Coordination.--In carrying out reviews, preparing 
reports, and conducting studies under this section, the 
Commission shall, to the extent practicable, 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 General.
``(8) Budgetary considerations.--Before making any 
recommendations to Congress, the Commission shall examine the 
budget consequences of such recommendations, directly or 
through consultation with appropriate expert entities.
``(9) Report.--
``(A) In general.--By not later than March 15 of 
each year, the Commission shall submit to Congress a 
report containing the results and recommendations from 
the review conducted under paragraph (1).
``(B) Inclusion of recommendations.--A 
recommendation may be included in a report under 
subparagraph (A) if a simple majority of the members of 
the Commission vote to include the recommendation in 
the report.
``(10) Limitation.--Nothing in this section shall be 
construed to authorize the Commission to direct, control, 
approve, suspend, delay, or administer any program, policy, 
contract, personnel action, budgetary decision, clinical 
decision, or operational activity of the Department. The 
Commission shall serve solely in an advisory capacity to 
Congress and to the Department on matters expressly authorized 
under laws administered by the Secretary.
``(g) Powers of Commission.--
``(1) In general.--The Commission may--
``(A) employ and fix the compensation:
``(i) of an Executive Director (at a rate 
of pay not greater than that provided for level 
III of the Executive Schedule under section 
5314 of title 5) who is confirmed by two thirds 
vote by members of the Commission; and
``(ii) other such personnel as may be 
necessary to carry out the duties of the 
Commission, without regard to the provisions of 
title 5 governing appointments in the 
competitive service;
``(B) 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 State;
``(C) enter into a contract or conduct original 
research only upon a written determination by the Chair 
and Vice Chair that comparable information is 
unavailable, insufficient, or outdated;
``(D) make advance, progress, and other payments 
that relate to the work of the Commission;
``(E) provide transportation and subsistence for 
individuals serving the Commission without 
compensation; and
``(F) prescribe such rules and regulations as the 
Commission determines necessary with respect to the 
internal organization and operation of the Commission.
``(2) Data collection.--In order to carry out its 
functions, the Commission shall--
``(A) utilize existing information, both published 
and unpublished, if possible, collected and assessed 
either by its own staff or under other arrangements 
made in accordance with this section;
``(B) to the maximum extent practicable, rely on 
existing data, reports, audits, evaluations, and 
assessments prepared by the Department, the Inspector 
General of the Department, the Government 
Accountability Office, the Congressional Research 
Service, the Congressional Budget Office, and other 
relevant Federal entities before entering into any 
contract or conducting original research; and
``(C) adopt procedures allowing any interested 
party to submit information for use by the Commission 
in making reports and recommendations.
``(3) Information from federal agencies.--
``(A) 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 section.
``(B) Timing.--Upon request of the Chairman, the 
head of a department or agency of the United States 
shall furnish information requested under subparagraph 
(A) to the Commission on an agreed upon schedule or not 
later than 180 days after the date of the request.
``(h) Compensation.--
``(1) Members.--
``(A) In general.--While conducting the business of 
the Commission (including travel time), 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 5315 of title 5.
``(B) Travel expenses.--While conducting the 
business of the Commission away from home and the 
regular place of business of the member, a member may 
be allowed travel expenses, as authorized by the 
Chairman.
``(2) 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 5948 of title 5, 
and for such purpose, subsection (i) of such section shall 
apply to the Commission in the same manner as it applies to the 
Tennessee Valley Authority.
``(3) Treatment of personnel.--For purposes of pay (other 
than pay of members of the Commission) and employment benefits, 
rights, and privileges, all personnel of the Commission shall 
be treated as if they were employees of the United States 
Senate.
``(i) 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 privileges.
``(j) Access of Congressional Support Agencies to Information.--The 
Commission shall provide to the Comptroller General, the Congressional 
Research Service, and the Congressional Budget Office unrestricted 
access to all deliberations, records, and nonproprietary data of the 
Commission not later than 30 days after such access is requested.
``(k) Authorization of Appropriations.--The Commission shall submit 
requests for appropriations in the same manner as the Comptroller 
General submits requests for appropriations, but amounts appropriated 
for the Commission shall be separate from amounts appropriated for the 
Comptroller General.
``(l) Termination.--
``(1) The Commission shall terminate on September 30, 2032.
``(2) Not later than 1 year before the date of termination 
under paragraph (1), 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 continued, modified, or allowed to terminate.
``(3) A member of the Commission shall be appointed under 
subsection (b)(1) for a term of 5 years, except that the 
Comptroller General shall designate staggered terms for the 
members first appointed.
``(4) No funds may be obligated by the Commission after the 
date of termination under paragraph (1), except for activities 
necessary to close out the operations of the Commission.''.
(b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by inserting after the item relating to section 
119 the following new item:

``120. Veterans Health Administration Policy Advisory Commission.''.
(c) Initial Appointment.--Not later than 280 days after the date on 
which amounts are first appropriated to the Veterans Health 
Administration Policy Advisory Commission established under section 120 
of title 38, United States Code, as added by subsection (a), the 
Comptroller General of the United States shall make initial 
appointments of members to the Commission under subsection (b)(1) of 
such section.

SEC. 327. ACCESS TO HEALTH CARE.

(a) Connection to Veterans Health Administration When a Disability 
Claim Related to Military Sexual Trauma Is Submitted to Veterans 
Benefits Administration.--Section 2 of the MST Claims Coordination Act 
(Public Law 117-303; 38 U.S.C. 1166 note) is amended--
(1) in subsection (a)(1)--
(A) in subparagraph (C), by striking ``; and'' and 
inserting a semicolon; and
(B) by striking subparagraph (D) and inserting the 
following:
``(D) 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 provide;
``(E) 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 provide;
``(F) the types of services that individuals who 
have experienced military sexual trauma are eligible to 
receive from the Department of Veterans Affairs, such 
as mental health counseling from providers trained in 
military sexual trauma issues and peer support 
services, including the nearest locations where such 
services are furnished, including the nearest 
Readjustment Counseling Service location, and the 
contact information for the providers of such services; 
and
``(G) such other information on services, care, or 
resources for military sexual trauma as the Secretary 
determines appropriate.''; and
(2) in subsection (d)--
(A) in paragraph (3)--
(i) in subparagraph (B), by striking ``; 
and'' and inserting a semicolon;
(ii) in subparagraph (C), by striking the 
period and inserting ``; and''; and
(iii) by adding at the end the following:
``(D) submitting a claim for disability 
compensation to the Veterans Benefits Administration 
for a disability relating to military sexual trauma.''; 
and
(B) by amending paragraph (5) to read as follows:
``(5) The term `military sexual trauma' with respect to 
eligibility for health care, has the meaning given such term in 
section 1166(d)(2) of title 38, United States Code.''.
(b) Care Relating to Military Sexual Trauma for Individuals Who 
Withdraw From or Otherwise Do Not Complete Service at Service 
Academies.--
(1) In general.--The Secretary of Veterans Affairs, in 
coordination with the Secretary of Defense, the Secretary of 
Homeland Security, and the Secretary of Transportation, shall 
ensure that each individual who withdraws from, or otherwise 
does not complete service at, a service academy is provided--
(A) information on the potential eligibility of 
such individual for care and counseling relating to 
military sexual trauma provided through the Department 
of Veterans Affairs; and
(B) the option to receive copies of--
(i) the individual's service treatment 
records or military personnel records that 
document military sexual trauma;
(ii) reporting forms of the Department of 
Defense, the Department of Homeland Security, 
or the Department of Transportation on sexual 
assault or sexual harassment for which the 
individual was the victim; and
(iii) 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 victim, which 
are in the possession of the Department of 
Defense, the Department of Homeland Security, 
or the Department of Transportation.
(2) Definitions.--In this subsection:
(A) Military sexual trauma.--The term ``military 
sexual trauma'' has the meaning given such term in 
section 1166(d)(2) of title 38, United States Code.--
(B) Service academy.--The term ``service academy'' 
means any of the following:
(i) The United States Military Academy.
(ii) The United States Naval Academy.
(iii) The United States Air Force Academy.
(iv) The United States Coast Guard Academy.
(v) The United States Merchant Marine 
Academy.

SEC. 328. RESEARCH ON HEALTH CONDITIONS OF DESCENDANTS OF TOXIC-EXPOSED 
VETERANS.

(a) Research on Diagnosis and Treatment of Health Conditions of 
Descendants of Individuals Exposed to Toxic Substances While Serving in 
Armed Forces.--
(1) 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 (in 
this section referred to as the ``Agency'') to perform the 
services covered by this section.
(2) Services.--Under a contract or agreement between the 
Secretary and the Agency under this section, the Agency shall--
(A) 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 topic;
(B) not later than 180 days after completing the 
literature review under subparagraph (A) establish and 
maintain a publicly available report with information 
on--
(i) the findings of the Agency with respect 
to such literature review; and
(ii) the ongoing research and activities 
directed by the Agency, 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 1173(c)(2) of title 38, United 
States Code; and
(C) not later than 30 days after the date on which 
the first review is published under subparagraph (B) 
and not less frequently than once every year 
thereafter, publish a new report containing the 
information made available under clause (ii) of such 
subparagraph.
(3) Sunset.--On the date that is 7 years after the date of 
enactment of this Act.
(4) Literature review.--
(A) In general.--In carrying out the literature 
review under paragraph (2)(A), 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 Forces.
(B) Report.--Not later than one year after the date 
of the enactment of this Act, the Agency shall submit 
to the Secretary, the Committee on Veterans' Affairs of 
the Senate, 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 (2)(A).
(C) Plan.--
(i) In general.--Not later than 180 days 
after the date of the enactment of this Act, 
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 (2)(A).
(ii) Contents.--The plan submitted pursuant 
to clause (i) shall include--
(I) the scope and key research 
questions to be addressed; and
(II) the methodology to be used in 
identifying, evaluating, and 
synthesizing relevant scientific and 
medical literature.
(5) Consultation.--The Agency shall carry out the services 
covered by this subsection in consultation with such Federal, 
State, and research partners as the Agency and the Secretary 
jointly consider appropriate.
(6) 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 Forces.
(b) Program for Monitoring Health of Descendants of Veterans and 
Members of the Armed Forces Subjected to Toxic Exposure in the Armed 
Forces.--
(1) In general.--The Secretary of Veterans Affairs shall 
use the results of the literature review conducted under 
subsection (a)(2)(A) to establish a health monitoring or 
screening program for descendants of toxic-exposed veterans and 
toxic-exposed members of the Armed Forces, to assist in 
identifying potential patterns or signals, supporting public 
health surveillance, and facilitating epidemiologic and 
clinical research related to birth defects.
(2) Requirements.--In carrying out the program required by 
paragraph (1), the Secretary shall--
(A) leverage Government data sets to improve the 
program;
(B) recruit additional descendants;
(C) consult with relevant stakeholders to develop a 
strategy to coordinate collection of information under 
the program; and
(D) ensure data from the program is used to inform 
basic research, translational research, and 
epidemiological studies to help address data and 
knowledge gaps identified in the literature review 
conducted under subsection (a)(2)(A).
(3) Mechanisms for administration.--The Secretary may 
administer the program required by paragraph (1) either 
directly or through such mechanisms as the Secretary considers 
appropriate, such as through the award of a grant or 
cooperative agreement.
(4) Collection of information.--In administering the health 
monitoring program required by paragraph (1), the Secretary may 
collect, process, maintain, and consolidate information on 
birth defects among descendants of toxic-exposed veterans and 
toxic-exposed members of the Armed Forces, including biological 
samples, environmental factors, and personal and social 
factors.
(5) Consultation.--The Secretary shall carry out the 
services covered by this section in consultation with such 
Federal, State, and research partners as the Department 
considers appropriate.
(6) Sunset.--On the date that is 7 years after the date of 
enactment of this Act.
(7) 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 Forces, 
unless otherwise authorized by another Act of Congress on a 
date after the passage of this legislation.
(c) Definitions.--In this subsection:
(1) Active military, naval, air, or space service.--The 
term ``active military, naval, air, or space service'' has the 
meaning given such term in section 101 of title 38, United 
States Code.
(2) Relevant stakeholders.--The term ``relevant 
stakeholders'' means--
(A) public health experts with experience in 
developing and maintaining registries;
(B) epidemiologists with experience in studying 
health effects of toxic exposure on the descendants of 
toxic-exposed veterans;
(C) descendants of toxic-exposed veterans; and
(D) veterans service organizations.
(3) 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 military, naval, air, or space service.
(4) 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 military, naval, air, or space 
service.
(5) Toxic exposure.--The terms ``toxic exposure'' and 
``toxic-exposed veteran'' have the meanings given such terms in 
section 101 of title 38, United States Code.

SEC. 329. VETERANS SPINAL TRAUMA ACCESS TO NEW DEVICES ACT.

Section 1706 of title 38, United States Code, is amended by adding 
at the end the following new subsection:
``(d)(1) In managing the provision of hospital care and medical 
services under section 1710(a) of this title, the Secretary shall 
furnish (through direct provision of service, referral, or a telehealth 
program operated by the Department) a preventative health evaluation 
annually to any veteran with a spinal cord injury or disorder who 
elects to undergo the evaluation.
``(2) The evaluation described in paragraph (1) shall include the 
following:
``(A) 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 disorder, 
including a risk of comorbidities.
``(B) An assessment regarding chronic pain and, if 
applicable, the management of chronic pain.
``(C) An assessment regarding dietary management and weight 
management.
``(D) An assessment regarding prosthetic equipment, 
including which prosthetic equipment the veteran needs, how 
well any existing prosthetic equipment is functioning 
considering the needs of the veteran, and any safety concerns 
regarding the prosthetic equipment in use by or recommended to 
the veteran.
``(E) An assessment with respect to the provision of 
assistive technology, including spinal cord neuromodulation 
technology (such as non-invasive transcutaneous spinal 
stimulation), that could help maximize the veteran's voluntary 
motor or autonomic function, independence, or mobility, 
including suitability for home use and need for training, 
programming, and remote follow-up.
``(3)(A) In maintaining, prescribing, or amending any guidance, 
rules, or regulations issued by the Department regarding the 
requirements set out in this subsection, the Secretary shall consult 
with--
``(i) the spinal cord injury and disorder program managers 
of the Department;
``(ii) clinicians employed by the Department as specialists 
in spinal cord injuries and disorders;
``(iii) clinicians and technologists with demonstrated 
expertise in spinal cord neuromodulation therapies, including 
non-invasive transcutaneous approaches; and
``(iv) representatives of organizations recognzied under 
section 5902 of this title.
``(B) Before issuing any guidance, rules, or regulations regarding 
the requirements set out in this subsection, the Secretary shall 
consult with manufacturers of assistive technologies and other entities 
relevant to the provision of assistive technologies if the guidance, 
rules, or regulations would directly affect such manufacturers or 
entities.
``(C) The Secretary shall ensure, to the extent possible, 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 
evaluation.
``(4) As the Secretary determines clinically appropriate, the 
Secretary may provide training, programming, remote monitoring, and 
follow-up for assistive technologies through telehealth.
``(5) Not later than one year after the date of the enactment of 
the Take Care of America's Veterans Act, and every two years 
thereafter, the Secretary shall submit to the Committees on Veterans' 
Affairs of the Senate and the House of Representatives a report that 
includes the following:
``(A) For the period covered by the report--
``(i) the number of veterans who--
``(I) received medical care or hospital 
services from the Department and used an 
assistive technology;
``(II) received medical care or hospital 
services from the Department and were assessed 
for the provision of an assistive technology; 
and
``(III) received medical care or hospital 
services from the Department and were 
prescribed an assistive technology.
``(ii) for any assistive technology prescribed, an 
identification of the category of such technology, 
including spinal cord neuromodulation, and a summary of 
functional outcomes associated with the prescription of 
such technology, if available.
``(B) The year-to-year change (for the period covered by 
the report, including the two years immediately prior to year 
the report is submitted) in the percent of veterans with a 
spinal cord injury or disorder who received an evaluation under 
this subsection.
``(6) 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 Act, the Secretary shall consider the provision of 
evaluations under paragraph (1).
``(7) In this subsection, 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 disorder, 
including the following:
``(A) A personal mobility device, including a powered 
exoskeleton device.
``(B) A speech generating device.
``(C) A spinal cord neuromodulation technology, including 
non-invasive transcutaneous spinal stimulation using sensory 
(afferent) pathways, intended to improve voluntary motor 
function, autonomic function, independence, or quality of life.
``(D) Where clinically appropriate, and consistent with the 
prosthetic and sensory aids policies of the Department, an 
implantable spinal cord stimulation system that is approved by 
the Food and Drug Administration.''.

SEC. 330. DEPARTMENT OF VETERANS AFFAIRS PILOT PROGRAM TO AWARD GRANTS 
FOR THE PROVISION OF SERVICE DOGS TO VETERANS.

