Us Congress House Bill HB8371 Engrossed / Bill

                    118THCONGRESS 
2
DSESSION H. R. 8371 
AN ACT 
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 2 
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SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 1
(a) S
HORTTITLE.—This Act may be cited as the 2
‘‘Senator Elizabeth Dole 21st Century Veterans 3
Healthcare and Benefits Improvement Act’’. 4
(b) T
ABLE OFCONTENTS.—The table of contents for 5
this Act is as follows: 6
Sec. 1. Short title; table of contents. 
TITLE I—HEALTH CARE MATTERS 
Subtitle A—Veterans Community Care Program Matters 
Sec. 101. Implementation of provision of care under Veterans Community Care 
Program upon determination of eligibility by veteran and vet-
eran’s referring clinician. 
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. Pilot program to improve administration of care under Veterans 
Community Care Program. 
Sec. 106. Pilot program on consolidating approval process of Department of 
Veterans Affairs for covered dental care. 
Sec. 107. Strategic plan on value-based health care system for Veterans Health 
Administration; pilot program. 
Sec. 108. Plan on adoption of certain health information standards for Depart-
ment of Veterans Affairs and certain health care providers. 
Sec. 109. Report on use of value-based reimbursement models under Veterans 
Community Care Program. 
Sec. 110. Inspector General assessment of implementation of Veterans Commu-
nity Care Program. 
Sec. 111. 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.  3 
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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. 
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.  4 
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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. 
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.  5 
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Sec. 304. Ensuring only licensed health care professionals perform medical dis-
ability examinations under certain Department of Veterans Af-
fairs pilot program. 
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—OVERSIGHT AND INVESTIGATIONS MATTERS 
Sec. 501. Department of Veterans Affairs employee training regarding Office of 
Inspector General. 
Sec. 502. Annual review of security at covered facilities of the Department of 
Veterans Affairs. 
Sec. 503. Modification of certain housing loan fees. 
TITLE I—HEALTH CARE 1
MATTERS 2
Subtitle A—Veterans Community 3
Care Program Matters 4
SEC. 101. IMPLEMENTATION OF PROVISION OF CARE 5
UNDER VETERANS COMMUNITY CARE PRO-6
GRAM UPON DETERMINATION OF ELIGI-7
BILITY BY VETERAN AND VETERAN’S REFER-8
RING CLINICIAN. 9
(a) I
NGENERAL.—During the period specified in 10
subsection (c), the Secretary of Veterans Affairs shall im-11
plement section 1703(d)(1)(E) of title 38, United States 12 6 
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Code, in compliance with the implementing regulations for 1
such section under section 17.4010(a)(5) of title 38, Code 2
of Federal Regulations, such that the determination of eli-3
gibility for care is final and shall be made by the veteran 4
and the veteran’s referring clinician. 5
(b) C
ORRECTION OF ERRORS.—A covered veteran 6
and the referring clinician of such veteran may correct any 7
errors made with respect to a determination described in 8
subsection (a). 9
(c) P
ERIODSPECIFIED.—The period specified in this 10
subsection is the two-year period beginning on the date 11
that is 90 days after the date of the enactment of this 12
Act. 13
(d) R
EPORT.—Not later than one year and not later 14
than two years after the commencement of the period 15
specified by subsection (c), the Secretary of Veterans Af-16
fairs shall submit to Congress a report on the care pro-17
vided under section 1703(d)(1)(E) of title 38, United 18
States Code, during the one-year period preceding the date 19
of the report, including— 20
(1) the number of instances of care provided; 21
(2) the type of care provided; and 22
(3) the cost of such care. 23
(e) R
ULE OFCONSTRUCTION.—Nothing in this sec-24
tion shall be construed to limit the Secretary’s authority 25 7 
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to prescribe, amend, or rescind regulations under section 1
1703 of title 38, United States Code. 2
(f) C
OVEREDVETERANDEFINED.—In this section, 3
the term ‘‘covered veteran’’ has the meaning given that 4
term in section 1703(b) of title 38, United States Code. 5
SEC. 102. OUTREACH REGARDING CARE AND SERVICES 6
UNDER VETERANS COMMUNITY CARE PRO-7
GRAM. 8
(a) R
EQUIREMENT.—Section 1703 of title 38, United 9
States Code, is further amended— 10
(1) by redesignating subsection (o) as sub-11
section (p); and 12
(2) by inserting after subsection (n) the fol-13
lowing new subsection (o): 14
‘‘(o) O
UTREACHREGARDINGAVAILABILITY OFCARE 15
ANDSERVICES.—(1) The Secretary shall conduct out-16
reach to inform veterans of the following: 17
‘‘(A) The conditions for care or services under 18
subsections (d) and (e). 19
‘‘(B) How to request such care or services. 20
‘‘(C) How to appeal a denial of a request for 21
such care or services using the clinical appeals proc-22
ess of the Veterans Health Administration. 23
‘‘(2) Upon enrollment of a veteran in the system of 24
annual patient enrollment established and operated under 25 8 
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section 1705 of this title, and not less frequently than 1
every two years thereafter, the Secretary shall inform the 2
veteran of information described in paragraph (1). 3
‘‘(3) The Secretary shall ensure that information de-4
scribed in paragraph (1) is— 5
‘‘(A) publicly displayed in each medical facility 6
of the Department; 7
‘‘(B) prominently displayed on a website of the 8
Department; and 9
‘‘(C) included in other outreach campaigns and 10
activities conducted by the Secretary.’’. 11
(b) S
OLIDSTARTPROGRAM.—Section 6320(a)(2)(A) 12
of title 38, United States Code, is amended by inserting 13
‘‘, including how to enroll in the system of annual patient 14
enrollment established and operated under section 1705 15
of this title and the ability to seek care and services under 16
sections 1703 and 1710 of this title’’ before the semicolon. 17
(c) C
OMPTROLLER GENERALREPORT ON OUT-18
REACH.—Not later than two years after the date of the 19
enactment of this Act, the Comptroller General of the 20
United Stats shall submit to Congress a report on the ef-21
forts of the Secretary of Veterans Affairs to ensure that 22
veterans are informed of the conditions for eligibility for 23
care and services under section 1703 of title 38, United 24
States Code, including such efforts to conduct outreach 25 9 
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pursuant to subsection (q) of such section (as added by 1
subsection (a)). 2
SEC. 103. ANNUAL REVIEW AND REPORT ON WAIVERS OF 3
CERTAIN PAYMENT RATES UNDER VETERANS 4
COMMUNITY CARE PROGRAM. 5
(a) I
NGENERAL.—Section 1703 of title 38, United 6
States Code, is further amended— 7
(1) by redesignating subsection (p) as sub-8
section (q); and 9
(2) by inserting after subsection (p) the fol-10
lowing new subsection (q): 11
‘‘(q) A
NNUALREVIEW ANDREPORT ONWAIVERS OF 12
P
AYMENTRATES.—(1) On an annual basis, the Secretary 13
shall— 14
‘‘(A) conduct a review of waivers of payment 15
rates under subsection (i) for Third Party Adminis-16
trators to identify whether such waivers help to al-17
leviate community-specific challenges, including scar-18
city of medical services associated with access to 19
health care; and 20
‘‘(B) submit to Congress a report on the results 21
of such review. 22
‘‘(2) Each report under paragraph (1)(B) shall in-23
clude, with respect to the period covered by the report— 24 10 
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‘‘(A) a statement, disaggregated by region, of 1
the total number of waivers described in subpara-2
graph (A) of such paragraph requested by Third 3
Party Administrators; 4
‘‘(B) a statement of the total number of such 5
waivers that were— 6
‘‘(i) granted by the Secretary; 7
‘‘(ii) denied by the Secretary; or 8
‘‘(iii) withdrawn by a Third Party Admin-9
istrator; 10
‘‘(C) a description of the process for the review 11
required under paragraph (1); 12
‘‘(D) a statement, disaggregated by region, of 13
the average time to process such waivers; 14
‘‘(E) an assessment, disaggregated by region, of 15
the extent to which such waivers that were granted 16
by the Secretary improved access to health care for 17
covered veterans; and 18
‘‘(F) a description of trends, if any, identified 19
by the Secretary with respect to such waivers. 20
‘‘(3) In this subsection, the term ‘Third Party Ad-21
ministrator’ has the meaning given such term in section 22
1703B of this title.’’. 23
(b) D
EADLINE.—The Secretary shall submit the first 24
report required under subsection (q) of section 1703 of 25 11 
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such title (as added by subsection (a)) not later than 180 1
days after the date of the enactment of this Act. 2
SEC. 104. MODIFICATION OF REQUIREMENTS FOR STAND-3
ARDS FOR QUALITY OF CARE FROM DEPART-4
MENT OF VETERANS AFFAIRS. 5
(a) I
NGENERAL.—Section 1703C of title 38, United 6
States Code, is amended— 7
(1) in subsection (a)— 8
(A) in paragraph (2)— 9
(i) by striking ‘‘In establishing’’ and 10
inserting ‘‘(A) In establishing’’; and 11
(ii) by adding at the end the following 12
new subparagraph: 13
‘‘(B) The Secretary shall ensure that the stand-14
ards for quality established under paragraph (1) are 15
comparable to industry standards to ensure there is 16
adequate data transference between care furnished 17
by the Department and care furnished by a non-De-18
partment provider.’’; 19
(B) in paragraph (3), by adding at the end 20
the following new clause: 21
‘‘(v) Outcomes relating to patient 22
quality of life.’’; 23
(C) in paragraph (4)— 24 12 
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(i) by striking ‘‘and the Centers for 1
Medicare & Medicaid Services’’ and insert-2
ing ‘‘the Centers for Medicare & Medicaid 3
Services, and the Indian Health Service’’; 4
and 5
(ii) by striking ‘‘and other nongovern-6
mental entities’’ and inserting ‘‘and other 7
non-governmental entities including Third 8
Party Administrators’’; and 9
(D) by striking paragraph (5) and insert-10
ing the following new paragraphs: 11
‘‘(5) When collecting, considering, and applying data 12
related to patient care for purposes of establishing stand-13
ards for quality under paragraph (1), the Secretary shall 14
ensure no metric is being over or under analyzed. 15
‘‘(6) In establishing standards for quality under para-16
graph (1), the Secretary shall— 17
‘‘(A) utilize the most up-to-date practices for 18
extracting and analyzing relevant data; 19
‘‘(B) utilize all relevant data available to the 20
Secretary; 21
‘‘(C) ensure the most efficient use of time and 22
resources related to the use of data scientists em-23
ployed by the Department; and 24 13 
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‘‘(D) collaborate, as appropriate, with entities 1
specified in paragraph (4). 2
‘‘(7)(A) Not less frequently than once every five 3
years, the Secretary shall update the standards for quality 4
established under paragraph (1) pursuant to the require-5
ments for the establishment of such standards under this 6
subsection. 7
‘‘(B) Not later than 30 days after any date on which 8
the Secretary updates, pursuant to subparagraph (A), the 9
standards for quality under paragraph (1), the Secretary 10
shall submit to the appropriate committees of Congress 11
a report on such updated standards for quality.’’; and 12
(2) in subsection (b)— 13
(A) in paragraph (1)— 14
(i) by striking ‘‘Not later than 1 year 15
after the date on which the Secretary es-16
tablishes standards for quality under sub-17
section (a)’’ and inserting ‘‘Not less fre-18
quently than once every three years’’; and 19
(ii) by inserting ‘‘pursuant to stand-20
ards for quality under subsection (a)’’ 21
after ‘‘medical facilities of the Depart-22
ment’’; and 23
(B) in paragraph (2), by inserting ‘‘or up-24
dates’’ after ‘‘establishes’’. 25 14 
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(b) DEADLINE FORUPDATE.—The Secretary, pursu-1
ant to paragraph (7) of section 1703C(a) of title 38, 2
United States Code (as added by subsection (a)), shall 3
make the first update to the standards for quality estab-4
lished under paragraph (1) of such section not later than 5
the date that is five years after the date on which the Sec-6
retary submits the report under paragraph (2) of sub-7
section (d). 8
(c) R
EPORT.—Not later than one year after the date 9
of the enactment of this Act, the Secretary of Veterans 10
Affairs shall submit to the appropriate committees of Con-11
gress a report on how the Secretary— 12
(1) has consulted with entities specified in para-13
graph (4) of section 1703C(a) of title 38, United 14
States Code, before the date of the enactment of this 15
Act in establishing standards for quality under such 16
section; 17
(2) has continued to consult with those entities 18
on and after such date of enactment; and 19
(3) intends to leverage data sciences to improve 20
standards for quality care furnished by the Depart-21
ment of Veterans Affairs. 22
(d) U
PDATES TOQUALITYCAREMETRICS.— 23
(1) I
NITIAL REPORT.—Not later than one year 24
after the date of the enactment of this Act, the Sec-25 15 
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retary of Veterans Affairs shall submit to the appro-1
priate committees of Congress a report on how the 2
Secretary plans to implement the amendments made 3
by subsections (a). 4
(2) D
EADLINE; SUMMARY REPORT .—Not later 5
than two years after the date of the enactment of 6
this Act, the Secretary shall— 7
(A) implement the amendments made by 8
subsection (a), including by updating the stand-9
ards for quality established under section 10
1703C of title 38, United States Code; and 11
(B) submit to the appropriate committees 12
of Congress a report detailing the standards for 13
quality updated pursuant to such amendments. 14
(e) A
UDIT OFQUALITYCAREMETRICS.— 15
(1) I
N GENERAL.—Not later than 180 days 16
after the date of the enactment of this Act, the Sec-17
retary of Veterans Affairs shall enter into one or 18
more contracts with a non-Department entity de-19
scribed in paragraph (2) to conduct an audit on the 20
quality of care from the Department of Veterans Af-21
fairs, including through non-Department health care 22
providers pursuant to section 1703 of title 38 23
United States Code. 24 16 
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(2) NON-DEPARTMENT ENTITY DESCRIBED .—A 1
non-Department entity described in this paragraph 2
is an entity that— 3
(A) specializes in analyzing large-scale or-4
ganizational data collection and analysis efforts, 5
especially with respect to the health care sector; 6
and 7
(B) has experience and proven outcomes in 8
optimizing the accuracy and comprehensiveness 9
of data collection and analysis related to the 10
quality of health care services. 11
(3) E
LEMENTS.—The audit required under 12
paragraph (1) shall include the following: 13
(A) An assessment of the methodology 14
used by the Department to collect and assess 15
data on the quality of care furnished by the De-16
partment, including any vulnerabilities in such 17
methodology. 18
(B) An assessment of the accuracy and re-19
liability of the data sources used by the Depart-20
ment to compile data on the quality of care fur-21
nished by the Department. 22
(C) The extent to which the standards the 23
Department uses to assess the quality of care 24
furnished by the Department are— 25 17 
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(i) comparable with industry stand-1
ards; 2
(ii) easily accessible to, and under-3
stood by— 4
(I) veterans; 5
(II) employees of the Depart-6
ment; and 7
(III) other individuals, as the pri-8
vate sector entity considers appro-9
priate. 10
(D) Any recommendations of such private 11
sector entity with respect to improvements that 12
the Secretary could administer to more accu-13
rately capture the quality of care furnished by 14
the Department. 15
(4) R
EPORTS ON AUDIT.— 16
(A) R
EPORT ON FINDINGS AND REC -17
OMMENDATIONS.—Not later than 60 days after 18
any date on which a private sector entity de-19
scribed in paragraph (2) completes an audit 20
under paragraph (1), such private sector entity 21
shall submit to the Secretary, the Committee on 22
Veterans’ Affairs of the Senate, and the Com-23
mittee on Veterans’ Affairs of the House of 24
Representatives a report that includes— 25 18 
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(i) the findings of such audit; and 1
(ii) recommendations of such private 2
sector entity with respect to such audit. 3
(B) R
EPORT ON PLANNED IMPROVE -4
MENTS.—Not later than 60 days after any date 5
on which the Secretary receives a report under 6
subparagraph (A), the Secretary shall submit to 7
the Committee on Veterans’ Affairs of the Sen-8
ate and the Committee on Veterans’ Affairs of 9
the House of Representatives a report on how 10
the Secretary plans to improve the standards 11
for quality of care of the Department. 12
(f) A
PPROPRIATECOMMITTEES OF CONGRESSDE-13
FINED.—In this section, the term ‘‘appropriate commit-14
tees of Congress’’ has the meaning given such term in sec-15
tion 1703C of title 38, United States Code. 16
SEC. 105. 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, acting through the Center for Innovation for Care 22
and Payment established under such section, shall carry 23
out a pilot program to seek to develop and implement a 24
plan— 25 19 
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(1) to provide monetary and non-monetary in-1
centives to a covered health care provider— 2
(A) to allow the Secretary to see the sched-3
uling system of the provider, to assess the avail-4
ability of, and to assist in scheduling appoint-5
ments for, veterans under the Veterans Com-6
munity Care Program under section 1703 of 7
such title, including through synchronous, asyn-8
chronous, and asynchronous assisted digital 9
scheduling; 10
(B) to complete continuing professional 11
educational training available through the VHA 12
TRAIN program (or any successor program or 13
initiative) regarding veteran cultural com-14
petency, the opioid safety initiative (or any suc-15
cessor program or initiative), and other subjects 16
determined appropriate by the Secretary; 17
(C) to improve methods of accounting for 18
non-Department training that is equivalent or 19
substantially similar to the continuing profes-20
sional educational training described in sub-21
paragraph (B); 22
(D) to improve the rate of the timely re-23
turn to the Secretary of medical record docu-24 20 
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mentation for care or services provided under 1
the Veterans Community Care Program; 2
(E) to improve the timeliness and quality 3
of the delivery of care and services to veterans 4
under such program; and 5
(F) to achieve other objectives determined 6
appropriate by the Secretary; and 7
(2) to decrease the rate of no-show appoint-8
ments under such program. 9
(b) R
EPORT.—Not later than one year after the date 10
of the establishment of the pilot program under this sec-11
tion, and annually thereafter during the term of the pilot 12
program, the Secretary of Veterans Affairs shall submit 13
to the Committees on Veterans’ Affairs of the House of 14
Representatives and the Senate a report on the pilot pro-15
gram that includes, with respect to the period covered by 16
the report— 17
(1) an assessment of the extent to which— 18
(A) the system of the Department of Vet-19
erans Affairs for scheduling appointments for 20
veterans under the Veterans Community Care 21
Program has improved; 22
(B) the rate of timely return to the Sec-23
retary of medical record documentation de-24 21 
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scribed in subparagraph (D) of subsection 1
(a)(1) has improved; 2
(C) the timeliness and quality of the deliv-3
ery of care and services described in subpara-4
graph (E) of such subsection has improved; and 5
(D) the frequency of no-show appointments 6
described in paragraph (2) of such subsection 7
decreased; 8
(2) a list of the continuing professional edu-9
cational training courses under subparagraph (B) of 10
such subsection available to covered health care pro-11
viders; 12
(3) the rate of participation in such continuing 13
professional education training courses; and 14
(4) any other matter the Secretary determines 15
appropriate. 16
(c) D
EFINITIONS.—In this section: 17
(1) The term ‘‘covered health care provider’’ 18
means a health care provider— 19
(A) described in subsection (c) of section 20
1703 of title 38, United States Code, that fur-21
nishes care or services under the Veterans Com-22
munity Care Program pursuant to a contract or 23
agreement with a Third Party Administrator; 24
or 25 22 
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(B) that otherwise furnishes care or serv-1
ices outside of Department facilities pursuant 2
to a contract or agreement with the Secretary 3
of Veterans Affairs. 4
(2) The term ‘‘opioid safety initiative’’ means 5
the programs, processes, and guidelines of the Vet-6
erans Health Administration of the Department of 7
Veterans Affairs relating to the management of 8
opioid therapy and chronic pain. 9
(3) The term ‘‘Third Party Administrator’’ 10
means an entity that manages a network of health 11
care providers and performs administrative services 12
related to such network under section 1703 of such 13
title. 14
(4) The term ‘‘VHA TRAIN program’’ means 15
the free program of the Veterans Health Adminis-16
tration that offers veteran-specific continuing med-17
ical education courses. 18
SEC. 106. PILOT PROGRAM ON CONSOLIDATING APPROVAL 19
PROCESS OF DEPARTMENT OF VETERANS AF-20
FAIRS FOR COVERED DENTAL CARE. 21
(a) I
NGENERAL.—Not later than 180 days after the 22
date of the enactment of this Act, the Secretary of Vet-23
erans Affairs, acting through the Center for Innovation 24
for Care and Payment established under section 1703E 25 23 
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of title 38, United States Code, shall carry out a pilot pro-1
gram under which the Secretary shall hire— 2
(1) general dentists at medical facilities of the 3
Department of Veterans Affairs to manage approval 4
by the Department of treatment plans requested by 5
dental providers in providing covered dental care; 6
and 7
(2) dental specialists at Veterans Integrated 8
Service Networks of the Department to manage ap-9
proval by the Department of treatment plans for 10
specialty dental care requested by dental providers 11
in providing covered dental care. 12
(b) L
OCATIONS.—The Secretary shall carry out the 13
pilot program in not fewer than two Veterans Integrated 14
Service Networks of the Department. 15
(c) R
EPORTS.— 16
(1) I
NITIAL REPORT.—Not later than one year 17
after the date of the commencement of such pilot 18
program, the Secretary shall submit to the Commit-19
tees on Veterans’ Affairs of the Senate and the 20
House of Representatives a report on the pilot pro-21
gram, that includes— 22
(A) an identification of the Veterans Inte-23
grated Service Networks participating in such 24
pilot program; 25 24 
•HR 8371 EH
(B) a description of the implementation of 1
such pilot program; 2
(C) an identification of any barriers or 3
challenges to implementing such pilot program; 4
(D) an assessment of the efficacy of hiring 5
general dentists and dental specialists pursuant 6
to such pilot program; 7
(E) aggregated feedback with respect to 8
such pilot program from dentists of the Depart-9
ment in Veterans Integrated Service Networks 10
participating in such pilot program; and 11
(F) aggregated feedback from dental pro-12
viders providing covered dental care within such 13
Veterans Integrated Service Networks regard-14
ing any changes in the timeliness of treatment 15
plan approvals by the Department. 16
(2) F
INAL REPORT.—Not later than 90 days 17
before the date of the completion of such pilot pro-18
gram, the Secretary shall submit to the Committees 19
on Veterans’ Affairs of the Senate and the House of 20
Representatives a report on the pilot program that— 21
(A) includes, with respect to the period 22
covered by the report, each element of the re-23
port required under paragraph (1) described in 24 25 
•HR 8371 EH
subparagraphs (A) through (F) of such para-1
graph; 2
(B) includes recommendations of the Sec-3
retary on whether the pilot program should 4
be— 5
(i) extended; 6
(ii) expanded; or 7
(iii) adopted throughout the Depart-8
ment; and 9
(C) indicates whether the Secretary re-10
quests action by Congress to make the pilot 11
program permanent. 12
(d) S
UNSET.—The authority to carry out the pilot 13
program under this section shall terminate on the date 14
that is two years after the date of the enactment of this 15
Act. 16
(e) C
OVEREDDENTALCAREDEFINED.—In this sec-17
tion, the term ‘‘covered dental care’’ means dental care 18
provided— 19
(1) under section 1703 of title 38, United 20
States Code; or 21
(2) pursuant to a Veterans Care Agreement 22
under section 1703A of such title. 23 26 
•HR 8371 EH
SEC. 107. STRATEGIC PLAN ON VALUE-BASED HEALTH 1
CARE SYSTEM FOR VETERANS HEALTH AD-2
MINISTRATION; PILOT PROGRAM. 3
(a) E
STABLISHMENT OF WORKINGGROUP.— 4
(1) I
N GENERAL.—Not later than one year 5
after the date of the enactment of this Act, the Sec-6
retary of Veterans Affairs shall— 7
(A) establish a working group on value- 8
based care; and 9
(B) submit to the Committees on Veterans’ 10
Affairs of the House of Representatives and the 11
Senate the strategic plan developed by the 12
working group pursuant to subsection (b). 13
(2) M
EMBERSHIP.— 14
(A) R
EQUIRED MEMBERS .—The working 15
group shall include, at a minimum, the fol-16
lowing members: 17
(i) The Under Secretary for Health of 18
the Department of Veterans Affairs. 19
(ii) The Director of the Office of Men-20
tal Health and Suicide Prevention of the 21
Department of Veterans Affairs (or any 22
successor office). 23
(iii) The Director of the Office of In-24
tegrated Veteran Care of the Department 25
(or any successor office). 26 27 
•HR 8371 EH
