I
118THCONGRESS
2
DSESSION H. R. 8371
To make certain improvements in the laws administered by the Secretary
of Veterans Affairs, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
MAY14, 2024
Mr. C
ISCOMANI(for himself, Mr. ELLZEY, Mr. CAREY, Mr. BAIRD, Mr.
B
ERGMAN, Mr. LUTTRELL, Mr. BACON, Mr. MURPHY, Mr. BOST, Mrs.
K
IGGANSof Virginia, Mrs. MILLER-MEEKS, Mr. GIMENEZ, Mr. WIL-
LIAMSof New York, Mr. EDWARDS, and Mrs. STEEL) introduced the fol-
lowing bill; which was referred to the Committee on Veterans’ Affairs,
and in addition to the Committees on Natural Resources, and Armed
Services, for a period to be subsequently determined by the Speaker, in
each case for consideration of such provisions as fall within the jurisdic-
tion of the committee concerned
A BILL
To make certain improvements in the laws administered by
the Secretary of Veterans Affairs, and for other purposes.
Be it enacted by the Senate and House of Representa-1
tives of the United States of America in Congress assembled, 2
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 3
(a) S
HORTTITLE.—This Act may be cited as the 4
‘‘Senator Elizabeth Dole 21st Century Veterans 5
Healthcare and Benefits Improvement Act’’. 6
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 2
•HR 8371 IH
(b) TABLE OFCONTENTS.—The table of contents for 1
this Act is as follows: 2
Sec. 1. Short title; table of contents.
TITLE I—HEALTH CARE MATTERS
Subtitle A—Veterans Community Care Program Matters
Sec. 101. Finality of decisions by veteran and referring clinician under Vet-
erans Community Care Program.
Sec. 102. Outreach regarding care and services under Veterans Community
Care Program.
Sec. 103. Annual review and report on waivers of certain payment rates under
Veterans Community Care Program.
Sec. 104. Modification of requirements for standards for quality of care from
Department of Veterans Affairs.
Sec. 105. Standardized process to determine eligibility of covered veterans for
participation in certain mental health treatment programs.
Sec. 106. Improvements to Department of Veterans Affairs Mental Health Res-
idential Rehabilitation Treatment Program.
Sec. 107. Pilot program to improve administration of care under Veterans
Community Care Program.
Sec. 108. Pilot program on consolidating approval process of Department of
Veterans Affairs for covered dental care.
Sec. 109. Strategic plan on value-based health care system for Veterans Health
Administration; pilot program.
Sec. 110. Plan on adoption of certain health information standards for Depart-
ment of Veterans Affairs and certain health care providers.
Sec. 111. Report on use of value-based reimbursement models under Veterans
Community Care Program.
Sec. 112. Inspector General assessment of implementation of Veterans Commu-
nity Care Program.
Sec. 113. Comptroller General report on dentistry under Veterans Community
Care Program.
Subtitle B—Matters Relating to Nursing Home and Other Long Term Care
and Family Caregivers
Sec. 120. Increase of expenditure cap for noninstitutional care alternatives to
nursing home care.
Sec. 121. Coordination with Program of All-Inclusive Care for the Elderly.
Sec. 122. Authority for Secretary of Veterans Affairs to award grants or con-
tracts to entities to improve provision of mental health support
to family caregivers of veterans.
Sec. 123. Home- and community-based services: programs.
Sec. 124. Coordination with assistance and support services for caregivers.
Sec. 125. Improvements to program of comprehensive assistance for family
caregivers.
Sec. 126. Improvements relating to Homemaker and Home Health Aide pro-
gram.
Sec. 127. Pilot program to furnish assisted living services to certain veterans.
Sec. 128. Provision of medicine, equipment, and supplies available to Depart-
ment of Veterans Affairs to State homes.
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6211 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 3
•HR 8371 IH
Sec. 129. Recognition of organizations and individuals to assist veterans, family
members, and caregivers navigating programs and services of
Veterans Health Administration.
Sec. 130. Reviews and other improvements relating to home- and community-
based services.
Sec. 131. GAO report on mental health support for caregivers.
Sec. 132. Development of centralized website for program information.
Sec. 133. Definitions.
Subtitle C—Medical Treatment and Other Matters
Sec. 140. Quarterly report on referrals for non-Department of Veterans Affairs
health care.
Sec. 141. Elimination of certain requirements for certain Department of Vet-
erans Affairs Assistant Under Secretaries.
Sec. 142. Modification of pay limitation for physicians, podiatrists, optom-
etrists, and dentists of Department of Veterans Affairs.
Sec. 143. Reimbursement of ambulance cost for care for certain rural veterans.
Sec. 144. Pilot program to furnish dental care from the Department of Vet-
erans Affairs to certain veterans diagnosed with ischemic heart
disease.
Sec. 145. Documentation of preferences of veterans for scheduling of appoint-
ments for health care under laws administered by Secretary of
Veterans Affairs.
Sec. 146. Staffing model and performance metrics for certain employees of the
Department of Veterans Affairs.
Sec. 147. Online health education portal for veterans enrolled in patient enroll-
ment system of Department of Veterans Affairs.
Sec. 148. Limitation on detail of directors of medical centers of Department of
Veterans Affairs to different positions.
Sec. 149. National Veteran Suicide Prevention Annual Report.
Sec. 150. Report on physical infrastructure required by medical facilities of De-
partment of Veterans Affairs to provide dental care services.
Sec. 151. Comptroller General report on certain oral health care programs
under laws administered by Secretary of Veterans Affairs.
Sec. 152. Review of workflows associated with processing referrals between fa-
cilities of the Veterans Health Administration.
Sec. 153. Plan for timely scheduling of appointments at medical facilities of
Department of Veterans Affairs.
Sec. 154. Authorization of appropriations to support initiatives for mobile
mammography services for veterans.
TITLE II—ECONOMIC OPPORTUNITY MATTERS
Subtitle A—Educational Assistance
Sec. 201. Temporary expansion of eligibility for Marine Gunnery Sergeant John
David Fry Scholarship.
Sec. 202. Removal of expiration on entitlement to Marine Gunnery Sergeant
John David Fry Scholarship for surviving spouses.
Sec. 203. Sole liability for transferred educational assistance by an individual
who fails to complete a service agreement.
Sec. 204. Notice to educational institutions of risk-based surveys.
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6211 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 4
•HR 8371 IH
Sec. 205. Relationship of participation by an educational institution in certain
Federal student financial aid programs to approval of such in-
stitution for purposes of Department of Veterans Affairs edu-
cational assistance programs.
Sec. 206. Expansion of Department of Veterans Affairs oversight of certain
educational institutions.
Sec. 207. Requirement that educational institutions approved for purposes of
Department of Veterans Affairs educational assistance pro-
grams provide digital official transcripts.
Sec. 208. Payment of full monthly housing stipend for veterans enrolled in final
semester using educational assistance under Post-9/11 Edu-
cational Assistance Program.
Sec. 209. Modification of rules for approval of commercial driver education pro-
grams for purposes of educational assistance programs of the
Department of Veterans Affairs.
Sec. 210. Provision of certificates of eligibility and award letters using elec-
tronic means.
Sec. 211. Retroactive effective date of law regarding charge to entitlement to
educational assistance for individuals who do not transfer cred-
its from certain closed or disapproved programs of education.
Sec. 212. Department of Veterans Affairs high technology program.
Sec. 213. Notice of changes to Department of Veterans Affairs policies and
guidance affecting the educational assistance programs of the
Department.
Sec. 214. Payment of VA educational assistance via electronic fund transfer to
a foreign institution of higher education.
Sec. 215. Improving transparency and accountability of educational institutions
for purposes of veterans educational assistance.
Subtitle B—Employment and Training
Sec. 221. Improvements to reemployment rights of members of the Armed
Forces.
Sec. 222. Review of investigations manual of Veterans’ Employment and Train-
ing Service.
Sec. 223. Warrior Training Advancement Course.
Subtitle C—Home Loans
Sec. 231. Improvements to program for direct housing loans made to Native
American veterans by the Secretary of Veterans Affairs.
Sec. 232. Native community development financial institution relending pro-
gram.
TITLE III—DISABILITY AND MEMORIAL AFFAIRS MATTERS
Sec. 301. Burial allowance for certain veterans who die at home while in receipt
of hospice care furnished by Department of Veterans Affairs.
Sec. 302. Authority for Secretary of Veterans Affairs to award grants to States
and Indian Tribes to improve outreach to veterans.
Sec. 303. Definition of surviving spouse.
Sec. 304. Ensuring only licensed health care professionals perform medical dis-
ability examinations under certain Department of Veterans Af-
fairs pilot program.
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6211 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 5
•HR 8371 IH
Sec. 305. Provision of information regarding an agent or attorney to a licensed
health care professional who performs a medical disability ex-
amination under certain Department of Veterans Affairs pilot
program.
Sec. 306. Modernization of Department of Veterans Affairs disability benefit
questionnaires.
Sec. 307. Department of Veterans Affairs automatic processing of certain
claims for temporary disability ratings.
TITLE IV—HOMELESSNESS MATTERS
Sec. 401. Short title.
Sec. 402. Per diem payments provided by the Secretary of Veterans Affairs for
services furnished to homeless veterans.
Sec. 403. Authorization for Secretary of Veterans Affairs to use of certain
funds for improved flexibility in assistance to homeless vet-
erans.
Sec. 404. Access to Department of Veterans Affairs telehealth services.
TITLE V—ELECTRONIC HEALTH RECORD MATTERS
Sec. 501. Short title.
Sec. 502. Definitions.
Subtitle A—Electronic Health Record System and Health Information
Technology Modernization
Sec. 511. Modernization of Department of Veterans Affairs electronic health
record system and health information technology.
Sec. 512. Responsibility for electronic health record program and health infor-
mation technology.
Sec. 513. Protection of personal information.
Subtitle B—Implementation Requirements
Sec. 521. Veterans Health Administration workflow baseline.
Sec. 522. Requirements for electronic health record system implementation.
Sec. 523. Conditional restructuring of Electronic Health Record Modernization
Program.
Subtitle C—Reporting
Sec. 531. Report on additional purposes.
Sec. 532. Reports on baseline of clinical workflows.
Sec. 533. Report on health care quality metrics.
Sec. 534. Report on support strategy for existing sites.
Sec. 535. Report on resources required for future sites.
Sec. 536. Report on alternative modernization strategies.
Sec. 537. Report on health information technology strategy and roadmap.
Sec. 538. Annual report on efforts to maintain VistA electronic health record
system.
Sec. 539. Modification of quarterly reports.
Sec. 540. Report on protection of personal information.
Sec. 541. Report on organization and needs.
Sec. 542. Report on governance, performance criteria, and readiness.
TITLE VI—OVERSIGHT AND INVESTIGATIONS MATTERS
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6211 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 6
•HR 8371 IH
Sec. 601. Department of Veterans Affairs employee training regarding Office of
Inspector General.
Sec. 602. Annual review of security at covered facilities of the Department of
Veterans Affairs.
Sec. 603. Modification of certain housing loan fees.
TITLE I—HEALTH CARE 1
MATTERS 2
Subtitle A—Veterans Community 3
Care Program Matters 4
SEC. 101. FINALITY OF DECISIONS BY VETERAN AND RE-5
FERRING CLINICIAN UNDER VETERANS COM-6
MUNITY CARE PROGRAM. 7
(a) I
NGENERAL.—During the period specified in 8
subsection (c), and subject to subsection (b), an agreement 9
under section 1703(d)(1)(E) of title 38, United States 10
Code, between a covered veteran and the referring clini-11
cian of such veteran regarding the best medical interest 12
of the veteran is final and is not subject to review, ap-13
proval, or change by the Department of Veterans Affairs 14
unless a statutory or regulatory barrier prevents the De-15
partment from providing the care or services required 16
under such agreement. 17
(b) C
ORRECTION OF ERRORS.—A covered veteran 18
and the referring clinician of such veteran may correct any 19
errors made with respect to an agreement described in 20
subsection (a). 21
(c) P
ERIODSPECIFIED.—The period specified in this 22
subsection is the two-year period beginning on the date 23
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 7
•HR 8371 IH
that is 180 days after the date of the enactment of this 1
Act. 2
(d) A
NNUALREPORT.—Not later than one year and 3
not later than two years after the commencement of the 4
period specified under subsection (c), the Secretary of Vet-5
erans Affairs shall submit to Congress a report on the care 6
provided under section 1703(d)(1)(E) of title 38, United 7
States Code, during the one-year period preceding the date 8
of the report, including— 9
(1) the number of instances of care provided; 10
(2) the type of care provided; and 11
(3) the cost of such care. 12
(e) C
OVEREDVETERANDEFINED.—In this section, 13
the term ‘‘covered veteran’’ has the meaning given that 14
term in section 1703(b) of title 38, United States Code. 15
SEC. 102. OUTREACH REGARDING CARE AND SERVICES 16
UNDER VETERANS COMMUNITY CARE PRO-17
GRAM. 18
(a) R
EQUIREMENT.—Section 1703 of title 38, United 19
States Code, is further amended— 20
(1) by redesignating subsection (o) as sub-21
section (p); and 22
(2) by inserting after subsection (n) the fol-23
lowing new subsection (o): 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 8
•HR 8371 IH
‘‘(o) OUTREACHREGARDINGAVAILABILITY OFCARE 1
ANDSERVICES.—(1) The Secretary shall conduct out-2
reach to inform veterans of the following: 3
‘‘(A) The conditions for care or services under 4
subsections (d) and (e). 5
‘‘(B) How to request such care or services. 6
‘‘(C) How to appeal a denial of a request for 7
such care or services using the clinical appeals proc-8
ess of the Veterans Health Administration. 9
‘‘(2) Upon enrollment of a veteran in the system of 10
annual patient enrollment established and operated under 11
section 1705 of this title, and not less frequently than 12
every two years thereafter, the Secretary shall inform the 13
veteran of information described in paragraph (1). 14
‘‘(3) The Secretary shall ensure that information de-15
scribed in paragraph (1) is— 16
‘‘(A) publicly displayed in each medical facility 17
of the Department; 18
‘‘(B) prominently displayed on a website of the 19
Department; and 20
‘‘(C) included in other outreach campaigns and 21
activities conducted by the Secretary.’’. 22
(b) T
RANSITIONAL SERVICES.—Section 23
1144(f)(1)(B)(i) of title 10, United States Code, is amend-24
ed by inserting ‘‘, including how to enroll in the system 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 9
•HR 8371 IH
of annual patient enrollment established and operated 1
under section 1705 of title 38 and the ability to seek care 2
and services under sections 1703 and 1710 of such title’’ 3
before the semicolon. 4
(c) S
OLIDSTARTPROGRAM.—Section 6320(a)(2)(A) 5
of title 38, United States Code, is amended by inserting 6
‘‘, including how to enroll in the system of annual patient 7
enrollment established and operated under section 1705 8
of this title and the ability to seek care and services under 9
sections 1703 and 1710 of this title’’ before the semicolon. 10
(d) C
OMPTROLLER GENERALREPORT ON OUT-11
REACH.—Not later than two years after the date of the 12
enactment of this Act, the Comptroller General of the 13
United Stats shall submit to Congress a report on the ef-14
forts of the Secretary of Veterans Affairs to ensure that 15
veterans are informed of the conditions for eligibility for 16
care and services under section 1703 of title 38, United 17
States Code, including such efforts to conduct outreach 18
pursuant to subsection (q) of such section (as added by 19
subsection (a)). 20
SEC. 103. ANNUAL REVIEW AND REPORT ON WAIVERS OF 21
CERTAIN PAYMENT RATES UNDER VETERANS 22
COMMUNITY CARE PROGRAM. 23
(a) I
NGENERAL.—Section 1703 of title 38, United 24
States Code, is further amended— 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 10
•HR 8371 IH
(1) by redesignating subsection (p) as sub-1
section (q); and 2
(2) by inserting after subsection (p) the fol-3
lowing new subsection (q): 4
‘‘(q) A
NNUALREVIEW ANDREPORT ONWAIVERS OF 5
P
AYMENTRATES.—(1) On an annual basis, the Secretary 6
shall— 7
‘‘(A) conduct a review of waivers of payment 8
rates under subsection (i) for Third Party Adminis-9
trators to identify whether such waivers help to al-10
leviate community-specific challenges, including scar-11
city of medical services associated with access to 12
health care; and 13
‘‘(B) submit to Congress a report on the results 14
of such review. 15
‘‘(2) Each report under paragraph (1)(B) shall in-16
clude, with respect to the period covered by the report— 17
‘‘(A) a statement, disaggregated by region, of 18
the total number of waivers described in subpara-19
graph (A) of such paragraph requested by Third 20
Party Administrators; 21
‘‘(B) a statement of the total number of such 22
waivers that were— 23
‘‘(i) granted by the Secretary; 24
‘‘(ii) denied by the Secretary; or 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 11
•HR 8371 IH
‘‘(iii) withdrawn by a Third Party Admin-1
istrator; 2
‘‘(C) a description of the process for the review 3
required under paragraph (1); 4
‘‘(D) a statement, disaggregated by region, of 5
the average time to process such waivers; 6
‘‘(E) an assessment, disaggregated by region, of 7
the extent to which such waivers that were granted 8
by the Secretary improved access to health care for 9
covered veterans; and 10
‘‘(F) a description of trends, if any, identified 11
by the Secretary with respect to such waivers. 12
‘‘(3) In this subsection, the term ‘Third Party Ad-13
ministrator’ has the meaning given such term in section 14
1703B of this title.’’. 15
(b) D
EADLINE.—The Secretary shall submit the first 16
report required under subsection (q) of section 1703 of 17
such title (as added by subsection (a)) not later than 180 18
days after the date of the enactment of this Act. 19
SEC. 104. MODIFICATION OF REQUIREMENTS FOR STAND-20
ARDS FOR QUALITY OF CARE FROM DEPART-21
MENT OF VETERANS AFFAIRS. 22
(a) I
NGENERAL.—Section 1703C of title 38, United 23
States Code, is amended— 24
(1) in subsection (a)— 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 12
•HR 8371 IH
(A) in paragraph (2)— 1
(i) by striking ‘‘In establishing’’ and 2
inserting ‘‘(A) In establishing’’; and 3
(ii) by adding at the end the following 4
new subparagraph: 5
‘‘(B) The Secretary shall ensure that the stand-6
ards for quality established under paragraph (1) are 7
comparable to industry standards to ensure there is 8
adequate data transference between care furnished 9
by the Department and care furnished by a non-De-10
partment provider.’’; 11
(B) in paragraph (3), by adding at the end 12
the following new clauses: 13
‘‘(v) Equitable care. 14
‘‘(vi) Outcomes relating to patient 15
quality of life.’’; 16
(C) in paragraph (4)— 17
(i) by striking ‘‘and the Centers for 18
Medicare & Medicaid Services’’ and insert-19
ing ‘‘the Centers for Medicare & Medicaid 20
Services, and the Indian Health Service’’; 21
and 22
(ii) by striking ‘‘and other nongovern-23
mental entities’’ and inserting ‘‘and other 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 13
•HR 8371 IH
non-governmental entities including Third 1
Party Administrators’’; and 2
(D) by striking paragraph (5) and insert-3
ing the following new paragraphs: 4
‘‘(5) When collecting, considering, and applying data 5
related to patient care for purposes of establishing stand-6
ards for quality under paragraph (1), the Secretary shall 7
ensure no metric is being over or under analyzed. 8
‘‘(6) In establishing standards for quality under para-9
graph (1), the Secretary shall— 10
‘‘(A) utilize the most up-to-date practices for 11
extracting and analyzing relevant data; 12
‘‘(B) utilize all relevant data available to the 13
Secretary; 14
‘‘(C) ensure the most efficient use of time and 15
resources related to the use of data scientists em-16
ployed by the Department; and 17
‘‘(D) collaborate, as appropriate, with entities 18
specified in paragraph (4). 19
‘‘(7)(A) Not less frequently than once every five 20
years, the Secretary shall update the standards for quality 21
established under paragraph (1) pursuant to the require-22
ments for the establishment of such standards under this 23
subsection. 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 14
•HR 8371 IH
‘‘(B) Not later than 30 days after any date on which 1
the Secretary updates, pursuant to subparagraph (A), the 2
standards for quality under paragraph (1), the Secretary 3
shall submit to the appropriate committees of Congress 4
a report on such updated standards for quality.’’; and 5
(2) in subsection (b)— 6
(A) in paragraph (1)— 7
(i) by striking ‘‘Not later than 1 year 8
after the date on which the Secretary es-9
tablishes standards for quality under sub-10
section (a)’’ and inserting ‘‘Not less fre-11
quently than once every three years’’; and 12
(ii) by inserting ‘‘pursuant to stand-13
ards for quality under subsection (a)’’ 14
after ‘‘medical facilities of the Depart-15
ment’’; and 16
(B) in paragraph (2), by inserting ‘‘or up-17
dates’’ after ‘‘establishes’’. 18
(b) D
EADLINE FORUPDATE.—The Secretary, pursu-19
ant to paragraph (7) of section 1703C(a) of title 38, 20
United States Code (as added by subsection (a)), shall 21
make the first update to the standards for quality estab-22
lished under paragraph (1) of such section not later than 23
the date that is five years after the date on which the Sec-24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00014 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 15
•HR 8371 IH
retary submits the report under paragraph (2) of sub-1
section (d). 2
(c) R
EPORT.—Not later than one year after the date 3
of the enactment of this Act, the Secretary of Veterans 4
Affairs shall submit to the appropriate committees of Con-5
gress a report on how the Secretary— 6
(1) has consulted with entities specified in para-7
graph (4) of section 1703C(a) of title 38, United 8
States Code, before the date of the enactment of this 9
Act in establishing standards for quality under such 10
section; 11
(2) has continued to consult with those entities 12
on and after such date of enactment; and 13
(3) intends to leverage data sciences to improve 14
standards for quality care furnished by the Depart-15
ment of Veterans Affairs. 16
(d) U
PDATES TOQUALITYCAREMETRICS.— 17
(1) I
NITIAL REPORT.—Not later than one year 18
after the date of the enactment of this Act, the Sec-19
retary of Veterans Affairs shall submit to the appro-20
priate committees of Congress a report on how the 21
Secretary plans to implement the amendments made 22
by subsection (a). 23
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00015 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 16
•HR 8371 IH
(2) DEADLINE; SUMMARY REPORT .—Not later 1
than two years after the date of the enactment of 2
this Act, the Secretary shall— 3
(A) implement the amendments made by 4
subsection (a), including by updating the stand-5
ards for quality established under section 6
1703C of title 38, United States Code; and 7
(B) submit to the appropriate committees 8
of Congress a report detailing the standards for 9
quality updated pursuant to such amendments. 10
(e) A
UDIT OFQUALITYCAREMETRICS.— 11
(1) I
N GENERAL.—Not later than 180 days 12
after the date of the enactment of this Act, the Sec-13
retary of Veterans Affairs shall enter into one or 14
more contracts with a non-Department entity de-15
scribed in paragraph (2) to conduct an audit on the 16
quality of care from the Department of Veterans Af-17
fairs, including through non-Department health care 18
providers pursuant to section 1703 of title 38 19
United States Code. 20
(2) N
ON-DEPARTMENT ENTITY DESCRIBED .—A 21
non-Department entity described in this paragraph 22
is an entity that— 23
(A) specializes in analyzing large-scale or-24
ganizational data collection and analysis efforts, 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00016 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 17
•HR 8371 IH
especially with respect to the health care sector; 1
and 2
(B) has experience and proven outcomes in 3
optimizing the accuracy and comprehensiveness 4
of data collection and analysis related to the 5
quality of health care services. 6
(3) E
LEMENTS.—The audit required under 7
paragraph (1) shall include the following: 8
(A) An assessment of the methodology 9
used by the Department to collect and assess 10
data on the quality of care furnished by the De-11
partment, including any vulnerabilities in such 12
methodology. 13
(B) An assessment of the accuracy and re-14
liability of the data sources used by the Depart-15
ment to compile data on the quality of care fur-16
nished by the Department. 17
(C) The extent to which the standards the 18
Department uses to assess the quality of care 19
furnished by the Department are— 20
(i) comparable with industry stand-21
ards; 22
(ii) easily accessible to, and under-23
stood by— 24
(I) veterans; 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00017 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 18
•HR 8371 IH
(II) employees of the Depart-1
ment; and 2
(III) other individuals, as the pri-3
vate sector entity considers appro-4
priate. 5
(D) Any recommendations of such private 6
sector entity with respect to improvements that 7
the Secretary could administer to more accu-8
rately capture the quality of care furnished by 9
the Department. 10
(4) R
EPORTS ON AUDIT.— 11
(A) R
EPORT ON FINDINGS AND REC -12
OMMENDATIONS.—Not later than 60 days after 13
any date on which a private sector entity de-14
scribed in paragraph (2) completes an audit 15
under paragraph (1), such private sector entity 16
shall submit to the Secretary, the Committee on 17
Veterans’ Affairs of the Senate, and the Com-18
mittee on Veterans’ Affairs of the House of 19
Representatives a report that includes— 20
(i) the findings of such audit; and 21
(ii) recommendations of such private 22
sector entity with respect to such audit. 23
(B) R
EPORT ON PLANNED IMPROVE -24
MENTS.—Not later than 60 days after any date 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00018 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 19
•HR 8371 IH
on which the Secretary receives a report under 1
subparagraph (A), the Secretary shall submit to 2
the Committee on Veterans’ Affairs of the Sen-3
ate and the Committee on Veterans’ Affairs of 4
the House of Representatives a report on how 5
the Secretary plans to improve the standards 6
for quality of care of the Department. 7
(f) A
PPROPRIATECOMMITTEES OF CONGRESSDE-8
FINED.—In this section, the term ‘‘appropriate commit-9
tees of Congress’’ has the meaning given such term in sec-10
tion 1703C of title 38, United States Code. 11
SEC. 105. STANDARDIZED PROCESS TO DETERMINE ELIGI-12
BILITY OF COVERED VETERANS FOR PAR-13
TICIPATION IN CERTAIN MENTAL HEALTH 14
TREATMENT PROGRAMS. 15
(a) S
TANDARDIZED SCREENING PROCESS.—Not 16
later than one year after the date of the enactment of this 17
Act, the Secretary of Veterans Affairs shall establish a 18
standardized screening process to determine, based on 19
clinical need, whether a covered veteran satisfies criteria 20
for priority or routine admission to a covered treatment 21
program. 22
(b) E
LIGIBILITYCRITERIA.— 23
(1) I
N GENERAL.—Under the standardized 24
screening process required by subsection (a), a cov-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00019 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 20
•HR 8371 IH
ered veteran shall be eligible for priority admission 1
to a covered treatment program if the covered vet-2
eran meets criteria that include, but are not limited 3
to, the following: 4
(A) Symptoms that— 5
(i) significantly affect activities of 6
daily life; and 7
(ii) increase the risk of such veteran 8
for adverse outcomes. 9
(B) An unsafe living situation. 10
(C) A high-risk flag for suicide. 11
(D) A determination of being a high risk 12
for suicide. 13
(E) Risk factors for overdose. 14
(F) Non-responsive, relapsed, or unable to 15
find recovery from one other course of treat-16
ment, such as outpatient or intensive outpatient 17
treatment. 18
(G) Other such criteria as the Secretary 19
determines appropriate. 20
(2) C
ONSIDERATION.—In making a determina-21
tion under paragraph (1), the Secretary shall con-22
sider any referral of a health care provider of a cov-23
ered veteran for such covered veteran to be admitted 24
to a covered treatment program. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00020 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 21
•HR 8371 IH
(c) TIME FORSCREENING ANDADMISSION.—Under 1
the standardized screening process required by subsection 2
(a), the Secretary shall ensure a covered veteran— 3
(1) is screened not later than 48 hours after the 4
date on which the covered veteran, or a relevant 5
health care provider, makes a request for the cov-6
ered veteran to be admitted to a covered treatment 7
program. 8
(2) determined eligible for priority admission to 9
a covered treatment program is admitted to such 10
covered treatment program not later than 48 hours 11
after the date of such determination. 12
(d) A
CCESSSTANDARDS FOR ROUTINEADMIS-13
SION.—The Secretary shall include the standardized 14
screening process under this section in the wait time ac-15
cess standards for eligibility for mental health care under 16
section 1703(d) of such title established by the Secretary 17
under section 1703B of such title. 18
(e) C
ONDITIONSUNDERWHICHCARESHALLBE 19
F
URNISHEDTHROUGHNON-DEPARTMENTPROVIDERS.— 20
If the Secretary determines a covered veteran to be eligible 21
for either priority or routine admission to a covered treat-22
ment program pursuant to the standardized screening 23
process required by subsection (a), and the Secretary is 24
unable to admit such covered veteran to a clinically appro-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00021 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 22
•HR 8371 IH
priate covered treatment program at a facility of the De-1
partment of Veterans Affairs within the State of residence 2
of the covered veteran in a manner that complies with the 3
applicable wait time standards established pursuant to 4
this section, the Secretary shall offer the covered veteran 5
the option to receive care— 6
(1) at another facility of the Department; or 7
(2) at a non-Department facility that— 8
(A) can admit the covered veteran within 9
the period required by the applicable standards 10
of the Department; and 11
(B) is party to a contract or agreement 12
with the Department or enters into such a con-13
tract or agreement under which the Department 14
furnishes a program that is equivalent to a cov-15
ered treatment program to a veteran through 16
such non-Departmental facility. 17
(f) S
UNSET.— 18
(1) I
N GENERAL.—The authority of the Sec-19
retary to make a determination under this section 20
expires on the day that is two years after the date 21
of the enactment of this Act. 22
(2) R
ULE OF CONSTRUCTION .—Paragraph (1) 23
shall not be construed to affect a covered veteran in 24
a covered treatment program pursuant to a deter-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00022 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 23
•HR 8371 IH
mination made on or before the date in such para-1
graph. 2
(g) D
EFINITIONS.—In this section: 3
(1) The term ‘‘covered treatment program’’— 4
(A) means a mental health residential re-5
habilitation treatment program of the Depart-6
ment of Veterans Affairs; 7
(B) a program of the Department for resi-8
dential care for mental health and substance 9
abuse disorders; 10
(C) includes— 11
(i) the programs designated as of the 12
date of the enactment of this section as 13
domiciliary residential rehabilitation treat-14
ment programs; and 15
(ii) any programs designated as domi-16
ciliary residential rehabilitation treatment 17
programs on or after such date of enact-18
ment; and 19
(D) does not include Compensated Work 20
Therapy Transition Residence programs of the 21
Department. 22
(2) The term ‘‘covered veteran’’ means a vet-23
eran described in section 1703(b) of title 38, United 24
States Code. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00023 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 24
•HR 8371 IH
SEC. 106. IMPROVEMENTS TO DEPARTMENT OF VETERANS 1
AFFAIRS MENTAL HEALTH RESIDENTIAL RE-2
HABILITATION TREATMENT PROGRAM. 3
(a) P
ERFORMANCEMETRICS.— 4
(1) I
N GENERAL.—The Secretary shall develop 5
metrics to track, and shall subsequently track, the 6
performance of medical facilities and Veterans Inte-7
grated Service Networks of the Department in meet-8
ing the requirements for— 9
(A) screening, under section 105 of this 10
Act, for the Mental Health Residential Rehabili-11
tation Treatment Program (in this section re-12
ferred to as the ‘‘Program’’) ; and 13
(B) timely admission, under such screen-14
ing, to the Program. 15
(2) E
LEMENTS.—The metrics developed under 16
paragraph (1) shall include metrics for tracking the 17
performance of such medical facilities and Veterans 18
Integrated Service Networks with respect to routine 19
and priority admission under the Program. 20
(b) P
LACEMENT; TRANSPORTATION.— 21
(1) L
OCATIONS.—If the Secretary determines 22
that a covered veteran is in need of residential care 23
under the Program, the Secretary shall provide to 24
the covered veteran a list of locations at which such 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00024 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 25
•HR 8371 IH
covered veteran can receive such residential care 1
that meets— 2
(A) the standards for screening under sec-3
tion 105 of this Act; and 4
(B) the care needs of the covered veteran, 5
including applicable treatment tracks. 6
(2) T
RANSPORTATION COVERAGE .—The Sec-7
retary shall provide transportation or pay for or re-8
imburse the costs of transportation for any covered 9
veteran who is admitted into the Program and needs 10
transportation assistance— 11
(A) from the residence of the covered vet-12
eran or a facility of the Department or author-13
ized non-Department facility that does not pro-14
vide such care to another such facility that pro-15
vides residential care covered under the Pro-16
gram; and 17
(B) back to the residence of the covered 18
veteran after the conclusion of the Program, if 19
applicable. 20
(c) C
ONSIDERATIONS.—In making placement deci-21
sions under the Program, the Secretary shall consider the 22
input of the covered veteran and the treating clinicians 23
of the covered veteran, including with respect to program 24
specialty, subtype, or treatment track offered to the cov-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00025 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 26
•HR 8371 IH
ered veteran, and the geographic placement of the covered 1
veteran, including family- or occupation-related pref-2
erences or circumstances. 3
(d) A
PPEALS.— 4
(1) I
N GENERAL.—The Secretary shall develop 5
a national policy and associated procedures under 6
which a covered veteran, a representative of a cov-7
ered veteran, or a provider who requests a covered 8
veteran be admitted to the Program, including a 9
provider of the Department or a non-Department 10
provider, may file a clinical appeal pursuant to this 11
subsection if the covered veteran is— 12
(A) denied admission into the Program; or 13
(B) accepted into the Program but is not 14
offered bed placement in a timely manner. 15
(2) T
IMELINESS STANDARDS FOR REVIEW .— 16
(A) I
N GENERAL.—The national policy and 17
procedures developed under paragraph (1) for 18
appeals described in such paragraph shall in-19
clude timeliness standards for the Department 20
to review and make a decision on such an ap-21
peal. 22
(B) D
ECISION.—The Secretary shall re-23
view and respond to any appeal under para-24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00026 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 27
•HR 8371 IH
graph (1) not later than 72 hours after the Sec-1
retary receives such appeal. 2
(3) P
UBLIC GUIDANCE.—The Secretary shall 3
develop, and make available to the public, guidance 4
on how a covered veteran, a representative of the 5
covered veteran, or a provider of the covered veteran 6
can file a clinical appeal pursuant to this sub-7
section— 8
(A) if the covered veteran is denied admis-9
sion into the Program; 10
(B) if the first date on which the covered 11
veteran may enter the Program does not comply 12
with the standards established by the Depart-13
ment under section 1703B of title 38, United 14
States Code for purposes of determining eligi-15
bility for mental health care under subsections 16
(d) and (h) of section 1703 of such title; or 17
(C) with respect to such other factors as 18
the Secretary may specify. 19
(4) R
ULE OF CONSTRUCTION .—Nothing in this 20
subsection may be construed as granting a covered 21
covered veteran the right to appeal a decision of the 22
Secretary with respect to admission to the Program 23
to the Board of Veterans’ Appeals under chapter 71 24
of title 38, United States Code. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00027 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 28
•HR 8371 IH
(e) TRACKING OFAVAILABILITY ANDWAITTIMES.— 1
(1) I
N GENERAL.—The Secretary shall, to the 2
extent practicable, create a method for tracking 3
availability and wait times under the Program across 4
all facilities of the Department, Veterans Integrated 5
Service Networks of the Department, and non-De-6
partment providers throughout the United States. 7
(2) A
VAILABILITY OF INFORMATION .—The Sec-8
retary shall, to the extent practicable, make the in-9
formation tracked under paragraph (1) available in 10
real time to— 11
(A) the mental health treatment coordina-12
tors at each facility of the Department; 13
(B) the leadership of each medical center 14
of the Department; 15
(C) the leadership of each Veterans Inte-16
grated Service Network; and 17
(D) the Office of the Under Secretary for 18
Health of the Department. 19
(f) T
RAINING ANDOVERSIGHT.— 20
(1) T
RAINING.— 21
(A) I
N GENERAL.—The Secretary shall up-22
date and implement training for staff of the 23
Department directly involved in the Program 24
regarding referrals, screening, admission, place-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00028 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 29
•HR 8371 IH
ment decisions, and appeals for the Program, 1
including all changes to processes and guidance 2
under the Program required by this section and 3
under section 105 of this Act. 4
(B) C
OVERED VETERANS AWAITING ADMIS -5
SION.—The training under subparagraph (A) 6
shall include procedures for the care of covered 7
veterans awaiting admission into the Program 8
and communication with such covered veterans 9
and the providers of such covered veterans. 10
(C) T
IMING OF TRAINING.— 11
(i) I
N GENERAL.—The Secretary shall 12
require the training under subparagraph 13
(A) to be completed by staff required to 14
complete such training— 15
(I) not later than 60 days after 16
beginning employment at the Depart-17
ment in a position that includes work 18
directly involving the Program; and 19
(II) not less frequently than an-20
nually. 21
(ii) T
RACKING.—The Secretary shall 22
track completion of training required 23
under clause (i) by staff required to com-24
plete such training. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00029 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 30
•HR 8371 IH
(2) OVERSIGHT STANDARDS .—The Secretary 1
shall review and revise oversight standards for the 2
leadership of the Veterans Integrated Service Net-3
works and the Veterans Health Administration to 4
ensure that facilities and staff of the Department 5
are adhering to the policy of the Program on access 6
to care. 7
(g) C
ARECOORDINATION AND FOLLOW-UPCARE.— 8
(1) C
ONTINUITY OF CARE.—The Secretary shall 9
ensure each covered veteran who is screened for ad-10
mission to the Program is offered, and provided if 11
agreed upon, care options during the period between 12
screening of the covered veteran and admission of 13
the covered veteran to the Program to ensure the 14
covered veteran does not experience any lapse in 15
care. 16
(2) C
ARE COORDINATION FOR SUBSTANCE USE 17
DISORDER.—For a covered veteran being treated for 18
substance use disorder, the Secretary shall— 19
(A) ensure there is a care plan in place 20
during the period between any detoxification 21
services or inpatient care received by the cov-22
ered veteran and admission of the covered vet-23
eran to the Program; and 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00030 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 31
•HR 8371 IH
(B) communicate that care plan to the cov-1
ered veteran, the primary care provider of the 2
covered veteran, and the facility of the Program 3
where the covered veteran is or will be residing. 4
(3) C
ARE PLANNING PRIOR TO DISCHARGE .— 5
(A) I
N GENERAL.—The Secretary, in con-6
sultation with the covered veteran and the 7
treating providers of the covered veteran in the 8
Program, shall ensure the completion of a care 9
plan prior to the covered veteran being dis-10
charged from the Program. 11
(B) M
ATTERS TO BE INCLUDED .—The 12
care plan required under subparagraph (A) for 13
a covered veteran shall include details on the 14
course of treatment for the covered veteran fol-15
lowing completion of treatment under the Pro-16
gram, including any necessary follow-up care. 17
(C) S
HARING OF CARE PLAN .—The care 18
plan required under subparagraph (A) shall be 19
shared with the covered veteran, the primary 20
care provider of the covered veteran, and any 21
other providers with which the covered veteran 22
consents to sharing the plan. 23
(D) D
ISCHARGE FROM NON -DEPARTMENT 24
FACILITY.—Upon discharge of a covered vet-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00031 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 32
•HR 8371 IH
eran under the Program from a non-Depart-1
ment facility, the facility shall share with the 2
Department all care records maintained by the 3
facility with respect to the covered veteran and 4
shall work in consultation with the Department 5
on the care plan of the covered veteran required 6
under subparagraph (A). 7
(h) R
EPORTS TOCONGRESS.— 8
(1) R
EPORT ON MODIFICATIONS TO PRO -9
GRAM.— 10
(A) I
N GENERAL.—Not later than two 11
years after the date of the enactment of this 12
Act, the Secretary of Veterans Affairs shall 13
submit to the Committees on Veterans’ Affairs 14
of the House of Representatives and the Senate 15
a report on modifications made to the guidance, 16
operation, and oversight of the Program to ful-17
fill the requirements of this section. 18
(B) E
LEMENTS.—The report required by 19
subparagraph (A) shall include— 20
(i) an assessment of whether costs of 21
the Program, including for residential care 22
provided through facilities of the Depart-23
ment and non-Department facilities, serve 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00032 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 33
•HR 8371 IH
as a disincentive to placement in the Pro-1
gram; 2
(ii) a description of actions taken by 3
the Department to address the findings 4
and recommendations by the Secretary 5
contained in the report under section 6
503(c) of the STRONG Veterans Act of 7
2022 (division V of Public Law 117–328), 8
including such actions with respect to— 9
(I) any new locations of the Pro-10
gram added; 11
(II) any beds added at existing 12
facilities of the Program; and 13
(III) any additional treatment 14
tracks or sex-specific programs cre-15
ated or added at facilities of the De-16
partment; and 17
(iii) such recommendations as the 18
Secretary may have for legislative or ad-19
ministrative action to address any funding 20
constraints or disincentives for use of the 21
Program. 22
(2) A
NNUAL REPORT ON OPERATION OF PRO -23
GRAM.— 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00033 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 34
•HR 8371 IH
(A) IN GENERAL.—Not later than one year 1
after the submission of the report under para-2
graph (1)(A), and not less frequently than an-3
nually thereafter during the duration of the 4
Program, the Secretary shall submit to the 5
Committees on Veterans’ Affairs of the House 6
of Representatives and the Senate a report on 7
the operation of the Program. 8
(B) E
LEMENTS.—Subject to subparagraph 9
(C), each report required by subparagraph (A) 10
shall include the following: 11
(i) The number of covered veterans 12
served by the Program, disaggregated by— 13
(I) Veterans Integrated Service 14
Network in which the covered veteran 15
receives care; 16
(II) facility, including facilities of 17
the Department and non-Department 18
facilities, at which the covered veteran 19
receives care; 20
(III) type of residential rehabili-21
tation treatment care received by the 22
covered veteran under the Program; 23
(IV) sex of the covered veteran; 24
and 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00034 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 35
•HR 8371 IH
(V) race or ethnicity of the cov-1
ered veteran. 2
(ii) Wait times under the Program for 3
the most recent year data is available, 4
disaggregated by— 5
(I) treatment track or specificity 6
of residential rehabilitation treatment 7
care sought by the covered veteran; 8
(II) sex of the covered veteran; 9
(III) State or territory in which 10
the covered veteran is located; 11
(IV) Veterans Integrated Service 12
Network in which the covered veteran 13
is located; and 14
(V) facility of the Department at 15
which the covered veteran seeks care. 16
(iii) A list of all locations of the Pro-17
gram and number of bed spaces at each 18
such location, disaggregated by residential 19
rehabilitation treatment care or treatment 20
track provided under the Program at such 21
location. 22
(iv) A list of any new Program loca-23
tions added or removed and any bed spaces 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00035 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 36
•HR 8371 IH
added or removed during the one-year pe-1
riod preceding the date of the report. 2
(v) Average cost of a stay under the 3
Program, including total stay average and 4
daily average, at— 5
(I) a facility of the Department; 6
and 7
(II) a non-Department facility. 8
(vi) A review of staffing needs and 9
gaps with respect to the Program. 10
(vii) Any recommendations for 11
changes to the operation of the Program, 12
including any policy changes, guidance 13
changes, training changes, or other 14
changes. 15
(C) A
NONYMITY.—The Secretary shall pro-16
vide the data under this paragraph pursuant to 17
Federal laws and in a manner that is wholly 18
consistent with applicable Federal privacy and 19
confidentiality laws, including the Privacy Act 20
(5 U.S.C. 552a), the Health Insurance Port-21
ability and Accountability Act (Public Law 22
104–191; 42 U.S.C. 201 note) and regulations 23
(title 45, Code of Federal Regulations, parts 24
160 and 164, or successor regulations), and 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00036 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 37
•HR 8371 IH
sections 5701, 5705, and 7332 of title 38, 1
United States Code, to ensure that the provided 2
data, or some portion of the data, will not un-3
dermine the anonymity of a veteran. 4
(i) R
EVISION OFGUIDANCE.—The Secretary shall 5
update the guidance of the Department of Veterans Af-6
fairs on the operation of the Mental Health Residential 7
Rehabilitation Treatment Program to reflect each of the 8
requirements under subsections (b) through (h). 9
(j) D
EADLINE.—The Secretary of Veterans Affairs 10
shall carry out each requirement under this section by not 11