(a) In General.--
(1) Pilot program required.--Not later than 24 months after 
the date of the enactment of this Act, the Secretary of 
Veterans Affairs shall establish a pilot program under which 
the Secretary shall award grants, on a competitive basis based 
on the application elements listed in subsection (b)(2), to 
nonprofit entities to provide service dogs to eligible 
veterans.
(2) 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 section.
(b) Applications.--
(1) In general.--To be eligible to receive a grant under 
this section, a nonprofit entity shall submit an application to 
the Secretary at such time and in such manner as the Secretary 
may require.
(2) Elements.--An application submitted by a nonprofit 
entity under paragraph (1) shall include the following:
(A) A proposal for the provision of service dogs to 
eligible veterans, including how the nonprofit entity 
will communicate with the Secretary to ensure an 
increasing number of service dogs are provided to 
veterans.
(B) A description of the following services or 
commitments to be provided by the nonprofit entity:
(i) The training that will be provided to 
eligible veterans.
(ii) The training of dogs that will serve 
as service dogs.
(iii) Any additional support or services 
that will be provided for such dogs and 
eligible veterans.
(iv) The plan for publicizing the 
availability of such service dogs through a 
marketing campaign that targets eligible 
veterans.
(v) The commitment to have humane standards 
for animals.
(vi) The demonstrated experience of the 
nonprofit entity in training service dogs in 
compliance with the requirements of the 
Americans with Disabilities Act of 1990 (42 
U.S.C. 12101 et seq.).
(c) Award of Grants.--
(1) In general.--The Secretary shall award a grant to each 
nonprofit entity for which the Secretary has approved an 
application submitted under subsection (b)(1).
(2) Agreement required.--Before the provision of any grant 
amounts to a nonprofit entity selected to receive a grant under 
this section, the Secretary shall enter into an agreement, 
containing such terms, conditions, and limitations as the 
Secretary determines appropriate, with such entity.
(3) Maximum grant amount.--Except as provided in 
subparagraph (B), a grant awarded to a nonprofit entity under 
this section may not exceed $2,000,000 in a fiscal year.
(4) Payments.--The Secretary shall establish intervals of 
payment for the administration of each grant awarded under this 
section.
(d) Use of Funds.--
(1) In general.--
(A) Requirement.--A recipient of a grant under this 
section shall use the grant amounts to plan, develop, 
implement, and manage one or more covered programs.
(B) Covered program defined.--In this paragraph, 
the term ``covered program'' means a program under 
which--
(i) service dogs are provided to 
participants in the program; and
(ii) only eligible veterans are allowed to 
participate in the program.
(2) 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 expenses.
(3) Other conditions and limitations.--The Secretary may 
establish other conditions or limitations on the use of grant 
amounts under this section.
(e) Requirements for Grant Recipients.--
(1) Notifications and information.--A recipient of a grant 
under this section shall--
(A) notify each veteran who receives a service dog 
through such grant that the service dog is being paid 
for, in whole or in part, by the Department of Veterans 
Affairs; and
(B) inform each such veteran of the benefits and 
services available from the Secretary for the veteran 
and the service dog.
(2) 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 grant.
(f) Veterinary Insurance.--
(1) 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 dog.
(2) Continuation.--If the Secretary provides a veterinary 
insurance policy to a veteran under paragraph (1), the 
Secretary shall continue to provide the policy to the veteran 
without regard to the continuation or termination of the pilot 
program.
(g) Training and Technical Assistance.--The Secretary may provide 
training and technical assistance regarding grant application and 
administration to recipients of grants under this section.
(h) Oversight and Monitoring.--The Secretary--
(1) may require each recipient of a grant under this 
section to provide, in such form as may be prescribed by the 
Secretary, such reports or answers in writing to specific 
questions, surveys, or questionnaires as the Secretary 
determines necessary to carry out the pilot program;
(2) shall establish such oversight and monitoring 
requirement as the Secretary determines appropriate to ensure 
that grant amounts awarded under this section are used 
appropriately; and
(3) 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 
requirements.
(i) Definitions.--In this section:
(1) Eligible veteran.--The term ``eligible veteran'' means 
a veteran (as defined in section 101 of title 38, United States 
Code) who--
(A) as determined by a physician, has one or more 
disabilities, conditions, or diagnoses described in 
paragraph (2); and
(B) is enrolled in the system of annual patient 
enrollment of the Department of Veterans Affairs 
established and operated under section 1705(a) of title 
38, United States Code, or is otherwise entitled to 
receive such care and services under subsection (c)(2) 
of such section.
(2) Disability, condition, diagnosis described.--A 
disability, condition, or diagnosis described in this 
subparagraph is any of the following:
(A) Blindness or visual impairment.
(B) Loss of use of a limb, paralysis, or other 
significant mobility issue.
(C) Loss of hearing.
(D) Post-traumatic stress disorder.
(E) Traumatic brain injury.
(F) Any other disability, condition, or diagnosis 
for which the Secretary determines, based on medical 
judgment, that it is optimal for the veteran to manage 
the disability, condition, or diagnosis and live 
independently through the assistance of a service dog.
(3) Pilot program.--The term ``pilot program'' means the 
pilot program required by subsection (a)(1).
(4) Service dog.--The term ``service dog'' means any dog 
that is individually trained to do work or perform tasks that 
are--
(A) for the benefit of a veteran with a disability, 
condition, or diagnosis described in paragraph (2); and
(B) directly related to the disability, condition, 
or diagnosis of the veteran.
(j) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $10,000,000 for each of the 
three consecutive fiscal years beginning the fiscal year in which the 
pilot program is established under subsection (a).
(k) Termination.--
(1) The authority to carry out a pilot program under this 
section shall terminate on September 30, 2029.
(2) No funds may be obligated by the Secretary to carry out 
a pilot program under this section after the date of 
termination in paragraph (1), except for activities necessary 
to close operations of such pilot program.

SEC. 331. AUTHORIZATION OF MAJOR MEDICAL FACILITY PROJECT OF DEPARTMENT 
OF VETERANS AFFAIRS FOR FISCAL YEAR 2027 IN MANCHESTER, 
NEW HAMPSHIRE.

(a) Authorization of Major Medical Facility Project of Department 
of Veterans Affairs for Fiscal Year 2027 in Manchester, New 
Hampshire.--
(1) In general.--The Secretary of Veterans Affairs shall 
carry out a major medical facility project for the replacement 
of a medical center, a new central utility plant, a community 
living center, a residential rehabilitation treatment facility, 
associated parking, and demolition of existing buildings in 
Manchester, New Hampshire.
(2) Non-department federal entity waiver.--In order to 
reduce cost and expedite timelines, the Secretary may waive the 
requirements under section 8103(e) of title 38, United States 
Code, and section 1096 of the National Defense Authorization 
Act for Fiscal Year 2016 (Public Law 114-92; 38 U.S.C. 8103 
note) for a non-Department Federal entity to be engaged in 
project management and other activities for the project under 
paragraph (1).
(3) Notification.--Not later than 60 days after making a 
waiver, modification, or substitution relating to the project 
under subsection (a), including a waiver under paragraph (2), 
the Secretary shall submit to the appropriate committees of 
Congress a notification describing the waiver, modification, or 
substitution and the reason for such waiver, modification, or 
substitution.
(4) Authorization of appropriations.--There is authorized 
to be appropriated to the Secretary of Veterans Affairs for the 
Construction, Major Projects account $1,180,000,000 for the 
project under paragraph (1), to remain available until 
expended.
(5) Appropriate committees of congress defined.--In this 
section the term ``appropriate committees of Congress'' means--
(A) the Committee on Veterans' Affairs and the 
Committee on Appropriations of the Senate; and
(B) the Committee on Veterans' Affairs and the 
Committee on Appropriations of the House of 
Representatives.
(b) Access to Information for Medical Facility Construction 
Projects and Leases.--
(1) In general.--Subchapter I of chapter 81 of title 38, 
United States Code, is amended by inserting after section 8106 
the following:
``Sec. 8107. Access to information for medical facility construction 
projects and leases
``(a) In General.--For any major construction project, lease, or 
enhanced-use lease for a medical facility of the Department, 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 information, records, 
documents, data, analyses, communications, contracts, agreements, 
project schedules, cost estimates, memoranda, briefings, reports, and 
other materials relating to the project or lease.
``(b) Prohibition on Withholding Information.--The Secretary may 
not withhold information under subsection (a) 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 predecisional, deliberative, advisory, procurement-
sensitive, or subject to an internal policy or directive of the 
Department.''.
(2) Clerical amendment.--The table of sections at the 
beginning of such chapter is amended by inserting after the 
item relating to section 8106 the following new item:

``8107. Access to information for medical facility construction 
projects and leases.''.

SEC. 332. BOWEL AND BLADDER CARE PROGRAM OF DEPARTMENT OF VETERANS 
AFFAIRS.

(a) Findings; Sense of Congress.--
(1) Findings.--Congress finds the following:
(A) 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 independently.
(B) Inadequate care will lead to complications and 
problems such as autonomic dysreflexia that can be 
potentially life-threatening and result in illness and 
hospitalization.
(C) Bowel care and bladder care are essential to 
support veterans with spinal cord injuries and 
disorders in non-institutional settings, improve 
quality of life, optimize health, and prevent 
complications from neurogenic bowel and bladder.
(D) 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 communities.
(2) Sense of congress.--It is the sense of Congress that--
(A) 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 care;
(B) 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 needs; and
(C) 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 needed.
(b) In General.--The Secretary of Veterans Affairs shall establish 
a program to address the bowel and bladder care needs of covered 
veterans (in this section referred to as the ``program'').
(c) Provision of Care.--
(1) Clinical need.--The Secretary shall provide bowel and 
bladder care under the program to covered veterans based on 
clinical need, which may include covered veterans receiving aid 
and attendance benefits from the Department of Veterans 
Affairs.
(2) Caregiver or agency.--A covered veteran may receive 
bowel and bladder care under the program through a qualified 
family member, an individually employed caregiver, or a 
contracted home health agency.
(3) 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 program.
(4) Denial of care.--Before denying bowel and bladder care 
for any covered veteran under the program, 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 Department.
(d) 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 services.
(e) Supportive Medical Training and Qualifications.--
(1) 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 care.
(2) Qualifications.--The Secretary shall establish such 
requirements, conditions, 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 
program.
(f) Payment.--
(1) 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 program.
(2) Limitation.--
(A) 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--
(i) shall be determined by the Secretary;
(ii) shall be based on the amount and 
degree of assistance provided; and
(iii) 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 veteran.
(B) 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 17.4035 of title 38, Code of 
Federal Regulations (relating to payment rates and 
methodologies), or successor regulations.
(g) 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 program.
(h) 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 more, 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 needed.
(i) 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 program.
(j) Limitation.--Care may not be provided under the program to a 
veteran who can perform the bowel and bladder functions of the veteran 
without assistance.
(k) Covered Veteran Defined.--In this section, the term ``covered 
veteran'' means a veteran who--
(1) is enrolled in the system of annual patient enrollment 
of the Department of Veterans Affairs established and operated 
under section 1705(a) of title 38, United States Code;
(2) has a spinal cord injury or disorder; and
(3) is dependent upon others for bowel and bladder care 
while residing in non-institutional settings.

TITLE IV--ORGANIZATION

SEC. 401. AUTHORIZATION OF APPROPRIATIONS TO THE OFFICE OF INFORMATION 
AND TECHNOLOGY OF THE DEPARTMENT OF VETERANS AFFAIRS FOR 
CERTAIN PURPOSES.

(a) Authorization of Appropriations.--There is authorized to be 
appropriated, and there is appropriated, to the Secretary of Veterans 
Affairs $500,000,000 for fiscal year 2026, to remain available until 
September 30, 2031, for deposit into the accounts of the Office of 
Information and Technology of the Department of Veterans Affairs for 
the purposes described in subsection (b).
(b) Use of Funds.--Funds shall be allocated and expended only as 
follows:
(1) $150,000,000 for Enterprise Logistics and Supply Chain 
Visibility -- To develop and deploy integrated, real-time 
enterprise-wide logistics systems, inventory visibility, 
pharmaceutical tracking, and medical supply chain resiliency 
capabilities. These systems shall support both routine veteran 
care operations and 4th Mission medical surge, patient 
movement, and emergency distribution requirements in 
consultation with DoD, FEMA, and other agencies.
(2) $200,000,000 for Cybersecurity and Operational 
Resiliency -- For zero trust architecture implementation, 
threat detection, secure cloud hardening, endpoint protection, 
continuity of operations (COOP) platforms, and protection of 
mission-essential systems against cyber and physical 
disruptions. Funds shall prioritize high-risk legacy systems 
and medical device security.
(3) $150,000,000 for Resilient Communications and Digital 
Records Modernization -- For interoperable, survivable 
communications infrastructure and targeted digitization/
automation of high-volume paper-based workflows (claims, 
correspondence, administrative records) to reduce fraud risk 
and improve continuity during degraded or emergency 
environments. Funds shall not be used for broad Electronic 
Health Record Modernization expansion.
(c) Oversight and Protection of Sensitive Information.--
(1) The Secretary may obligate and expend amounts under 
this section in classified, controlled, or protected 
environments consistent with applicable law.
(2) Not later than 90 days after the date of enactment of 
this Act, and annually thereafter until September 30, 2031, the 
Secretary shall provide to the Committees on Veterans' Affairs 
of the House of Representatives and the Senate a briefing and 
report on--
(A) activities carried out using funds made 
available under this section;
(B) progress on improving cybersecurity, 
resiliency, continuity, logistics, communications, 
digitization, and mission assurance capabilities; and
(C) coordination with other Federal agencies, as 
appropriate. Such reports may include a classified 
annex.
(3) Detailed implementation plan and quarterly briefings.--
(A) Not later than 90 days after the date of 
enactment of this Act, the Secretary, acting through 
the Office of Information and Technology, shall submit 
to the Committees on Veterans' Affairs of the House of 
Representatives and the Senate a comprehensive 
implementation plan. The plan shall include--
(i) specific milestones, deliverables, and 
performance metrics for each category of 
activities in subsection (b);
(ii) a zero trust architecture strategy 
with timelines and technical requirements;
(iii) a detailed expenditure plan by fiscal 
quarter and by activity category; and(iv) any 
proposed interagency or private-sector 
partnerships.
(B) Not later than 30 days after the end of each 
fiscal quarter through September 30, 2031, the 
Secretary shall provide the Committees a briefing and 
written report on--
(i) obligations and expenditures to date, 
by category;
(ii) progress against the implementation 
plan;
(iii) any deviations from the plan and 
corrective actions; and
(iv) updated projections for remaining 
funds. The initial briefing shall be in person; 
subsequent briefings may be virtual unless 
otherwise requested by the Committees. Reports 
may include a classified annex.
(d) Limitation.--Funds made available under this section may not be 
used for any purpose unrelated to information technology modernization, 
cybersecurity, operational resilience, logistics modernization, 
communications modernization, digitization, or fraud prevention 
activities of the Department.
(e) Supplement, 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 Affairs.
(f) Rule of Construction.--Nothing in this section shall be 
construed to require the public disclosure of classified information, 
controlled unclassified information, operational details, cybersecurity 
architecture, contingency planning information, mission-essential 
system design, or information otherwise protected from disclosure under 
Federal law or Executive Order.
(g) Reauthorization and Sunset.--
(1) Reauthorization required.--The authority provided under 
this section to obligate or expend amounts appropriated 
pursuant to subsection (a) shall terminate on September 30, 
2031, unless subsequently reauthorized by law.
(2) Limitation on new obligations after sunset.--Beginning 
on October 1, 2031, the Secretary may not initiate, award, 
enter into, renew, extend, or otherwise obligate funds for any 
new program, project, activity, contract, task order, or 
operational capability carried out pursuant to this section 
unless expressly authorized by a subsequent Act of Congress.
(3) Continuation of existing activities.--Nothing in 
paragraph (2) shall be construed to prohibit the Secretary 
from--
(A) maintaining, sustaining, securing, operating, 
completing, or supporting any program, project, 
activity, contract, system, platform, infrastructure 
capability, or operational activity lawfully initiated 
using amounts obligated before September 30, 2031; or
(B) carrying out similar information technology 
modernization, cybersecurity, continuity of operations, 
logistics modernization, communications modernization, 
operational resiliency, or mission assurance activities 
using amounts otherwise authorized and appropriated 
under any other provision of law.
(h) Use of Existing Contracting Authorities.--The Secretary shall 
carry out the activities authorized under this section, to the maximum 
extent practicable, through contracts, task orders, delivery orders, 
interagency agreements, cooperative agreements, or other agreements 
entered into under existing authorities of title 38, United States 
Code, as applicable. Amounts made available under this section shall 
not be used to establish a new full-time equivalent position, hire 
additional employees of the Department, or otherwise increase the 
number of full-time equivalent employees of the Department, except to 
the extent the Secretary determines that such personnel are necessary 
for the oversight, management, cybersecurity supervision, acquisition 
administration, or operational integration of activities carried out 
under this section.

SEC. 402. ESTABLISHMENT OF UNDER SECRETARY FOR MANAGEMENT AND CHIEF 
FINANCIAL OFFICER.

(a) Chief Financial Officer; Office of Budget.--Section 309 of 
title 38, United States Code, is amended to read as follows:
``Sec. 309. Under Secretary for Management and Chief Financial Officer
``(a) Under Secretary for Management and Chief Financial Officer.--
``(1) The Under Secretary for Management and Chief 
Financial Officer shall be the principal management and 
financial officer of the Department.
``(2) The Under Secretary shall report directly to the 
Secretary.
``(3) The Under Secretary shall serve as the Chief 
Financial Officer of the Department for purposes of chapter 9 
of title 31.
``(4) The Under Secretary shall exercise authority, 
direction, and control over the Office of Budget and such other 
offices as may be assigned by law or by the Secretary.
``(b) Duties.--The duties of the Under Secretary include the 
following:
``(1) To advise the Secretary on financial management of 
the Department.
``(2) To formulate, justify, execute, oversee, and certify 
the budget of the Department.
``(3) To control, account for, audit, and report on the 
finances of the Department.
``(4) To coordinate and assist the Chief Acquisition 
Officer with the life cycle of major acquisition programs of 
the Department.
``(5) To exercise the authority and carry out the functions 
specified in section 902 of title 31.
``(6) To ensure compliance with sections 1341, 1342, 1349, 
1350, and 1511 through 1519 of title 31.
``(7) To provide to Congress, or a congressional committee 
upon request, information regarding the budget, finances, and 
fiscal condition of the Department.
``(8) To serve as the head of the Office of Budget of the 
Department.
``(9) To establish and oversee Department-wide financial 
management policies, accounting systems, internal controls, 
enterprise risk management programs, strategic planning 
processes, and capital planning activities.
``(10) To oversee infrastructure investment planning, 
financial systems modernization, and business transformation 
initiatives of the Department.
``(c) Deputy Assistant Secretary.--(1) There is in the Department a 
Deputy Assistant Secretary for Infrastructure and Construction.
``(2) Such Deputy Assistant Secretary shall be a career appointee 
(as that term is defined in section 3132(a) of title 5) within the 
Senior Executive Service of the Department.
``(d) Office of Infrastructure and Construction.--There is an 
Office of Infrastructure and Construction in the Department.
``(e) Budget and Appropriations Affairs Office.--(1) There is 
within the Office of Management a Budget and Appropriations Affairs 
Office (in this subsection referred to as the `BAA office'). The 
Undersecretary shall appoint a head of the BAA Office who shall report 
exclusively to the Undersecretary.
``(2) The sole function of the BAA Office is to provide to Congress 
(or a congressional committee), accurate, timely, and certified 
information regarding the finances and budget of the Department.
``(3) Congress or a congressional committee may submit a request 
for information described in paragraph (2) directly to the BAA Office.
``(4) Paragraphs (2) and (3) notwithstanding, the Assistant 
Secretary for Congressional and Legislative Affairs may facilitate and 
transmit responses to requests described in paragraph (3) that are 
submitted to the BAA Office. Any response containing information 
described in paragraph (2) shall be prepared and certified by the BAA 
Office and may not be altered, delayed, withheld, edited, or modified 
by any other officer or employee of the Department prior to 
transmission to Congress or a congressional committee.
``(5) Not more than six full-time equivalent employees, including 
supervisors, may be assigned to the BAA Office.
``(f) Limitation on Authority to Appoint.--The Secretary may not 
establish an employee position--
``(1) that performs a function substantially similar to the 
function of the Budget and Appropriations Affairs Office 
established under section 309(e); and
``(2) that is not within the Office of Management.
``(g) Transfer of Functions.--(1) All functions, powers, duties, 
authorities, responsibilities, personnel, property, records, contracts, 
delegations, directives, regulations, administrative actions, 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 Officer.
``(2) Any delegation, determination, rule, regulation, order, 
permit, contract, agreement, certification, or other administrative 
action in effect immediately before the effective date of this Act 
shall continue in effect according to its terms until modified, 
superseded, terminated, or revoked.
``(h) References.--Any reference in any law, regulation, rule, 
directive, delegation, contract, agreement, determination, record, 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 Officer.''.
(b) Technical and Conforming Amendments.--
(1) The table of sections for chapter 3 of title 38, United 
States Code, is amended accordingly.
(2) The Secretary shall make such additional technical and 
conforming amendments to regulations, directives, delegations, 
organizational charters, manuals, and internal guidance as may 
be necessary to carry out this Act.