(iv) The Director of the Office of 1
Rural Health of the Department (or any 2
successor office). 3
(v) The Director of the Office of Con-4
nected Care of the Department (or any 5
successor office). 6
(vi) The Assistant Secretary for the 7
Office of Information Technology (or any 8
successor office). 9
(vii) The Chief Officer of the Office of 10
Healthcare Innovation and Learning of the 11
Office of Discovery, Education, and Affil-12
iate Networks of the Veterans Health Ad-13
ministration (or any successor office). 14
(viii) An individual designated by the 15
Secretary from the Center for Innovation 16
for Care and Payment of the Department 17
under section 1703E of title 38, United 18
States Code. 19
(ix) An individual designated by the 20
Administrator of the Centers for Medicare 21
& Medicaid Services from the Center for 22
Medicare and Medicaid Innovation. 23
(x) An individual designated by the 24
Secretary of Health and Human Services 25 28 
•HR 8371 EH
from the Federal Office of Rural Health 1
Policy of the Health Resources and Serv-2
ices Administration. 3
(xi) The Chief of Human Capital 4
Management for the Veterans Health Ad-5
ministration. 6
(xii) An individual designated by the 7
Secretary of Defense that is a representa-8
tive of the Defense Health Agency. 9
(xiii) An individual selected by the 10
Secretary of Veterans Affairs from the spe-11
cial medical advisory group established 12
under section 7312 of title 38, United 13
States Code. 14
(B) O
PTIONAL MEMBERS .—The Secretary 15
of Veterans Affairs may appoint any of the fol-16
lowing individuals as members of the working 17
group: 18
(i) An individual representing the 19
Health and Medicine Division of the Na-20
tional Academies of Sciences, Engineering, 21
and Medicine. 22
(ii) Three individuals representing a 23
private health care system that has made 24
the transition to value-based care. 25 29 
•HR 8371 EH
(iii) Three individuals representing an 1
organization recognized by the Secretary of 2
Veterans Affairs under section 5902 of 3
title 38, United States Code. 4
(3) P
UBLIC AVAILABILITY.—All meetings delib-5
erations, and products of the working group shall be 6
made publicly available throughout the duration of 7
the working group, including to individuals rep-8
resenting organizations recognized by the Secretary 9
of Veterans Affairs under section 5902 of title 38, 10
United States Code. 11
(4) E
XEMPTION FROM FACA .—Chapter 10 of 12
title 5, United States Code, shall not apply to the 13
working group established under paragraph (1). 14
(b) D
EVELOPMENT OF STRATEGICPLAN.—The 15
working group shall develop a strategic plan to implement 16
value-based care into the Veterans Health Administration 17
that includes the following: 18
(1) An identification of the state of the Vet-19
erans Health Administration as of the date of the 20
enactment of this Act, including an assessment of 21
the current model of health care delivery used by the 22
Veterans Health Administration in medical facilities 23
of the Department of Veterans Affairs. 24 30 
•HR 8371 EH
(2) An assessment of the capacity needs of the 1
Veterans Health Administration during the five-year 2
period beginning on the date of the enactment of 3
this Act. 4
(3) An analysis of the leadership of the Vet-5
erans Health Administration, including an assess-6
ment of leadership acumen and ability to implement 7
a clear, shared vision and effective change manage-8
ment and care coordination. 9
(4) An identification of goals for the future of 10
the Veterans Health Administration. 11
(5) An identification and classification of the 12
current capabilities, capacity, and gaps in access and 13
quality of the health care system of the Department 14
of Veterans Affairs. 15
(6) An analysis of value-based care models, in-16
cluding— 17
(A) a selection of potential models that 18
would best work for the Veterans Health Ad-19
ministration; 20
(B) the capacity and capabilities of each 21
such model; and 22
(C) a thorough justification of the selection 23
of each selected model, including an summary 24 31 
•HR 8371 EH
of the ability of such model to improve the 1
metrics described under paragraph (9). 2
(7) A definition of what quality means with re-3
spect to— 4
(A) access to health care under the laws 5
administered by the Secretary of Veterans Af-6
fairs; and 7
(B) delivery of such health care. 8
(8) A definition of what value means with re-9
spect to care furnished by the Veterans Health Ad-10
ministration, 11
(9) A system for measuring value within the 12
Veterans Health Administration that includes 13
metrics for— 14
(A) outcomes; 15
(B) safety; 16
(C) service; 17
(D) access; 18
(E) productivity; 19
(F) capacity; and 20
(G) total cost of patient care. 21
(10) With respect to the system described in 22
subparagraph (H), an analysis of variable value with 23
respect to patient outcomes across different health 24
care types and specialties. 25 32 
•HR 8371 EH
(11) An assessment of— 1
(A) previous or ongoing assessments of the 2
current information technology infrastructure of 3
the Veterans Health Administration, includ-4
ing— 5
(i) such assessments conducted pursu-6
ant to the Electronic Health Record Mod-7
ernization program of the Department of 8
Veterans Affairs; and 9
(ii) any other ongoing information 10
technology modernization programs of such 11
Department and any unimplemented rel-12
evant recommendations from such assess-13
ments; 14
(B) the information technology infrastruc-15
ture of the Veterans Health Administration in 16
effect as of the date of the enactment of this 17
Act; 18
(C) the value-driven framework of the De-19
partment, in effect as of the date of the enact-20
ment of this Act, for evaluating health care in-21
novations, and how improvements in such 22
framework could be used to encourage innova-23
tion; and 24 33 
•HR 8371 EH
(D) workforce challenges and needs of the 1
Veterans Health Administration based on— 2
(i) reviews of workforce assessment 3
data available as of the date of the enact-4
ment of this Act; and 5
(ii) the findings of— 6
(I) the report required by section 7
301(d) of the Veterans Access, 8
Choice, and Accountability Act of 9
2014 (Public Law 113–146); 10
(II) the reports required by sec-11
tion 505 of the John S. McCain III, 12
Daniel K. Akaka and Samuel R. 13
Johnson VA Maintaining Internal 14
Systems and Strengthening Inte-15
grated Outside Networks Act of 2018 16
(Public Law 115–182); 17
(III) the report required by sec-18
tion 301 of the VA Choice and Qual-19
ity Employment Act of 2017 (Public 20
Law 115–46); and 21
(IV) any comprehensive health 22
care inspection conducted by the In-23
spector General of the Department of 24 34 
•HR 8371 EH
Veterans Affairs as of the date of the 1
enactment of this Act. 2
(12) Any recommendations of the working 3
group with respect to improving the information 4
technology infrastructure described in clause (i) of 5
subparagraph (J). 6
(13) An analysis of how the value-driven frame-7
work described in clause (iii) of such subparagraph 8
could be used to improve the model of care delivery 9
by the Department. 10
(14) A description of how a value-based care 11
system would apply to primary care, inpatient and 12
outpatient mental health care, and inpatient and 13
outpatient substance use treatment, spinal cord in-14
jury disorder care, and polytrauma care furnished by 15
the Veterans Health Administration. 16
(15) With respect to legislative or administra-17
tive action necessary to incorporate value-based care 18
models into the Veterans Health Administration, a 19
description of the estimated timelines, effect on 20
workforce, and costs. 21
(c) P
ILOTPROGRAM.— 22
(1) I
N GENERAL.—Not later than 180 days 23
after the submission of the strategic plan pursuant 24
to subsection (b), the Secretary of Veterans Affairs, 25 35 
•HR 8371 EH
acting through the Center for Innovation for Care 1
and Payment established under section 1703E of 2
title 38, United States Code, shall commence a 3
three-year pilot program under which the Secretary 4
shall implement the elements of such strategic plan 5
relating to the delivery, by the Veterans Health Ad-6
ministration, of primary care, inpatient and out-7
patient mental health treatment, inpatient and out-8
patient substance abuse treatment, spinal cord in-9
jury disorder care, and polytrauma care. 10
(2) L
OCATIONS.—The Secretary shall carry out 11
such pilot program in four Veterans Integrated 12
Service Networks that are geographically dispersed 13
and shall include the following: 14
(A) A Veterans Integrated Service Net-15
work that predominately serves veterans in 16
rural and highly rural areas. 17
(B) A Veterans Integrated Service Net-18
work that predominately serves veterans in 19
urban areas. 20
(C) A Veterans Integrated Service Net-21
work that has a high rate of suicide among vet-22
erans. 23 36 
•HR 8371 EH
(D) A Veterans Integrated Service Net-1
work that has a high rate of substance use dis-2
order among veterans. 3
(E) A Veterans Integrated Service Net-4
work that has access or productivity challenges. 5
(3) R
EPORTS TO CONGRESS.— 6
(A) A
NNUAL REPORT.—Not later than one 7
year after the commencement of the pilot pro-8
gram, and annually thereafter during the dura-9
tion of the pilot program, the Secretary shall 10
submit to Congress a report on the pilot pro-11
gram. 12
(B) F
INAL REPORT.—Not later than 90 13
days before the conclusion of the pilot program, 14
the Secretary shall submit to Congress a final 15
report on the pilot program that includes— 16
(i) lessons learned during the adminis-17
tration of such pilot program; and 18
(ii) specific health outcomes in veteran 19
patient care compared to the Veterans 20
Health Administration system of care in 21
effect as of the date of the enactment of 22
this Act. 23 37 
•HR 8371 EH
SEC. 108. PLAN ON ADOPTION OF CERTAIN HEALTH INFOR-1
MATION STANDARDS FOR DEPARTMENT OF 2
VETERANS AFFAIRS AND CERTAIN HEALTH 3
CARE PROVIDERS. 4
(a) P
LAN FOR CERTAINHEALTHINFORMATION 5
S
TANDARDS.— 6
(1) I
N GENERAL.—The Secretary of Veterans 7
Affairs, in consultation with the Secretary of Health 8
and Human Services, the Administrator of the Cen-9
ters for Medicare & Medicaid Services, and the Na-10
tional Coordinator for Health Information Tech-11
nology of the Department of Health and Human 12
Services, shall create and implement a plan to adopt, 13
as rapidly and to the most comprehensive extent fea-14
sible, national health information interoperability 15
standards for the Department of Veterans Affairs 16
and community care providers with respect to— 17
(A) coordination of— 18
(i) care; and 19
(ii) benefits; 20
(B) patient identity matching; 21
(C) measurement and reporting of quality; 22
(D) population health; and 23
(E) public health. 24 38 
•HR 8371 EH
(2) CONSIDERATION.—In developing the plan 1
under paragraph (1), the Secretary of Veterans Af-2
fairs shall consider challenges faced by— 3
(A) small community care providers; and 4
(B) community care providers located in 5
rural areas. 6
(b) P
LAN ONELECTRONICHEALTHRECORDEX-7
CHANGE.— 8
(1) I
N GENERAL.—Not later than one year 9
after the date of enactment of this Act, the Sec-10
retary shall submit to the Committees on Veterans’ 11
Affairs of the Senate and the House of Representa-12
tives a plan to provide, at no cost, to community 13
care providers of the Department, through Third 14
Party Administrators, a capability to facilitate the 15
electronic direct exchange, between such providers 16
and the Department, of— 17
(A) the health records of veterans; and 18
(B) documents relating to health care of 19
veterans, clinical notes, and any other informa-20
tion the Secretary determines necessary. 21
(2) P
RIORITIZATION.—In developing the plan 22
required under paragraph (1), the Secretary shall 23
prioritize providing the capability described in such 24
paragraph to community care providers that— 25 39 
•HR 8371 EH
(A) provide care under the laws adminis-1
tered by the Secretary to— 2
(i) a lower volume of veterans; and 3
(ii) veterans who are located in rural 4
areas; and 5
(B) are unable or unwilling to exchange 6
the records and documents described in sub-7
paragraphs (A) and (B) of such paragraph with 8
the Department through standards-based or di-9
rect exchange mechanisms in effect as of the 10
date of the enactment of this Act. 11
(c) R
EPORTS ON PLAN FOR INTEROPERABILITY 12
S
TANDARDS.— 13
(1) I
NITIAL REPORT.—Not later than one year 14
after the date of the enactment of this Act, the Sec-15
retary of Veterans Affairs shall submit to the Com-16
mittees on Veterans’ Affairs of the Senate and the 17
House of Representatives— 18
(A) the plan required by subsection (a); 19
and 20
(B) a report that includes— 21
(i) an analysis of gaps, if any, be-22
tween the use, by the Department and 23
other agencies, health information ex-24
changes, and technology companies, of na-25 40 
•HR 8371 EH
tional health information interoperability 1
standards and the potential, or optimal, 2
use of such national health information 3
interoperability standards; 4
(ii) an analysis and description of the 5
participation by the Department, commu-6
nity care providers, and other relevant en-7
tities in the Trusted Exchange Framework 8
and Common Agreement program of the 9
Department of Health and Human Serv-10
ices as of the date of the enactment of this 11
Act; 12
(iii) recommendations of the Secretary 13
with respect to development of health in-14
formation interoperability standards; 15
(iv) timelines or schedules to imple-16
ment the plan required by subsection (a); 17
and 18
(v) an identification of any legislative 19
authorities or resources the Secretary re-20
quires to implement such plan. 21
(2) R
ECURRING REPORT REQUIREMENT .— 22
(A) I
N GENERAL.—Not later than 18 23
months after the date of the enactment of this 24
Act, and every 180 days thereafter for four 25 41 
•HR 8371 EH
years, the Secretary of Veterans Affairs shall 1
submit to Committees on Veterans’ Affairs of 2
the Senate and the House of Representatives a 3
report on the status of implementation of the 4
plan required under subsection (a). 5
(B) E
LEMENTS OF SUBSEQUENT RE -6
PORTS.—Each report under subparagraph (A) 7
submitted after the date on which the first re-8
port required by such subparagraph is sub-9
mitted shall include a description of any revi-10
sions to— 11
(i) the plan required by subsection (a) 12
made during the period covered by the re-13
port; and 14
(ii) the analysis, recommendations, 15
timelines, and legislative authorities re-16
ported pursuant to paragraph (1). 17
(d) D
EFINITIONS.—In this section: 18
(1) The term ‘‘community care provider’’ means 19
a non-Department health care provider providing 20
care (including dental care)— 21
(A) under section 1703 of title 38, United 22
States Code; 23
(B) pursuant to a Veterans Care Agree-24
ment under section 1703A of such title; or 25 42 
•HR 8371 EH
(C) under any other law administered by 1
the Secretary of Veterans Affairs. 2
(2) The term ‘‘Third Party Administrator’’ 3
means an entity that manages a provider network 4
and performs administrative services related to such 5
network under section 1703 of title 38, United 6
States Code. 7
SEC. 109. REPORT ON USE OF VALUE-BASED REIMBURSE-8
MENT MODELS UNDER VETERANS COMMU-9
NITY CARE PROGRAM. 10
(a) R
EPORT ON VALUE-BASEDREIMBURSEMENT 11
M
ODELS.—Not later than one year after the date of the 12
enactment of this Act, the Secretary of Veterans Affairs, 13
in consultation with the Center for Innovation for Care 14
and Payment of the Department of Veterans Affairs under 15
section 1703E of title 38 United States Code, the Office 16
of Integrated Veteran Care of the Department, or suc-17
cessor office, and Third Party Administrators, shall sub-18
mit to the Committees on Veterans’ Affairs of the House 19
of Representatives and the Senate a report containing— 20
(1) an assessment of the efforts of the Depart-21
ment pursuant to section 1703(i)(5) of such title, to 22
incorporate value-based reimbursement models under 23
the Veterans Community Care Program to promote 24
the provision of high-quality care to veterans; and 25 43 
•HR 8371 EH
(2) such recommendations for legislative or ad-1
ministrative action as the Secretary considers appro-2
priate regarding the use of value-based reimburse-3
ment models throughout the Veterans Community 4
Care Program under section 1703 of such title. 5
(b) R
ULE OFCONSTRUCTION.—This section shall not 6
be construed to be a pilot program subject to the require-7
ments of section 1703E of title 38, United States Code. 8
(c) T
HIRDPARTYADMINISTRATORDEFINED.—In 9
this section, the term ‘‘Third Party Administrator’’ means 10
an entity that manages a provider network and performs 11
administrative services related to such network under sec-12
tion 1703 of title 38, United States Code. 13
SEC. 110. INSPECTOR GENERAL ASSESSMENT OF IMPLE-14
MENTATION OF VETERANS COMMUNITY 15
CARE PROGRAM. 16
(a) I
NGENERAL.—Not later than 18 months after 17
the date of the enactment of this Act, and periodically 18
thereafter, the Inspector General shall assess the perform-19
ance of the Department of Veterans Affairs in— 20
(1) appropriately identifying veterans eligible 21
for care and services under section 1703 of title 38, 22
United States Code; 23
(2) informing veterans of their eligibility for 24
such care and services; and 25 44 
•HR 8371 EH
(3) delivering such care and services in a timely 1
manner. 2
(b) B
RIEFING ONASSESSMENTS.—Upon the submis-3
sion of the assessment required by subsection (a), the In-4
spector General of the Department of Veterans Affairs 5
shall provide to the Committees on Veterans Affairs of the 6
House of Representatives and the Senate a briefing on the 7
results of such assessment. 8
SEC. 111. COMPTROLLER GENERAL REPORT ON DENTISTRY 9
UNDER VETERANS COMMUNITY CARE PRO-10
GRAM. 11
(a) I
NGENERAL.—Not later than one year after the 12
date of the enactment of this Act, the Comptroller General 13
of the United States shall submit to the Committees on 14
Veterans’ Affairs of the Senate and the House of Rep-15
resentatives a report on dental care furnished by the Sec-16
retary of Veterans Affairs under the Veterans Community 17
Care Program under section 1703 of title 38, United 18
States Code, that includes a review of— 19
(1) the impact current reimbursement rates 20
provided by the Department of Veterans Affairs to 21
dental providers under such program have on— 22
(A) the availability of dental care for vet-23
erans; and 24 45 
•HR 8371 EH
(B) the ability of Third Party Administra-1
tors to meet their contractual obligations for 2
network adequacy; 3
(2) the satisfaction of dental providers pro-4
viding dental care under such program with the 5
processes of the Department for approving dental 6
care under such program; and 7
(3) the current processes of the Department for 8
approving emergent dental care under such program. 9
(b) T
HIRDPARTYADMINISTRATORDEFINED.—In 10
this section, the term ‘‘Third Party Administrator’’ means 11
an entity that manages a provider network and performs 12
administrative services related to such network under sec-13
tion 1703 of title 38, United States Code. 14
Subtitle B—Matters Relating to 15
Nursing Home and Other Long 16
Term Care and Family Care-17
givers 18
SEC. 120. INCREASE OF EXPENDITURE CAP FOR NON-19
INSTITUTIONAL CARE ALTERNATIVES TO 20
NURSING HOME CARE. 21
(a) I
NCREASE OF EXPENDITURE CAP.—Section 22
1720C(d) of title 38, United States Code, is amended— 23 46 
•HR 8371 EH
(1) by striking ‘‘The total cost’’ and inserting 1
‘‘(1) Except as provided in paragraph (2), the total 2
cost’’; 3
(2) by striking ‘‘65 percent’’ and inserting ‘‘100 4
percent’’; and 5
(3) by adding at the end the following new 6
paragraph: 7
‘‘(2)(A) The total cost of providing services or in-kind 8
assistance in the case of any veteran described in subpara-9
graph (B) for any fiscal year under the program may ex-10
ceed 100 percent of the cost that would otherwise have 11
been incurred as specified in paragraph (1) if the Sec-12
retary determines, based on a consideration of clinical 13
need, geographic market factors, and such other matters 14
as the Secretary may prescribe through regulation, that 15
such higher total cost is in the best interest of the veteran. 16
‘‘(B) A veteran described in this subparagraph is a 17
veteran with amyotrophic lateral sclerosis, a spinal cord 18
injury, or a condition the Secretary determines to be simi-19
lar to such conditions.’’. 20
(b) A
PPLICABILITY.—The amendments made by sub-21
section (a) shall apply with respect to fiscal years begin-22
ning on or after the date of the enactment of this Act. 23 47 
•HR 8371 EH
SEC. 121. COORDINATION WITH PROGRAM OF ALL-INCLU-1
SIVE CARE FOR THE ELDERLY. 2
Section 1720C of title 38, United States Code, as 3
amended by section 120, is further amended by adding 4
at the end the following new subsection: 5
‘‘(f) In furnishing services to a veteran under the pro-6
gram conducted pursuant to subsection (a), if a medical 7
center of the Department through which such program is 8
administered is located in a geographic area in which serv-9
ices are available to the veteran under a PACE program 10
(as such term is defined in sections 1894(a)(2) and 11
1934(a)(2) of the Social Security Act (42 U.S.C. 12
1395eee(a)(2); 1396u–4(a)(2))), the Secretary shall seek 13
to enter into an agreement with the PACE program oper-14
ating in that area for the furnishing of such services.’’. 15
SEC. 122. AUTHORITY FOR SECRETARY OF VETERANS AF-16
FAIRS TO AWARD GRANTS OR CONTRACTS TO 17
ENTITIES TO IMPROVE PROVISION OF MEN-18
TAL HEALTH SUPPORT TO FAMILY CARE-19
GIVERS OF VETERANS. 20
Subchapter II of chapter 17 of title 38, United States 21
Code, is amended by adding at the end the following new 22
section (and conforming the table of sections at the begin-23
ning of such chapter accordingly): 24 48 
•HR 8371 EH
‘‘§ 1720K. Grants or contracts to provide mental 1
health support to family caregivers of 2
veterans 3
‘‘(a) A
UTHORITY.—The Secretary may award grants 4
to carry out, coordinate, improve, or otherwise enhance 5
mental health counseling, treatment, or support to the 6
family caregivers of veterans participating in the family 7
caregiver program. 8
‘‘(b) A
PPLICATION.—(1) To be eligible for a grant or 9
contract under this section, an entity shall submit to the 10
Secretary an application therefor at such time, in such 11
manner, and containing such information as the Secretary 12
may require. 13
‘‘(2) Each application submitted under paragraph (1) 14
shall include the following: 15
‘‘(A) A detailed plan for the use of the grant 16
or contract. 17
‘‘(B) A description of the programs or efforts 18
through which the entity will meet the outcome 19
measures developed by the Secretary under sub-20
section (g). 21
‘‘(C) A description of how the entity will dis-22
tribute grant or contract amounts equitably among 23
areas with varying levels of urbanization. 24
‘‘(D) A plan for how the grant or contract will 25
be used to meet the unique needs of veterans resid-26 49 
•HR 8371 EH
ing in rural areas, Native American, Native Hawai-1
ian, or Alaska Native veterans, elderly veterans, 2
women veterans, and veterans from other under-3
served communities. 4
‘‘(c) D
ISTRIBUTION.—The Secretary shall seek to en-5
sure that grants and contracts awarded under this section 6
are equitably distributed among entities located in States 7
with varying levels of urbanization. 8
‘‘(d) P
RIORITY.—The Secretary shall prioritize 9
awarding grants or contracts under this section that will 10
serve the following areas: 11
‘‘(1) Areas with high rates of veterans enrolled 12
in the family caregiver program. 13
‘‘(2) Areas with high rates of— 14
‘‘(A) suicide among veterans; or 15
‘‘(B) referrals to the Veterans Crisis Line. 16
‘‘(e) R
EQUIREDACTIVITIES.—Any grant or contract 17
awarded under this section shall be used— 18
‘‘(1) to expand existing programs, activities, 19
and services; 20
‘‘(2) to establish new or additional programs, 21
activities, and services; or 22
‘‘(3) for travel and transportation to facilitate 23
carrying out paragraph (1) or (2). 24 50 
•HR 8371 EH
‘‘(f) OUTCOMEMEASURES.—(1) The Secretary shall 1
develop and provide to each entity that receives a grant 2
or contract under this section written guidance on the fol-3
lowing: 4
‘‘(A) Outcome measures. 5
‘‘(B) Policies of the Department. 6
‘‘(2) In developing outcome measures under para-7
graph (1), the Secretary shall consider the following goals: 8
‘‘(A) Increasing the utilization of mental health 9
services among family caregivers of veterans partici-10
pating in the family caregiver program. 11
‘‘(B) Reducing barriers to mental health serv-12
ices among family caregivers of veterans partici-13
pating in such program. 14
‘‘(g) T
RACKINGREQUIREMENTS.—(1) The Secretary 15
shall establish appropriate tracking requirements with re-16
spect to the entities receiving a grant or contract under 17
this section. 18
‘‘(2) Not less frequently than annually, the Secretary 19
shall submit to Congress a report on such tracking re-20
quirements. 21
‘‘(h) P
ERFORMANCE REVIEW.—The Secretary 22
shall— 23
‘‘(1) review the performance of each entity that 24
receives a grant or contract under this section; and 25 51 
•HR 8371 EH
‘‘(2) make information regarding such perform-1
ance publicly available. 2
‘‘(i) R
EMEDIATIONPLAN.—(1) In the case of an enti-3
ty that receives a grant or contract under this section and 4
does not meet the outcome measures developed by the Sec-5
retary under subsection (g), the Secretary shall require the 6
entity to submit to the Secretary a remediation plan under 7
which the entity shall describe how and when it plans to 8
meet such outcome measures. 9
‘‘(2) The Secretary may not award a subsequent 10
grant or contract under this section to an entity described 11
in paragraph (1) unless the Secretary approves the reme-12
diation plan submitted by the entity under such para-13
graph. 14
‘‘(j) M
AXIMUMAMOUNT.—The amount of a grant or 15
contract awarded under this section may not exceed 10 16
percent of amounts made available for grants or contracts 17
under this section for the fiscal year in which the grant 18
or contract is awarded. 19
‘‘(k) S
UPPLEMENT, NOTSUPPLANT.—Any grant or 20
contract awarded under this section shall be used to sup-21
plement and not supplant funding that is otherwise avail-22