later than one year after the date of the enactment of this 12
Act, unless otherwise specified. 13
(k) C
OMPTROLLERGENERALREVIEW.— 14
(1) I
N GENERAL.—Not later than two years 15
after the date of the enactment of this Act, the 16
Comptroller General of the United States shall re-17
view access to care under the Program for covered 18
veterans in need of residential mental health care 19
and substance use disorder care. 20
(2) E
LEMENTS.—The review required by para-21
graph (1) shall include the following: 22
(A) A review of wait times under the Pro-23
gram, disaggregated by— 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00037 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 38
•HR 8371 IH
(i) treatment track or specificity of 1
residential rehabilitation treatment care 2
needed; 3
(ii) sex of the covered veteran; 4
(iii) home State of the covered vet-5
eran; 6
(iv) home Veterans Integrated Service 7
Network of the covered veteran; and 8
(v) wait times for— 9
(I) facilities of the Department; 10
and 11
(II) non-Department facilities. 12
(B) A review of policy and training of the 13
Department on screening, admission, and place-14
ment under the Program. 15
(C) A review of the rights of covered vet-16
erans and providers to appeal admission deci-17
sions under the Program and how the Depart-18
ment adjudicates appeals. 19
(D) When determining the facility at which 20
a covered veteran admitted to the Program will 21
be placed in the Program, a review of how the 22
input of the covered veteran is taken into con-23
sideration with respect to— 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00038 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 39
•HR 8371 IH
(i) program specialty, subtype, or 1
treatment track offered to the covered vet-2
eran; and 3
(ii) the geographic placement of the 4
covered veteran, including family- or occu-5
pation-related preferences or cir-6
cumstances. 7
(E) A review of staffing and staffing needs 8
and gaps of the Program, including with re-9
spect to— 10
(i) mental health providers and coor-11
dinators at the facility level; 12
(ii) staff of Program facilities; 13
(iii) staff of Veterans Integrated Serv-14
ice Networks; and 15
(iv) overall administration of the Pro-16
gram at the national level. 17
(F) Recommendations for improvement of 18
access by covered veterans to care under the 19
Program, including with respect to— 20
(i) any new sites or types of programs 21
needed or in development; 22
(ii) changes in training or policy; 23
(iii) changes in communications with 24
covered veterans; and 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00039 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 40
•HR 8371 IH
(iv) oversight of the Program by the 1
Department. 2
(l) D
EFINITIONS.—In this section: 3
(1) The term ‘‘covered veteran’’ means a vet-4
eran described in section 1703(b) of title 38, United 5
States Code. 6
(2) The term ‘‘Mental Health Residential Reha-7
bilitation Treatment Program’’— 8
(A) means— 9
(i) a mental health residential reha-10
bilitation treatment program of the De-11
partment under sections 103 and 104 of 12
the Veterans Mental Health and Other 13
Care Improvement Act of 2008 (Public 14
Law 110–387); and 15
(ii) the array of programs and serv-16
ices of the Department that comprise resi-17
dential care for mental health and sub-18
stance use disorders; 19
(B) includes— 20
(i) the programs designated as of the 21
date of the enactment of this Act as domi-22
ciliary residential rehabilitation treatment 23
programs; and 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00040 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 41
•HR 8371 IH
(ii) any programs designated as domi-1
ciliary residential rehabilitation treatment 2
programs on or after such date of enact-3
ment; and 4
(C) does not include compensated work 5
therapy transition resident programs of the De-6
partment. 7
(3) The term ‘‘treatment track’’ means a spe-8
cialized treatment program that is provided to a sub-9
set of covered veterans in the Program who receive 10
the same or similar intensive treatment and rehabili-11
tative services. 12
(m) S
UNSET.—This section shall terminate on the 13
day that is two years after that date on which the Sec-14
retary completes carrying out each requirement pursuant 15
to subsection (j). 16
SEC. 107. PILOT PROGRAM TO IMPROVE ADMINISTRATION 17
OF CARE UNDER VETERANS COMMUNITY 18
CARE PROGRAM. 19
(a) E
STABLISHMENT.—Pursuant to section 1703E of 20
title 38, United States Code, the Secretary of Veterans 21
Affairs shall carry out a pilot program to seek to develop 22
and implement a plan— 23
(1) to provide monetary and non-monetary in-24
centives to a covered health care provider— 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00041 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 42
•HR 8371 IH
(A) to allow the Secretary to see the sched-1
uling system of the provider, to assess the avail-2
ability of, and to assist in scheduling appoint-3
ments for, veterans under the Veterans Com-4
munity Care Program under section 1703 of 5
such title, including through synchronous, asyn-6
chronous, and asynchronous assisted digital 7
scheduling; 8
(B) to complete continuing professional 9
educational training available through the VHA 10
TRAIN program (or any successor program or 11
initiative) regarding veteran cultural com-12
petency, the opioid safety initiative (or any suc-13
cessor program or initiative), and other subjects 14
determined appropriate by the Secretary; 15
(C) to improve methods of accounting for 16
non-Department training that is equivalent or 17
substantially similar to the continuing profes-18
sional educational training described in sub-19
paragraph (B); 20
(D) to improve the rate of the timely re-21
turn to the Secretary of medical record docu-22
mentation for care or services provided under 23
the Veterans Community Care Program; 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00042 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 43
•HR 8371 IH
(E) to improve the timeliness and quality 1
of the delivery of care and services to veterans 2
under such program; and 3
(F) to achieve other objectives determined 4
appropriate by the Secretary; and 5
(2) to decrease the rate of no-show appoint-6
ments under such program. 7
(b) R
EPORT.—Not later than one year after the date 8
of the establishment of the pilot program under this sec-9
tion, annually thereafter during the term of the pilot pro-10
gram, the Secretary of Veterans Affairs shall submit to 11
the Committees on Veterans’ Affairs of the House of Rep-12
resentatives and the Senate a report on the pilot program 13
that includes, with respect to the period covered by the 14
report— 15
(1) an assessment of the extent to which— 16
(A) the system of the Department of Vet-17
erans Affairs for scheduling appointments for 18
veterans under the Veterans Community Care 19
Program has improved; 20
(B) the rate of timely return to the Sec-21
retary of medical record documentation de-22
scribed in subparagraph (D) of subsection 23
(a)(1) has improved; 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00043 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 44
•HR 8371 IH
(C) the timeliness and quality of the deliv-1
ery of care and services described in subpara-2
graph (E) of such subsection has improved; and 3
(D) the frequency of no-show appointments 4
described in paragraph (2) of such subsection 5
decreased; 6
(2) a list of the continuing professional edu-7
cational training courses under subparagraph (B) of 8
such subsection available to covered health care pro-9
viders; 10
(3) the rate of participation in such continuing 11
professional education training courses; and 12
(4) any other matter the Secretary determines 13
appropriate. 14
(c) D
EFINITIONS.—In this section: 15
(1) The term ‘‘covered health care provider’’ 16
means a health care provider— 17
(A) described in subsection (c) of section 18
1703 of title 38, United States Code, that fur-19
nishes care or services under the Veterans Com-20
munity Care Program pursuant to a contract or 21
agreement with a Third Party Administrator; 22
or 23
(B) that otherwise furnishes care or serv-24
ices outside of Department facilities pursuant 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00044 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 45
•HR 8371 IH
to a contract or agreement with the Secretary 1
of Veterans Affairs. 2
(2) The term ‘‘opioid safety initiative’’ means 3
the programs, processes, and guidelines of the Vet-4
erans Health Administration of the Department of 5
Veterans Affairs relating to the management of 6
opioid therapy and chronic pain. 7
(3) The term ‘‘Third Party Administrator’’ 8
means an entity that manages a network of health 9
care providers and performs administrative services 10
related to such network under section 1703 of such 11
title. 12
(4) The term ‘‘VHA TRAIN program’’ means 13
the free program of the Veterans Health Adminis-14
tration that offers veteran-specific continuing med-15
ical education courses. 16
SEC. 108. PILOT PROGRAM ON CONSOLIDATING APPROVAL 17
PROCESS OF DEPARTMENT OF VETERANS AF-18
FAIRS FOR COVERED DENTAL CARE. 19
(a) I
NGENERAL.—Not later than 180 days after the 20
date of the enactment of this Act, the Secretary of Vet-21
erans Affairs shall carry out a pilot program to hire— 22
(1) general dentists at medical facilities of the 23
Department of Veterans Affairs to manage approval 24
by the Department of treatment plans requested by 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00045 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 46
•HR 8371 IH
dental providers in providing covered dental care; 1
and 2
(2) dental specialists at Veterans Integrated 3
Service Networks of the Department to manage ap-4
proval by the Department of treatment plans for 5
specialty dental care requested by dental providers 6
in providing covered dental care. 7
(b) L
OCATIONS.—The Secretary shall carry out the 8
pilot program in not fewer than two Veterans Integrated 9
Service Networks of the Department. 10
(c) R
EPORTS.— 11
(1) I
NITIAL REPORT.—Not later than one year 12
after the date of the commencement of such pilot 13
program, the Secretary shall submit to the Commit-14
tees on Veterans’ Affairs of the Senate and the 15
House of Representatives a report on the pilot pro-16
gram, that includes— 17
(A) an identification of the Veterans Inte-18
grated Service Networks participating in such 19
pilot program; 20
(B) a description of the implementation of 21
such pilot program; 22
(C) an identification of any barriers or 23
challenges to implementing such pilot program; 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00046 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 47
•HR 8371 IH
(D) an assessment of the efficacy of hiring 1
general dentists and dental specialists pursuant 2
to such pilot program; 3
(E) aggregated feedback with respect to 4
such pilot program from dentists of the Depart-5
ment in Veterans Integrated Service Networks 6
participating in such pilot program; and 7
(F) aggregated feedback from dental pro-8
viders providing covered dental care within such 9
Veterans Integrated Service Networks regard-10
ing any changes in the timeliness of treatment 11
plan approvals by the Department. 12
(2) F
INAL REPORT.—Not later than 90 days 13
before the date of the completion of such pilot pro-14
gram, the Secretary shall submit to the Committees 15
on Veterans’ Affairs of the Senate and the House of 16
Representatives a report on the pilot program that— 17
(A) includes, with respect to the period 18
covered by the report, each element of the re-19
port required under paragraph (1) described in 20
subparagraphs (A) through (F) of such para-21
graph; 22
(B) includes recommendations of the Sec-23
retary on whether the pilot program should 24
be— 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00047 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 48
•HR 8371 IH
(i) extended; 1
(ii) expanded; or 2
(iii) adopted throughout the Depart-3
ment; and 4
(C) indicates whether the Secretary re-5
quests action by Congress to make the pilot 6
program permanent. 7
(d) S
UNSET.—The authority to carry out the pilot 8
program under this section shall terminate on the date 9
that is two years after the date of the enactment of this 10
Act. 11
(e) C
OVEREDDENTALCAREDEFINED.—In this sec-12
tion, the term ‘‘covered dental care’’ means dental care 13
provided— 14
(1) under section 1703 of title 38, United 15
States Code; or 16
(2) pursuant to a Veterans Care Agreement 17
under section 1703A of such title. 18
SEC. 109. STRATEGIC PLAN ON VALUE-BASED HEALTH 19
CARE SYSTEM FOR VETERANS HEALTH AD-20
MINISTRATION; PILOT PROGRAM. 21
(a) E
STABLISHMENT OF WORKINGGROUP.— 22
(1) I
N GENERAL.—Not later than one year 23
after the date of the enactment of this Act, the Sec-24
retary of Veterans Affairs shall— 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00048 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 49
•HR 8371 IH
(A) establish a working group on value- 1
based care; and 2
(B) submit to the Committees on Veterans’ 3
Affairs of the House of Representatives and the 4
Senate the strategic plan developed by the 5
working group pursuant to subsection (b). 6
(2) M
EMBERSHIP.— 7
(A) R
EQUIRED MEMBERS .—The working 8
group shall include, at a minimum, the fol-9
lowing members: 10
(i) The Under Secretary for Health of 11
the Department of Veterans Affairs. 12
(ii) The Director of the Office of Men-13
tal Health and Suicide Prevention of the 14
Department of Veterans Affairs (or any 15
successor office). 16
(iii) The Director of the Office of In-17
tegrated Veteran Care of the Department 18
(or any successor office). 19
(iv) The Director of the Office of 20
Rural Health of the Department (or any 21
successor office). 22
(v) The Director of the Office of Con-23
nected Care of the Department (or any 24
successor office). 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00049 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 50
•HR 8371 IH
(vi) The Assistant Secretary for the 1
Office of Information Technology (or any 2
successor office). 3
(vii) The Chief Officer of the Office of 4
Healthcare Innovation and Learning of the 5
Office of Discovery, Education, and Affil-6
iate Networks of the Veterans Health Ad-7
ministration (or any successor office). 8
(viii) An individual designated by the 9
Secretary from the Center for Innovation 10
for Care and Payment of the Department 11
under section 1703E of title 38, United 12
States Code. 13
(ix) An individual designated by the 14
Administrator of the Centers for Medicare 15
& Medicaid Services from the Center for 16
Medicare and Medicaid Innovation. 17
(x) An individual designated by the 18
Secretary of Health and Human Services 19
from the Federal Office of Rural Health 20
Policy of the Health Resources and Serv-21
ices Administration. 22
(xi) The Chief of Human Capital 23
Management for the Veterans Health Ad-24
ministration. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00050 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 51
•HR 8371 IH
(xii) An individual designated by the 1
Secretary of Defense that is a representa-2
tive of the Defense Health Agency. 3
(xiii) An individual selected by the 4
Secretary of Veterans Affairs from the spe-5
cial medical advisory group established 6
under section 7312 of title 38, United 7
States Code. 8
(B) O
PTIONAL MEMBERS .—The Secretary 9
of Veterans Affairs may appoint any of the fol-10
lowing individuals as members of the working 11
group: 12
(i) An individual representing the 13
Health and Medicine Division of the Na-14
tional Academies of Sciences, Engineering, 15
and Medicine. 16
(ii) Three individuals representing a 17
private health care system that has made 18
the transition to value-based care. 19
(iii) Three individuals representing an 20
organization recognized by the Secretary of 21
Veterans Affairs under section 5902 of 22
title 38, United States Code. 23
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00051 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 52
•HR 8371 IH
(3) EXEMPTION FROM FACA .—Chapter 10 of 1
title 5, United States Code, shall not apply to the 2
working group established under paragraph (1). 3
(b) D
EVELOPMENT OF STRATEGICPLAN.—The 4
working group shall develop a strategic plan to implement 5
value-based care into the Veterans Health Administration 6
that includes the following: 7
(1) An identification of the state of the Vet-8
erans Health Administration as of the date of the 9
enactment of this Act, including an assessment of 10
the current model of health care delivery used by the 11
Veterans Health Administration in medical facilities 12
of the Department of Veterans Affairs. 13
(2) An assessment of the capacity needs of the 14
Veterans Health Administration during the five-year 15
period beginning on the date of the enactment of 16
this Act. 17
(3) An analysis of the leadership of the Vet-18
erans Health Administration, including an assess-19
ment of leadership acumen and ability to implement 20
a clear, shared vision and effective change manage-21
ment and care coordination. 22
(4) An identification of goals for the future of 23
the Veterans Health Administration. 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00052 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 53
•HR 8371 IH
(5) An identification and classification of the 1
current capabilities, capacity, and gaps in access and 2
quality of the health care system of the Department 3
of Veterans Affairs. 4
(6) An analysis of value-based care models, in-5
cluding— 6
(A) a selection of potential models that 7
would best work for the Veterans Health Ad-8
ministration; 9
(B) the capacity and capabilities of each 10
such model; and 11
(C) a thorough justification of the selection 12
of each selected model, including an summary 13
of the ability of such model to improve the 14
metrics described under paragraph (9). 15
(7) A definition of what quality means with re-16
spect to— 17
(A) access to health care under the laws 18
administered by the Secretary of Veterans Af-19
fairs; and 20
(B) delivery of such health care. 21
(8) A definition of what value means with re-22
spect to care furnished by the Veterans Health Ad-23
ministration, 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00053 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 54
•HR 8371 IH
(9) A system for measuring value within the 1
Veterans Health Administration that includes 2
metrics for— 3
(A) outcomes; 4
(B) safety; 5
(C) service; 6
(D) access; 7
(E) productivity; 8
(F) capacity; 9
(G) equity; and 10
(H) total cost of patient care. 11
(10) With respect to the system described in 12
subparagraph (H), an analysis of variable value with 13
respect to patient outcomes across different health 14
care types and specialties. 15
(11) An assessment of— 16
(A) previous or ongoing assessments of the 17
current information technology infrastructure of 18
the Veterans Health Administration, includ-19
ing— 20
(i) such assessments conducted pursu-21
ant to the Electronic Health Record Mod-22
ernization program of the Department of 23
Veterans Affairs; and 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00054 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 55
•HR 8371 IH
(ii) any other ongoing information 1
technology modernization programs of such 2
Department and any unimplemented rel-3
evant recommendations from such assess-4
ments; 5
(B) the information technology infrastruc-6
ture of the Veterans Health Administration in 7
effect as of the date of the enactment of this 8
Act; 9
(C) the value-driven framework of the De-10
partment, in effect as of the date of the enact-11
ment of this Act, for evaluating health care in-12
novations, and how improvements in such 13
framework could be used to encourage innova-14
tion; and 15
(D) workforce challenges and needs of the 16
Veterans Health Administration based on— 17
(i) reviews of workforce assessment 18
data available as of the date of the enact-19
ment of this Act; and 20
(ii) the findings of— 21
(I) the report required by section 22
301(d) of the Veterans Access, 23
Choice, and Accountability Act of 24
2014 (Public Law 113–146); 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00055 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 56
•HR 8371 IH
(II) the reports required by sec-1
tion 505 of the John S. McCain III, 2
Daniel K. Akaka and Samuel R. 3
Johnson VA Maintaining Internal 4
Systems and Strengthening Inte-5
grated Outside Networks Act of 2018 6
(Public Law 115–182); 7
(III) the report required by sec-8
tion 301 of the VA Choice and Qual-9
ity Employment Act of 2017 (Public 10
Law 115–46); and 11
(IV) any comprehensive health 12
care inspection conducted by the In-13
spector General of the Department of 14
Veterans Affairs as of the date of the 15
enactment of this Act. 16
(12) Any recommendations of the working 17
group with respect to improving the information 18
technology infrastructure described in clause (i) of 19
subparagraph (J). 20
(13) An analysis of how the value-driven frame-21
work described in clause (iii) of such subparagraph 22
could be used to improve the model of care delivery 23
by the Department. 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00056 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 57
•HR 8371 IH
(14) A description of how a value-based care 1
system would apply to primary care, inpatient and 2
outpatient mental health care, and inpatient and 3
outpatient substance use treatment, spinal cord in-4
jury disorder care, and polytrauma care furnished by 5
the Veterans Health Administration. 6
(15) With respect to legislative or administra-7
tive action necessary to incorporate value-based care 8
models into the Veterans Health Administration, a 9
description of the estimated timelines, effect on 10
workforce, and costs. 11
(c) P
ILOTPROGRAM.— 12
(1) I
N GENERAL.—Not later than 180 days 13
after the submission of the strategic plan pursuant 14
to subsection (b), the Secretary of Veterans Affairs 15
shall commence a three-year pilot program to imple-16
ment the elements of such strategic plan relating to 17
the delivery, by the Veterans Health Administration, 18
of primary care, inpatient and outpatient mental 19
health treatment, inpatient and outpatient substance 20
abuse treatment, spinal cord injury disorder care, 21
and polytrauma care. 22
(2) L
OCATIONS.—The Secretary shall carry out 23
such pilot program in four Veterans Integrated 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00057 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 58
•HR 8371 IH
Service Networks that are geographically dispersed 1
and shall include the following: 2
(A) A Veterans Integrated Service Net-3
work that predominately serves veterans in 4
rural and highly rural areas. 5
(B) A Veterans Integrated Service Net-6
work that predominately serves veterans in 7
urban areas. 8
(C) A Veterans Integrated Service Net-9
work that has a high rate of suicide among vet-10
erans. 11
(D) A Veterans Integrated Service Net-12
work that has a high rate of substance use dis-13
order among veterans. 14
(E) A Veterans Integrated Service Net-15
work that has access or productivity challenges. 16
(3) R
EPORTS TO CONGRESS.— 17
(A) A
NNUAL REPORT.—Not later than one 18
year after the commencement of the pilot pro-19
gram, and annually thereafter during the dura-20
tion of the pilot program, the Secretary shall 21
submit to Congress a report on the pilot pro-22
gram. 23
(B) F
INAL REPORT.—Not later than 90 24
days before the conclusion of the pilot program, 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00058 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 59
•HR 8371 IH
the Secretary shall submit to Congress a final 1
report on the pilot program that includes— 2
(i) lessons learned during the adminis-3
tration of such pilot program; and 4
(ii) specific health outcomes in veteran 5
patient care compared to the Veterans 6
Health Administration system of care in 7
effect as of the date of the enactment of 8
this Act. 9
SEC. 110. PLAN ON ADOPTION OF CERTAIN HEALTH INFOR-10
MATION STANDARDS FOR DEPARTMENT OF 11
VETERANS AFFAIRS AND CERTAIN HEALTH 12
CARE PROVIDERS. 13
(a) P
LAN FOR CERTAINHEALTHINFORMATION 14
S
TANDARDS.— 15
(1) I
N GENERAL.—The Secretary of Veterans 16
Affairs, in consultation with the Secretary of Health 17
and Human Services, the Administrator of the Cen-18
ters for Medicare & Medicaid Services, and the Na-19
tional Coordinator for Health Information Tech-20
nology of the Department of Health and Human 21
Services, shall create and implement a plan to adopt, 22
as rapidly and to the most comprehensive extent fea-23
sible, national health information interoperability 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00059 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 60
•HR 8371 IH
standards for the Department of Veterans Affairs 1
and community care providers with respect to— 2
(A) coordination of— 3
(i) care; and 4
(ii) benefits; 5
(B) patient identity matching; 6
(C) measurement and reporting of quality; 7
(D) population health; and 8
(E) public health. 9
(2) C
ONSIDERATION.—In developing the plan 10
under paragraph (1), the Secretary of Veterans Af-11
fairs shall consider challenges faced by— 12
(A) small community care providers; and 13
(B) community care providers located in 14
rural areas. 15
(b) P
LAN ONELECTRONICHEALTHRECORDEX-16
CHANGE.— 17
(1) I
N GENERAL.—Not later than one year 18
after the date of enactment of this Act, the Sec-19
retary shall submit to the Committees on Veterans’ 20
Affairs of the Senate and the House of Representa-21
tives a plan to provide, at no cost, to community 22
care providers of the Department, through Third 23
Party Administrators, a capability to facilitate the 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00060 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 61
•HR 8371 IH
electronic direct exchange, between such providers 1
and the Department, of— 2
(A) the health records of veterans; and 3
(B) documents relating to health care of 4
veterans, clinical notes, and any other informa-5
tion the Secretary determines necessary. 6
(2) P
RIORITIZATION.—In developing the plan 7
required under paragraph (1), the Secretary shall 8
prioritize providing the capability described in such 9
paragraph to community care providers that— 10
(A) provide care under the laws adminis-11
tered by the Secretary to— 12
(i) a lower volume of veterans; and 13
(ii) veterans who are located in rural 14
areas; and 15
(B) are unable or unwilling to exchange 16
the records and documents described in sub-17
paragraphs (A) and (B) of such paragraph with 18
the Department through standards-based or di-19
rect exchange mechanisms in effect as of the 20
date of the enactment of this Act. 21
(c) R
EPORTS ON PLAN FOR INTEROPERABILITY 22
S
TANDARDS.— 23
(1) I
NITIAL REPORT.—Not later than one year 24
after the date of the enactment of this Act, the Sec-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00061 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 62
•HR 8371 IH
retary of Veterans Affairs shall submit to the Com-1
mittees on Veterans’ Affairs of the Senate and the 2
House of Representatives— 3
(A) the plan required by subsection (a); 4
and 5
(B) a report that includes— 6
(i) an analysis of gaps, if any, be-7
tween the use, by the Department and 8
other agencies, health information ex-9
changes, and technology companies, of na-10
tional health information interoperability 11
standards and the potential, or optimal, 12
use of such national health information 13
interoperability standards; 14
(ii) an analysis and description of the 15
participation by the Department, commu-16
nity care providers, and other relevant en-17
tities in the Trusted Exchange Framework 18
and Common Agreement program of the 19
Department of Health and Human Serv-20
ices as of the date of the enactment of this 21
Act; 22
(iii) recommendations of the Secretary 23
with respect to development of health in-24
formation interoperability standards; 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00062 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 63
•HR 8371 IH
(iv) timelines or schedules to imple-1
ment the plan required by subsection (a); 2
and 3
(v) an identification of any legislative 4
authorities or resources the Secretary re-5
quires to implement such plan. 6
(2) R
ECURRING REPORT REQUIREMENT .— 7
(A) I
N GENERAL.—Not later than 18 8
months after the date of the enactment of this 9
Act, and every 180 days thereafter for four 10
years, the Secretary of Veterans Affairs shall 11
submit to Committees on Veterans’ Affairs of 12
the Senate and the House of Representatives a 13
report on the status of implementation of the 14
plan required under subsection (a). 15
(B) E
LEMENTS OF SUBSEQUENT RE -16
PORTS.—Each report under subparagraph (A) 17
submitted after the date on which the first re-18
port required by such subparagraph is sub-19
mitted shall include a description of any revi-20
sions to— 21
(i) the plan required by subsection (a) 22
made during the period covered by the re-23
port; and 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00063 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 64
•HR 8371 IH
(ii) the analysis, recommendations, 1
timelines, and legislative authorities re-2
ported pursuant to paragraph (1). 3
(d) D
EFINITIONS.—In this section: 4
(1) The term ‘‘community care provider’’ means 5
a non-Department health care provider providing 6
care (including dental care)— 7
(A) under section 1703 of title 38, United 8
States Code; 9
(B) pursuant to a Veterans Care Agree-10
ment under section 1703A of such title; or 11
(C) under any other law administered by 12
the Secretary of Veterans Affairs. 13
(2) The term ‘‘Third Party Administrator’’ 14
means an entity that manages a provider network 15
and performs administrative services related to such 16
network under section 1703 of title 38, United 17
States Code. 18
SEC. 111. REPORT ON USE OF VALUE-BASED REIMBURSE-19
MENT MODELS UNDER VETERANS COMMU-20
NITY CARE PROGRAM. 21
(a) R
EPORT ON VALUE-BASEDREIMBURSEMENT 22
M
ODELS.—Not later than one year after the date of the 23
enactment of this Act, the Secretary of Veterans Affairs, 24
in consultation with the Center for Innovation for Care 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00064 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 65
•HR 8371 IH
and Payment of the Department of Veterans Affairs under 1
section 1703E of title 38 United States Code, the Office 2
of Integrated Veteran Care of the Department, or suc-3
cessor office, and Third Party Administrators, shall sub-4
mit to the Committees on Veterans’ Affairs of the House 5
of Representatives and the Senate a report containing— 6
(1) an assessment of the efforts of the Depart-7
ment pursuant to section 1703(i)(5) of such title, to 8
incorporate value-based reimbursement models under 9
the Veterans Community Care Program to promote 10
the provision of high-quality care to veterans; and 11
(2) such recommendations for legislative or ad-12
ministrative action as the Secretary considers appro-13
priate regarding the use of value-based reimburse-14
ment models throughout the Veterans Community 15
Care Program under section 1703 of such title. 16
(b) R
ULE OFCONSTRUCTION.—This section shall not 17
be construed to be a pilot program subject to the require-18
ments of section 1703E of title 38, United States Code. 19
(c) T
HIRDPARTYADMINISTRATORDEFINED.—In 20
this section, the term ‘‘Third Party Administrator’’ means 21
an entity that manages a provider network and performs 22
administrative services related to such network under sec-23
tion 1703 of title 38, United States Code. 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00065 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 66
•HR 8371 IH
SEC. 112. INSPECTOR GENERAL ASSESSMENT OF IMPLE-1
MENTATION OF VETERANS COMMUNITY 2
CARE PROGRAM. 3
(a) I
NGENERAL.—Not later than two years after the 4
date of the enactment of this Act, and periodically there-5
after, the Inspector General shall assess the performance 6
of a representative sample of medical centers in each Vet-7
erans Integrated Service Network of the Department of 8
Veterans Affairs in— 9
(1) appropriately identifying veterans eligible 10
for care and services under section 1703 of title 38, 11
United States Code; 12
(2) informing veterans of their eligibility for 13
such care and services; and 14
(3) delivering such care and services in a timely 15
manner. 16
(b) B
RIEFING ONASSESSMENTS.—Upon the submis-17
sion of the initial assessment required by subsection (a), 18
the Inspector General of the Department of Veterans Af-19
fairs shall provide to the Committees on Veterans Affairs 20
of the House of Representatives and the Senate a briefing 21
on the plans of such Inspector General with respect to the 22
findings, frequency, and methodology relating to such as-23
sessment. 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00066 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 67
•HR 8371 IH
SEC. 113. COMPTROLLER GENERAL REPORT ON DENTISTRY 1
UNDER VETERANS COMMUNITY CARE PRO-2
GRAM. 3
(a) I
NGENERAL.—Not later than one year after the 4
date of the enactment of this Act, the Comptroller General 5
of the United States shall submit to the Committees on 6
Veterans’ Affairs of the Senate and the House of Rep-7
resentatives a report on dental care furnished by the Sec-8
retary of Veterans Affairs under the Veterans Community 9
Care Program under section 1703 of title 38, United 10
States Code, that includes a review of— 11
(1) the impact current reimbursement rates 12
provided by the Department of Veterans Affairs to 13
dental providers under such program have on— 14
(A) the availability of dental care for vet-15
erans; and 16
(B) the ability of Third Party Administra-17
tors to meet their contractual obligations for 18
network adequacy; 19
(2) the satisfaction of dental providers pro-20
viding dental care under such program with the 21
processes of the Department for approving dental 22
care under such program; and 23
(3) the current processes of the Department for 24
approving emergent dental care under such program. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00067 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 68
•HR 8371 IH
(b) THIRDPARTYADMINISTRATORDEFINED.—In 1
this section, the term ‘‘Third Party Administrator’’ means 2
an entity that manages a provider network and performs 3
administrative services related to such network under sec-4
tion 1703 of title 38, United States Code. 5
Subtitle B—Matters Relating to 6
Nursing Home and Other Long 7
Term Care and Family Care-8
givers 9
SEC. 120. INCREASE OF EXPENDITURE CAP FOR NON-10
INSTITUTIONAL CARE ALTERNATIVES TO 11
NURSING HOME CARE. 12
(a) I
NCREASE OF EXPENDITURE CAP.—Section 13
1720C(d) of title 38, United States Code, is amended— 14
(1) by striking ‘‘The total cost’’ and inserting 15
‘‘(1) Except as provided in paragraph (2), the total 16
cost’’; 17
(2) by striking ‘‘65 percent’’ and inserting ‘‘100 18
percent’’; and 19
(3) by adding at the end the following new 20
paragraph: 21
‘‘(2)(A) The total cost of providing services or in-kind 22
assistance in the case of any veteran described in subpara-23
graph (B) for any fiscal year under the program may ex-24
ceed 100 percent of the cost that would otherwise have 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00068 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 69
•HR 8371 IH
been incurred as specified in paragraph (1) if the Sec-1
retary determines, based on a consideration of clinical 2
need, geographic market factors, and such other matters 3
as the Secretary may prescribe through regulation, that 4
such higher total cost is in the best interest of the veteran. 5
‘‘(B) A veteran described in this subparagraph is a 6
veteran with amyotrophic lateral sclerosis, a spinal cord 7
injury, or a condition the Secretary determines to be simi-8
lar to such conditions.’’. 9
(b) A
PPLICABILITY.—The amendments made by sub-10
section (a) shall apply with respect to fiscal years begin-11
ning on or after the date of the enactment of this Act. 12
SEC. 121. COORDINATION WITH PROGRAM OF ALL-INCLU-13
SIVE CARE FOR THE ELDERLY. 14
Section 1720C of title 38, United States Code, as 15
amended by section 120, is further amended by adding 16
at the end the following new subsection: 17
‘‘(f) In furnishing services to a veteran under the pro-18
gram conducted pursuant to subsection (a), if a medical 19
center of the Department through which such program is 20
administered is located in a geographic area in which serv-21
ices are available to the veteran under a PACE program 22
(as such term is defined in sections 1894(a)(2) and 23
1934(a)(2) of the Social Security Act (42 U.S.C. 24
1395eee(a)(2); 1396u–4(a)(2))), the Secretary shall seek 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00069 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 70
•HR 8371 IH
to enter into an agreement with the PACE program oper-1
ating in that area for the furnishing of such services.’’. 2
SEC. 122. AUTHORITY FOR SECRETARY OF VETERANS AF-3
FAIRS TO AWARD GRANTS OR CONTRACTS TO 4
ENTITIES TO IMPROVE PROVISION OF MEN-5
TAL HEALTH SUPPORT TO FAMILY CARE-6
GIVERS OF VETERANS. 7
Subchapter II of chapter 17 of title 38, United States 8
Code, is amended by adding at the end the following new 9
section (and conforming the table of sections at the begin-10
ning of such chapter accordingly): 11
‘‘§ 1720K. Grants or contracts to provide mental 12
health support to family caregivers of 13
veterans 14
‘‘(a) A
UTHORITY.—The Secretary may award grants 15
to carry out, coordinate, improve, or otherwise enhance 16
mental health counseling, treatment, or support to the 17
family caregivers of veterans participating in the family 18
caregiver program. 19
‘‘(b) A
PPLICATION.—(1) To be eligible for a grant or 20
contract under this section, an entity shall submit to the 21
Secretary an application therefor at such time, in such 22
manner, and containing such information as the Secretary 23
may require. 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00070 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 71
•HR 8371 IH
‘‘(2) Each application submitted under paragraph (1) 1
shall include the following: 2
‘‘(A) A detailed plan for the use of the grant 3
or contract. 4
‘‘(B) A description of the programs or efforts 5
through which the entity will meet the outcome 6
measures developed by the Secretary under sub-7
section (g). 8
‘‘(C) A description of how the entity will dis-9
tribute grant or contract amounts equitably among 10
areas with varying levels of urbanization. 11
‘‘(D) A plan for how the grant or contract will 12
be used to meet the unique needs of veterans resid-13
ing in rural areas, Native American, Native Hawai-14
ian, or Alaska Native veterans, elderly veterans, 15
women veterans, and veterans from other under-16
served communities. 17
‘‘(c) D
ISTRIBUTION.—The Secretary shall seek to en-18
sure that grants and contracts awarded under this section 19
are equitably distributed among entities located in States 20
with varying levels of urbanization. 21
‘‘(d) P
RIORITY.—The Secretary shall prioritize 22
awarding grants or contracts under this section that will 23
serve the following areas: 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00071 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 72
•HR 8371 IH
‘‘(1) Areas with high rates of veterans enrolled 1
in the family caregiver program. 2
‘‘(2) Areas with high rates of— 3
‘‘(A) suicide among veterans; or 4
‘‘(B) referrals to the Veterans Crisis Line. 5
‘‘(e) R
EQUIREDACTIVITIES.—Any grant or contract 6
awarded under this section shall be used— 7
‘‘(1) to expand existing programs, activities, 8
and services; 9
‘‘(2) to establish new or additional programs, 10
activities, and services; or 11
‘‘(3) for travel and transportation to facilitate 12
carrying out paragraph (1) or (2). 13
‘‘(f) O
UTCOMEMEASURES.—(1) The Secretary shall 14
develop and provide to each entity that receives a grant 15
or contract under this section written guidance on the fol-16
lowing: 17
‘‘(A) Outcome measures. 18
‘‘(B) Policies of the Department. 19
‘‘(2) In developing outcome measures under para-20
graph (1), the Secretary shall consider the following goals: 21
‘‘(A) Increasing the utilization of mental health 22
services among family caregivers of veterans partici-23
pating in the family caregiver program. 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00072 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 73
•HR 8371 IH
‘‘(B) Reducing barriers to mental health serv-1
ices among family caregivers of veterans partici-2
pating in such program. 3
‘‘(g) T
RACKINGREQUIREMENTS.—(1) The Secretary 4
shall establish appropriate tracking requirements with re-5
spect to the entities receiving a grant or contract under 6
this section. 7
‘‘(2) Not less frequently than annually, the Secretary 8
shall submit to Congress a report on such tracking re-9
quirements. 10
‘‘(h) P
ERFORMANCE REVIEW.—The Secretary 11
shall— 12
‘‘(1) review the performance of each entity that 13
receives a grant or contract under this section; and 14
‘‘(2) make information regarding such perform-15
ance publicly available. 16
‘‘(i) R
EMEDIATIONPLAN.—(1) In the case of an enti-17
ty that receives a grant or contract under this section and 18
does not meet the outcome measures developed by the Sec-19
retary under subsection (g), the Secretary shall require the 20
entity to submit to the Secretary a remediation plan under 21
which the entity shall describe how and when it plans to 22
meet such outcome measures. 23
‘‘(2) The Secretary may not award a subsequent 24
grant or contract under this section to an entity described 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00073 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 74
•HR 8371 IH
in paragraph (1) unless the Secretary approves the reme-1
diation plan submitted by the entity under such para-2
graph. 3
‘‘(j) M
AXIMUMAMOUNT.—The amount of a grant or 4
contract awarded under this section may not exceed 10 5
percent of amounts made available for grants or contracts 6
under this section for the fiscal year in which the grant 7
or contract is awarded. 8
‘‘(k) S
UPPLEMENT, NOTSUPPLANT.—Any grant or 9
contract awarded under this section shall be used to sup-10
plement and not supplant funding that is otherwise avail-11
able through the Department to provide mental health 12
support among family caregivers of veterans participating 13
in the family caregiver program. 14
‘‘(l) O
UTREACH TOFAMILYCAREGIVERS.—The Sec-15
retary shall include, in the outreach materials regularly 16
provided to a family caregiver who participates in the fam-17
ily caregiver program, notice of mental health support pro-18
vided by recipients of grants or contracts under this sec-19
tion that are located in the relevant Veterans Integrated 20
Service Network. 21
‘‘(m) F
UNDING.—(1) Amounts for the activities of 22
the Department under this section shall be budgeted and 23
appropriated through a separate appropriation account. 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00074 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 75
•HR 8371 IH
‘‘(2) In the budget justification materials submitted 1
to Congress in support of the budget of the Department 2
for any fiscal year (as submitted with the budget of the 3
President under section 1105(a) of title 31), the Secretary 4
shall include a separate statement of the amount re-5
quested to be appropriated for that fiscal year for the ac-6
count specified in paragraph (1). 7
‘‘(n) A
UTHORIZATION OF APPROPRIATIONS.—There 8
is authorized to be appropriated to the Secretary, for each 9
of fiscal years 2025 and 2026, $10,000,000 to carry out 10
this section. 11
‘‘(o) D
EFINITIONS.—In this section: 12
‘‘(1) The terms ‘caregiver’ and ‘family care-13
giver’ have the meanings given those terms in sec-14
tion 1720G of this title. 15
‘‘(2) The term ‘family caregiver program’ 16
means the program of comprehensive assistance for 17
family caregivers under section 1720G of this title. 18
‘‘(3) The term ‘Veterans Crisis Line’ means the 19
toll-free hotline for veterans established under sec-20
tion 1720F of this title.’’. 21
SEC. 123. HOME- AND COMMUNITY-BASED SERVICES: PRO-22
GRAMS. 23
(a) P
ROGRAMS.—Such subchapter is further amend-24
ed by inserting after section 1720K (as added by section 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00075 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 76
•HR 8371 IH
122) the following new section (and conforming the table 1
of sections at the beginning of such chapter accordingly): 2
‘‘§ 1720L. Home- and community-based services: pro-3
grams 4
‘‘(a) I
NGENERAL.—In furnishing noninstitutional al-5
ternatives to nursing home care pursuant to the authority 6
of section 1720C of this title (or any other authority under 7
this chapter or other provision of law administered by the 8
Secretary of Veterans Affairs), the Secretary shall carry 9
out each of the programs specified in this section in ac-10
cordance with such relevant authorities except as other-11
wise provided in this section. 12
‘‘(b) V
ETERAN-DIRECTEDCAREPROGRAM.—(1) The 13
Secretary of Veterans Affairs, in collaboration with the 14
Secretary of Health and Human Services, shall carry out 15
a program to be known as the ‘Veteran-Directed Care pro-16
gram’. Under such program, the Secretary of Veterans Af-17
fairs may enter into agreements with the providers de-18
scribed in paragraph (2) to provide to eligible veterans 19
funds, to the extent practicable, to obtain such in-home 20
care services and related items that support clinical need 21
and improve quality of life, as may be determined appro-22
priate by the Secretary of Veterans Affairs and selected 23
by the veteran, including through the veteran hiring indi-24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00076 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 77
•HR 8371 IH
viduals to provide such services and items or directly pur-1
chasing such services and items. 2
‘‘(2) The providers described in this paragraph are 3
the following: 4
‘‘(A) An Aging and Disability Resource Center, 5
an area agency on aging, or a State agency. 6
‘‘(B) A center for independent living. 7
‘‘(C) An Indian tribe or tribal organization re-8
ceiving assistance under title VI of the Older Ameri-9
cans Act of 1965 (42 U.S.C. 3057 et seq.). 10
‘‘(D) Any other entity that the Secretary, in 11
consultation with the Secretary of Health and 12
Human Services, determines appropriate. 13
‘‘(3) In carrying out the Veteran-Directed Care pro-14
gram, the Secretary of Veterans Affairs shall— 15
‘‘(A) administer such program through each 16
medical center of the Department of Veterans Af-17
fairs; 18
‘‘(B) seek to ensure the availability of such pro-19
gram in American Samoa, Guam, the Common-20
wealth of the Northern Mariana Islands, the Com-21
monwealth of Puerto Rico, the Virgin Islands of the 22
United States, and any other territory or possession 23
of the United States, to the extent practicable; and 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00077 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 78
•HR 8371 IH
‘‘(C) seek to ensure the availability of such pro-1
gram for eligible veterans who are Native American 2
veterans receiving care and services furnished by the 3
Indian Health Service, a tribal health program, an 4
Urban Indian organization, or (in the case of a Na-5
tive Hawaiian veteran) a Native Hawaiian health 6
care system, to the extent practicable. 7
‘‘(4) If a veteran participating in the Veteran-Di-8
rected Care program is hospitalized, the veteran may con-9
tinue to use funds under the program during a period of 10
hospitalization in the same manner that the veteran would 11
be authorized to use such funds under the program if the 12
veteran were not hospitalized. 13
‘‘(c) H
OMEMAKER AND HOMEHEALTHAIDEPRO-14
GRAM.—(1) The Secretary shall carry out a program to 15
be known as the ‘Homemaker and Home Health Aide pro-16
gram’ under which the Secretary may enter into agree-17
ments with home health agencies to provide to eligible vet-18
erans such home health aide services as may be deter-19
mined appropriate by the Secretary. 20
‘‘(2) In carrying out the Homemaker and Home 21
Health Aide program, the Secretary shall— 22
‘‘(A) administer such program in the locations 23
specified in subparagraph (A) of subsection (b)(3); 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00078 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 79
•HR 8371 IH
‘‘(B) seek to ensure the availability of such pro-1
gram in the locations specified in subparagraph (B) 2
of subsection (b)(3); and 3