SEC. 403. DEPARTMENT OF VETERANS AFFAIRS ACQUISITION REFORM AND COST 
ASSESSMENT.

(a) Department of Veterans Affairs Acquisition Organization.--
(1) Definitions.--Chapter 81 of title 38, United States 
Code, is amended by inserting after subchapter VI the following 
new subchapter:

``SUBCHAPTER VII--ACQUISITION ORGANIZATION, COST ASSESSMENT, AND 
PROGRAM EVALUATION

``Sec. 8181. Definition of major acquisition program
``In this subchapter, the term `major acquisition program' means a 
program of the Department to acquire services, supplies, technology, 
systems, or a combination thereof, with an estimated total program 
cost, estimated by the Secretary, that exceeds--
``(1) $1,000,000,000 (adjusted pursuant to section 1908 of 
title 41) for the total life cycle cost of the program; or
``(2) $200,000,000 (adjusted pursuant to section 1908 of 
title 41) annually.''.
(2) Assistant secretary for acquisition.--Section 308 of 
such title is amended--
(A) in subsection (a)(1), by striking ``seven'' and 
inserting ``eight''; and
(B) in subsection (b)(10), by striking 
``Procurement functions'' and inserting ``Acquisition 
functions''.
(3) Acquisition organization.--Subchapter VII of chapter 81 
of such title, as added by paragraph (1), is amended by adding 
at the end the following new section:
``Sec. 8182. Acquisition organization
``(a) Assistant Secretary for Acquisition; Chief Acquisition 
Officer.--(1) The Secretary shall designate one of the Assistant 
Secretaries specified in subsection (a)(1) of section 308 of this title 
as the Assistant Secretary of Veterans Affairs for Acquisition, who 
shall focus solely on the administration of functions specified in 
subsection (b)(10) of such section.
``(2) Pursuant to section 1702(a) of title 41, the Secretary shall 
designate the Assistant Secretary of Veterans Affairs for Acquisition 
as the Chief Acquisition Officer of the Department.
``(b) Office of Acquisition.--(1) There is in the Department an 
Office of Acquisition.
``(2) The head of the Office of Acquisition shall be the Assistant 
Secretary of Veterans Affairs for Acquisition designated pursuant to 
subsection (a).
``(3) 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 Acquisition.
``(4) The budget of the Office of Acquisition, including budgets 
for major acquisition programs, shall be established in the budget 
justification materials submitted to Congress in support of the budget 
of the Department (as submitted with the budget of the President under 
section 1105(a) of title 31).
``(c) Deputy Assistant Secretary for Logistics.--(1) Pursuant to 
section 308(d) of this title, the Secretary shall appoint a Deputy 
Assistant Secretary of Veterans Affairs for Logistics, who shall report 
to the Assistant Secretary for Acquisition.
``(2) The Deputy Assistant Secretary of Veterans Affairs for 
Logistics shall be responsible for administration of logistics and 
supply chain operations of the Department.
``(d) Deputy Assistant Secretary for Procurement.--(1) Pursuant to 
section 308(d) of this title, the Secretary shall appoint a Deputy 
Assistant Secretary of Veterans Affairs for Procurement, who shall 
report to the Assistant Secretary for Acquisition.
``(2) The Deputy Assistant Secretary of Veterans Affairs for 
Procurement shall be responsible for all procurement and contracting 
organizations of the Department.
``(e) Deputy Assistant Secretary for Acquisition, Program 
Management, and Performance.--(1) Pursuant to section 308(d) of this 
title, the Secretary shall appoint a Deputy Assistant Secretary of 
Veterans Affairs for Acquisition, Program Management, and Performance, 
who shall report to the Assistant Secretary for Acquisition.
``(2) The Deputy Assistant Secretary for Acquisition, Program 
Management, and Performance shall be responsible for the following:
``(A) Lifecycle management.
``(B) Requirements planning.
``(C) Programming and budgeting.
``(D) Policy.
``(E) Performance standards.
``(F) Governance.
``(G) Enhancing the capabilities of the acquisition 
workforce.
``(f) Program Executive Officers.--(1) The Assistant Secretary for 
Acquisition shall appoint no fewer than four Program Executive 
Officers, each responsible for overseeing major acquisition programs in 
one of the following areas:
``(A) Medical.
``(B) Information technology.
``(C) Professional services.
``(D) Other areas not included in subparagraphs (A) through 
(C).
``(2) 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 area, as appointed 
under section 8183 of this title.
``(3) Each Program Executive Officer shall be--
``(A) certified in project management at level three by--
``(i) the Department;
``(ii) the Federal Acquisition Institute pursuant 
to section 1201 of title 41; or
``(iii) the Department of Defense pursuant to 
section 1701a of title 10; or
``(B) hold an equivalent certification by a private sector 
project management certification organization, as determined 
appropriate by the Secretary.''.
(b) Department of Veterans Affairs Major Acquisition Program 
Managers.--Subchapter VII of chapter 81 of title 38, United States 
Code, as added by subsection (a), is amended by adding at the end the 
following new section:
``Sec. 8183. Major acquisition program managers
``(a) Appointments.--Not later than 30 days after any date on which 
the Secretary approves a major acquisition program to commence, the 
applicable Program Executive Officer shall appoint a manager to be 
responsible for administering such program.
``(b) Qualifications.--Each manager appointed pursuant to 
subsection (a) shall be--
``(1) certified in project management at level three by--
``(A) the Department;
``(B) the Federal Acquisition Institute pursuant to 
section 1201 of title 41; or
``(C) the Department of Defense pursuant to section 
1701a of title 10; or
``(2) hold an equivalent certification by a private sector 
project management certification organization, as determined 
appropriate by the Secretary.
``(c) Duties.--Each manager appointed pursuant to subsection (a) 
for a major acquisition program shall--
``(1) report to the Assistant Secretary for Acquisition 
through the Program Executive Officer responsible for the major 
acquisition program; and
``(2) shall be responsible for, with respect to the major 
acquisition program--
``(A) developing, in coordination with the Program 
Executive Officer, a plan to administer major 
acquisition program, which shall be known as the 
`program baseline' for the major acquisition program, 
that includes--
``(i) a description of each acquisition 
phase of the major acquisition program;
``(ii) for each such acquisition phase, 
requirements for advancing the major 
acquisition program to a subsequent acquisition 
phase; and
``(iii) estimates of the cost, schedule, 
and performance of the major acquisition 
program that account for the entire life cycle 
of the major acquisition program;
``(B) ensuring the major acquisition program is in 
compliance with such requirements and providing all 
program documentation, including program baseline 
documentation, cost, schedule, performance and risk 
assessments, and other relevant materials, to 
designated officials and relevant governance boards;
``(C) developing resource requests and 
justifications necessary to satisfy such requirements; 
and
``(D) on a continuous basis, assessing and managing 
risks to satisfying the requirements of such program 
baseline relating to cost and schedule.
``(d) Program Decision Authority.--The Secretary shall ensure 
that--
``(1) program decision authority for oversight of a major 
acquisition program is the Assistant Secretary for Acquisition; 
and
``(2) program management offices for major acquisition 
programs are independent of the Veterans Benefits 
Administration, the Veterans Health Administration, the 
National Cemetery Administration, and staff offices of the 
Department by reporting directly to the Assistant Secretary for 
Acquisition.
``(e) Program Decision Authority Notification Required.--Not later 
than 30 days after any date on which a major acquisition program 
concludes an acquisition phase, the manager of such program appointed 
pursuant to subsection (a) shall notify the program decision authority 
under subsection (c).''.
(c) Department of Veterans Affairs Acquisition and Procurement 
Reorganization Matters.--
(1) Organizational consolidation.--Not later than one year 
after the date of the enactment of this Act, the Secretary of 
Veterans Affairs shall organizationally consolidate under the 
Assistant Secretary of Veterans Affairs for Acquisition every 
activity of the Department of Veterans Affairs, including the 
Veterans Benefits Administration, the Veterans Health 
Administration, and the National Cemetery Administration, that 
relates to--
(A) acquisition;
(B) procurement and contracting; or
(C) logistics and supply chain.
(2) Relocation.--Paragraph (1) shall not be construed to 
require the physical relocation of employees of the Department.
(3) Plan and briefing.--
(A) In general.--Not later than 90 days after 
commencing organizational consolidation under 
subsection (a), the Secretary shall--
(i) 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 consolidation; and
(ii) provide such committees a briefing on 
such plan.
(B) Contents.--The plan submitted pursuant to 
subparagraph (A)(i) shall include the following:
(i) A timeline.
(ii) A plan for communication and training 
activities for relevant Department personnel.
(iii) A plan for modification of relevant 
Department policy and guidance.
(iv) Such other matters as the Secretary 
considers relevant and appropriate.
(d) Independent Verification and Validation of Major Acquisition 
Programs of Department of Veterans Affairs.--
(1) Contracting authority.--Not later than 120 days after 
the date of the enactment of this Act, 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 (3).
(2) Eligibility.--
(A) 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 determines, at the time of evaluation of offers 
submitted under paragraph (1), that the entity is 
currently performing or has performed, during the 
preceding three-year period, not fewer than three prime 
contracts from either governmental or commercial health 
care organizations for--
(i) the independent verification and 
validation services or equivalent services, 
including systems engineering and technical 
advisory (SETA) support of major acquisition 
programs; or
(ii) the independent verification and 
validation or systems engineering and technical 
advisory (SETA) support of the development or 
acquisition of major acquisition programs or 
defense systems, in accordance with guidance of 
the Department of Defense relating to such 
acquisition programs or such business systems.
(B) Past performance.--For any contract used to 
demonstrate eligibility under subparagraph (A), 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 System, or successor system.
(C) 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 (3).
(D) 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 subsection.
(3) Functions.--The functions specified in this subsection 
are the following:
(A) The independent verification and validation of 
each major acquisition program project--
(i) when such major acquisition program is 
initiated, with respect to its design and the 
development of its requirements and 
acquisition;
(ii) at the conclusion of such program; and
(iii) at any other intervals during such 
program selected by the Chief Acquisition 
Officer of the Department.
(B) The independent verification and validation of 
other programs or projects of the Department selected 
by the Chief Acquisition Officer of the Department, at 
intervals selected by the Chief Acquisition Officer.
(4) Funding.--The Chief Financial Officer of the Department 
shall ensure that each organizational subdivision of the 
Department that enters into a contract under paragraph (1) 
proportionally contributes amounts to fund each such contract.
(5) Definitions.--In this section:
(A) Covered contract.--The term ``covered 
contract'' means any prime or subcontract with the 
Department, including--
(i) information technology support or 
software or system design, development, 
sustainment, or maintenance services;
(ii) professional or management consulting 
services; or
(iii) advisory and assistance services.
(B) Independent verification validation.--The term 
``independent verification and validation'' means a 
comprehensive inspection, a review, analysis, and 
testing, or an assessment of systems, software, or 
hardware, as applicable, performed by an entity awarded 
a contract under paragraph (1)--
(i) to verify that the requirements of a 
program, project or system, or a development 
phase of such a program or project, are 
correctly defined; and
(ii) to validate cost, schedule, and 
performance baselines of current programs and 
measure program effectiveness.
(e) Department of Veterans Affairs Cost Assessment and Program 
Evaluation.--
(1) In general.--Subchapter VII of chapter 81 of title 38, 
United States Code, as added by subsection (a) and amended by 
subsection (b), is further amended by adding at the end the 
following new section:
``Sec. 8184. Cost assessment and program evaluation
``(a) Director of Cost Assessment and Program Evaluation.--There is 
in the Department a Director of Cost Assessment and Program Evaluation, 
who shall report directly to the Secretary.
``(b) Responsibilities.--The responsibilities of the Director are 
as follows:
``(1) To develop policies and procedures for cost 
estimation and analysis of major acquisition programs of the 
Department.
``(2) To conduct independent cost estimates and analyses 
for major acquisition programs to support acquisition 
decisions, or any other acquisitions as directed by the 
Secretary,
``(3) 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 Director.
``(4) To evaluate the effectiveness of major acquisition 
programs in meeting Department objectives.
``(5) Not less frequently than once each year, 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 activities, including recommendations to improve 
acquisition efficiency. 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 5 percent.
``(c) 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 Evaluation.''.
(2) Report on monitoring of operating and support costs for 
major acquisition programs.--
(A) Report to secretary of veterans affairs.--Not 
later than one year after the date of the enactment of 
this Act, and not less frequently than once each year 
thereafter until December 31, 2028, 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 (as defined 
in section 8181 of title 38, United States Code, as 
added by subsection (a)), including recommendations for 
establishing cost baselines.
(B) Transmittal to congress.--Not later than 30 
days after receiving a report pursuant to subparagraph 
(A), 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 Secretary.
(f) Improvements to Hiring of Entry-level Acquisition Positions in 
Department of Veterans Affairs.--
(1) 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 Affairs.
(2) Annual number of participants in acquisition internship 
programs.--
(A) In general.--Not later than September 30 of the 
first fiscal year beginning after the date of the 
enactment of this Act, 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--
(i) not fewer than twice the number of 
participants in such programs during fiscal 
year 2025; and
(ii) not more than 4 times the number of 
participants in such programs during such 
fiscal year.
(B) Termination.--The requirements of subparagraph 
(A) 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 
acquisition, taking into account the rate of attrition 
and projected retirements of personnel.
(C) Appropriate committees of congress defined.--In 
this subsection, 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 Representatives.
(g) Independent Analysis of Acquisition Process of Department of 
Veterans Affairs.--
(1) Systems engineering analysis.--Not later than one year 
after the date of the enactment of this Act, 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 Affairs.
(2) Report.--Not later than one year after the date in 
which the Secretary enters into the memorandum of understanding 
required by paragraph (1), 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 subsection.
(h) Requirements Development Process.--
(1) In general.--Subchapter VII of chapter 81 of title 38, 
United States Code, as added by subsection (a) and amended by 
subsections (b) and (e), is further amended by adding at the 
end the following new section:
``Sec. 8185. Requirements development process
``(a) Establishment of Process.--(1) The Secretary shall establish 
a standardized requirements development process for major acquisition 
programs.
``(2) The process established pursuant to paragraph (1) shall--
``(A) define and validate mission-driven requirements for 
major acquisition programs exceeding $200,000,000 annually or 
$1,000,000,000 in lifecycle costs, in coordination with the 
Assistant Secretary for Acquisition;
``(B) incorporate data-driven needs assessments, 
stakeholder input from relevant administrations, staff offices, 
and other elements of the Department, and alignment with 
statutory mandates, such as section 8121 of this title; and
``(C) ensure iterative validation of requirements through 
independent verification and validation, as described in 
section 8185 of this title, to confirm cost, schedule, and 
performance baselines.
``(b) Limitation on Personnel.--The Secretary shall implement the 
process established pursuant to subsection (a) using staff within the 
Office of Acquisition and other relevant offices of the Department, as 
established under section 8182 of this title, without creating new 
positions, unless a subsequent cost-benefit analysis, validated by the 
Director of Cost Assessment and Program Evaluation, justifies 
additional resources.''.
(2) Report.--Not later than 180 days after the enactment of 
this Act, 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 8187 of 
such title, as added by paragraph (1) and a plan for 
implementation of such process, including timelines for 
integration with major acquisition program baselines.
(i) Conforming Amendments.--Subchapter VI of chapter 81 of title 
38, United States Code, is amended--
(1) in section 8171, by striking paragraphs (5) and (6); 
and
(2) by striking section 8172.
(j) Clerical Amendments.--The table of sections at the beginning of 
chapter 81 of title 38, United States Code, is amended--
(1) by striking the item relating to section 8172; and
(2) by adding at the end the following:

``subchapter vii--acquisition review, cost assessment, and program 
evaluation

``8181. Definition of major acquisition program.
``8182. Acquisition reorganization.
``8183. Major acquisition program managers.
``8184. Cost assessment and program evaluation.
``8185. Requirements development process.''.

SEC. 404. IMPROVEMENT OF TELEPHONE COMMUNICATION BY DEPARTMENT OF 
VETERANS AFFAIRS.