able through the Department to provide mental health 23
support among family caregivers of veterans participating 24
in the family caregiver program. 25 52 
•HR 8371 EH
‘‘(l) OUTREACH TOFAMILYCAREGIVERS.—The Sec-1
retary shall include, in the outreach materials regularly 2
provided to a family caregiver who participates in the fam-3
ily caregiver program, notice of mental health support pro-4
vided by recipients of grants or contracts under this sec-5
tion that are located in the relevant Veterans Integrated 6
Service Network. 7
‘‘(m) F
UNDING.—(1) Amounts for the activities of 8
the Department under this section shall be budgeted and 9
appropriated through a separate appropriation account. 10
‘‘(2) In the budget justification materials submitted 11
to Congress in support of the budget of the Department 12
for any fiscal year (as submitted with the budget of the 13
President under section 1105(a) of title 31), the Secretary 14
shall include a separate statement of the amount re-15
quested to be appropriated for that fiscal year for the ac-16
count specified in paragraph (1). 17
‘‘(n) A
UTHORIZATION OF APPROPRIATIONS.—There 18
is authorized to be appropriated to the Secretary, for each 19
of fiscal years 2025 and 2026, $10,000,000 to carry out 20
this section. 21
‘‘(o) D
EFINITIONS.—In this section: 22
‘‘(1) The terms ‘caregiver’ and ‘family care-23
giver’ have the meanings given those terms in sec-24
tion 1720G of this title. 25 53 
•HR 8371 EH
‘‘(2) The term ‘family caregiver program’ 1
means the program of comprehensive assistance for 2
family caregivers under section 1720G of this title. 3
‘‘(3) The term ‘Veterans Crisis Line’ means the 4
toll-free hotline for veterans established under sec-5
tion 1720F of this title.’’. 6
SEC. 123. HOME- AND COMMUNITY-BASED SERVICES: PRO-7
GRAMS. 8
(a) P
ROGRAMS.—Such subchapter is further amend-9
ed by inserting after section 1720K (as added by section 10
122) the following new section (and conforming the table 11
of sections at the beginning of such chapter accordingly): 12
‘‘§ 1720L. Home- and community-based services: pro-13
grams 14
‘‘(a) I
NGENERAL.—In furnishing noninstitutional al-15
ternatives to nursing home care pursuant to the authority 16
of section 1720C of this title (or any other authority under 17
this chapter or other provision of law administered by the 18
Secretary of Veterans Affairs), the Secretary shall carry 19
out each of the programs specified in this section in ac-20
cordance with such relevant authorities except as other-21
wise provided in this section. 22
‘‘(b) V
ETERAN-DIRECTEDCAREPROGRAM.—(1) The 23
Secretary of Veterans Affairs, in collaboration with the 24
Secretary of Health and Human Services, shall carry out 25 54 
•HR 8371 EH
a program to be known as the ‘Veteran-Directed Care pro-1
gram’. Under such program, the Secretary of Veterans Af-2
fairs may enter into agreements with the providers de-3
scribed in paragraph (2) to provide to eligible veterans 4
funds, to the extent practicable, to obtain such in-home 5
care services and related items that support clinical need 6
and improve quality of life, as may be determined appro-7
priate by the Secretary of Veterans Affairs and selected 8
by the veteran, including through the veteran hiring indi-9
viduals to provide such services and items or directly pur-10
chasing such services and items. 11
‘‘(2) The providers described in this paragraph are 12
the following: 13
‘‘(A) An Aging and Disability Resource Center, 14
an area agency on aging, or a State agency. 15
‘‘(B) A center for independent living. 16
‘‘(C) An Indian tribe or tribal organization re-17
ceiving assistance under title VI of the Older Ameri-18
cans Act of 1965 (42 U.S.C. 3057 et seq.). 19
‘‘(D) Any other entity that the Secretary, in 20
consultation with the Secretary of Health and 21
Human Services, determines appropriate. 22
‘‘(3) In carrying out the Veteran-Directed Care pro-23
gram, the Secretary of Veterans Affairs shall— 24 55 
•HR 8371 EH
‘‘(A) administer such program through each 1
medical center of the Department of Veterans Af-2
fairs; 3
‘‘(B) seek to ensure the availability of such pro-4
gram in American Samoa, Guam, the Common-5
wealth of the Northern Mariana Islands, the Com-6
monwealth of Puerto Rico, the Virgin Islands of the 7
United States, and any other territory or possession 8
of the United States, to the extent practicable; and 9
‘‘(C) seek to ensure the availability of such pro-10
gram for eligible veterans who are Native American 11
veterans receiving care and services furnished by the 12
Indian Health Service, a tribal health program, an 13
Urban Indian organization, or (in the case of a Na-14
tive Hawaiian veteran) a Native Hawaiian health 15
care system, to the extent practicable. 16
‘‘(4) If a veteran participating in the Veteran-Di-17
rected Care program is hospitalized, the veteran may con-18
tinue to use funds under the program during a period of 19
hospitalization in the same manner that the veteran would 20
be authorized to use such funds under the program if the 21
veteran were not hospitalized. 22
‘‘(c) H
OMEMAKER AND HOMEHEALTHAIDEPRO-23
GRAM.—(1) The Secretary shall carry out a program to 24
be known as the ‘Homemaker and Home Health Aide pro-25 56 
•HR 8371 EH
gram’ under which the Secretary may enter into agree-1
ments with home health agencies to provide to eligible vet-2
erans such home health aide services as may be deter-3
mined appropriate by the Secretary. 4
‘‘(2) In carrying out the Homemaker and Home 5
Health Aide program, the Secretary shall— 6
‘‘(A) administer such program in the locations 7
specified in subparagraph (A) of subsection (b)(3); 8
‘‘(B) seek to ensure the availability of such pro-9
gram in the locations specified in subparagraph (B) 10
of subsection (b)(3); and 11
‘‘(C) seek to ensure the availability of such pro-12
gram for the veteran populations specified in sub-13
paragraph (C) of subsection (b)(3). 14
‘‘(d) H
OME-BASEDPRIMARYCAREPROGRAM.—The 15
Secretary shall carry out a program to be known as the 16
‘Home-Based Primary Care program’ under which the 17
Secretary may furnish to eligible veterans in-home health 18
care, the provision of which is overseen by a provider of 19
the Department. 20
‘‘(e) P
URCHASEDSKILLEDHOMECAREPROGRAM.— 21
The Secretary shall carry out a program to be known as 22
the ‘Purchased Skilled Home Care program’ under which 23
the Secretary may furnish to eligible veterans such in- 24 57 
•HR 8371 EH
home care services as may be determined appropriate and 1
selected by the Secretary for the veteran. 2
‘‘(f) C
AREGIVERSUPPORT.—(1) With respect to a 3
resident eligible caregiver of a veteran participating in a 4
program under this section, the Secretary shall— 5
‘‘(A) if the veteran meets the requirements of 6
a covered veteran under section 1720G(b) of this 7
title, provide to such caregiver the option of enroll-8
ing in the program of general caregiver support serv-9
ices under such section; 10
‘‘(B) provide to such caregiver covered respite 11
care of not less than 30 days annually; and 12
‘‘(C) conduct on an annual basis (and, to the 13
extent practicable, in connection with in-person serv-14
ices provided under the program in which the vet-15
eran is participating), a wellness contact of such 16
caregiver. 17
‘‘(2) Covered respite care provided to a resident eligi-18
ble caregiver of a veteran under paragraph (1) may exceed 19
30 days annually if such extension is requested by the resi-20
dent eligible caregiver or veteran and determined medi-21
cally appropriate by the Secretary. 22
‘‘(g) R
ULE OFCONSTRUCTION.—Nothing in this sec-23
tion shall be construed to limit the authority of the Sec-24 58 
•HR 8371 EH
retary to carry out programs providing home- and commu-1
nity-based services under any other provision of law. 2
‘‘(h) D
EFINITIONS.—In this section: 3
‘‘(1) The terms ‘Aging and Disability Resource 4
Center’, ‘area agency on aging’, and ‘State agency’ 5
have the meanings given those terms in section 102 6
of the Older Americans Act of 1965 (42 U.S.C. 7
3002). 8
‘‘(2) The terms ‘caregiver’ and ‘family care-9
giver’, with respect to a veteran, have the meanings 10
given those terms, respectively, under subsection (e) 11
of section 1720G of this title with respect to an eli-12
gible veteran under subsection (a) of such section or 13
a covered veteran under subsection (b) of such sec-14
tion, as the case may be. 15
‘‘(3) The term ‘center for independent living’ 16
has the meaning given that term in section 702 of 17
the Rehabilitation Act of 1973 (29 U.S.C. 796a). 18
‘‘(4) The term ‘covered respite care’ has the 19
meaning given such term in section 1720G(d) of this 20
title. 21
‘‘(5) The term ‘eligible veteran’ means any vet-22
eran— 23
‘‘(A) for whom the Secretary determines 24
participation in a specific program under this 25 59 
•HR 8371 EH
section is medically necessary to promote, pre-1
serve, or restore the health of the veteran; and 2
‘‘(B) who absent such participation would 3
be at increased risk for hospitalization, place-4
ment in a nursing home, or emergency room 5
care. 6
‘‘(6) The term ‘home health aide’ means an in-7
dividual employed by a home health agency to pro-8
vide in-home care services. 9
‘‘(7) The term ‘in-home care service’ means any 10
service, including a personal care service, provided to 11
enable the recipient of such service to live at home. 12
‘‘(8) The terms ‘Indian tribe’ and ‘tribal organi-13
zation’ have the meanings given those terms in sec-14
tion 4 of the Indian Self-Determination and Edu-15
cation Assistance Act (25 U.S.C. 5304). 16
‘‘(9) The terms ‘Native American’ and ‘Native 17
American veteran’ have the meanings given those 18
terms in section 3765 of this title. 19
‘‘(10) The terms ‘Native Hawaiian’ and ‘Native 20
Hawaiian health care system’ have the meanings 21
given those terms in section 12 of the Native Hawai-22
ian Health Care Improvement Act (42 U.S.C. 23
11711). 24 60 
•HR 8371 EH
‘‘(11) The terms ‘tribal health programs’ and 1
‘Urban Indian organizations’ have the meanings 2
given those terms in section 4 of the Indian Health 3
Care Improvement Act (25 U.S.C. 1603). 4
‘‘(12) The term ‘resident eligible caregiver’ 5
means an individual who— 6
‘‘(A) is a caregiver, or a family caregiver, 7
of a veteran and resides with that veteran; and 8
‘‘(B) has not entered into a contract, 9
agreement, or other arrangement for such indi-10
vidual to act as a caregiver for that veteran un-11
less such individual is a family member of the 12
veteran or is furnishing caregiver services 13
through a medical foster home.’’. 14
(b) D
EADLINE FORIMPROVEDADMINISTRATION.— 15
The Secretary of Veterans Affairs shall ensure that the 16
Veteran-Directed Care program and the Homemaker and 17
Home Health Aide program are administered through 18
each medical center of the Department of Veterans Affairs 19
in accordance with section 1720L of title 38, United 20
States Code (as added by subsection (a)), by not later 21
than two years after the date of the enactment of this Act. 22
(c) A
DMINISTRATION OF VETERAN-DIRECTEDCARE 23
P
ROGRAM.— 24
(1) P
ROCEDURES.— 25 61 
•HR 8371 EH
(A) The Secretary shall establish proce-1
dures to— 2
(i) identify the staffing needs for the 3
Veteran-Directed Care program of the De-4
partment of Veterans Affairs under such 5
section (as added by subsection (a)); and 6
(ii) define the roles and responsibil-7
ities for personnel of the Department re-8
sponsible for the administration of such 9
program, including such personnel em-10
ployed at the national, Veterans Integrated 11
Service Network, or medical facility level. 12
(B) The responsibilities described in clause 13
(ii) of subparagraph (A) shall include respon-14
sibilities for engagement with— 15
(i) veterans participating in such pro-16
gram; 17
(ii) veterans interested in partici-18
pating in such program; and 19
(iii) providers described in section 20
1720L(b)(2) (as added by subsection (a)). 21
(2) S
TAFFING MODEL ; REPORT.—Not later 22
than two years after enactment of this Act, the Sec-23
retary of Veterans Affairs shall— 24 62 
•HR 8371 EH
(A) establish a staffing model for the ad-1
ministration of such program at each medical 2
facility of the Department of Veterans Affairs; 3
and 4
(B) submit to the Committees on Veterans’ 5
Affairs of the House of Representatives and the 6
Senate a report containing the following: 7
(i) A description of— 8
(I) the staffing model described 9
in subparagraph (A); and 10
(II) the rationale for such staff-11
ing model. 12
(ii) An identification of the ratio of 13
staff required to administer such program 14
to the number of veterans served by such 15
program, disaggregated by each medical 16
facility of the Department of Veterans Af-17
fairs. 18
(iii) A description of budgetary re-19
sources or other support, if any, required 20
to accommodate an increase in staffing at 21
medical facilities of the Department of 22
Veterans Affairs pursuant to the require-23
ments of the staffing model described in 24
subparagraph (A). 25 63 
•HR 8371 EH
(iv) Such other matters as the Sec-1
retary of Veterans Affairs determines ap-2
propriate. 3
SEC. 124. COORDINATION WITH ASSISTANCE AND SUPPORT 4
SERVICES FOR CAREGIVERS. 5
(a) C
OORDINATIONWITHPROGRAM OFCOMPREHEN-6
SIVEASSISTANCE FORFAMILYCAREGIVERS.— 7
(1) C
OORDINATION.—Section 1720G(a) of title 8
38, United States Code, is amended by adding at 9
the end the following new paragraph: 10
‘‘(14)(A) In the case of a veteran or caregiver who 11
seeks services under this subsection and is denied such 12
services, or a veteran or the family caregiver of a veteran 13
who is discharged from the program under this subsection, 14
the Secretary shall— 15
‘‘(i) if the veteran meets the requirements of a 16
covered veteran under subsection (b), provide to 17
such caregiver the option of enrolling in the program 18
of general caregiver support services under such sub-19
section; 20
‘‘(ii) assess the veteran or caregiver for partici-21
pation in any other available program of the Depart-22
ment for home- and community-based services (in-23
cluding the programs specified in section 1720L of 24
this title) for which the veteran or caregiver may be 25 64 
•HR 8371 EH
eligible and, with respect to the veteran, store (and 1
make accessible to the veteran) the results of such 2
assessment in the electronic medical record of the 3
veteran; and 4
‘‘(iii) provide to the veteran or caregiver written 5
information on any such program identified pursu-6
ant to the assessment under clause (ii), including in-7
formation about facilities, eligibility requirements, 8
and relevant contact information for each such pro-9
gram. 10
‘‘(B) The Secretary shall, to the extent practicable, 11
provide to a veteran or family caregiver the option of ob-12
taining clinically appropriate services under any other 13
available program of the Department for home- and com-14
munity-based services (including the programs specified in 15
section 1720L of this title) for which the veteran or family 16
caregiver may be eligible prior to discharging the veteran 17
or family caregiver from the program under this sub-18
section. 19
‘‘(C) For each veteran or family caregiver who is dis-20
charged from the program under this subsection, a care-21
giver support coordinator shall provide for a smooth and 22
personalized transition from such program to an appro-23
priate program of the Department for home- and commu-24
nity-based services (including the programs specified in 25 65 
•HR 8371 EH
section 1720L of this title), including by integrating care-1
giver support across programs.’’. 2
(2) A
PPLICABILITY.—The amendments made 3
by paragraph (1) shall apply with respect to denials 4
and discharges occurring on or after the date that 5
is 180 days after the date of the enactment of this 6
Act. 7
(3) T
ECHNICAL AND CONFORMING AMEND -8
MENTS.—Section 1720G(d) of such title is amend-9
ed— 10
(A) by striking ‘‘or a covered veteran’’ 11
each place it appears and inserting ‘‘, a veteran 12
denied or discharged as specified in paragraph 13
(14) of such subsection, or a covered veteran’’; 14
and 15
(B) by striking ‘‘under subsection (a), 16
means’’ each place it appears and inserting 17
‘‘under subsection (a) or a veteran denied or 18
discharged as specified in paragraph (14) of 19
such subsection, means’’. 20
(b) C
ONFORMITY OF RESPITECAREACROSSPRO-21
GRAMS.—Section 1720G of title 38, United States Code, 22
as amended by subsection (a)(3), is further amended— 23
(1) in subsection (a)(3)— 24 66 
•HR 8371 EH
(A) by amending subparagraph (A)(ii)(III) 1
to read as follows: 2
‘‘(III) covered respite care of not less than 3
30 days annually;’’; and 4
(B) by striking subparagraph (B) and re-5
designating subparagraphs (C) and (D) as sub-6
paragraphs (B) through (C), respectively; and 7
(2) by amending subsection (b)(3)(A)(iii) to 8
read as follows: 9
‘‘(iii) Covered respite care of not less than 30 10
days annually.’’; and 11
(3) in subsection (d)— 12
(A) by redesignating paragraphs (2) 13
through (4) as paragraphs (3) through (5), re-14
spectively; and 15
(B) by inserting after paragraph (1) the 16
following new paragraph: 17
‘‘(2) The term ‘covered respite care’ means, 18
with respect to a caregiver of a veteran, respite care 19
under section 1720B of this title that— 20
‘‘(A) is medically and age appropriate for 21
the veteran (including 24-hour per day care of 22
the veteran commensurate with the care pro-23
vided by the caregiver); and 24
‘‘(B) includes in-home care.’’. 25 67 
•HR 8371 EH
(c) REVIEWRELATING TOCAREGIVERCONTACT.— 1
The Secretary shall conduct a review of the capacity of 2
the Department to establish a streamlined system for con-3
tacting all caregivers enrolled in the program of general 4
caregiver support services under section 1720G(b) of title 5
38, United States Code, to provide to such caregivers pro-6
gram updates and alerts relating to emerging services for 7
which such caregivers or the veterans for which they pro-8
vide care may be eligible. 9
SEC. 125. IMPROVEMENTS TO PROGRAM OF COMPREHEN-10
SIVE ASSISTANCE FOR FAMILY CAREGIVERS. 11
Section 1720G(a) of title 38, United States Code, as 12
amended by section 124, is further amended— 13
(1) in paragraph (12)— 14
(A) in subparagraph (A), by inserting ‘‘, 15
which shall include all criteria used to deter-16
mine eligibility for such assistance and, in the 17
case of a completed evaluation, how such cri-18
teria were used to evaluate information pro-19
vided in assessments to determine such eligi-20
bility’’ before the period at the end; and 21
(B) in subparagraph (C)(i), by striking 22
‘‘who submits’’ and all that follows through the 23
end of the clause and inserting the following: 24
‘‘who— 25 68 
•HR 8371 EH
‘‘(I) submits an application for the pro-1
gram established under paragraph (1); or 2
‘‘(II) is being reassessed for eligibility to 3
continue in such program.’’; and 4
(2) by adding at the end the following new 5
paragraph: 6
‘‘(15)(A) Not less frequently than annually, the Sec-7
retary shall submit to the Committees on Veterans’ Affairs 8
of the Senate and the House of Representatives a com-9
prehensive report on the program required by paragraph 10
(1) that includes, with respect to one-year period pre-11
ceding the date of the submission of such report, the fol-12
lowing: 13
‘‘(i) The number of applications received for 14
such program. 15
‘‘(ii) The number, disaggregated by race, sex, 16
and era and branch of service in the Armed Forces 17
of the applicant, of— 18
‘‘(I) approvals of such applications; and 19
‘‘(II) denials of such applications. 20
‘‘(iii) The number of reassessments conducted 21
for such program. 22
‘‘(iv) An identification of each decision made 23
with respect to a reassessment conducted for such 24
program, disaggregated by decisions resulting in— 25 69 
•HR 8371 EH
‘‘(I) disenrollment, including removal, dis-1
charge, or voluntary withdrawal; 2
‘‘(II) tier reduction; and 3
‘‘(III) tier continuation. 4
‘‘(v) The number of appeals of decisions made 5
with respect to such program, disaggregated by type 6
of appeal. 7
‘‘(vi) With respect to each appeal described in 8
clause (v), the decision rendered, if any. 9
‘‘(vii) A description of all tools used in assess-10
ments conducted for such program, including an ex-11
planation of how and by whom such tools are admin-12
istered. 13
‘‘(viii) A description of procedures used under 14
such program for reviewing and integrating clinical 15
records from health care providers that includes an 16
explanation of how such records are used in deter-17
minations of eligibility for such program. 18
‘‘(ix) A description of procedures available 19
under such program for health care providers to 20
communicate medical opinions to the teams con-21
ducting assessments to determine eligibility for such 22
program, including health care providers in the pri-23
vate sector and health care providers specified in 24
subsection (c) of section 1703 of this title. 25 70 
•HR 8371 EH
‘‘(x) A description of information technology 1
systems and processes used under such program to 2
upload and integrate all clinical records from all 3
non-Department providers, including providers in 4
the private sector and providers under the Veterans 5
Community Care Program established under such 6
section. 7
‘‘(B) The Secretary shall ensure that all data in-8
cluded in a report under subparagraph (A)— 9
‘‘(i) relating to a decision made under the pro-10
gram required by paragraph (1), are disaggregated 11
by the specific reason for the decision; 12
‘‘(ii) relating to a veteran, include comprehen-13
sive demographic information of the veteran, includ-14
ing the time period of the injuries, if any, of the vet-15
eran and the Veterans Integrated Service Network 16
in which the veteran is located; and 17
‘‘(iii) with respect to eligibility determinations 18
relating to a serious injury of a veteran, specify— 19
‘‘(I) how many such determinations relate 20
to the ability of the veteran to perform activi-21
ties of daily living; and 22
‘‘(II) how many such determinations relate 23
to the need of a veteran for supervision and 24
protection. 25 71 
•HR 8371 EH
‘‘(C) The Secretary shall provide the data under 1
paragraph (B) pursuant to Federal laws and in a manner 2
that is wholly consistent with applicable Federal privacy 3
and confidentiality laws, including but the Privacy Act (5 4
U.S.C. 552a), the Health Insurance Portability and Ac-5
countability Act (Public Law 104–191; 42 U.S.C. 201 6
note) and regulations (title 45, Code of Federal Regula-7
tions, parts 160 and 164, or successor regulations), and 8
sections 5701, 5705, and 7332 of this title to ensure that 9
the provided data, or some portion of the data, will not 10
undermine the anonymity of a veteran.’’. 11
SEC. 126. IMPROVEMENTS RELATING TO HOMEMAKER AND 12
HOME HEALTH AIDE PROGRAM. 13
(a) P
ILOTPROGRAM FOR COMMUNITIES WITH 14
S
HORTAGE OFHOMEHEALTHAIDES.— 15
(1) P
ROGRAM.—Beginning not later than 18 16
months after the date of the enactment of this Act, 17
the Secretary shall carry out a three-year pilot pro-18
gram under which the Secretary shall provide home-19
maker and home health aide services to veterans 20
who reside in communities with a shortage of home 21
health aides. 22
(2) L
OCATIONS.—The Secretary shall select not 23
fewer than five geographic locations in which the 24
Secretary determines there is a shortage of home 25 72 
•HR 8371 EH
health aides at which to carry out the pilot program 1
under paragraph (1). 2
(3) N
URSING ASSISTANTS.— 3
(A) I
N GENERAL.—In carrying out the 4
pilot program under paragraph (1), the Sec-5
retary may hire nursing assistants as new em-6
ployees of the Department of Veterans Affairs, 7
or reassign nursing assistants who are existing 8
employees of the Department, to provide to vet-9
erans in-home care services (including basic 10
tasks authorized by the State certification of 11
the nursing assistant) under the pilot program, 12
in lieu of or in addition to the provision of such 13
services through non-Department home health 14
aides. 15
(B) R
ELATIONSHIP TO HOME -BASED PRI-16
MARY CARE PROGRAM .—Nursing assistants 17
hired or reassigned under subparagraph (A) 18
may provide services to a veteran under the 19
pilot program under paragraph (1) while serv-20
ing as part of a health care team for the vet-21
eran under the Home-Based Primary Care pro-22
gram. 23
(4) R
EPORT TO CONGRESS.—Not later than one 24
year before the date of the termination of the pilot 25 73 
•HR 8371 EH
program under paragraph (1), the Secretary shall 1
submit to the Committees on Veterans’ Affairs of 2
the House of Representatives and the Senate a re-3
port that includes— 4
(A) a statement of the results of such pilot 5
program; and 6
(B) an assessment of the feasibility and 7
advisability of— 8
(i) extending such pilot program; or 9
(ii) making such pilot program a per-10
manent program of the Department of 11
Veterans Affairs. 12
(b) R
EPORT ONUSE OFFUNDS.—Not later than one 13
year after the date of the enactment of this Act, the Sec-14
retary of Veterans Affairs shall submit to the Committees 15
on Veterans’ Affairs of the House of Representatives and 16
the Senate a report containing, with respect to the period 17
beginning in fiscal year 2012 and ending in fiscal year 18
2024, the following: 19
(1) An identification of the amount of funds 20
that were included in a budget of the Department of 21
Veterans Affairs during such period for the provision 22
of in-home care to veterans under the Homemaker 23
and Home Health Aide program but were not ex-24
pended for such provision, disaggregated by medical 25 74 
•HR 8371 EH
center of the Department for which such unex-1
pended funds were budgeted (if such disaggregation 2
is possible). 3
(2) To the extent practicable, an identification 4
of the number of veterans for whom, during such pe-5
riod, the hours during which a home health aide was 6
authorized to provide services to the veteran under 7
the Homemaker and Home Health Aide program 8
were reduced for a reason other than a change in 9
the health care needs of the veteran, and a detailed 10
description of the reasons why any such reductions 11
may have occurred. 12
(c) U
PDATEDGUIDANCE ONPROGRAM.—Not later 13
than one year after the date of the enactment of this Act, 14
the Secretary shall issue updated guidance for the Home-15
maker and Home Health Aide program. Such updated 16