‘‘(C) seek to ensure the availability of such pro-4
gram for the veteran populations specified in sub-5
paragraph (C) of subsection (b)(3). 6
‘‘(d) H
OME-BASEDPRIMARYCAREPROGRAM.—The 7
Secretary shall carry out a program to be known as the 8
‘Home-Based Primary Care program’ under which the 9
Secretary may furnish to eligible veterans in-home health 10
care, the provision of which is overseen by a provider of 11
the Department. 12
‘‘(e) P
URCHASEDSKILLEDHOMECAREPROGRAM.— 13
The Secretary shall carry out a program to be known as 14
the ‘Purchased Skilled Home Care program’ under which 15
the Secretary may furnish to eligible veterans such in- 16
home care services as may be determined appropriate and 17
selected by the Secretary for the veteran. 18
‘‘(f) C
AREGIVERSUPPORT.—(1) With respect to a 19
resident eligible caregiver of a veteran participating in a 20
program under this section, the Secretary shall— 21
‘‘(A) if the veteran meets the requirements of 22
a covered veteran under section 1720G(b) of this 23
title, provide to such caregiver the option of enroll-24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00079 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 80
•HR 8371 IH
ing in the program of general caregiver support serv-1
ices under such section; 2
‘‘(B) provide to such caregiver covered respite 3
care of not less than 30 days annually; and 4
‘‘(C) conduct on an annual basis (and, to the 5
extent practicable, in connection with in-person serv-6
ices provided under the program in which the vet-7
eran is participating), a wellness contact of such 8
caregiver. 9
‘‘(2) Covered respite care provided to a resident eligi-10
ble caregiver of a veteran under paragraph (1) may exceed 11
30 days annually if such extension is requested by the resi-12
dent eligible caregiver or veteran and determined medi-13
cally appropriate by the Secretary. 14
‘‘(g) R
ULE OFCONSTRUCTION.—Nothing in this sec-15
tion shall be construed to limit the authority of the Sec-16
retary to carry out programs providing home- and commu-17
nity-based services under any other provision of law. 18
‘‘(h) D
EFINITIONS.—In this section: 19
‘‘(1) The terms ‘Aging and Disability Resource 20
Center’, ‘area agency on aging’, and ‘State agency’ 21
have the meanings given those terms in section 102 22
of the Older Americans Act of 1965 (42 U.S.C. 23
3002). 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00080 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 81
•HR 8371 IH
‘‘(2) The terms ‘caregiver’ and ‘family care-1
giver’, with respect to a veteran, have the meanings 2
given those terms, respectively, under subsection (e) 3
of section 1720G of this title with respect to an eli-4
gible veteran under subsection (a) of such section or 5
a covered veteran under subsection (b) of such sec-6
tion, as the case may be. 7
‘‘(3) The term ‘center for independent living’ 8
has the meaning given that term in section 702 of 9
the Rehabilitation Act of 1973 (29 U.S.C. 796a). 10
‘‘(4) The term ‘covered respite care’ has the 11
meaning given such term in section 1720G(d) of this 12
title. 13
‘‘(5) The term ‘eligible veteran’ means any vet-14
eran— 15
‘‘(A) for whom the Secretary determines 16
participation in a specific program under this 17
section is medically necessary to promote, pre-18
serve, or restore the health of the veteran; and 19
‘‘(B) who absent such participation would 20
be at increased risk for hospitalization, place-21
ment in a nursing home, or emergency room 22
care. 23
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00081 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 82
•HR 8371 IH
‘‘(6) The term ‘home health aide’ means an in-1
dividual employed by a home health agency to pro-2
vide in-home care services. 3
‘‘(7) The term ‘in-home care service’ means any 4
service, including a personal care service, provided to 5
enable the recipient of such service to live at home. 6
‘‘(8) The terms ‘Indian tribe’ and ‘tribal organi-7
zation’ have the meanings given those terms in sec-8
tion 4 of the Indian Self-Determination and Edu-9
cation Assistance Act (25 U.S.C. 5304). 10
‘‘(9) The terms ‘Native American’ and ‘Native 11
American veteran’ have the meanings given those 12
terms in section 3765 of this title. 13
‘‘(10) The terms ‘Native Hawaiian’ and ‘Native 14
Hawaiian health care system’ have the meanings 15
given those terms in section 12 of the Native Hawai-16
ian Health Care Improvement Act (42 U.S.C. 17
11711). 18
‘‘(11) The terms ‘tribal health programs’ and 19
‘Urban Indian organizations’ have the meanings 20
given those terms in section 4 of the Indian Health 21
Care Improvement Act (25 U.S.C. 1603). 22
‘‘(12) The term ‘resident eligible caregiver’ 23
means an individual who— 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00082 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 83
•HR 8371 IH
‘‘(A) is a caregiver, or a family caregiver, 1
of a veteran and resides with that veteran; and 2
‘‘(B) has not entered into a contract, 3
agreement, or other arrangement for such indi-4
vidual to act as a caregiver for that veteran un-5
less such individual is a family member of the 6
veteran or is furnishing caregiver services 7
through a medical foster home.’’. 8
(b) D
EADLINE FORIMPROVEDADMINISTRATION.— 9
The Secretary of Veterans Affairs shall ensure that the 10
Veteran-Directed Care program and the Homemaker and 11
Home Health Aide program are administered through 12
each medical center of the Department of Veterans Affairs 13
in accordance with section 1720L of title 38, United 14
States Code (as added by subsection (a)), by not later 15
than two years after the date of the enactment of this Act. 16
(c) A
DMINISTRATION OF VETERAN-DIRECTEDCARE 17
P
ROGRAM.— 18
(1) P
ROCEDURES.— 19
(A) The Secretary shall establish proce-20
dures to— 21
(i) identify the staffing needs for the 22
Veteran-Directed Care program of the De-23
partment of Veterans Affairs under such 24
section (as added by subsection (a)); and 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00083 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 84
•HR 8371 IH
(ii) define the roles and responsibil-1
ities for personnel of the Department re-2
sponsible for the administration of such 3
program, including such personnel em-4
ployed at the national, Veterans Integrated 5
Service Network, or medical facility level. 6
(B) The responsibilities described in clause 7
(ii) of subparagraph (A) shall include respon-8
sibilities for engagement with— 9
(i) veterans participating in such pro-10
gram; 11
(ii) veterans interested in partici-12
pating in such program; and 13
(iii) providers described in section 14
1720L(b)(2) (as added by subsection (a)). 15
(2) S
TAFFING MODEL ; REPORT.—Not later 16
than two years after enactment of this Act, the Sec-17
retary of Veterans Affairs shall— 18
(A) establish a staffing model for the ad-19
ministration of such program at each medical 20
facility of the Department of Veterans Affairs; 21
and 22
(B) submit to the Committees on Veterans’ 23
Affairs of the House of Representatives and the 24
Senate a report containing the following: 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00084 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 85
•HR 8371 IH
(i) A description of— 1
(I) the staffing model described 2
in subparagraph (A); and 3
(II) the rationale for such staff-4
ing model. 5
(ii) An identification of the ratio of 6
staff required to administer such program 7
to the number of veterans served by such 8
program, disaggregated by each medical 9
facility of the Department of Veterans Af-10
fairs. 11
(iii) A description of budgetary re-12
sources or other support, if any, required 13
to accommodate an increase in staffing at 14
medical facilities of the Department of 15
Veterans Affairs pursuant to the require-16
ments of the staffing model described in 17
subparagraph (A). 18
(iv) Such other matters as the Sec-19
retary of Veterans Affairs determines ap-20
propriate. 21
SEC. 124. COORDINATION WITH ASSISTANCE AND SUPPORT 22
SERVICES FOR CAREGIVERS. 23
(a) C
OORDINATIONWITHPROGRAM OFCOMPREHEN-24
SIVEASSISTANCE FORFAMILYCAREGIVERS.— 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00085 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 86
•HR 8371 IH
(1) COORDINATION.—Section 1720G(a) of title 1
38, United States Code, is amended by adding at 2
the end the following new paragraph: 3
‘‘(14)(A) In the case of a veteran or caregiver who 4
seeks services under this subsection and is denied such 5
services, or a veteran or the family caregiver of a veteran 6
who is discharged from the program under this subsection, 7
the Secretary shall— 8
‘‘(i) if the veteran meets the requirements of a 9
covered veteran under subsection (b), provide to 10
such caregiver the option of enrolling in the program 11
of general caregiver support services under such sub-12
section; 13
‘‘(ii) assess the veteran or caregiver for partici-14
pation in any other available program of the Depart-15
ment for home- and community-based services (in-16
cluding the programs specified in section 1720L of 17
this title) for which the veteran or caregiver may be 18
eligible and, with respect to the veteran, store (and 19
make accessible to the veteran) the results of such 20
assessment in the electronic medical record of the 21
veteran; and 22
‘‘(iii) provide to the veteran or caregiver written 23
information on any such program identified pursu-24
ant to the assessment under clause (ii), including in-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00086 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 87
•HR 8371 IH
formation about facilities, eligibility requirements, 1
and relevant contact information for each such pro-2
gram. 3
‘‘(B) The Secretary shall, to the extent practicable, 4
provide to a veteran or family caregiver the option of ob-5
taining clinically appropriate services under any other 6
available program of the Department for home- and com-7
munity-based services (including the programs specified in 8
section 1720L of this title) for which the veteran or family 9
caregiver may be eligible prior to discharging the veteran 10
or family caregiver from the program under this sub-11
section. 12
‘‘(C) For each veteran or family caregiver who is dis-13
charged from the program under this subsection, a care-14
giver support coordinator shall provide for a smooth and 15
personalized transition from such program to an appro-16
priate program of the Department for home- and commu-17
nity-based services (including the programs specified in 18
section 1720L of this title), including by integrating care-19
giver support across programs.’’. 20
(2) A
PPLICABILITY.—The amendments made 21
by paragraph (1) shall apply with respect to denials 22
and discharges occurring on or after the date that 23
is 180 days after the date of the enactment of this 24
Act. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00087 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 88
•HR 8371 IH
(3) TECHNICAL AND CONFORMING AMEND -1
MENTS.—Section 1720G(d) of such title is amend-2
ed— 3
(A) by striking ‘‘or a covered veteran’’ 4
each place it appears and inserting ‘‘, a veteran 5
denied or discharged as specified in paragraph 6
(14) of such subsection, or a covered veteran’’; 7
and 8
(B) by striking ‘‘under subsection (a), 9
means’’ each place it appears and inserting 10
‘‘under subsection (a) or a veteran denied or 11
discharged as specified in paragraph (14) of 12
such subsection, means’’. 13
(b) C
ONFORMITY OF RESPITECAREACROSSPRO-14
GRAMS.—Section 1720G of title 38, United States Code, 15
as amended by subsection (a)(3), is further amended— 16
(1) in subsection (a)(3)— 17
(A) by amending subparagraph (A)(ii)(III) 18
to read as follows: 19
‘‘(III) covered respite care of not less than 20
30 days annually;’’; and 21
(B) by striking subparagraph (B) and re-22
designating subparagraphs (C) and (D) as sub-23
paragraphs (B) through (C), respectively; and 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00088 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 89
•HR 8371 IH
(2) by amending subsection (b)(3)(A)(iii) to 1
read as follows: 2
‘‘(iii) Covered respite care of not less than 30 3
days annually.’’; and 4
(3) in subsection (d)— 5
(A) by redesignating paragraphs (2) 6
through (4) as paragraphs (3) through (5), re-7
spectively; and 8
(B) by inserting after paragraph (1) the 9
following new paragraph: 10
‘‘(2) The term ‘covered respite care’ means, 11
with respect to a caregiver of a veteran, respite care 12
under section 1720B of this title that— 13
‘‘(A) is medically and age appropriate for 14
the veteran (including 24-hour per day care of 15
the veteran commensurate with the care pro-16
vided by the caregiver); and 17
‘‘(B) includes in-home care.’’. 18
(c) R
EVIEWRELATING TOCAREGIVERCONTACT.— 19
The Secretary shall conduct a review of the capacity of 20
the Department to establish a streamlined system for con-21
tacting all caregivers enrolled in the program of general 22
caregiver support services under section 1720G(b) of title 23
38, United States Code, to provide to such caregivers pro-24
gram updates and alerts relating to emerging services for 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00089 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 90
•HR 8371 IH
which such caregivers or the veterans for which they pro-1
vide care may be eligible. 2
SEC. 125. IMPROVEMENTS TO PROGRAM OF COMPREHEN-3
SIVE ASSISTANCE FOR FAMILY CAREGIVERS. 4
Section 1720G(a) of title 38, United States Code, as 5
amended by section 124, is further amended— 6
(1) in paragraph (12)— 7
(A) in subparagraph (A), by inserting ‘‘, 8
which shall include all criteria used to deter-9
mine eligibility for such assistance and, in the 10
case of a completed evaluation, how such cri-11
teria were used to evaluate information pro-12
vided in assessments to determine such eligi-13
bility’’ before the period at the end; and 14
(B) in subparagraph (C)(i), by striking 15
‘‘who submits’’ and all that follows through the 16
end of the clause and inserting the following: 17
‘‘who— 18
‘‘(I) submits an application for the pro-19
gram established under paragraph (1); or 20
‘‘(II) is being reassessed for eligibility to 21
continue in such program.’’; and 22
(2) by adding at the end the following new 23
paragraph: 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00090 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 91
•HR 8371 IH
‘‘(15)(A) Not less frequently than annually, the Sec-1
retary shall submit to the Committees on Veterans’ Affairs 2
of the Senate and the House of Representatives a com-3
prehensive report on the program required by paragraph 4
(1) that includes, with respect to one-year period pre-5
ceding the date of the submission of such report, the fol-6
lowing: 7
‘‘(i) The number of applications received for 8
such program. 9
‘‘(ii) The number, disaggregated by race, sex, 10
and era and branch of service in the Armed Forces 11
of the applicant, of— 12
‘‘(I) approvals of such applications; and 13
‘‘(II) denials of such applications. 14
‘‘(iii) The number of reassessments conducted 15
for such program. 16
‘‘(iv) An identification of each decision made 17
with respect to a reassessment conducted for such 18
program, disaggregated by decisions resulting in— 19
‘‘(I) disenrollment, including removal, dis-20
charge, or voluntary withdrawal; 21
‘‘(II) tier reduction; and 22
‘‘(III) tier continuation. 23
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00091 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 92
•HR 8371 IH
‘‘(v) The number of appeals of decisions made 1
with respect to such program, disaggregated by type 2
of appeal. 3
‘‘(vi) With respect to each appeal described in 4
clause (v), the decision rendered, if any. 5
‘‘(vii) A description of all tools used in assess-6
ments conducted for such program, including an ex-7
planation of how and by whom such tools are admin-8
istered. 9
‘‘(viii) A description of procedures used under 10
such program for reviewing and integrating clinical 11
records from health care providers that includes an 12
explanation of how such records are used in deter-13
minations of eligibility for such program. 14
‘‘(ix) A description of procedures available 15
under such program for health care providers to 16
communicate medical opinions to the teams con-17
ducting assessments to determine eligibility for such 18
program, including health care providers in the pri-19
vate sector and health care providers specified in 20
subsection (c) of section 1703 of this title. 21
‘‘(x) A description of information technology 22
systems and processes used under such program to 23
upload and integrate all clinical records from all 24
non-Department providers, including providers in 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00092 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 93
•HR 8371 IH
the private sector and providers under the Veterans 1
Community Care Program established under such 2
section. 3
‘‘(B) The Secretary shall ensure that all data in-4
cluded in a report under subparagraph (A)— 5
‘‘(i) relating to a decision made under the pro-6
gram required by paragraph (1), are disaggregated 7
by the specific reason for the decision; 8
‘‘(ii) relating to a veteran, include comprehen-9
sive demographic information of the veteran, includ-10
ing the time period of the injuries, if any, of the vet-11
eran and the Veterans Integrated Service Network 12
in which the veteran is located; and 13
‘‘(iii) with respect to eligibility determinations 14
relating to a serious injury of a veteran, specify— 15
‘‘(I) how many such determinations relate 16
to the ability of the veteran to perform activi-17
ties of daily living; and 18
‘‘(II) how many such determinations relate 19
to the need of a veteran for supervision and 20
protection. 21
‘‘(C) The Secretary shall provide the data under 22
paragraph (B) pursuant to Federal laws and in a manner 23
that is wholly consistent with applicable Federal privacy 24
and confidentiality laws, including but the Privacy Act (5 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00093 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 94
•HR 8371 IH
U.S.C. 552a), the Health Insurance Portability and Ac-1
countability Act (Public Law 104–191; 42 U.S.C. 201 2
note) and regulations (title 45, Code of Federal Regula-3
tions, parts 160 and 164, or successor regulations), and 4
sections 5701, 5705, and 7332 of this title to ensure that 5
the provided data, or some portion of the data, will not 6
undermine the anonymity of a veteran.’’. 7
SEC. 126. IMPROVEMENTS RELATING TO HOMEMAKER AND 8
HOME HEALTH AIDE PROGRAM. 9
(a) P
ILOTPROGRAM FOR COMMUNITIES WITH 10
S
HORTAGE OFHOMEHEALTHAIDES.— 11
(1) P
ROGRAM.—Beginning not later than 18 12
months after the date of the enactment of this Act, 13
the Secretary shall carry out a three-year pilot pro-14
gram under which the Secretary shall provide home-15
maker and home health aide services to veterans 16
who reside in communities with a shortage of home 17
health aides. 18
(2) L
OCATIONS.—The Secretary shall select not 19
fewer than five geographic locations in which the 20
Secretary determines there is a shortage of home 21
health aides at which to carry out the pilot program 22
under paragraph (1). 23
(3) N
URSING ASSISTANTS.— 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00094 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 95
•HR 8371 IH
(A) IN GENERAL.—In carrying out the 1
pilot program under paragraph (1), the Sec-2
retary may hire nursing assistants as new em-3
ployees of the Department of Veterans Affairs, 4
or reassign nursing assistants who are existing 5
employees of the Department, to provide to vet-6
erans in-home care services (including basic 7
tasks authorized by the State certification of 8
the nursing assistant) under the pilot program, 9
in lieu of or in addition to the provision of such 10
services through non-Department home health 11
aides. 12
(B) R
ELATIONSHIP TO HOME -BASED PRI-13
MARY CARE PROGRAM .—Nursing assistants 14
hired or reassigned under subparagraph (A) 15
may provide services to a veteran under the 16
pilot program under paragraph (1) while serv-17
ing as part of a health care team for the vet-18
eran under the Home-Based Primary Care pro-19
gram. 20
(4) R
EPORT TO CONGRESS.—Not later than one 21
year before the date of the termination of the pilot 22
program under paragraph (1), the Secretary shall 23
submit to the Committees on Veterans’ Affairs of 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00095 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 96
•HR 8371 IH
the House of Representatives and the Senate a re-1
port that includes— 2
(A) a statement of the results of such pilot 3
program; and 4
(B) an assessment of the feasibility and 5
advisability of— 6
(i) extending such pilot program; or 7
(ii) making such pilot program a per-8
manent program of the Department of 9
Veterans Affairs. 10
(b) R
EPORT ONUSE OFFUNDS.—Not later than one 11
year after the date of the enactment of this Act, the Sec-12
retary of Veterans Affairs shall submit to the Committees 13
on Veterans’ Affairs of the House of Representatives and 14
the Senate a report containing, with respect to the period 15
beginning in fiscal year 2012 and ending in fiscal year 16
2023, the following: 17
(1) An identification of the amount of funds 18
that were included in a budget of the Department of 19
Veterans Affairs during such period for the provision 20
of in-home care to veterans under the Homemaker 21
and Home Health Aide program but were not ex-22
pended for such provision, disaggregated by medical 23
center of the Department for which such unex-24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00096 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 97
•HR 8371 IH
pended funds were budgeted (if such disaggregation 1
is possible). 2
(2) To the extent practicable, an identification 3
of the number of veterans for whom, during such pe-4
riod, the hours during which a home health aide was 5
authorized to provide services to the veteran under 6
the Homemaker and Home Health Aide program 7
were reduced for a reason other than a change in 8
the health care needs of the veteran, and a detailed 9
description of the reasons why any such reductions 10
may have occurred. 11
(c) U
PDATEDGUIDANCE ONPROGRAM.—Not later 12
than one year after the date of the enactment of this Act, 13
the Secretary shall issue updated guidance for the Home-14
maker and Home Health Aide program. Such updated 15
guidance shall include the following: 16
(1) A process for the transition of veterans 17
from the Homemaker and Home Health Aide pro-18
gram to other covered programs. 19
(2) A requirement for the directors of the med-20
ical facilities of the Department to complete such 21
process whenever a veteran with care needs has been 22
denied services from home health agencies under the 23
Homemaker and Home Health Aide program as a 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00097 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 98
•HR 8371 IH
result of the clinical needs or behavioral issues of the 1
veteran. 2
SEC. 127. PILOT PROGRAM TO FURNISH ASSISTED LIVING 3
SERVICES TO CERTAIN VETERANS. 4
(a) E
STABLISHMENT.—Beginning not later than two 5
years after the date of the enactment of this Act, the Sec-6
retary of Veterans Affairs shall carry out a pilot program 7
to assess— 8
(1) the effectiveness of providing assisted living 9
services to eligible veterans, at the election of such 10
veterans; and 11
(2) the satisfaction with the pilot program of 12
veterans participating in such pilot program. 13
(b) P
ROGRAMLOCATIONS.— 14
(1) V
ETERANS INTEGRATED SERVICE NET -15
WORKS.—The Secretary shall select two Veterans 16
Integrated Service Networks of the Department of 17
Veterans Affairs at which to carry out the pilot pro-18
gram under subsection (a). 19
(2) F
ACILITIES.— 20
(A) I
N GENERAL.—Within the Veterans 21
Integrated Service Networks selected under 22
paragraph (1), the Secretary shall select facili-23
ties at which to carry out the pilot program 24
under subsection (a)(1). 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00098 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 99
•HR 8371 IH
(B) SELECTION CRITERIA.—In selecting 1
facilities under subparagraph (A) at which to 2
carry out the pilot program under subsection 3
(a)(1), the Secretary shall ensure that— 4
(i) the locations of such facilities are 5
in geographically diverse areas; 6
(ii) not fewer than one such facility 7
serves veterans in rural or highly rural 8
areas (as determined through the use of 9
the Rural-Urban Commuting Areas coding 10
system of the Department of Agriculture); 11
(iii) not fewer than one such facility is 12
located in each Veterans Integrated Service 13
Network selected under paragraph (1); and 14
(iv) not fewer than one such facility is 15
a State home. 16
(c) P
ROGRAMPARTICIPANTS.—Not more than 60 eli-17
gible veterans may participate in the pilot program under 18
subsection (a)(1) in each Veterans Integrated Service Net-19
work selected under subsection (b)(1). 20
(d) P
ROVISION OFASSISTEDLIVINGSERVICES.— 21
(1) A
GREEMENTS.—In carrying out the pilot 22
program under subsection (a)(1), the Secretary may 23
enter into agreements for the provision of assisted 24
living services on behalf of eligible veterans with— 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00099 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 100
•HR 8371 IH
(A) a provider participating under a State 1
plan or waiver under title XIX of the Social Se-2
curity Act (42 U.S.C. 1396 et seq.); or 3
(B) a State home recognized and certified 4
under subpart B of part 51 of title 38, Code of 5
Federal Regulations, or successor regulations. 6
(2) S
TANDARDS.—The Secretary may not place, 7
transfer, or admit a veteran to any facility for as-8
sisted living services under the pilot program under 9
subsection (a)(1) unless the Secretary determines 10
that— 11
(A) the facility meets the standards for 12
community residential care established under 13
sections 17.61 through 17.72 of title 38, Code 14
of Federal Regulations, or successor regula-15
tions, and any additional standards of care as 16
the Secretary may specify; or 17
(B) in the case of a facility that is a State 18
home, the State home meets such standards of 19
care as the Secretary may specify. 20
(3) I
NSPECTION.—The Secretary shall inspect 21
facilities at which veterans are placed under the pilot 22
program under subsection (a)(1)— 23
(A) with respect to a facility that is a 24
State home, not less frequently than annually 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00100 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 101
•HR 8371 IH
and in the same manner as the Secretary con-1
ducts inspection of State homes under section 2
1742 of title 38, United States Code; and 3
(B) with respect to any other facility, not 4
less frequently than annually and in the same 5
manner as the Secretary conducts inspection of 6
facilities under section 1730 of such title. 7
(4) P
AYMENT TO CERTAIN FACILITIES .— 8
(A) S
TATE HOMES.—In the case of a facil-9
ity participating in the pilot program under 10
subsection (a)(1) that is a State home, the Sec-11
retary shall pay to the State home a per diem 12
for each veteran participating in the pilot pro-13
gram at a rate agreed to by the Secretary and 14
the State home. 15
(B) C
OMMUNITY ASSISTED LIVING FACILI -16
TIES.—In the case of a facility participating in 17
the pilot program under subsection (a)(1) that 18
is a community assisted living facility, the Sec-19
retary shall— 20
(i) pay to the facility an amount that 21
is less than the average rate paid by the 22
Department for placement in a community 23
nursing home in the same Veterans Inte-24
grated Service Network; and 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00101 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 102
•HR 8371 IH
(ii) re-evaluate payment rates annu-1
ally to account for current economic condi-2
tions and current costs of assisted living 3
services. 4
(e) C
ONTINUITY OFCARE.—Upon the termination of 5
the pilot program under subsection (a)(1), the Secretary 6
shall— 7
(1) provide to all veterans participating in the 8
pilot program at the time of such termination the 9
option to continue to receive assisted living services 10
at the site they were assigned to under the pilot pro-11
gram, at the expense of the Department; and 12
(2) for such veterans who do not opt to con-13
tinue to receive such services— 14
(A) ensure such veterans do not experience 15
lapses in care; and 16
(B) provide such veterans with information 17
on, and furnish such veterans with, other ex-18
tended care services based on their preferences 19
and best medical interest. 20
(f) D
ETERMINATION OF QUALITY.—The Secretary 21
shall determine a method for assessment of quality of care 22
provided to veterans participating in the pilot program 23
under subsection (a)(1) and shall communicate that meth-24
od to providers of services under the pilot program. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00102 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 103
•HR 8371 IH
(g) ANNUALREPORT.—Not later than one year after 1
the initiation of the pilot program under subsection (a)(1), 2
and annually thereafter for the duration of such pilot pro-3
gram, the Secretary shall submit to the Committees on 4
Veterans’ Affairs of the House of Representatives and the 5
Senate a report on the pilot program that includes— 6
(1) an identification of Veterans Integrated 7
Services Networks and facilities of the Department 8
participating in the pilot program and assisted living 9
facilities and State homes at which veterans are 10
placed under the pilot program; 11
(2) the number of participants in the pilot pro-12
gram, disaggregated by facility; 13
(3) general demographic information of partici-14
pants in the pilot program, including average age, 15
sex, and race or ethnicity; 16
(4) disability status of participants in the pilot 17
program; 18
(5) an identification of any barriers or chal-19
lenges to furnishing care to veterans under the pilot 20
program, conducting oversight of the pilot program, 21
or any other barriers or challenges; 22
(6) the cost of care at each assisted living facil-23
ity and State home participating in the pilot pro-24
gram, including an analysis of any cost savings by 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00103 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 104
•HR 8371 IH
the Department when comparing that cost to the 1
cost of nursing home care; 2
(7) aggregated feedback from participants in 3
the pilot program, including from veteran resident 4
surveys and interviews; and 5
(8) such other matters the Secretary considers 6
appropriate. 7
(h) F
INALREPORT.—Not later than one year after 8
the pilot program terminates under subsection (j), the 9
Secretary shall submit to the Committees on Veterans’ Af-10
fairs of the House of Representatives and the Senate a 11
report on the pilot program that— 12
(1) includes the matters required under para-13
graphs (1) through (8) of subsection (g); 14
(2) includes recommendations on whether the 15
model studied in the pilot program should be contin-16
ued or adopted throughout the Department; and 17
(3) indicates whether the Secretary requests ac-18
tion by Congress to make the pilot program perma-19
nent. 20
(i) I
NSPECTORGENERALREPORT.— 21
(1) I
N GENERAL.—Not later than three years 22
after the initiation of the pilot program under sub-23
section (a)(1), the Inspector General of the Depart-24
ment of Veterans Affairs shall submit to the Sec-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00104 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 105
•HR 8371 IH
retary of Veterans Affairs and the Committees on 1
Veterans’ Affairs of the House of Representatives 2
and the Senate a report on the pilot program. 3
(2) E
LEMENTS.—The report required by para-4
graph (1) shall include an assessment of— 5
(A) the quality of care provided to veterans 6
at facilities participating in the pilot program, 7
measured pursuant to the method determined 8
under subsection (f); 9
(B) the oversight of such facilities, as con-10
ducted by the Department, the Centers for 11
Medicare & Medicaid Services, State agencies, 12
and other relevant entities; and 13
(C) such other matters as the Inspector 14
General considers appropriate. 15
(3) P
LAN REQUIRED.—Not later than 90 days 16
after the submission of the report under paragraph 17
(1), the Secretary shall submit to the Committees on 18
Veterans’ Affairs of the House of Representatives 19
and the Senate a plan to address the deficiencies 20
identified in the report, if any. 21
(j) T
ERMINATION.— 22
(1) I
N GENERAL.—Subject to paragraph (2), 23
the pilot program under subsection (a)(1) shall ter-24
minate on September 30, 2026. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00105 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 106
•HR 8371 IH
(2) EXTENSION.—The Secretary may extend 1
the duration of the pilot program for an additional 2
two-year period if the Secretary, based on the results 3
of the reports submitted under subsection (g), deter-4
mines such an extension is appropriate. 5
(k) D
EFINITIONS.—In this section: 6
(1) The term ‘‘assisted living services’’ means 7
services of a facility in providing room, board, and 8
personal care for and supervision of residents for 9
their health, safety, and welfare. 10
(2) The term ‘‘eligible veteran’’ means a vet-11
eran who is— 12
(A) receiving nursing home care paid for 13
by the Department of Veterans Affairs, eligible 14
to receive such care pursuant to section 1710A 15
of title 38, United States Code, or requires a 16
higher level of care than the domiciliary care 17
provided by the Department of Veterans Af-18
fairs, but does not meet the requirements for 19
nursing home level care provided by the Depart-20
ment pursuant to such section; and 21
(B) eligible for assisted living services, as 22
determined by the Secretary or meets such ad-23
ditional criteria for eligibility for the pilot pro-24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00106 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 107
•HR 8371 IH
gram under subsection (a)(1) as the Secretary 1
may establish. 2
(3) The term ‘‘State home’’ has the meaning 3
given that term in section 101 of title 38, United 4
States Code. 5
SEC. 128. PROVISION OF MEDICINE, EQUIPMENT, AND SUP-6
PLIES AVAILABLE TO DEPARTMENT OF VET-7
ERANS AFFAIRS TO STATE HOMES. 8
(a) P
ROVISIONAUTHORIZED.—The Secretary of Vet-9
erans Affairs may provide to State homes medicine, per-10
sonal protective equipment, medical supplies, and any 11
other equipment, supplies, and assistance available to the 12
Department of Veterans Affairs. 13
(b) D
EFINITION.—In this section: 14
(1) The term ‘‘personal protective equipment’’ 15
means any protective equipment required to prevent 16
the wearer from contracting an infectious disease, 17
including gloves, N–95 respirator masks, gowns, 18
goggles, face shields, or other equipment required 19
for safety. 20
(2) The term ‘‘State home’’ has the meaning 21
given such term in section 101 of title 38, United 22
States Code. 23
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00107 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 108
•HR 8371 IH
SEC. 129. RECOGNITION OF ORGANIZATIONS AND INDIVID-1
UALS TO ASSIST VETERANS, FAMILY MEM-2
BERS, AND CAREGIVERS NAVIGATING PRO-3
GRAMS AND SERVICES OF VETERANS 4
HEALTH ADMINISTRATION. 5
(a) I
NGENERAL.—Not later than one year after the 6
date of the enactment of this Act, the Secretary of Vet-7
erans Affairs shall establish a process through which the 8
Department of Veterans Affairs may recognize organiza-9
tions and individuals to assist a veteran, a family member 10
of a veteran, or a caregiver of a veteran (as defined in 11
section 1720G(d) of title 38, United States Code) in navi-12
gating the programs and services of the Veterans Health 13
Administration. 14
(b) S
OLICITATION OF FEEDBACK.—The Secretary 15
shall solicit feedback and recommendations in the creation 16
of the process under subsection (a) from such organiza-17
tions as the Secretary may consider relevant. 18
(c) L
IMITATION.—The Secretary may not recognize 19
an organization or individual pursuant to the process es-20
tablished under subsection (a) unless the organization or 21
individual has certified to the Secretary that no fee or 22
compensation of any nature will be charged to any indi-23
vidual for services rendered in providing assistance pursu-24
ant to such subsection. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00108 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 109
•HR 8371 IH
SEC. 130. REVIEWS AND OTHER IMPROVEMENTS RELATING 1
TO HOME- AND COMMUNITY-BASED SERV-2
ICES. 3
(a) O
FFICE OFGERIATRIC ANDEXTENDEDCARE.— 4
(1) R
EVIEW OF PROGRAMS .—The Under Sec-5
retary for Health of the Department of Veterans Af-6
fairs shall conduct a review of each program admin-7
istered through the Office of Geriatric and Extended 8
Care of the Department and the Caregiver Support 9
Program Office of the Department, or any successor 10
offices, to— 11
(A) eliminate service gaps at the medical 12
center level; and 13
(B) ensure— 14
(i) the clinical needs of veterans are 15
met; 16
(ii) consistency in program manage-17
ment; 18
(iii) the availability of, and the access 19
by veterans to, home- and community- 20
based services, including for veterans living 21
in rural areas; and 22
(iv) proper coordination between cov-23
ered programs. 24
(2) A
SSESSMENT OF STAFFING NEEDS .—The 25
Secretary of Veterans Affairs shall conduct an as-26
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00109 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 110
•HR 8371 IH
sessment of the staffing needs of the Office of Geri-1
atric and Extended Care of the Department and the 2
Caregiver Support Program Office of the Depart-3
ment, or any successor offices. 4
(3) G
OALS FOR GEOGRAPHIC ALIGNMENT OF 5
CARE.— 6
(A) E
STABLISHMENT OF GOALS .—The Di-7
rector of the Office of Geriatric and Extended 8
Care, or successor office, shall establish quan-9
titative goals to enable aging or disabled vet-10
erans who are not located near medical centers 11
of the Department to access extended care serv-12
ices (including by improving access to home- 13
and community-based services for such vet-14
erans). 15
(B) I
MPLEMENTATION TIMELINE .—Each 16
goal established under subparagraph (A) shall 17
include a timeline for the implementation of the 18
goal at each medical center of the Department. 19
(4) G
OALS FOR IN-HOME SPECIALTY CARE .— 20
The Director of the Office of Geriatric and Extended 21
Care, or successor office, shall establish quantitative 22
goals to address the specialty care needs of veterans 23
through in-home care, including by ensuring the 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00110 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 111
•HR 8371 IH
education of home health aides and caregivers of vet-1
erans in the following areas: 2
(A) Dementia care. 3
(B) Care for spinal cord injuries and dis-4
eases. 5
(C) Ventilator care. 6
(D) Other speciality care areas as deter-7
mined by the Secretary. 8
(5) I
NPUT ON GOALS .—To the extent prac-9
ticable, the head of the Caregiver Support Program 10
Office, or successor office, shall provide to the Direc-11
tor of the Office of Geriatric and Extended Care, or 12
successor office, input with respect to the establish-13
ment of the goals under paragraphs (3) and (4). 14
(6) R
EPORT TO CONGRESS.—Not later than one 15
year after the date of the enactment of this Act, the 16
Secretary shall submit to the Committees on Vet-17
erans’ Affairs of the House of Representatives and 18
the Senate a report containing the findings of the 19
review under paragraph (1), the results of the as-20
sessment under paragraph (2), and the goals estab-21
lished under paragraphs (3) and (4). 22
(b) R
EVIEW OFINCENTIVES AND EFFORTSRELAT-23
ING TOHOME- ANDCOMMUNITY-BASEDSERVICES.— 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00111 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 112
•HR 8371 IH
(1) REVIEW.—The Secretary of Veterans Af-1
fairs shall conduct a review of the following: 2
(A) The financial and organizational incen-3
tives or disincentives for the directors of med-4
ical centers of the Department to establish or 5
expand covered programs at such medical cen-6
ters. 7
(B) Any incentives or disincentives for 8
such directors to provide to veterans home- and 9
community-based services in lieu of institutional 10
care. 11
(C) The efforts taken by the Secretary to 12
enhance spending of the Department for ex-13
tended care by balancing spending between in-14
stitutional care and home- and community- 15
based services consistent with the demand for 16
such services. 17
(D) The plan of the Under Secretary for 18
Health of the Department to accelerate efforts 19
to enhance spending as specified in subpara-20
graph (C), to match the progress of similar ef-21
forts taken by the Administrator of the Centers 22
for Medicare & Medicaid Services with respect 23
to spending of the Centers for Medicare & Med-24
icaid Services for extended care. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00112 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 113
•HR 8371 IH
(2) REPORT TO CONGRESS.—Not later than one 1
year after the date of the enactment of this Act, the 2
Secretary shall submit to the Committees on Vet-3
erans’ Affairs of the House of Representatives and 4
the Senate a report on the findings of the review 5
under paragraph (1). 6
(c) R
EVIEW OFRESPITECARESERVICES.—Not later 7
than two years after the date of the enactment of this Act, 8
the Secretary of Veterans Affairs shall conduct a review 9
of the use, availability, cost, and effectiveness, of the res-10
pite care services furnished by the Secretary under chapter 11
17 of title 38, United States Code, including— 12
(1) the frequency at which the Department of 13
Veterans Affairs is unable to meet demand for such 14
services; 15
(2) a detailed description of— 16
(A) the reasons the Department of Vet-17
erans Affairs is unable to meet the demand for 18
such services; and 19
(B) any actions, or planned actions, of the 20
Secretary of Veterans Affairs to ensure such 21
demand is met. 22
(d) C
OLLABORATIONTOIMPROVEHOME- ANDCOM-23
MUNITY-BASEDSERVICES.— 24
(1) R
ECOMMENDATIONS .— 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00113 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 114
•HR 8371 IH
(A) DEVELOPMENT.—The Secretary of 1
Veterans Affairs shall develop recommendations 2
as follows: 3
(i) With respect to home- and commu-4
nity-based services for veterans, the Sec-5
retary of Veterans Affairs shall develop 6
recommendations regarding new services 7
(in addition to those furnished as of the 8
date of enactment of this Act) in collabora-9
tion with the Secretary of Health and 10
Human Services. 11
(ii) With respect to the national short-12
age of home health aides, the Secretary of 13
Veterans Affairs shall develop rec-14
ommendations regarding methods to ad-15
dress such shortage in collaboration with 16
the Secretary of Health and Human Serv-17
ices and the Secretary of Labor. 18
(B) S
UBMISSION TO CONGRESS .—The Sec-19
retary of Veterans Affairs shall submit to the 20
Committees on Veterans’ Affairs of the House 21
of Representatives and the Senate a report con-22
taining the recommendations developed under 23
subparagraph (A) and an identification of any 24
changes in existing law or new statutory au-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00114 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 115
•HR 8371 IH
thority necessary to implement the rec-1
ommendations, as determined by the Secretary. 2
(C) C
ONSULTATION WITH SECRETARY OF 3
LABOR.—In carrying out this paragraph, the 4
Secretary of Veterans Affairs shall consult with 5
the Secretary of Labor. 6
(2) F
EEDBACK AND RECOMMENDATIONS ON 7
CAREGIVER SUPPORT.— 8
(A) F
EEDBACK AND RECOMMENDA -9
TIONS.—The Secretary of Veterans Affairs shall 10
solicit from the entities described in subpara-11
graph (B) feedback and recommendations re-12
garding opportunities for the Secretary to en-13
hance home- and community-based services for 14
veterans and the caregivers of veterans, includ-15
ing through the potential provision by the entity 16
of care and respite services to veterans and 17
caregivers who may not be eligible for any pro-18
gram under section 1720G of title 38, United 19
States Code, or section 1720L of such title (as 20
added by section 124), but have a need for as-21
sistance. 22
(B) C
OVERED ENTITIES.—The entities de-23
scribed in this subparagraph are veterans serv-24
ice organizations and nonprofit organizations 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00115 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 116
•HR 8371 IH
with a focus on caregiver support or long term 1
care (as determined by the Secretary). 2
(3) C
OLLABORATION FOR CERTAIN VET -3
ERANS.—The Secretary of Veterans Affairs shall col-4
laborate with the Director of the Indian Health 5
Service and representatives from tribal health pro-6
grams and Urban Indian organizations to ensure the 7
availability of home- and community-based services 8
for— 9
(A) Native American veterans, including 10
Native American veterans receiving health care 11
and medical services under multiple health care 12
systems; and 13
(B) Native Hawaiian veterans, including 14
Native Hawaiian veterans receiving health care 15
and medical services under the Native Hawaiian 16
health care system. 17
SEC. 131. GAO REPORT ON MENTAL HEALTH SUPPORT FOR 18
CAREGIVERS. 19
(a) R
EPORTREQUIRED.—Not later than one year 20
after the date of the enactment of this Act, the Comp-21
troller General of the United States shall submit to the 22
Committee on Veterans’ Affairs of the Senate and the 23
Committee on Veterans’ Affairs of the House of Rep-24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00116 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 117
•HR 8371 IH
resentatives a report on the provision of mental health 1
support to caregivers of veterans. 2
(b) C
ONTENTS.—The report submitted under sub-3
section (a) shall include the following: 4
(1) An assessment of the need for mental 5
health support among caregivers participating in the 6
caregiver programs. 7
(2) An assessment of options for mental health 8
support in facilities of the Department of Veterans 9
Affairs and in the community for caregivers partici-10
pating in the caregiver programs. 11
(3) An assessment of the availability and acces-12
sibility of mental health support in facilities of the 13
Department and in the community for caregivers 14
participating in the caregiver programs. 15
(4) An assessment of the awareness among 16
caregivers of the availability of mental health sup-17
port in facilities of the Department and in the com-18
munity for caregivers participating in the caregiver 19
programs. 20
(5) An assessment of barriers to mental health 21
support in facilities of the Department and in the 22
community for caregivers participating in the care-23
giver programs. 24
(c) D
EFINITIONS.—In this section: 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00117 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 118
•HR 8371 IH
(1) The term ‘‘caregiver’’ has the meaning 1
given that term in section 1720G of title 38, United 2
States Code. 3
(2) The term ‘‘caregiver programs’’ means— 4
(A) the program of comprehensive assist-5
ance for family caregivers under subsection (a) 6
of section 1720G of title 38, United States 7
Code; and 8
(B) the program of support services for 9
caregivers under subsection (b) of such section. 10
SEC. 132. DEVELOPMENT OF CENTRALIZED WEBSITE FOR 11
PROGRAM INFORMATION. 12
(a) C
ENTRALIZEDWEBSITE.—The Secretary shall 13
develop and maintain a centralized and publicaly acces-14
sible internet website of the Department as a clearing-15
house for information and resources relating to covered 16
programs. 17
(b) C
ONTENTS.—The website under subsection (a) 18
shall contain the following: 19
(1) A description of each covered program. 20
(2) An informational assessment tool that— 21
(A) explains the administrative eligibility, 22
if applicable, of a veteran, or a caregiver of a 23
veteran, for any covered program; and 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00118 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 119
•HR 8371 IH
(B) provides information, as a result of 1
such explanation, on any covered program for 2
which the veteran or caregiver (as the case may 3
be) may be eligible. 4
(3) A list of required procedures for the direc-5