(a) In General.--Chapter 63 of title 38, United States Code, is 
amended by adding at the end the following new section:
``Sec. 6321. Telephone communication
``(a) Calls Associated With Department.--Not later than one year 
after the date of the enactment of the Take Care of America's Veterans 
Act, the Secretary shall ensure, to the extent practicable and 
feasible, that any call made to a veteran, beneficiary, claimant, or 
other relevant individual by an employee or contractor of the 
Department regarding services or benefits furnished by the Department--
``(1) is made from a single, well-known telephone number; 
and
``(2) uses caller identification branding that indicates to 
the individual that the call is from or on behalf of the 
Department.
``(b) Call Centers for Health Care Appointments and Referrals.--
``(1) In general.--Not later than one year after the date 
of the enactment of the Take Care of America's Veterans Act, 
the Secretary shall ensure that the Veterans Health 
Administration has at least one call center in each of the time 
zones specified in paragraph (3) to address concerns regarding 
appointments and referrals for health care under the laws 
administered by the Secretary.
``(2) Existing efforts and call centers.--In carrying out 
paragraph (1), the Secretary--
``(A) shall ensure coordination with existing 
efforts of the Department to improve call center 
operations; and
``(B) may use existing call centers to meet the 
requirements of such paragraph.
``(3) Time zones specified.--The time zones specified in 
this paragraph are the following:
``(A) Eastern time.
``(B) Central time.
``(C) Mountain time.
``(D) Pacific time.
``(E) Alaska time.
``(F) Hawaii time.
``(4) 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 (3) that does not follow daylight saving time.''.
(b) Clerical Amendment.--The table of sections at the beginning of 
chapter 63 of such title is amended by adding at the end the following 
new item:

``6321. Telephone communication.''.
(c) Report.--Not later than 180 days after enactment, and annually 
for three years thereafter, the Secretary shall submit to the 
Committees on Veterans' Affairs a report on implementation, including 
call-answer rates, abandoned-call rates, average wait times, veteran 
complaints, spoofing or fraud-prevention measures, and any exceptions 
granted.

SEC. 405. ADVANCING DEPARTMENT OF VETERANS AFFAIRS EMERGENCY RESPONSE 
TO CRISIS.

(a) Report on Emergency Management Roles for Department of Veterans 
Affairs.--
(1) In general.--Not later than 180 days after the date of 
the enactment of this Act, 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 management.
(2) Consultation.--In preparing the report required by 
paragraph (1), the Secretary of Veterans Affairs shall consult 
with the Comptroller General of the United States, the 
Inspector General of the Department of Veterans Affairs, the 
Secretary of Homeland Security, the Secretary of Defense, and 
such other Federal agencies as the Secretary of Veterans 
Affairs considers relevant, to obtain insights from their 
experience and trends that they have found, and such 
recommendations as they may have with respect to the management 
by the Department of Veterans Affairs of emergency management 
functions.
(3) Contents.--The report submitted pursuant to paragraph 
(1) shall include the following:
(A) A description of the organizational structure 
of each office, both during normal operations and 
during emergency or disaster operations.
(B) The roles and responsibilities of each office.
(C) A detailed description of roles and 
responsibilities that are shared by both the Office of 
Emergency Management of the Department and the Office 
of Operations, Security, and Preparedness of the 
Department, including an analysis of how each office 
plays a part in emergency management functions.
(D) Recommendations for improving the structure and 
alignment of relevant offices to better prepare the 
Department for emergencies, remove redundancies, and 
improve accountability.
(E) 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 Department.
(b) Plan to Allow Fuel Sharing and Increased Coordination Between 
the Federal Emergency Management Agency and the Department of Veterans 
Affairs.--Not later than 90 days after the date of the enactment of 
this Act, the Secretary of Veterans Affairs shall, after consulting 
with the Administrator of the Federal Emergency Management Agency, 
submit to the Committee on Veterans' Affairs of the Senate, the 
Committee on Veterans' Affairs of the House of Representatives, the 
Committee on Homeland Security and Government Affairs of the Senate, 
and the Committee on Homeland Security of the House of Representatives 
a report regarding--
(1) the current limitations preventing the Federal 
Emergency Management Agency from providing fuel or other 
resources to the Department of Veterans Affairs during 
emergencies;
(2) whether the Department requires action by Congress to 
allow such resource provision to occur;
(3) 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 
coordination;
(4) whether the Secretary requires action by Congress to 
address any of the issues mentioned under paragraph (3); and
(5) whether the Secretary requires action by Congress to 
address the issue of Department employees or responders being 
unable to use Department-purchased fuel.

SEC. 406. MEMBERSHIP OF DEPARTMENT OF VETERANS AFFAIRS GERIATRICS AND 
GERONTOLOGY ADVISORY COMMITTEE.

Section 7315 of title 38, United States Code, is amended, in 
subsection (a)--
(1) in the second sentence, by striking ``and at least one 
representative of a national veterans service organization'' 
and inserting ``, at least one individual who represents a 
national veterans service organization, at least one individual 
who has served veterans or families of veterans in a State 
home, and at least one individual who holds a professional 
license in nursing home administration''; and
(2) by designating the first, second, and third sentences 
as paragraphs (1) through (3), respectively (and adjusting the 
margins accordingly).

SEC. 407. SCHEDULING OF APPOINTMENTS UNDER THE VETERANS COMMUNITY CARE 
PROGRAM.

(a) In General.--
(1) Electronic process.--Subsection (d) of section 3101 of 
the Johnny Isakson and David P. Roe, M.D. Veterans Health Care 
and Benefits Improvement Act of 2020 (Public Law 116-315; 38 
U.S.C. 1701 note) is amended to read as follows:
``(d) Electronic Process.--(1) The Secretary shall implement an 
electronic process through which a scheduler of the Department, using 
an information technology system, may schedule an appointment for 
health care furnished by the Department or through the Veterans 
Community Care Program, under section 1703 of this title, by a non-
Department health care provider.
``(2) The electronic process under this subsection shall allow a 
scheduler, with regards to appointments described in--
``(A) either clause of subparagraph (A) of subsection 
(a)(1), to view, search, and sort such appointments by type of 
care, location, and date; and
``(B) clause (ii) of such subparagraph--
``(i) to schedule such an appointment;
``(ii) to provide referral and authorization 
documents directly to a non-Department provider; and
``(iii) to perform any other function the Secretary 
determines necessary.
``(3) 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 Department.
``(4) The Secretary shall implement the electronic process through 
an existing agreement if practicable.
``(5) The Secretary shall submit to the Committees on Veterans' 
Affairs of the Senate and House of Representatives the following 
regarding the electronic process:
``(A) Not later than 90 days after the Secretary makes a 
determination under subparagraph (B)(iii) of paragraph (2), a 
briefing regarding the functions the Secretary has determined 
necessary.
``(B) Not later than six months after the date of the 
enactment of Take Care of America's Veterans Act, and 
semiannually thereafter during the following three years, 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 
Act. Such a report shall include the following for each such 
period:
``(i) The number of non-Department health care 
providers that participated in such electronic process, 
disaggregated by--
``(I) category of hospital care or medical 
services provided; and
``(II) medical center of the Department;
``(ii) The number of appointments scheduled 
pursuant to the electronic process, disaggregated by--
``(I) category of hospital care or medical 
services provided;
``(II) medical center of the Department; 
and
``(III) month.
``(iii) A comparison of the average wait time for 
appointments scheduled through the electronic process 
and through non-electronic methods, disaggregated by 
medical center of the Department.
``(iv) The rates at which veterans cancelled 
appointments scheduled through the electronic process.
``(v) The rates at which veterans did not appear 
for appointments scheduled through the electronic 
process.''.
(2) Implementation.--
(A) Date.--The Secretary of Veterans Affairs shall 
implement the electronic process under subsection (d) 
of section 1703H of such title, as added by this 
section, not later than two years after the date of the 
enactment of this Act.
(B) Guidelines.--Not later than 90 days after the 
date of the enactment of this Act, the Secretary of 
Veterans Affairs shall establish guidelines. Such 
guidelines shall include the following:
(i) Procedures for schedulers and other 
employees of the Department involved in the 
scheduling of appointments described in such 
section.
(ii) A directive that employees described 
in clause (i) use the electronic process to the 
extent practicable.
(iii) A directive that employees described 
in clause (i), when scheduling an appointment 
for a covered veteran (as such term is used in 
section 1703 of such title) for health care 
furnished by the Secretary, inform such covered 
veteran of available appointments though 
providers of the Department and through 
providers under the Veterans Community Care 
Program when eligible.
(iv) Procedures for engaging with non-
Department health care providers in specialized 
cases.
(v) Standards regarding timeliness and 
accuracy.
(vi) Escalation protocols for scheduling 
failures or delays.
(C) Training.--Not later than 180 days after the 
date of the enactment of this Act, the Secretary shall 
implement a mandatory training program for employees 
described in subparagraph (B) regarding the guidelines 
under subparagraph (B).
(D) Evaluation.--Not later than 60 days after the 
date of the enactment of this Act, the Secretary shall 
prescribe performance benchmarks and outcome-based 
metrics for the electronic process under such section, 
including--
(i) time between a referral and a scheduled 
appointment;
(ii) patient satisfaction; and
(iii) the percentage of appointments 
scheduled exclusively through the electronic 
process.
(E) Outreach.--Not later than 90 days after the 
date of the enactment of this Act, 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 subsection. Such outreach shall--
(i) include contacting each such provider 
during such 90 days;
(ii) include seeking to enter into an 
agreement with each such provider under which 
the provider shall participate in the 
electronic process;
(iii) include collaborating with State 
hospital associations and rural health 
associations to promote such participation;
(iv) focus on providers in specialties or 
underserved areas, as determined by the 
Secretary; and
(v) include the publication, on a publicly 
accessible website of the Department, of 
information regarding--
(I) details of the electronic 
process;
(II) how a provider may elect to 
participate in the electronic process; 
and
(III) a point of contact in the 
Department regarding the electronic 
process.
(F) Oversight.--The Secretary shall submit to the 
Committees on Veterans' Affairs of the Senate and House 
of Representatives, with regards to the electronic 
process under such subsection, the following:
(i) Not later than 30 days after the 
Secretary establishes guidelines under 
subparagraph (B) of this paragraph, a copy of 
such guidelines.
(ii) Not later than 30 days after the 
Secretary formulates the plan under 
subparagraph (E) of this paragraph, a briefing 
on the outreach strategy under such paragraph.
(iii) Not later than 180 days after the 
date of the enactment of this Act, the 
benchmarks and metrics prescribed under 
subparagraph (D).
(3) Expansion.--Not later than 90 days after the date of 
the enactment of this Act, 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 (d) of section 1703H of 
such title. Such plan shall include the following elements:
(A) A timeline to implement such plan.
(B) Estimated costs to carry out such plan.
(C) Changes to policies and procedures of the 
Department the Secretary determines necessary to 
implement such plan.
(4) Codification.--
(A) In general.--Section 3101 of such Act, as 
amended by paragraph (1), is transferred to subchapter 
I of chapter 17 of title 38, United States Code, 
inserted after section 1703G, and redesignated as 
section 1703H.
(B) Conforming amendments.--Section 1703H of such 
title, as transferred and redesignated by this 
subsection, is amended--
(i) by striking any heading that is not a 
section heading or subsection heading and 
conforming the margins accordingly;
(ii) by striking ``of title 38, United 
States Code'' both places it appears and 
inserting ``of this title'';
(iii) in subsection (b)(1), by striking 
``Not later than one year after the date of the 
enactment of this Act, the Secretary'' and 
inserting ``The Secretary'';
(iv) in subsection (c)--
(I) in paragraph (1), in the matter 
preceding subparagraph (A), by striking 
``Not later than 180 days after the 
date of the enactment of this Act, the 
Secretary'' and inserting ``The 
Secretary''; and
(II) in paragraph (2), by striking 
subparagraphs (A) and (B) and inserting 
``The Secretary shall require each 
medical facility of the Department to 
use the method or tool described in 
paragraph (1).'';
(v) in the section enumerator, by striking 
``sec.'' and inserting ``Sec. ''; and
(vi) in the section heading--
(I) by striking ``process and 
requirements for scheduling 
appointments for health care from 
department of veterans affairs and non-
department health care.'' and inserting 
``scheduling of appointments''; and
(II) by conforming the typeface and 
typestyle, including capitalization, to 
the typeface and typestyle used in the 
section heading of section 1703G of 
such title.
(C) Table of sections.--The table of sections at 
the beginning of such chapter is amended by inserting, 
after the item relating to section 1703G, the following 
new item:

``1703H. Scheduling of appointments.''.

TITLE V--MEMORIAL AFFAIRS

SEC. 501. EXPANSION OF ELIGIBILITY FOR DEPARTMENT OF VETERANS AFFAIRS 
MEMORIAL HEADSTONE OR MARKER FOR CERTAIN INDIVIDUALS.

Section 2306(b)(2) of title 38, United States Code, is amended in 
subparagraphs (B) and (C) by striking ``who dies on or after November 
11, 1998,'' each place it appears.

SEC. 502. DEPARTMENT OF VETERANS AFFAIRS PROVISION OF ADDITIONAL BURIAL 
BENEFITS WHEN AN URN OR COMMEMORATIVE PLAQUE IS 
FURNISHED.

(a) In General.--Paragraph (2) of section 2306(h) of title 38, 
United States Code, is amended to read as follows:
``(2) If the Secretary furnishes an urn or commemorative plaque for 
an individual under paragraph (1), the Secretary may not provide for 
such individual a headstone or marker under this section, or any 
interment benefit under section 2402 of this title, unless--
``(A) in the case of a request for a headstone or marker 
under this section--
``(i) 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 cemetery, a 
veterans' cemetery in receipt of a grant made under 
section 2408 of this title, or a post cemetery; and
``(ii) the Secretary furnishes one headstone or 
marker inscribed for both individuals; or
``(B) in the case of a request for interment, 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 2402(a) of this 
title.''.
(b) Applicability.--The amendment made by subsection (a) shall 
apply with respect to an individual who dies on or after January 5, 
2021.

SEC. 503. FALLEN SERVICEMEMBERS RELIGIOUS HERITAGE RESTORATION PROGRAM.

(a) Findings.--Congress finds the following:
(1) An estimated 900 American-Jewish servicemembers of the 
Armed Forces, killed in World War I and World War II and buried 
overseas in United States military cemeteries were, for various 
reasons, mistakenly buried under Latin Crosses. In most 
instances, those mistakes were made inadvertently.
(2) In 2022, more than 2,000,000 people visited the United 
States World War I and World War II cemeteries in foreign 
countries.
(3) American-Jewish servicemembers played a vital role in 
the Allied victories in World War I and World War II.
(4) American-Jewish servicemembers who fought and died for 
the United States must have their heritage properly recognized 
and honored.
(5) The United States Government has a solemn 
responsibility to ensure that every American servicemember 
killed in action and buried overseas is properly honored.
(6) 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 corrected.
(b) Fallen Servicemembers Religious Heritage Restoration Program.--
(1) Establishment.--The American Battle Monuments 
Commission shall establish a program to identify covered 
members and to contact survivors and descendants of such 
covered members. Such program shall be known as the ``Fallen 
Servicemembers Religious Heritage Restoration Program''.
(2) 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 Act.
(3) Contracts.--
(A) Authority.--During each fiscal year described 
in subsection (b), 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 (a).
(B) Term; amount.--Each contract under this 
subsection shall be for one year and in the amount of 
$500,000 to the nonprofit organization.
(C) Priority.--In awarding a contract under this 
subsection, the Commission shall give priority to a 
nonprofit organization that has demonstrated capability 
and expertise in carrying out the purpose described in 
subsection (a).
(4) Definitions.--In this section:
(A) The term ``covered member'' means a deceased 
member of the Armed Forces who was Jewish and buried--
(i) in a United States military cemetery 
located outside the United States; and
(ii) under a marker that indicates such 
member was not Jewish.
(B) The term ``nonprofit organization'' means an 
organization described in section 501(c)(3) of the 
Internal Revenue Code of 1986 and exempt from taxation 
under section 501(a) of such Code.

TITLE VI--VETERANS' ASSURING CRITICAL CARE EXPANSIONS TO SUPPORT 
SERVICEMEMBERS

Subtitle A--Improvement of Veterans Community Care Program

SEC. 601. CODIFICATION OF REQUIREMENTS FOR ELIGIBILITY STANDARDS FOR 
ACCESS TO COMMUNITY CARE FROM DEPARTMENT OF VETERANS 
AFFAIRS.