guidance shall include the following: 17
(1) A process for the transition of veterans 18
from the Homemaker and Home Health Aide pro-19
gram to other covered programs. 20
(2) A requirement for the directors of the med-21
ical facilities of the Department to complete such 22
process whenever a veteran with care needs has been 23
denied services from home health agencies under the 24
Homemaker and Home Health Aide program as a 25 75 
•HR 8371 EH
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 76 
•HR 8371 EH
(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 77 
•HR 8371 EH
(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 78 
•HR 8371 EH
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 79 
•HR 8371 EH
(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 80 
•HR 8371 EH
(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 81 
•HR 8371 EH
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 82 
•HR 8371 EH
retary of Veterans Affairs and the Committees on 1
Veterans’ Affairs of House of Representatives and 2
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 83 
•HR 8371 EH
(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 84 
•HR 8371 EH
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 85 
•HR 8371 EH
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 86 
•HR 8371 EH
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 87 
•HR 8371 EH
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 88 
•HR 8371 EH
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 89 
•HR 8371 EH
(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 90 
•HR 8371 EH
(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
OLLABORATION TO IMPROVEHOME- ANDCOM-23
MUNITY-BASEDSERVICES.— 24
(1) R
ECOMMENDATIONS .— 25 91 
•HR 8371 EH
(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 92 
•HR 8371 EH
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 93 
•HR 8371 EH
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 94 
•HR 8371 EH
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 95 
•HR 8371 EH
(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 publically 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 96 
•HR 8371 EH
(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 97 
•HR 8371 EH
(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 98 
•HR 8371 EH
(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 99 
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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 24 100 
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‘‘(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)— 25 101 
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(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 25 102 
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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— 25 103 
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‘‘(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-24 104 
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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. 25 105 
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‘‘(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 23 106 
•HR 8371 EH
‘‘(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 25 107 
•HR 8371 EH
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. 23 108 
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(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-25 109 
•HR 8371 EH
cause the payment such compensation would have 1
exceeded an applicable cap on annual compensation. 2
(2) P
ERIOD SPECIFIED.—The period specified 3
in this paragraph is the period beginning on Janu-4
ary 8, 2006, and ending on December 31, 2017. 5
(3) E
XCLUSION.—Compensation authorized 6
under this subsection shall not be included in the 7
calculation of any aggregate limit on compensation 8
for a covered employee for the year in which it is 9
paid. 10
(4) C
HARGING OF COMPENSATION .—Compensa-11
tion authorized under this subsection shall be 12
charged to the appropriate medical care appropria-13
tion account of the Department of Veterans Affairs 14
for the fiscal year in which the work was performed 15
except as follows: 16
(A) In the case of an account that has 17
closed pursuant to section 1552 of title 31, 18
United States Code, the compensation shall be 19
charged to a current appropriation account in 20
accordance with section 1553 of such title. 21
(B) In the case of an expired account that 22
has not closed, if charging the compensation to 23
the expired account would cause such account 24
to have a negative unliquidated or unexpended 25 110 
•HR 8371 EH
balance, the compensation may be charged to a 1
current appropriation account available for the 2
same purpose. 3
(5) D
EFINITIONS.—In this subsection: 4
(A) The term ‘‘compensation’’ means any 5
pay, including salary, awards, and incentives. 6
(B) The term ‘‘covered employee’’ means a 7
physician, podiatrist, or dentist subject to mar-8
ket pay under section 7431 of title 38, United 9
States Code. 10
SEC. 143. REIMBURSEMENT OF AMBULANCE COST FOR 11
CARE FOR CERTAIN RURAL VETERANS. 12
(a) I
NGENERAL.—The Secretary of Veterans Affairs 13
shall pay, or reimburse a covered veteran for, the cost of 14
transporting the veteran by ambulance, including air am-15
bulance, from a covered location to a provider of the De-16
partment of Veterans Affairs, a non-Department provider, 17
or the nearest hospital that can meet the needs of the vet-18
eran (including a hospital that compacts with the Indian 19
Health Service) for covered care. 20
(b) A
MOUNTCOVERED.—The maximum cumulative 21
amount covered under this section for a covered veteran 22
is $46,000. 23
(c) S
UNSET.—This section shall cease to be effective 24
on September 30, 2026. 25 111 
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(d) DEFINITIONS.—In this section: 1
(1) The term ‘‘covered care’’ means care for a 2
veteran eligible for care provided by the Department 3
of Veterans Affairs under title 38, United States 4
Code, or any other law administered by the Sec-5
retary of Veterans Affairs, even if the care associ-6
ated with the transport described in subsection (a) 7
is not authorized by the Department. 8
(2) The term ‘‘covered location’’ means a loca-9
tion that is— 10
(A) in a State that is 100 miles or more 11
from the nearest medical center of the Depart-12
ment of Veterans Affairs; and 13
(B) in an area rated as a 10 or higher 14
under the rural-urban commuting areas coding 15
system of the Department of Agriculture. 16
(3) The term ‘‘covered veteran’’ means a vet-17
eran who— 18
(A) has a service-connected disability rated 19
by the Secretary as between 0 and 30 percent 20
disabling; 21
(B) is not eligible for payments or reim-22
bursements for beneficiary travel or other 23
transportation under the laws administered by 24 112 
•HR 8371 EH
the Secretary of Veterans Affairs, other than 1
under this section; and 2
(C) is not entitled to care or services under 3
a non-Department of Veterans Affairs health- 4
plan contract. 5
(4) The term ‘‘health-plan contract’’ has the 6
meaning given that term in section 1725 of title 38, 7
United States Code. 8
(5) The term ‘‘service-connected’’ has the 9
meaning given that term in section 101 of such title. 10
SEC. 144. PILOT PROGRAM TO FURNISH DENTAL CARE 11
FROM THE DEPARTMENT OF VETERANS AF-12
FAIRS TO CERTAIN VETERANS DIAGNOSED 13
WITH ISCHEMIC HEART DISEASE. 14
(a) I
NGENERAL.—Beginning not later than one year 15
after the date of the enactment of this Act, the Secretary 16
of Veterans Affairs shall carry out a two-year pilot pro-17
gram (in this section referred to as the ‘‘pilot program’’) 18
under which the Secretary shall furnish covered care to 19
covered veterans through means that include the use of 20
community care. 21
(b) L
OCATIONS.— 22
(1) I
N GENERAL.—The Secretary shall select 23
not more than four States in which to carry out the 24
pilot program. 25 113 
•HR 8371 EH
(2) SELECTION CRITERIA.—In selecting States 1
under paragraph (1), the Secretary shall prioritize 2
States in which— 3
(A) the Department of Veterans Affairs 4
serves a high proportion, as determined by the 5
Secretary, of veterans residing in rural or high-6
ly rural areas (as determined through the use 7
of the Rural-Urban Commuting Areas coding 8
system of the Department of Agriculture); 9
(B) dental clinics operated by the Depart-10
ment of Veterans Affairs currently utilize tele-11
dentistry; 12
(C) the Department of Veterans Affairs 13
does not currently operate a dental clinic; or 14
(D) the Secretary determines a large per-15
centage of veterans enrolled in the system of 16
annual patient enrollment of the Department of 17
Veterans Affairs established and operated under 18
paragraphs (1) or (2) of section 1705(a) of title 19
38, United States Code, visit emergency rooms 20
for dental emergencies at high rates. 21
(c) P
ARTICIPATIONLIMITATION.—Participation in a 22
pilot program established pursuant to this section shall be 23
limited to a covered veteran who receives health care in 24 114 
•HR 8371 EH
a facility of the Department located in a State selected 1
under subsection (b). 2
(d) U
SE OFCERTAINMETHODS TO PROVIDE 3
C
ARE.— 4
(1) M
OBILE DENTAL CLINICS.—In carrying out 5
the pilot program, the Secretary shall test the effi-6
cacy of mobile dental clinics to service rural areas 7
that do not have a population base to warrant a full- 8
time clinic but where there are covered veterans in 9
need of dental care. 10
(2) H
OME-BASED DENTAL CARE .—In carrying 11
out the pilot program, the Secretary shall test the 12
efficacy of portable dental care units to service rural 13
veterans in their homes, as the Secretary considers 14
medically appropriate. 15
(e) A
DMINISTRATION.— 16
(1) C
OMMUNITY CARE NETWORK REVIEW .— 17
(A) I
N GENERAL.—Before commencing the 18
pilot program, the Secretary shall work with 19
third party administrators to conduct a review 20
of dental providers who are part of the commu-21
nity care network of the Department in each 22
State selected under subsection (b)(1) to en-23
sure— 24 115 
•HR 8371 EH
(i) dental providers who are no longer 1
accepting patients from the Department— 2
(I) are not still listed as pro-3
viders accepting referrals from the 4
Department; and 5
(II) are not sent referrals from 6
the Department; and 7
(ii) dental providers participating in 8
each such network are capable of receiving 9
an influx of patients from the Department 10
under the pilot program. 11
(B) E
XPANSION OF NETWORK .—If, pursu-12
ant to a review under subparagraph (A), the 13
Secretary determines the community care net-14
work in a State selected under subsection (b)(1) 15
is not capable of receiving an influx of patients 16
under the pilot program, the Secretary shall co-17
ordinate with the Third Party Administrator 18
for such State to ensure the dental provider 19
network of such community care network is suf-20
ficiently expanded before the initiation of the 21
pilot program. 22
(2) N
OTICE TO COVERED VETERANS .—In car-23
rying out the pilot program, the Secretary shall in-24
form all covered veterans in States selected under 25 116 
•HR 8371 EH
subsection (b)(1) of the covered care available under 1
the pilot program. 2
(3) L
OSS OF ELIGIBILITY.—Any veteran par-3
ticipating in the pilot program who ceases to be a 4
covered veteran shall be removed from the pilot pro-5
gram on the date that is 90 days after the Secretary 6
determines the participant is no longer a covered 7
veteran. 8
(4) C
ONTINUITY OF CARE.— 9
(A) I
N GENERAL.—Upon the termination 10
of the pilot program, the Secretary shall provide 11
to all veterans participating in the pilot pro-12
gram at the time of such termination— 13
(i) information on how to enroll in the 14
dental insurance plan of the Department of 15
Veterans Affairs under section 1712C of 16
title 38, United States Code; 17
(ii) if appropriate, information on the 18
VETSmile program of the Department of 19
Veterans Affairs, or any successor pro-20
gram; or 21
(iii) contact information for dental 22
providers in the surrounding community 23
who provide low- or no-cost dental care 24 117 
•HR 8371 EH
and whom the Secretary has confirmed are 1
available to take on new patients. 2
(B) C
ONTINUATION OF TREATMENT 3
PLAN.—Any veteran participating in the pilot 4
program may continue to receive services under 5
the pilot program after the termination of the 6
pilot program to complete a treatment plan 7
commenced under the pilot program, as deter-8
mined necessary by the Secretary. 9
(f) R
EPORTS.— 10
(1) A
NNUAL REPORT.—Not later than one year 11
after the commencement of the pilot program, and 12
annually thereafter for the duration of the pilot pro-13
gram, the Secretary of Veterans Affairs shall submit 14
to the Committees on Veterans’ Affairs of the House 15
of Representatives and the Senate a report on the 16
pilot program that includes— 17
(A) an identification of the States partici-18
pating in the pilot program; 19
(B) a description of the implementation 20
and operation of the pilot program; 21
(C) the number of participants in the pilot 22
program, disaggregated by— 23
(i) State; and 24
(ii) disability rating; 25 118 
•HR 8371 EH
(D) an identification of any barriers or 1
challenges to implementing the pilot program; 2
(E) aggregated feedback from participants 3
in the pilot program, including from interviews 4
and surveys; 5
(F) the average annual cost of providing 6
covered care to a participant in the pilot pro-7
gram, disaggregated by— 8
(i) State; 9
(ii) disability rating; and 10
(iii) whether the care was provided 11
through the community care network or 12
through a provider of the Department; 13
(G) an analysis of the communication and 14
collaboration of the Department with Third 15
Party Administrators and community care den-16
tal providers, disaggregated by State; 17
(H) an analysis of any cost savings by the 18
Department with respect to the treatment of 19
ischemic heart disease; 20
(I) an assessment of the impact of the 21
pilot program on appointments for care, pre-22
scriptions, hospitalizations, emergency room vis-23
its, wellness, employability, satisfaction, and 24
perceived quality of life of covered veterans re-25 119 
•HR 8371 EH
lated to their diagnosis of ischemic heart dis-1
ease; 2
(J) an analysis and assessment of the effi-3
cacy of mobile clinics and portable dental care 4
units, to the extent such modalities are used, to 5
service the needs of covered veterans under the 6
pilot program; 7
(K) an analysis and assessment of the 8
usage of teledentistry to service the needs of 9
covered veterans under the pilot program, to in-10
clude a cost benefit analysis of such services; 11
and 12
(L) such other matters as the Secretary 13
considers appropriate. 14
(2) F
INAL REPORT.—Not later than 90 days 15
before the completion of the pilot program, the Sec-16
retary shall submit to the Committees on Veterans’ 17
Affairs of the House of Representatives and the Sen-18
ate a report on the pilot program that— 19
(A) includes the matters required under 20
paragraph (1); 21
(B) includes recommendations on whether 22
the pilot program should be continued, ex-23
panded, or adopted throughout the Department; 24
and 25 120 
•HR 8371 EH
(C) indicates whether the Secretary re-1
quests action by Congress to make the pilot 2
program permanent. 3
(g) I
MPACT ONCOMMUNITYCARE.—Participants in 4
the pilot program shall be able to access covered care in 5
the community under section 1703 of title 38, United 6
States Code. 7
(h) D
EFINITIONS.—In this section: 8
(1) The term ‘‘covered care’’ means dental care 9
that is consistent with the dental services and treat-10
ment furnished by the Secretary of Veterans Affairs 11
to veterans pursuant to section 1712(a)(1)(G) of 12
title 38, United States Code. 13
(2) The term ‘‘covered veteran’’ means a vet-14
eran who— 15
(A) is enrolled in the system of annual pa-16
tient enrollment of the Department established 17
and operated under paragraphs (1) or (2) of 18
section 1705(a) of title 38, United States Code; 19
(B) is not eligible for dental services and 20
treatment and related dental appliances under 21
the laws administered by the Secretary as of 22
the date of the enactment of this Act; and 23
(C) has a diagnosis of ischemic heart dis-24
ease. 25 121 
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(3) The term ‘‘Third Party Administrator’’ has 1
the meaning given such term in section 1703F of 2
such title. 3
SEC. 145. DOCUMENTATION OF PREFERENCES OF VET-4
ERANS FOR SCHEDULING OF APPOINTMENTS 5
FOR HEALTH CARE UNDER LAWS ADMINIS-6
TERED BY SECRETARY OF VETERANS AF-7
FAIRS. 8
(a) I
NGENERAL.—Not later than one year after the 9
date of the enactment of this Act, the Secretary of Vet-10
erans Affairs shall develop a mechanism to solicit informa-11
tion regarding the preference of veterans enrolled in the 12
system of annual patient enrollment of the Department 13
of Veterans Affairs established and operated under section 14
1705(a) of title 38, United States Code, for scheduling 15
of appointments for health care and related services under 16
the laws administered by the Secretary, including through 17
non-Department providers. 18
(b) D
OCUMENTATION OF PREFERENCE.—Pref-19
erences provided voluntarily by a veteran pursuant to sub-20
section (a) shall be documented on My HealtheVet or an-21
other system designated by the Secretary that allows the 22
veteran to view and change such preferences at any time. 23
(c) I
NCLUSION INPREFERENCE.—Preferences solic-24
ited under subsection (a) shall include the following: 25 122 
•HR 8371 EH
(1) How and when the veteran prefers to be 1
contacted about an appointment for health care. 2
(2) Whether the veteran prefers to schedule ap-3
pointments without the assistance of the Depart-4
ment, if able. 5
(3) Whether the veteran prefers to select a pro-6
vider without the assistance of the Department, if 7
able. 8
(4) Whether the veteran prefers appointments 9
to be scheduled during certain days or times. 10
(d) U
SE OFPREFERENCE.—The Secretary shall 11
make the preferences provided under subsection (a) easily 12
accessible to medical support assistants and other staff of 13
the Department, or non-Department staff, as the Sec-14
retary determines appropriate, who assist in the appoint-15
ment scheduling process. 16
(e) D
EPLOYMENT OFMECHANISM.— 17
(1) I
N GENERAL.—Beginning after the date on 18
which the Secretary develops the mechanism re-19
quired under subsection (a), the Secretary shall— 20
(A) test the mechanism in not fewer than 21
three geographically diverse Veterans Inte-22
grated Service Networks; and 23
(B) gather feedback about the effectiveness 24
of such mechanism from veterans, medical sup-25 123 
•HR 8371 EH
port assistants, staff and other stakeholders as 1
the Secretary determines appropriate. 2
(2) L
IMITATION.—The Secretary may not im-3
plement such mechanism across the Veterans Health 4
Administration of the Department before the Sec-5
retary addresses the feedback described in para-6
graph (1)(B). 7
SEC. 146. STAFFING MODEL AND PERFORMANCE METRICS 8
FOR CERTAIN EMPLOYEES OF THE DEPART-9
MENT OF VETERANS AFFAIRS. 10
(a) S
TAFFINGMODEL.— 11
(1) I
N GENERAL.—Not later than one year 12
after the date of the enactment of this Act, the Sec-13
retary of Veterans Affairs shall— 14
(A) develop, validate, and implement a 15
staffing model for the Office of Integrated Vet-16
eran Care of the Department of Veterans Af-17
fairs, or successor office, Veterans Integrated 18
Services Networks, and medical centers of the 19
Department that includes appropriate target 20
staffing levels nationally, regionally, and locally 21
to ensure timely access to care and effectively 22
oversee the provision of care by the Depart-23
ment, whether at a facility of the Department 24
or through a non-Department provider; and 25 124 
•HR 8371 EH
(B) provide to Congress a briefing on such 1
staffing model, which shall include— 2
(i) the metrics and measures used by 3
the Secretary in developing such staffing 4
model; 5
(ii) an analysis of how such staffing 6
model compares to the staffing models of 7
other relevant Government-owned and pri-8
vate sector health care systems; and 9
(iii) an estimate of the portion of the 10
roles in such staffing model that will be 11
filled by contracted staff at any given time. 12
(2) R
EPORT ON IMPLEMENTATION OF STAFF -13
ING MODEL.—Not later than one year after the date 14
on which the Secretary implements the staffing 15
model required under paragraph (1), the Secretary 16
shall submit to Congress and the Comptroller Gen-17
eral of the United States a report containing— 18
(A) an update on such implementation; 19
and 20
(B) information on the outcomes yielded 21
by such staffing model in terms of improved ac-22
cess to care for veterans and improved compli-23
ance with relevant laws, regulations, policy di-24
rectives, and guidance governing access to care. 25 125 
•HR 8371 EH
(b) PERFORMANCEMETRICS.— 1
(1) I
N GENERAL.—Not later than one year 2
after the date of the enactment of this Act, the Sec-3
retary shall develop and implement a plan, with an 4
appropriate tracking system, to incorporate appro-5
priate standardized performance metrics and over-6
sight measures within the performance appraisal 7
systems for employees of the Department specified 8
in paragraph (2). 9
(2) E
MPLOYEES OF THE DEPARTMENT SPECI -10
FIED.—Employees of the Department specified in 11
this paragraph are employees who are responsible 12
for ensuring timely access to care from the Depart-13
ment, compliance with relevant statutes and regula-14
tions relating to the provision of care, including sec-15
tion 1703 of title 38, United States Code, and over-16
seeing the provision of care, whether at a facility of 17
the Department or through a non-Department pro-18
vider, including employees within the Office of Inte-19
grated Veteran Care of the Department, or suc-20
cessor office, employees of a Veterans Integrated 21
Service Network, and employees of a medical center 22
of the Department. 23
(3) R
EPORT ON IMPLEMENTATION OF PER -24
FORMANCE METRICS .—Not later than one year after 25 126 
•HR 8371 EH
implementing the performance metrics required 1
under paragraph (1), the Secretary shall submit to 2
Congress and the Comptroller General of the United 3
States a report containing— 4
(A) an update on such implementation; 5
and 6
(B) information on the outcomes yielded 7
by such performance metrics in terms of im-8
proved access to care for veterans and improved 9
compliance with relevant laws, policy directives, 10
and guidance governing access to care. 11
(c) GAO R
EPORT.—Not later than two years after 12
the later of the date on which the Comptroller General 13
receives the report under subsection (a)(2) or the report 14
under subsection (b)(3), the Comptroller General shall 15
submit to Congress a report that includes— 16
(1) an assessment of the performance of the Of-17
fice of Integrated Veteran Care of the Department, 18
or successor office, in improving access to care for 19
veterans in facilities of the Department and pursu-20
ant to section 1703 of title 38, United States Code; 21
and 22
(2) such recommendations as the Comptroller 23
General considers appropriate with respect to im-24 127 
•HR 8371 EH
proving access to the care described in paragraph 1
(1) for veterans. 2
SEC. 147. ONLINE HEALTH EDUCATION PORTAL FOR VET-3
ERANS ENROLLED IN PATIENT ENROLLMENT 4
SYSTEM OF DEPARTMENT OF VETERANS AF-5
FAIRS. 6
Not later than one year after the date of the enact-7
ment of this Act, the Secretary of Veterans Affairs shall 8
establish, on an Internet website of the Department, a 9
health education portal that includes interactive edu-10
cational modules to ensure veterans enrolled in the patient 11
enrollment system of the Department of Veterans Affairs 12
established and operated under section 1705(a) of title 38, 13
United States Code, understand the basic health care eli-14
gibilities and entitlements of veterans under the laws ad-15
ministered by the Secretary, including under the Veterans 16
Community Care Program under section 1703 of such 17
title. 18
SEC. 148. LIMITATION ON DETAIL OF DIRECTORS OF MED-19
ICAL CENTERS OF DEPARTMENT OF VET-20
ERANS AFFAIRS TO DIFFERENT POSITIONS. 21
(a) N
OTIFICATION.— 22
(1) I
N GENERAL.—Not later than 90 days after 23
detailing a director of a medical center of the De-24
partment of Veterans Affairs to a different position 25 128 
•HR 8371 EH
within the Department, the Secretary of Veterans 1
Affairs shall notify the Committee on Veterans’ Af-2
fairs of the Senate and the Committee on Veterans’ 3
Affairs of the House of Representatives of such de-4
tail. 5
(2) M
ATTERS TO BE INCLUDED .—The notifica-6
tion required by paragraph (1) shall include, with re-7
spect to a director of a medical center who is de-8
tailed to a different position within the Department, 9
the following information: 10
(A) The location at which the director is 11
detailed. 12
(B) The position title of the detail. 13
(C) The estimated time the director is ex-14
pected to be absent from their duties at the 15
medical center. 16
(D) Such other information as the Sec-17
retary may determine appropriate. 18
(b) A
PPOINTMENT OFACTINGDIRECTOR.—Not later 19
than 120 days after detailing a director of a medical cen-20
ter of the Department to a different position within the 21
Department, the Secretary shall appoint an individual as 22
acting director of such medical center with all of the au-23
thority and responsibilities of the detailed director. 24 129 
•HR 8371 EH
(c) UPDATE ONDETAIL.—Not later than 120 days 1
after detailing a director of a medical center of the De-2
partment to a different position within the Department, 3
and not less frequently than every 30 days thereafter while 4
the detail is in effect or while the director position at the 5
medical center is vacant, the Secretary shall submit to the 6
Committee on Veterans’ Affairs of the Senate and the 7
Committee on Veterans’ Affairs of the House of Rep-8
resentatives an update regarding the status of the detail. 9
(d) R
ETURN TOPOSITION ORREASSIGNMENT.— 10
(1) I
N GENERAL.—Except as provided in para-11
graph (2), not later than 180 days after detailing a 12
director of a medical center of the Department to a 13
different position within the Department, for a rea-14