tors of the medical facilities of the Department to 6
follow in determining the eligibility and suitability of 7
veterans for participation in a covered program, in-8
cluding procedures applicable to instances in which 9
the resource constraints of a facility (or of a commu-10
nity in which a facility is located) may result in the 11
inability to address the health needs of a veteran 12
under a covered program in a timely manner. 13
(c) U
PDATES.—The Secretary shall ensure the 14
website under subsection (a) is updated on a periodic 15
basis. 16
SEC. 133. DEFINITIONS. 17
In this title: 18
(1) The terms ‘‘caregiver’’ and ‘‘family care-19
giver’’ have the meanings given those terms under 20
section 1720L(h) of title 38, United States Code (as 21
added by section 123). 22
(2) The term ‘‘covered program’’— 23
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00119 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 120
•HR 8371 IH
(A) means any program of the Department 1
of Veterans Affairs for home- and community- 2
based services; and 3
(B) includes the programs specified in sec-4
tion 1720L of title 38, United States Code (as 5
added by section 123). 6
(3) The term ‘‘home- and community-based 7
services’’— 8
(A) means the services referred to in sec-9
tion 1701(6)(E) of title 38, United States Code; 10
and 11
(B) includes services furnished under a 12
program specified in section 1720L of such title 13
(as added by section 123). 14
(4) The terms ‘‘Home-Based Primary Care pro-15
gram’’, ‘‘Homemaker and Home Health Aide pro-16
gram’’, and ‘‘Veteran-Directed Care program’’ mean 17
the programs of the Department of Veterans Affairs 18
specified in subsection (d), (c), and (b) of such sec-19
tion 1720L, respectively. 20
(5) The terms ‘‘home health aide’’, ‘‘Native 21
American’’, ‘‘Native American veteran’’, ‘‘tribal 22
health programs’’, and ‘‘Urban Indian organiza-23
tions’’ have the meanings given those terms in sub-24
section (h) of such section 1720L. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00120 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 121
•HR 8371 IH
(6) The term ‘‘Vet Center’’ has the meaning 1
given that term in section 1712A(h) of title 38, 2
United States Code. 3
(7) The term ‘‘veterans service organization’’ 4
means any organization recognized by the Secretary 5
under section 5902 of such title. 6
Subtitle C—Medical Treatment and 7
Other Matters 8
SEC. 140. QUARTERLY REPORT ON REFERRALS FOR NON- 9
DEPARTMENT OF VETERANS AFFAIRS 10
HEALTH CARE. 11
Subchapter I of chapter 5 of title 38, United States 12
Code, is amended by adding at the end the following new 13
section (and amending the table of sections at the begin-14
ning of such chapter accordingly): 15
‘‘§ 534. Quarterly report on referrals for non-Depart-16
ment health care 17
‘‘Not later than 180 days after the date of the enact-18
ment of this section, and not less frequently than quarterly 19
thereafter, the Secretary shall submit to the Committees 20
on Veterans’ Affairs of the Senate and the House of Rep-21
resentatives a report containing, with respect to referrals 22
for non-Department health care originating from a med-23
ical facility of the Department during the quarter pre-24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00121 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 122
•HR 8371 IH
ceding the date of the submission of the report, a measure-1
ment of, for each such medical facility— 2
‘‘(1) the period of time between— 3
‘‘(A) the date on which a clinician em-4
ployed by the Department determines that a 5
veteran requires care, or a veteran presents to 6
the Department requesting care, and the date 7
on which the referral for care is sent to a non- 8
Department health care provider; 9
‘‘(B) the date on which such referral is 10
sent to a non-Department health care provider 11
and the date on which such non-Department 12
health care provider accepts such referral; 13
‘‘(C) the date on which such non-Depart-14
ment health care provider accepts such referral 15
and the date on which such referral is com-16
pleted; 17
‘‘(D) the date on which such referral is 18
completed and the date on which an appoint-19
ment with a non-Department health care pro-20
vider is made; and 21
‘‘(E) the date on which such an appoint-22
ment is made and the date on which such ap-23
pointment occurs; and 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00122 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 123
•HR 8371 IH
‘‘(2) any other period of time that the Secretary 1
determines necessary.’’. 2
SEC. 141. ELIMINATION OF CERTAIN REQUIREMENTS FOR 3
CERTAIN DEPARTMENT OF VETERANS AF-4
FAIRS ASSISTANT UNDER SECRETARIES. 5
Section 7306 of title 38, United States Code, is 6
amended— 7
(1) by striking subsection (b); 8
(2) by redesignating subsections (c) through (g) 9
as subsections (b) through (f), respectively; and 10
(3) in subsection (c) (as so redesignated), by 11
striking ‘‘subsection (e)’’ and inserting ‘‘subsection 12
(f)’’. 13
SEC. 142. MODIFICATION OF PAY LIMITATION FOR PHYSI-14
CIANS, PODIATRISTS, OPTOMETRISTS, AND 15
DENTISTS OF DEPARTMENT OF VETERANS 16
AFFAIRS. 17
(a) P
AY.— 18
(1) I
N GENERAL.—Section 7431 of title 38, 19
United States Code, is amended— 20
(A) by inserting ‘‘optometrists,’’ after ‘‘po-21
diatrists,’’ each place it appears; 22
(B) by inserting ‘‘optometrist’’ after ‘‘podi-23
atrist,’’ each place it appears; 24
(C) in subsection (c)— 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00123 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 124
•HR 8371 IH
(i) in paragraph (5), by adding at the 1
end the following new sentence: ‘‘Such a 2
notice shall include a statement of whether 3
the market pay will increase, decrease, or 4
remain unchanged following such evalua-5
tion.’’; and 6
(ii) by adding at the end the following 7
new paragraphs: 8
‘‘(7) The Secretary shall ensure that each phy-9
sician, podiatrist, optometrist, and dentist in the 10
Veterans Health Administration is— 11
‘‘(A) advised, on an annual basis, of the 12
criteria described in subparagraph (F) of para-13
graph (4); 14
‘‘(B) evaluated in accordance with such 15
criteria; and 16
‘‘(C) compensated in accordance with— 17
‘‘(i) applicable assignment and pay 18
levels, subject to relevant pay limitations; 19
and 20
‘‘(ii) the extent to which such criteria 21
is met. 22
‘‘(8) Not later than 120 days after the end of 23
each fiscal year, the Secretary shall submit to the 24
Committees on Veterans’ Affairs of the Senate and 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00124 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 125
•HR 8371 IH
the House of Representatives a report that includes 1
the following: 2
‘‘(A) A list of each facility and specialty 3
that conducted an evaluation of pay during the 4
period covered by the report. 5
‘‘(B) For each evaluation described in sub-6
paragraph (A)— 7
‘‘(i) a list of occupations for which 8
pay was evaluated, disaggregated by med-9
ical specialty, number of authorized full- 10
time employees, and onsite full-time em-11
ployees as of the date of the evaluation; 12
‘‘(ii) the date such evaluation was 13
completed; 14
‘‘(iii) whether a market pay adjust-15
ment was made following the evaluation 16
per each occupation and specialty evalu-17
ated; 18
‘‘(iv) whether applicable employees 19
were notified of such evaluation; 20
‘‘(v) whether local labor partners were 21
notified of such evaluation; and 22
‘‘(vi) in the case of an evaluation that 23
resulted in an adjustment of pay— 24
‘‘(I) the date such adjustment— 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00125 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 126
•HR 8371 IH
‘‘(aa) was implemented; and 1
‘‘(bb) became effective; and 2
‘‘(II) the percentage of employees 3
of each occupation and specialty for 4
which pay was adjusted pursuant to 5
such evaluation. 6
‘‘(C) A list of facilities of the Department 7
that have not conducted an evaluation of mar-8
ket pay, pursuant to paragraph (5), during the 9
18-month period that precedes the date of the 10
submission of such report.’’; 11
(D) in subsection (e)— 12
(i) in paragraph (1)(A), by inserting 13
‘‘optometrists,’’ after ‘‘podiatrists,’’; and 14
(ii) by adding at the end the following 15
new paragraphs: 16
‘‘(5) Notwithstanding any compensation or pay 17
limitations under this title or title 5, the Secretary 18
may authorize the Under Secretary for Health to 19
pay physicians, podiatrists, optometrists and den-20
tists— 21
‘‘(A) awards authorized under this title; 22
‘‘(B) advance payments, recruitment or re-23
location bonuses, and retention allowances au-24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00126 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 127
•HR 8371 IH
thorized under section 7410(a) of this title or 1
as otherwise provided by law; 2
‘‘(C) incentives or bonuses under section 3
706 of this title or as otherwise provided by 4
law; and 5
‘‘(D) earnings from fee-basis appointments 6
under section 7405(a)(2) of this title. 7
‘‘(6)(A) The Secretary may waive any pay limi-8
tation described in this section (including tier limita-9
tions) that the Secretary determines necessary for 10
the recruitment or retention of critical health care 11
personnel whom the Secretary determines would pro-12
vide direct patient care. 13
‘‘(B) Priority for such waivers shall be given for 14
positions, locations, and care provided through con-15
tracts at a high cost to the Department. 16
‘‘(C) The Chief Human Capital Officer of the 17
Department, the Chief Financial Officer of the De-18
partment, and the Office of the General Counsel of 19
the Department shall review any waiver issued under 20
subparagraph (A). 21
‘‘(D) During the period the authority under 22
subparagraph (A) is effective, the Secretary may not 23
issue more than 300 waivers under such subpara-24
graph. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00127 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 128
•HR 8371 IH
‘‘(E) The Secretary may prescribe require-1
ments, limitations, and other considerations for 2
waivers under such subparagraph. 3
‘‘(F) Not later than 180 days after the date of 4
the enactment of the Senator Elizabeth Dole 21st 5
Century Veterans Healthcare and Benefits Improve-6
ment Act, and annually thereafter, the Secretary 7
shall submit to the Committees on Veterans’ Affairs 8
of the Senate and the House of Representatives a 9
report that includes— 10
‘‘(i) any updates to the requirements, limi-11
tations, and considerations prescribed under 12
subparagraph (B) during the period covered by 13
the report; 14
‘‘(ii) a description of the findings of each 15
review, if any, conducted pursuant to subpara-16
graph (C); 17
‘‘(iii) a description of each waiver under 18
subparagraph (A) in effect as of the date of the 19
submission of the report, including the— 20
‘‘(I) duty location, position, specialty, 21
market and performance considerations for 22
the waiver; and 23
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00128 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 129
•HR 8371 IH
‘‘(II) impact, if any, of the waiver on 1
contracted care purchased by the Depart-2
ment for the region; and 3
‘‘(iv) a list of any separation actions dur-4
ing the period covered by the report with re-5
spect to a position for which a waiver under 6
subparagraph (A) is in effect. 7
‘‘(G) The authority of the Secretary under sub-8
paragraph (A) shall terminate on the last day of the 9
third full fiscal year following the date of the enact-10
ment of the Senator Elizabeth Dole 21st Century 11
Veterans Healthcare and Benefits Improvement 12
Act.’’. 13
(2) R
EPORT ON WAIVER AUTHORITY .—Not 14
later than 180 days after the date of the enactment 15
of this Act, the Secretary of Veterans Affairs shall 16
submit to the Committees on Veterans’ Affairs of 17
the Senate and the House of Representatives a re-18
port that includes a description of the requirements, 19
limitations, and other considerations prescribed 20
under section 7431(b)(6)(D) of title 38, United 21
States Code, as added by paragraph (1). 22
(3) C
ONFORMING AMENDMENTS .— 23
(A) P
AY OF UNDER SECRETARY FOR 24
HEALTH.—Section 7432(b)(1) of such title is 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00129 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 130
•HR 8371 IH
amended by inserting ‘‘, podiatrist, optom-1
etrist,’’ after ‘‘physician’’. 2
(B) A
DMINISTRATIVE MATTERS .—Section 3
7433 of such title is amended by inserting ‘‘op-4
tometrists,’’ after ‘‘physicians,’’ each place it 5
appears. 6
(C) C
OMPETITIVE PAY .—Section 7
7451(a)(2)(C) of such title is amended by in-8
serting ‘‘optometrist,’’ after ‘‘physician,’’. 9
(4) C
LERICAL AMENDMENTS .— 10
(A) S
UBCHAPTER HEADING .—Subchapter 11
III of chapter 74 of such title is amended in the 12
heading by inserting ‘‘Optometrists,’’ after 13
‘‘PODIATRISTS,’’. 14
(B) T
ABLE OF SECTIONS .—The table of 15
sections for such chapter is amended by strik-16
ing the item relating to subchapter III and in-17
serting the following: 18
‘‘SUBCHAPTER III—PAY FOR PHYSICIANS AND OTHER HEALTH -CARE
PERSONNEL’’.
(5) APPLICABILITY DATES.—The amendments 19
made by this subsection shall apply to any pay pe-20
riod of the Department of Veterans Affairs begin-21
ning on or after the date that is 180 days after the 22
date of the enactment of this Act. 23
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00130 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 131
•HR 8371 IH
(b) MODIFICATION AND CLARIFICATION OF PAY 1
G
RADE FOROPTOMETRISTS.—Section 7404 of title 38, 2
United States Code, is amended— 3
(1) in subsection (a)(2)(A), by striking ‘‘podia-4
trists, and dentists’’ and inserting ‘‘podiatrists, op-5
tometrists, and dentists’’; and 6
(2) in subsection (b)— 7
(A) by striking ‘‘podiatrist (dpm), and den-8
tist’’ and inserting ‘‘podiatrist (dpm), optom-9
etrist (od), and dentist’’; 10
(B) by striking ‘‘clinical chiropractor and 11
optometrist schedule,’’ and inserting ‘‘clinical 12
chiropractor schedule’’; and 13
(C) by inserting ‘‘optometrist grade’’ after 14
‘‘Podiatrist grade’’. 15
(c) R
ETROACTIVE AUTHORITY FOR COMPENSA-16
TION.— 17
(1) I
N GENERAL.—The Secretary of Veterans 18
Affairs may pay retroactive compensation to a cov-19
ered employee in an amount that equals the amount 20
of compensation that was authorized to be paid to 21
such covered employee during the period specified in 22
paragraph (2), but was deferred and paid to such 23
employee in the calendar year following the calender 24
year in which such compensation was authorized be-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00131 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 132
•HR 8371 IH
cause the payment for such compensation would 1
have exceeded an applicable cap on annual com-2
pensation. 3
(2) P
ERIOD SPECIFIED.—The period specified 4
in this paragraph is the period beginning on Janu-5
ary 8, 2006, and ending on December 31, 2017. 6
(3) E
XCLUSION.—Compensation authorized 7
under this subsection shall not be included in the 8
calculation of any aggregate limit on compensation 9
for a covered employee for the year in which it is 10
paid. 11
(4) C
HARGING OF COMPENSATION .—Compensa-12
tion authorized under this subsection shall be 13
charged to the appropriate medical care appropria-14
tion account of the Department of Veterans Affairs 15
for the fiscal year in which the work was performed 16
except as follows: 17
(A) In the case of an account that has 18
closed pursuant to section 1552 of title 31, 19
United States Code, the compensation shall be 20
charged to a current appropriation account in 21
accordance with section 1553 of such title. 22
(B) In the case of an expired account that 23
has not closed, if charging the compensation to 24
the expired account would cause such account 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00132 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 133
•HR 8371 IH
to have a negative unliquidated or unexpended 1
balance, the compensation may be charged to a 2
current appropriation account available for the 3
same purpose. 4
(5) D
EFINITIONS.—In this subsection: 5
(A) The term ‘‘compensation’’ means any 6
pay, including salary, awards, and incentives. 7
(B) The term ‘‘covered employee’’ means a 8
physician, podiatrist, or dentist subject to mar-9
ket pay under section 7431 of title 38, United 10
States Code. 11
SEC. 143. REIMBURSEMENT OF AMBULANCE COST FOR 12
CARE FOR CERTAIN RURAL VETERANS. 13
(a) I
NGENERAL.—The Secretary of Veterans Affairs 14
shall pay, or reimburse a covered veteran for, the cost of 15
transporting the veteran by ambulance, including air am-16
bulance, from a covered location to a provider of the De-17
partment of Veterans Affairs, a non-Department provider, 18
or the nearest hospital that can meet the needs of the vet-19
eran (including a hospital that compacts with the Indian 20
Health Service) for covered care. 21
(b) A
MOUNTCOVERED.—The maximum cumulative 22
amount covered under this section for a covered veteran 23
is $46,000. 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00133 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 134
•HR 8371 IH
(c) SUNSET.—This section shall cease to be effective 1
on September 30, 2026. 2
(d) D
EFINITIONS.—In this section: 3
(1) The term ‘‘covered care’’ means care for a 4
veteran eligible for care provided by the Department 5
of Veterans Affairs under title 38, United States 6
Code, or any other law administered by the Sec-7
retary of Veterans Affairs, even if the care associ-8
ated with the transport described in subsection (a) 9
is not authorized by the Department. 10
(2) The term ‘‘covered location’’ means a loca-11
tion that is— 12
(A) in a State that is 100 miles or more 13
from the nearest medical center of the Depart-14
ment of Veterans Affairs; and 15
(B) in an area rated as a 10 or higher 16
under the rural-urban commuting areas coding 17
system of the Department of Agriculture. 18
(3) The term ‘‘covered veteran’’ means a vet-19
eran who— 20
(A) has a service-connected disability rated 21
by the Secretary as between 0 and 30 percent 22
disabling; 23
(B) is not eligible for payments or reim-24
bursements for beneficiary travel or other 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00134 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 135
•HR 8371 IH
transportation under the laws administered by 1
the Secretary of Veterans Affairs, other than 2
under this section; and 3
(C) is not entitled to care or services under 4
a non-Department of Veterans Affairs health- 5
plan contract. 6
(4) The term ‘‘health-plan contract’’ has the 7
meaning given that term in section 1725 of title 38, 8
United States Code. 9
(5) The term ‘‘service-connected’’ has the 10
meaning given that term in section 101 of such title. 11
SEC. 144. PILOT PROGRAM TO FURNISH DENTAL CARE 12
FROM THE DEPARTMENT OF VETERANS AF-13
FAIRS TO CERTAIN VETERANS DIAGNOSED 14
WITH ISCHEMIC HEART DISEASE. 15
(a) I
NGENERAL.—Beginning not later than one year 16
after the date of the enactment of this Act, the Secretary 17
of Veterans Affairs shall carry out a two-year pilot pro-18
gram (in this section referred to as the ‘‘pilot program’’) 19
under which the Secretary shall furnish covered care to 20
covered veterans through means that include the use of 21
community care. 22
(b) L
OCATIONS.— 23
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00135 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 136
•HR 8371 IH
(1) IN GENERAL.—The Secretary shall select 1
not more than four States in which to carry out the 2
pilot program. 3
(2) S
ELECTION CRITERIA.—In selecting States 4
under paragraph (1), the Secretary shall prioritize 5
States in which— 6
(A) the Department of Veterans Affairs 7
serves a high proportion, as determined by the 8
Secretary, of veterans residing in rural or high-9
ly rural areas (as determined through the use 10
of the Rural-Urban Commuting Areas coding 11
system of the Department of Agriculture); 12
(B) dental clinics operated by the Depart-13
ment of Veterans Affairs currently utilize tele-14
dentistry; 15
(C) the Department of Veterans Affairs 16
does not currently operate a dental clinic; or 17
(D) the Secretary determines a large per-18
centage of veterans enrolled in the system of 19
annual patient enrollment of the Department of 20
Veterans Affairs established and operated under 21
paragraphs (1) or (2) of section 1705(a) of title 22
38, United States Code, visit emergency rooms 23
for dental emergencies at high rates. 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00136 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 137
•HR 8371 IH
(c) PARTICIPATIONLIMITATION.—Participation in a 1
pilot program established pursuant to this section shall be 2
limited to a covered veteran who receives health care in 3
a facility of the Department located in a State selected 4
under subsection (b). 5
(d) U
SE OFCERTAINMETHODSTOPROVIDE 6
C
ARE.— 7
(1) M
OBILE DENTAL CLINICS.—In carrying out 8
the pilot program, the Secretary shall test the effi-9
cacy of mobile dental clinics to service rural areas 10
that do not have a population base to warrant a full- 11
time clinic but where there are covered veterans in 12
need of dental care. 13
(2) H
OME-BASED DENTAL CARE .—In carrying 14
out the pilot program, the Secretary shall test the 15
efficacy of portable dental care units to service rural 16
veterans in their homes, as the Secretary considers 17
medically appropriate. 18
(e) A
DMINISTRATION.— 19
(1) C
OMMUNITY CARE NETWORK REVIEW .— 20
(A) I
N GENERAL.—Before commencing the 21
pilot program, the Secretary shall work with 22
third party administrators to conduct a review 23
of dental providers who are part of the commu-24
nity care network of the Department in each 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00137 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 138
•HR 8371 IH
State selected under subsection (b)(1) to en-1
sure— 2
(i) dental providers who are no longer 3
accepting patients from the Department— 4
(I) are not still listed as pro-5
viders accepting referrals from the 6
Department; and 7
(II) are not sent referrals from 8
the Department; and 9
(ii) dental providers participating in 10
each such network are capable of receiving 11
an influx of patients from the Department 12
under the pilot program. 13
(B) E
XPANSION OF NETWORK .—If, pursu-14
ant to a review under subparagraph (A), the 15
Secretary determines the community care net-16
work in a State selected under subsection (b)(1) 17
is not capable of receiving an influx of patients 18
under the pilot program, the Secretary shall co-19
ordinate with the Third Party Administrator 20
for such State to ensure the dental provider 21
network of such community care network is suf-22
ficiently expanded before the initiation of the 23
pilot program. 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00138 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 139
•HR 8371 IH
(2) NOTICE TO COVERED VETERANS .—In car-1
rying out the pilot program, the Secretary shall in-2
form all covered veterans in States selected under 3
subsection (b)(1) of the covered care available under 4
the pilot program. 5
(3) L
OSS OF ELIGIBILITY.—Any veteran par-6
ticipating in the pilot program who ceases to be a 7
covered veteran shall be removed from the pilot pro-8
gram on the date that is 90 days after the Secretary 9
determines the participant is no longer a covered 10
veteran. 11
(4) C
ONTINUITY OF CARE.— 12
(A) I
N GENERAL.—Upon the termination 13
of the pilot program, the Secretary shall provide 14
to all veterans participating in the pilot pro-15
gram at the time of such termination— 16
(i) information on how to enroll in the 17
dental insurance plan of the Department of 18
Veterans Affairs under section 1712C of 19
title 38, United States Code; 20
(ii) if appropriate, information on the 21
VETSmile program of the Department of 22
Veterans Affairs, or any successor pro-23
gram; or 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00139 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 140
•HR 8371 IH
(iii) contact information for dental 1
providers in the surrounding community 2
who provide low- or no-cost dental care 3
and whom the Secretary has confirmed are 4
available to take on new patients. 5
(B) C
ONTINUATION OF TREATMENT 6
PLAN.—Any veteran participating in the pilot 7
program may continue to receive services under 8
the pilot program after the termination of the 9
pilot program to complete a treatment plan 10
commenced under the pilot program, as deter-11
mined necessary by the Secretary. 12
(f) R
EPORTS.— 13
(1) A
NNUAL REPORT.—Not later than one year 14
after the commencement of the pilot program, and 15
annually thereafter for the duration of the pilot pro-16
gram, the Secretary of Veterans Affairs shall submit 17
to the Committees on Veterans’ Affairs of the House 18
of Representatives and the Senate a report on the 19
pilot program that includes— 20
(A) an identification of the States partici-21
pating in the pilot program; 22
(B) a description of the implementation 23
and operation of the pilot program; 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00140 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 141
•HR 8371 IH
(C) the number of participants in the pilot 1
program, disaggregated by— 2
(i) State; and 3
(ii) disability rating; 4
(D) an identification of any barriers or 5
challenges to implementing the pilot program; 6
(E) aggregated feedback from participants 7
in the pilot program, including from interviews 8
and surveys; 9
(F) the average annual cost of providing 10
covered care to a participant in the pilot pro-11
gram, disaggregated by— 12
(i) State; 13
(ii) disability rating; and 14
(iii) whether the care was provided 15
through the community care network or 16
through a provider of the Department; 17
(G) an analysis of the communication and 18
collaboration of the Department with Third 19
Party Administrators and community care den-20
tal providers, disaggregated by State; 21
(H) an analysis of any cost savings by the 22
Department with respect to the treatment of 23
ischemic heart disease; 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00141 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 142
•HR 8371 IH
(I) an assessment of the impact of the 1
pilot program on appointments for care, pre-2
scriptions, hospitalizations, emergency room vis-3
its, wellness, employability, satisfaction, and 4
perceived quality of life of covered veterans re-5
lated to their diagnosis of ischemic heart dis-6
ease; 7
(J) an analysis and assessment of the effi-8
cacy of mobile clinics and portable dental care 9
units, to the extent such modalities are used, to 10
service the needs of covered veterans under the 11
pilot program; 12
(K) an analysis and assessment of the 13
usage of teledentistry to service the needs of 14
covered veterans under the pilot program, to in-15
clude a cost benefit analysis of such services; 16
and 17
(L) such other matters as the Secretary 18
considers appropriate. 19
(2) F
INAL REPORT.—Not later than 90 days 20
before the completion of the pilot program, the Sec-21
retary shall submit to the Committees on Veterans’ 22
Affairs of the House of Representatives and the Sen-23
ate a report on the pilot program that— 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00142 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 143
•HR 8371 IH
(A) includes the matters required under 1
paragraph (1); 2
(B) includes recommendations on whether 3
the pilot program should be continued, ex-4
panded, or adopted throughout the Department; 5
and 6
(C) indicates whether the Secretary re-7
quests action by Congress to make the pilot 8
program permanent. 9
(g) I
MPACT ONCOMMUNITYCARE.—Participants in 10
the pilot program shall be able to access covered care in 11
the community under section 1703 of title 38, United 12
States Code. 13
(h) D
EFINITIONS.—In this section: 14
(1) The term ‘‘covered care’’ means dental care 15
that is consistent with the dental services and treat-16
ment furnished by the Secretary of Veterans Affairs 17
to veterans pursuant to section 1712(a)(1)(G) of 18
title 38, United States Code. 19
(2) The term ‘‘covered veteran’’ means a vet-20
eran who— 21
(A) is enrolled in the system of annual pa-22
tient enrollment of the Department established 23
and operated under paragraphs (1) or (2) of 24
section 1705(a) of title 38, United States Code; 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00143 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 144
•HR 8371 IH
(B) is not eligible for dental services and 1
treatment and related dental appliances under 2
the laws administered by the Secretary as of 3
the date of the enactment of this Act; and 4
(C) has a diagnosis of ischemic heart dis-5
ease. 6
(3) The term ‘‘Third Party Administrator’’ has 7
the meaning given such term in section 1703F of 8
such title. 9
SEC. 145. DOCUMENTATION OF PREFERENCES OF VET-10
ERANS FOR SCHEDULING OF APPOINTMENTS 11
FOR HEALTH CARE UNDER LAWS ADMINIS-12
TERED BY SECRETARY OF VETERANS AF-13
FAIRS. 14
(a) I
NGENERAL.—Not later than one year after the 15
date of the enactment of this Act, the Secretary of Vet-16
erans Affairs shall develop a mechanism to solicit informa-17
tion regarding the preference of veterans enrolled in the 18
system of annual patient enrollment of the Department 19
of Veterans Affairs established and operated under section 20
1705(a) of title 38, United States Code, for scheduling 21
of appointments for health care and related services under 22
the laws administered by the Secretary, including through 23
non-Department providers. 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00144 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 145
•HR 8371 IH
(b) DOCUMENTATION OF PREFERENCE.—Pref-1
erences provided voluntarily by a veteran pursuant to sub-2
section (a) shall be documented on My HealtheVet or an-3
other system designated by the Secretary that allows the 4
veteran to view and change such preferences at any time. 5
(c) I
NCLUSION INPREFERENCE.—Preferences solic-6
ited under subsection (a) shall include the following: 7
(1) How and when the veteran prefers to be 8
contacted about an appointment for health care. 9
(2) Whether the veteran prefers to schedule ap-10
pointments without the assistance of the Depart-11
ment, if able. 12
(3) Whether the veteran prefers to select a pro-13
vider without the assistance of the Department, if 14
able. 15
(4) Whether the veteran prefers appointments 16
to be scheduled during certain days or times. 17
(d) U
SE OFPREFERENCE.—The Secretary shall 18
make the preferences provided under subsection (a) easily 19
accessible to medical support assistants and other staff of 20
the Department, or non-Department staff, as the Sec-21
retary determines appropriate, who assist in the appoint-22
ment scheduling process. 23
(e) D
EPLOYMENT OFMECHANISM.— 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00145 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 146
•HR 8371 IH
(1) IN GENERAL.—Beginning after the date on 1
which the Secretary develops the mechanism re-2
quired under subsection (a), the Secretary shall— 3
(A) test the mechanism in not fewer than 4
three geographically diverse Veterans Inte-5
grated Service Networks; and 6
(B) gather feedback about the effectiveness 7
of such mechanism from veterans, medical sup-8
port assistants, staff and other stakeholders as 9
the Secretary determines appropriate. 10
(2) L
IMITATION.—The Secretary may not im-11
plement such mechanism across the Veterans Health 12
Administration of the Department before the Sec-13
retary addresses the feedback described in para-14
graph (1)(B). 15
SEC. 146. STAFFING MODEL AND PERFORMANCE METRICS 16
FOR CERTAIN EMPLOYEES OF THE DEPART-17
MENT OF VETERANS AFFAIRS. 18
(a) S
TAFFINGMODEL.— 19
(1) I
N GENERAL.—Not later than one year 20
after the date of the enactment of this Act, the Sec-21
retary of Veterans Affairs shall— 22
(A) develop, validate, and implement a 23
staffing model for the Office of Integrated Vet-24
eran Care of the Department of Veterans Af-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00146 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 147
•HR 8371 IH
fairs, or successor office, Veterans Integrated 1
Services Networks, and medical centers of the 2
Department that includes appropriate target 3
staffing levels nationally, regionally, and locally 4
to ensure timely access to care and effectively 5
oversee the provision of care by the Depart-6
ment, whether at a facility of the Department 7
or through a non-Department provider; and 8
(B) provide to Congress a briefing on such 9
staffing model, which shall include— 10
(i) the metrics and measures used by 11
the Secretary in developing such staffing 12
model; 13
(ii) an analysis of how such staffing 14
model compares to the staffing models of 15
other relevant Government-owned and pri-16
vate sector health care systems; and 17
(iii) an estimate of the portion of the 18
roles in such staffing model that will be 19
filled by contracted staff at any given time. 20
(2) R
EPORT ON IMPLEMENTATION OF STAFF -21
ING MODEL.—Not later than one year after the date 22
on which the Secretary implements the staffing 23
model required under paragraph (1), the Secretary 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00147 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 148
•HR 8371 IH
shall submit to Congress and the Comptroller Gen-1
eral of the United States a report containing— 2
(A) an update on such implementation; 3
and 4
(B) information on the outcomes yielded 5
by such staffing model in terms of improved ac-6
cess to care for veterans and improved compli-7
ance with relevant laws, regulations, policy di-8
rectives, and guidance governing access to care. 9
(b) P
ERFORMANCEMETRICS.— 10
(1) I
N GENERAL.—Not later than one year 11
after the date of the enactment of this Act, the Sec-12
retary shall develop and implement a plan, with an 13
appropriate tracking system, to incorporate appro-14
priate standardized performance metrics and over-15
sight measures within the performance appraisal 16
systems for employees of the Department specified 17
in paragraph (2). 18
(2) E
MPLOYEES OF THE DEPARTMENT SPECI -19
FIED.—Employees of the Department specified in 20
this paragraph are employees who are responsible 21
for ensuring timely access to care from the Depart-22
ment, compliance with relevant statutes and regula-23
tions relating to the provision of care, including sec-24
tion 1703 of title 38, United States Code, and over-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00148 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 149
•HR 8371 IH
seeing the provision of care, whether at a facility of 1
the Department or through a non-Department pro-2
vider, including employees within the Office of Inte-3
grated Veteran Care of the Department, or suc-4
cessor office, employees of a Veterans Integrated 5
Service Network, and employees of a medical center 6
of the Department. 7
(3) R
EPORT ON IMPLEMENTATION OF PER -8
FORMANCE METRICS .—Not later than one year after 9
implementing the performance metrics required 10
under paragraph (1), the Secretary shall submit to 11
Congress and the Comptroller General of the United 12
States a report containing— 13
(A) an update on such implementation; 14
and 15
(B) information on the outcomes yielded 16
by such performance metrics in terms of im-17
proved access to care for veterans and improved 18
compliance with relevant laws, policy directives, 19
and guidance governing access to care. 20
(c) GAO R
EPORT.—Not later than two years after 21
the later of the date on which the Comptroller General 22
receives the report under subsection (a)(2) or the report 23
under subsection (b)(3), the Comptroller General shall 24
submit to Congress a report that includes— 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00149 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 150
•HR 8371 IH
(1) an assessment of the performance of the Of-1
fice of Integrated Veteran Care of the Department, 2
or successor office, in improving access to care for 3
veterans in facilities of the Department and pursu-4
ant to section 1703 of title 38, United States Code; 5
and 6
(2) such recommendations as the Comptroller 7
General considers appropriate with respect to im-8
proving access to the care described in paragraph 9
(1) for veterans. 10
SEC. 147. ONLINE HEALTH EDUCATION PORTAL FOR VET-11
ERANS ENROLLED IN PATIENT ENROLLMENT 12
SYSTEM OF DEPARTMENT OF VETERANS AF-13
FAIRS. 14
Not later than one year after the date of the enact-15
ment of this Act, the Secretary of Veterans Affairs shall 16
establish, on an Internet website of the Department, a 17
health education portal that includes interactive edu-18
cational modules to ensure veterans enrolled in the patient 19
enrollment system of the Department of Veterans Affairs 20
established and operated under section 1705(a) of title 38, 21
United States Code, understand the basic health care eli-22
gibilities and entitlements of veterans under the laws ad-23
ministered by the Secretary, including under the Veterans 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00150 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 151
•HR 8371 IH
Community Care Program under section 1703 of such 1
title. 2
SEC. 148. LIMITATION ON DETAIL OF DIRECTORS OF MED-3
ICAL CENTERS OF DEPARTMENT OF VET-4
ERANS AFFAIRS TO DIFFERENT POSITIONS. 5
(a) N
OTIFICATION.— 6
(1) I
N GENERAL.—Not later than 90 days after 7
detailing a director of a medical center of the De-8
partment of Veterans Affairs to a different position 9
within the Department, the Secretary of Veterans 10
Affairs shall notify the Committee on Veterans’ Af-11
fairs of the Senate and the Committee on Veterans’ 12
Affairs of the House of Representatives of such de-13
tail. 14
(2) M
ATTERS TO BE INCLUDED .—The notifica-15
tion required by paragraph (1) shall include, with re-16
spect to a director of a medical center who is de-17
tailed to a different position within the Department, 18
the following information: 19
(A) The location at which the director is 20
detailed. 21
(B) The position title of the detail. 22
(C) The estimated time the director is ex-23
pected to be absent from their duties at the 24
medical center. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00151 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 152
•HR 8371 IH
(D) Such other information as the Sec-1
retary may determine appropriate. 2
(b) A
PPOINTMENT OFACTINGDIRECTOR.—Not later 3
than 120 days after detailing a director of a medical cen-4
ter of the Department to a different position within the 5
Department, the Secretary shall appoint an individual as 6
acting director of such medical center with all of the au-7
thority and responsibilities of the detailed director. 8
(c) U
PDATE ONDETAIL.—Not later than 120 days 9
after detailing a director of a medical center of the De-10
partment to a different position within the Department, 11
and not less frequently than every 30 days thereafter while 12
the detail is in effect or while the director position at the 13
medical center is vacant, the Secretary shall submit to the 14
Committee on Veterans’ Affairs of the Senate and the 15
Committee on Veterans’ Affairs of the House of Rep-16
resentatives an update regarding the status of the detail. 17
(d) R
ETURN TOPOSITION ORREASSIGNMENT.— 18
(1) I
N GENERAL.—Except as provided in para-19
graph (2), not later than 180 days after detailing a 20
director of a medical center of the Department to a 21
different position within the Department, for a rea-22
son other than an ongoing investigation or adminis-23
trative action with respect to the director, the Sec-24
retary shall— 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00152 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 153
•HR 8371 IH
(A) return the individual to the position as 1
director of the medical center; or 2
(B) reassign the individual from the posi-3
tion as director of the medical center and begin 4
the process of hiring a new director for such po-5
sition. 6
(2) W
AIVER.— 7
(A) I
N GENERAL.—The Secretary may 8
waive the requirement under paragraph (1) 9
with respect to an individual for successive 90- 10
day increments for a total period of not more 11
than 540 days from the original date the indi-12
vidual was detailed away from their position as 13
director of a medical center. 14
(B) N
OTIFICATION.—Not later than 30 15
days after exercising a waiver under subpara-16
graph (A), the Secretary shall notify Congress 17
of the waiver and provide to Congress informa-18
tion as to why the waiver is necessary. 19
SEC. 149. NATIONAL VETERAN SUICIDE PREVENTION AN-20
NUAL REPORT. 21
(a) N
ATIONALVETERANSUICIDEPREVENTIONAN-22
NUALREPORT.— 23
(1) I
N GENERAL.—Not later than 18 months 24
after the date of the enactment of this Act, and not 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00153 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 154
•HR 8371 IH
later than September 30 of each year thereafter, the 1
Secretary of Veterans Affairs shall submit to the ap-2
propriate congressional committees and publish on a 3
publicly available website of the Department of Vet-4
erans Affairs a report to be known as the ‘‘National 5
Veteran Suicide Prevention Annual Report’’. 6
(2) E
XTENSION.— 7
(A) I
N GENERAL.—If the Secretary re-8
quires an extension of the deadline for a report 9
under subsection (a), the Secretary shall submit 10
to the appropriate congressional committees a 11
written request for such an extension. 12
(B) E
LEMENTS.—Each written request 13
under paragraph (1) for an extension for a re-14
port shall include the following: 15
(i) The rationale for the delay in the 16
submission of the report. 17
(ii) An explanation of the need for an 18
extension. 19
(iii) A proposed amended date for the 20
submission and publication of the report. 21
(3) B
RIEFING.—With respect to each report re-22
quired under paragraph (1), the Secretary shall, be-23
fore the date on which the Secretary submits such 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00154 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 155
•HR 8371 IH
report, provide to the appropriate congressional com-1
mittees a briefing on such report. 2
(4) E
LEMENTS.— 3
(A) I
N GENERAL.—Each report required 4
under paragraph (1) shall include— 5
(i) the findings of the national anal-6
ysis of veteran suicide rates for the latest 7
year for which data is available; 8
(ii) an identification of trends, if any, 9
demonstrated by such data; and 10
(iii) a comparison of such data to data 11
on veteran suicide rates during preceding 12
years. 13
(B) A
DDITIONAL ELEMENTS .—Each report 14
under paragraph (1) shall include, for the year 15
covered by the report, the following: 16
(i) Suicide rates of veterans 17
disaggregated by age, gender, and race or 18
ethnicity. 19
(ii) Trends in suicide rates of veterans 20
compared to engagement of those veterans 21
with health care from the Veterans Health 22
Administration, including an examination 23
of trends in suicide rates or deaths 24
among— 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00155 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 156
•HR 8371 IH
(I) veterans who have recently re-1
ceived health care from the Veterans 2
Health Administration as compared to 3
veterans who have never received 4
health care from the Veterans Health 5
Administration; 6
(II) veterans who are enrolled in 7
the patient enrollment system of the 8
Department of Veterans Affairs under 9
section 1705(a) of title 38, United 10
States Code, as compared to veterans 11
who have never enrolled in such sys-12
tem; 13
(III) veterans who have recently 14
used services from a Vet Center as 15
compared to veterans who have never 16
used such services; 17
(IV) to the extent practicable, 18
veterans who have a diagnosis of sub-19
stance use disorder; and 20
(V) other groups of veterans re-21
lating to engagement with health care 22
from the Veterans Health Administra-23
tion, as the Secretary considers prac-24
ticable. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00156 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 157
•HR 8371 IH
(iii) To the extent practicable, trends 1
in suicide rates of veterans compared to 2
engagement of those veterans with benefits 3
from the Veterans Benefits Administra-4
tion, including an examination of trends in 5
suicide rates or deaths among— 6
(I) veterans who are currently 7
using, have previously used, or have 8
never used educational assistance 9
under the laws administered by the 10
Secretary; 11
(II) veterans who are currently 12
receiving, have previously received, or 13
have never received services or assist-14
ance under chapter 31 of title 38, 15
United States Code; 16
(III) with respect to compensa-17
tion under chapter 11 of such title— 18
(aa) veterans who were re-19
cipients of such compensation as 20
compared to veterans who never 21
applied for such compensation 22
prior to death; 23
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00157 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 158
•HR 8371 IH
(bb) veterans who had a 1
claim denied for such compensa-2
tion prior to death; 3
(cc) veterans who had a 4
pending claim for such com-5
pensation at time of death; and 6
(dd) veterans who had an 7
entitlement for such compensa-8
tion reduced prior to death; 9
(IV) veterans who are currently 10
receiving or have never received pen-11
sion under chapter 15 of title 38, 12
United States Code; 13
(V) veterans who are currently 14
using, have recently used, or have 15
never used programs or services pro-16
vided by the Homeless Programs Of-17
fice of the Department, including an 18
examination of trends in suicide rates 19
or deaths among veterans who made 20
contact with such office but were de-21
nied or deemed ineligible for any such 22
program or service; 23
(VI) with respect to housing 24
loans guaranteed by the Secretary 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00158 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 159
•HR 8371 IH
under chapter 37 of title 38, United 1
States Code, veterans who are current 2
recipients of, were recent recipients of, 3
or have never received such a loan; 4
(VII) veterans owing debts to the 5
Department; 6
(VIII) veterans who were in-7
volved in a veterans treatment court 8
program, whether they graduated suc-9
cessfully or not; and 10
(IX) veterans who were success-11
fully contacted, unsuccessfully con-12
tacted, or never contacted by the De-13
partment through the Solid Start pro-14
gram under section 6320 of title 38, 15
United States Code. 16
(C) S
TRATEGY AND RECOMMENDATIONS .— 17
(i) I
NITIAL REPORT.—The initial re-18
port under paragraph (1) shall include a 19
strategy and recommendations developed 20
by the Secretary of Veterans Affairs, in 21
collaboration with the Director of the Cen-22
ters for Disease Control and Prevention 23
and the Secretary of Defense, for— 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00159 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 160
•HR 8371 IH
(I) improving data collection at 1
the State and local levels to accurately 2
capture suicide deaths of veterans; 3
(II) improving the timeliness, ef-4
ficacy, and standardization of data re-5
porting on suicide deaths of veterans 6
at the Federal level, including by the 7
Centers for Disease Control and Pre-8
vention, the Department of Defense, 9
and the Department of Veterans Af-10
fairs; 11
(III) improving the timeliness of 12
identification and analysis of suicide 13
deaths of veterans by Federal agen-14
cies, including the Centers for Disease 15
Control and Prevention, the Depart-16
ment of Defense, and the Department 17
of Veterans Affairs; and 18
(IV) any other necessary process 19
improvements for improving the time-20
liness, efficacy, and standardization of 21
reporting of data relating to suicide 22
deaths of veterans, particularly with 23
respect to the annual report under 24
this section. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00160 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 161
•HR 8371 IH
(ii) SUBSEQUENT REPORTS .—Each 1
report after the initial report under para-2
graph (1) shall include updates on actions 3
taken to meet the strategy and rec-4
ommendations developed under subpara-5
graph (A). 6
(5) D
EFINITIONS.—In this subsection: 7
(A) The term ‘‘appropriate congressional 8
committees’’ means the Committees on Vet-9
erans’ Affairs of the Senate and the House of 10
Representatives. 11
(B) The term ‘‘Vet Center’’ means a cen-12
ter for readjustment counseling and related 13
mental health services for veterans under sec-14
tion 1712A of title 38, United States Code. 15
(b) I