(a) Eligibility Access Standards.--Section 1703B of title 38, 
United States Code, is amended--
(1) by striking subsections (a) through (e) and inserting 
the following:
``(a) Access Standards for Community Care.--(1) For purposes of 
section 1703(d)(1)(D) of this title, the eligibility access standards 
for hospital care, medical services, or non-institutional extended care 
services, are as follows:
``(A) With respect to primary care, mental health care, or 
non-institutional extended care services, the Secretary must 
schedule an appointment for the covered veteran with a health 
care provider of the Department who can provide the needed 
service--
``(i) within 30 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 
veteran; and
``(ii) within 20 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 veteran.
``(B) With respect to specialty care, the Secretary must 
schedule an appointment for the covered veteran with a health 
care provider of the Department who can provide the needed 
service--
``(i) within 60 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 
veteran; and
``(ii) within 28 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 veteran.
``(C) With respect to a covered treatment program, the 
Secretary must--
``(i) provide to a covered veteran a screening not 
later than 48 hours after the date on which the 
veteran, or a relevant health care provider, makes a 
documented request for the veteran to be admitted to a 
covered treatment program; and
``(ii) if the veteran is determined eligible for 
priority admission to a covered treatment program--
``(I) admit the veteran to a covered 
treatment program not later than 48 hours after 
the date of such determination or give the 
veteran the option of seeking care at a non-
Department facility pursuant to section 1792(e) 
of this title; or
``(II) give the veteran the option of 
seeking care at a non-Department facility 
pursuant to section 1792(e) of this title.
``(2) 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 (1), the Secretary shall not 
take into consideration the availability of telehealth appointments 
from the Department.
``(3) 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 scheduled, in calculating a 
wait time for a subsequent appointment under the eligibility access 
standards established under paragraph (1), the Secretary shall 
calculate such wait time from the date of the request for the original, 
canceled appointment.
``(4) If a veteran agrees to a longer average drive time or a later 
date under paragraph (1), 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 
documentation. Such copy may be provided electronically.
``(5) Paragraph (1)(C) 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 Act.
``(6)(A) Subject to the provisions of this paragraph, subparagraphs 
(A) and (B) of paragraph (1) shall terminate on the date that is eight 
years after the date of the enactment of the Take Care of America's 
Veterans Act.
``(B) Not later than seven years after the date of the enactment of 
the Take Care of America's Veterans Act, 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--
``(i) an assessment of the effects of the codification of 
eligibility access standards for primary care, mental health 
care, non-institutional extended care services, and specialty 
care under this subsection on the management and oversight of 
the Veterans Community Care Program under section 1703 of this 
title; and
``(ii) the recommendation of the Secretary for continued 
codification of such standards along with a justification for 
such recommendation.
``(C) On and after the date that is eight years after the date of 
the enactment of the Take Care of America's Veterans Act, the Secretary 
may not establish access standards for care and services described in 
subparagraph (A) or (B) of paragraph (1) that are different from the 
standards set forth in those subparagraphs unless, not later than 180 
days before establishing such different standards--
``(i) 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 standards, including a 
description of the changes the Secretary intends to make and 
the justification for such changes; and
``(ii) a joint resolution of approval is enacted that 
approves such different standards.
``(D) For purposes of this subsection, the term `joint resolution 
of approval' means only a joint resolution the matter after the 
resolving clause of which is as follows: `That Congress approves the 
access standards established by the Secretary submitted on __ relating 
to __.', with the first blank space filled by the appropriate date and 
the second blank space filled with a description of the access 
standards.
``(E) A joint resolution of approval shall be considered under the 
expedited procedures outlined in section 802 of title 5 to the same 
extent as a joint resolution described in subsection (a) of that 
section is considered.
``(b) Application.--The Secretary shall ensure that the eligibility 
access standards established under subsection (a) apply--
``(1) to all care and services within the medical benefits 
package of the Department to which a covered veteran is 
eligible under section 1703 of this title; and
``(2) to all covered veterans, regardless of whether a 
veteran is a new or established patient.
``(c) Periodic Review of Access Standards.--(1) Not later than 
three years after the date of the enactment of the Take Care of 
America's Veterans Act, and not less frequently than once every three 
years thereafter, the Secretary shall--
``(A) conduct a review of the eligibility access standards 
under subsection (a) in consultation with--
``(i) such Federal entities as the Secretary 
considers appropriate, including the Department of 
Defense, the Department of Health and Human Services, 
and the Centers for Medicare & Medicaid Services;
``(ii) entities and individuals in the private 
sector, including--
``(I) veteran patients;
``(II) representatives of veterans, 
including individual veterans and participants 
from veteran stakeholder organizations selected 
through an open and transparent process; and
``(III) health care providers participating 
in the Veterans Community Care Program under 
section 1703 of this title; and
``(iii) other entities that are not part of the 
Federal Government; and
``(B) submit to the appropriate committees of Congress a 
report on--
``(i) the findings of the Secretary with respect to 
the review conducted under paragraph (1); and
``(ii) such recommendations as the Secretary may 
have with respect to the eligibility access standards 
under subsection (a).
``(2) Chapter 10 of title 5 shall not apply to the consultation 
required by paragraph (1)(A).'';
(2) by striking subsection (g);
(3) by redesignating subsections (f), (h), and (i) as 
subsections (d), (e), and (f), respectively;
(4) in subsection (d), as redesignated by paragraph (3)--
(A) by striking ``established'' each place it 
appears; and
(B) in paragraph (1), by striking ``(1) Subject 
to'' and inserting ``Compliance by Community Care 
Providers With Access Standards.--(1) Subject to'';
(5) in subsection (e), as so redesignated--
(A) in paragraph (1)--
(i) by striking ``(1) Consistent with'' and 
inserting ``Determination Regarding 
Eligibility.--(1) Consistent with''; and
(ii) by striking ``designated access 
standards established under this section'' and 
inserting ``eligibility access standards under 
subsection (a)''; and
(B) in paragraph (2)(B), by striking ``designated 
access standards established under this section'' and 
inserting ``eligibility access standards under 
subsection (a)''; and
(6) in subsection (f), as redesignated by paragraph (2)--
(A) in the matter preceding paragraph (1), by 
striking ``In this section'' and inserting 
``Definitions.--In this section''; and
(B) in paragraph (2)--
(i) by striking ``covered veterans'' and 
inserting ``covered veteran'';
(ii) by striking ``veterans described'' and 
inserting ``a veteran described'';
(iii) by redesignating paragraphs (3) and 
(4) as paragraphs (4) and (5), respectively; 
and
(iv) by inserting after paragraph (2) the 
following new paragraph (3):
``(3) The term `covered treatment program' has the meaning 
given such term in section 1791 of this title.''.
(b) Conforming Amendments.--Section 1703(d) of such title is 
amended--
(1) in paragraph (1)(D), by striking ``designated access 
standards developed by the Secretary under section 1703B of 
this title'' and inserting ``eligibility access standards under 
section 1703B(a) of this title'';
(2) in paragraph (3), by striking ``designated access 
standards developed by the Secretary under section 1703B of 
this title'' and inserting ``eligibility access standards under 
section 1703B(a) of this title''; and
(3) in paragraph (4), by striking ``designated access 
standards developed by the Secretary under section 1703B of 
this title'' and inserting ``eligibility access standards under 
section 1703B(a) of this title''.

SEC. 602. REQUIREMENT THAT SECRETARY NOTIFY VETERANS OF ELIGIBILITY FOR 
CARE OR DENIAL OF REQUEST FOR CARE UNDER VETERANS 
COMMUNITY CARE PROGRAM.

(a) In General.--Section 1703(a) of title 38, United States Code, 
is amended by adding at the end the following new paragraph:
``(5)(A)(i) Except as provided in clause (iii), 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 section.
``(ii) The Secretary is required to notify a covered veteran under 
clause (i) only at the start of an episode of care for such veteran.
``(iii) The Secretary shall allow a covered veteran to opt out of 
receiving notification under clause (i).
``(B) With respect to each covered veteran eligible for care or 
services under subsection (d), and consistent with subparagraph (A), 
the Secretary shall provide such veteran periodic reminders, as 
applicable and as the Secretary determines appropriate, of their 
ongoing eligibility under such subsection.
``(C) Any notification or reminder under this paragraph may be 
provided electronically.
``(6)(A) If a request by a veteran for the Secretary to authorize 
care or services under this section is denied, except as provided in 
subparagraph (C), the Secretary shall notify the veteran in writing as 
soon as possible but not later than five days after the denial is 
made--
``(i) of the reason for the denial; and
``(ii) with instructions on how to appeal such denial using 
the clinical appeals process of the Veterans Health 
Administration.
``(B) If a denial under subparagraph (A) is due to the Secretary 
meeting the eligibility access standards under section 1703B(a) of this 
title, notice under such subparagraph shall include an explanation of 
how the Secretary met such standards.
``(C) The Secretary shall allow a covered veteran to opt out of 
receiving notification under subparagraph (A).
``(D) Any notification under this paragraph may be provided 
electronically.''.
(b) Reports to Congress.-- Not later than one year after the date 
of the enactment of this Act, and not less frequently than annually 
thereafter for a period of five years, 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 (a), including--
(1) an assessment of the timeliness of the notifications 
required by those amendments;
(2) a description of barriers to increasing the timeliness 
of those notifications; and
(3) the number of veterans who opt out of receiving those 
notifications.

SEC. 603. CONSIDERATION UNDER VETERANS COMMUNITY CARE PROGRAM OF 
CONTINUITY OF CARE AND NEED FOR CAREGIVER OR ATTENDANT.

Section 1703(d) of title 38, United States Code, is amended--
(1) in paragraph (2), by adding at the end the following 
new subparagraphs:
``(F) The potential for improved continuity of care, 
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 care, including if the 
veteran would abstain from seeking such care if required to 
seek such care at a facility of the Department.
``(G) Whether the covered veteran needs an attendant to 
provide required aid or assistance to the veteran, including 
for the veteran to travel to a facility of the Department.''; 
and
(2) by adding at the end the following new paragraph:
``(5) The Secretary shall ensure that consideration of the factors 
specified in paragraph (2) includes consideration of all relevant 
factors, is driven by clinical need, and that no single factor is 
required to be determinative when considering the best medical interest 
of a covered veteran.''.

SEC. 604. DISCUSSION OF TELEHEALTH OPTIONS UNDER VETERANS COMMUNITY 
CARE PROGRAM.

Section 1703 of title 38, United States Code, is amended--
(1) by redesignating subsection (q) as subsection (r); and
(2) by inserting after subsection (p) the following new 
subsection (q):
``(q) Discussion of Options for Telehealth.--(1) When discussing 
options for care or services for a covered veteran under this section, 
the Secretary shall ensure that the veteran is informed of the ability 
of the veteran to seek care or services via telehealth, either through 
a medical facility of the Department or through a non-Department 
provider, if--
``(A) telehealth is--
``(i) available to the veteran;
``(ii) appropriate for the type of care or services 
the veteran is seeking, as determined by the Secretary; 
and
``(iii) is acceptable to the veteran; or
``(B) the care or services the veteran is seeking is only 
or primarily available through telehealth.
``(2) Nothing in paragraph (1) shall be construed to prohibit a 
health care provider specified in subsection (c) from furnishing 
hospital care, medical services, or extended care services under this 
section via telehealth.''.

SEC. 605. EXTENSION OF DEADLINE FOR SUBMITTAL OF CLAIMS BY HEALTH CARE 
ENTITIES AND PROVIDERS UNDER PROMPT PAYMENT STANDARD.

Section 1703D of title 38, United States Code, is amended--
(1) in subsection (a)(2), by striking ``the reason for 
denying the claim and what, if any, additional information is 
required to process the claim'' and inserting ``the reason for 
denying the claim and request additional missing information, 
if any, that is required to process the claim'';
(2) by amending subsection (b) to read as follows:
``(b) Submittal of Claims by Health Care Entities and Providers.--
(1) A health care entity or provider that furnishes hospital care, a 
medical service, or an extended care services under this chapter 
pursuant to a contract, agreement, or other arrangement shall submit to 
the Secretary a claim for payment for furnishing the hospital care, 
medical service, or extended care service not later than one year after 
the date on which the entity or provider furnished the hospital care, 
medical service, or extended care service.
``(2) 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 (1).''; and
(3) in subsection (c), by adding at the end the following 
new paragraph:
``(3)(A) If the Secretary determines, based on reliable evidence, 
that a health care entity or provider has submitted or caused to be 
submitted a fraudulent claim for payment under this chapter, the 
Secretary may suspend such entity or provider from furnishing hospital 
care, medical services, or extended care services under this chapter.
``(B) Before imposing a suspension under subparagraph (A) with 
respect to an entity or provider, the Secretary shall--
``(i) provide written notice to the entity or provider 
identifying the basis for the proposed suspension;
``(ii) afford the entity or provider an opportunity to 
respond within a period of 30 days; and
``(iii) consider any evidence or explanation submitted by 
the entity or provider.
``(C)(i) The Secretary shall take all necessary actions to resolve 
a suspension under subparagraph (A) as soon as possible but not longer 
than within one year of the date of the beginning of the suspension, 
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 Department.
``(ii) Any extension under clause (i) of a suspension shall--
``(I) be for an additional period of not longer than one 
year; and
``(II) shall be reported to the Committee on Veterans' 
Affairs of the Senate and the Committee on Veterans' Affairs of 
the House of Representatives.
``(D) The Secretary shall establish procedures for reinstatement of 
an entity or provider suspended under subparagraph (A) following the 
resolution of any fraud-related investigation or proceeding.
``(E) The Secretary shall coordinate actions under this paragraph 
with the Office of Inspector General of the Department.
``(F) The Secretary shall prescribe regulations to carry out this 
paragraph, including standards of evidence, notice, and appeal 
procedures.
``(G)(i) Not less frequently than quarterly, 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 into, if any, during 
the preceding quarter that includes--
``(I) the identity of the suspended entity or provider;
``(II) the statutory or regulatory basis for the 
suspension;
``(III) a summary of the factual findings or evidence 
supporting the action; and
``(IV) the status of any related investigation of or 
referral to the Office of Inspector General of the Department 
or any other appropriate Federal agency.
``(ii) The Secretary shall provide to the Committee on Veterans' 
Affairs of the Senate and the Committee on Veterans' Affairs of the 
House of Representatives, upon request, all records, memoranda, and 
communications relevant to any suspension or reinstatement action taken 
under this paragraph, in accordance with applicable laws related to 
privacy, ongoing investigations, or sensitive law enforcement 
information.
``(iii) Failure by the Secretary to provide notice under clause (i) 
shall be treated as a failure to comply with a statutory reporting 
requirement.''.

SEC. 606. 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 
Act, and not less frequently than annually thereafter for the following 
five years, the Secretary of Veterans Affairs shall--
(1) conduct an audit, for the one-year period preceding the 
audit, of--
(A) the number of veterans eligible for care or 
services under section 1703 of title 38, United States 
Code, and the reasons for such eligibility, including 
multiple such reasons for veterans eligible under more 
than one eligibility criteria;
(B) of those veterans eligible for care or services 
under section 1703 of title 38, United States Code, the 
number of veterans who are informed of such 
eligibility;
(C) the number of veterans who opt to seek care or 
services under such section;
(D) the number of veterans who do not opt to seek 
care or services under such section;
(E) the timeliness of referrals for care or 
services under such section and the timeliness of 
receipt of such care or services, 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 Department;
(F) 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 
Administration;
(G) the timeliness of each such appeal; and
(H) the outcome of each such appeal; and
(2) 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 
(1).

SEC. 607. INFORMATION ON WAIT TIME AND DRIVE TIME OPTIONS FOR RECEIPT 
OF CARE BY VETERANS.

(a) In General.--To the greatest extent practicable, the Secretary 
of Veterans Affairs shall ensure that veterans are informed in writing, 
for each episode of care provided under the laws administered by the 
Secretary, of current wait time and average drive time options for such 
episode of care disaggregated by care provided--
(1) in person at a facility of the Department of Veterans 
Affairs;
(2) via telehealth through a provider of the Department.
(3) 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 
1703 of title 38, United States Code; and
(4) 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 time.
(b) Form of Information.--Information provided under subsection 
(a)--
(1) may be provided electronically; and
(2) shall be documented in the health record of the 
veteran.
(c) Opt Out.--The Secretary shall permit a veteran to opt out of 
receiving information under subsection (a).

SEC. 608. ESTABLISHMENT OF PERIOD DURING WHICH A REFERRAL UNDER 
VETERANS COMMUNITY CARE PROGRAM REMAINS VALID.

Section 1703(a) of title 38, United States Code, as amended by 
section 602(a), is further amended by adding at the end the following 
new paragraph:
``(7) When authorizing care or services under this section, the 
Secretary shall ensure that the period during which such care or 
services may be performed by a health care provider specified in 
subsection (c) begins on the date that the covered veteran has the 
first appointment with such provider.''.

SEC. 609. UPDATES TO CONTRACTING REQUIREMENTS UNDER VETERANS COMMUNITY 
CARE PROGRAM.

Section 1703(h) of title 38, United States Code, is amended--
(1) in paragraph (3)--
(A) by amending subparagraph (A) to read as 
follows:
``(A) The Secretary may terminate a contract with an entity entered 
into under paragraph (1) at such time and upon such notice to the 
entity as the Secretary may specify for purposes of this section, if 
the Secretary notifies the appropriate committees of Congress that, at 
a minimum--
``(i) 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 section, 
including with respect to access, quality, training, and 
medical documentation;
``(ii) it is reasonable to terminate the contract based on 
the health care needs of veterans; or
``(iii) it is reasonable to terminate the contract based on 
coverage provided by contracts or sharing agreements entered 
into under authorities other than this section.'';
(B) by redesignating subparagraph (B) as 
subparagraph (D);
(C) by inserting after subparagraph (A) the 
following new subparagraphs:
``(B)(i) The Secretary shall terminate a contract with an entity 
entered into under paragraph (1) at such a time and upon such notice to 
the entity as the Secretary may specify for the purposes of this 
section, if the entity--
``(I) is excluded from participation in a Federal health 
care program (as defined in section 1128B(f) of the Social 
Security Act (42 U.S.C. 1320a-7b(f))) under section 1128 or 
1128A of the Social Security Act (42 U.S.C. 1320a-7 and 1320a-
7a);
``(II) 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 Department; or
``(III) is identified as an excluded source on the list 
maintained in the System for Award Management, or any successor 
system.
``(ii) The Secretary may issue a waiver for entities subject to 
clause (i) for a one-year period, and such a waiver shall be reported 
to Congress not later than 30 days after such waiver is issued.
``(C) 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 administrator.'';
(D) in subparagraph (D), as redesignated by 
subparagraph (B) of this paragraph, by striking ``in 
subparagraph (A)'' and inserting ``in this paragraph''; 
and
(2) by adding at the end the following new paragraph:
``(7) 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 (c) that is made with respect to 
care or services provided under this section shall include--
``(A) notice of obligations to comply with Federal laws and 
the consequences for failure to comply with those laws, 
including specific information regarding claims for payment and 
consequences for any false claims, statements, or documents, or 
concealment of a material fact;
``(B) 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 services; and
``(C) 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 
Department.''.

SEC. 610. 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 
Act, and not less frequently than annually thereafter, the Secretary of 
Veterans Affairs shall publish on a publicly available and user-
friendly website--
(1) the information contained in the most recent report 
required by section 1703(p) of title 38, United States Code; 
and
(2) an overview, disaggregated by region, of the waivers 
requested, approved, and denied under section 1703B(f)(3) of 
such title.

SEC. 611. REQUIREMENTS RELATING TO QUALITY OF COMMUNITY CARE PROVIDERS.