son other than an ongoing investigation or adminis-15
trative action with respect to the director, the Sec-16
retary shall— 17
(A) return the individual to the position as 18
director of the medical center; or 19
(B) reassign the individual from the posi-20
tion as director of the medical center and begin 21
the process of hiring a new director for such po-22
sition. 23
(2) W
AIVER.— 24 130 
•HR 8371 EH
(A) IN GENERAL.—The Secretary may 1
waive the requirement under paragraph (1) 2
with respect to an individual for successive 90- 3
day increments for a total period of not more 4
than 540 days from the original date the indi-5
vidual was detailed away from their position as 6
director of a medical center. 7
(B) N
OTIFICATION.—Not later than 30 8
days after exercising a waiver under subpara-9
graph (A), the Secretary shall notify Congress 10
of the waiver and provide to Congress informa-11
tion as to why the waiver is necessary. 12
SEC. 149. NATIONAL VETERAN SUICIDE PREVENTION AN-13
NUAL REPORT. 14
(a) N
ATIONALVETERANSUICIDEPREVENTIONAN-15
NUALREPORT.— 16
(1) I
N GENERAL.—Not later than 18 months 17
after the date of the enactment of this Act, and not 18
later than September 30 of each year thereafter, the 19
Secretary of Veterans Affairs shall submit to the ap-20
propriate congressional committees and publish on a 21
publicly available website of the Department of Vet-22
erans Affairs a report to be known as the ‘‘National 23
Veteran Suicide Prevention Annual Report’’. 24
(2) E
XTENSION.— 25 131 
•HR 8371 EH
(A) IN GENERAL.—If the Secretary re-1
quires an extension of the deadline for a report 2
under subsection (a), the Secretary shall submit 3
to the appropriate congressional committees a 4
written request for such an extension. 5
(B) E
LEMENTS.—Each written request 6
under paragraph (1) for an extension for a re-7
port shall include the following: 8
(i) The rationale for the delay in the 9
submission of the report. 10
(ii) An explanation of the need for an 11
extension. 12
(iii) A proposed amended date for the 13
submission and publication of the report. 14
(3) B
RIEFING.—With respect to each report re-15
quired under paragraph (1), the Secretary shall, be-16
fore the date on which the Secretary submits such 17
report, provide to the appropriate congressional com-18
mittees a briefing on such report. 19
(4) E
LEMENTS.— 20
(A) I
N GENERAL.—Each report required 21
under paragraph (1) shall include— 22
(i) the findings of the national anal-23
ysis of veteran suicide rates for the latest 24
year for which data is available; 25 132 
•HR 8371 EH
(ii) an identification of trends, if any, 1
demonstrated by such data; and 2
(iii) a comparison of such data to data 3
on veteran suicide rates during preceding 4
years. 5
(B) A
DDITIONAL ELEMENTS .—Each report 6
under paragraph (1) shall include, for the year 7
covered by the report, the following: 8
(i) Suicide rates of veterans 9
disaggregated by age, gender, and race or 10
ethnicity. 11
(ii) Trends in suicide rates of veterans 12
compared to engagement of those veterans 13
with health care from the Veterans Health 14
Administration, including an examination 15
of trends in suicide rates or deaths 16
among— 17
(I) veterans who have recently re-18
ceived health care from the Veterans 19
Health Administration as compared to 20
veterans who have never received 21
health care from the Veterans Health 22
Administration; 23
(II) veterans who are enrolled in 24
the patient enrollment system of the 25 133 
•HR 8371 EH
Department of Veterans Affairs under 1
section 1705(a) of title 38, United 2
States Code, as compared to veterans 3
who have never enrolled in such sys-4
tem; 5
(III) veterans who have recently 6
used services from a Vet Center as 7
compared to veterans who have never 8
used such services; 9
(IV) to the extent practicable, 10
veterans who have a diagnosis of sub-11
stance use disorder; and 12
(V) other groups of veterans re-13
lating to engagement with health care 14
from the Veterans Health Administra-15
tion, as the Secretary considers prac-16
ticable. 17
(iii) To the extent practicable, trends 18
in suicide rates of veterans compared to 19
engagement of those veterans with benefits 20
from the Veterans Benefits Administra-21
tion, including an examination of trends in 22
suicide rates or deaths among— 23
(I) veterans who are currently 24
using, have previously used, or have 25 134 
•HR 8371 EH
never used educational assistance 1
under the laws administered by the 2
Secretary; 3
(II) veterans who are currently 4
receiving, have previously received, or 5
have never received services or assist-6
ance under chapter 31 of title 38, 7
United States Code; 8
(III) with respect to compensa-9
tion under chapter 11 of such title— 10
(aa) veterans who were re-11
cipients of such compensation as 12
compared to veterans who never 13
applied for such compensation 14
prior to death; 15
(bb) veterans who had a 16
claim denied for such compensa-17
tion prior to death; 18
(cc) veterans who had a 19
pending claim for such com-20
pensation at time of death; and 21
(dd) veterans who had an 22
entitlement for such compensa-23
tion reduced prior to death; 24 135 
•HR 8371 EH
(IV) veterans who are currently 1
receiving or have never received pen-2
sion under chapter 15 of title 38, 3
United States Code; 4
(V) veterans who are currently 5
using, have recently used, or have 6
never used programs or services pro-7
vided by the Homeless Programs Of-8
fice of the Department, including an 9
examination of trends in suicide rates 10
or deaths among veterans who made 11
contact with such office but were de-12
nied or deemed ineligible for any such 13
program or service; 14
(VI) with respect to housing 15
loans guaranteed by the Secretary 16
under chapter 37 of title 38, United 17
States Code, veterans who are current 18
recipients of, were recent recipients of, 19
or have never received such a loan; 20
(VII) veterans owing debts to the 21
Department; 22
(VIII) veterans who were in-23
volved in a veterans treatment court 24 136 
•HR 8371 EH
program, whether they graduated suc-1
cessfully or not; and 2
(IX) veterans who were success-3
fully contacted, unsuccessfully con-4
tacted, or never contacted by the De-5
partment through the Solid Start pro-6
gram under section 6320 of title 38, 7
United States Code. 8
(C) S
TRATEGY AND RECOMMENDATIONS .— 9
(i) I
NITIAL REPORT.—The initial re-10
port under paragraph (1) shall include a 11
strategy and recommendations developed 12
by the Secretary of Veterans Affairs, in 13
collaboration with the Director of the Cen-14
ters for Disease Control and Prevention, 15
for— 16
(I) improving data collection at 17
the State and local levels to accurately 18
capture suicide deaths of veterans; 19
(II) improving the timeliness, ef-20
ficacy, and standardization of data re-21
porting on suicide deaths of veterans 22
at the Federal level, including by the 23
Centers for Disease Control and Pre-24 137 
•HR 8371 EH
vention and the Department of Vet-1
erans Affairs; 2
(III) improving the timeliness of 3
identification and analysis of suicide 4
deaths of veterans by Federal agen-5
cies, including the Centers for Disease 6
Control and Prevention, and the De-7
partment of Veterans Affairs; and 8
(IV) any other necessary process 9
improvements for improving the time-10
liness, efficacy, and standardization of 11
reporting of data relating to suicide 12
deaths of veterans, particularly with 13
respect to the annual report under 14
this section. 15
(ii) S
UBSEQUENT REPORTS .—Each 16
report after the initial report under para-17
graph (1) shall include updates on actions 18
taken to meet the strategy and rec-19
ommendations developed under subpara-20
graph (A). 21
(5) D
EFINITIONS.—In this subsection: 22
(A) The term ‘‘appropriate congressional 23
committees’’ means the Committees on Vet-24 138 
•HR 8371 EH
erans’ Affairs of the Senate and the House of 1
Representatives. 2
(B) The term ‘‘Vet Center’’ means a cen-3
ter for readjustment counseling and related 4
mental health services for veterans under sec-5
tion 1712A of title 38, United States Code. 6
(b) I
NDEPENDENT ASSESSMENT OFNATIONALVET-7
ERANSUICIDEPREVENTIONANNUALREPORT.— 8
(1) I
N GENERAL.—Not later than 90 days after 9
the date of the enactment of this Act, the Secretary 10
of Veterans Affairs shall enter into one or more con-11
tracts with a private sector entity described in para-12
graph (5) to conduct an independent assessment of 13
the National Veteran Suicide Prevention Annual Re-14
port required under subsection (a). 15
(2) F
REQUENCY.—The private sector entity or 16
entities carrying out the assessment required under 17
paragraph (1) shall complete such assessment not 18
later than 240 days after entering into the contract 19
described in such subsection and not less frequently 20
than every five years thereafter. 21
(3) E
LEMENTS.—Each assessment required 22
under paragraph (1) shall analyze the following: 23
(A) The methodology used by the Depart-24
ment to track, analyze, categorize, and report 25 139 
•HR 8371 EH
suicide deaths and suicide rates among vet-1
erans. 2
(B) Whether data sources used by the De-3
partment to compile data on suicide deaths and 4
suicide rates among veterans are accurately re-5
flecting such data. 6
(C) Vulnerabilities in the methodology used 7
by the Department that could lead to inac-8
curate counting of suicide deaths and suicide 9
rates among veterans. 10
(D) The ability of the Department to cross 11
reference suicide deaths and suicide rates 12
among veterans with trends in usage of pro-13
grams of the Veterans Health Administration 14
or the Veterans Benefits Administration or 15
other programs that could serve as widespread 16
protective factors against suicide. 17
(E) Improvements that could be made to 18
ensure the National Veteran Suicide Prevention 19
Annual Report required under subsection (a) is 20
accurate and comprehensive and provides in-21
sights for making improvements to the suicide 22
prevention efforts of the Department. 23
(4) R
EPORT ON ASSESSMENT .— 24 140 
•HR 8371 EH
(A) REPORT ON FINDINGS AND REC -1
OMMENDATIONS.—Not later than 60 days after 2
completing an assessment required by para-3
graph (1), the private sector entity or entities 4
carrying out the assessment shall submit to the 5
Secretary of Veterans Affairs and the Commit-6
tees on Veterans’ Affairs of the Senate and the 7
House of Representatives a report on the find-8
ings and recommendations of the private sector 9
entity or entities with respect to such assess-10
ment. 11
(B) R
EPORT ON PLANNED IMPROVE -12
MENTS.—Not later than 60 days after receiving 13
a report under paragraph (1) with respect to an 14
assessment required by paragraph (1), the Sec-15
retary shall submit to the Committees on Vet-16
erans’ Affairs of the Senate and the House of 17
Representatives a report on how the Depart-18
ment plans to improve the National Veteran 19
Suicide Prevention Annual Report required 20
under subsection (a) based on such assessment. 21
(5) P
RIVATE SECTOR ENTITY DESCRIBED .—A 22
private sector entity described in this paragraph is 23
a private entity that— 24 141 
•HR 8371 EH
(A) specializes in analyzing large-scale or-1
ganizational data collection and analysis efforts, 2
especially with respect to the health care sector; 3
and 4
(B) has experience and proven outcomes in 5
optimizing the accuracy and comprehensiveness 6
of data collection and analysis related to sui-7
cide. 8
(c) R
EPORT ONADDITIONALBENEFITS ANDSERV-9
ICESFROMDEPARTMENT OF VETERANSAFFAIRS TO 10
P
REVENTVETERANSUICIDE.— 11
(1) I
N GENERAL.—Not later than three years 12
after the date of the enactment of this Act, the Sec-13
retary of Veterans Affairs shall submit to the Com-14
mittees on Veterans’ Affairs of the Senate and the 15
House of Representatives and publish on a publicly 16
available website of the Department of Veterans Af-17
fairs a report that analyzes which benefits and serv-18
ices under the laws administered by such Secretary, 19
including such benefits and services furnished by the 20
Veterans Benefits Administration, have the greatest 21
impact on the prevention of suicide among veterans, 22
including recommendations for potential expansion 23
of services and benefits to reduce the number of vet-24
eran suicides. 25 142 
•HR 8371 EH
(2) ASSESSMENT OF SOLID START PROGRAM .— 1
The report required by paragraph (1) shall include 2
an analysis of the effectiveness of the Solid Start 3
program under section 6320 of title 38, United 4
States Code, on prevention of suicide among vet-5
erans. 6
(d) T
OOLKIT FORSTATE ANDLOCALCORONERS AND 7
M
EDICALEXAMINERS ONBESTPRACTICES FORIDENTI-8
FYING ANDREPORTING ONSUICIDEDEATHS OFVET-9
ERANS.— 10
(1) I
N GENERAL.—The Secretary of Veterans 11
Affairs, in collaboration with the Director of the 12
Centers for Disease Control and Prevention, shall 13
develop a toolkit for State and local coroners and 14
medical examiners that contains best practices for— 15
(A) accurately identifying and reporting 16
suicide deaths of veterans, including how to 17
identify veteran status; and 18
(B) reporting such deaths to the Centers 19
for Disease Control and Prevention and other 20
applicable entities. 21
(2) A
VAILABILITY.—Not later than two years 22
after the date of the enactment of this Act, the Sec-23
retary shall make the toolkit developed under para-24 143 
•HR 8371 EH
graph (1) available on a publicly available website of 1
the Department of Veterans Affairs. 2
(3) O
UTREACH.—The Secretary, in collabora-3
tion with the Director of the Centers for Disease 4
Control and Prevention, shall conduct outreach to 5
appropriate State and local agencies to promote the 6
availability and use of the toolkit developed under 7
paragraph (1). 8
SEC. 150. REPORT ON PHYSICAL INFRASTRUCTURE RE-9
QUIRED BY MEDICAL FACILITIES OF DEPART-10
MENT OF VETERANS AFFAIRS TO PROVIDE 11
DENTAL CARE SERVICES. 12
Not later than one year after the date of the enact-13
ment of this Act, the Secretary of Veterans Affairs shall 14
submit to the Committees on Veterans’ Affairs of the Sen-15
ate and the House of Representatives a report, for each 16
medical center or other relevant health care facility of the 17
Department of Veterans Affairs, that includes— 18
(1) an identification of the physical infrastruc-19
ture, including new facilities, renovations, remodels, 20
leases, or other infrastructure, such medical center 21
or health care facility requires to provide dental care 22
services to veterans eligible for such services under 23
the laws administered by the Secretary; and 24 144 
•HR 8371 EH
(2) an analysis of the physical infrastructure 1
such medical center or health care facility would re-2
quire if a greater number of veterans became eligible 3
for such dental care services pursuant to a modifica-4
tion of the laws administered by the Secretary. 5
SEC. 151. COMPTROLLER GENERAL REPORT ON CERTAIN 6
ORAL HEALTH CARE PROGRAMS UNDER 7
LAWS ADMINISTERED BY SECRETARY OF 8
VETERANS AFFAIRS. 9
(a) I
NGENERAL.—Not later than one year after the 10
date of the enactment of this Act, the Comptroller General 11
of the United States shall submit to the Committees on 12
Veterans’ Affairs of the Senate and the House of Rep-13
resentatives a report on the status of the oral health care 14
programs of the Department of Veterans Affairs, that in-15
cludes an assessment of— 16
(1) any issues with information technology pro-17
grams, including Dental Record Manager Plus, that 18
affect dental care staff of the Department; 19
(2) the implementation of the dental insurance 20
plan of the Department under section 1712C of title 21
38, United States Code; 22
(3) the implementation and expansion of the 23
VETSmile program of the Department; 24 145 
•HR 8371 EH
(4) barriers preventing the Department from 1
expanding dental care eligibility to all veterans with 2
ischemic heart disease, including such barriers relat-3
ing to physical infrastructure, workforce, and cost of 4
such dental care; 5
(5) barriers preventing dental clinics of the De-6
partment, if any, from adopting teledentistry; 7
(6) the demographic makeup of veterans eligible 8
for dental care paid for by the Department as of the 9
commencement of the pilot program under section 10
145 of this Act, including information on— 11
(A) age; 12
(B) gender; 13
(C) race or ethnicity, disaggregated by— 14
(i) membership in an Indian Tribe; 15
and 16
(ii) the major race groups used in the 17
decennial census; 18
(D) employment status; and 19
(E) location of residence, disaggregated by 20
rural, highly rural, and urban locations; and 21
(7) changes to such demographic makeup if 22
any, that would result from an expansion of eligi-23
bility for dental care under the laws administered by 24
the Secretary to all veterans with ischemic heart dis-25 146 
•HR 8371 EH
ease including changes to demographics specified in 1
paragraph (6). 2
(b) T
HIRDPARTYADMINISTRATORDEFINED.—In 3
this section, the term ‘‘Third Party Administrator’’ means 4
an entity that manages a provider network and performs 5
administrative services related to such network under sec-6
tion 1703 of title 38, United States Code. 7
SEC. 152. REVIEW OF WORKFLOWS ASSOCIATED WITH 8
PROCESSING REFERRALS BETWEEN FACILI-9
TIES OF THE VETERANS HEALTH ADMINIS-10
TRATION. 11
(a) I
NGENERAL.—The Secretary of Veterans Affairs 12
shall conduct a review of the workflows directly associated 13
with processing referrals of patients between facilities of 14
the Veterans Health Administration of the Department of 15
Veterans Affairs to identify specific delays or bottlenecks 16
in such referrals. 17
(b) E
LEMENTS OF REVIEW.—The review required 18
under subsection (a) shall include a review of— 19
(1) the interfacility consult management guid-20
ance of the Veterans Health Administration that as-21
sists facilities described in subsection (a) in con-22
structing a workflow for consults between such fa-23
cilities; and 24 147 
•HR 8371 EH
(2) the roles and responsibilities of the individ-1
uals involved in the consult management process in 2
managing such consults, including the role of the re-3
ferral coordination team. 4
(c) R
EPORT.—Not later than 180 days after the date 5
of the enactment of this Act, the Secretary shall submit 6
to Congress a report on the results of the review required 7
under subsection (a). 8
SEC. 153. PLAN FOR TIMELY SCHEDULING OF APPOINT-9
MENTS AT MEDICAL FACILITIES OF DEPART-10
MENT OF VETERANS AFFAIRS. 11
(a) P
LANREQUIRED.—To improve responsiveness in 12
the provision of hospital care and medical services at med-13
ical facilities of the Department of Veterans Affairs, the 14
Secretary of Veterans Affairs shall develop a plan to— 15
(1) ensure that whenever a covered veteran con-16
tacts the Department by telephone to request the 17
scheduling of an appointment for care or services for 18
the covered veteran at such a facility, the scheduling 19
for the appointment occurs during that telephone 20
call (regardless of the prospective date of the ap-21
pointment being scheduled); and 22
(2) provide timely and, where applicable, same- 23
day scheduling for an appointment described in 24
paragraph (1). 25 148 
•HR 8371 EH
(b) REPORT.—Not later than one year after the date 1
of the enactment of this Act, the Secretary shall submit 2
to the Committees on Veterans’ Affairs of the House of 3
Representatives and the Senate a report on the plan under 4
subsection (a). 5
(c) C
OVEREDVETERANDEFINED.—In this section, 6
the term ‘‘covered veteran’’ means a veteran who is en-7
rolled in the system of patient enrollment of the Depart-8
ment under section 1705(a) of title 38, United States 9
Code. 10
SEC. 154. AUTHORIZATION OF APPROPRIATIONS TO SUP-11
PORT INITIATIVES FOR MOBILE MAMMOG-12
RAPHY SERVICES FOR VETERANS. 13
There is authorized to be appropriated to the Sec-14
retary of Veterans Affairs $5,000,000 for fiscal year 2025 15
for the Office of Women’s Health of the Department of 16
Veterans Affairs under section 7310 of title 38, United 17
States Code, to be used by the Secretary to expand access 18
of women veterans to— 19
(1) mobile mammography initiatives; 20
(2) advanced mammography equipment; and 21
(3) outreach activities to publicize those initia-22
tives and equipment. 23 149 
•HR 8371 EH
TITLE II—ECONOMIC 1
OPPORTUNITY MATTERS 2
Subtitle A—Educational Assistance 3
SEC. 201. TEMPORARY EXPANSION OF ELIGIBILITY FOR MA-4
RINE GUNNERY SERGEANT JOHN DAVID FRY 5
SCHOLARSHIP. 6
(a) I
NGENERAL.—The Secretary of Veterans Affairs 7
shall treat an individual described in subsection (b) as a 8
covered individual described in section 3311(b) of title 38, 9
United States Code. 10
(b) C
OVEREDINDIVIDUALDESCRIBED.—An indi-11
vidual described in this subsection is an individual who 12
is the child or spouse of a person— 13
(1) who dies from a service-connected disability 14
during the 120-day period immediately following the 15
day on which the person was discharged or released 16
from duty as a member of the Armed Forces (with-17
out regard to whether such duty was active duty); 18
and 19
(2)(A) who received an honorable discharge; or 20
(B) whose service in the Armed Forces is char-21
acterized by the Secretary concerned as honorable 22
service. 23
(c) A
PPLICABILITY.—This section shall apply with re-24
spect to— 25 150 
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(1) deaths that occur before, on, or after the 1
date of the enactment of this Act; and 2
(2) a quarter, semester, or term, as applicable, 3
commencing— 4
(A) on or after August 1, 2025; and 5
(B) before October 1, 2027. 6
SEC. 202. REMOVAL OF EXPIRATION ON ENTITLEMENT TO 7
MARINE GUNNERY SERGEANT JOHN DAVID 8
FRY SCHOLARSHIP FOR SURVIVING SPOUSES. 9
Section 3311(f) of title 38, United States Code, is 10
amended— 11
(1) by striking paragraph (2); 12
(2) by redesignating paragraphs (3) through 13
(5) as paragraphs (2) through (4), respectively; 14
(3) in paragraph (2), as redesignated by para-15
graph (2) of this section, by striking ‘‘in paragraph 16
(4)’’ and inserting ‘‘in paragraph (3)’’; and 17
(4) in paragraph (3)(A), as redesignated by 18
paragraph (2) of this section, by striking ‘‘under 19
paragraph (3)’’ and inserting ‘‘under paragraph 20
(2)’’. 21 151 
•HR 8371 EH
SEC. 203. SOLE LIABILITY FOR TRANSFERRED EDU-1
CATIONAL ASSISTANCE BY AN INDIVIDUAL 2
WHO FAILS TO COMPLETE A SERVICE AGREE-3
MENT. 4
Subsection (i) of section 3319 of title 38, United 5
States Code, is amended— 6
(1) in paragraph (1)— 7
(A) by striking ‘‘In the event’’ and insert-8
ing ‘‘Subject to paragraph (2), in the event’’; 9
and 10
(B) by inserting ‘‘of this title’’ after ‘‘sec-11
tion 3685’’; 12
(2) in subparagraph (A) of paragraph (2)— 13
(A) in the heading, by striking ‘‘I
N GEN-14
ERAL’’ and inserting ‘‘SOLE LIABILITY’’; and 15
(B) by striking ‘‘under paragraph (1)’’ and 16
inserting ‘‘for which the individual shall be sole-17
ly liable to the United States for the amount of 18
the overpayment for purposes of section 3685 19
of this title’’; and 20
(3) in subparagraph (B) of paragraph (2)— 21
(A) in the matter preceding clause (i), by 22
striking ‘‘Subparagraph (A) shall not apply’’ 23
and inserting ‘‘Neither the individual nor the 24
dependent shall be liable to the United States 25 152 
•HR 8371 EH
for the amount of the overpayment for purposes 1
of section 3685 of this title’’; and 2
(B) in clause (ii), by inserting ‘‘of this 3
title’’ after ‘‘section 3311(c)(4)’’. 4
SEC. 204. NOTICE TO EDUCATIONAL INSTITUTIONS OF 5
RISK-BASED SURVEYS. 6
Section 3673A(d) of title 38, United States Code, is 7
amended by striking ‘‘one business day’’ and inserting 8
‘‘two business days’’. 9
SEC. 205. RELATIONSHIP OF PARTICIPATION BY AN EDU-10
CATIONAL INSTITUTION IN CERTAIN FED-11
ERAL STUDENT FINANCIAL AID PROGRAMS 12
TO APPROVAL OF SUCH INSTITUTION FOR 13
PURPOSES OF DEPARTMENT OF VETERANS 14
AFFAIRS EDUCATIONAL ASSISTANCE PRO-15
GRAMS. 16
Paragraph (4) of section 3675(b) of title 38, United 17
States Code, is amended to read as follows: 18
‘‘(4) The educational institution— 19
‘‘(A) is approved and participates in a pro-20
gram under title IV of the Higher Education 21
Act of 1965 (20 U.S.C. 1070 et seq.); or 22
‘‘(B) does not participate in such a pro-23
gram and the Secretary has waived the require-24
ment under this paragraph with respect to the 25 153 
•HR 8371 EH
educational institution, and submits to the 1
Committee on Veterans’ Affairs of the Senate 2
and the Committee on Veterans’ Affairs of the 3
House of Representatives notice of such waiver, 4
because the Secretary determines that the edu-5
cational institution— 6
‘‘(i) elects not to participate in such a 7
program; 8
‘‘(ii) cannot participate in such a pro-9
gram; or 10
‘‘(iii) is in the process of making a 11
good-faith effort to submit an initial appli-12
cation for approval to participate in such a 13
program, except that a waiver under this 14
clause may not be provided for a period of 15
longer than 36 months.’’. 16
SEC. 206. EXPANSION OF DEPARTMENT OF VETERANS AF-17
FAIRS OVERSIGHT OF CERTAIN EDU-18
CATIONAL INSTITUTIONS. 19
(a) A
DDITIONALREQUIREMENT FOR APPROVAL.— 20
Section 3675(b) of title 38, United States Code, as amend-21
ed by section 205, is further amended by adding at the 22
end the following new paragraph: 23
‘‘(5) The educational institution agrees to, not 24
later than 30 days after any date on which such 25 154 
•HR 8371 EH
educational institution becomes subject to an action 1
or event described in section 3673(e)(3) of this title, 2
submit to the State approving agency, or the Sec-3
retary when acting in the role of a State approving 4
agency, a notification of such action or event in such 5
form and containing such information as the Sec-6
retary determines appropriate.’’. 7
(b) A
DDITIONALREQUIREMENT FOR APPROVAL OF 8
N
ONACCREDITEDCOURSES.— 9
(1) I
N GENERAL.—Section 3676(c) of such title 10
is amended— 11
(A) by redesignating paragraphs (14) 12
through (16) as paragraphs (15) through (17), 13
respectively; and 14
(B) by inserting after paragraph (13) the 15
following new paragraph: 16
‘‘(14) The institution agrees to, not later than 17
30 days after any date on which such institution be-18
comes subject to an action or event described in sec-19
tion 3673(e)(3) of this title, submit to the State ap-20
proving agency, or the Secretary when acting in the 21
role of a State approving agency, a notification of 22
such action or event in such form and containing 23