NDEPENDENT ASSESSMENT OFNATIONALVET-16
ERANSUICIDEPREVENTIONANNUALREPORT.— 17
(1) I
N GENERAL.—Not later than 90 days after 18
the date of the enactment of this Act, the Secretary 19
of Veterans Affairs shall enter into one or more con-20
tracts with a private sector entity described in para-21
graph (5) to conduct an independent assessment of 22
the National Veteran Suicide Prevention Annual Re-23
port required under subsection (a). 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00161 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 162
•HR 8371 IH
(2) FREQUENCY.—The private sector entity or 1
entities carrying out the assessment required under 2
paragraph (1) shall complete such assessment not 3
later than 240 days after entering into the contract 4
described in such subsection and not less frequently 5
than every five years thereafter. 6
(3) E
LEMENTS.—Each assessment required 7
under paragraph (1) shall analyze the following: 8
(A) The methodology used by the Depart-9
ment to track, analyze, categorize, and report 10
suicide deaths and suicide rates among vet-11
erans. 12
(B) Whether data sources used by the De-13
partment to compile data on suicide deaths and 14
suicide rates among veterans are accurately re-15
flecting such data. 16
(C) Vulnerabilities in the methodology used 17
by the Department that could lead to inac-18
curate counting of suicide deaths and suicide 19
rates among veterans. 20
(D) The ability of the Department to 21
cross-reference suicide deaths and suicide rates 22
among veterans with trends in usage of pro-23
grams of the Veterans Health Administration 24
or the Veterans Benefits Administration or 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00162 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 163
•HR 8371 IH
other programs that could serve as widespread 1
protective factors against suicide. 2
(E) Improvements that could be made to 3
ensure the National Veteran Suicide Prevention 4
Annual Report required under subsection (a) is 5
accurate and comprehensive and provides in-6
sights for making improvements to the suicide 7
prevention efforts of the Department. 8
(4) R
EPORT ON ASSESSMENT .— 9
(A) R
EPORT ON FINDINGS AND REC -10
OMMENDATIONS.—Not later than 60 days after 11
completing an assessment required by para-12
graph (1), the private sector entity or entities 13
carrying out the assessment shall submit to the 14
Secretary of Veterans Affairs and the Commit-15
tees on Veterans’ Affairs of the Senate and the 16
House of Representatives a report on the find-17
ings and recommendations of the private sector 18
entity or entities with respect to such assess-19
ment. 20
(B) R
EPORT ON PLANNED IMPROVE -21
MENTS.—Not later than 60 days after receiving 22
a report under paragraph (1) with respect to an 23
assessment required by paragraph (1), the Sec-24
retary shall submit to the Committees on Vet-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00163 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 164
•HR 8371 IH
erans’ Affairs of the Senate and the House of 1
Representatives a report on how the Depart-2
ment plans to improve the National Veteran 3
Suicide Prevention Annual Report required 4
under subsection (a) based on such assessment. 5
(5) P
RIVATE SECTOR ENTITY DESCRIBED .—A 6
private sector entity described in this paragraph is 7
a private entity that— 8
(A) specializes in analyzing large-scale or-9
ganizational data collection and analysis efforts, 10
especially with respect to the health care sector; 11
and 12
(B) has experience and proven outcomes in 13
optimizing the accuracy and comprehensiveness 14
of data collection and analysis related to sui-15
cide. 16
(c) R
EPORT ONADDITIONALBENEFITS ANDSERV-17
ICESFROMDEPARTMENT OF VETERANSAFFAIRSTO 18
P
REVENTVETERANSUICIDE.— 19
(1) I
N GENERAL.—Not later than three years 20
after the date of the enactment of this Act, the Sec-21
retary of Veterans Affairs shall submit to the Com-22
mittees on Veterans’ Affairs of the Senate and the 23
House of Representatives and publish on a publicly 24
available website of the Department of Veterans Af-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00164 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 165
•HR 8371 IH
fairs a report that analyzes which benefits and serv-1
ices under the laws administered by such Secretary, 2
including such benefits and services furnished by the 3
Veterans Benefits Administration, have the greatest 4
impact on the prevention of suicide among veterans, 5
including recommendations for potential expansion 6
of services and benefits to reduce the number of vet-7
eran suicides. 8
(2) A
SSESSMENT OF SOLID START PROGRAM .— 9
The report required by paragraph (1) shall include 10
an analysis of the effectiveness of the Solid Start 11
program under section 6320 of title 38, United 12
States Code, on prevention of suicide among vet-13
erans. 14
(d) T
OOLKIT FORSTATE ANDLOCALCORONERS AND 15
M
EDICALEXAMINERS ONBESTPRACTICES FORIDENTI-16
FYING ANDREPORTING ONSUICIDEDEATHS OFVET-17
ERANS.— 18
(1) I
N GENERAL.—The Secretary of Veterans 19
Affairs, in collaboration with the Director of the 20
Centers for Disease Control and Prevention, shall 21
develop a toolkit for State and local coroners and 22
medical examiners that contains best practices for— 23
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00165 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 166
•HR 8371 IH
(A) accurately identifying and reporting 1
suicide deaths of veterans, including how to 2
identify veteran status; and 3
(B) reporting such deaths to the Centers 4
for Disease Control and Prevention and other 5
applicable entities. 6
(2) A
VAILABILITY.—Not later than two years 7
after the date of the enactment of this Act, the Sec-8
retary shall make the toolkit developed under para-9
graph (1) available on a publicly available website of 10
the Department of Veterans Affairs. 11
(3) O
UTREACH.—The Secretary, in collabora-12
tion with the Director of the Centers for Disease 13
Control and Prevention, shall conduct outreach to 14
appropriate State and local agencies to promote the 15
availability and use of the toolkit developed under 16
paragraph (1). 17
SEC. 150. REPORT ON PHYSICAL INFRASTRUCTURE RE-18
QUIRED BY MEDICAL FACILITIES OF DEPART-19
MENT OF VETERANS AFFAIRS TO PROVIDE 20
DENTAL CARE SERVICES. 21
Not later than one year after the date of the enact-22
ment of this Act, the Secretary of Veterans Affairs shall 23
submit to the Committees on Veterans’ Affairs of the Sen-24
ate and the House of Representatives a report, for each 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00166 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 167
•HR 8371 IH
medical center or other relevant health care facility of the 1
Department of Veterans Affairs, that includes— 2
(1) an identification of the physical infrastruc-3
ture, including new facilities, renovations, remodels, 4
leases, or other infrastructure, such medical center 5
or health care facility requires to provide dental care 6
services to veterans eligible for such services under 7
the laws administered by the Secretary; and 8
(2) an analysis of the physical infrastructure 9
such medical center or health care facility would re-10
quire if a greater number of veterans became eligible 11
for such dental care services pursuant to a modifica-12
tion of the laws administered by the Secretary. 13
SEC. 151. COMPTROLLER GENERAL REPORT ON CERTAIN 14
ORAL HEALTH CARE PROGRAMS UNDER 15
LAWS ADMINISTERED BY SECRETARY OF 16
VETERANS AFFAIRS. 17
(a) I
NGENERAL.—Not later than one year after the 18
date of the enactment of this Act, the Comptroller General 19
of the United States shall submit to the Committees on 20
Veterans’ Affairs of the Senate and the House of Rep-21
resentatives a report on the status of the oral health care 22
programs of the Department of Veterans Affairs, that in-23
cludes an assessment of— 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00167 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 168
•HR 8371 IH
(1) any issues with information technology pro-1
grams, including Dental Record Manager Plus, that 2
affect dental care staff of the Department; 3
(2) the implementation of the dental insurance 4
plan of the Department under section 1712C of title 5
38, United States Code; 6
(3) the implementation and expansion of the 7
VETSmile program of the Department; 8
(4) barriers preventing the Department from 9
expanding dental care eligibility to all veterans with 10
ischemic heart disease, including such barriers relat-11
ing to physical infrastructure, workforce, and cost of 12
such dental care; 13
(5) barriers preventing dental clinics of the De-14
partment, if any, from adopting teledentistry; 15
(6) the demographic makeup of veterans eligible 16
for dental care paid for by the Department as of the 17
commencement of the pilot program under section 18
145 of this Act, including information on— 19
(A) age; 20
(B) gender; 21
(C) race or ethnicity, disaggregated by— 22
(i) membership in an Indian Tribe; 23
and 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00168 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 169
•HR 8371 IH
(ii) the major race groups used in the 1
decennial census; 2
(D) employment status; and 3
(E) location of residence, disaggregated by 4
rural, highly rural, and urban locations; and 5
(7) changes to such demographic makeup if 6
any, that would result from an expansion of eligi-7
bility for dental care under the laws administered by 8
the Secretary to all veterans with ischemic heart dis-9
ease including changes to demographics specified in 10
paragraph (6). 11
(b) T
HIRDPARTYADMINISTRATORDEFINED.—In 12
this section, the term ‘‘Third Party Administrator’’ means 13
an entity that manages a provider network and performs 14
administrative services related to such network under sec-15
tion 1703 of title 38, United States Code. 16
SEC. 152. REVIEW OF WORKFLOWS ASSOCIATED WITH 17
PROCESSING REFERRALS BETWEEN FACILI-18
TIES OF THE VETERANS HEALTH ADMINIS-19
TRATION. 20
(a) I
NGENERAL.—The Secretary of Veterans Affairs 21
shall conduct a review of the workflows directly associated 22
with processing referrals of patients between facilities of 23
the Veterans Health Administration of the Department of 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00169 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 170
•HR 8371 IH
Veterans Affairs to identify specific delays or bottlenecks 1
in such referrals. 2
(b) E
LEMENTS OF REVIEW.—The review required 3
under subsection (a) shall include a review of— 4
(1) the interfacility consult management guid-5
ance of the Veterans Health Administration that as-6
sists facilities described in subsection (a) in con-7
structing a workflow for consults between such fa-8
cilities; and 9
(2) the roles and responsibilities of the individ-10
uals involved in the consult management process in 11
managing such consults, including the role of the re-12
ferral coordination team. 13
(c) R
EPORT.—Not later than 180 days after the date 14
of the enactment of this Act, the Secretary shall submit 15
to Congress a report on the results of the review required 16
under subsection (a). 17
SEC. 153. PLAN FOR TIMELY SCHEDULING OF APPOINT-18
MENTS AT MEDICAL FACILITIES OF DEPART-19
MENT OF VETERANS AFFAIRS. 20
(a) P
LANREQUIRED.—To improve responsiveness in 21
the provision of hospital care and medical services at med-22
ical facilities of the Department of Veterans Affairs, the 23
Secretary of Veterans Affairs shall develop a plan to— 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00170 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 171
•HR 8371 IH
(1) ensure that whenever a covered veteran con-1
tacts the Department by telephone to request the 2
scheduling of an appointment for care or services for 3
the covered veteran at such a facility, the scheduling 4
for the appointment occurs during that telephone 5
call (regardless of the prospective date of the ap-6
pointment being scheduled); and 7
(2) provide timely and, where applicable, same- 8
day scheduling for an appointment described in 9
paragraph (1). 10
(b) R
EPORT.—Not later than one year after the date 11
of the enactment of this Act, the Secretary shall submit 12
to the Committees on Veterans’ Affairs of the House of 13
Representatives and the Senate a report on the plan under 14
subsection (a). 15
(c) C
OVEREDVETERANDEFINED.—In this section, 16
the term ‘‘covered veteran’’ means a veteran who is en-17
rolled in the system of patient enrollment of the Depart-18
ment under section 1705(a) of title 38, United States 19
Code. 20
SEC. 154. AUTHORIZATION OF APPROPRIATIONS TO SUP-21
PORT INITIATIVES FOR MOBILE MAMMOG-22
RAPHY SERVICES FOR VETERANS. 23
There is authorized to be appropriated to the Sec-24
retary of Veterans Affairs $5,000,000 for fiscal year 2025 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00171 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 172
•HR 8371 IH
for the Office of Women’s Health of the Department of 1
Veterans Affairs under section 7310 of title 38, United 2
States Code, to be used by the Secretary to expand access 3
of women veterans to— 4
(1) mobile mammography initiatives; 5
(2) advanced mammography equipment; and 6
(3) outreach activities to publicize those initia-7
tives and equipment. 8
TITLE II—ECONOMIC 9
OPPORTUNITY MATTERS 10
Subtitle A—Educational Assistance 11
SEC. 201. TEMPORARY EXPANSION OF ELIGIBILITY FOR MA-12
RINE GUNNERY SERGEANT JOHN DAVID FRY 13
SCHOLARSHIP. 14
(a) I
NGENERAL.—The Secretary of Veterans Affairs 15
shall treat an individual described in subsection (b) as a 16
covered individual described in section 3311(b) of title 38, 17
United States Code. 18
(b) C
OVEREDINDIVIDUALDESCRIBED.—An indi-19
vidual described in this subsection is an individual who 20
is the child or spouse of a person— 21
(1) who dies from a service-connected disability 22
during the 120-day period immediately following the 23
day on which the person was discharged or released 24
from duty as a member of the Armed Forces (with-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00172 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 173
•HR 8371 IH
out regard to whether such duty was active duty); 1
and 2
(2)(A) who received an honorable discharge; or 3
(B) whose service in the Armed Forces is char-4
acterized by the Secretary concerned as honorable 5
service. 6
(c) A
PPLICABILITY.—This section shall apply with re-7
spect to— 8
(1) deaths that occur before, on, or after the 9
date of the enactment of this Act; and 10
(2) a quarter, semester, or term, as applicable, 11
commencing— 12
(A) on or after August 1, 2024; and 13
(B) before October 1, 2026. 14
SEC. 202. REMOVAL OF EXPIRATION ON ENTITLEMENT TO 15
MARINE GUNNERY SERGEANT JOHN DAVID 16
FRY SCHOLARSHIP FOR SURVIVING SPOUSES. 17
Section 3311(f) of title 38, United States Code, is 18
amended— 19
(1) by striking paragraph (2); 20
(2) by redesignating paragraphs (3) through 21
(5) as paragraphs (2) through (4), respectively; 22
(3) in paragraph (2), as redesignated by para-23
graph (2) of this section, by striking ‘‘in paragraph 24
(4)’’ and inserting ‘‘in paragraph (3)’’; and 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00173 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 174
•HR 8371 IH
(4) in paragraph (3)(A), as redesignated by 1
paragraph (2) of this section, by striking ‘‘under 2
paragraph (3)’’ and inserting ‘‘under paragraph 3
(2)’’. 4
SEC. 203. SOLE LIABILITY FOR TRANSFERRED EDU-5
CATIONAL ASSISTANCE BY AN INDIVIDUAL 6
WHO FAILS TO COMPLETE A SERVICE AGREE-7
MENT. 8
Subsection (i) of section 3319 of title 38, United 9
States Code, is amended— 10
(1) in paragraph (1)— 11
(A) by striking ‘‘In the event’’ and insert-12
ing ‘‘Subject to paragraph (2), in the event’’; 13
and 14
(B) by inserting ‘‘of this title’’ after ‘‘sec-15
tion 3685’’; 16
(2) in subparagraph (A) of paragraph (2)— 17
(A) in the heading, by striking ‘‘I
N GEN-18
ERAL’’ and inserting ‘‘SOLE LIABILITY’’; and 19
(B) by striking ‘‘under paragraph (1)’’ and 20
inserting ‘‘for which the individual shall be sole-21
ly liable to the United States for the amount of 22
the overpayment for purposes of section 3685 23
of this title’’; and 24
(3) in subparagraph (B) of paragraph (2)— 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00174 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 175
•HR 8371 IH
(A) in the matter preceding clause (i), by 1
striking ‘‘Subparagraph (A) shall not apply’’ 2
and inserting ‘‘Neither the individual nor the 3
dependent shall be liable to the United States 4
for the amount of the overpayment for purposes 5
of section 3685 of this title’’; and 6
(B) in clause (ii), by inserting ‘‘of this 7
title’’ after ‘‘section 3311(c)(4)’’. 8
SEC. 204. NOTICE TO EDUCATIONAL INSTITUTIONS OF 9
RISK-BASED SURVEYS. 10
Section 3673A(d) of title 38, United States Code, is 11
amended by striking ‘‘one business day’’ and inserting 12
‘‘two business days’’. 13
SEC. 205. RELATIONSHIP OF PARTICIPATION BY AN EDU-14
CATIONAL INSTITUTION IN CERTAIN FED-15
ERAL STUDENT FINANCIAL AID PROGRAMS 16
TO APPROVAL OF SUCH INSTITUTION FOR 17
PURPOSES OF DEPARTMENT OF VETERANS 18
AFFAIRS EDUCATIONAL ASSISTANCE PRO-19
GRAMS. 20
Paragraph (4) of section 3675(b) of title 38, United 21
States Code, is amended to read as follows: 22
‘‘(4) The educational institution— 23
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00175 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 176
•HR 8371 IH
‘‘(A) is approved and participates in a pro-1
gram under title IV of the Higher Education 2
Act of 1965 (20 U.S.C. 1070 et seq.); or 3
‘‘(B) does not participate in such a pro-4
gram and the Secretary has waived the require-5
ment under this paragraph with respect to the 6
educational institution, and submits to the 7
Committee on Veterans’ Affairs of the Senate 8
and the Committee on Veterans’ Affairs of the 9
House of Representatives notice of such waiver, 10
because the Secretary determines that the edu-11
cational institution— 12
‘‘(i) elects not to participate in such a 13
program; 14
‘‘(ii) cannot participate in such a pro-15
gram; or 16
‘‘(iii) is in the process of making a 17
good-faith effort to submit an initial appli-18
cation for approval to participate in such a 19
program, except that a waiver under this 20
clause may not be provided for a period of 21
longer than 36 months.’’. 22
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00176 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 177
•HR 8371 IH
SEC. 206. EXPANSION OF DEPARTMENT OF VETERANS AF-1
FAIRS OVERSIGHT OF CERTAIN EDU-2
CATIONAL INSTITUTIONS. 3
(a) A
DDITIONALREQUIREMENT FOR APPROVAL.— 4
Section 3675(b) of title 38, United States Code, as amend-5
ed by section 205, is further amended by adding at the 6
end the following new paragraph: 7
‘‘(5) The educational institution agrees to, not 8
later than 30 days after any date on which such 9
educational institution becomes subject to an action 10
or event described in section 3673(e)(3) of this title, 11
submit to the State approving agency, or the Sec-12
retary when acting in the role of a State approving 13
agency, a notification of such action or event in such 14
form and containing such information as the Sec-15
retary determines appropriate.’’. 16
(b) A
DDITIONALREQUIREMENT FOR APPROVAL OF 17
N
ONACCREDITEDCOURSES.— 18
(1) I
N GENERAL.—Section 3676(c) of such title 19
is amended— 20
(A) by redesignating paragraphs (14) 21
through (16) as paragraphs (15) through (17), 22
respectively; and 23
(B) by inserting after paragraph (13) the 24
following new paragraph: 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00177 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 178
•HR 8371 IH
‘‘(14) The institution agrees to, not later than 1
30 days after any date on which such institution be-2
comes subject to an action or event described in sec-3
tion 3673(e)(3) of this title, submit to the State ap-4
proving agency, or the Secretary when acting in the 5
role of a State approving agency, a notification of 6
such action or event in such form and containing 7
such information as the Secretary determines appro-8
priate.’’. 9
(2) C
ONFORMING AMENDMENTS .—Such title is 10
further amended— 11
(A) in section 3672(b)(2)(C), by striking 12
‘‘paragraph (14) or (15)’’ and inserting ‘‘para-13
graph (15) or (16)’’; 14
(B) in section 3675(b)(3), by striking 15
‘‘(14), (15), and (16)’’ and inserting ‘‘(15), 16
(16), and (17)’’; 17
(C) in section 3679(d), by striking ‘‘de-18
scribed in paragraph (14) or (15)’’ and insert-19
ing ‘‘described in paragraph (15) or (16)’’; and 20
(D) in section 3680A(a)(4)(C)(iii), by 21
striking ‘‘section 3676(c)(14) and (15)’’ and in-22
serting ‘‘section 3676(c)(15) and (16)’’. 23
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00178 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 179
•HR 8371 IH
(c) ADDITIONALGROUNDS FORSUSPENSION OFAP-1
PROVAL.—Section 3679(f)(1) of such title is amended by 2
adding at the end the following new subparagraph: 3
‘‘(I) Comply with the notification requirements 4
under sections 3675(b)(5) and 3676(c)(14) of this 5
title, when applicable.’’. 6
(d) D
EADLINE FOR RISK-BASEDSURVEYSDATA-7
BASE.—The Secretary of Veterans Affairs shall establish 8
the database required under section 3673A(c) of title 38, 9
United States Code, by not later than 180 days after the 10
date of the enactment of this Act. 11
SEC. 207. REQUIREMENT THAT EDUCATIONAL INSTITU-12
TIONS APPROVED FOR PURPOSES OF DE-13
PARTMENT OF VETERANS AFFAIRS EDU-14
CATIONAL ASSISTANCE PROGRAMS PROVIDE 15
DIGITAL OFFICIAL TRANSCRIPTS. 16
(a) R
EQUIREMENT.—Section 3675(b) of title 38, 17
United States Code, as amended by sections 205 and 206, 18
is further amended by adding at the end the following new 19
paragraph: 20
‘‘(6) The educational institution makes avail-21
able to each eligible person or veteran a copy of the 22
person or veteran’s official transcript in a digital 23
format.’’. 24
(b) C
ONFORMINGAMENDMENTS.— 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00179 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 180
•HR 8371 IH
(1) APPROVAL OF COURSES .—Section 1
3672(b)(2)(A) of such title is amended by striking 2
‘‘(b)(1) and (b)(2)’’ and inserting ‘‘paragraphs (1), 3
(2), and (6) of section 3675(b)’’. 4
(2) A
PPROVAL OF NONACCREDITED COURSES .— 5
Section 3676(c) of such title is amended— 6
(A) by redesignating paragraph (17) as 7
paragraph (18); and 8
(B) by inserting after paragraph (16) the 9
following new paragraph (17): 10
‘‘(17) In the case of a course that leads to a 11
standard college degree, the educational institution 12
satisfies the requirements of section 3675(b)(6) of 13
this title.’’. 14
(3) C
ONFORMING AMENDMENTS .—Section 15
3675(b)(3) of such title is amended by striking 16
‘‘(15), (16), and (17)’’ and inserting ‘‘(15), (16), 17
and (18)’’. 18
(c) E
FFECTIVEDATE.—The amendments made by 19
this section shall take effect on August 1, 2025, and apply 20
with respect to a quarter, semester, or term, as applicable, 21
commencing on or after such date. 22
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00180 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 181
•HR 8371 IH
SEC. 208. PAYMENT OF FULL MONTHLY HOUSING STIPEND 1
FOR VETERANS ENROLLED IN FINAL SEMES-2
TER USING EDUCATIONAL ASSISTANCE 3
UNDER POST-9/11 EDUCATIONAL ASSISTANCE 4
PROGRAM. 5
(a) H
OUSINGALLOWANCE.—Section 3680(a)(3) of 6
title 38, United States Code, is amended— 7
(1) by redesignating subparagraphs (A) and 8
(B) as clauses (i) and (ii), respectively (and by re-9
designating each subordinate provision and the mar-10
gins thereof accordingly); 11
(2) by striking ‘‘Notwithstanding paragraph 12
(1)’’ and inserting ‘‘(A) Notwithstanding paragraph 13
(1)’’; 14
(3) by striking ‘‘, including a monthly housing 15
stipend described in section 3313(c) of this title,’’; 16
and 17
(4) by adding at the end the following new sub-18
paragraph (B): 19
‘‘(B) For purposes of providing a monthly housing 20
stipend described in section 3313(c) to an eligible veteran 21
or eligible person for whom the Secretary is providing edu-22
cational assistance under chapter 33 of this title during 23
a period that is the last semester, term, or academic period 24
pursuant to subparagraph (A), the Secretary shall treat 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00181 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 182
•HR 8371 IH
the veteran or person as pursuing a program of education 1
on a full-time basis.’’. 2
(b) A
PPLICATION.—The amendments made by sub-3
section (a) shall take effect on the date of the enactment 4
of this Act and apply with respect to a quarter, semester, 5
or term, as applicable, commencing on or after August 1, 6
2024. 7
SEC. 209. MODIFICATION OF RULES FOR APPROVAL OF 8
COMMERCIAL DRIVER EDUCATION PRO-9
GRAMS FOR PURPOSES OF EDUCATIONAL AS-10
SISTANCE PROGRAMS OF THE DEPARTMENT 11
OF VETERANS AFFAIRS. 12
(a) I
NGENERAL.—Section 3680A(e) of title 38, 13
United States Code, is amended— 14
(1) by redesignating paragraphs (1) through 15
(3) as subparagraphs (A) though (C), respectively; 16
(2) in the matter before subparagraph (A), as 17
redesignated by paragraph (1), by inserting ‘‘(1)’’ 18
before ‘‘The Secretary’’; 19
(3) in paragraph (1)(B), as redesignated by 20
paragraph (1), by inserting ‘‘except as provided in 21
paragraph (2),’’ before ‘‘the course’’; and 22
(4) by adding at the end the following new 23
paragraph (2): 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00182 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 183
•HR 8371 IH
‘‘(2)(A) Subject to this paragraph, a commercial driv-1
er education program is exempt from paragraph (1)(B) 2
for a branch of an educational institution if the commer-3
cial driver education program offered at the branch by the 4
educational institution— 5
‘‘(i) is appropriately licensed; and 6
‘‘(ii)(I) the branch is located in a State in 7
which the same commercial driver education pro-8
gram is offered by the same educational institution 9
at another branch of that educational institution in 10
the same State that is approved for purposes of this 11
chapter by a State approving agency or the Sec-12
retary when acting in the role of a State approving 13
agency; or 14
‘‘(II)(aa) the branch is located in a State in 15
which the same commercial driver education pro-16
gram is not offered at another branch of the same 17
educational institution in the same State; and 18
‘‘(bb) the branch has been operating for a pe-19
riod of at least one year using the same curriculum 20
as a commercial driver education program offered by 21
the educational institution at another location that is 22
approved for purposes of this chapter by a State ap-23
proving agency or the Secretary when acting in the 24
role of a State approving agency. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00183 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 184
•HR 8371 IH
‘‘(B)(i) In order for a commercial driver education 1
program of an educational institution offered at a branch 2
described in paragraph (1)(B) to be exempt under sub-3
paragraph (A) of this paragraph, the educational institu-4
tion shall submit to the Secretary each year that para-5
graph (1)(B) would otherwise apply a report that dem-6
onstrates that the curriculum at the new branch is the 7
same as the curriculum at the primary location. 8
‘‘(ii) Reporting under clause (i) shall be submitted 9
in accordance with such requirements as the Secretary 10
shall establish in consultation with the State approving 11
agencies. 12
‘‘(C)(i) The Secretary may withhold an exemption 13
under subparagraph (A) for any educational institution or 14
branch of an educational institution as the Secretary con-15
siders appropriate. 16
‘‘(ii) In making any determination under clause (i), 17
the Secretary may consult with the Secretary of Transpor-18
tation on the performance of a provider of a commercial 19
driver program, including the status of the provider within 20
the Training Provider Registry of the Federal Motor Car-21
rier Safety Administration when appropriate. 22
‘‘(D) The Secretary shall submit to the Committees 23
on Veterans’ Affairs of the Senate and the House of Rep-24
resentatives a notification not later than 30 days after the 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00184 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 185
•HR 8371 IH
Secretary grants an exemption under this paragraph. 1
Such notification shall identify the educational institution 2
and branch of such educational institution granted such 3
exemption.’’. 4
(b) I
MPLEMENTATION.— 5
(1) E
STABLISHMENT OF REQUIREMENTS .—Not 6
later than 180 days after the date of the enactment 7
of this Act, the Secretary of Veterans Affairs shall 8
establish requirements under section 9
3680A(e)(2)(B)(ii) of such title, as added by sub-10
section (a). 11
(2) R
ULEMAKING.—In promulgating any rules 12
to carry out paragraph (2) of section 3680A(e) of 13
title 38, United States Code, as added by subsection 14
(a), the Secretary of Veterans Affairs shall consult 15
with State approving agencies. 16
(3) A
PPLICABILITY.—The amendments made 17
by subsection (a) shall apply to commercial driver 18
education programs on and after the day that is 365 19
days after the date on which the Secretary estab-20
lishes the requirements under paragraph (1) of this 21
subsection. 22
(c) C
OMPTROLLER GENERAL OF THE UNITED 23
S
TATESSTUDY.—Not later than 365 days after the date 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00185 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 186
•HR 8371 IH
of the enactment of this Act, the Comptroller General of 1
the United States shall— 2
(1) conduct a study to— 3
(A) ascertain the effects of the amend-4
ments made by subsection (a); and 5
(B) the feasibility and advisability of simi-6
larly amending the rules for approval of pro-7
grams of education for other vocational pro-8
grams of education; and 9
(2) submit to the Committees on Veterans’ Af-10
fairs of the Senate and the House of Representatives 11
a report on the findings of the Comptroller General 12
with respect to such study. 13
SEC. 210. PROVISION OF CERTIFICATES OF ELIGIBILITY 14
AND AWARD LETTERS USING ELECTRONIC 15
MEANS. 16
(a) I
NGENERAL.—Chapter 36 of title 38, United 17
States Code, is amended by inserting after section 3698 18
the following new section (and conforming the table of sec-19
tions at the beginning of such chapter accordingly): 20
‘‘§ 3698A. Provision of certificates of eligibility and 21
award letters using electronic means 22
‘‘(a) R
EQUIREMENT.—Except as provided by sub-23
section (b), the Secretary shall provide to an individual 24
the following documents using electronic means: 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00186 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 187
•HR 8371 IH
‘‘(1) A certificate of eligibility for the entitle-1
ment of the individual to covered educational assist-2
ance. 3
‘‘(2) An award letter regarding the authoriza-4
tion of the individual to receive covered educational 5
assistance. 6
‘‘(b) E
LECTIONTOOPTOUT.—An individual may 7
elect to receive the documents specified in subsection (a) 8
by mail rather than through electronic means under sub-9
section (a). An individual may revoke such an election at 10
any time, by means prescribed by the Secretary. 11
‘‘(c) C
OVEREDEDUCATIONALASSISTANCE.—In this 12
section, the term ‘covered educational assistance’ means 13
educational assistance under chapter 30, 33, or 35 of this 14
title, or section 3699C of this title.’’. 15
(b) C
LERICALAMENDMENT.—The table of sections 16
at the beginning of such chapter is amended by inserting 17
after the item relating to section 3698 the following new 18
item: 19
‘‘3698A. Provision of certificates of eligibility and award letters using electronic
means.’’.
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00187 Fmt 6652 Sfmt 6211 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 188
•HR 8371 IH
SEC. 211. RETROACTIVE EFFECTIVE DATE OF LAW RE-1
GARDING CHARGE TO ENTITLEMENT TO EDU-2
CATIONAL ASSISTANCE FOR INDIVIDUALS 3
WHO DO NOT TRANSFER CREDITS FROM CER-4
TAIN CLOSED OR DISAPPROVED PROGRAMS 5
OF EDUCATION. 6
Section 3699(c)(2) of title 38, United States Code, 7
is amended by striking subparagraph (C) and inserting 8
the following new subparagraph (C): 9
‘‘(C) This paragraph, including clauses (ii) and (iii) 10
of subparagraph (A), shall apply with respect to the clo-11
sure or discontinuation of a course or program of edu-12
cation, as described in subsection (b)(1), that occurs dur-13
ing the period beginning on August 1, 2021, and ending 14
on September 30, 2025.’’. 15
SEC. 212. DEPARTMENT OF VETERANS AFFAIRS HIGH 16
TECHNOLOGY PROGRAM. 17
(a) H
IGHTECHNOLOGYPROGRAM.— 18
(1) I
N GENERAL.—Chapter 36 of title 38, 19
United States Code, as amended by section 210, is 20
amended by adding at the end the following new sec-21
tion: 22
‘‘§ 3699C. High technology program 23
‘‘(a) E
STABLISHMENT.—(1) The Secretary shall 24
carry out a program under which the Secretary provides 25
covered individuals with the opportunity to enroll in high 26
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00188 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 189
•HR 8371 IH
technology programs of education that the Secretary de-1
termines provide training or skills sought by employers in 2
a relevant field or industry. 3
‘‘(2) Not more than 4,000 covered individuals may 4
participate in the program under this section in any fiscal 5
year. 6
‘‘(b) A
MOUNT OFASSISTANCE.—(1) The Secretary 7
shall provide, to each covered individual who pursues a 8
high technology program of education under this section, 9
educational assistance in amounts equal to the amounts 10
provided under section 3313(c)(1) of this title, including, 11
except as provided in paragraph (3), with respect to the 12
housing stipend described in that section and in accord-13
ance with the treatment of programs that are distance 14
learning and programs that are less than half-time. 15
‘‘(2) Under paragraph (1), the Secretary shall pro-16
vide such amounts of educational assistance to a covered 17
individual for each of the following: 18
‘‘(A) A high technology program of education. 19
‘‘(B) A second such program if— 20
‘‘(i) the second such program begins at 21
least 18 months after the covered individual 22
graduates from the first such program; and 23
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00189 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 190
•HR 8371 IH
‘‘(ii) the covered individual uses edu-1
cational assistance under chapter 33 of this 2
title to pursue the second such program. 3
‘‘(3) No covered individual may receive a housing sti-4
pend under this subsection for any month if such indi-5
vidual is in receipt of a housing stipend under chapter 33 6
of this title for that month. 7
‘‘(c) C
ONTRACTS.—(1) For purposes of carrying out 8
subsection (a), the Secretary shall seek to enter into con-9
tracts with any number of qualified providers of high tech-10
nology programs of education for the provision of such 11
programs to covered individuals. Each such contract shall 12
provide for the conditions under which the Secretary may 13
terminate the contract with the provider and the proce-14
dures for providing for the graduation of students who 15
were enrolled in a program provided by such provider in 16
the case of such a termination. 17
‘‘(2) A contract under this subsection shall provide 18
that the Secretary shall pay to a provider— 19
‘‘(A) upon the enrollment of a covered indi-20
vidual in the program, 25 percent of the cost of the 21
tuition and other fees for the program of education 22
for the individual; 23
‘‘(B) upon graduation of the individual from 24
the program, 25 percent of such cost; and 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00190 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 191
•HR 8371 IH
‘‘(C) 50 percent of such cost upon— 1
‘‘(i) the successful employment of the cov-2
ered individual for a period— 3
‘‘(I) of 180 days in the field of study 4
of the program; and 5
‘‘(II) that begins not later than 180 6
days following graduation of the covered 7
individual from the program; 8
‘‘(ii) the employment of the individual by 9
the provider for a period of one year; or 10
‘‘(iii) the enrollment of the individual in a 11
program of education to continue education in 12
such field of study. 13
‘‘(3) For purposes of this section, a provider of a high 14
technology program of education is qualified if— 15
‘‘(A) the provider employs instructors whom the 16
Secretary determines are experts in their respective 17
fields in accordance with paragraph (5); 18
‘‘(B) the provider has successfully provided the 19
high technology program for at least one year; 20
‘‘(C) the provider does not charge tuition and 21
fees to a covered individual who receives assistance 22
under this section to pursue such program that are 23
higher than the tuition and fees charged by such 24
provider to another individual; and 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00191 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 192
•HR 8371 IH
‘‘(D) the provider meets the approval criteria 1
developed by the Secretary under paragraph (4). 2
‘‘(4)(A) The Secretary shall prescribe criteria for ap-3
proving providers of a high technology program of edu-4
cation under this section. 5
‘‘(B) In developing such criteria, the Secretary may 6
consult with State approving agencies. 7
‘‘(C) Such criteria are not required to meet the re-8
quirements of section 3672 of this title. 9
‘‘(D) Such criteria shall include the job placement 10
rate, in the field of study of a program of education, of 11
covered individuals who complete such program of edu-12
cation. 13
‘‘(5) The Secretary shall determine whether instruc-14
tors are experts under paragraph (3)(A) based on evidence 15
furnished to the Secretary by the provider regarding the 16
ability of the instructors to— 17
‘‘(A) identify professions in need of new em-18
ployees to hire, tailor the programs to meet market 19
needs, and identify the employers likely to hire grad-20
uates; 21
‘‘(B) effectively teach the skills offered to cov-22
ered individuals; 23
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00192 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 193
•HR 8371 IH
‘‘(C) provide relevant industry experience in the 1
fields of programs offered to incoming covered indi-2
viduals; and 3
‘‘(D) demonstrate relevant industry experience 4
in such fields of programs. 5
‘‘(6) In entering into contracts under this subsection, 6
the Secretary shall give preference to a provider of a high 7
technology program of education— 8
‘‘(A) from which at least 70 percent of grad-9
uates find full-time employment in the field of study 10
of the program during the 180-day period beginning 11
on the date the student graduates from the program; 12
or 13
‘‘(B) that offers tuition reimbursement for any 14
student who graduates from such a program and 15
does not find employment described in subparagraph 16
(A). 17
‘‘(d) E
FFECT ONOTHERENTITLEMENT.—(1) If a 18
covered individual enrolled in a high technology program 19
of education under this section has remaining entitlement 20
to educational assistance under chapter 30, 32, 33, 34, 21
or 35 of this title, such entitlement shall be charged at 22
the rate of one month of such entitlement for each month 23
of educational assistance provided under this section. 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00193 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 194
•HR 8371 IH
‘‘(2) If a covered individual enrolled in a high tech-1
nology program of education under this section does not 2
have remaining entitlement to educational assistance 3
under chapter 30, 32, 33, 34, or 35 of this title, any edu-4
cational assistance provided to such individual under this 5
section shall be provided in addition to the entitlement 6
that the individual has used. 7
‘‘(3) The Secretary may not consider enrollment in 8
a high technology program of education under this section 9
to be assistance under a provision of law referred to in 10
section 3695 of this title. 11
‘‘(4)(A) An application for enrollment in a high tech-12
nology program of education under this section shall in-13
clude notice of the requirements relating to use of entitle-14
ment under paragraphs (1) and (2), including— 15
‘‘(i) in the case of the enrollment of an indi-16
vidual referred to under paragraph (1), the amount 17
of entitlement that is typically charged for such en-18
rollment; 19
‘‘(ii) an identification of any methods that may 20
be available for minimizing the amount of entitle-21
ment required for such enrollment; and 22
‘‘(iii) an element requiring applicants to ac-23
knowledge receipt of the notice under this subpara-24
graph. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00194 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 195
•HR 8371 IH
‘‘(B) If the Secretary approves the enrollment of a 1
covered individual in a high technology program of edu-2
cation under this section, the Secretary shall deliver elec-3
tronically to the individual an award letter that provides 4
notice of such approval and includes specific information 5
describing how paragraphs (1) and (2) will be applied to 6
the individual if the individual chooses to enroll in the pro-7
gram. 8
‘‘(e) R
EQUIREMENTS FOR EDUCATIONALINSTITU-9
TIONS.—(1) The Secretary shall not approve the enroll-10
ment of any covered individual, not already enrolled, in 11
any high technology programs of education under this sec-12
tion for any period during which the Secretary finds that 13
more than 85 percent of the students enrolled in the pro-14
gram are having all or part of their tuition, fees, or other 15
charges paid to or for them by the educational institution 16
or by the Department of Veterans Affairs under this title 17
or under chapter 1606 or 1607 of title 10, except with 18
respect to tuition, fees, or other charges that are paid 19
under a payment plan at an educational institution that 20
the Secretary determines has a history of offering pay-21
ment plans that are completed not later than 180 days 22
after the end of the applicable term, quarter, or semester. 23
‘‘(2) The Secretary may waive a requirement of para-24
graph (1) if the Secretary determines, pursuant to regula-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00195 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 196
•HR 8371 IH
tions which the Secretary shall prescribe, such waiver to 1
be in the interest of the covered individual and the Federal 2
Government. Not later than 30 days after the Secretary 3
waives such a requirement, the Secretary shall submit to 4
the Committees on Veterans’ Affairs of the Senate and 5
the House of Representatives a report regarding such 6
waiver. 7
‘‘(3)(A)(i) The Secretary shall establish and maintain 8
a process by which an educational institution may request 9
a review of a determination that the educational institu-10
tion does not meet the requirements of paragraph (1). 11
‘‘(ii) The Secretary may consult with a State approv-12
ing agency regarding such process or such a review. 13
‘‘(iii) Not later than 180 days after the Secretary es-14
tablishes or revises a process under this subparagraph, the 15
Secretary shall submit to the Committees on Veterans’ Af-16
fairs of the Senate and the House of Representatives a 17
report regarding such process. 18
‘‘(B) An educational institution that requests a re-19
view under subparagraph (A)— 20
‘‘(i) shall request the review not later than 30 21
days after the start of the term, quarter, or semester 22
for which the determination described in subpara-23
graph (A) applies; and 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00196 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 197
•HR 8371 IH
‘‘(ii) may include any information that the edu-1
cational institution believes the Department should 2
have taken into account when making the deter-3
mination, including with respect to any mitigating 4
circumstances. 5
‘‘(f) A
NNUALREPORTS.—Not later than one year 6
after the date of the enactment of this section, and annu-7
ally thereafter until the termination date specified in sub-8
section (i), the Secretary shall submit to the Committees 9
on Veterans’ Affairs of the Senate and the House of Rep-10
resentatives a report on the operation of program under 11
this section during the year covered by the report. Each 12
such report shall include each of the following: 13
‘‘(1) The number of covered individuals enrolled 14
in the program, disaggregated by type of educational 15
institution, during the year covered by the report. 16
‘‘(2) The number of covered individuals who 17
completed a high technology program of education 18
under the program during the year covered by the 19
report. 20
‘‘(3) The average employment rate of covered 21
individuals who completed such a program of edu-22
cation during such year, as of 180 days after the 23
date of completion. 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00197 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 198
•HR 8371 IH
‘‘(4) The average length of time between the 1
completion of such a program of education and em-2
ployment. 3
‘‘(5) The total number of covered individuals 4
who completed a program of education under the 5
program and who, as of the date of the submission 6
of the report, are employed in a position related to 7
technology. 8
‘‘(6) The average salary of a covered individual 9
who completed a program of education under the 10
program and who is employed in a position related 11
to technology, in various geographic areas deter-12
mined by the Secretary. 13
‘‘(7) The average salary of all individuals em-14
ployed in positions related to technology in the geo-15
graphic areas determined under subparagraph (F), 16
and the difference, if any, between such average sal-17
ary and the average salary of a covered individual 18
who completed a program of education under the 19
program and who is employed in a position related 20
to technology. 21
‘‘(8) The number of covered individuals who 22
completed a program of education under the pro-23
gram and who subsequently enrolled in a second 24
program of education under the program. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00198 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 199
•HR 8371 IH
‘‘(g) COLLECTION OF INFORMATION; CONSULTA-1
TION.—(1) The Secretary shall develop practices to use 2
to collect information about covered individuals and pro-3
viders of high technology programs of education. 4
‘‘(2) For the purpose of carrying out program under 5
this section, the Secretary may consult with providers of 6
high technology programs of education and may establish 7
an advisory group made up of representatives of such pro-8
viders, private employers in the technology field, and other 9
relevant groups or entities, as the Secretary determines 10
necessary. 11
‘‘(h) D
EFINITIONS.—In this section: 12
‘‘(1) The term ‘covered individual’ means any of 13
the following: 14
‘‘(A) A veteran whom the Secretary deter-15
mines— 16
‘‘(i) served an aggregate of at least 36 17
months on active duty in the Armed 18
Forces (including service on active duty in 19
entry level and skill training) and was dis-20
charged or released therefrom under condi-21
tions other than dishonorable; and 22
‘‘(ii) has not attained the age of 62. 23
‘‘(B) A member of the Armed Forces that 24
the Secretary determines will become a veteran 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00199 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 200
•HR 8371 IH
described in subparagraph (A) fewer than 180 1
days after the date of such determination. 2
‘‘(2) The term ‘high technology program of edu-3
cation’ means a program of education— 4
‘‘(A) offered by a public or private edu-5
cational institution; 6
‘‘(B) if offered by an institution of higher 7
learning, that is provided directly by such insti-8
tution rather than by an entity other than such 9
institution under a contract or other agreement; 10
‘‘(C) that does not lead to a degree; 11
‘‘(D) that has a term of not less than six 12
and not more than 28 weeks; and 13
‘‘(E) that provides instruction in computer 14
programming, computer software, media appli-15
cation, data processing, or information sciences. 16
‘‘(i) T
ERMINATION.—The Secretary may not provide 17
educational assistance under this section for a high tech-18
nology program of education that begins after September 19
30, 2026.’’. 20
(2) C
LERICAL AMENDMENT .—The table of sec-21
tions at the beginning of such chapter is amended 22
by inserting after the item relating to section 3699B 23
the following new item: 24
‘‘3699C. High technology program.’’.