(a) 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 identifiers.
(b) Revision of Provider Exclusion Standard Operating Procedures.--
Not later than 90 days after the date of the enactment of this Act, 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 identifiers.
(c) Process to Identify Department Providers Terminated or 
Resigning From Employment.--Not later than 90 days after the date of 
the enactment of this Act, 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 terminated, retire, 
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 Program.
(d) Update of Information on Providers.--Not later than one year 
after the date of the enactment of this Act, the Secretary, through the 
Office of Integrated Veteran Care or successor office, shall develop a 
process to ensure that third party administrators regularly, not less 
frequently than quarterly--
(1) update their lists of community care providers to 
reflect accurate provider contact information;
(2) annotate providers that are not currently accepting 
patients under the Veterans Community Care Program; and
(3) remove providers from the provider profile management 
system that--
(A) are on the list of excluded individuals or 
entities set forth by the Office of Inspector General 
of the Department of Health and Human Services;
(B) are in the system for award management 
exclusions of the General Services Administration; or
(C) have been terminated from employment with the 
Department of Veterans Affairs due to quality of care 
concerns or left such employment voluntarily, through 
resignation, or through retirement, while under 
investigation for quality of care concerns.
(e) Definitions.--In this section:
(1) Community care provider.--The term ``community care 
provider'' means a health care provider specified under section 
1703(c) of title 38, United States Code.
(2) Veterans community care program.--The term ``Veterans 
Community Care Program'' means the Veterans Community Care 
Program under section 1703 of title 38, United States Code.

SEC. 612. PROVIDER TRAINING.

(a) Development of Plan.--Not later than 180 days after the date of 
the enactment of this Act, 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 providers, 
residents, and trainees of the Department of Veterans Affairs.
(b) Elements.--The plan required under subsection (a) shall--
(1) identify existing training requirements or incentives 
applicable to health care providers of the Department;
(2) identify existing training requirements or incentives 
applicable to health care trainees or residents of the 
Department;
(3) identify existing training requirements or incentives 
applicable to community care providers;
(4) assess gaps between training requirements and 
incentives for health care providers of the Department, 
trainees or residents of the Department, and community care 
providers;
(5) establish standardized baseline training requirements 
to ensure consistency in the quality of care furnished through 
the Department from health care providers of the Department, 
trainees or residents of the Department, and community care 
providers; and
(6) provide a strategy, assessment of barriers, and 
timeline for implementing such baseline training requirements, 
including--
(A) through online modules and continuing medical 
education programs; and
(B) within such strategy--
(i) metrics to measure the effectiveness of 
baseline training requirements in improving 
clinical quality, satisfaction of veterans, and 
health outcomes for veterans;
(ii) a mechanism to account for non-
Department training that is equivalent or 
substantially similar to the Department 
training in length, scope, and content, as 
determined by the Secretary;
(iii) a mechanism to regularly communicate, 
including through direct outreach and 
publication online and in provider handbooks of 
third party administrators under the Veterans 
Community Care Program, requirements and 
expectations with respect to training;
(iv) a mechanism to track, report, and 
address non-compliance, to include corrective 
actions, which may include suspending or 
barring providers who are routinely non-
compliant; and
(v) 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 Department, as the Secretary considers 
appropriate.
(c) Implementation.--Not later than one year after submission of 
the report required under subsection (d), the Secretary shall begin 
implementing the plan required under subsection (a).
(d) Report to Congress.--Not later than 180 days after the date of 
the enactment of this Act, 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--
(1) the plan required under subsection (a);
(2) a description of identified gaps between training or 
incentives for providers of the Department, trainees or 
residents of the Department, and community care providers;
(3) the estimated costs associated with implementation of 
the plan; and
(4) a description of any legislative or regulatory changes 
necessary to carry out the plan.
(e) Annual Updates.--Not later than one year after the submission 
of the report required by subsection (d), and annually thereafter for 
the following two years, 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--
(1) describing progress in implementing the plan required 
under subsection (a);
(2) assessing any measurable impacts of such implementation 
on quality of care; and
(3) assessing any improvements in rates of compliance with 
training requirements among health care providers, trainees, 
and residents of the Department and community care providers.
(f) Definitions.--In this section:
(1) Community care provider.--The term ``community care 
provider'' means a health care provider specified under section 
1703(c) of title 38, United States Code.
(2) Training.--The term ``training'' includes training 
relating to--
(A) veteran-specific cultural competency;
(B) health conditions related to military service, 
including toxic exposures, post-traumatic stress 
disorder, traumatic brain injury, and military sexual 
trauma;
(C) suicide prevention;
(D) pain management and opioid safety; and
(E) any other matter the Secretary determines 
appropriate.
(3) Veterans community care program.--The term ``Veterans 
Community Care Program'' means the Veterans Community Care 
Program under section 1703 of title 38, United States Code.

SEC. 613. OVERSIGHT AUTHORITY OVER COMMUNITY CARE.

(a) 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 
officials, including the Office of the Inspector General of the 
Department of Veterans Affairs, access, within a reasonable time and 
manner, to records, materials, documents, data, and personnel necessary 
to conduct audits, inspections, evaluations, or investigations related 
to such care or services.
(b) Third Party Administrators.--
(1) 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 
(a).
(2) 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 Program.
(c) Standard Contract Language.--The Secretary shall establish 
standard contract language under this section in consultation with the 
Inspector General of the Department of Veterans Affairs.
(d) Veterans Community Care Program Defined.--In this section, the 
term ``Veterans Community Care Program'' means the Veterans Community 
Care Program under section 1703 of title 38, United States Code.

Subtitle B--Mental Health Treatment Programs

SEC. 621. VETERAN PARTICIPATION IN CERTAIN MENTAL HEALTH PROGRAMS.

(a) Establishment.--Chapter 17 of title 38, United States Code, is 
amended by adding at the end the following new subchapter:

``SUBCHAPTER IX--PARTICIPATION BY VETERANS IN CERTAIN MENTAL HEALTH 
TREATMENT PROGRAMS

``Sec. 1791. Definitions
``In this subchapter:
``(1) Activities of daily living.--The term `activities of 
daily living' means specific personal care activities that are 
required for basic daily maintenance and sustenance, to include 
eating, toileting, bathing, grooming, dressing and undressing, 
and mobility.
``(2) Covered treatment program.--
``(A) In general.--The term `covered treatment 
program'--
``(i) means--
``(I) a mental health residential 
rehabilitation treatment program of the 
Department; or
``(II) a program of the Department 
for residential care for mental health 
and substance use disorders;
``(ii) includes--
``(I) the programs designated as of 
the date of the enactment of the Take 
Care of America's Veterans Act as 
domiciliary residential rehabilitation 
treatment programs; and
``(II) any programs designated as 
domiciliary residential rehabilitation 
treatment programs on or after such 
date of enactment; and
``(iii) does not include--
``(I) Compensated Work Therapy 
Transition Residence programs of the 
Department; or
``(II) Department or non-Department 
programs in which more than 20 percent 
of the care provided is provided 
through telehealth.
``(B) Accreditation.--A program described in 
subparagraph (A) must maintain accreditation by the 
Commission on Accreditation of Rehabilitation 
Facilities and the Joint Commission.
``(3) Covered veteran.--The term `covered veteran' means a 
veteran described in section 1703(b) of this title.
``(4) 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 
Disorder, or any successor similar guidelines.
``(5) Social support systems.--The term `social support 
systems', with respect to a covered veteran--
``(A) means--
``(i) a member of the family of the covered 
veteran, including a parent, spouse, child, 
step-family member, or extended family member; 
or
``(ii) an individual who lives with the 
veteran but is not a member of the family of 
the veteran; and
``(B) does not include a facility-organized peer 
support program.
``Sec. 1792. Standardized process to determine eligibility of covered 
veterans for participation in certain mental health 
treatment programs
``(a) Standardized Screening Process.--Not later than one year 
after the date of the enactment of the Take Care of America's Veterans 
Act, the Secretary shall establish a standardized screening process to 
determine, based on clinical need, whether a covered veteran satisfies 
criteria for priority or routine admission to a covered treatment 
program.
``(b) Eligibility Criteria for Priority Admission.--
``(1) In general.--Under the standardized screening process 
required by subsection (a), 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 following:
``(A) A clinical assessment of the symptoms of the 
veteran, including symptoms that--
``(i) significantly affect activities of 
daily life; and
``(ii) increase the risk of adverse 
outcomes, such as overdose, suicide, self-harm, 
or an unsafe living situation.
``(B) The lack of availability and applicability of 
other treatment options.
``(C) Whether the veteran has a recent suicide or 
overdose attempt.
``(D) Whether the veteran is determined to be a 
high risk for suicide or overdose.
``(E) Whether the veteran has a demonstrated 
history of non-responsiveness, relapse, or inability to 
find recovery from two other completed courses of 
treatment, such as outpatient or intensive outpatient 
treatment, through a program that--
``(i) is licensed by a State;
``(ii) is accredited by the Commission on 
Accreditation of Rehabilitation Facilities or 
the Joint Commission; and
``(iii) provides evidence-based treatment.
``(F) Such other criteria as the Secretary 
determines appropriate, in consultation with Congress.
``(2) Consideration.--In making a determination that a 
covered veteran meets criteria established by the Secretary 
under paragraph (1) for priority admission to a covered 
treatment program, the Secretary shall--
``(A) consider any referral of a health care 
provider of a covered veteran; and
``(B) ensure that consideration of such criteria 
includes consideration of all relevant factors, is 
driven by clinical need, and that no single factor is 
required to be determinative when considering the best 
medical interest of a covered veteran.
``(3) 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 care, 
such as being at a high acute risk for suicide.
``(c) Screening for Traumatic Brain Injury.--Under the standardized 
screening process required by subsection (a), the Secretary shall 
ensure a covered veteran is screened at an appropriate time for 
potential mild, moderate, or severe traumatic brain injury.
``(d) Considerations.--In making placement decisions in a covered 
treatment program for veterans who meet criteria for priority or 
routine admission, the Secretary shall--
``(1) consider the input of the covered veteran with 
respect to the--
``(A) program specialty, subtype, and treatment 
track offered to the covered veteran; and
``(B) geographic placement of the covered veteran, 
including proximity to the current residence, time 
zone, or geographic region of the covered veteran;
``(2) maximize the proximity of the covered veteran to 
social support systems; and
``(3) to the greatest extent practicable, 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 admission.
``(e) Conditions Under Which Care Shall Be Furnished Through Non-
Department Providers.--
``(1) 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 (a) 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 (d) and section 1703B(a)(1)(C) of 
this title, the Secretary shall offer the covered veteran the 
option to receive care at a non-Department facility that--
``(A) can admit the covered veteran within the 
period required by section 1703B(a)(1)(C)(ii)(I) of 
this title;
``(B) 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 facility;
``(C) is licensed by a State;
``(D) is accredited by the Commission on 
Accreditation of Rehabilitation Facilities or the Joint 
Commission; and
``(E) provides evidence-based treatment.
``(2) 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 (a) 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 1703B(a)(1)(C) of this title with 
respect to routine admission, the Secretary shall offer the 
covered veteran the option to receive care at a non-Department 
facility that--
``(A) 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 facility;
``(B) is licensed by a State;
``(C) is accredited by the Commission on 
Accreditation of Rehabilitation Facilities or the Joint 
Commission; and
``(D) provides evidence-based treatment.
``(3) 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 Act.
``Sec. 1793. Improvements to Department of Veterans Affairs mental 
health residential rehabilitation treatment program
``(a) Performance Metrics.--
``(1) In general.--The Secretary shall develop metrics to 
track, and shall subsequently track, the performance of medical 
facilities of the Department, Veterans Integrated Service 
Networks, and non-Department facilities in meeting the 
requirements for--
``(A) screening, under section 1792 of this title, 
for a covered treatment program;
``(B) timely admission, under section 1792 of this 
title, to a covered treatment program pursuant to such 
screening; and
``(C) 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 programs, or 
made of professionals who provide for such programs, 
including by--
``(i) using placement criteria established 
by the American Society of Addiction Medicine; 
and
``(ii) maintaining standards to meet 
accreditation by the Commission on 
Accreditation of Rehabilitation Facilities or 
the Joint Commission.
``(2) Elements.--The metrics developed under paragraph (1) 
shall include metrics for tracking the performance of medical 
facilities of the Department, Veterans Integrated Service 
Networks, and non-Department facilities with respect to routine 
and priority admission under a covered treatment program as 
well as adherence to evidence-based treatment standards.
``(3) Consultation.--In developing metrics under paragraph 
(1), the Secretary shall consult with mental health and 
substance use disorder providers, including providers employed 
by the Department and those employed by non-Department 
entities, and ensure adherence to industry standards.
``(4) Report.--Not later than one year after the date of 
the enactment of the Take Care of America's Veterans Act, 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 subsection.
``(b) Oversight.--
``(1) In general.--The Secretary shall develop a process 
for systematically assessing at the facility, network, and 
regional level, as the Secretary considers appropriate, 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 
concerns.
``(2) Elements.--The processes required under paragraph (1) 
shall include assessments of--
``(A) the extent to which providers at the facility 
deliver evidence-based treatments to covered veterans;
``(B) clinical outcomes for covered veterans, 
including those outcomes assessment pursuant to a 
subsequent clinical screening under subsection 
(g)(3)(E);
``(C) the ratio of licensed independent 
practitioners per resident;
``(D) the rate of completion of training under 
section 1795 of this title by licensed independent 
practitioners;
``(E) whether non-Department facilities and 
providers generally meet the criteria outlined in 
section 1792(e) of this title;
``(F) the timeliness, completeness, and rate of 
transmission, if applicable, of medical records during 
and following treatment of covered veterans; and
``(G) potentially wasteful, fraudulent, or 
inappropriate referral or billing practices.
``(3) Consultation.--In developing the processes required 
under paragraph (1), the Secretary shall consult with relevant 
stakeholders, including mental health and substance use 
disorder providers employed by the Department and those 
employed by non-Department entities, and ensure adherence to 
industry standards.
``(4) Report.--Not later than one year after the date of 
the enactment of the Take Care of America's Veterans Act, 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 subsection.
``(c) Placement; Transportation.--
``(1) Locations.--If the Secretary determines that a 
covered veteran is in need of residential care under a covered 
treatment program, the Secretary shall provide to the covered 
veteran a list of locations at which such covered veteran can 
receive such residential care that meets--
``(A) the standards for screening under section 
1792 of this title; and
``(B) the care needs of the covered veteran, 
including applicable treatment tracks.
``(2) Transportation coverage.--
``(A) In general.--Notwithstanding any other 
provision of law regarding the transportation of 
individuals under this title, or any other law 
administered by the Secretary, and except as provided 
in subparagraph (B), the Secretary shall provide 
transportation, pay for, or reimburse the costs of 
transportation for any covered veteran who is admitted 
into a covered treatment program and needs 
transportation assistance--
``(i) 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 program; and
``(ii) 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 program, if 
applicable.
``(B) Limitations.--
``(i) Costs incurred by veterans.--The 
Secretary shall provide reimbursement under 
subparagraph (A) directly to a covered veteran 
only for costs directly incurred by the covered 
veteran and pre-approved by the Department.
``(ii) 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 program, unless 
for a purpose and amount approved by the 
Secretary.
``(d) Appeals.--
``(1) In general.--The Secretary shall develop a national 
policy and associated procedures, in accordance with the 
existing clinical appeals process of the Veterans Health 
Administration, under which a covered veteran, a representative 
of a covered veteran, or a provider who requests a covered 
veteran be admitted to a covered treatment program, including a 
provider of the Department or a non-Department provider, may 
file a clinical appeal pursuant to this subsection if the 
covered veteran is--
``(A) denied admission into a covered treatment 
program; or
``(B) accepted into a covered treatment program but 
is not offered bed placement in a timely manner.
``(2) Timeliness standards for review.--
``(A) In general.--The national policy and 
procedures developed under paragraph (1) for appeals 
described in such paragraph shall include timeliness 
standards for the Department to review and make a 
decision on such an appeal.
``(B) Decision.--The Secretary shall review and 
respond to any appeal under paragraph (1) not later 
than 72 hours after the Secretary receives such appeal.
``(3) Public guidance.--The Secretary shall develop, and 
make available to the public, guidance on how a covered 
veteran, a representative of the covered veteran, or a provider 
of the covered veteran can file a clinical appeal pursuant to 
this subsection--
``(A) if the covered veteran is denied admission 
into a covered treatment program;
``(B) 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 1703B(a) of this title for care at a covered 
treatment program; or
``(C) with respect to such other factors as the 
Secretary may specify.
``(4) Rule of construction.--Nothing in this subsection may 
be construed as granting a covered veteran, a representative of 
a covered veteran, or a provider who requests a covered veteran 
be admitted to a covered treatment program, including a 
provider of the Department or a non-Department provider, 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 71 of this title.
``(e) Tracking of Availability and Wait Times.--
``(1) In general.--The Secretary, to the extent 
practicable, shall create a method for tracking availability 
and wait times under a covered treatment program across all 
facilities of the Department, Veterans Integrated Service 
Networks, and non-Department providers throughout the United 
States.
``(2) Availability of information.--The Secretary shall 
make the information tracked under paragraph (1) available, in 
real time to--
``(A) the mental health treatment coordinators at 
each facility of the Department;
``(B) the leadership of each medical center of the 
Department;
``(C) the leadership of each Veterans Integrated 
Service Network; and
``(D) the Office of the Under Secretary for Health 
of the Department.
``(3) Publication of information.--Not less frequently than 
monthly, the Secretary shall publish the information tracked 
under paragraph (1) on a publicly accessible website of the 
Department.
``(f) Staffing Matters.--
``(1) Training.--
``(A) In general.--The Secretary shall update and 
implement training for staff of the Department directly 
involved in a covered treatment program regarding 
referrals, screening, admission, placement decisions, 
and appeals for such program, including all changes to 
processes and guidance under such program required by 
this section and section 1792.
``(B) Covered veterans awaiting admission.--The 
training under subparagraph (A) 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 veterans.
``(C) Timing of training.--
``(i) In general.--The Secretary shall 
require the training under subparagraph (A) to 
be completed by staff required to complete such 
training--
``(I) not later than 60 days after 
beginning employment at the Department 
in a position that includes work 
directly involving a covered treatment 
program; and
``(II) not less frequently than 
annually.
``(ii) Tracking.--The Secretary shall track 
completion of training required under clause 
(i) by staff required to complete such 
training.
``(2) 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 program.
``(3) Staff coverage.--The Secretary shall not require 
staff of a covered treatment program to act as coverage for any 
other team, service, 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 declaration.
``(g) Care Coordination and Follow-up Care.--
``(1) Continuity of care.--The Secretary shall ensure each 
covered veteran who is screened for admission to a covered 
treatment program is offered, and provided if agreed upon, 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 
care.
``(2) Care coordination for substance use disorder.--For a 
covered veteran being treated for substance use disorder, the 
Secretary shall--
``(A) 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 
program; and
``(B) communicate that care plan to the covered 
veteran, the primary care provider of the covered 
veteran, and the facility where the covered veteran is 
or will be residing under such program.
``(3) Care planning and clinical screening.--
``(A) In general.--A covered treatment program, in 
consultation with the covered veteran and the treating 
providers of the covered veteran in the covered 
treatment program, 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 program, which shall include 
an assessment of, with respect to the covered veteran--
``(i) overall mental health;
``(ii) risk for suicide;
``(iii) risk for overdose;
``(iv) housing insecurity;
``(v) food insecurity;
``(vi) employment;
``(vii) complex medical needs and 
diagnoses; and
``(viii) any other factors the Secretary 
determines necessary.
``(B) Matters to be included.--The care plan 
required under subparagraph (A) for a covered veteran 
shall include details on the course of treatment for 
the covered veteran following completion of treatment 
under the covered treatment program, including 
recommended length of stay and any necessary follow-up 
care and the results of any screening conducted under 
such subparagraph.
``(C) Length of stay.--
``(i) In general.--Covered treatment 
programs at non-Department facilities shall 
submit the care plan under subparagraph (A) for 
a covered veteran, including the requested or 
recommended length of stay for the covered 
veteran, to the Department not later than 72 
hours after the veteran is admitted to the 
covered treatment program.
``(ii) Approval required.--Any length of 
stay of a covered veteran at a covered 
treatment program longer than 30 days or 
extensions of length of stay greater than a 
total of 30 days shall require approval by the 
Secretary. The Secretary shall respond to any 
such requests for approval within 72 hours. Any 
such requests that have not received a response 
within 72 hours shall be automatically approved 
on a daily basis until the Secretary responds.
``(D) Sharing of care plan.--The care plan required 
under subparagraph (A) shall be shared with the covered 
veteran, the primary care provider of the covered 
veteran, and any other providers with which the covered 
veteran consents to sharing the plan.
``(E) Discharge from non-department facility.--Upon 
discharge of a covered veteran under a covered 
treatment program from a non-Department facility, and 
not later than 30 days after discharge, 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 (A).
``(F) Subsequent clinical screening.--Not later 
than 180 days after the end of treatment of a covered 
veteran in a covered treatment program, the covered 
treatment program or a Department or non-Department 
provider shall conduct a subsequent clinical screening, 
which shall include an assessment of the factors 
specified in clauses (i) through (viii) of subparagraph 
(A) and recommendations for follow-up care as the 
Secretary considers appropriate.
``(G) Complex medical needs.--Before, during, and 
after treatment in a covered treatment program, the 
Secretary shall provide greater engagement, 
coordination, and monitoring of care for covered 
veterans with--
``(i) complex medical diagnoses, including 
diagnoses of dementia, spinal cord injury or 
disorder, epilepsy, Parkinson's, anemia, severe 
mental illness, multiple sclerosis, 
incontinence of the bladder or bowel, mobility 
limitations, or impaired vision; or
``(ii) complex medical needs, including 
chemotherapy or other oncology care, dialysis, 
recurring blood transfusions, or physical or 
occupational therapy.
``(h) Data Collection.--The Secretary shall consult with the Office 
of Research and Development of the Department, or any successor office, 
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 programs.
``(i) Reports to Congress.--
``(1) Report on modifications to programs.--
``(A) In general.--Not later than two years after 
the date of the enactment of the Take Care of America's 
Veterans Act, 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 
guidance, operation, and oversight of covered treatment 
programs to fulfill the requirements of this section.
``(B) Elements.--The report required by 
subparagraph (A) shall include--
``(i) an assessment of whether costs of 
covered treatment programs, including for 
residential care provided through facilities of 
the Department and non-Department facilities, 
serve as a disincentive to placement in the 
such a program;
``(ii) a description of actions taken by 
the Department to address the findings and 
recommendations by the Secretary contained in 
the report under section 503(c) of the STRONG 
Veterans Act of 2022 (division V of Public Law 
117-328; 136 Stat. 5515), including--
``(I) such actions with respect 
to--
``(aa) any new locations 
added for covered treatment 
programs;
``(bb) any beds added at 
existing facilities of such 
programs; and
``(cc) any additional 
treatment tracks or sex-
specific programs created or 
added at facilities of the 
Department; and
``(II) 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 program; and
``(iii) 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 program.
``(2) Annual report on operation of programs.--
``(A) In general.--Not later than one year after 
the submission of the report under paragraph (1), and 
not less frequently than annually thereafter for the 
following five years, 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 programs.
``(B) Elements.--Subject to subparagraph (C), each 
report required by subparagraph (A) shall include the 
following:
``(i) The number of covered veterans served 
by a covered treatment program, disaggregated 
by--
``(I) Veterans Integrated Service 
Network in which the covered veteran 
receives care;
``(II) facility, including 
facilities of the Department and non-
Department facilities, at which the 
covered veteran receives care;
``(III) type of residential 
rehabilitation treatment care received 
by the covered veteran under such 
program;
``(IV) sex of the covered veteran; 
and
``(V) race or ethnicity of the 
covered veteran.
``(ii) Wait times under a covered treatment 
program for the most recent year data is 
available, disaggregated by--
``(I) treatment track or 
specificity of residential 
rehabilitation treatment care sought by 
the covered veteran;
``(II) sex of the covered veteran;
``(III) State or territory in which 
the covered veteran is located;
``(IV) Veterans Integrated Service 
Network in which the covered veteran is 
located; and
``(V) facility of the Department at 
which the covered veteran seeks care.
``(iii) A list of all locations of a 
covered treatment program and number of bed 
spaces at each such location, disaggregated by 
residential rehabilitation treatment care or 
treatment track provided under such program at 
such location.
``(iv) 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 report.
``(v) Average cost of a stay under a 
covered treatment program, including total stay 
average and daily average, at facilities of the 
Department compared to non-Department 
facilities.
``(vi) A review of staffing needs and gaps 
with respect to covered treatment programs that 
is data-driven and aligned with industry 
benchmarks and standards, including--
``(I) a list of facilities that had 
unstaffed beds or closed beds due to 
lack of staffing at any point in the 
previous year;
``(II) the number of additional 
staff needed to staff those beds;
``(III) the number of beds at each 
facility;
``(IV) the average wait-times for 
the covered treatment program, 
disaggregated by month, during the 
periods of bed closures; and
``(V) 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 days.
``(vii) An overview of data collected 
pursuant to a subsequent clinical screening 
under subsection (g)(3)(F).
``(viii) 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 factors.
``(ix) 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 20 days and 
an assessment of the feasibility and 
advisability of expanding such covered 
treatment program to lower such average wait 
time.
``(x) Any recommendations for changes to 
the operation of covered treatment programs, 
including any policy changes, guidance changes, 
training changes, or other changes.
``(C) Anonymity.--To ensure that the data provided 
under this paragraph, or some portion of that data, 
will not undermine the anonymity of a veteran, 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 laws, including--
``(i) section 552a of title 5 (commonly 
known as the `Privacy Act of 1974');
``(ii) the Health Insurance Portability and 
Accountability Act of 1996 (Public Law 104-
191);
``(iii) parts 160 and 164 of title 45, Code 
of Federal Regulations, or successor 
regulations; and
``(iv) sections 5701, 5705, and 7332 of 
this title.
``(3) 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 unavailable, closed, 
or reassigned due to lack of staffing, including--
``(A) information on the staff needed to reopen 
beds that are closed;
``(B) plans to recruit and retain staff;
``(C) the total number of beds closed or expected 
to be closed;
``(D) the estimated length of time until those 
closed beds are made available; and
``(E) the current wait time for access to those 
beds.
``(j) Third-party Assessment.--
``(1) In general.--Not later than two years after the date 
of the enactment of the Take Care of America's Veterans Act, 
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 facilities.
``(2) Elements.--The study required under paragraph (1) 
shall include a review of--
``(A) whether facilities are meeting requirements 
of the Department pursuant to law, regulation, or 
policy;
``(B) staffing models used by facilities and level 
of adherence to those models;
``(C) 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 program;
``(D) adherence of non-Department facilities to 
timelines for claim submission and record returns to 
the Department; and
``(E) any other factors the Secretary or the 
appropriate entity determines relevant or appropriate 
to include.
``(3) Completion of study.--The contract sought under 
paragraph (1) shall include a requirement that the appropriate 
entity, not later than four years after the date of the 
enactment of the Take Care of America's Veterans Act, complete 
the study required under such paragraph and submit to the 
Secretary a report on the study.
``(4) Action plan and commentary.--Not later than five 
years after the date of the enactment of the Take Care of 
America's Veterans Act, the Secretary shall 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 accessible website of the Department, a 
report containing--
``(A) the results of the study required under 
paragraph (1);
``(B) action plans for improvement based on the 
results of the study; and
``(C) general commentary and feedback on the 
results of the study.
``(5) Appropriate entity defined.--In this subsection, the 
term `appropriate entity' means--
``(A) a nongovernmental entity with experience in 
assessing programs that deliver services provided under 
covered treatment programs on a large scale; or
``(B) a federally funded research and development 
center.
``(k) 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 section.
``(l) Deadline.--Unless otherwise specified, 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 Act.
``(m) Comptroller General Review.--
``(1) In general.--Not later than two years after the date 
of the enactment of the Take Care of America's Veterans Act, 
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 care.
``(2) Elements.--The review required by paragraph (1) shall 
include the following:
``(A) A review of wait times for covered veterans 
under a covered treatment program, disaggregated by--
``(i) treatment track or specificity of 
residential rehabilitation treatment care 
needed;
``(ii) sex of the covered veteran;
``(iii) home State of the covered veteran;
``(iv) home Veterans Integrated Service 
Network of the covered veteran; and
``(v) wait times for--
``(I) facilities of the Department; 
and
``(II) non-Department facilities.
``(B) A review of policy and training of the 
Department on screening, admission, and placement under 
a covered treatment program.
``(C) A review of the rights of covered veterans 
and providers to appeal admission decisions under a 
covered treatment program and how the Department 
adjudicates appeals.
``(D) When determining the facility at which a 
covered veteran admitted to a covered treatment program 
will be placed in such program, a review of how the 
input of the covered veteran is taken into 
consideration with respect to--
``(i) program specialty, subtype, or 
treatment track offered to the covered veteran; 
and
``(ii) the geographic placement of the 
covered veteran, including family- or 
occupation-related preferences or 
circumstances.
``(E) A review of staffing and staffing needs and 
gaps of covered treatment programs, including with 
respect to--
``(i) mental health providers and 
coordinators at the facility level;
``(ii) staff of facilities of such 
programs;
``(iii) staff of Veterans Integrated 
Service Networks; and
``(iv) overall administration of such 
programs at the national level.
``(F) 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 (g)(3)(E).
``(G) Recommendations for improvement of access by 
covered veterans to care under a covered treatment 
program, including with respect to--
``(i) any new sites or types of programs 
needed or in development;
``(ii) changes in training or policy;
``(iii) changes in communications with 
covered veterans; and
``(iv) oversight of covered treatment 
programs by the Department.
``Sec. 1794. Fee schedule
``(a) In General.--Not later than 180 days after the date of the 
enactment of the Take Care of America's Veterans Act, 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 1710 of this title.
``(b) Elements.--The fee schedule required under subsection (a) for 
a covered treatment program shall--
``(1) reflect reasonable charges for the services provided;
``(2) be based on the amounts customarily paid for similar 
services under the Medicaid program under title XIX of the 
Social Security Act (42 U.S.C. 1396 et seq.) and by commercial 
health insurance providers;
``(3) to the greatest extent practicable, be consistent 
with payment rates under section 1703(i) of this title;
``(4) be comprehensive to include a variety of possible 
types of care, services, and charges; and
``(5) be sufficient to ensure a robust network of qualified 
community providers able to provide services under a covered 
treatment program to covered veterans.
``(c) Coordination of Payment Rates.--After the date of the initial 
publication of the fee schedule under subsection (a), the rate paid by 
the Department for residential substance use disorder treatment shall 
be the rate provided in the fee schedule required under such 
subsection.
``(d) Recoupment of Amounts.--
``(1) In general.--The Secretary shall recoup from a non-
Department entity, including a third party administrator, any 
amount paid to such entity that exceeds the amount specified 
under the fee schedule under subsection (a) for the care or 
services provided.
``(2) Limitation.--A non-Department entity shall not bill a 
veteran for any charges recouped under paragraph (1).
``Sec. 1795. Training
``(a) In General.--Not later than one year after the date of the 
enactment of the Take Care of America's Veterans Act, the Secretary 
shall--
``(1) 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 practices; and
``(2) submit that plan to the Committee on Veterans' 
Affairs of the Senate and the Committee on Veterans' Affairs of 
the House of Representatives.
``(b) Elements of Training.--Training required under subsection (a) 
shall--
``(1) be easily accessible, no-cost, and offered in such a 
manner as to qualify for or fulfill continuing education 
requirements for health care professionals;
``(2) include course modules related to military culture, 
post-traumatic stress disorder, the evaluation and management 
of suicide, traumatic brain injury, and opioid safety, or 
comparable course modules, as determined by the Secretary; and
``(3) be offered through Department and non-Department 
entities or organizations.
``(c) Elements of Plan.--The plan required under subsection (a) 
shall--
``(1) 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 
(a); and
``(2) include details regarding consequences for non-
compliance with training required under such plan, which may 
include removal from a network of providers under the Veterans 
Community Care Program under section 1703 of this title for a 
specified period of time.
``(d) Consultation.--The Secretary shall consult with relevant 
professional organizations with respect to the content of relevant 
training required under subsection (a).''.
(b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by adding at the end the following new items:

``subchapter ix--participation by veterans in certain mental health 
treatment programs

``1791. Definitions.
``1792. Standardized process to determine eligibility of covered 
veterans for participation in certain 
mental health treatment programs.
``1793. Improvements to Department of Veterans Affairs mental health 
residential rehabilitation treatment 
program.
``1794. Fee schedule.
``1795. Training.''.

SEC. 622. ACCESS TO MENTAL HEALTH RESIDENTIAL REHABILITATION TREATMENT 
PROGRAMS FOR VETERANS WITH SPINAL CORD INJURY OR 
DISORDER.

(a) Plan.--
(1) In general.--Not later than 90 days after the date of 
the enactment of this Act, 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 disorder.
(2) Elements.--The plan required under paragraph (1) shall 
include--
(A) a staffing plan, which shall include a plan for 
how the Department will--
(i) incorporate staff from other facilities 
to support the pilot program required under 
subsection (b); and
(ii) ensure adequate staffing to support 
the needs of veterans with a spinal cord injury 
or disorder;
(B) an assessment of medical equipment needs; and
(C) an assessment of the best location to deliver 
treatment and health care under mental health 
residential treatment programs, including through the 
use of spinal cord injury or disorder centers, spinal 
cord injury or disorder spokes, and community care 
providers.
(b) Pilot Program.--
(1) In general.--Commencing not later than 120 days after 
the date of the enactment of this Act, 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 
Department.
(2) Selection of locations.--In selecting sites for the 
pilot program under paragraph (1), the Secretary shall 
prioritize sites in the following areas:
(A) Areas with geographic diversity, including 
areas that serve veterans residing in rural or highly 
rural areas.
(B) Areas with a significant number of veterans 
with spinal cord injury or disorder.
(c) Report.--Not later than one year after the date of the 
enactment of this Act, 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--
(1) the implementation of the plan required under 
subsection (a);
(2) the initial results from the pilot program under 
subsection (b), including the number of unique veterans who 
participated in the pilot program, the cost of the pilot 
program, and an assessment of the effectiveness of the pilot 
program in increasing access to, and improving outcomes for, 
participants in the pilot program;
(3) plans, if any, 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 disorder; 
and
(4) Such other matters as the Secretary considers 
appropriate.

Subtitle C--Staffing Matters

SEC. 631. TREATMENT OF PSYCHOLOGISTS.

(a) Treatment as Title 38 Employees.--Section 7401 of title 38, 
United States Code, is amended--
(1) in paragraph (1), by inserting ``psychologists,'' after 
``chiropractors,''; and
(2) in paragraph (3), by striking ``psychologists,''.
(b) Inclusion in Contracts for Scarce Medical Specialist 
Services.--Section 7409(a) of title 38, United States Code, is amended 
by inserting ``psychologists,'' after ``chiropractors,''.

SEC. 632. MENTORSHIP PROGRAM FOR EXECUTIVE LEADERSHIP TEAMS AT MEDICAL 
CENTERS OF THE DEPARTMENT OF VETERANS AFFAIRS.