such information as the Secretary determines appro-24
priate.’’. 25 155 
•HR 8371 EH
(2) CONFORMING AMENDMENTS .—Such title is 1
further amended— 2
(A) in section 3672(b)(2)(C), by striking 3
‘‘paragraph (14) or (15)’’ and inserting ‘‘para-4
graph (15) or (16)’’; 5
(B) in section 3675(b)(3), by striking 6
‘‘(14), (15), and (16)’’ and inserting ‘‘(15), 7
(16), and (17)’’; 8
(C) in section 3679(d), by striking ‘‘de-9
scribed in paragraph (14) or (15)’’ and insert-10
ing ‘‘described in paragraph (15) or (16)’’; and 11
(D) in section 3680A(a)(4)(C)(iii), by 12
striking ‘‘section 3676(c)(14) and (15)’’ and in-13
serting ‘‘section 3676(c)(15) and (16)’’. 14
(c) A
DDITIONALGROUNDS FORSUSPENSION OFAP-15
PROVAL.—Section 3679(f)(1) of such title is amended by 16
adding at the end the following new subparagraph: 17
‘‘(I) Comply with the notification requirements 18
under sections 3675(b)(5) and 3676(c)(14) of this 19
title, when applicable.’’. 20
(d) D
EADLINE FOR RISK-BASEDSURVEYSDATA-21
BASE.—The Secretary of Veterans Affairs shall establish 22
the database required under section 3673A(c) of title 38, 23
United States Code, by not later than 180 days after the 24
date of the enactment of this Act. 25 156 
•HR 8371 EH
SEC. 207. REQUIREMENT THAT EDUCATIONAL INSTITU-1
TIONS APPROVED FOR PURPOSES OF DE-2
PARTMENT OF VETERANS AFFAIRS EDU-3
CATIONAL ASSISTANCE PROGRAMS PROVIDE 4
DIGITAL OFFICIAL TRANSCRIPTS. 5
(a) R
EQUIREMENT.—Section 3675(b) of title 38, 6
United States Code, as amended by sections 205 and 206, 7
is further amended by adding at the end the following new 8
paragraph: 9
‘‘(6) The educational institution makes avail-10
able to each eligible person or veteran a copy of the 11
person or veteran’s official transcript in a digital 12
format.’’. 13
(b) C
ONFORMINGAMENDMENTS.— 14
(1) A
PPROVAL OF COURSES .—Section 15
3672(b)(2)(A) of such title is amended by striking 16
‘‘(b)(1) and (b)(2)’’ and inserting ‘‘paragraphs (1), 17
(2), and (6) of section 3675(b)’’. 18
(2) A
PPROVAL OF NONACCREDITED COURSES .— 19
Section 3676(c) of such title is amended— 20
(A) by redesignating paragraph (17) as 21
paragraph (18); and 22
(B) by inserting after paragraph (16) the 23
following new paragraph (17): 24
‘‘(17) In the case of a course that leads to a 25
standard college degree, the educational institution 26 157 
•HR 8371 EH
satisfies the requirements of section 3675(b)(6) of 1
this title.’’. 2
(3) C
ONFORMING AMENDMENTS .—Section 3
3675(b)(3) of such title is amended by striking 4
‘‘(15), (16), and (17)’’ and inserting ‘‘(15), (16), 5
and (18)’’. 6
(c) E
FFECTIVEDATE.—The amendments made by 7
this section shall take effect on August 1, 2025, and apply 8
with respect to a quarter, semester, or term, as applicable, 9
commencing on or after such date. 10
SEC. 208. PAYMENT OF FULL MONTHLY HOUSING STIPEND 11
FOR VETERANS ENROLLED IN FINAL SEMES-12
TER USING EDUCATIONAL ASSISTANCE 13
UNDER POST-9/11 EDUCATIONAL ASSISTANCE 14
PROGRAM. 15
(a) H
OUSINGALLOWANCE.—Section 3680(a)(3) of 16
title 38, United States Code, is amended— 17
(1) by redesignating subparagraphs (A) and 18
(B) as clauses (i) and (ii), respectively (and by re-19
designating each subordinate provision and the mar-20
gins thereof accordingly); 21
(2) by striking ‘‘Notwithstanding paragraph 22
(1)’’ and inserting ‘‘(A) Notwithstanding paragraph 23
(1)’’; 24 158 
•HR 8371 EH
(3) by striking ‘‘, including a monthly housing 1
stipend described in section 3313(c) of this title,’’; 2
and 3
(4) by adding at the end the following new sub-4
paragraph (B): 5
‘‘(B) For purposes of providing a monthly housing 6
stipend described in section 3313(c) to an eligible veteran 7
or eligible person for whom the Secretary is providing edu-8
cational assistance under chapter 33 of this title during 9
a period that is the last semester, term, or academic period 10
pursuant to subparagraph (A), the Secretary shall treat 11
the veteran or person as pursuing a program of education 12
on a full-time basis.’’. 13
(b) A
PPLICATION.—The amendments made by sub-14
section (a) shall take effect on the date of the enactment 15
of this Act and apply with respect to a quarter, semester, 16
or term, as applicable, commencing on or after January 17
1, 2025. 18
SEC. 209. MODIFICATION OF RULES FOR APPROVAL OF 19
COMMERCIAL DRIVER EDUCATION PRO-20
GRAMS FOR PURPOSES OF EDUCATIONAL AS-21
SISTANCE PROGRAMS OF THE DEPARTMENT 22
OF VETERANS AFFAIRS. 23
(a) I
NGENERAL.—Section 3680A(e) of title 38, 24
United States Code, is amended— 25 159 
•HR 8371 EH
(1) by redesignating paragraphs (1) through 1
(3) as subparagraphs (A) though (C), respectively; 2
(2) in the matter before subparagraph (A), as 3
redesignated by paragraph (1), by inserting ‘‘(1)’’ 4
before ‘‘The Secretary’’; 5
(3) in paragraph (1)(B), as redesignated by 6
paragraph (1), by inserting ‘‘except as provided in 7
paragraph (2),’’ before ‘‘the course’’; and 8
(4) by adding at the end the following new 9
paragraph (2): 10
‘‘(2)(A) Subject to this paragraph, a commercial driv-11
er education program is exempt from paragraph (1)(B) 12
for a branch of an educational institution if the commer-13
cial driver education program offered at the branch by the 14
educational institution— 15
‘‘(i) is appropriately licensed; and 16
‘‘(ii)(I) the branch is located in a State in 17
which the same commercial driver education pro-18
gram is offered by the same educational institution 19
at another branch of that educational institution in 20
the same State that is approved for purposes of this 21
chapter by a State approving agency or the Sec-22
retary when acting in the role of a State approving 23
agency; or 24 160 
•HR 8371 EH
‘‘(II)(aa) the branch is located in a State in 1
which the same commercial driver education pro-2
gram is not offered at another branch of the same 3
educational institution in the same State; and 4
‘‘(bb) the branch has been operating for a pe-5
riod of at least one year using the same curriculum 6
as a commercial driver education program offered by 7
the educational institution at another location that is 8
approved for purposes of this chapter by a State ap-9
proving agency or the Secretary when acting in the 10
role of a State approving agency. 11
‘‘(B)(i) In order for a commercial driver education 12
program of an educational institution offered at a branch 13
described in paragraph (1)(B) to be exempt under sub-14
paragraph (A) of this paragraph, the educational institu-15
tion shall submit to the Secretary each year that para-16
graph (1)(B) would otherwise apply a report that dem-17
onstrates that the curriculum at the new branch is the 18
same as the curriculum at the primary location. 19
‘‘(ii) Reporting under clause (i) shall be submitted 20
in accordance with such requirements as the Secretary 21
shall establish in consultation with the State approving 22
agencies. 23
‘‘(C)(i) The Secretary may withhold an exemption 24
under subparagraph (A) for any educational institution or 25 161 
•HR 8371 EH
branch of an educational institution as the Secretary con-1
siders appropriate. 2
‘‘(ii) In making any determination under clause (i), 3
the Secretary may consult with the Secretary of Transpor-4
tation on the performance of a provider of a commercial 5
driver program, including the status of the provider within 6
the Training Provider Registry of the Federal Motor Car-7
rier Safety Administration when appropriate. 8
‘‘(D) The Secretary shall submit to the Committees 9
on Veterans’ Affairs of the Senate and House of Rep-10
resentatives a notification not later than 30 days after the 11
Secretary grants an exemption under this paragraph. 12
Such notification shall identify the educational institution 13
and branch of such educational institution granted such 14
exemption.’’. 15
(b) I
MPLEMENTATION.— 16
(1) E
STABLISHMENT OF REQUIREMENTS .—Not 17
later than 180 days after the date of the enactment 18
of this Act, the Secretary of Veterans Affairs shall 19
establish requirements under section 20
3680A(e)(2)(B)(ii) of such title, as added by sub-21
section (a). 22
(2) R
ULEMAKING.—In promulgating any rules 23
to carry out paragraph (2) of section 3680A(e) of 24
title 38, United States Code, as added by subsection 25 162 
•HR 8371 EH
(a), the Secretary of Veterans Affairs shall consult 1
with State approving agencies. 2
(3) A
PPLICABILITY.—The amendments made 3
by subsection (a) shall apply to commercial driver 4
education programs on and after the day that is 365 5
days after the date on which the Secretary estab-6
lishes the requirements under paragraph (1) of this 7
subsection. 8
(c) C
OMPTROLLER GENERAL OF THE UNITED 9
S
TATESSTUDY.—Not later than 365 days after the date 10
of the enactment of this Act, the Comptroller General of 11
the United States shall— 12
(1) conduct a study to— 13
(A) ascertain the effects of the amend-14
ments made by subsection (a); and 15
(B) the feasibility and advisability of simi-16
larly amending the rules for approval of pro-17
grams of education for other vocational pro-18
grams of education; and 19
(2) submit to the Committees on Veterans’ Af-20
fairs of the Senate and House of Representatives a 21
report on the findings of the Comptroller General 22
with respect to such study. 23 163 
•HR 8371 EH
SEC. 210. PROVISION OF CERTIFICATES OF ELIGIBILITY 1
AND AWARD LETTERS USING ELECTRONIC 2
MEANS. 3
(a) I
NGENERAL.—Chapter 36 of title 38, United 4
States Code, is amended by inserting after section 3698 5
the following new section (and conforming the table of sec-6
tions at the beginning of such chapter accordingly): 7
‘‘§ 3698A. Provision of certificates of eligibility and 8
award letters using electronic means 9
‘‘(a) R
EQUIREMENT.—Except as provided by sub-10
section (b), the Secretary shall provide to an individual 11
the following documents using electronic means: 12
‘‘(1) A certificate of eligibility for the entitle-13
ment of the individual to covered educational assist-14
ance. 15
‘‘(2) An award letter regarding the authoriza-16
tion of the individual to receive covered educational 17
assistance. 18
‘‘(b) E
LECTION TOOPTOUT.—An individual may 19
elect to receive the documents specified in subsection (a) 20
by mail rather than through electronic means under sub-21
section (a). An individual may revoke such an election at 22
any time, by means prescribed by the Secretary. 23
‘‘(c) C
OVEREDEDUCATIONALASSISTANCE.—In this 24
section, the term ‘covered educational assistance’ means 25 164 
•HR 8371 EH
educational assistance under chapter 30, 33, or 35 of this 1
title, or section 3699C of this title.’’. 2
(b) C
LERICALAMENDMENT.—The table of sections 3
at the beginning of such chapter is amended by inserting 4
after the item relating to section 3698 the following new 5
item: 6
‘‘3698A. Provision of certificates of eligibility and award letters using electronic 
means.’’. 
SEC. 211. RETROACTIVE EFFECTIVE DATE OF LAW RE-
7
GARDING CHARGE TO ENTITLEMENT TO EDU-8
CATIONAL ASSISTANCE FOR INDIVIDUALS 9
WHO DO NOT TRANSFER CREDITS FROM CER-10
TAIN CLOSED OR DISAPPROVED PROGRAMS 11
OF EDUCATION. 12
Section 3699(c)(2) of title 38, United States Code, 13
is amended by striking subparagraph (C) and inserting 14
the following new subparagraph (C): 15
‘‘(C) This paragraph, including clauses (ii) and (iii) 16
of subparagraph (A), shall apply with respect to the clo-17
sure or discontinuation of a course or program of edu-18
cation, as described in subsection (b)(1), that occurs dur-19
ing the period beginning on August 1, 2021, and ending 20
on September 30, 2025.’’. 21
SEC. 212. DEPARTMENT OF VETERANS AFFAIRS HIGH 22
TECHNOLOGY PROGRAM. 23
(a) H
IGHTECHNOLOGYPROGRAM.— 24 165 
•HR 8371 EH
(1) IN GENERAL.—Chapter 36 of title 38, 1
United States Code, as amended by section 210, is 2
amended by adding at the end the following new sec-3
tion: 4
‘‘§ 3699C. High technology program 5
‘‘(a) E
STABLISHMENT.—(1) The Secretary shall 6
carry out a program under which the Secretary provides 7
covered individuals with the opportunity to enroll in high 8
technology programs of education that the Secretary de-9
termines provide training or skills sought by employers in 10
a relevant field or industry. 11
‘‘(2) Not more than 4,000 covered individuals may 12
participate in the program under this section in any fiscal 13
year. 14
‘‘(b) A
MOUNT OFASSISTANCE.—(1) The Secretary 15
shall provide, to each covered individual who pursues a 16
high technology program of education under this section, 17
educational assistance in amounts equal to the amounts 18
provided under section 3313(c)(1) of this title, including, 19
except as provided in paragraph (3), with respect to the 20
housing stipend described in that section and in accord-21
ance with the treatment of programs that are distance 22
learning and programs that are less than half-time. 23 166 
•HR 8371 EH
‘‘(2) Under paragraph (1), the Secretary shall pro-1
vide such amounts of educational assistance to a covered 2
individual for each of the following: 3
‘‘(A) A high technology program of education. 4
‘‘(B) A second such program if— 5
‘‘(i) the second such program begins at 6
least 18 months after the covered individual 7
graduates from the first such program; and 8
‘‘(ii) the covered individual uses edu-9
cational assistance under chapter 33 of this 10
title to pursue the second such program. 11
‘‘(3) No covered individual may receive a housing sti-12
pend under this subsection for any month if such indi-13
vidual is in receipt of a housing stipend under chapter 33 14
of this title for that month. 15
‘‘(c) C
ONTRACTS.—(1) For purposes of carrying out 16
subsection (a), the Secretary shall seek to enter into con-17
tracts with any number of qualified providers of high tech-18
nology programs of education for the provision of such 19
programs to covered individuals. Each such contract shall 20
provide for the conditions under which the Secretary may 21
terminate the contract with the provider and the proce-22
dures for providing for the graduation of students who 23
were enrolled in a program provided by such provider in 24
the case of such a termination. 25 167 
•HR 8371 EH
‘‘(2) A contract under this subsection shall provide 1
that the Secretary shall pay to a provider— 2
‘‘(A) upon the enrollment of a covered indi-3
vidual in the program, 25 percent of the cost of the 4
tuition and other fees for the program of education 5
for the individual; 6
‘‘(B) upon graduation of the individual from 7
the program, 25 percent of such cost; and 8
‘‘(C) 50 percent of such cost upon— 9
‘‘(i) the successful employment of the cov-10
ered individual for a period— 11
‘‘(I) of 180 days in the field of study 12
of the program; and 13
‘‘(II) that begins not later than 180 14
days following graduation of the covered 15
individual from the program; 16
‘‘(ii) the employment of the individual by 17
the provider for a period of one year; or 18
‘‘(iii) the enrollment of the individual in a 19
program of education to continue education in 20
such field of study. 21
‘‘(3) For purposes of this section, a provider of a high 22
technology program of education is qualified if— 23 168 
•HR 8371 EH
‘‘(A) the provider employs instructors whom the 1
Secretary determines are experts in their respective 2
fields in accordance with paragraph (5); 3
‘‘(B) the provider has successfully provided the 4
high technology program for at least one year; 5
‘‘(C) the provider does not charge tuition and 6
fees to a covered individual who receives assistance 7
under this section to pursue such program that are 8
higher than the tuition and fees charged by such 9
provider to another individual; and 10
‘‘(D) the provider meets the approval criteria 11
developed by the Secretary under paragraph (4). 12
‘‘(4)(A) The Secretary shall prescribe criteria for ap-13
proving providers of a high technology program of edu-14
cation under this section. 15
‘‘(B) In developing such criteria, the Secretary may 16
consult with State approving agencies. 17
‘‘(C) Such criteria are not required to meet the re-18
quirements of section 3672 of this title. 19
‘‘(D) Such criteria shall include the job placement 20
rate, in the field of study of a program of education, of 21
covered individuals who complete such program of edu-22
cation. 23
‘‘(5) The Secretary shall determine whether instruc-24
tors are experts under paragraph (3)(A) based on evidence 25 169 
•HR 8371 EH
furnished to the Secretary by the provider regarding the 1
ability of the instructors to— 2
‘‘(A) identify professions in need of new em-3
ployees to hire, tailor the programs to meet market 4
needs, and identify the employers likely to hire grad-5
uates; 6
‘‘(B) effectively teach the skills offered to cov-7
ered individuals; 8
‘‘(C) provide relevant industry experience in the 9
fields of programs offered to incoming covered indi-10
viduals; and 11
‘‘(D) demonstrate relevant industry experience 12
in such fields of programs. 13
‘‘(6) In entering into contracts under this subsection, 14
the Secretary shall give preference to a provider of a high 15
technology program of education— 16
‘‘(A) from which at least 70 percent of grad-17
uates find full-time employment in the field of study 18
of the program during the 180-day period beginning 19
on the date the student graduates from the program; 20
or 21
‘‘(B) that offers tuition reimbursement for any 22
student who graduates from such a program and 23
does not find employment described in subparagraph 24
(A). 25 170 
•HR 8371 EH
‘‘(d) EFFECT ONOTHERENTITLEMENT.—(1) If a 1
covered individual enrolled in a high technology program 2
of education under this section has remaining entitlement 3
to educational assistance under chapter 30, 32, 33, 34, 4
or 35 of this title, such entitlement shall be charged at 5
the rate of one month of such entitlement for each month 6
of educational assistance provided under this section. 7
‘‘(2) If a covered individual enrolled in a high tech-8
nology program of education under this section does not 9
have remaining entitlement to educational assistance 10
under chapter 30, 32, 33, 34, or 35 of this title, any edu-11
cational assistance provided to such individual under this 12
section shall be provided in addition to the entitlement 13
that the individual has used. 14
‘‘(3) The Secretary may not consider enrollment in 15
a high technology program of education under this section 16
to be assistance under a provision of law referred to in 17
section 3695 of this title. 18
‘‘(4)(A) An application for enrollment in a high tech-19
nology program of education under this section shall in-20
clude notice of the requirements relating to use of entitle-21
ment under paragraphs (1) and (2), including— 22
‘‘(i) in the case of the enrollment of an indi-23
vidual referred to under paragraph (1), the amount 24 171 
•HR 8371 EH
of entitlement that is typically charged for such en-1
rollment; 2
‘‘(ii) an identification of any methods that may 3
be available for minimizing the amount of entitle-4
ment required for such enrollment; and 5
‘‘(iii) an element requiring applicants to ac-6
knowledge receipt of the notice under this subpara-7
graph. 8
‘‘(B) If the Secretary approves the enrollment of a 9
covered individual in a high technology program of edu-10
cation under this section, the Secretary shall deliver elec-11
tronically to the individual an award letter that provides 12
notice of such approval and includes specific information 13
describing how paragraphs (1) and (2) will be applied to 14
the individual if the individual chooses to enroll in the pro-15
gram. 16
‘‘(e) R
EQUIREMENTS FOR EDUCATIONALINSTITU-17
TIONS.—(1) The Secretary shall not approve the enroll-18
ment of any covered individual, not already enrolled, in 19
any high technology programs of education under this sec-20
tion for any period during which the Secretary finds that 21
more than 85 percent of the students enrolled in the pro-22
gram are having all or part of their tuition, fees, or other 23
charges paid to or for them by the educational institution 24
or by the Department of Veterans Affairs under this title 25 172 
•HR 8371 EH
or under chapter 1606 or 1607 of title 10, except with 1
respect to tuition, fees, or other charges that are paid 2
under a payment plan at an educational institution that 3
the Secretary determines has a history of offering pay-4
ment plans that are completed not later than 180 days 5
after the end of the applicable term, quarter, or semester. 6
‘‘(2) The Secretary may waive a requirement of para-7
graph (1) if the Secretary determines, pursuant to regula-8
tions which the Secretary shall prescribe, such waiver to 9
be in the interest of the covered individual and the Federal 10
Government. Not later than 30 days after the Secretary 11
waives such a requirement, the Secretary shall submit to 12
the Committees on Veterans’ Affairs of the Senate and 13
House of Representatives a report regarding such waiver. 14
‘‘(3)(A)(i) The Secretary shall establish and maintain 15
a process by which an educational institution may request 16
a review of a determination that the educational institu-17
tion does not meet the requirements of paragraph (1). 18
‘‘(ii) The Secretary may consult with a State approv-19
ing agency regarding such process or such a review. 20
‘‘(iii) Not later than 180 days after the Secretary es-21
tablishes or revises a process under this subparagraph, the 22
Secretary shall submit to the Committees on Veterans’ Af-23
fairs of the Senate and House of Representatives a report 24
regarding such process. 25 173 
•HR 8371 EH
‘‘(B) An educational institution that requests a re-1
view under subparagraph (A)— 2
‘‘(i) shall request the review not later than 30 3
days after the start of the term, quarter, or semester 4
for which the determination described in subpara-5
graph (A) applies; and 6
‘‘(ii) may include any information that the edu-7
cational institution believes the Department should 8
have taken into account when making the deter-9
mination, including with respect to any mitigating 10
circumstances. 11
‘‘(f) A
NNUALREPORTS.—Not later than one year 12
after the date of the enactment of this section, and annu-13
ally thereafter until the termination date specified in sub-14
section (i), the Secretary shall submit to the Committees 15
on Veterans’ Affairs of the Senate and House of Rep-16
resentatives a report on the operation of program under 17
this section during the year covered by the report. Each 18
such report shall include each of the following: 19
‘‘(1) The number of covered individuals enrolled 20
in the program, disaggregated by type of educational 21
institution, during the year covered by the report. 22
‘‘(2) The number of covered individuals who 23
completed a high technology program of education 24 174 
•HR 8371 EH
under the program during the year covered by the 1
report. 2
‘‘(3) The average employment rate of covered 3
individuals who completed such a program of edu-4
cation during such year, as of 180 days after the 5
date of completion. 6
‘‘(4) The average length of time between the 7
completion of such a program of education and em-8
ployment. 9
‘‘(5) The total number of covered individuals 10
who completed a program of education under the 11
program and who, as of the date of the submission 12
of the report, are employed in a position related to 13
technology. 14
‘‘(6) The average salary of a covered individual 15
who completed a program of education under the 16
program and who is employed in a position related 17
to technology, in various geographic areas deter-18
mined by the Secretary. 19
‘‘(7) The average salary of all individuals em-20
ployed in positions related to technology in the geo-21
graphic areas determined under subparagraph (F), 22
and the difference, if any, between such average sal-23
ary and the average salary of a covered individual 24
who completed a program of education under the 25 175 
•HR 8371 EH
program and who is employed in a position related 1
to technology. 2
‘‘(8) The number of covered individuals who 3
completed a program of education under the pro-4
gram and who subsequently enrolled in a second 5
program of education under the program. 6
‘‘(g) C
OLLECTION OF INFORMATION; CONSULTA-7
TION.—(1) The Secretary shall develop practices to use 8
to collect information about covered individuals and pro-9
viders of high technology programs of education. 10
‘‘(2) For the purpose of carrying out program under 11
this section, the Secretary may consult with providers of 12
high technology programs of education and may establish 13
an advisory group made up of representatives of such pro-14
viders, private employers in the technology field, and other 15
relevant groups or entities, as the Secretary determines 16
necessary. 17
‘‘(h) D
EFINITIONS.—In this section: 18
‘‘(1) The term ‘covered individual’ means any of 19
the following: 20
‘‘(A) A veteran whom the Secretary deter-21
mines— 22
‘‘(i) served an aggregate of at least 36 23
months on active duty in the Armed 24
Forces (including service on active duty in 25 176 
•HR 8371 EH
entry level and skill training) and was dis-1
charged or released therefrom under condi-2
tions other than dishonorable; and 3
‘‘(ii) has not attained the age of 62. 4
‘‘(B) A member of the Armed Forces that 5
the Secretary determines will become a veteran 6
described in subparagraph (A) fewer than 180 7
days after the date of such determination. 8
‘‘(2) The term ‘high technology program of edu-9
cation’ means a program of education— 10
‘‘(A) offered by a public or private edu-11
cational institution; 12
‘‘(B) if offered by an institution of higher 13
learning, that is provided directly by such insti-14
tution rather than by an entity other than such 15
institution under a contract or other agreement; 16
‘‘(C) that does not lead to a degree; 17
‘‘(D) that has a term of not less than six 18
and not more than 28 weeks; and 19
‘‘(E) that provides instruction in computer 20
programming, computer software, media appli-21
cation, data processing, or information sciences. 22
‘‘(i) T
ERMINATION.—The Secretary may not provide 23
educational assistance under this section for a high tech-24 177 
•HR 8371 EH
nology program of education that begins after September 1
30, 2027.’’. 2
(2) C
LERICAL AMENDMENT .—The table of sec-3
tions at the beginning of such chapter is amended 4
by inserting after the item relating to section 3699B 5
the following new item: 6
‘‘3699C. High technology program.’’. 