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00200 Fmt 6652 Sfmt 6211 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 201
•HR 8371 IH
(b) EFFECT ONHIGHTECHNOLOGY PILOTPRO-1
GRAM.—Section 116 of the Harry W. Colmery Veterans 2
Educational Assistance Act of 2017 (Public Law 115–48; 3
38 U.S.C. 3001 note) is amended— 4
(1) by amending subsection (d) to read as fol-5
lows: 6
‘‘(d) H
OUSINGSTIPEND.— 7
‘‘(1) I
N GENERAL.—Except as provided under 8
paragraph (2), the Secretary shall pay to each eligi-9
ble veteran (not including an individual described in 10
the second sentence of subsection (b)) who is en-11
rolled in a high technology program of education 12
under the pilot program on a full-time or part-time 13
basis a monthly housing stipend equal to the prod-14
uct— 15
‘‘(A) of— 16
‘‘(i) in the case of a veteran pursuing 17
resident training, the monthly amount of 18
the basic allowance for housing payable 19
under section 403 of title 37, United 20
States Code, for a member with depend-21
ents in pay grade E–5 residing in the mili-22
tary housing area that encompasses all or 23
the majority portion of the ZIP code area 24
in which is located the campus of the insti-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00201 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 202
•HR 8371 IH
tution where the individual physically par-1
ticipates in a majority of classes; or 2
‘‘(ii) in the case of a veteran pursuing 3
a program of education through distance 4
learning, a monthly amount equal to 50 5
percent of the national average of the 6
monthly amount of the basic allowance for 7
housing payable under section 403 of title 8
37, United States Code, for a member with 9
dependents in pay grade E–5, multiplied 10
by 11
‘‘(B) the lesser of— 12
‘‘(i) 1.0; or 13
‘‘(ii) the number of course hours 14
borne by the individual in pursuit of the 15
program of education involved, divided by 16
the minimum number of course hours re-17
quired for full-time pursuit of such pro-18
gram of education, rounded to the nearest 19
multiple of 10. 20
‘‘(2) B
AR TO DUAL ELIGIBILITY .—No covered 21
individual may receive a housing stipend under this 22
subsection for any month if such individual is in re-23
ceipt of a housing stipend under chapter 33 ot title 24
38, United States Code, for that month.’’; 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00202 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 203
•HR 8371 IH
(2) in subsection (g), by striking paragraph (6); 1
and 2
(3) by striking subsection (h) and inserting the 3
following new subsection (h): 4
‘‘(h) T
ERMINATION.—The Secretary may not, under 5
this section, pay a provider for a high technology program 6
of education that begins after September 30, 2024.’’. 7
(c) A
PPROVAL OFCERTAINHIGHTECHNOLOGYPRO-8
GRAMS.—Section 3680A of title 38, United States Code, 9
is amended— 10
(1) in subsection (a), by striking paragraph (4) 11
and inserting the following: 12
‘‘(4) Any independent study program except— 13
‘‘(A) an independent study program (in-14
cluding such a program taken over open circuit 15
television) that— 16
‘‘(i) is accredited by an accrediting 17
agency or association recognized by the 18
Secretary of Education under subpart 2 of 19
part H of title IV of the Higher Education 20
Act of 1965 (20 U.S.C. 1099b); 21
‘‘(ii) leads to— 22
‘‘(I) a standard college degree; 23
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00203 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 204
•HR 8371 IH
‘‘(II) a certificate that reflects 1
educational attainment offered by an 2
institution of higher learning; or 3
‘‘(III) a certificate that reflects 4
graduation from a course of study of-5
fered by— 6
‘‘(aa) an area career and 7
technical education school (as de-8
fined in subparagraphs (C) and 9
(D) of section 3(3) of the Carl D. 10
Perkins Career and Technical 11
Education Act of 2006 (20 12
U.S.C. 2302(3))) that provides 13
education at the postsecondary 14
level; or 15
‘‘(bb) a postsecondary voca-16
tional institution (as defined in 17
section 102(c) of the Higher 18
Education Act of 1965 (20 19
U.S.C. 1002(c))) that provides 20
education at the postsecondary 21
level; and 22
‘‘(iii) in the case of a program de-23
scribed in clause (ii)(III)— 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00204 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 205
•HR 8371 IH
‘‘(I) provides training aligned 1
with the requirements of employers in 2
the State or local area where the pro-3
gram is located, which may include in- 4
demand industry sectors or occupa-5
tions; 6
‘‘(II) provides a student, upon 7
graduation from the program, with a 8
recognized postsecondary credential 9
that is recognized by employers in the 10
relevant industry, which may include 11
a credential recognized by industry or 12
sector partnerships in the State or 13
local area where the industry is lo-14
cated; and 15
‘‘(III) meets such content and in-16
structional standards as may be re-17
quired to comply with the criteria 18
under section 3676(c)(14) and (15) of 19
this title; or 20
‘‘(B) an online high technology program of 21
education (as defined in subsection (h)(2) of 22
section 3699C of this title)— 23
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00205 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 206
•HR 8371 IH
‘‘(i) the provider of which has entered 1
into a contract with the Secretary under 2
subsection (c) of such section; 3
‘‘(ii) that has been provided to covered 4
individuals (as defined in subsection (h)(1) 5
of such section) under such contract for a 6
period of at least five years; 7
‘‘(iii) regarding which the Secretary 8
has determined that the average employ-9
ment rate of covered individuals who grad-10
uated from such program of education is 11
65 percent or higher for the year preceding 12
such determination; and 13
‘‘(iv) that satisfies the requirements of 14
subsection (e) of such section.’’; and 15
(2) in subsection (d), by adding at the end the 16
following: 17
‘‘(8) Paragraph (1) shall not apply to the enrollment 18
of a veteran in an online high technology program de-19
scribed in subsection (a)(4)(B).’’. 20
(d) E
FFECTIVEDATE.—The amendments made by 21
subsections (a) and (c) shall take effect on October 1, 22
2024. 23
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00206 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 207
•HR 8371 IH
SEC. 213. NOTICE OF CHANGES TO DEPARTMENT OF VET-1
ERANS AFFAIRS POLICIES AND GUIDANCE 2
AFFECTING THE EDUCATIONAL ASSISTANCE 3
PROGRAMS OF THE DEPARTMENT. 4
(a) I
NGENERAL.—Subchapter III of chapter 36 of 5
title 38, United States Code, as amended by sections 210 6
and 212, is further amended by adding at the end the 7
following new section: 8
‘‘§ 3699D. Notice of changes to policies and guidance 9
relating to educational assistance pro-10
grams 11
‘‘In the case of any change to any policy or guidance 12
provided by the Secretary that relates to any educational 13
assistance program of the Department, the Secretary may 14
not implement the change before the date that is 90 days 15
after the date on which the Secretary makes available to 16
students, educational institutions, and the Committees on 17
Veterans’ Affairs of the Senate and House of Representa-18
tives notice of, and justification for, the change.’’. 19
(b) C
LERICALAMENDMENT.—The table of sections 20
at the beginning of such chapter is amended by inserting 21
after the item relating to section 3699B the following new 22
item: 23
‘‘3699D. Notice of changes to policies and guidance relating to educational as-
sistance programs.’’.
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00207 Fmt 6652 Sfmt 6211 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 208
•HR 8371 IH
(c) EFFECTIVEDATE.—Section 3699D of title 38, 1
United States Code, as added by subsection (a), shall take 2
effect on the date of the enactment of this Act and apply 3
with respect to a rule making on or after August 1, 2024. 4
SEC. 214. PAYMENT OF VA EDUCATIONAL ASSISTANCE VIA 5
ELECTRONIC FUND TRANSFER TO A FOREIGN 6
INSTITUTION OF HIGHER EDUCATION. 7
Not later than 90 days after the date of the enact-8
ment of this Act, the Secretary of Veterans Affairs shall 9
update the payment system of the Department of Veterans 10
Affairs to allow for electronic fund transfer of educational 11
assistance, administered by the Secretary, to a foreign in-12
stitution of higher education that— 13
(1) provides an approved course of education to 14
an eligible recipient of such assistance; and 15
(2) does not have— 16
(A) an employer identification number; or 17
(B) an account with a domestic bank. 18
SEC. 215. IMPROVING TRANSPARENCY AND ACCOUNT-19
ABILITY OF EDUCATIONAL INSTITUTIONS 20
FOR PURPOSES OF VETERANS EDUCATIONAL 21
ASSISTANCE. 22
(a) R
EQUIREMENT RELATING TOG.I. BILLCOM-23
PARISONTOOL.— 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00208 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 209
•HR 8371 IH
(1) REQUIREMENT TO MAINTAIN TOOL .—The 1
Secretary of Veterans Affairs shall maintain the G.I. 2
Bill Comparison Tool that was established pursuant 3
to Executive Order 13607 (77 Fed. Reg. 25861; re-4
lating to establishing principles of excellence for edu-5
cational institutions serving service members, vet-6
erans, spouses, and other family members) and in 7
effect on the day before the date of enactment of 8
this Act, or a successor tool, to provide relevant and 9
timely information about programs of education ap-10
proved under chapter 36 of title 38, United States 11
Code, and the educational institutions that offer 12
such programs. 13
(2) D
ATA RETENTION.—The Secretary shall en-14
sure that historical data that is reported via the tool 15
maintained under paragraph (1) remains easily and 16
prominently accessible on the benefits.va.gov website, 17
or a successor website, for a period of not less than 18
six years from the date of initial publication. 19
(b) P
ROVIDINGTIMELY ANDRELEVANTEDUCATION 20
I
NFORMATION TO VETERANS, MEMBERS OF THE ARMED 21
F
ORCES, ANDOTHERINDIVIDUALS.— 22
(1) I
N GENERAL.—Not later than one year 23
after the date of the enactment of this Act, the Sec-24
retary of Veterans Affairs, in consultation with the 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00209 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 210
•HR 8371 IH
Secretary of Education, the Secretary of the Treas-1
ury, and the heads of other relevant Federal agen-2
cies, shall make such changes to the tool maintained 3
under subsection (a) as the Secretary of Veterans 4
Affairs determines appropriate to ensure that such 5
tool is an effective and efficient method for providing 6
information pursuant to section 3698(b)(5) of title 7
38, United States Code. 8
(2) M
EMORANDUM OF UNDERSTANDING RE -9
QUIRED.—Not later than two years after the date of 10
the enactment of this Act, the Secretary of Veterans 11
Affairs shall seek to enter into a memorandum of 12
understanding with the Secretary of Education and 13
the heads other relevant Federal agencies, as the 14
Secretary of Veterans Affairs determines appro-15
priate, to obtain information on outcomes with re-16
spect to individuals who are entitled to educational 17
assistance under the laws administered by the Sec-18
retary of Veterans Affairs and who are attending 19
educational institutions. Such memorandum of un-20
derstanding may include data sharing or computer 21
matching agreements. 22
(3) M
ODIFICATION OF SCOPE OF COMPREHEN -23
SIVE POLICY ON PROVIDING EDUCATION INFORMA -24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00210 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 211
•HR 8371 IH
TION.—Section 3698 of title 38, United States Code, 1
is amended— 2
(A) in subsection (a), by striking ‘‘veterans 3
and members of the Armed Forces’’ and insert-4
ing ‘‘individuals entitled to educational assist-5
ance under laws administered by the Secretary 6
of Veterans Affairs’’; and 7
(B) in subsection (b)(5)— 8
(i) by striking ‘‘veterans and members 9
of the Armed Forces’’ and inserting ‘‘indi-10
viduals described in subsection (a)’’; and 11
(ii) by striking ‘‘the veteran or mem-12
ber’’ and inserting ‘‘the individual’’. 13
(4) G.I.
BILL COMPARISON TOOL REQUIRED 14
DISCLOSURES.—Paragraph (1) of subsection (c) of 15
such section is amended— 16
(A) by striking subparagraph (B) and in-17
serting the following: 18
‘‘(B) for each individual described in subsection 19
(a) seeking information provided under subsection 20
(b)(5), the name of each Federal student aid pro-21
gram, and a description of each such program, from 22
which the individual may receive educational assist-23
ance;’’; 24
(B) in subparagraph (C)— 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00211 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 212
•HR 8371 IH
(i) in clause (i), by inserting ‘‘and a 1
definition of each type of institution’’ be-2
fore the semicolon; 3
(ii) in clause (iv), by inserting ‘‘and if 4
so, which programs’’ before the semicolon; 5
(iii) by striking clause (v) and insert-6
ing the following: 7
‘‘(v) the average annual cost and the total 8
cost to earn an associate’s degree and a bach-9
elor’s degree, with available cost information on 10
any other degree or credential the institution 11
awards;’’; 12
(iv) in clause (vi), by inserting before 13
the semicolon the following: ‘‘disaggregated 14
by— 15
‘‘(I) the type of beneficiary of edu-16
cational assistance; 17
‘‘(II) individuals who received a cre-18
dential and individuals who did not; and 19
‘‘(II) individuals using educational as-20
sistance under laws administered by the 21
Secretary and individuals who are not’’; 22
(v) in clause (xiv), by striking ‘‘and’’ 23
at the end; 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00212 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 213
•HR 8371 IH
(vi) in clause (xv), by striking the pe-1
riod at the end and inserting a semicolon; 2
and 3
(vii) by adding at the end the fol-4
lowing new clauses: 5
‘‘(xvi) the number of veterans or members 6
who completed covered education at the institu-7
tion leading to— 8
‘‘(I) a degree, disaggregated by type 9
of program, including— 10
‘‘(aa) an associate degree; 11
‘‘(bb) a bachelor’s degree; and 12
‘‘(cc) a postbaccalaureate degree; 13
and 14
‘‘(II) a certificate or professional li-15
cense, disaggregated by type of certificate 16
or professional license; 17
‘‘(xvii) programs available and the average 18
time for completion of each program; 19
‘‘(xviii) employment rate and median in-20
come of graduates of the institution in general 21
two and five years after graduation, 22
disaggregated by— 23
‘‘(I) specific program; and 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00213 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 214
•HR 8371 IH
‘‘(II) individuals using educational as-1
sistance under laws administered by the 2
Secretary and individuals who are not; and 3
‘‘(xix) the number of individuals using edu-4
cational assistance under laws administered by 5
the Secretary who are enrolled in the both the 6
institution and specific program per year.’’. 7
(5) C
LARITY AND ANONYMITY OF INFORMATION 8
PROVIDED.—Paragraph (2) of such subsection is 9
amended— 10
(A) by inserting ‘‘(A)’’ before ‘‘To the ex-11
tent’’; and 12
(B) by adding at the end the following new 13
subparagraph: 14
‘‘(B) The Secretary shall ensure that information 15
provided pursuant to subsection (b)(5) is provided in a 16
manner that is easy for, and accessible to, individuals de-17
scribed in subsection (a). 18
‘‘(C) In providing information pursuant to subsection 19
(b)(5), the Secretary shall maintain the anonymity of indi-20
viduals described in subsection (a) and, to the extent that 21
a portion of any data would undermine such anonymity, 22
ensure that such data is not made available pursuant to 23
such subsection.’’. 24
(c) I
MPROVEMENTS FOR STUDENTFEEDBACK.— 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00214 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 215
•HR 8371 IH
(1) IN GENERAL.—Subsection (b)(2) of such 1
section is amended— 2
(A) by amending subparagraph (A) to read 3
as follows: 4
‘‘(A) provides institutions of higher learn-5
ing— 6
‘‘(i) up to 30 days to review and re-7
spond to feedback from individuals de-8
scribed in subsection (a) and address 9
issues regarding the feedback before the 10
feedback is published; and 11
‘‘(I) if an institution of higher learn-12
ing contests the accuracy of the feedback, 13
the opportunity to challenge the inclusion 14
of such data with an official appointed by 15
the Secretary;’’; 16
(B) in subparagraph (B), by striking 17
‘‘and’’ at the end; 18
(C) in subparagraph (C), by striking ‘‘that 19
conforms with criteria for relevancy that the 20
Secretary shall determine.’’ and inserting ‘‘, 21
and responses from institutions of higher learn-22
ing to such feedback, that conform with criteria 23
for relevancy that the Secretary shall deter-24
mine;’’; and 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00215 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 216
•HR 8371 IH
(D) by adding at the end the following new 1
subparagraphs: 2
‘‘(D) for each institution of higher learning 3
that is approved under this chapter, retains, 4
maintains, and publishes all of such feedback 5
for not less than six years; and 6
‘‘(E) is easily accessible to individuals de-7
scribed in subsection (a) and to the general 8
public.’’. 9
(2) A
CCESSIBILITY FROM G.I. BILL COMPARISON 10
TOOL.—The Secretary shall ensure that— 11
(A) the feedback tracked and published 12
under subsection (b)(2) of such section, as 13
amended by paragraph (1), is prominently dis-14
played in the tool maintained under subsection 15
(a) of this section; and 16
(B) when such tool displays information 17
for an institution of higher learning, the appli-18
cable feedback is also displayed for such institu-19
tion of higher learning. 20
(d) T
RAINING FORPROVISION OFEDUCATIONCOUN-21
SELINGSERVICES.— 22
(1) I
N GENERAL.—Not less than one year after 23
the date of the enactment of this Act, the Secretary 24
shall ensure that personnel employed by the Depart-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00216 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 217
•HR 8371 IH
ment of Veteran Affairs, or a contractor of the De-1
partment, to provide education benefits counseling, 2
vocational or transition assistance, or similar func-3
tions, including employees or contractors of the De-4
partment who provide such counseling or assistance 5
as part of the Transition Assistance Program, are 6
trained on how— 7
(A) to use properly the tool maintained 8
under subsection (a); and 9
(B) to provide appropriate educational 10
counseling services to individuals described in 11
section 3698(a) of such title, as amended by 12
subsection (b)(3)(A). 13
(2) T
RANSITION ASSISTANCE PROGRAM DE -14
FINED.—In this subsection, the term ‘‘Transition 15
Assistance Program’’ means the program of coun-16
seling, information, and services under section 1142 17
of title 10, United States Code. 18
Subtitle B—Employment and 19
Training 20
SEC. 221. IMPROVEMENTS TO REEMPLOYMENT RIGHTS OF 21
MEMBERS OF THE ARMED FORCES. 22
(a) USERRA P
URPOSES.—Section 4301(a)(1) of 23
title 38, United States Code, is amended by striking ‘‘en-24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00217 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 218
•HR 8371 IH
courage noncareer service in the uniformed services’’ and 1
inserting ‘‘encourage service in the uniformed services’’. 2
(b) P
ROHIBITION OFRETALIATION.—Subsection (b) 3
of section 4311 of title 38, United States Code, is amend-4
ed by inserting ‘‘or other retaliatory action’’ after ‘‘em-5
ployment action’’. 6
(c) E
XPANSION OF INJUNCTIVERELIEF.—Sub-7
section (e) of section 4323 of such title is amended— 8
(1) by striking ‘‘The court shall use’’ and in-9
serting ‘‘(1) The court shall use’’; and 10
(2) by adding at the end the following new 11
paragraphs: 12
‘‘(2) A person bringing an action to enforce a provi-13
sion of this chapter pursuant to subsection (a) shall be 14
entitled to an injunction under paragraph (1) if such per-15
son demonstrates— 16
‘‘(A) a violation— 17
‘‘(i) of the provisions of this chapter; or 18
‘‘(ii) of the provisions of this chapter is 19
threatened or is imminent; 20
‘‘(B) the harm to the person outweighs the in-21
jury to the employer; 22
‘‘(C) a likelihood of success on the merits of 23
such action; and 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00218 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 219
•HR 8371 IH
‘‘(D) awarding such relief is in the public inter-1
est. 2
‘‘(3) The court may not deny a motion for injunctive 3
relief on the basis that a party bringing an action to en-4
force a provision of this chapter may be awarded wages 5
unearned due to an unlawful termination or denial of em-6
ployment at the conclusion of such action.’’. 7
(d) D
AMAGESAGAINST ASTATE ORPRIVATEEM-8
PLOYER.—Section 4323 of such title is further amended, 9
in paragraph (1) of subsection (d), by striking subpara-10
graph (C) and inserting the following new subparagraphs: 11
‘‘(C) The court may require the employer to 12
pay the person the amount referred to in subpara-13
graph (B) and interest on such amount, calculated 14
at a rate of 3 percent per year. 15
‘‘(D) The court may require the employer to 16
pay the person the greater of $50,000 or the amount 17
equal to the amounts referred to in subparagraphs 18
(B) and (C) as liquidated damages, if the court de-19
termines that the employer knowingly failed to com-20
ply with the provisions of this chapter.’’. 21
(e) M
ANDATORYATTORNEYFEESAWARD INSUC-22
CESSFULACTIONS FORREEMPLOYMENT.— 23
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00219 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 220
•HR 8371 IH
(1) MSPB ACTIONS.—Paragraph (4) of sub-1
section (c) of section 4324 of such title is amend-2
ed— 3
(A) by striking ‘‘may, in its discretion,’’ 4
and inserting ‘‘shall’’; and 5
(B) by adding at the end the following new 6
sentence: ‘‘The Board may, in its discretion, 7
award reasonable attorney fees in a case settled 8
before the issuance of an order if the person 9
can demonstrate that significant attorney fees 10
were incurred and that justice requires such an 11
award.’’. 12
(2) F
EDERAL CIRCUIT ACTIONS .—Subsection 13
(d) of such section is amended by adding at the end 14
the following new paragraph: 15
‘‘(3) In such Federal Circuit proceeding, the court 16
shall award such person reasonable attorney fees, expert 17
witness fees, and other litigation expenses if such person— 18
‘‘(A) prevails in such Federal Circuit pro-19
ceeding; and 20
‘‘(B) is not represented by the Special Counsel 21
in such Federal Circuit proceeding.’’. 22
(3) A
CTIONS AGAINST A STATE OR PRIVATE EM -23
PLOYER.—Paragraph (2) of section 4323(h) of such 24
title is amended— 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00220 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 221
•HR 8371 IH
(A) by striking ‘‘subsection (a)(2)’’ and in-1
serting ‘‘subsection (a)(3)’’; and 2
(B) by striking ‘‘the court may award any 3
such person who prevails in such action or pro-4
ceeding reasonable attorney fees’’ and inserting 5
‘‘the court shall award any such person who 6
prevails in such action or proceeding reasonable 7
attorney fees’’. 8
(f) GAO R
EVIEW ANDREPORT ONUSERRA.— 9
(1) R
EVIEW.—The Comptroller General of the 10
United States shall review the methods through 11
which the Secretary of Labor, acting through the 12
Veterans’ Employment and Training Service, proc-13
esses actions for relief under chapter 43 of title 38, 14
United States Code. 15
(2) E
LEMENTS.—Not later than one year after 16
the date of the enactment of this Act, the Comp-17
troller General shall submit to the Committees on 18
Veterans’ Affairs of the House of Representatives 19
and the Senate a report that includes— 20
(A) the findings of the review required 21
under paragraph (1); 22
(B) an identification of the number of ac-23
tions for relief under chapter 43 of title 38, 24
United States Code, initiated during the period 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00221 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 222
•HR 8371 IH
covered by the report, disaggregated by size of 1
employer and geographic region; 2
(C) an identification of the number of such 3
actions for relief that were erroneously dis-4
missed, as determined by the Comptroller Gen-5
eral; 6
(D) an identification of the number of such 7
actions for relief that were referred to the De-8
partment of Justice; and 9
(E) an assessment of trends, if any, in 10
such actions for relief initiated during such pe-11
riod. 12
(g) GAO R
EVIEW OFPROTECTIONS FOR MEMBERS 13
OF THEUNIFORMEDSERVICES BYFEDERALINTEL-14
LIGENCEAGENCIES.— 15
(1) I
N GENERAL.—Not later than one year 16
after the date of the enactment of this Act, the 17
Comptroller General of the United States shall sub-18
mit to the appropriate congressional committees a 19
report on the processes and procedures adopted and 20
used by the intelligence community to provide the 21
protections for members of the uniformed services 22
otherwise established under chapter 43 of title 38, 23
United States Code. 24
(2) D
EFINITIONS.—In this subsection: 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00222 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 223
•HR 8371 IH
(A) The term ‘‘appropriate congressional 1
committees’’ means the Committees on Vet-2
erans’ Affairs of the House of Representatives 3
and Senate, the Permanent Select Committee 4
on Intelligence of the House of Representatives, 5
and the Select Committee on Intelligence of the 6
Senate. 7
(B) The term ‘‘intelligence community’’ 8
has the meaning given such term in section 9
3(4) of the National Security Act of 1947 (50 10
U.S.C. 3003(4)). 11
SEC. 222. REVIEW OF INVESTIGATIONS MANUAL OF VET-12
ERANS’ EMPLOYMENT AND TRAINING SERV-13
ICE. 14
(a) I
NGENERAL.—Not later than one year after the 15
date of the enactment of this Act, and once every two 16
years thereafter for the period of five years beginning on 17
such date, the Secretary of Labor, shall review the manual 18
of the Department of Labor titled ‘‘Veterans’ Employment 19
and Training Service Investigations Manual: USERRA, 20
VEOA, and VP’’ (or a successor manual) and make such 21
revisions to such manual as the Secretary determines ap-22
propriate. 23
(b) R
EPORT.—Not later than 90 days after any date 24
on which the Secretary completes a review required under 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00223 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 224
•HR 8371 IH
subsection (a), the Secretary shall submit to the Commit-1
tees on Veterans’ Affairs of the House of Representatives 2
and the Senate— 3
(1) a report that includes a description of any 4
revision to such manual made pursuant to such re-5
view; and 6
(2) a copy of the entire such manual which— 7
(A) shall be provided to the Chairman and 8
Ranking Member of each such committee; and 9
(B) may contain a separate addendum for 10
portions of the manual that contain law en-11
forcement sensitive materials. 12
SEC. 223. WARRIOR TRAINING ADVANCEMENT COURSE. 13
(a) R
EPORTING ON THE WARRIORTRAININGAD-14
VANCEMENTCOURSE.— 15
(1) R
EPORTS REQUIRED.— 16
(A) I
NITIAL REPORT.—Not later than six 17
months after the date of the enactment of this 18
Act, the Secretary of Veterans Affairs shall 19
submit to the Committees on Veterans’ Affairs 20
of the Senate and the House of Representatives 21
a report on WARTAC. 22
(B) A
NNUAL REPORT.—One year after the 23
submission of the report required under para-24
graph subparagraph (A) and annually there-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00224 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 225
•HR 8371 IH
after, the Secretary shall submit to such Com-1
mittees a report that contains the elements 2
under subparagraphs (A) and (C) of paragraph 3
(2) with regards to the preceding year. 4
(2) E
LEMENTS.—Except as provided in para-5
graph (1)(B), the reports under this subsection shall 6
include the following elements: 7
(A) B
EST PRACTICES.—With regards to 8
best practices of WARTAC— 9
(i) how many covered members have 10
applied to participate in WARTAC; 11
(ii) how many covered members have 12
participated in WARTAC; 13
(iii) how the Secretary provides train-14
ing to covered members during TAP; 15
(iv) how many covered members have 16
completed WARTAC; and 17
(v) any other information the Sec-18
retary determines appropriate. 19
(B) C
OST SAVINGS.—With regards to cost 20
savings of WARTAC— 21
(i) how much money the Secretary de-22
termines WARTAC saves the United 23
States each fiscal year; 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00225 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 226
•HR 8371 IH
(ii) how much money the Secretary 1
determines WARTAC has saved the 2
United States since its establishment; and 3
(iii) the determination of the Sec-4
retary whether other Federal agencies may 5
save money by establishing a program 6
similar to WARTAC. 7
(C) H
IRING.—With regards to hiring cov-8
ered members who complete WARTAC— 9
(i) how the Secretary identifies posi-10
tions in the Department of Veterans Af-11
fairs for which such covered members may 12
qualify; 13
(ii) the grades of such positions on 14
the General Schedule under section 5332 15
of title 5, United States Code; and 16
(iii) how many such covered members 17
the Secretary has hired to such positions. 18
(3) D
ISTRIBUTION.—Not later than 30 days 19
after submitting the report under paragraph (1)(A), 20
the Secretary of Veterans Affairs shall transmit a 21
copy of the report under this section to the head of 22
each Federal agency. 23
(4) D
EFINITIONS.—In this subsection: 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00226 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 227
•HR 8371 IH
(A) The term ‘‘covered member’’ means 1
members of the Armed Forces participating in 2
TAP. 3
(B) The term ‘‘TAP’’ means the Transi-4
tion Assistance Program under sections 1142 5
and 1144 of title 10, United States Code. 6
(C) The term ‘‘WARTAC’’ means the 7
Warrior Training Advancement Course of the 8
Veterans Benefit Administration, in which the 9
Secretary provides training to covered members 10
so such covered members may qualify for cer-11
tain employment in the Veterans Benefit Ad-12
ministration. 13
(b) P
ILOTPROGRAMTOEMPLOYVETERANS INPO-14
SITIONSRELATING TOCONSERVATION AND RESOURCE 15
M
ANAGEMENTACTIVITIES.— 16
(1) B
EST PRACTICES FOR OTHER DEPART -17
MENTS.—The Assistant Secretary of Labor for Vet-18
erans’ Employment and Training, in consultation 19
with the Secretary of Veterans Affairs, shall estab-20
lish guidelines containing best practices for depart-21
ments and agencies of the Federal Government that 22
carry out programs to employ veterans who are 23
transitioning from service in the Armed Forces. 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00227 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 228
•HR 8371 IH
Such guidelines shall include the findings of the ini-1
tial report required under subsection (a)(1). 2
(2) P
ILOT PROGRAM.— 3
(A) E
STABLISHMENT.—The Secretary of 4
the Interior, in consultation with the Assistant 5
Secretary of Labor for Veterans’ Employment 6
and Training and the Secretary of Veterans Af-7
fairs, shall establish a pilot program under 8
which veterans are employed by the Federal 9
Government in positions that relate to the con-10
servation and resource management activities of 11
the Department of the Interior. 12
(B) C
OMMENCEMENT .—The Secretary of 13
the Interior shall commence the pilot program 14
at least 60, but not more than 180, days after 15
the date of the submission of the report re-16
quired under subsection (a)(1)(A). 17
(C) P
OSITIONS.—The Secretary of the In-18
terior shall— 19
(i) identify vacant positions in the De-20
partment of the Interior that are appro-21
priate to fill using the pilot program; and 22
(ii) to the extent practicable, fill such 23
positions using the pilot program. 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00228 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 229
•HR 8371 IH
(D) APPLICATION OF CIVIL SERVICE 1
LAWS.—A veteran employed under the pilot 2
program shall be treated as an employee as de-3
fined by section 2105 of title 5, United States 4
Code. 5
(E) B
RIEFINGS AND REPORT.— 6
(i) I
NITIAL BRIEFING.—Not later 7
than 60 days after the date of the submis-8
sion of the report required under sub-9
section (a)(1)(A), the Secretary of the In-10
terior and the Assistant Secretary of Labor 11
for Veterans’ Employment and Training 12
shall jointly provide to the appropriate con-13
gressional committees a briefing on the 14
pilot program under this subsection, which 15
shall include a description of how the pilot 16
program will be carried out in a manner to 17
reduce the unemployment of veterans. 18
(ii) I
MPLEMENTATION BRIEFING .— 19
Not later than one year after the date on 20
which the pilot program under this para-21
graph commences, the Secretary of the In-22
terior and the Assistant Secretary of Labor 23
for Veterans’ Employment and Training 24
shall jointly provide to the appropriate con-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00229 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 230
•HR 8371 IH
gressional committees a briefing on the im-1
plementation of the pilot program. 2
(iii) F
INAL REPORT.—Not later than 3
30 days after the date on which the pilot 4
program under this paragraph is com-5
pleted, the Secretary of the Interior and 6
the Assistant Secretary of Labor for Vet-7
erans’ Employment and Training shall 8
jointly submit to the appropriate congres-9
sional committees a report on the pilot 10
program that includes the following: 11
(I) The number of veterans who 12
applied to participate in the pilot pro-13
gram. 14
(II) The number of such veterans 15
employed under the pilot program. 16
(III) The number of veterans 17
identified in subclause (II) who 18
transitioned to full-time positions with 19
the Federal Government after partici-20
pating in the pilot program. 21
(IV) Recommendations with re-22
spect to extending the pilot or making 23
the program permanent. 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00230 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 231
•HR 8371 IH
(V) Any other information the 1
Secretary and the Assistant Secretary 2
determine appropriate with respect to 3
measuring the effectiveness of the 4
pilot program. 5
(F) D
URATION.—The authority to carry 6
out the pilot program under this paragraph 7
shall terminate on the date that is two years 8
after the date on which the pilot program com-9
mences. 10
(3) A
PPROPRIATE CONGRESSIONAL COMMIT -11
TEES DEFINED.—In this subsection, the term ‘‘ap-12
propriate congressional committees’’ means— 13
(A) the Committee on Veterans’ Affairs 14
and the Committee on Natural Resources of the 15
House of Representatives; and 16
(B) the Committee on Veterans’ Affairs 17
and the Committee on Energy and Natural Re-18
sources of the Senate. 19
Subtitle C—Home Loans 20
SEC. 231. IMPROVEMENTS TO PROGRAM FOR DIRECT 21
HOUSING LOANS MADE TO NATIVE AMER-22
ICAN VETERANS BY THE SECRETARY OF VET-23
ERANS AFFAIRS. 24
(a) G
ENERALAUTHORITIES ANDREQUIREMENTS.— 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00231 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 232
•HR 8371 IH
(1) DIRECT HOUSING LOANS TO NATIVE AMER -1
ICAN VETERANS.—Section 3762(a) of title 38, 2
United States Code, is amended to read as follows: 3
‘‘(a) The Secretary may make a direct housing loan 4
to a Native American veteran under this subchapter if the 5
Secretary ensures the following: 6
‘‘(1) That each Native American veteran to 7
whom the Secretary makes a direct housing loan 8
under this subchapter— 9
‘‘(A) holds, possesses, or purchases using 10
the proceeds of the loan a meaningful interest 11
in a lot or dwelling (or both) that is located on 12
trust land; and 13
‘‘(B) will purchase, construct, or improve 14
(as the case may be) a dwelling on the lot using 15
the proceeds of the loan. 16
‘‘(2) That each such Native American veteran 17
will convey to the Secretary by an appropriate in-18
strument the interest referred to in paragraph 19
(1)(A) as security for a direct housing loan under 20
this subchapter. 21
‘‘(3) That the Secretary, including the Sec-22
retary’s employees or agents, may enter upon the 23
trust land for the purposes of carrying out such ac-24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00232 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 233
•HR 8371 IH
tions as the Secretary determines are necessary, in-1
cluding— 2
‘‘(A) to evaluate the advisability of the 3
loan; 4
‘‘(B) to monitor any purchase, construc-5
tion, or improvements carried out using the 6
proceeds of the loan; and 7
‘‘(C) to manage any servicing or post-fore-8
closure activities, including acquisition, property 9
inspections, and property management. 10
‘‘(4) That there are established standards and 11
procedures that apply to the foreclosure of the inter-12
est conveyed by a Native American veteran pursuant 13
to paragraph (2), including— 14
‘‘(A) procedures for foreclosing the inter-15
est; and 16
‘‘(B) procedures for the resale of the lot or 17
dwelling (or both) purchased, constructed, or 18
improved using the proceeds of the loan. 19
‘‘(5) That the loan is made in a responsible and 20
prudent manner, subject to standards and proce-21
dures as are necessary for the reasonable protection 22
of the financial interests of the United States.’’. 23
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00233 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 234
•HR 8371 IH
(2) MEMORANDUMS OF UNDERSTANDING , 1
AGREEMENTS, AND DETERMINATIONS .—Section 2
3762(b) of such title is amended to read as follows: 3
‘‘(b)(1) To carry out the purpose of subsection (a), 4
the Secretary may— 5
‘‘(A) enter into a memorandum of under-6
standing with a tribal organization, other entity, or 7
individual; 8
‘‘(B) rely on agreements or determinations of 9
other Federal agencies to guarantee, insure, or make 10
loans on trust land; and 11
‘‘(C) enter into other agreements or take such 12
other actions as the Secretary determines necessary. 13
‘‘(2) If the Secretary determines that the require-14
ments under subsection (a) are not being enforced by a 15
tribal organization, other entity, or individual that is a 16
party to any memorandum of understanding, agreement, 17
or determination described in paragraph (1), the Secretary 18
may cease making new direct housing loans to Native 19
American veterans under this subchapter within the area 20
of the authority of the tribal organization, other entity, 21
or individual (as the case may be).’’. 22
(b) D
IRECTLOANS TONATIVEAMERICANVETERANS 23
T
OREFINANCEEXISTINGMORTGAGELOANS.—Section 24
3762(h) of such title is amended to read as follows: 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00234 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 235
•HR 8371 IH
‘‘(h) The Secretary may make direct loans to Native 1
American veterans in order to enable such veterans to refi-2
nance existing mortgage loans for any of the following 3
purposes: 4
‘‘(1) To refinance an existing loan made under 5
this section, if the loan— 6
‘‘(A) meets the requirements set forth in 7
subparagraphs (B), (C), and (E) of paragraph 8
(1) of section 3710(e) of this title; 9
‘‘(B) will bear an interest rate at least one 10
percentage point less than the interest rate 11
borne by the loan being refinanced; and 12
‘‘(C) complies with paragraphs (2) and (3) 13
of section 3710(e) of this title, except that for 14
the purposes of this subsection the reference to 15
subsection (a)(8) of section 3710 of this title in 16
such paragraphs (2) and (3) shall be deemed to 17
be a reference to this subsection. 18
‘‘(2) To refinance an existing mortgage loan not 19
made under this section on a dwelling owned and oc-20
cupied by the veteran as the veteran’s home, if all 21
of the following requirements are met: 22
‘‘(A) The loan will be secured by the same 23
dwelling as was the loan being refinanced. 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00235 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 236
•HR 8371 IH
‘‘(B) The loan will provide the veteran with 1
a net tangible benefit. 2
‘‘(C) The nature and condition of the prop-3
erty is such as to be suitable for dwelling pur-4
poses. 5
‘‘(D) The amount of the loan does not ex-6
ceed either of the following: 7
‘‘(i) 100 percent of the reasonable 8
value of the dwelling, with such reasonable 9
value determined under the procedures es-10
tablished by the Secretary under sub-11
section (d)(2). 12
‘‘(ii) An amount equal to the sum of 13
the balance of the loan being refinanced 14
and such closing costs (including any dis-15
count points) as may be authorized by the 16
Secretary to be included in the loan. 17
‘‘(E) Notwithstanding subparagraph (D), 18
if a loan is made for both the purpose of this 19
paragraph and to make energy efficiency im-20
provements, the loan must not exceed either of 21
the following: 22
‘‘(i) 100 percent of the reasonable 23
value of the dwelling as improved for en-24
ergy efficiency, with such reasonable value 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00236 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 237
•HR 8371 IH
determined under the procedures estab-1
lished by the Secretary under subsection 2
(d)(2). 3
‘‘(ii) The amount referred to under 4
subparagraph (D)(ii), plus the applicable 5
amount specified under section 3710(d)(2) 6
of this title. 7
‘‘(F) The loan meets all other require-8
ments the Secretary may establish under this 9
subchapter. 10
‘‘(G) The existing mortgage being refi-11
nanced is a first lien on the property and se-12
cured of record. 13
‘‘(3) To refinance an existing mortgage loan to 14
repair, alter, or improve a dwelling owned by the 15
veteran and occupied by the veteran as the veteran’s 16
home, if all of the following requirements are met: 17
‘‘(A) The loan will be secured by the same 18
dwelling as was the loan being refinanced. 19
‘‘(B) The nature and condition of the 20
property is such as to be suitable for dwelling 21
purposes, and the repair, alteration, or improve-22
ment substantially protects or improves the 23
basic livability or utility of such property. 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00237 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 238
•HR 8371 IH
‘‘(C) The amount of the loan, including the 1
costs of repairs, alterations, and improvements, 2
does not exceed either of the following: 3
‘‘(i) 100 percent of the reasonable 4
value of the dwelling as repaired, altered, 5
or improved, with such reasonable value 6
determined under the procedures estab-7
lished by the Secretary under subsection 8
(d)(2). 9
‘‘(ii) An amount equal to the sum 10
of— 11
‘‘(I) the balance of the loan being 12
refinanced; 13
‘‘(II) the actual cost of repairs, 14
alterations, or improvements; and 15
‘‘(III) such closing costs (includ-16
ing any discount points) as may be 17
authorized by the Secretary to be in-18
cluded in the loan. 19
‘‘(D) The loan meets all other require-20
ments the Secretary may establish under this 21
subchapter. 22
‘‘(E) The existing mortgage loan being re-23
financed is a first lien on the property and se-24
cured of record.’’. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00238 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 239
•HR 8371 IH
(c) EXPANSION OFOUTREACHPROGRAM ONAVAIL-1
ABILITY OFDIRECTHOUSINGLOANS FORNATIVEAMER-2
ICANVETERANS.—Section 3762(i)(2) of such title is 3
amended by adding at the end the following new subpara-4
graph: 5
‘‘(G) Pursuant to subsection (g)(4), assisting 6
Native American veterans in qualifying for mortgage 7
financing by— 8
‘‘(i) partnering with local service providers, 9
such as tribal organizations, tribally designated 10
housing entities, Native community development 11
financial institutions, and nonprofit organiza-12
tions, for conducting outreach, homebuyer edu-13
cation, housing counseling, and post-purchase 14
education; and 15
‘‘(ii) providing other technical assistance as 16
needed. 17
‘‘(H) Attending conferences and conventions 18
conducted by the network of Native community de-19
velopment financial institutions and other Native 20
American homeownership organizations to provide 21
information and training to Native community devel-22
opment financial institutions about the availability of 23
the relending program under section 3762A of this 24
title.’’. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00239 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 240
•HR 8371 IH
(d) ADEQUATEPERSONNEL.—Section 3762 of such 1
title is amended by adding at the end the following new 2
subsection: 3
‘‘(k) The Secretary shall assign a sufficient number 4
of personnel of the Department dedicated to carrying out 5
the authority of the Secretary under this subchapter, in-6
cluding construction and valuation specialists to assist 7
with issues unique to new construction and renovations 8
on trust land.’’. 9
(e) D
EFINITIONS.—Section 3765 of such title is 10
amended— 11
(1) in paragraph (1)— 12
(A) by amending subparagraph (C) to read 13
as follows: 14
‘‘(C) is located in the State of Alaska with-15
in a region established under section 7(a) of the 16
Alaska Native Claims Settlement Act (43 17
U.S.C. 1606(a));’’; 18
(B) in subparagraph (D), by striking the 19
period at the end and inserting a semicolon; 20
and 21
(C) by adding at the end the following new 22
subparagraphs: 23
‘‘(E) is defined by the Secretary of the In-24
terior and recognized by the United States as 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00240 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 241
•HR 8371 IH
land over which an Indian Tribe has govern-1
mental dominion; or 2
‘‘(F) is on any land that the Secretary de-3
termines is provided to Native American vet-4
erans because of their status as Native Ameri-5
cans.’’; and 6
(2) by adding at the end the following new 7
paragraphs: 8
‘‘(6) The term ‘community development finan-9
cial institution’ has the meaning given that term in 10
section 103 of the Community Development Banking 11
and Financial Institutions Act of 1994 (12 U.S.C. 12
4702). 13
‘‘(7) The term ‘Indian Tribe’ means any Indian 14
tribe, band, nation, or other organized group or com-15
munity, including any Alaska Native village or re-16
gional or village corporation as defined in or estab-17
lished pursuant to the Alaska Native Claims Settle-18
ment Act (43 U.S.C. 1601 et seq.), which is recog-19
nized as eligible for the special programs and serv-20
ices provided by the United States to Indians be-21
cause of their status as Indians. 22
‘‘(8) The term ‘Native community development 23
financial institution’ means any entity— 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00241 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 242
•HR 8371 IH
‘‘(A) that has been certified as a commu-1
nity development financial institution by the 2
Secretary of the Treasury; 3
‘‘(B) that is not less than 51 percent 4
owned or controlled by Native Americans; and 5
‘‘(C) for which not less than 51 percent of 6
the activities of the entity serve Native Ameri-7
cans. 8
‘‘(9) The term ‘net tangible benefit’ shall have 9
such meaning as the Secretary determines appro-10
priate, but shall include the refinance of an interim 11
construction loan. 12
‘‘(10) The term ‘other technical assistance’ 13
means services to assist a Native American veteran 14
to navigate the steps necessary for securing a mort-15
gage loan on trust land, including pre-development 16
activities related to utilities, identifying appropriate 17
residential construction services, and obtaining lease 18
clearances and title status reports from the applica-19
ble tribal organization or the Bureau of Indian Af-20
fairs. 21
‘‘(11) The term ‘tribally designated housing en-22
tity’ has the meaning given that term in section 4 23
of the Native American Housing Assistance and 24
Self-Determination Act of 1996 (25 U.S.C. 4103).’’. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00242 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 243
•HR 8371 IH
(f) INTEREST RATEREDUCTION FINANCING 1
L
OAN.—Section 3729(b)(4)(F) of such title is amended 2
by striking ‘‘3762(h)’’ and inserting ‘‘3762(h)(1)’’. 3
(g) R
EGULATIONS.—Section 3761 of such title is 4
amended by adding at the end the following new sub-5
section: 6
‘‘(c) The Secretary shall prescribe such regulations 7
as may be necessary to carry out this subchapter.’’. 8
SEC. 232. NATIVE COMMUNITY DEVELOPMENT FINANCIAL 9
INSTITUTION RELENDING PROGRAM. 10
(a) I
NGENERAL.—Subchapter V of chapter 37 of 11
title 38, United States Code, is amended by inserting after 12
section 3762 the following new section: 13
‘‘§ 3762A. Native community development financial 14
institution relending program 15
‘‘(a) P
URPOSE.—The Secretary may make a loan to 16
a Native community development financial institution for 17
the purpose of allowing the institution to relend loan 18
amounts to qualified Native American veterans, subject to 19
the requirements of this section. 20
‘‘(b) S
TANDARDS.—(1) The Secretary shall establish 21
standards to be used in evaluating whether to make a loan 22
to a Native community development financial institution 23
under this section. 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00243 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 244
•HR 8371 IH
‘‘(2) In establishing standards under paragraph (1), 1
the Secretary shall ensure that a Native community devel-2
opment financial institution— 3
‘‘(A) is able to originate and service loans for 4
single-family homes; 5
‘‘(B) is able to operate the relending program 6
in a manner consistent with the mission of the De-7
partment to serve veterans; and 8
‘‘(C) uses loan amounts received under this sec-9
tion only for the purpose of relending, as described 10
in subsection (c), to Native American veterans. 11
‘‘(c) R
ELENDINGREQUIREMENTS.—(1) A Native 12
community development financial institution that receives 13
a loan under this section shall use the loan amounts to 14
make loans to Native American veterans residing on trust 15
land. 16
‘‘(2) A loan to a Native American veteran made by 17
a Native community development financial institution 18
under paragraph (1) shall— 19
‘‘(A) be limited either to the purpose of pur-20
chase, construction, or improvement of a dwelling lo-21
cated on trust land or to the refinance of an existing 22
mortgage loan for a dwelling on trust land, con-23
sistent with the requirements of section 3762(h) of 24
this title; and 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00244 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 245
•HR 8371 IH
‘‘(B) comply with such terms and conditions as 1
the Secretary determines are necessary to protect 2
against predatory lending, including the interest rate 3
charged on a loan to a Native American veteran. 4
‘‘(d) R
EPAYMENT.—A loan made to a Native commu-5
nity development financial institution under this section 6
shall— 7
‘‘(1) be payable to the Secretary upon such 8
terms and conditions as are prescribed in regulations 9
pursuant to this subchapter; and 10
‘‘(2) bear interest at a rate of one percent. 11
‘‘(e) O
VERSIGHT.—Subject to notice and opportunity 12
for a hearing, whenever the Secretary finds with respect 13
to loans made under subsection (a) or (c) that any Native 14
community development financial institution has failed to 15
maintain adequate loan accounting records, to dem-16
onstrate proper ability to service loans adequately, or to 17
exercise proper credit judgment, or that such Native com-18
munity development financial institution has willfully or 19
negligently engaged in practices otherwise detrimental to 20
the interest of veterans or of the Government, the Sec-21
retary may take such actions as the Secretary determines 22
necessary to protect veterans or the Government, such as 23
requiring immediate repayment of any loans made under 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00245 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 246
•HR 8371 IH
subsection (a) and the assignment to the Secretary of 1
loans made under subsection (c). 2
‘‘(f) S
UNSET.—The Secretary may not make a loan 3
under this section after September 30, 2026.’’. 4
(b) C
LERICALAMENDMENT.—The table of sections 5
at the beginning of chapter 37 of such title is amended 6
by inserting after the item relating to section 3762 the 7
following new item: 8
‘‘3762A. Native community development financial institution relending pro-
gram.’’.