(a) In General.--The Secretary of Veterans Affairs may establish a 
program to connect covered individuals (in this section referred to as 
``mentees'') 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 (in this section referred to as the 
``mentorship program'').
(b) Covered Individual Defined.--In this section, the term 
``covered individual'' means--
(1) an individual in the position of Facility Director, 
Chief of Staff, Associate Director of Patient Care Services, 
Associate Director, Assistant Director, or Deputy Director at a 
medical center of the Department; or
(2) any other employee of the Department who is determined 
by the Secretary to be an executive leader at a medical center 
of the Department.
(c) Eligibility.--The following employees of the Department are 
eligible for participation as mentees in the mentorship program:
(1) An employee appointed to a position as a covered 
individual who has been in that position for less than one 
year.
(2) A covered individual employed at a medical center of 
the Department (regardless of appointment commencement date) 
that meets one or more of the following criteria:
(A) Reports poor performance, as defined by the 
Secretary, on the Strategic Analytics for Improvement 
and Learning Value Model of the Department, or 
successor similar model.
(B) Reports data under section 1703C(a)(3) of title 
38, United States Code, as published on the Access to 
Care website of the Department, or successor similar 
website, that--
(i) does not consistently meet the level 
reported in the community surrounding such 
medical center, as determined by the Secretary; 
or
(ii) does not meet a threshold level 
determined by the Secretary.
(C) 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 published.
(3) A covered individual employed at a medical center of 
the Department (regardless of appointment commencement date) 
who is recommended by the regional leadership overseeing such 
medical center.
(d) Criteria for Peer Mentors.--Each peer mentor to be paired with 
a mentee under subsection (a) shall meet each of the following 
criteria:
(1) Previous or current employment in the same position 
title as the mentee.
(2) Employment in that position for not less than two 
years.
(3) Employment at a medical center of the Department that 
reports--
(A) above average performance, as defined by the 
Secretary, on the Strategic Analytics for Improvement 
and Learning Value Model of the Department, or 
successor similar model; and
(B) data under section 1703C(a)(3) of title 38, 
United States Code, as published on the Access to Care 
website of the Department, or successor similar 
website, that exceeds the level reported in the 
community surrounding such medical center, as 
determined by the Secretary.
(e) Report.--Not later than one year after the date of the 
enactment of this Act, and annually thereafter for an additional three 
years, 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 program, including--
(1) the number of mentees and peer mentors participating in 
the mentorship program, disaggregated by medical center of the 
Department;
(2) the number of mentor-mentee pairings initiated under 
each of the eligibility criteria outlined in paragraphs (1), 
(2), and (3) of subsection (c), including information on any 
circumstances in which multiple criteria under such paragraphs 
were met;
(3) a description of the actions taken by the Department to 
encourage communication between mentees and peer mentors;
(4) aggregated feedback from participants in the mentorship 
program; and
(5) the turnover rate for mentee participants in the 
mentorship program.
(f) Termination.--The authority under this section shall terminate 
on September 30, 2030.

SEC. 633. REQUIREMENT FOR EQUIVALENT ROLE POSTINGS FOR VACANT POSITIONS 
AT DEPARTMENT OF VETERANS AFFAIRS.

(a) In General.--Whenever possible and practicable, 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 clinician, the Secretary shall issue 
postings for all possible clinicians or professionals who could fill 
the position.
(b) Application to Certain Positions.--The Secretary shall consider 
the requirement under subsection (a) in particular with respect to 
hard-to-recruit, hard-to-retain, primary care, and mental health care 
positions.

SEC. 634. IMPROVEMENTS TO DEPARTMENT OF VETERANS AFFAIRS HIRING 
PROCESSES.

(a) In General.--Subchapter I of chapter 7 of title 38, United 
States Code, is amended by inserting after section 701 the following 
new section:
``Sec. 702. Hiring processes
``(a) Standardized Approval Process for Filling Vacant Positions.--
``(1) Process required.--
``(A) In general.--The Secretary shall establish a 
standardized, nationwide approval process for filling 
vacant employment positions within the Department.
``(B) Variability.--The process required by 
subparagraph (A) may be different for each type of 
employment position in the Department.
``(C) Approval windows.--The process required by 
subparagraph (A) shall include a standardized approval 
window for each approval step.
``(2) Delegation.--If the approval authority for a step in 
the hiring process established under paragraph (1) is vacant, 
on leave, or otherwise unable to respond to requests for 
approval in an appropriate timeframe, 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 command.
``(3) Time to fill goal.--Each window of time allotted for 
each approval step under paragraph (1)(C) when added together 
shall not exceed the goal of the Department to fill window for 
that employment position.
``(b) 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 
practicable.
``(c) Third-party Contracts.--The Secretary may conduct laboratory 
testing, background clearances, 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 timeliness.
``(d) Electronic Signatures.--
``(1) Authority.--The Secretary shall allow electronic 
signatures on any hiring, recruitment, retention, or other 
employment documents once a standardized process for such 
signatures is developed and implemented under paragraph (2).
``(2) Standardized process.--The Secretary shall develop a 
standardized process for use of electronic signatures as 
described in paragraph (1), which shall include exceptions and 
limitations as the Secretary considers appropriate and that 
allows for use of electronic signatures for employment 
documents, including SF 1152 and related successor forms, SF 
2823 and related successor forms, and SF 3102-FERS and related 
successor forms.
``(e) Employee Community Building Program.--The Secretary shall, to 
the extent practicable, establish an employee community building 
program that connects employees in similar positions, offices, and 
programs to connect with each other nationwide.''.
(b) Clerical Amendment.--The table of sections at the beginning of 
chapter 7 of such title is amended by inserting after the item relating 
to section 701 the following new item:

``702. Hiring processes.''.

SEC. 635. DEPARTMENT OF VETERANS AFFAIRS TELEWORK POLICY.

(a) Policy Required.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall, in 
accordance with the requirements of this section and the requirements 
of section 6502 of title 5, United States Code, establish a policy for 
the use of telework within the Department of Veterans Affairs.
(b) Locations.--The policy established under subsection (a) may be 
different for different locations, specialties, and categories of 
employees, as determined appropriate by the Secretary.
(c) Assessment.--In developing the policy required by subsection 
(a), the Secretary shall assess the following for each category of 
employees at the Department--
(1) staffing levels and trends over the last 5 years;
(2) exit survey data related to telework;
(3) the availability of dedicated work space at facilities 
of the Department to enable onsite work at a duty station;
(4) a comparison of productivity levels when duties are 
performed on site or through telework;
(5) telework flexibilities for comparable categories of 
employees in the private sector and in other Federal agencies; 
and
(6) particular duties that necessitate on site work.
(d) Notice and Reporting.--
(1) In general.--For any change made to the policy 
established pursuant to subsection (a), the Secretary shall--
(A) notify all affected employees of the Department 
of the changes; and
(B) 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 changes.
(2) Report contents.--For each report submitted to Congress 
under paragraph (1)(B), the Secretary shall include the 
analyses for each category conducted in subsection (c) and the 
role of those analyses in the telework policy for each 
category.
(3) Deadline.--A report submitted under paragraph (1)(B) 
regarding a change to the policy established under subsection 
(a) shall be made not fewer than 90 days before the change goes 
into effect.
(e) Report on Budgetary Impact.--Not later than 1 year after the 
date on which the policy established pursuant to subsection (a) goes 
into effect, 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 policy.
(f) Effective Date and Changes.--
(1) Effective date of initial policy.--The initial policy 
established by pursuant to subsection (a) shall go into effect 
not later than 180 days after the date on which the policy is 
established.
(2) Effective date of subsequent changes.--Any change made 
to the policy established pursuant to subsection (a) after the 
effective date set forth in paragraph (1) shall take effect not 
less than 90 days after the date on which the change is made.
(3) Notice.--For any change made to the policy established 
pursuant to subsection (a) after the effective date set forth 
in paragraph (1), the Secretary shall--
(A) notify all affected employees of the Department 
of the changes; and
(B) 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 changes.

SEC. 636. EXPANSION OF REIMBURSEMENT OF CONTINUING PROFESSIONAL 
EDUCATION EXPENSES.

(a) In General.--Section 7411 of title 38, United States Code, is 
amended to read as follows:
``Sec. 7411. Reimbursement of continuing professional education 
expenses
``(a) Required Reimbursement.--The Secretary shall reimburse any 
full-time physician, dentist, podiatrist, chiropractor, optometrist, 
psychologist, registered nurse (including any advanced practice 
registered nurse), or physician assistant appointed under section 
7401(1) of this title not more than $1,000 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 employee.
``(b) Authorized Reimbursement.--The Secretary may reimburse any 
full-time licensed practical or vocational nurse (including any nurse 
practitioner), medical technologist, pharmacist, pharmacy technician, 
diagnostic radiologic technologist, or social worker appointed under 
section 7401(3) of this title, not more than $1,000 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 employee.
``(c) Maximum Number of Individuals Reimbursed.--The total number 
of individuals who may be reimbursed under this section may not exceed 
50,000 per year.
``(d) Priority Reimbursements.--In providing reimbursement under 
subsection (a), the Secretary shall prioritize reimbursement for 
individuals providing direct patient care or individuals who are 
decision-makers for direct patient care.
``(e) Report Required.--
``(1) 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 Act, 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 section, including--
``(A) locations at which reimbursement is claimed;
``(B) position title and specialty of the 
individual claiming reimbursement;
``(C) average amount claimed per position and 
specialty; and
``(D) percent utilization by each position and 
specialty overall.
``(2) Authority to include in existing report.--The 
information required under paragraph (1) may be submitted 
independently or included in another annual report to 
Congress.''.
(b) Clerical Amendment.--The table of sections at the beginning of 
subchapter I of chapter 74 of title 38, United States Code, is amended 
by striking the item relating to section 7411 and inserting the 
following new item:

``7411. Reimbursement of continuing professional education expenses.''.

SEC. 637. DEPARTMENT OF VETERANS AFFAIRS PERSONNEL TRANSPARENCY.

(a) In General.--Section 505 of the John S. McCain III, Daniel K. 
Akaka, and Samuel R. Johnson VA Maintaining Internal Systems and 
Strengthening Integrated Outside Networks Act of 2018 (Public Law 115-
182; 38 U.S.C. 301 note) is amended--
(1) in subsection (a)--
(A) in paragraph (1)--
(i) in the matter before subparagraph (A), 
by striking ``information,'' and all that 
follows through ``facility:'' and inserting 
``information:'';
(ii) in subparagraph (B)--
(I) by inserting ``(i)'' before 
``The number''; and
(II) by adding at the end the 
following new clause:
``(ii) 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 data.'';
(iii) in subparagraph (C), by striking 
``vacancies, by occupation.'' and inserting 
``positions currently undergoing a recruitment 
action, disaggregated by occupation and by 
stage of recruitment.'';
(iv) in subparagraph (E)(iii), by striking 
``potential hires or''; and
(v) by adding at the end the following new 
subparagraph:
``(F) 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 action.'';
(B) by redesignating paragraph (5) as paragraph 
(6);
(C) by inserting after paragraph (4) the following 
new paragraph (5):
``(5) Display of information.--The display of information 
made publicly available on a website of the Department pursuant 
to paragraph (1) shall be disaggregated--
``(A) by departmental component;
``(B) in the case of information relating to 
Veterans Health Administration positions, by medical 
facility; and
``(C) in the case of information relating to 
Veterans Benefits Administration positions, by regional 
office.''; and
(D) in paragraph (6), as redesignated by 
subparagraph (B), by striking ``shall'' and all that 
follows and inserting the following: ``shall--
``(A) review the administration of the website 
required under paragraph (1);
``(B) develop recommendations relating to the 
improvement of such administration; and
``(C) submit to the Committee on Veterans' Affairs 
of the Senate and the Committee on Veterans' Affairs of 
the House of Representatives a report containing--
``(i) the findings of the Inspector General 
with respect to the most recent review 
conducted under subparagraph (A); and
``(ii) the recommendations most recently 
developed under subparagraph (B).''; and
(2) by amending subsection (b) to read as follows:
``(b) Annual Report.--Each year, the Secretary shall submit to 
Congress an annual report that includes the following:
``(1) A description of the steps the Department is taking 
to achieve full staffing capacity.
``(2) A description of the actions the Department is taking 
to improve the onboard timeline for facilities of the 
Department, including--
``(A) in the case of facilities of the Veterans 
Health Administration, 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 Administration, or successor model; and
``(B) in the case of the Veterans Benefits 
Administration, for regional offices that exceed the 
time-to-hire target of the Office of Personnel 
Management.
``(3) The amount of additional funds necessary to enable 
the Department to reach full staffing capacity.
``(4) Such recommendations for legislative or 
administrative action as the Secretary may have in order to 
achieve full staffing capacity at the Department.''.
(b) Effective Date.--The amendments made by subsection (a) shall 
take effect on the date of the enactment of this Act and shall apply 
with respect to the second update under section 505(a)(3) of such Act 
beginning after the date of the enactment of this Act and each update 
thereafter.

SEC. 638. MODIFICATION OF AUTHORITY OF LICENSURE OF HEALTH CARE 
PROFESSIONALS PROVIDING TREATMENT VIA TELEMEDICINE.

Section 1730C of title 38, United States Code, is amended--
(1) by amending subsection (a) to read as follows:
``(a) In General.--Notwithstanding any provision of law regarding 
the licensure of health care professionals or the prescribing of 
controlled substances, 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 (as defined in section 1724(f) of this 
title), regardless of where the covered health care professional or the 
patient is located, if the covered health care professional is using 
telemedicine to provide treatment or prescribe controlled substances to 
an individual under this chapter.'';
(2) in subsection (b), by adding at the end the following 
new paragraph:
``(4) 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 active, current, full, and 
unrestricted license, registration, or certification in a State 
to practice the health care profession of the health care 
professional, excluding the following:
``(A) A health care professional located outside a 
facility or clinic of the Department providing care 
through the Veterans Community Care Program under 
section 1703 of this title or a similar authority under 
the laws administered by the Secretary.
``(B) A health care professional conducting 
disability compensation evaluations pursuant to a 
contract with the Department.'';
(3) in subsection (d)--
(A) by redesignating paragraph (2) as paragraph 
(3); and
(B) by inserting after paragraph (1) the following 
new paragraph (2):
``(2) State laws that may be inconsistent under paragraph (1) 
include--
``(A) the laws of--
``(i) the State of licensure, certification, or 
registration of the covered health care professional;
``(ii) the State of practice of the covered health 
care professional;
``(iii) the State in which the patient is located; 
or
``(iv) the State of residence of the patient; and
``(B) such laws specified under subparagraph (A) as 
incorporated by the Controlled Substances Act (21 U.S.C. 801 et 
seq.).''; and
(4) in subsection (e), striking ``Nothing'' and inserting 
``Except as provided in subsections (a) and (d), nothing.''.

SEC. 639. PROVISION OF DATA ON EDUCATIONAL ASSISTANCE PROGRAMS OF 
VETERANS HEALTH ADMINISTRATION.

(a) In General.--Beginning not later than 180 days after the date 
of the enactment of this Act, 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 programs, health profession scholarship 
programs, and any other educational assistance programs within the 
Veterans Health Administration.
(b) Elements.--The data required to be provided under subsection 
(a) shall include, for each program, the following:
(1) The number of active participants, broken down by 
position or expected future position or licensure.
(2) The amount of funds spent each fiscal year.
(3) The number of participants who have completed their 
education and are currently completing their service 
requirements at the Department of Veterans Affairs.
(4) 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 provided.
(5) An overview of outreach by the Department to 
prospective participants in the program.
(6) Such other information as the Secretary considers 
appropriate.
(c) Update and Submittal of Data.--The data required to be provided 
under subsection (a)--
(1) shall be updated not less frequently than annually; and
(2) 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 
law.
(d) Initial Data.--With the first iteration of data provided under 
subsection (a), 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 246 of the Military Construction, Veterans 
Affairs, and Related Agencies Appropriations Act, 2018 (division J of 
Public Law 115-141; 38 U.S.C. 7601 note), including the current status 
of the pilot program and a timeline of the status of the pilot program 
since its initial implementation.

Subtitle D--Optimization of Workforce

SEC. 641. DEPARTMENT OF VETERANS AFFAIRS STRATEGIC HUMAN CAPITAL PLAN.

(a) In General.--Subchapter I of chapter 7 of title 38, United 
States Code, is amended by adding at the end the following new section:
``Sec. 729. Strategic human capital plan
``(a) Plan Development.--(1) Not later than September 30, 2027, 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 Department, disaggregated by the 
Veterans Health Administration, the Veterans Benefits Administration, 
the National Cemetery Administration, and such other administrative 
components of the Department as the Secretary considers necessary to 
carry out the mission of the Department.
``(2) Not later than September 30, 2028, and each September 30 
thereafter, the Secretary shall update the plan developed pursuant to 
paragraph (1) and extend the plan so that it covers the next period of 
five fiscal years commencing immediately after the date of the update.
``(b) Requirements.--(1) In developing the plan required by 
subsection (a), the Secretary shall take into account and document 
current and future projected demand for benefits and services 
administered by the Department, disaggregated for each component by 
facility location, facility type, region, administration, program 
office, the type of benefit or service, and such other categories as 
the Secretary determines appropriate.
``(2) The Secretary shall develop and update the plan under 
subsection (a) in consultation with veterans service organizations and 
such other stakeholders as the Secretary considers appropriate.
``(c) Contents.--The strategic human capital plan required by 
subsection (a) shall incorporate leading practices, including the 
following:
``(1) A workforce gap analysis, including an assessment 
of--
``(A) the staffing levels of each employee position 
needed to deliver high quality, accessible, and timely 
health care, benefits, and other services the Secretary 
considers appropriate, disaggregated by employee 
position, facility location, facility type, region, 
administration, program office, the type of benefit or 
service, and such other categories as the Secretary 
determines appropriate;
``(B) how the staffing levels described in 
subparagraph (A) align with industry best practices in 
each employee position for the anticipated demand for 
health care, benefits, and other services described in 
subsection (b); and
``(C) core competencies, as defined by the 
Secretary, and the staffing levels needed in each of 
these core competencies, disaggregated by employee 
position, facility location, facility type, region, 
administration, program office, the type of benefit or 
service and such other categories as the Secretary 
considers appropriate.
``(2) An implementation plan that includes the following:
``(A) 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 goals.
``(B) Specific strategies--
``(i) to improve workforce productivity 
using technological, organizational, 
behavioral, and such other approaches as the 
Secretary determines appropriate and 
productivity measures that are specific to 
employee positions and the benefits or services 
they provide; and
``(ii) that are informed by applicable 
industry best practices.
``(C) Specific strategies for recruiting and 
retaining veterans, spouses of veterans and members of 
the Armed Forces, family members of veterans and 
members of the Armed Forces, caregivers of veterans, 
and survivors of members of the Armed Forces as 
employees of the Department.
``(D) Specific goals to reduce the time to hire and 
onboard employees of the Department and a strategy to 
achieve such goals, including draft legislative 
language for any legislative action necessary to 
achieve such goals, without degradation of--
``(

[Text truncated for length — see the official source above for the complete bill.]