(b) EFFECT ONHIGHTECHNOLOGY PILOTPRO-7
GRAM.—Section 116 of the Harry W. Colmery Veterans 8
Educational Assistance Act of 2017 (Public Law 115–48; 9
38 U.S.C. 3001 note) is amended— 10
(1) by amending subsection (d) to read as fol-11
lows: 12
‘‘(d) H
OUSINGSTIPEND.— 13
‘‘(1) I
N GENERAL.—Except as provided under 14
paragraph (2), the Secretary shall pay to each eligi-15
ble veteran (not including an individual described in 16
the second sentence of subsection (b)) who is en-17
rolled in a high technology program of education 18
under the pilot program on a full-time or part-time 19
basis a monthly housing stipend equal to the prod-20
uct— 21
‘‘(A) of— 22
‘‘(i) in the case of a veteran pursuing 23
resident training, the monthly amount of 24
the basic allowance for housing payable 25 178 
•HR 8371 EH
under section 403 of title 37, United 1
States Code, for a member with depend-2
ents in pay grade E–5 residing in the mili-3
tary housing area that encompasses all or 4
the majority portion of the ZIP code area 5
in which is located the campus of the insti-6
tution where the individual physically par-7
ticipates in a majority of classes; or 8
‘‘(ii) in the case of a veteran pursuing 9
a program of education through distance 10
learning, a monthly amount equal to 50 11
percent of the national average of the 12
monthly amount of the basic allowance for 13
housing payable under section 403 of title 14
37, United States Code, for a member with 15
dependents in pay grade E–5, multiplied 16
by 17
‘‘(B) the lesser of— 18
‘‘(i) 1.0; or 19
‘‘(ii) the number of course hours 20
borne by the individual in pursuit of the 21
program of education involved, divided by 22
the minimum number of course hours re-23
quired for full-time pursuit of such pro-24 179 
•HR 8371 EH
gram of education, rounded to the nearest 1
multiple of 10. 2
‘‘(2) B
AR TO DUAL ELIGIBILITY .—No covered 3
individual may receive a housing stipend under this 4
subsection for any month if such individual is in re-5
ceipt of a housing stipend under chapter 33 ot title 6
38, United States Code, for that month.’’; 7
(2) in subsection (g), by striking paragraph (6); 8
and 9
(3) by striking subsection (h) and inserting the 10
following new subsection (h): 11
‘‘(h) T
ERMINATION.—The Secretary may not, under 12
this section, pay a provider for a high technology program 13
of education that begins after September 30, 2024.’’. 14
(c) A
PPROVAL OFCERTAINHIGHTECHNOLOGYPRO-15
GRAMS.—Section 3680A of title 38, United States Code, 16
is amended— 17
(1) in subsection (a), by striking paragraph (4) 18
and inserting the following: 19
‘‘(4) Any independent study program except— 20
‘‘(A) an independent study program (in-21
cluding such a program taken over open circuit 22
television) that— 23
‘‘(i) is accredited by an accrediting 24
agency or association recognized by the 25 180 
•HR 8371 EH
Secretary of Education under subpart 2 of 1
part H of title IV of the Higher Education 2
Act of 1965 (20 U.S.C. 1099b); 3
‘‘(ii) leads to— 4
‘‘(I) a standard college degree; 5
‘‘(II) a certificate that reflects 6
educational attainment offered by an 7
institution of higher learning; or 8
‘‘(III) a certificate that reflects 9
graduation from a course of study of-10
fered by— 11
‘‘(aa) an area career and 12
technical education school (as de-13
fined in subparagraphs (C) and 14
(D) of section 3(3) of the Carl D. 15
Perkins Career and Technical 16
Education Act of 2006 (20 17
U.S.C. 2302(3))) that provides 18
education at the postsecondary 19
level; or 20
‘‘(bb) a postsecondary voca-21
tional institution (as defined in 22
section 102(c) of the Higher 23
Education Act of 1965 (20 24
U.S.C. 1002(c))) that provides 25 181 
•HR 8371 EH
education at the postsecondary 1
level; and 2
‘‘(iii) in the case of a program de-3
scribed in clause (ii)(III)— 4
‘‘(I) provides training aligned 5
with the requirements of employers in 6
the State or local area where the pro-7
gram is located, which may include in- 8
demand industry sectors or occupa-9
tions; 10
‘‘(II) provides a student, upon 11
graduation from the program, with a 12
recognized postsecondary credential 13
that is recognized by employers in the 14
relevant industry, which may include 15
a credential recognized by industry or 16
sector partnerships in the State or 17
local area where the industry is lo-18
cated; and 19
‘‘(III) meets such content and in-20
structional standards as may be re-21
quired to comply with the criteria 22
under section 3676(c)(14) and (15) of 23
this title; or 24 182 
•HR 8371 EH
‘‘(B) an online high technology program of 1
education (as defined in subsection (h)(2) of 2
section 3699C of this title)— 3
‘‘(i) the provider of which has entered 4
into a contract with the Secretary under 5
subsection (c) of such section; 6
‘‘(ii) that has been provided to covered 7
individuals (as defined in subsection (h)(1) 8
of such section) under such contract for a 9
period of at least five years; 10
‘‘(iii) regarding which the Secretary 11
has determined that the average employ-12
ment rate of covered individuals who grad-13
uated from such program of education is 14
65 percent or higher for the year preceding 15
such determination; and 16
‘‘(iv) that satisfies the requirements of 17
subsection (e) of such section.’’; and 18
(2) in subsection (d), by adding at the end the 19
following: 20
‘‘(8) Paragraph (1) shall not apply to the enrollment 21
of a veteran in an online high technology program de-22
scribed in subsection (a)(4)(B).’’. 23 183 
•HR 8371 EH
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.’’.  184 
•HR 8371 EH
SEC. 214. PAYMENT OF VA EDUCATIONAL ASSISTANCE VIA 1
ELECTRONIC FUND TRANSFER TO A FOREIGN 2
INSTITUTION OF HIGHER EDUCATION. 3
Not later than 90 days after the date of the enact-4
ment of this Act, the Secretary of Veterans Affairs shall 5
update the payment system of the Department of Veterans 6
Affairs to allow for electronic fund transfer of educational 7
assistance, administered by the Secretary, to a foreign in-8
stitution of higher education that— 9
(1) provides an approved course of education to 10
an eligible recipient of such assistance; and 11
(2) does not have— 12
(A) an employer identification number; or 13
(B) an account with a domestic bank. 14
SEC. 215. IMPROVING TRANSPARENCY AND ACCOUNT-15
ABILITY OF EDUCATIONAL INSTITUTIONS 16
FOR PURPOSES OF VETERANS EDUCATIONAL 17
ASSISTANCE. 18
(a) R
EQUIREMENT RELATING TOG.I. BILLCOM-19
PARISONTOOL.— 20
(1) R
EQUIREMENT TO MAINTAIN TOOL .—The 21
Secretary of Veterans Affairs shall maintain the G.I. 22
Bill Comparison Tool that was established pursuant 23
to Executive Order 13607 (77 Fed. Reg. 25861; re-24
lating to establishing principles of excellence for edu-25
cational institutions serving service members, vet-26 185 
•HR 8371 EH
erans, spouses, and other family members) and in 1
effect on the day before the date of enactment of 2
this Act, or a successor tool, to provide relevant and 3
timely information about programs of education ap-4
proved under chapter 36 of title 38, United States 5
Code, and the educational institutions that offer 6
such programs. 7
(2) D
ATA RETENTION.—The Secretary shall en-8
sure that historical data that is reported via the tool 9
maintained under paragraph (1) remains easily and 10
prominently accessible on the benefits.va.gov website, 11
or a successor website, for a period of not less than 12
six years from the date of initial publication. 13
(b) P
ROVIDINGTIMELY ANDRELEVANTEDUCATION 14
I
NFORMATION TO VETERANS, MEMBERS OF THE ARMED 15
F
ORCES, ANDOTHERINDIVIDUALS.— 16
(1) I
N GENERAL.—Not later than one year 17
after the date of the enactment of this Act, the Sec-18
retary of Veterans Affairs, in consultation with the 19
Secretary of Education, the Secretary of the Treas-20
ury, and the heads of other relevant Federal agen-21
cies, shall make such changes to the tool maintained 22
under subsection (a) as the Secretary of Veterans 23
Affairs determines appropriate to ensure that such 24
tool is an effective and efficient method for providing 25 186 
•HR 8371 EH
information pursuant to section 3698(b)(5) of title 1
38, United States Code. 2
(2) M
EMORANDUM OF UNDERSTANDING RE -3
QUIRED.—Not later than two years after the date of 4
the enactment of this Act, the Secretary of Veterans 5
Affairs shall seek to enter into a memorandum of 6
understanding with the Secretary of Education and 7
the heads other relevant Federal agencies, as the 8
Secretary of Veterans Affairs determines appro-9
priate, to obtain information on outcomes with re-10
spect to individuals who are entitled to educational 11
assistance under the laws administered by the Sec-12
retary of Veterans Affairs and who are attending 13
educational institutions. Such memorandum of un-14
derstanding may include data sharing or computer 15
matching agreements. 16
(3) M
ODIFICATION OF SCOPE OF COMPREHEN -17
SIVE POLICY ON PROVIDING EDUCATION INFORMA -18
TION.—Section 3698 of title 38, United States Code, 19
is amended— 20
(A) in subsection (a), by striking ‘‘veterans 21
and members of the Armed Forces’’ and insert-22
ing ‘‘individuals entitled to educational assist-23
ance under laws administered by the Secretary 24
of Veterans Affairs’’; and 25 187 
•HR 8371 EH
(B) in subsection (b)(5)— 1
(i) by striking ‘‘veterans and members 2
of the Armed Forces’’ and inserting ‘‘indi-3
viduals described in subsection (a)’’; and 4
(ii) by striking ‘‘the veteran or mem-5
ber’’ and inserting ‘‘the individual’’. 6
(4) G.I. 
BILL COMPARISON TOOL REQUIRED 7
DISCLOSURES.—Paragraph (1) of subsection (c) of 8
such section is amended— 9
(A) by striking subparagraph (B) and in-10
serting the following: 11
‘‘(B) for each individual described in subsection 12
(a) seeking information provided under subsection 13
(b)(5), the name of each Federal student aid pro-14
gram, and a description of each such program, from 15
which the individual may receive educational assist-16
ance; and’’; 17
(B) in subparagraph (C)— 18
(i) in clause (i), by inserting ‘‘and a 19
definition of each type of institution’’ be-20
fore the semicolon; 21
(ii) in clause (iv), by inserting ‘‘and if 22
so, which programs’’ before the semicolon; 23
(iii) by striking clause (v) and insert-24
ing the following: 25 188 
•HR 8371 EH
‘‘(v) the average annual cost and the total 1
cost to earn an associate’s degree and a bach-2
elor’s degree, with available cost information on 3
any other degree or credential the institution 4
awards;’’; 5
(iv) in clause (vi), by inserting before 6
the semicolon the following: ‘‘disaggregated 7
by— 8
‘‘(I) the type of beneficiary of edu-9
cational assistance; 10
‘‘(II) individuals who received a cre-11
dential and individuals who did not; and 12
‘‘(II) individuals using educational as-13
sistance under laws administered by the 14
Secretary and individuals who are not;’’; 15
(v) in clause (xiv), by striking ‘‘and’’ 16
at the end; 17
(vi) in clause (xv), by striking the pe-18
riod at the end and inserting a semicolon; 19
and 20
(vii) by adding at the end the fol-21
lowing new clauses: 22
‘‘(xvi) the number of veterans or members 23
who completed covered education at the institu-24
tion leading to— 25 189 
•HR 8371 EH
‘‘(I) a degree, disaggregated by type 1
of program, including— 2
‘‘(aa) an associate degree; 3
‘‘(bb) a bachelor’s degree; and 4
‘‘(cc) a postbaccalaureate degree; 5
and 6
‘‘(II) a certificate or professional li-7
cense, disaggregated by type of certificate 8
or professional license; 9
‘‘(xvii) programs available and the average 10
time for completion of each program; 11
‘‘(xviii) employment rate and median in-12
come of graduates of the institution in general 13
two and five years after graduation, 14
disaggregated by— 15
‘‘(I) specific program; and 16
‘‘(II) individuals using educational as-17
sistance under laws administered by the 18
Secretary and individuals who are not; and 19
‘‘(xix) the number of individuals using edu-20
cational assistance under laws administered by 21
the Secretary who are enrolled in the both the 22
institution and specific program per year.’’. 23 190 
•HR 8371 EH
(5) CLARITY AND ANONYMITY OF INFORMATION 1
PROVIDED.—Paragraph (2) of such subsection is 2
amended— 3
(A) by inserting ‘‘(A)’’ before ‘‘To the ex-4
tent’’; and 5
(B) by adding at the end the following new 6
subparagraph: 7
‘‘(B) The Secretary shall ensure that information 8
provided pursuant to subsection (b)(5) is provided in a 9
manner that is easy for, and accessible to, individuals de-10
scribed in subsection (a). 11
‘‘(C) In providing information pursuant to subsection 12
(b)(5), the Secretary shall maintain the anonymity of indi-13
viduals described in subsection (a) and, to the extent that 14
a portion of any data would undermine such anonymity, 15
ensure that such data is not made available pursuant to 16
such subsection.’’. 17
(c) I
MPROVEMENTS FOR STUDENTFEEDBACK.— 18
(1) I
N GENERAL.—Subsection (b)(2) of such 19
section is amended— 20
(A) by amending subparagraph (A) to read 21
as follows: 22
‘‘(A) provides institutions of higher learn-23
ing— 24 191 
•HR 8371 EH
‘‘(i) up to 30 days to review and re-1
spond to feedback from individuals de-2
scribed in subsection (a) and address 3
issues regarding the feedback before the 4
feedback is published; and 5
‘‘(ii) if an institution of higher learn-6
ing contests the accuracy of the feedback, 7
the opportunity to challenge the inclusion 8
of such data with an official appointed by 9
the Secretary;’’; 10
(B) in subparagraph (B), by striking 11
‘‘and’’ at the end; 12
(C) in subparagraph (C), by striking ‘‘that 13
conforms with criteria for relevancy that the 14
Secretary shall determine.’’ and inserting ‘‘, 15
and responses from institutions of higher learn-16
ing to such feedback, that conform with criteria 17
for relevancy that the Secretary shall deter-18
mine;’’; and 19
(D) by adding at the end the following new 20
subparagraphs: 21
‘‘(D) for each institution of higher learning 22
that is approved under this chapter, retains, 23
maintains, and publishes all of such feedback 24
for not less than six years; and 25 192 
•HR 8371 EH
‘‘(E) is easily accessible to individuals de-1
scribed in subsection (a) and to the general 2
public.’’. 3
(2) A
CCESSIBILITY FROM G.I. BILL COMPARISON 4
TOOL.—The Secretary shall ensure that— 5
(A) the feedback tracked and published 6
under subsection (b)(2) of such section, as 7
amended by paragraph (1), is prominently dis-8
played in the tool maintained under subsection 9
(a) of this section; and 10
(B) when such tool displays information 11
for an institution of higher learning, the appli-12
cable feedback is also displayed for such institu-13
tion of higher learning. 14
(d) T
RAINING FORPROVISION OFEDUCATIONCOUN-15
SELINGSERVICES.— 16
(1) I
N GENERAL.—Not less than one year after 17
the date of the enactment of this Act, the Secretary 18
shall ensure that personnel employed by the Depart-19
ment of Veteran Affairs, or a contractor of the De-20
partment, to provide education benefits counseling, 21
vocational or transition assistance, or similar func-22
tions, including employees or contractors of the De-23
partment who provide such counseling or assistance 24 193 
•HR 8371 EH
as part of the Transition Assistance Program, are 1
trained on how— 2
(A) to use properly the tool maintained 3
under subsection (a); and 4
(B) to provide appropriate educational 5
counseling services to individuals described in 6
section 3698(a) of such title, as amended by 7
subsection (b)(3)(A). 8
(2) T
RANSITION ASSISTANCE PROGRAM DE -9
FINED.—In this subsection, the term ‘‘Transition 10
Assistance Program’’ means the program of coun-11
seling, information, and services under section 1142 12
of title 10, United States Code. 13
Subtitle B—Employment and 14
Training 15
SEC. 221. IMPROVEMENTS TO REEMPLOYMENT RIGHTS OF 16
MEMBERS OF THE ARMED FORCES. 17
(a) USERRA P
URPOSES.—Section 4301(a)(1) of 18
title 38, United States Code, is amended by striking ‘‘en-19
courage noncareer service in the uniformed services’’ and 20
inserting ‘‘encourage service in the uniformed services’’. 21
(b) P
ROHIBITION OFRETALIATION.—Subsection (b) 22
of section 4311 of title 38, United States Code, is amend-23
ed by inserting ‘‘or other retaliatory action’’ after ‘‘em-24
ployment action’’. 25 194 
•HR 8371 EH
(c) EXPANSION OF INJUNCTIVERELIEF.—Sub-1
section (e) of section 4323 of such title is amended— 2
(1) by striking ‘‘The court shall use’’ and in-3
serting ‘‘(1) The court shall use’’; and 4
(2) by adding at the end the following new 5
paragraphs: 6
‘‘(2) A person bringing an action to enforce a provi-7
sion of this chapter pursuant to subsection (a) shall be 8
entitled to an injunction under paragraph (1) if such per-9
son demonstrates— 10
‘‘(A) a violation— 11
‘‘(i) of the provisions of this chapter; or 12
‘‘(ii) of the provisions of this chapter is 13
threatened or is imminent; 14
‘‘(B) the harm to the person outweighs the in-15
jury to the employer; 16
‘‘(C) a likelihood of success on the merits of 17
such action; and 18
‘‘(D) awarding such relief is in the public inter-19
est. 20
‘‘(3) The court may not deny a motion for injunctive 21
relief on the basis that a party bringing an action to en-22
force a provision of this chapter may be awarded wages 23
unearned due to an unlawful termination or denial of em-24
ployment at the conclusion of such action.’’. 25 195 
•HR 8371 EH
(d) DAMAGESAGAINST ASTATE ORPRIVATEEM-1
PLOYER.—Section 4323 of such title is further amended, 2
in paragraph (1) of subsection (d), by striking subpara-3
graph (C) and inserting the following new subparagraphs: 4
‘‘(C) The court may require the employer to 5
pay the person the amount referred to in subpara-6
graph (B) and interest on such amount, calculated 7
at a rate of 3 percent per year. 8
‘‘(D) The court may require the employer to 9
pay the person the greater of $50,000 or the amount 10
equal to the amounts referred to in subparagraphs 11
(B) and (C) as liquidated damages, if the court de-12
termines that the employer knowingly failed to com-13
ply with the provisions of this chapter.’’. 14
(e) M
ANDATORYATTORNEYFEESAWARD INSUC-15
CESSFULACTIONS FORREEMPLOYMENT.— 16
(1) MSPB 
ACTIONS.—Paragraph (4) of sub-17
section (c) of section 4324 of such title is amend-18
ed— 19
(A) by striking ‘‘may, in its discretion,’’ 20
and inserting ‘‘shall’’; and 21
(B) by adding at the end the following new 22
sentence: ‘‘The Board may, in its discretion, 23
award reasonable attorney fees in a case settled 24
before the issuance of an order if the person 25 196 
•HR 8371 EH
can demonstrate that significant attorney fees 1
were incurred and that justice requires such an 2
award.’’. 3
(2) F
EDERAL CIRCUIT ACTIONS .—Subsection 4
(d) of such section is amended by adding at the end 5
the following new paragraph: 6
‘‘(3) In such Federal Circuit proceeding, the court 7
shall award such person reasonable attorney fees, expert 8
witness fees, and other litigation expenses if such person— 9
‘‘(A) prevails in such Federal Circuit pro-10
ceeding; and 11
‘‘(B) is not represented by the Special Counsel 12
in such Federal Circuit proceeding.’’. 13
(3) A
CTIONS AGAINST A STATE OR PRIVATE EM -14
PLOYER.—Paragraph (2) of section 4323(h) of such 15
title is amended— 16
(A) by striking ‘‘subsection (a)(2)’’ and in-17
serting ‘‘subsection (a)(3)’’; and 18
(B) by striking ‘‘the court may award any 19
such person who prevails in such action or pro-20
ceeding reasonable attorney fees’’ and inserting 21
‘‘the court shall award any such person who 22
prevails in such action or proceeding reasonable 23
attorney fees’’. 24
(f) GAO R
EVIEW ANDREPORT ONUSERRA.— 25 197 
•HR 8371 EH
(1) REVIEW.—The Comptroller General of the 1
United States shall review the methods through 2
which the Secretary of Labor, acting through the 3
Veterans’ Employment and Training Service, proc-4
esses actions for relief under chapter 43 of title 38, 5
United States Code. 6
(2) E
LEMENTS.—Not later than one year after 7
the date of the enactment of this Act, the Comp-8
troller General shall submit to the Committees on 9
Veterans’ Affairs of the House of Representatives 10
and the Senate a report that includes— 11
(A) the findings of the review required 12
under paragraph (1); 13
(B) an identification of the number of ac-14
tions for relief under chapter 43 of title 38, 15
United States Code, initiated during the period 16
covered by the report, disaggregated by size of 17
employer and geographic region; 18
(C) an identification of the number of such 19
actions for relief that were erroneously dis-20
missed, as determined by the Comptroller Gen-21
eral; 22
(D) an identification of the number of such 23
actions for relief that were referred to the De-24
partment of Justice; and 25 198 
•HR 8371 EH
(E) an assessment of trends, if any, in 1
such actions for relief initiated during such pe-2