(c) NATIVEAMERICANVETERANHOUSINGLOAN 9
P
ROGRAMACCOUNT.—Section 3763 of such title is 10
amended by adding at the end the following new sub-11
section: 12
‘‘(c) Of amounts available in the Account, the Sec-13
retary may use for loans made under section 3762A of 14
this title— 15
‘‘(1) in fiscal year 2024, not more than 16
$5,000,000; and 17
‘‘(2) in any fiscal year after fiscal year 2024, 18
an amount determined necessary by the Secretary to 19
meet the demand for such loans.’’. 20
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00246 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 247
•HR 8371 IH
TITLE III—DISABILITY AND 1
MEMORIAL AFFAIRS MATTERS 2
SEC. 301. BURIAL ALLOWANCE FOR CERTAIN VETERANS 3
WHO DIE AT HOME WHILE IN RECEIPT OF 4
HOSPICE CARE FURNISHED BY DEPARTMENT 5
OF VETERANS AFFAIRS. 6
(a) I
NGENERAL.—The Secretary of Veterans Affairs 7
shall treat a veteran described in subsection (b) as a vet-8
eran described in subparagraph (A) of section 2303(a)(2) 9
of title 38, United States Code. 10
(b) V
ETERANDESCRIBED.—A veteran described in 11
this subsection is a veteran who dies in a home or other 12
setting at which the deceased veteran was, at the time of 13
death, receiving hospice care pursuant to section 1717(a) 14
of such title if such care was directly preceded by the Sec-15
retary furnishing to the veteran hospital care or nursing 16
home care described in clause (ii) of such subparagraph. 17
(c) E
FFECTIVEDATE; APPLICABILITY.—This section 18
shall apply with respect to deaths that occur— 19
(1) on or after the date that is 180 days after 20
the date of the enactment of this Act; and 21
(2) before October 1, 2026. 22
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00247 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 248
•HR 8371 IH
SEC. 302. AUTHORITY FOR SECRETARY OF VETERANS AF-1
FAIRS TO AWARD GRANTS TO STATES AND IN-2
DIAN TRIBES TO IMPROVE OUTREACH TO 3
VETERANS. 4
(a) I
NGENERAL.—Chapter 63 of title 38, United 5
States Code, is amended— 6
(1) by redesignating sections 6307 and 6308 as 7
sections 6308 and 6309, respectively; and 8
(2) by inserting after section 6306 the following 9
new section 6307: 10
‘‘§ 6307. Grants to States and Indian Tribes to im-11
prove outreach to veterans 12
‘‘(a) P
URPOSE.—It is the purpose of this section to 13
provide for assistance by the Secretary to States and In-14
dian Tribes to carry out programs that improve covered 15
outreach and assistance to veterans and the spouses, chil-16
dren, and parents of veterans, to ensure that such individ-17
uals are fully informed about, and assisted in applying for, 18
any veterans and veterans-related benefits and programs 19
(including veterans programs of a State or Indian Tribe) 20
for which they may be eligible and facilitate opportunities 21
for such individuals to receive competent, qualified serv-22
ices in the preparation, presentation and prosecution of 23
veterans benefits claims. 24
‘‘(b) A
UTHORITY.—The Secretary may award grants 25
to States and Indian Tribes— 26
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00248 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 249
•HR 8371 IH
‘‘(1) to carry out, coordinate, improve, or other-1
wise enhance— 2
‘‘(A) covered outreach activities; or 3
‘‘(B) activities to assist in the development 4
and submittal of claims for veterans and vet-5
erans-related benefits; or 6
‘‘(2) to increase the number of county or Tribal 7
veterans service officers serving in the State by hir-8
ing new, additional such officers. 9
‘‘(c) A
PPLICATION.—(1) To be eligible for a grant 10
under this section, a State or Indian Tribe shall submit 11
to the Secretary an application therefor at such time, in 12
such manner, and containing such information as the Sec-13
retary may require. 14
‘‘(2) Each application submitted under paragraph (1) 15
shall include the following: 16
‘‘(A) A detailed plan for the use of the grant. 17
‘‘(B) A description of the programs through 18
which the State or Indian Tribe will meet the out-19
come measures developed by the Secretary under 20
subsection (j). 21
‘‘(C) A description of how the State or Indian 22
Tribe will distribute grant amounts equitably among 23
counties or Tribal lands with varying levels of urban-24
ization. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00249 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 250
•HR 8371 IH
‘‘(D) A plan for how the grant will be used to 1
meet the unique needs of American Indian veterans, 2
Alaska Native veterans, or Native Hawaiian vet-3
erans, elderly veterans, and veterans from other un-4
derserved communities. 5
‘‘(d) D
ISTRIBUTION.—The Secretary shall seek to en-6
sure that grants awarded under this section are equitably 7
distributed among States and Indian Tribes with varying 8
levels of urbanization. 9
‘‘(e) S
ET-ASIDE.—Of the amounts authorized to be 10
appropriated or otherwise made available for grants under 11
this section for any fiscal year, the Secretary shall ensure 12
that not less than five percent is used to make grants to 13
Indian Tribes. 14
‘‘(f) P
RIORITY.—The Secretary shall prioritize 15
awarding grants under this section that will serve the fol-16
lowing areas: 17
‘‘(1) Areas with a critical shortage of county or 18
Tribal veterans service officers. 19
‘‘(2) Areas with high rates of— 20
‘‘(A) suicide among veterans; or 21
‘‘(B) referrals to the Veterans Crisis Line. 22
‘‘(g) U
SE OFCOUNTY ORTRIBALVETERANSSERV-23
ICEOFFICERS.—A State or Indian Tribe that receives a 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00250 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 251
•HR 8371 IH
grant under this section to carry out an activity described 1
in subsection (b)(1) shall carry out the activity through— 2
‘‘(1) a county or Tribal veterans service officer 3
of the State; or 4
‘‘(2) if the State or Indian Tribe does not have 5
a county or Tribal veterans service officer, or if the 6
county or Tribal veterans service officers of the 7
State or Indian Tribe cover only a portion of that 8
State or Indian Tribe, an appropriate entity of a 9
State, local, or Tribal government, as determined by 10
the Secretary. 11
‘‘(h) R
EQUIREDACTIVITIES.—Any grant awarded 12
under this section shall be used— 13
‘‘(1) to expand existing programs, activities, 14
and services; 15
‘‘(2) to hire new, additional county or Tribal 16
veterans service officers; or 17
‘‘(3) for travel and transportation to facilitate 18
carrying out paragraph (1) or (2). 19
‘‘(i) A
UTHORIZEDACTIVITIES.—A grant under this 20
section may be used to provide education and training, in-21
cluding on-the-job training, for State, county, local, and 22
Tribal government employees who provide (or when 23
trained will provide) covered outreach services in order for 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00251 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 252
•HR 8371 IH
those employees to obtain accreditation in accordance with 1
procedures approved by the Secretary. 2
‘‘(j) O
UTCOMEMEASURES.—(1) The Secretary shall 3
develop and provide to each State or Indian Tribe that 4
receives a grant under this section written guidance on 5
the following: 6
‘‘(A) Outcome measures. 7
‘‘(B) Policies of the Department. 8
‘‘(2) In developing outcome measures under para-9
graph (1), the Secretary shall consider the following goals: 10
‘‘(A) Increasing the use of veterans and vet-11
erans-related benefits, particularly among vulnerable 12
populations. 13
‘‘(B) Increasing the number of county and 14
Tribal veterans service officers recognized by the 15
Secretary for the representation of veterans under 16
chapter 59 of this title. 17
‘‘(k) T
RACKINGREQUIREMENTS.—(1) With respect 18
to each grant awarded under this section, the Secretary 19
shall track the use of veterans and veterans-related bene-20
fits among the population served by the grant, including 21
the average period of time between the date on which a 22
veteran applies for such a benefit and the date on which 23
the veteran receives the benefit, disaggregated by type of 24
benefit. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00252 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 253
•HR 8371 IH
‘‘(2) Not less frequently than annually during the life 1
of the grant program established under this section, the 2
Secretary shall submit to Congress a report on— 3
‘‘(A) the information tracked under paragraph 4
(1); 5
‘‘(B) how the grants awarded under this section 6
serve the unique needs of American Indian veterans, 7
Alaska Native veterans, or Native Hawaiian vet-8
erans, elderly veterans, and veterans from other un-9
derserved communities; and 10
‘‘(C) other information provided by States and 11
Indian Tribes pursuant to the grant reporting re-12
quirements. 13
‘‘(l) P
ERFORMANCEREVIEW.—The Secretary shall— 14
‘‘(1) review the performance of each State or 15
Indian Tribe that receives a grant under this sec-16
tion; and 17
‘‘(2) make information regarding such perform-18
ance publicly available. 19
‘‘(m) R
EMEDIATIONPLAN.—(1) In the case of a 20
State or Indian Tribe that receives a grant under this sec-21
tion and does not meet the outcome measures developed 22
by the Secretary under subsection (j), the Secretary shall 23
require the State or Indian Tribe to submit a remediation 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00253 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 254
•HR 8371 IH
plan under which the State shall describe how and when 1
it plans to meet such outcome measures. 2
‘‘(2) The Secretary may not award a subsequent 3
grant under this section to a State or Indian Tribe de-4
scribed in paragraph (1) unless the Secretary approves the 5
remediation plan submitted by the State or Indian Tribe. 6
‘‘(n) D
EFINITIONS.—In this section: 7
‘‘(1) The term ‘county or Tribal veterans serv-8
ice officer’ includes a local equivalent veterans serv-9
ice officer. 10
‘‘(2) The term ‘covered outreach’ means out-11
reach with respect to— 12
‘‘(A) benefits administered by the Under 13
Secretary for Benefits; or 14
‘‘(B) similar benefits administered by a 15
State or Indian Tribe. 16
‘‘(3) The term ‘Indian Tribe’ has the meaning 17
given such term in section 4 of the Indian Self-De-18
termination and Education Assistance Act (25 19
U.S.C. 5304). 20
‘‘(4) The term ‘State’ includes the District of 21
Columbia, the Commonwealth of Puerto Rico, the 22
Commonwealth of the Northern Mariana Islands, 23
and any territory or possession of the United States. 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00254 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 255
•HR 8371 IH
‘‘(5) The term ‘Veterans Crisis Line’ means the 1
toll-free hotline for veterans established under sec-2
tion 1720F(h) of this title.’’. 3
(b) C
LERICALAMENDMENT.—The table of sections 4
at the beginning of chapter 63 of such title is amended 5
by striking the items relating to sections 6307 and 6308 6
and inserting the following new items: 7
‘‘6307. Grants to States and Indian Tribes to improve outreach to veterans
‘‘6308. Outreach for eligible dependents
‘‘6309. Biennial report to Congress’’.
(c) AUTHORIZATION OF APPROPRIATIONS.—There is 8
authorized to be appropriated to the Secretary of Veterans 9
Affairs for each of fiscal years 2025 and 2026, 10
$10,000,000 to carry out section 6307 of title 28, United 11
States Code, as added by subsection (a). 12
SEC. 303. DEFINITION OF SURVIVING SPOUSE. 13
Paragraph (3) of section 101 of title 38, United 14
States Code, is amended to read as follows: 15
‘‘(3) The term ‘surviving spouse’ means (except for 16
purposes of chapter 19 of this title) a person who was 17
the spouse of a veteran at the time of the veteran’s death, 18
and who lived with the veteran continuously from the date 19
of marriage to the date of the veteran’s death (except 20
where there was a separation which was due to the mis-21
conduct of, or procured by, the veteran without the fault 22
of the spouse) and who has not remarried.’’. 23
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00255 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 256
•HR 8371 IH
SEC. 304. ENSURING ONLY LICENSED HEALTH CARE PRO-1
FESSIONALS PERFORM MEDICAL DISABILITY 2
EXAMINATIONS UNDER CERTAIN DEPART-3
MENT OF VETERANS AFFAIRS PILOT PRO-4
GRAM. 5
(a) P
ROHIBITION ON USE OFCERTAINHEALTH 6
C
AREPROFESSIONALS.—Section 504(c)(1) of the Vet-7
erans’ Benefits Improvements Act of 1996 (Public Law 8
104–275; 38 U.S.C. 5101 note) is amended by inserting 9
‘‘only’’ before ‘‘a health care professional’’. 10
(b) R
EMEDIES.—The Secretary of Veterans Affairs 11
shall take such actions as the Secretary considers appro-12
priate to ensure compliance with section 504(c) of the Vet-13
erans’ Benefits Improvements Act of 1996 (Public Law 14
104–275; 38 U.S.C. 5101 note), as amended by subsection 15
(a). 16
(c) A
NNUALREPORT.—Not later than one year after 17
the date of the enactment of this Act and not less fre-18
quently than once each year thereafter, the Secretary shall 19
submit to the Committee on Veterans’ Affairs of the Sen-20
ate and the Committee on Veterans’ Affairs of the House 21
of Representatives a report on— 22
(1) the conduct of the pilot program established 23
under section 504 of the Veterans’ Benefits Im-24
provements Act of 1996 (Public Law 104–275; 38 25
U.S.C. 5101 note); and 26
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00256 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 257
•HR 8371 IH
(2) the actions of the Secretary under sub-1
section (b). 2
(d) T
ECHNICALCORRECTIONS.—Section 504 of the 3
Veterans’ Benefits Improvements Act of 1996 (Public 4
Law 104–275; 38 U.S.C. 5101 note) is amended, in the 5
section heading, by striking ‘‘
PHYSICIANS’’ and inserting 6
‘‘
HEALTH CARE PROFESSIONALS ’’. 7
SEC. 305. PROVISION OF INFORMATION REGARDING AN 8
AGENT OR ATTORNEY TO A LICENSED 9
HEALTH CARE PROFESSIONAL WHO PER-10
FORMS A MEDICAL DISABILITY EXAMINATION 11
UNDER CERTAIN DEPARTMENT OF VET-12
ERANS AFFAIRS PILOT PROGRAM. 13
(a) I
NGENERAL.—Section 504 of the Veterans’ Ben-14
efits Improvements Act of 1996 (Public Law 104–275; 38 15
U.S.C. 5101 note), as amended by section 304, is further 16
amended by adding at the end the following new sub-17
section: 18
‘‘(f) C
ERTAININFORMATIONPROVIDED TOHEALTH 19
C
AREPROFESSIONAL.—The Secretary shall provide to a 20
health care professional who performs an examination 21
under subsection (a) the contact information of any agent 22
or attorney recognized by the Secretary under chapter 59 23
of title 38, United States Code, with regards to a claim 24
for benefits that gives rise to such examination.’’. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00257 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 258
•HR 8371 IH
(b) APPLICABILITY.—The amendment made by this 1
section shall apply to an examination described in sub-2
section (a) of such section that is performed on or after 3
the date of the enactment of this Act. 4
SEC. 306. MODERNIZATION OF DEPARTMENT OF VETERANS 5
AFFAIRS DISABILITY BENEFIT QUESTION-6
NAIRES. 7
(a) R
EQUIREMENT FOR TRANSMISSION OFCERTAIN 8
I
NFORMATION INMACHINE-READABLEFORMAT.— 9
(1) R
EQUIREMENT.—Not later than 180 days 10
after enactment of this Act, the Secretary of Vet-11
erans Affairs shall require all disability benefit ques-12
tionnaire data collected in the course of medical dis-13
ability examinations made by covered non-Depart-14
ment providers to be transmitted to the Department 15
in a machine-readable format. 16
(2) I
SSUANCE OF STANDARDS .—Not later than 17
90 days after the date of the enactment of this Act, 18
the Secretary shall issue standards for the trans-19
mission of disability benefit questionnaire data in a 20
machine-readable format as required under para-21
graph (1). 22
(3) U
PDATES.—In making updates to disability 23
benefit questionnaires after the date specified in 24
paragraph (1), the Secretary shall— 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00258 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 259
•HR 8371 IH
(A) ensure that the updates are made in a 1
manner that allows for the data collected under 2
the questionnaires to be in a machine-readable 3
format as of the date on which the update goes 4
into effect; and 5
(B) not later than 30 days before an up-6
date goes into effect, notify the covered non-De-7
partment providers (or their employers) de-8
scribed in such paragraph of such updates. 9
(b) P
LAN FORINFORMATIONTECHNOLOGYSYSTEM 10
M
ODIFICATION.—Not later than 180 days after the date 11
of the enactment of this Act, the Secretary shall submit 12
to the Committees on Veterans’ Affairs of the Senate and 13
the House of Representatives a plan to modify the infor-14
mation technology systems and processes of the Depart-15
ment to enable a non-Department health care professional, 16
assigned to or selected by a claimant, to transmit to the 17
Department, in a machine-readable format, disability ben-18
efit questionnaire data, including complete disability ben-19
efit questionnaires rather than partial questionnaires or 20
elements of medical evidence. 21
(c) P
UBLICAVAILABILITY OFINFORMATION.—The 22
Secretary shall make publicly available on the internet 23
website of the Department referred to in section 5101(d) 24
of title 38, United States Code— 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00259 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 260
•HR 8371 IH
(1) a description of the standards issued under 1
subsection (a)(2); and 2
(2) the plan required under subsection (b). 3
(d) D
EFINITIONS.—In this section: 4
(1) The term ‘‘claimant’’ has the meaning given 5
such term in section 5100 of title 38, United States 6
Code. 7
(2) The term ‘‘covered non-Department pro-8
vider’’ means a health care provider who— 9
(A) is not an employee of the Department 10
of Veterans Affairs; and 11
(B) pursuant to a contract under section 12
504 of the Veterans Benefits Improvement Act 13
of 1996 (Public Law 104–275; 38 U.S.C. 5101 14
note), as amended by sections 304 and 305, ex-15
amines a claimant for a medical disability. 16
SEC. 307. DEPARTMENT OF VETERANS AFFAIRS AUTO-17
MATIC PROCESSING OF CERTAIN CLAIMS 18
FOR TEMPORARY DISABILITY RATINGS. 19
(a) I
NGENERAL.—Not later than one year after the 20
date of the enactment of this Act, the Secretary of Vet-21
erans Affairs shall modify the information technology sys-22
tems of the Department of Veterans Affairs to use auto-23
mation technology for claims for temporary disability rat-24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00260 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 261
•HR 8371 IH
ings for veterans described in section 1156(a)(1)(C) of 1
title 38, United States Code. 2
(b) A
DDITIONALREQUIREMENTS.—In providing for 3
the automatic processing of claims as required under sub-4
section (a), the Secretary shall ensure that— 5
(1) medical evidence is obtained from the cor-6
porate data warehouse of the Department or other 7
sources of data, the Secretary determines appro-8
priate; 9
(2) employees of the Department continue to 10
determine whether a veteran is entitled to a tem-11
porary disability rating under section 1156(a)(1)(C) 12
of title 38, United States Code; and 13
(3) claims may be processed manually if the 14
evidence of record is not sufficient to decide the 15
claim or if the medical evidence is provided in a for-16
mat that is not compatible with the system devel-17
oped under subsection (a). 18
TITLE IV—HOMELESSNESS 19
MATTERS 20
SEC. 401. SHORT TITLE. 21
This title may be cited as the ‘‘Housing our Military 22
Veterans Effectively Act of 2023’’ or the ‘‘HOME Act of 23
2023’’. 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00261 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 262
•HR 8371 IH
SEC. 402. PER DIEM PAYMENTS PROVIDED BY THE SEC-1
RETARY OF VETERANS AFFAIRS FOR SERV-2
ICES FURNISHED TO HOMELESS VETERANS. 3
(a) I
NGENERAL.—Section 2012 of title 38, United 4
States Code, is amended— 5
(1) in subsection (a)— 6
(A) in paragraph (2)(B)— 7
(i) in clause (i)(II)(aa)(BB), by strik-8
ing ‘‘115 percent’’ and inserting ‘‘115 per-9
cent (or, during the period beginning on 10
the date of the enactment of the the Sen-11
ator Elizabeth Dole 21st Century Veterans 12
Healthcare and Benefits Improvement Act 13
and ending on September 30, 2026, 133 14
percent)’’; and 15
(ii) by adding at the end the fol-16
lowing: 17
‘‘(iii) For each of fiscal years 2024 through 2026, 18
the Secretary may waive the maximum rate for per diem 19
payments under clause (i)(II)(aa)(BB) or (ii) and, subject 20
to the availability of appropriations, provide such pay-21
ments at a rate that does not exceed 200 percent of the 22
rate authorized for State homes for domiciliary care under 23
subsection (a)(1)(A) of section 1741 of this title, as the 24
Secretary may increase from time to time under sub-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00262 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 263
•HR 8371 IH
section (c) of that section, if the Secretary notifies Con-1
gress of such waiver. 2
‘‘(iv) The Secretary may not, pursuant to clause (iii), 3
waive the maximum rate described in such clause for more 4
than 50 percent of all grant recipients and eligible entities 5
for a fiscal year.’’; and 6
(B) by adding at the end the following new 7
paragraph: 8
‘‘(4) The Secretary may not provide more than 9
12,000 per diem payments under this section for a fiscal 10
year.’’; and 11
(2) by adding at the end the following new sub-12
section: 13
‘‘(f) R
EPORTSREQUIRED.—Not later than 90 days 14
after the date of the enactment of the HOME Act of 2023, 15
and not less frequently than twice each year thereafter, 16
the Secretary shall submit to the Committee on Veterans’ 17
Affairs of the Senate and the Committee on Veterans’ Af-18
fairs of the House of Representatives a report on the rate 19
for per diem payments under this section that includes, 20
for each Veterans Integrated Service Network of the De-21
partment, the following data: 22
‘‘(1) The average rate for such a payment. 23
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00263 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 264
•HR 8371 IH
‘‘(2) A list of locations where the rate for such 1
a payment is within 10 percent of the maximum rate 2
for such a payment authorized under this section. 3
‘‘(3) The average length of stay by a veteran 4
participating in a program described in section 5
2012(a) of this title.’’. 6
(b) R
EGULATORY AUTHORITY.—The Secretary of 7
Veterans Affairs may prescribe interim guidance to carry 8
out the amendments made by subsection (a). 9
(c) S
TRATEGICPLAN.— 10
(1) I
N GENERAL.—Not later than the end of 11
fiscal year 2025, the Secretary of Veterans Affairs 12
shall submit to the Committee on Veterans’ Affairs 13
of the Senate and the Committee on Veterans’ Af-14
fairs of the House of Representatives a strategic 15
plan for the provision of grants and per diem pay-16
ments for services furnished to homeless veterans 17
under sections 2011 and 2012 of title 38, United 18
States Code. 19
(2) E
LEMENTS.—The plan required by para-20
graph (1) shall include the following: 21
(A) A method for administering grant 22
funding equitably without using the rate au-23
thorized for State homes for domiciliary care 24
under subsection (a)(1)(A) of section 1741 of 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00264 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 265
•HR 8371 IH
title 38, United States Code, as the Secretary 1
may increase from time to time under sub-2
section (c) of that section, that takes into ac-3
count— 4
(i) the wide variety of services fur-5
nished by grant recipients and eligible enti-6
ties under sections 2011 and 2012 of title 7
38, United States Code; 8
(ii) varying costs of living across dif-9
ferent geographic locations; 10
(iii) varying availability of affordable 11
housing in different geographic locations; 12
(iv) circumstances of housing insecu-13
rity in rural and Tribal communities; 14
(v) veterans with significant medical 15
care needs; and 16
(vi) the changing dynamic of the vet-17
eran population nationwide. 18
(B) A plan and timeline for implementa-19
tion of the method included under subpara-20
graph (A). 21
(C) An estimate of increased costs or sav-22
ings per year under the plan. 23
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00265 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 266
•HR 8371 IH
(D) An overview of the different grants 1
that will be available once the plan is imple-2
mented. 3
SEC. 403. AUTHORIZATION FOR SECRETARY OF VETERANS 4
AFFAIRS TO USE OF CERTAIN FUNDS FOR IM-5
PROVED FLEXIBILITY IN ASSISTANCE TO 6
HOMELESS VETERANS. 7
(a) U
SE OFFUNDS.—During the period beginning on 8
the date of the enactment of this Act and ending on the 9
termination date specified in subsection (d), the Secretary 10
of Veterans Affairs may provide to a covered veteran, as 11
the Secretary determines necessary— 12
(1) food, shelter, clothing, blankets, and hy-13
giene items required for the safety and survival of 14
the veteran; 15
(2) transportation required to support the sta-16
bility and health of the veteran for appointments 17
with service providers, the conduct of housing and 18
employment searches, and the obtainment of food 19
and supplies; and 20
(3) tablets, smartphones, disposable phones and 21
other technology, and related service plans required 22
to support the stability and health of the veteran 23
through the maintenance of contact with service pro-24
viders, prospective landlords, and family members. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00266 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 267
•HR 8371 IH
(b) HOMELESSVETERANS ONDEPARTMENT OFVET-1
ERANSAFFAIRSLAND.— 2
(1) I
N GENERAL.—The Secretary may collabo-3
rate, to the extent practicable, with one or more or-4
ganizations to manage the use of land of the Depart-5
ment of Veterans Affairs for homeless veterans for 6
living and sleeping. 7
(2) F
ORMS OF COLLABORATION .—Collaboration 8
under paragraph (1) may include the provision by ei-9
ther the Secretary or the head of the organization 10
concerned of food services and security for property, 11
buildings, and other facilities owned or controlled by 12
the Department of Veterans Affairs. 13
(c) R
EPORTREQUIRED.—Not later than six months 14
after the date of the enactment of this Act, and annually 15
thereafter until the date specified in subsection (d), the 16
Secretary shall submit to Congress a report that includes, 17
with respect to the period covered by such report— 18
(1) a statement, disaggregated by each medical 19
center of the Department of Veterans Affairs, of the 20
amount of funds under this section— 21
(A) each such medical center requested 22
from the Secretary; and 23
(B) to which the Secretary provided each 24
such medical center; 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00267 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 268
•HR 8371 IH
(2) data, disaggregated by each such medical 1
center, relating to how each such medical center 2
used amounts provided by the Secretary under this 3
section; 4
(3) the number of covered veterans to which the 5
Secretary provided assistance under this section; 6
(4) the total amount of assistance the Secretary 7
provided to covered veterans pursuant to subsection 8
(a)(3) for communications equipment, broken down 9
by the type of equipment provided; 10
(5) the total amount of assistance the Secretary 11
provided covered veterans pursuant to subsection 12
(a)(2) for ridesharing; 13
(6) the number of covered veterans who re-14
ceived such assistance; and 15
(7) a description, for each rideshare used by a 16
covered veteran with such assistance, of the reasons 17
such covered veteran used such rideshare; 18
(8) the number of covered veterans who lived or 19
slept on Department land; 20
(9) the amount of funds used to make available 21
Department land for covered veterans to live and 22
sleep; 23
(10) the number of Department employees 24
whose primary responsibilities involved providing 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00268 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 269
•HR 8371 IH
services for covered veterans living or sleeping on 1
Department land; 2
(11) the average length of time a covered vet-3
eran lived or slept on Department land; and 4
(12) the period of time the Secretary expects 5
Department land will be made available for covered 6
veterans to live and sleep. 7
(d) T
ERMINATIONDATE.—The termination date 8
specified in this subsection is September 30, 2026. 9
(e) D
EFINITIONS.—In this section, the term ‘‘covered 10
veteran’’ means— 11
(1) a homeless veteran, as such term is defined 12
in section 2002 of title 38, United States Code; and 13
(2) a veteran participating in the program car-14
ried out under section 8(o)(19) of the United States 15
Housing Act of 1937 (42 U.S.C. 1437f(o)(19)). 16
SEC. 404. ACCESS TO DEPARTMENT OF VETERANS AFFAIRS 17
TELEHEALTH SERVICES. 18
(a) I
NGENERAL.—Subtitle VII of chapter 20 of title 19
38, United States Code is amended by adding at the end 20
the following new section: 21
‘‘§ 2069. Access to telehealth services 22
‘‘To the extent practicable, the Secretary shall ensure 23
that veterans participating in or receiving services from 24
a program under this chapter have access to telehealth 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00269 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 270
•HR 8371 IH
services to which such veterans are eligible under the laws 1
administered by the Secretary, including by ensuring that 2
telehealth capabilities are available to— 3
‘‘(1) such veterans; 4
‘‘(2) case managers of the Department of pro-5
grams for homeless veterans authorized under this 6
chapter; and 7
‘‘(3) community-based service providers for 8
homeless veterans receiving funds from the Depart-9
ment through grants or contracts.’’. 10
(b) C
LERICALAMENDMENT.—The table of sections 11
at the beginning of chapter 20 of title 38, United States 12
Code, is amended by adding at the end the following new 13
item: 14
‘‘2069. Access to telehealth services.’’.
TITLE V—ELECTRONIC HEALTH 15
RECORD MATTERS 16
SEC. 501. SHORT TITLE. 17
This title may be cited as the ‘‘Electronic Health 18
Record Program Restructure, Enhance, Strengthen, and 19
Empower Technology Act of 2024’’ or the ‘‘EHR Program 20
RESET Act of 2024’’. 21
SEC. 502. DEFINITIONS. 22
In this title: 23
(1) The term ‘‘appropriate congressional com-24
mittees’’ means— 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00270 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 271
•HR 8371 IH
(A) the Committee on Veterans’ Affairs 1
and the Committee on Appropriations of the 2
House of Representatives; and 3
(B) the Committee on Veterans’ Affairs 4
and the Committee on Appropriations of the 5
Senate. 6
(2) The term ‘‘Electronic Health Record Mod-7
ernization Program’’ means any activities being car-8
ried out, as of the date of the enactment of this Act, 9
by the Department of Veterans Affairs to procure 10
and implement an electronic health record system to 11
replace significant medical functions or applications 12
of the Veterans Information Systems and Tech-13
nology Architecture. 14
(3) The term ‘‘other health information tech-15
nology activities and systems of the Department’’ 16
means health information technology activities and 17
systems other than electronic health record systems, 18
including functions supporting clinical care or func-19
tional requirements, notwithstanding the Determina-20
tion and Findings executed by the Secretary of Vet-21
erans Affairs on June 1, 2017. 22
(4) The term ‘‘preliminary program activity’’ 23
means an activity under the Electronic Health 24
Record Modernization Program, including any local 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00271 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 272
•HR 8371 IH
workshop, training, testing, or any other activity 1
that is a direct precursor to the activation of the 2
electronic health record system at a particular Vet-3
erans Health Administration facility. 4
Subtitle A—Electronic Health 5
Record System and Health In-6
formation Technology Mod-7
ernization 8
SEC. 511. MODERNIZATION OF DEPARTMENT OF VETERANS 9
AFFAIRS ELECTRONIC HEALTH RECORD SYS-10
TEM AND HEALTH INFORMATION TECH-11
NOLOGY. 12
(a) I
NGENERAL.—The Secretary of Veterans Affairs 13
is authorized to carry out a program to modernize— 14
(1) the electronic health record system of the 15
Department of Veterans Affairs, either by making 16
changes to the Electronic Health Record Moderniza-17
tion Program, as in effect on the date of the enact-18
ment of this Act, or by establishing a new program; 19
and 20
(2) other health information technology activi-21
ties and systems of the Department. 22
(b) P
URPOSE OFMODERNIZATIONPROGRAM.—If the 23
Secretary carries out a program under subsection (a), 24
some combination of the components of such program as 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00272 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 273
•HR 8371 IH
described in paragraphs (1) and (2) of subsection (a) shall 1
be designed to fulfill the following purposes: 2
(1) To improve the quality of hospital care, 3
medical services, and nursing home care furnished 4
by the Department of Veterans Affairs, including— 5
(A) by improving the delivery of care con-6
sistent with quality and safety standards of the 7
Department; 8
(B) by improving the coordination of such 9
care and services for such patients; and 10
(C) by improving timely access to such 11
care and services for such patients; 12
(2) To increase the productivity, efficiency, and 13
satisfaction of employees of the Veterans Health Ad-14
ministration. 15
(3) To improve the experience of patients en-16
rolled in the patient enrollment system of the De-17
partment of Veterans Affairs under section 1705 of 18
title 38, United States Code. 19
(4) To reduce unnecessary variation in care de-20
livery. 21
(5) To improve the quality, consistency, and 22
management of— 23
(A) data created or received by the Vet-24
erans Health Administration, including such 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00273 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 274
•HR 8371 IH
data related to or needed for benefits deter-1
minations by the Department; and 2
(B) data generated by or exchanged with a 3
health care provider through which the Sec-4
retary furnishes such care and services under 5
the laws administered by the Secretary. 6
(6) To increase the interoperability of the elec-7
tronic health record systems and health information 8
technology systems of the Department by— 9
(A) expressing the content and format of 10
health data using a common language to im-11
prove the exchange of data within and outside 12
the Department; 13
(B) ensuring that Department medical per-14
sonnel have access to integrated, computable, 15
and comprehensive health records and health 16
data of patients sufficient to enable the provi-17
sion of seamless care within and outside the 18
Department; 19
(C) surpassing the capabilities achievable 20
through bidirectional information exchange be-21
tween electronic health record systems or the 22
exchange of read-only data; and 23
(D) planning for and effectuating the 24
broadest possible implementation of interoper-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00274 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 275
•HR 8371 IH
ability and data standards, specifically with re-1
spect to the Fast Healthcare Interoperability 2
Resources standard or successor standard, the 3
evolution of such standards, and the obsoles-4
cence of such standards. 5
(7) To increase the amount of medical collec-6
tions in the Department of Veterans Affairs Medical 7
Care Collections Fund established under section 8
1729A of title 38, United States Code. 9
(8) To support and strengthen research and de-10
velopment activities, including such activities re-11
quired under section 7303 of title 38, United States 12
Code. 13
(9) To protect the personal information, includ-14
ing personally identifiable information and protected 15
health information, of veterans, patients, and other 16
users of electronic health record systems and health 17
information technology systems authorized under 18
subsection (a) from cyber attacks, identity theft, and 19
other cyber and security threats. 20
(10) Such other purposes as the Secretary may 21
determine appropriate. 22
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00275 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 276
•HR 8371 IH
SEC. 512. RESPONSIBILITY FOR ELECTRONIC HEALTH 1
RECORD PROGRAM AND HEALTH INFORMA-2
TION TECHNOLOGY. 3
(a) I
NGENERAL.—If the Secretary of Veterans Af-4
fairs carries out a program under subsection (a) of section 5
511— 6
(1) with respect to the modernization of the 7
electronic health record system of the Department of 8
Veterans Affairs pursuant to section 511(a)(1)— 9
(A) the Deputy Secretary of Veterans Af-10
fairs shall— 11
(i) be directly responsible to the Sec-12
retary for such electronic health record 13
system modernization; 14
(ii) oversee such electronic health 15
record system modernization; 16
(iii) direct resources, subject to the 17
availability of appropriations, to the Office 18
of Information and Technology, the Vet-19
erans Health Administration, or other or-20
ganizational subdivisions of the Depart-21
ment to facilitate such modernization; 22
(iv) designate officials and offices 23
within the Department as operationally re-24
sponsible for such modernization, including 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00276 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 277
•HR 8371 IH
a Program Executive Director for Elec-1
tronic Health Record Modernization; and 2
(v) coordinate with the Under Sec-3
retary of Veterans Affairs for Health and 4
the Assistant Secretary of Veterans Affairs 5
for Information and Technology; 6
(B) the Under Secretary for Health 7
shall— 8
(i) have primary responsibility for de-9
termining strategy and objectives of such 10
modernization; 11
(ii) exercise responsibility for the im-12
plementation and operation of any func-13
tions assigned by the Deputy Secretary 14
pursuant to subparagraph (D); 15
(iii) coordinate with the Deputy Sec-16
retary, the Program Executive Director 17
designated pursuant to subparagraph 18
(A)(iv), and the Assistant Secretary for In-19
formation and Technology; 20
(C) the Assistant Secretary for Informa-21
tion and Technology shall— 22
(i) be responsible for carrying out the 23
information technology activities of the De-24
partment in accordance with— 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00277 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 278
•HR 8371 IH
(I) section 310 of title 38, United 1
States Code; 2
(II) chapter 35 of title 44, 3
United States Code; and 4
(III) subtitle III of title 40, 5
United States Code; 6
(ii) exercise responsibility for the im-7
plementation and operation of any func-8
tions assigned by the Deputy Secretary 9
pursuant to subparagraph (D); 10
(iii) coordinate with the Deputy Sec-11
retary, the Program Executive Director 12
designated pursuant to subparagraph 13
(A)(iv), and the Under Secretary for 14
Health; and 15
(D) the Deputy Secretary, in consultation 16
with the Under Secretary for Health and the 17
Assistant Secretary for Information and Tech-18
nology, shall determine the distribution or as-19
signment of responsibilities among the Under 20
Secretary for Health, the Assistant Secretary 21
for Information and Technology, and the Pro-22
gram Executive Director designated pursuant 23
to subparagraph (A)(iv) for— 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00278 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 279
•HR 8371 IH
(i) defining and elaborating require-1
ments; 2
(ii) implementation schedule; 3
(iii) system design and configuration; 4
(iv) workflow; 5
(v) system usability; 6
(vi) change management; 7
(vii) training; and 8
(viii) other functions relevant to such 9
modernization; and 10
(2) with respect to the modernization of other 11
health information technology activities and systems 12
of the Department pursuant to section 511(a)(2)— 13
(A) the Under Secretary for Health and 14
the Assistant Secretary for Information and 15
Technology shall share primary responsibility, 16
shall coordinate with one another, and shall 17
jointly— 18
(i) coordinate with any other relevant 19
organizational subdivisions of the Depart-20
ment regarding the prioritization, invest-21
ment in, and deployment of health infor-22
mation technology regarding such mod-23
ernization; and 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00279 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 280
•HR 8371 IH
(ii) develop the health information 1
technology strategy and roadmap required 2
under section 537; 3
(B) the Assistant Secretary for Informa-4
tion and Technology shall be responsible for 5
carrying out the information technology activi-6
ties of the Department in accordance with— 7
(i) section 310 of title 38, United 8
States Code; 9
(ii) chapter 35 of title 44, United 10
States Code; and 11
(iii) subtitle III of title 40, United 12
States Code; and 13
(C) The Under Secretary for Health, act-14
ing through the Chief Digital Health Officer of 15
the Department or a successor or equivalent of-16
ficer, shall coordinate the activities and func-17
tions of the Veterans Health Administration, 18
including health informatics. 19
(b) E
XECUTIVEDIRECTOR.—With respect to the 20
Electronic Health Record Modernization program and any 21
program carried out pursuant to section 511(a)(1), the 22
Program Executive Director designated pursuant to sub-23
section (a)(1)(A)(iv) shall— 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00280 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 281
•HR 8371 IH
(1) exercise responsibility for the implementa-1
tion and operation of the functions assigned by the 2
Deputy Secretary pursuant to subsection (a)(1)(D); 3
(2) oversee work performed by contractors re-4
lated to such programs, in coordination with the 5
Principal Executive Director of the Office of Acqui-6
sition, Logistics, and Construction; and 7
(3) coordinate with the Under Secretary for 8
Health, the Assistant Secretary for Information and 9
Technology, and any other relevant organizational 10
subdivisions of the Department. 11
SEC. 513. PROTECTION OF PERSONAL INFORMATION. 12
(a) I
NGENERAL.—Not later than one year after the 13
date of the enactment of this Act, the Secretary of Vet-14
erans Affairs shall— 15
(1) ensure that each covered contract includes, 16
or is modified to include, a clause prohibiting cov-17
ered information from being monetized, sold, or oth-18
erwise misused by any contractor, including any sub-19
contractor or affiliate thereof, or other non-Depart-20
ment of Veterans Affairs entity; and 21
(2) issue a directive or other policy providing 22
guidance to employees and contractors of the De-23
partment on how to identify the monetization, sale, 24
or misuse of covered information in order to ensure 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00281 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 282
•HR 8371 IH
contractors are in compliance with clauses in covered 1
contracts included pursuant to paragraph (1). 2
(b) D
EFINITIONS.—In this section: 3
(1) The term ‘‘covered contract’’ means a con-4
tract of the Department of Veterans Affairs that 5
provides for the handling of covered information and 6
is entered into— 7
(A) after the date of the enactment of this 8
Act; or 9
(B) before the date of the enactment of 10
this Act and does not expire before the date of 11
the enactment of this Act. 12
(2) The term ‘‘covered information’’— 13
(A) means protected health information or 14
personally identifiable information, including 15
such information that has been anonymized; 16
and 17
(B) includes information protected 18
under— 19
(i) section 552a of title 5, United 20
States Code; 21
(ii) section 5701 or 7332 of title 38 22
United States Code; 23
(iii) parts 160, 161, and 164 of title 24
45, Code of Federal Regulations; and 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00282 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 283
•HR 8371 IH
(iv) any other provision of law, as de-1
termined by the Secretary. 2
Subtitle B—Implementation 3
Requirements 4
SEC. 521. VETERANS HEALTH ADMINISTRATION 5
WORKFLOW BASELINE. 6
(a) E
STABLISHMENT.—The Under Secretary of Vet-7
erans Affairs for Health, shall— 8
(1) conduct an enterprise inventory of core clin-9
ical and business processes relevant to the program 10
described in section 511(a)(1), including all 11
workflows underlying such processes throughout the 12
Veterans Health Administration; 13
(2) evaluate and compare the workflows re-14
ferred to in paragraph (1) against relevant health 15
care industry best practices and clinical practice 16
guidelines; and 17
(3) establish a baseline of clinical workflows for 18
the Veterans Health Administration. 19
(b) I
NCORPORATION.—The Under Secretary for 20
Health shall incorporate the baseline established under 21
subsection (a)(3) into the program described in section 22
511(a)(1). 23
(c) M
ONITORING AND CONTROL OFVARIATIONS.— 24
The Under Secretary for Health shall— 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00283 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 284
•HR 8371 IH
(1) establish a process to monitor and control 1
variations from the baseline established under sub-2
section (a)(3); and 3
(2) evaluate progress relative to such baseline. 4
(d) S
TANDARDS.—The Under Secretary for Health 5
shall establish national standards for the Veterans Health 6
Administration, pertaining to the implementation and 7
adoption of the electronic health record system, for— 8
(1) order sets; 9
(2) user roles; 10
(3) medical devices; 11
(4) system interfaces and connectivity of med-12
ical devices; and 13
(5) any clinical process not described in sub-14
section (a) that the Under Secretary for Health de-15
termines appropriate. 16
SEC. 522. REQUIREMENTS FOR ELECTRONIC HEALTH 17
RECORD SYSTEM IMPLEMENTATION. 18
(a) M
ETRICS.— 19
(1) E
STABLISHMENT.—Not later than 90 days 20
after the date of the enactment of this Act, the Sec-21
retary of Veterans Affairs, acting through the Under 22
Secretary of Veterans Affairs for Health, shall es-23
tablish standard health care quality metrics for pur-24
poses of evaluating the provision of health care dur-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00284 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 285
•HR 8371 IH
ing the implementation and adoption of the elec-1
tronic health record system. Such metrics shall— 2
(A) be uniform in composition; 3
(B) take into account relevant differences 4
in size, complexity, and market composition of 5
facilities of the Veterans Health Administra-6
tion; 7
(C) incorporate the Strategic Analytics for 8
Improvement and Learning Value Model of the 9
Department, any other relevant methodology, or 10
any successor methodology; and 11
(D) reflect the purposes referred to in sec-12
tion 511(b). 13
(2) S
TRATEGIC ANALYTICS FOR IMPROVEMENT 14
AND LEARNING VALUE MODEL .—Upon the enact-15
ment of this Act, the Secretary shall continue mak-16
ing publicly available the results of the Strategic 17
Analytics for Improvement and Learning Value 18
Model with respect to all medical facilities where the 19
electronic health record system pursuant to the Elec-20
tronic Health Record Modernization Program is ac-21
tive. 22
(b) L
IMITATION ONPRELIMINARYPROGRAMACTIVI-23
TIES ATCERTAINFACILITIES.—In the case of any med-24
ical facility of the Department where, as of the date of 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00285 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 286
•HR 8371 IH
the enactment of this Act, a preliminary program activity 1
has not been initiated or is not being carried out, the Sec-2
retary may not carry out such an activity at such facility 3
before the date on which the Secretary submits to the ap-4
propriate congressional committees certification that— 5
(1) each medical facility where the electronic 6
health record system pursuant to the Electronic 7
Health Record Modernization Program is active as 8
of such date of enactment, has met or exceeded the 9
operational levels of such medical facility prior to 10
implementing such system with respect to oper-11
ational areas of the Department related to the pur-12
poses described in paragraphs (1), (2), (3), and (7) 13
of section 511(b); and 14
(2) includes data to support such certification. 15
(c) L
IMITATION ON IMPLEMENTATION OF ELEC-16
TRONICHEALTHRECORDMODERNIZATIONPROGRAM.— 17
The Secretary may not implement the electronic health 18
record system pursuant to the Electronic Health Record 19
Modernization Program at a Department medical facility 20
where such system is not active as of date of enactment 21
unless— 22
(1) the Secretary has made the certification de-23
scribed in subsection (b); and 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00286 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 287
•HR 8371 IH
(2) the Under Secretary for Health, in con-1
sultation with the director of the facility, submits to 2
the Secretary, and the Secretary transmits to the 3
appropriate congressional committees, written cer-4
tification that— 5
(A) the director has confidence that the 6
build and configuration of the electronic health 7
record, as proposed to be carried out at such 8
medical facility, are accurate and complete; 9
(B) the staff and infrastructure of such fa-10
cility are adequately prepared to receive such 11
system; 12
(C) the facility and the Department have 13
taken appropriate action to mitigate any ad-14
verse effects of the implementation of such sys-15
tem on health outcomes, coordination of care, 16
wait times, patient safety, or veteran experience 17
at such medical facility; and 18
(D) such system has demonstrated a sus-19
tained record of achieving the contractual re-20
quirements for outage-free time and incident- 21
free time prior to such certification. 22
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00287 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 288
•HR 8371 IH
SEC. 523. CONDITIONAL RESTRUCTURING OF ELECTRONIC 1
HEALTH RECORD MODERNIZATION PRO-2
GRAM. 3
(a) I
NGENERAL.—Beginning on the date that is two 4
years after the date of the enactment of this Act, the Sec-5
retary of Veterans Affairs may not exercise any option pe-6
riods or optional tasks or extend any contracts to carry 7
out the Electronic Health Record Modernization Program, 8
unless before the date that is two years after the date of 9
enactment of this Act— 10
(1) the Secretary submits to the appropriate 11
congressional committees a certification, including 12
supporting data, that the metrics described in sec-13
tion 522(a) show overall improvement in each meas-14
urement period during the period beginning on the 15
date of the enactment of this Act and ending on the 16
date on which the certification under this paragraph 17
is made; and 18
(2) the Secretary has made the certification de-19
scribed in section 522(b). 20
(b) R
ULE OFCONSTRUCTION.—Nothing in this sec-21
tion may be construed to require the Secretary to termi-22
nate any contract, task order, modification, or other simi-23
lar instrument under the Electronic Health Record Mod-24
ernization Program before the expiration of the period of 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00288 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 289
•HR 8371 IH
performance of such contract, task order, modification, or 1
other similar instrument. 2
(c) F
AILURETOMAKECERTIFICATIONS.—In the 3
event that each certification referred to in paragraphs (1) 4
and (2) of subsection (a) is not made before the date that 5
is two years after the date of the enactment of this Act, 6
not later than 180 days after the date that is two years 7
after the date of the enactment of this Act, the Secretary 8
shall either— 9
(1) ensure that each facility of the Veterans 10
Health Administration using the electronic health 11
record system implemented pursuant to the Elec-12
tronic Health Record Modernization Program reacti-13
vates and resumes using the Veterans Health Infor-14
mation Systems and Technology Architecture and 15
the Computerized Patient Record System of the De-16
partment; or 17
(2) if the Secretary has submitted the report on 18
alternative modernization strategies under section 19
536, select and pursue a strategy included in the re-20
port. 21
Subtitle C—Reporting 22
SEC. 531. REPORT ON ADDITIONAL PURPOSES. 23
If the Secretary determines any purpose to be appro-24
priate pursuant to section 511(b)(10), not later than 30 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00289 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 290
•HR 8371 IH
days after the date of such determination, the Secretary 1
shall submit to the appropriate congressional committees 2
a report that includes a description of such purpose. 3
SEC. 532. REPORTS ON BASELINE OF CLINICAL 4
WORKFLOWS. 5
(a) B
ASELINE.—Not later than 90 days after the 6
date on which the Secretary establishes a baseline of clin-7
ical workflows pursuant to section 521(a)(3), the Sec-8
retary shall submit to the appropriate congressional com-9
mittees a report that includes an identification of such 10
baseline. 11
(b) S
TANDARDS.—Not later than 90 days after the 12
date on which the Secretary establishes the national stand-13
ards pursuant to section 521(d), the Secretary shall sub-14
mit to the appropriate congressional committees a report 15
that describes such standards. 16
SEC. 533. REPORT ON HEALTH CARE QUALITY METRICS. 17
Not later than 90 days after the date on which the 18
Secretary establishes the health care quality metrics de-19
scribed in section 522(a), the Secretary shall submit to 20
the appropriate congressional committees a report that in-21
cludes an identification of such metrics. 22
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00290 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 291
•HR 8371 IH
SEC. 534. REPORT ON SUPPORT STRATEGY FOR EXISTING 1
SITES. 2
(a) I
NGENERAL.—Not later than 180 days after the 3
date of the enactment of this Act, the Secretary shall sub-4
mit to the appropriate congressional committees a report 5
on the strategy of the Department to enable each medical 6
facility of the Department where the electronic health 7
record system implemented pursuant to the Electronic 8
Health Record Modernization Program is active as of the 9
date of enactment of this Act to achieve full user adoption 10
of the system and meet or exceed the operational levels 11
of such medical center prior to implementing such system 12
with respect to operational areas of the Department re-13
lated to the purposes described in paragraphs (1), (2), (3), 14
and (7) of section 511(b). Such report shall include an 15
estimated budget, or revisions to an existing budget, if 16
any, for each such facility to implement such strategy, in-17
cluding with respect to costs related to— 18
(1) training; 19
(2) additional staff; 20
(3) technical support; 21
(4) support contracts; 22
(5) mitigation strategies; and 23
(6) any other resources determined necessary 24
by the director of the facility. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00291 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 292
•HR 8371 IH
(b) INPUT.—The report described in subsection (a) 1
shall be developed with input from the directors of each 2
such medical facility and the directors of each Veterans 3
Integrated Service Network in which each such medical 4
facility is located. 5
SEC. 535. REPORT ON RESOURCES REQUIRED FOR FUTURE 6
SITES. 7
Not later than 90 days before a medical facility is 8
scheduled to implement the electronic health record sys-9
tem pursuant to the Electronic Health Record Moderniza-10
tion Program, the Secretary shall submit to the appro-11
priate congressional committees a report provided by the 12
director of the medical facility, in consultation with the 13
chief of staff of the medical facility and the director of 14
the Veterans Integrated Service Network in which such 15
medical facility is located. Such report shall include a de-16
tailed description of the resources provided to the medical 17
facility, and the estimated resources still required, to im-18
plement such system successfully, including with respect 19
to— 20
(1) funding; 21
(2) training; 22
(3) additional staff; 23
(4) technical support; 24
(5) support contracts; 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00292 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 293
•HR 8371 IH
(6) mitigation strategies; and 1
(7) any other resources determined necessary 2
by the director of the facility. 3
SEC. 536. REPORT ON ALTERNATIVE MODERNIZATION 4
STRATEGIES. 5
(a) I
NGENERAL.—Not later than one year after 6
completing the baseline required under section 521(a), the 7
Secretary, in consultation with the Under Secretary of 8
Veterans Affairs for Health, the Executive Director of the 9
Electronic Health Record Modernization Program, and 10
the Assistant Secretary of Veterans Affairs for Informa-11
tion and Technology, shall submit to the appropriate con-12
gressional committees a report that includes a description 13
of not fewer than two alternative strategies to the Elec-14
tronic Health Record Modernization Program to carry out 15
the program described in section 511(a) and the purposes 16
described in section 511(b) in the event that each of the 17
certifications referred to in paragraphs (1) and (2) of sec-18
tion 523(a) are not made. 19
(b) A
LTERNATIVE STRATEGIES.—The alternative 20
strategies included in the report shall include— 21
(1) a strategy of modernizing the Veterans 22
Health Information Systems and Technology Archi-23
tecture in conjunction with other health information 24
technology activities and systems; 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00293 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 294
•HR 8371 IH
(2) a strategy of implementing a commercial 1
electronic health record system, other than the Elec-2
tronic Health Record Modernization Program, in 3
conjunction with other health information technology 4
activities and systems; and 5
(3) any other strategy the Secretary determines 6
appropriate. 7
(c) R
EQUIREMENTS.—For each alternative strategy 8
included in the report, the Secretary shall include— 9
(1) a description of how the strategy incor-10
porates the baseline required under section 521(a); 11
(2) an indication of what combination of an 12
electronic health record system and other health in-13
formation technology activities and systems will be 14
used to fulfill the purposes described in section 15
511(b); 16
(3) a notional schedule for the implementation 17
of the strategy; 18
(4) a preliminary life cycle cost estimate for the 19
implementation of the strategy, including what, if 20
any, costs incurred during the implementation of the 21
Electronic Health Record Modernization Program 22
may be recovered or investments made during the 23
implementation of such program may be reused; 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00294 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 295
•HR 8371 IH
(5) an explanation of how the strategy, if imple-1
mented, would achieve the purposes described in sec-2
tion 511(b); 3
(6) a description of any improvements in gov-4
ernance, management, and oversight made by the 5
Department or proposed to be made with respect to 6
a program to carry out an alternative strategy; 7
(7) an analysis of the feasibility of imple-8
menting the strategy; 9
(8) an analysis of the level of risk to taxpayers 10
and the Department to implement the strategy as 11
well as strategies to mitigate any such risks; 12
(9) an analysis of the strengths and weaknesses 13
of the strategy; and 14
(10) a description of how the electronic health 15
record system implemented pursuant to the Elec-16
tronic Health Record Modernization Program will be 17
sustained, deprecated, and replaced through imple-18
mentation of the strategy. 19
SEC. 537. REPORT ON HEALTH INFORMATION TECH-20
NOLOGY STRATEGY AND ROADMAP. 21
(a) I
NGENERAL.—Not later than 270 days after the 22
date of the enactment of this Act, the Chief Digital Health 23
Officer, or any successor officer of the Department of Vet-24
erans Affairs, in coordination with the Assistant Secretary 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00295 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 296
•HR 8371 IH
of Veterans Affairs for Information and Technology, the 1
Chief Acquisition Officer of the Department of Veterans 2
Affairs, and the Program Executive Director designated 3
pursuant to section 512(a)(1)(A)(iv) shall submit to the 4
appropriate congressional committees a report a con-5
taining a health information technology strategy and road-6
map. 7
(b) C
ONTENTS OF REPORT.—The report required 8
under subsection (a) shall include each of the following: 9
(1) A health information technology strategy 10
presenting the comprehensive approach of the De-11
partment and objectives to identify, prioritize, pro-12
cure and use health information technology of the 13
Department as well as interfaces with health infor-14
mation technology of non-Department entities and 15
integration of such systems and interfaces to im-16
prove— 17
(A) health care quality; 18
(B) health care delivery and coordination, 19
including of interfaced medical devices; 20
(C) efficiency of the health business and 21
administrative functions; and 22
(D) research functions of the Department. 23
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00296 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 297
•HR 8371 IH
(2) Goals and measurable metrics to assess im-1
plementation of the strategy described in paragraph 2
(1) and the roadmap described in paragraph (4). 3
(3) As assessment of the current state and de-4
sired future state of the Department, including tech-5
nical architecture, enterprise processes, and systems 6
integration with respect to health information tech-7
nology. 8
(4) A roadmap to implement the strategy de-9
scribed in paragraph (1), consisting of— 10
(A) a revised governance model, to include 11
management and oversight responsibilities, to 12
holistically organize, prioritize, and invest in 13
health information technology initiatives of the 14
Department, regardless of funding source, while 15
removing duplication and fragmentation in such 16
initiatives of the Department; 17
(B) a timeline to implement and 18
operationalize the strategy described in para-19
graph (1); 20
(C) a description of the acquisition and 21
contracting strategies of the Department at the 22
national, regional, or local levels to be created 23
or modified to implement the strategy described 24
in paragraph (1); and 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00297 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 298
•HR 8371 IH
(D) a description of any human capital 1
needs required to implement the strategy and 2
roadmap, including qualifications or incentives 3
to obtain such needs. 4
(c) U
PDATE TOREPORT.—Not later than 120 days 5
after the first day of the fiscal year after the fiscal year 6
during which the report required under subsection (a) is 7
submitted, and annually thereafter until the date specified 8
in subsection (d), the Chief Digital Health Officer shall 9
submit to the appropriate congressional committees an up-10
dated report that includes each of the following: 11
(1) An identification of any significant changes 12
to the strategy described in subsection (b)(1) or any 13
of the elements of the strategy. 14
(2) An assessment of the extent to which the 15
goals described in subsection (b)(2) have been 16
achieved, including supporting metrics and data. 17
(3) An assessment of the progress and mile-18
stones achieved related to the timeline described in 19
subsection (b)(4)(D). 20
(4) A description of any corrective actions to be 21
taken in response to failure to meet any goals or 22
milestones. 23
(5) The budget and spending plan of the De-24
partment for health information technology, includ-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00298 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 299
•HR 8371 IH
ing all relevant accounts, for the fiscal year during 1
which the updated report is submitted and the next 2
fiscal year. 3
(d) T
ERMINATIONDATE.—The date specified in this 4
subsection is the date that is four years after the date 5
on which the first update is submitted under subsection 6
(c). 7
SEC. 538. ANNUAL REPORT ON EFFORTS TO MAINTAIN 8
VISTA ELECTRONIC HEALTH RECORD SYS-9
TEM. 10
(a) I
NGENERAL.—Not later than 120 days after the 11
first day of each fiscal year that begins after the date of 12
the enactment of this Act until the date specified in sub-13
section (c), the Secretary shall submit to the appropriate 14
congressional committees a report on the Veterans Infor-15
mation Systems and Technology Architecture. 16
(b) C
ONTENTS OFREPORT.—The report required by 17
subsection (a) shall include— 18
(1) the operation and maintenance costs and 19
development and enhancement costs for the most re-20
cent fiscal year that ended before the date of the 21
submission of the report; 22
(2) the planned operation and maintenance ef-23
forts and development and enhancement efforts dur-24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00299 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 300
•HR 8371 IH
ing the fiscal year during which the report is sub-1
mitted and subsequent fiscal years; 2
(3) the projected operation and maintenance 3
and development and enhancement costs for the nine 4
fiscal years following the fiscal year during which 5
the report is submitted; 6
(4) a list of modules, applications, or systems 7
within the Veterans Information Systems and Tech-8
nology Architecture— 9
(A) that have been retired or have been, or 10
are planned to be, subsumed by other systems 11
or applications; or 12
(B) that the Department plans to retire 13
during the fiscal year or in a future fiscal year; 14
or 15
(C) for which there is no plan to retire or 16
subsume; 17
(5) a list of applications or systems to be devel-18
oped within, significantly modernized, or integrated 19
with, the Veterans Information Systems and Tech-20
nology Architecture during the fiscal year during 21
which the report is submitted or during any future 22
fiscal year; 23
(6) a list of current, scheduled activity and as-24
sociated costs towards achieving certification as a 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00300 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 301
•HR 8371 IH
certified electronic health record technology pursu-1
ant to the program under section 3001(c) of the 2
Public Health Service Act (42 U.S.C. 300jj–11(c)); 3
and 4
(7) a report on the stability of the system, in-5
cluding— 6
(A) outage-free time; 7
(B) incident-free time; and 8
(C) user interruptions across all instances 9
of the Veterans Information Systems and Tech-10
nology Architecture during the two previous fis-11
cal years. 12
(c) T
ERMINATION.—The date specified in this sub-13
section is the date that is 10 years after the date of the 14
enactment of this Act. 15
SEC. 539. MODIFICATION OF QUARTERLY REPORTS. 16
Section 503 of the Veterans Benefits and Transition 17
Act of 2018 (Public Law 115–407) is amended— 18
(1) in subsection (b)— 19
(A) by redesignating paragraphs (1) 20
through (6) as subparagraphs (A) through (F), 21
respectively; 22
(B) in the matter preceding subparagraph 23
(A), as redesignated by paragraph (1), by strik-24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00301 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 302
•HR 8371 IH
ing ‘‘Not later than 30 days’’ and inserting the 1
following: 2
‘‘(1) I
N GENERAL.—Not later than 30 days’’; 3
and 4
(C) by adding at the end the following: 5
‘‘(2) A
DDITIONAL MATTERS TO BE IN -6
CLUDED.—The Secretary shall include with any up-7
date submitted under paragraph (1) on or after the 8
date of enactment of the the Senator Elizabeth Dole 9
21st Century Veterans Healthcare and Benefits Im-10
provement Act with respect to the quarter covered 11
by the report, the following: 12
‘‘(A) Data on user adoption and employee 13
satisfaction with the electronic health record 14
system implemented pursuant to the Electronic 15
Health Record Modernization program or suc-16
cessor system implemented pursuant to section 17
511(a)(1) of the the Senator Elizabeth Dole 18
21st Century Veterans Healthcare and Benefits 19
Improvement Act, including training on such 20
system, using surveys of the Department and 21
surveys conducted for the Department. 22
‘‘(B) Data on employee retention and turn-23
over at medical facilities where such electronic 24
health record system is in use. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00302 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 303
•HR 8371 IH
‘‘(C) Data on downtime, performance dis-1
ruptions, or impaired functionality of such elec-2
tronic health record system including— 3
‘‘(i) cause; 4
‘‘(ii) length; 5
‘‘(iii) responsible entity; and 6
‘‘(iv) corrective actions planned or 7
taken. 8
‘‘(D) Data on the impact of such system 9
on revenue and collections at medical facilities 10
where such electronic health record system is in 11
use, including— 12
‘‘(i) planned revenue and collections; 13
‘‘(ii) actual revenue and collections; 14
and 15
‘‘(iii) steps planned or taken to 16
achieve planned revenue and collections. 17
‘‘(E) Data on ticket resolution. 18
‘‘(F) A list of any credits, reimbursements, 19
or monies provided by a contractor under the 20
Electronic Health Record Modernization pro-21
gram or invoice deductions or withholdings 22
taken by the Department from such contractor 23
in the reporting period to include due to failure 24
to meet the terms of a service level agreement 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00303 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 304
•HR 8371 IH
or other terms and conditions of the contract.’’; 1
and 2
(2) in subsection (d)(2)(C)— 3
(A) by striking ‘‘or dispute, and’’ and in-4
serting ‘‘dispute, cure notice, letter of concern, 5
or other official communication by the Depart-6
ment to a contractor concerning contract non-7
compliance or corrective action, the official re-8
sponse of the contractor, and’’; and 9
(B) by striking ‘‘or dispute (as’’ and in-10
serting ‘‘dispute, cure notice, letter of concern, 11
or other official communication concerning con-12
tract noncompliance and the official response of 13
the contractor (as’’. 14
SEC. 540. REPORT ON PROTECTION OF PERSONAL INFOR-15
MATION. 16
Not later than one year after the date of the enact-17
ment of this Act, the Secretary of Veterans Affairs shall 18
submit to the appropriate congressional committees a re-19
port that includes— 20
(1) a copy of the contract clause required by 21
section 513(a); 22
(2) the guidance required by section 513(b); 23
and 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00304 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 305
•HR 8371 IH
(3) a summary of any other actions taken to 1
comply with section 513. 2
SEC. 541. REPORT ON ORGANIZATION AND NEEDS. 3
(a) C
ONGRESSIONALNOTICEREGARDINGCERTAIN 4
A
CTIONS.— 5
(1) I
N GENERAL.—Not later than 90 days after 6
the date on which an official of the Department of 7
Veterans Affairs takes an action specified in para-8
graph (2), the Secretary of Veterans Affairs shall 9
submit to the appropriate congressional committees 10
notice of such action. 11
(2) A
CTION SPECIFIED.—An action specified in 12
this paragraph is any of the following: 13
(A) The designation of any official or of-14
fice by the Deputy Secretary of Veterans Af-15
fairs pursuant to section 512(a)(1)(A)(iv). 16
(B) The designation of any responsibility 17
by the Deputy Secretary pursuant to section 18
512(a)(1)(D). 19
(C) Any action related to the reorganiza-20
tion of a program pursuant to section 511(a)(1) 21
or (2). 22
(b) R
EPORT ON NECESSARY LEGISLATIVE 23
C
HANGES.—Not later than one year after the date of the 24
enactment of this Act, the Secretary shall submit to the 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00305 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 306
•HR 8371 IH
appropriate congressional committees a report that in-1
cludes a description of any legislative changes the Sec-2
retary determines are necessary in order to carry out the 3
responsibilities of the Secretary with respect to the pro-4
grams described in section 511(a)(1) or (2), regarding— 5
(1) organization; 6
(2) hiring or compensation authorities; 7
(3) appropriations; or 8
(4) related matters, as determined by the Sec-9
retary. 10
SEC. 542. REPORT ON GOVERNANCE, PERFORMANCE CRI-11
TERIA, AND READINESS. 12
Not later than 90 days after the date of the enact-13
ment of this Act, the Secretary of Veterans Affairs shall 14
submit to the appropriate congressional committees a re-15
port describing the following: 16
(1) The clinical decision making structure of 17
the Department of Veterans Affairs and efforts to 18
achieve a more uniform clinical decision making 19
structure, pertaining to the Electronic Health 20
Record Modernization Program, including— 21
(A) new service requirements; 22
(B) workflow decisions; 23
(C) change requests; and 24
(D) interface needs. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00306 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 307
•HR 8371 IH
(2) The criteria or metrics used by the Sec-1
retary to measure improvements in the Electronic 2
Health Record Modernization Program with respect 3
to— 4
(A) end user experience; 5
(B) system stability; 6
(C) training; 7
(D) help desk ticket management; configu-8
ration; and 9
(E) any other criteria or metrics deter-10
mined appropriate by the Secretary. 11
(3) The most recent data reported pursuant to 12
criteria or metrics described in paragraph (2) from 13
each facility of the Veterans Health Administration 14
using the electronic health record system imple-15
mented pursuant to the Electronic Health Record 16
Modernization Program. 17
(4) A description of steps being taken by the 18
Secretary to achieve performance goals relevant to 19
criteria or metrics described in paragraph (2). 20
(5) The standard readiness task list used in fa-21
cilities of the Veterans Health Administration to 22
prepare for implementation of the electronic health 23
record system pursuant to the Electronic Health 24
Record Modernization Program. 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00307 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 308
•HR 8371 IH
TITLE VI—OVERSIGHT AND 1
INVESTIGATIONS MATTERS 2
SEC. 601. DEPARTMENT OF VETERANS AFFAIRS EMPLOYEE 3
TRAINING REGARDING OFFICE OF INSPEC-4
TOR GENERAL. 5
(a) T
RAINING.—The Secretary of Veterans Affairs 6
shall require each employee of the Department of Veterans 7
Affairs who begins employment with the Department on 8
or after the date of the enactment of this Act to receive 9
training that the Inspector General of the Department 10
shall develop on the reporting of wrongdoing to, respond-11
ing to requests from, and the duty of cooperating with 12
the Office of Inspector General of the Department. 13
(b) T
IMING OFTRAINING.—In carrying out sub-14
section (a), the Secretary shall require each employee of 15
the Department covered under such subsection to undergo 16
the training required by such subsection not later than 17
one year after the date on which the employee begins em-18
ployment with the Department. 19
(c) E
LEMENTS.—Training developed and required 20
under subsection (a) shall include the following: 21
(1) Definition of the role, responsibilities, and 22
legal authority of the Inspector General of the De-23
partment and the duties of employees of the Depart-24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00308 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 309
•HR 8371 IH
ment for engaging with the Office of Inspector Gen-1
eral. 2
(2) Identification of Federal whistleblower pro-3
tection rights, including the right to report fraud, 4
waste, abuse, and other wrongdoing to Congress. 5
(3) Identification of the circumstances and 6
mechanisms for reporting fraud, waste, abuse, and 7
other wrongdoing to the Inspector General, including 8
making confidential complaints to the Inspector 9
General. 10
(4) Identification of the prohibitions and rem-11
edies that help to protect employees of the Depart-12
ment from retaliation when reporting wrongdoing to 13
the Inspector General. 14
(5) Recognition of opportunities to engage with 15
staff of the Office of Inspector General to improve 16
programs, operations, and services of the Depart-17
ment. 18
(6) Notification of the authority of the Inspec-19
tor General to subpoena the attendance and testi-20
mony of witnesses, including former employees of 21
the Department, as necessary to carry out the duties 22
of the Office of Inspector General under section 312 23
of title 38, United States Code. 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00309 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 310
•HR 8371 IH
(d) DESIGN ANDUPDATE.—The Inspector General of 1
the Department shall design, and update as the Inspector 2
General considers appropriate, the training developed and 3
required by subsection (a). 4
(e) S
YSTEM.—The Secretary shall provide, via the 5
talent management system of the Department, or suc-6
cessor system, the training developed and required under 7
subsection (a). 8
(f) R
ELATION TOCERTAINTRAINING.—The Sec-9
retary shall ensure that training developed and required 10
under subsection (a) is separate and distinct from training 11
provided under section 733 of title 38, United States 12
Code. 13
(g) N
OTICE TOEMPLOYEES.—The Secretary shall 14
ensure that the Inspector General is afforded the oppor-15
tunity, not less frequently than twice each year and more 16
frequently if the Inspector General considers appropriate 17
under extraordinary circumstances, to use the electronic 18
mail system of the Department to notify all authorized 19
users of such system of the following: 20
(1) The roles and responsibilities of the employ-21
ees of the Department when engaging with the Of-22
fice of Inspector General. 23
(2) The availability of training provided under 24
subsection (a). 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00310 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 311
•HR 8371 IH
(3) How to access training provided under sub-1
section (a). 2
(4) Information about how to contact the Office 3
of Inspector General, including a link to any 4
website-based reporting form of the Office. 5
SEC. 602. ANNUAL REVIEW OF SECURITY AT COVERED FA-6
CILITIES OF THE DEPARTMENT OF VET-7
ERANS AFFAIRS. 8
(a) A
NNUALSURVEY.—Not later than one year after 9
the date of the enactment of this Act, and annually there-10
after for each of the following five fiscal years, the Sec-11
retary of Veterans Affairs, in coordination with the Direc-12
tor of the Office of Security and Law Enforcement of the 13
Department of Veterans Affairs, shall conduct a survey 14
of the covered employees at each covered facility to collect 15
information regarding security. Each annual survey shall 16
include questions about— 17
(1) the type and frequency of criminal activity 18
experienced at the covered facility during the fiscal 19
year which most recently concluded including wheth-20
er or not the criminal activity was related to resi-21
dents at the facility or campus such as those in a 22
residential rehabilitation treatment program or en-23
hanced-use lease facility; 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00311 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 312
•HR 8371 IH
(2) the number of vacancies and number of 1
days vacant for Department police officers at the 2
covered facility at the time of the survey delineated 3
by recruitment status and stage; 4
(3) the availability and adequacy of covered 5
equipment; 6
(4) the availability and adequacy of resources, 7
classes, or other time set aside for training Depart-8
ment police officers who work at each covered facil-9
ity about any skill or tactic related to law enforce-10
ment, including the proper use of force, firearms 11
qualifications and training, procedures for respond-12
ing to an active threat, and any other training re-13
quired for Department police officers; 14
(5) any security weakness at covered facilities; 15
(6) the relationship between the covered facility 16
(including the Department police officers who work 17
at the covered facility) and local, state, and federal 18
law enforcement agencies including what agreements 19
or memorandums of understanding exist between 20
each covered facility and external law enforcement 21
agencies; 22
(7) efforts by the personnel of the covered facil-23
ity to address and reduce criminal activity at, or in 24
close proximity to, the covered facility; and 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00312 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 313
•HR 8371 IH
(8) recommendations for the Secretary to better 1
address and reduce criminal activity at, or in close 2
proximity to, covered facilities so as to improve the 3
safety of veterans, employees, visitors, other author-4
ized personnel, and the surrounding community. 5
(b) R
EPORT.—Not later than 30 days after the end 6
of the next full Fiscal Year after the enactment of this 7
Act and for each of the following five fiscal years, the Sec-8
retary shall submit to each of the Committees on Vet-9
erans’ Affairs of the Senate and the House of Representa-10
tives a report regarding the results of the surveys con-11
ducted under subsection (a) during the previous fiscal 12
year. The report shall include— 13
(1) the results of the annual survey described 14
under subsection (a) for the year covered by the re-15
port; 16
(2) an analysis, made in coordination with the 17
Director of the Office of Security and Law Enforce-18
ment of such Department, each director and police 19
chief of a Veterans Integrated Service Network, and 20
the directors and police chiefs of the medical centers 21
within the Veterans Integrated Service Network of 22
the results of the triannual security inspections con-23
ducted in prior fiscal year, to include a plan of ac-24
tion that describes how the Secretary plans to ad-25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00313 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 314
•HR 8371 IH
dress any security weakness identified in the results 1
of the triannual security inspections and includes 2
clearly-stated goals with measurable benchmarks for 3
each goal and deadlines for each benchmark; and 4
(3) a list of all vacant positions for police chief 5
or deputy police chief at each covered facility during 6
the prior fiscal year, the number of individuals who 7
filled those positions over the two years prior to the 8
date of the survey, the number of days the positions 9
were vacant without someone serving in an acting 10
capacity, and the number of days the positions were 11
filled by individuals serving in an acting capacity. 12
(c) D
EFINITIONS.—In this section: 13
(1) The term ‘‘covered equipment’’ means any 14
item issued by the Secretary of Veterans Affairs to 15
a Department police officer (including firearms, 16
weapons detecting technology, ballistic vests, body- 17
worn cameras, and radios) for use in the provision 18
of services under section 902 of title 38, United 19
States Code. 20
(2) The term ‘‘covered employee’’ means an em-21
ployee of the Department of Veterans Affairs who is 22
employed and responsible for security operations at 23
a covered facility including a covered facility’s police 24
chief, facility emergency management leader, facility 25
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00314 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 315
•HR 8371 IH
director, or person carrying out the responsibilities 1
of one of these positions in an acting capacity. 2
(3) The term ‘‘covered facility’’ means any fa-3
cility of the Department of Veterans Affairs where 4
Department police officers have jurisdiction. 5
(4) The term ‘‘Department police officer’’ has 6
the meaning given to such term as used in section 7
902 of title 38, United States Code. 8
(5) The term ‘‘security weakness’’ means a defi-9
ciency in the facilities, staffing, or covered equip-10
ment at a covered facility that a covered employee 11
of the covered facility determines presents a risk to 12
the safety of visitors or staff, including an unsecured 13
door, inoperable security camera, unsecured police 14
operations room, a lack of security presence at an 15
entrance to the covered facility, and a lack of secu-16
rity presence in an area of the covered facility or the 17
grounds of the covered facility that the director of 18
the covered facility determines requires an increased 19
security presence. 20
SEC. 603. MODIFICATION OF CERTAIN HOUSING LOAN 21
FEES. 22
The loan fee table in section 3729(b)(2) of title 38, 23
United States Code, is amended by striking ‘‘November 24
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00315 Fmt 6652 Sfmt 6201 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS 316
•HR 8371 IH
15, 2031’’ each place it appears and inserting ‘‘September 1
30, 2034’’. 2
Æ
VerDate Sep 11 2014 18:49 May 29, 2024 Jkt 049200 PO 00000 Frm 00316 Fmt 6652 Sfmt 6301 E:\BILLS\H8371.IH H8371
ssavage on LAPJG3WLY3PROD with BILLS