riod. 3
(g) GAO R
EVIEW OFPROTECTIONS FOR MEMBERS 4
OF THEUNIFORMEDSERVICES BYFEDERALINTEL-5
LIGENCEAGENCIES.— 6
(1) I
N GENERAL.—Not later than one year 7
after the date of the enactment of this Act, the 8
Comptroller General of the United States shall sub-9
mit to the appropriate congressional committees a 10
report on the processes and procedures adopted and 11
used by the intelligence community to provide the 12
protections for members of the uniformed services 13
otherwise established under chapter 43 of title 38, 14
United States Code. 15
(2) D
EFINITIONS.—In this subsection: 16
(A) The term ‘‘appropriate congressional 17
committees’’ means the Committees on Vet-18
erans’ Affairs of the House of Representatives 19
and Senate, the Permanent Select Committee 20
on Intelligence of the House of Representatives, 21
and the Select Committee on Intelligence of the 22
Senate. 23
(B) The term ‘‘intelligence community’’ 24
has the meaning given such term in section 25 199 
•HR 8371 EH
3(4) of the National Security Act of 1947 (50 1
U.S.C. 3003(4)). 2
SEC. 222. REVIEW OF INVESTIGATIONS MANUAL OF VET-3
ERANS’ EMPLOYMENT AND TRAINING SERV-4
ICE. 5
(a) I
NGENERAL.—Not later than one year after the 6
date of the enactment of this Act, and once every two 7
years thereafter for the period of five years beginning on 8
such date, the Secretary of Labor, shall review the manual 9
of the Department of Labor titled ‘‘Veterans’ Employment 10
and Training Service Investigations Manual: USERRA, 11
VEOA, and VP’’ (or a successor manual) and make such 12
revisions to such manual as the Secretary determines ap-13
propriate. 14
(b) R
EPORT.—Not later than 90 days after any date 15
on which the Secretary completes a review required under 16
subsection (a), the Secretary shall submit to the Commit-17
tees on Veterans’ Affairs of the House of Representatives 18
and the Senate— 19
(1) a report that includes a description of any 20
revision to such manual made pursuant to such re-21
view; and 22
(2) a copy of the entire such manual which— 23
(A) shall be provided to the Chairman and 24
Ranking Member of each such committee; and 25 200 
•HR 8371 EH
(B) may contain a separate addendum for 1
portions of the manual that contain law en-2
forcement sensitive materials. 3
SEC. 223. WARRIOR TRAINING ADVANCEMENT COURSE. 4
(a) R
EPORTING ON THE WARRIORTRAININGAD-5
VANCEMENTCOURSE.— 6
(1) R
EPORTS REQUIRED.— 7
(A) I
NITIAL REPORT.—Not later than six 8
months after the date of the enactment of this 9
Act, the Secretary of Veterans Affairs shall 10
submit to the Committees on Veterans’ Affairs 11
of the Senate and House of Representatives a 12
report on WARTAC. 13
(B) A
NNUAL REPORT.—One year after the 14
submission of the report required under para-15
graph subparagraph (A) and annually there-16
after, the Secretary shall submit to such Com-17
mittees a report that contains the elements 18
under subparagraphs (A) and (C) of paragraph 19
(2) with regards to the preceding year. 20
(2) E
LEMENTS.—Except as provided in para-21
graph (1)(B), the reports under this subsection shall 22
include the following elements: 23
(A) B
EST PRACTICES.—With regards to 24
best practices of WARTAC— 25 201 
•HR 8371 EH
(i) how many covered members have 1
applied to participate in WARTAC; 2
(ii) how many covered members have 3
participated in WARTAC; 4
(iii) how the Secretary provides train-5
ing to covered members during TAP; 6
(iv) how many covered members have 7
completed WARTAC; and 8
(v) any other information the Sec-9
retary determines appropriate. 10
(B) C
OST SAVINGS.—With regards to cost 11
savings of WARTAC— 12
(i) how much money the Secretary de-13
termines WARTAC saves the United 14
States each fiscal year; 15
(ii) how much money the Secretary 16
determines WARTAC has saved the 17
United States since its establishment; and 18
(iii) the determination of the Sec-19
retary whether other Federal agencies may 20
save money by establishing a program 21
similar to WARTAC. 22
(C) H
IRING.—With regards to hiring cov-23
ered members who complete WARTAC— 24 202 
•HR 8371 EH
(i) how the Secretary identifies posi-1
tions in the Department of Veterans Af-2
fairs for which such covered members may 3
qualify; 4
(ii) the grades of such positions on 5
the General Schedule under section 5332 6
of title 5, United States Code; and 7
(iii) how many such covered members 8
the Secretary has hired to such positions. 9
(3) D
ISTRIBUTION.—Not later than 30 days 10
after submitting the report under paragraph (1)(A), 11
the Secretary of Veterans Affairs shall transmit a 12
copy of the report under this section to the head of 13
each Federal agency. 14
(4) D
EFINITIONS.—In this subsection: 15
(A) The term ‘‘covered member’’ means 16
members of the Armed Forces participating in 17
TAP. 18
(B) The term ‘‘TAP’’ means the Transi-19
tion Assistance Program under sections 1142 20
and 1144 of title 10, United States Code. 21
(C) The term ‘‘WARTAC’’ means the 22
Warrior Training Advancement Course of the 23
Veterans Benefit Administration, in which the 24
Secretary provides training to covered members 25 203 
•HR 8371 EH
so such covered members may qualify for cer-1
tain employment in the Veterans Benefit Ad-2
ministration. 3
(b) P
ILOTPROGRAM TOEMPLOYVETERANS INPOSI-4
TIONSRELATING TO CONSERVATION AND RESOURCE 5
M
ANAGEMENTACTIVITIES.— 6
(1) B
EST PRACTICES FOR OTHER DEPART -7
MENTS.—The Assistant Secretary of Labor for Vet-8
erans’ Employment and Training, in consultation 9
with the Secretary of Veterans Affairs, shall estab-10
lish guidelines containing best practices for depart-11
ments and agencies of the Federal Government that 12
carry out programs to employ veterans who are 13
transitioning from service in the Armed Forces. 14
Such guidelines shall include the findings of the ini-15
tial report required under subsection (a)(1). 16
(2) P
ILOT PROGRAM.— 17
(A) E
STABLISHMENT.—The Secretary of 18
the Interior, in consultation with the Assistant 19
Secretary of Labor for Veterans’ Employment 20
and Training and the Secretary of Veterans Af-21
fairs, shall establish a pilot program under 22
which veterans are employed by the Federal 23
Government in positions that relate to the con-24 204 
•HR 8371 EH
servation and resource management activities of 1
the Department of the Interior. 2
(B) P
OSITIONS.—The Secretary of the In-3
terior shall— 4
(i) identify vacant positions in the De-5
partment of the Interior that are appro-6
priate to fill using the pilot program; and 7
(ii) to the extent practicable, fill such 8
positions using the pilot program. 9
(C) A
PPLICATION OF CIVIL SERVICE 10
LAWS.—A veteran employed under the pilot 11
program shall be treated as an employee as de-12
fined by section 2105 of title 5, United States 13
Code. 14
(D) B
RIEFINGS AND REPORT.— 15
(i) I
NITIAL BRIEFING.—Not later 16
than 60 days after the date of the submis-17
sion of the report required under sub-18
section (a)(1)(A), the Secretary of the In-19
terior and the Assistant Secretary of Labor 20
for Veterans’ Employment and Training 21
shall jointly provide to the appropriate con-22
gressional committees a briefing on the 23
pilot program under this subsection, which 24
shall include a description of how the pilot 25 205 
•HR 8371 EH
program will be carried out in a manner to 1
reduce the unemployment of veterans and 2
any recommendations for legislative actions 3
to improve the pilot program. 4
(ii) I
MPLEMENTATION BRIEFING .— 5
Not later than one year after the date on 6
which the pilot program under this para-7
graph commences, the Secretary of the In-8
terior and the Assistant Secretary of Labor 9
for Veterans’ Employment and Training 10
shall jointly provide to the appropriate con-11
gressional committees a briefing on the im-12
plementation of the pilot program. 13
(iii) F
INAL REPORT.—Not later than 14
30 days after the date on which the pilot 15
program under this paragraph is com-16
pleted, the Secretary of the Interior and 17
the Assistant Secretary of Labor for Vet-18
erans’ Employment and Training shall 19
jointly submit to the appropriate congres-20
sional committees a report on the pilot 21
program that includes the following: 22
(I) The number of veterans who 23
applied to participate in the pilot pro-24
gram. 25 206 
•HR 8371 EH
(II) The number of such veterans 1
employed under the pilot program. 2
(III) The number of veterans 3
identified in subclause (II) who 4
transitioned to full-time positions with 5
the Federal Government after partici-6
pating in the pilot program. 7
(IV) Any other information the 8
Secretary and the Assistant Secretary 9
determine appropriate with respect to 10
measuring the effectiveness of the 11
pilot program. 12
(E) D
URATION.—The authority to carry 13
out the pilot program under this paragraph 14
shall terminate on the date that is two years 15
after the date on which the pilot program com-16
mences. 17
(3) O
UTDOOR RECREATION PROGRAM ATTEND -18
ANCE.—The Secretary of each of the military de-19
partment is encouraged to allow members of the 20
Armed Forces serving on active duty to participate 21
in programs related to environmental stewardship or 22
guided outdoor recreation. 23 207 
•HR 8371 EH
(4) APPROPRIATE CONGRESSIONAL COMMIT -1
TEES DEFINED.—In this subsection, the term ‘‘ap-2
propriate congressional committees’’ means— 3
(A) the Committee on Veterans’ Affairs 4
and the Committee on Natural Resources of the 5
House of Representatives; and 6
(B) the Committee on Veterans’ Affairs 7
and the Committee on Energy and Natural Re-8
sources of the Senate. 9
Subtitle C—Home Loans 10
SEC. 231. IMPROVEMENTS TO PROGRAM FOR DIRECT 11
HOUSING LOANS MADE TO NATIVE AMER-12
ICAN VETERANS BY THE SECRETARY OF VET-13
ERANS AFFAIRS. 14
(a) G
ENERALAUTHORITIES ANDREQUIREMENTS.— 15
(1) D
IRECT HOUSING LOANS TO NATIVE AMER -16
ICAN VETERANS.—Section 3762(a) of title 38, 17
United States Code, is amended to read as follows: 18
‘‘(a) The Secretary may make a direct housing loan 19
to a Native American veteran under this subchapter if the 20
Secretary ensures the following: 21
‘‘(1) That each Native American veteran to 22
whom the Secretary makes a direct housing loan 23
under this subchapter— 24 208 
•HR 8371 EH
‘‘(A) holds, possesses, or purchases using 1
the proceeds of the loan a meaningful interest 2
in a lot or dwelling (or both) that is located on 3
trust land; and 4
‘‘(B) will purchase, construct, or improve 5
(as the case may be) a dwelling on the lot using 6
the proceeds of the loan. 7
‘‘(2) That each such Native American veteran 8
will convey to the Secretary by an appropriate in-9
strument the interest referred to in paragraph 10
(1)(A) as security for a direct housing loan under 11
this subchapter. 12
‘‘(3) That the Secretary, including the Sec-13
retary’s employees or agents, may enter upon the 14
trust land for the purposes of carrying out such ac-15
tions as the Secretary determines are necessary, in-16
cluding— 17
‘‘(A) to evaluate the advisability of the 18
loan; 19
‘‘(B) to monitor any purchase, construc-20
tion, or improvements carried out using the 21
proceeds of the loan; and 22
‘‘(C) to manage any servicing or post-fore-23
closure activities, including acquisition, property 24
inspections, and property management. 25 209 
•HR 8371 EH
‘‘(4) That there are established standards and 1
procedures that apply to the foreclosure of the inter-2
est conveyed by a Native American veteran pursuant 3
to paragraph (2), including— 4
‘‘(A) procedures for foreclosing the inter-5
est; and 6
‘‘(B) procedures for the resale of the lot or 7
dwelling (or both) purchased, constructed, or 8
improved using the proceeds of the loan. 9
‘‘(5) That the loan is made in a responsible and 10
prudent manner, subject to standards and proce-11
dures as are necessary for the reasonable protection 12
of the financial interests of the United States.’’. 13
(2) M
EMORANDUMS OF UNDERSTANDING , 14
AGREEMENTS, AND DETERMINATIONS .—Section 15
3762(b) of such title is amended to read as follows: 16
‘‘(b)(1) To carry out the purpose of subsection (a), 17
the Secretary may— 18
‘‘(A) enter into a memorandum of under-19
standing with a tribal organization, other entity, or 20
individual; 21
‘‘(B) rely on agreements or determinations of 22
other Federal agencies to guarantee, insure, or make 23
loans on trust land; and 24 210 
•HR 8371 EH
‘‘(C) enter into other agreements or take such 1
other actions as the Secretary determines necessary. 2
‘‘(2) If the Secretary determines that the require-3
ments under subsection (a) are not being enforced by a 4
tribal organization, other entity, or individual that is a 5
party to any memorandum of understanding, agreement, 6
or determination described in paragraph (1), the Secretary 7
may cease making new direct housing loans to Native 8
American veterans under this subchapter within the area 9
of the authority of the tribal organization, other entity, 10
or individual (as the case may be).’’. 11
(b) D
IRECTLOANS TONATIVEAMERICANVETERANS 12
T
OREFINANCEEXISTINGMORTGAGELOANS.—Section 13
3762(h) of such title is amended to read as follows: 14
‘‘(h) The Secretary may make direct loans to Native 15
American veterans in order to enable such veterans to refi-16
nance existing mortgage loans for any of the following 17
purposes: 18
‘‘(1) To refinance an existing loan made under 19
this section, if the loan— 20
‘‘(A) meets the requirements set forth in 21
subparagraphs (B), (C), and (E) of paragraph 22
(1) of section 3710(e) of this title; 23 211 
•HR 8371 EH
‘‘(B) will bear an interest rate at least one 1
percentage point less than the interest rate 2
borne by the loan being refinanced; and 3
‘‘(C) complies with paragraphs (2) and (3) 4
of section 3710(e) of this title, except that for 5
the purposes of this subsection the reference to 6
subsection (a)(8) of section 3710 of this title in 7
such paragraphs (2) and (3) shall be deemed to 8
be a reference to this subsection. 9
‘‘(2) To refinance an existing mortgage loan not 10
made under this section on a dwelling owned and oc-11
cupied by the veteran as the veteran’s home, if all 12
of the following requirements are met: 13
‘‘(A) The loan will be secured by the same 14
dwelling as was the loan being refinanced. 15
‘‘(B) The loan will provide the veteran with 16
a net tangible benefit. 17
‘‘(C) The nature and condition of the prop-18
erty is such as to be suitable for dwelling pur-19
poses. 20
‘‘(D) The amount of the loan does not ex-21
ceed either of the following: 22
‘‘(i) 100 percent of the reasonable 23
value of the dwelling, with such reasonable 24
value determined under the procedures es-25 212 
•HR 8371 EH
tablished by the Secretary under sub-1
section (d)(2). 2
‘‘(ii) An amount equal to the sum of 3
the balance of the loan being refinanced 4
and such closing costs (including any dis-5
count points) as may be authorized by the 6
Secretary to be included in the loan. 7
‘‘(E) Notwithstanding subparagraph (D), 8
if a loan is made for both the purpose of this 9
paragraph and to make energy efficiency im-10
provements, the loan must not exceed either of 11
the following: 12
‘‘(i) 100 percent of the reasonable 13
value of the dwelling as improved for en-14
ergy efficiency, with such reasonable value 15
determined under the procedures estab-16
lished by the Secretary under subsection 17
(d)(2). 18
‘‘(ii) The amount referred to under 19
subparagraph (D)(ii), plus the applicable 20
amount specified under section 3710(d)(2) 21
of this title. 22
‘‘(F) The loan meets all other require-23
ments the Secretary may establish under this 24
subchapter. 25 213 
•HR 8371 EH
‘‘(G) The existing mortgage being refi-1
nanced is a first lien on the property and se-2
cured of record. 3
‘‘(3) To refinance an existing mortgage loan to 4
repair, alter, or improve a dwelling owned by the 5
veteran and occupied by the veteran as the veteran’s 6
home, if all of the following requirements are met: 7
‘‘(A) The loan will be secured by the same 8
dwelling as was the loan being refinanced. 9
‘‘(B) The nature and condition of the 10
property is such as to be suitable for dwelling 11
purposes, and the repair, alteration, or improve-12
ment substantially protects or improves the 13
basic livability or utility of such property. 14
‘‘(C) The amount of the loan, including the 15
costs of repairs, alterations, and improvements, 16
does not exceed either of the following: 17
‘‘(i) 100 percent of the reasonable 18
value of the dwelling as repaired, altered, 19
or improved, with such reasonable value 20
determined under the procedures estab-21
lished by the Secretary under subsection 22
(d)(2). 23
‘‘(ii) An amount equal to the sum 24
of— 25 214 
•HR 8371 EH
‘‘(I) the balance of the loan being 1
refinanced; 2
‘‘(II) the actual cost of repairs, 3
alterations, or improvements; and 4
‘‘(III) such closing costs (includ-5
ing any discount points) as may be 6
authorized by the Secretary to be in-7
cluded in the loan. 8
‘‘(D) The loan meets all other require-9
ments the Secretary may establish under this 10
subchapter. 11
‘‘(E) The existing mortgage loan being re-12
financed is a first lien on the property and se-13
cured of record.’’. 14
(c) E
XPANSION OFOUTREACHPROGRAM ONAVAIL-15
ABILITY OFDIRECTHOUSINGLOANS FORNATIVEAMER-16
ICANVETERANS.—Section 3762(i)(2) of such title is 17
amended by adding at the end the following new subpara-18
graph: 19
‘‘(G) Pursuant to subsection (g)(4), assisting 20
Native American veterans in qualifying for mortgage 21
financing by— 22
‘‘(i) partnering with local service providers, 23
such as tribal organizations, tribally designated 24
housing entities, Native community development 25 215 
•HR 8371 EH
financial institutions, and nonprofit organiza-1
tions, for conducting outreach, homebuyer edu-2
cation, housing counseling, and post-purchase 3
education; and 4
‘‘(ii) providing other technical assistance as 5
needed. 6
‘‘(H) Attending conferences and conventions 7
conducted by the network of Native community de-8
velopment financial institutions and other Native 9
American homeownership organizations to provide 10
information and training to Native community devel-11
opment financial institutions about the availability of 12
the relending program under section 3762A of this 13
title.’’. 14
(d) A
DEQUATEPERSONNEL.—Section 3762 of such 15
title is amended by adding at the end the following new 16
subsection: 17
‘‘(k) The Secretary shall assign a sufficient number 18
of personnel of the Department dedicated to carrying out 19
the authority of the Secretary under this subchapter, in-20
cluding construction and valuation specialists to assist 21
with issues unique to new construction and renovations 22
on trust land.’’. 23
(e) D
EFINITIONS.—Section 3765 of such title is 24
amended— 25 216 
•HR 8371 EH
(1) in paragraph (1)— 1
(A) by amending subparagraph (C) to read 2
as follows: 3
‘‘(C) is located in the State of Alaska with-4
in a region established under section 7(a) of the 5
Alaska Native Claims Settlement Act (43 6
U.S.C. 1606(a));’’; 7
(B) in subparagraph (D), by striking the 8
period at the end and inserting a semicolon; 9
and 10
(C) by adding at the end the following new 11
subparagraphs: 12
‘‘(E) is defined by the Secretary of the In-13
terior and recognized by the United States as 14
land over which an Indian Tribe has govern-15
mental dominion; or 16
‘‘(F) is on any land that the Secretary de-17
termines is provided to Native American vet-18
erans because of their status as Native Ameri-19
cans.’’; and 20
(2) by adding at the end the following new 21
paragraphs: 22
‘‘(6) The term ‘community development finan-23
cial institution’ has the meaning given that term in 24
section 103 of the Community Development Banking 25 217 
•HR 8371 EH
and Financial Institutions Act of 1994 (12 U.S.C. 1
4702). 2
‘‘(7) The term ‘Indian Tribe’ means any Indian 3
tribe, band, nation, or other organized group or com-4
munity, including any Alaska Native village or re-5
gional or village corporation as defined in or estab-6
lished pursuant to the Alaska Native Claims Settle-7
ment Act (43 U.S.C. 1601 et seq.), which is recog-8
nized as eligible for the special programs and serv-9
ices provided by the United States to Indians be-10
cause of their status as Indians. 11
‘‘(8) The term ‘Native community development 12
financial institution’ means any entity— 13
‘‘(A) that has been certified as a commu-14
nity development financial institution by the 15
Secretary of the Treasury; 16
‘‘(B) that is not less than 51 percent 17
owned or controlled by Native Americans; and 18
‘‘(C) for which not less than 51 percent of 19
the activities of the entity serve Native Ameri-20
cans. 21
‘‘(9) The term ‘net tangible benefit’ shall have 22
such meaning as the Secretary determines appro-23
priate, but shall include the refinance of an interim 24
construction loan. 25 218 
•HR 8371 EH
‘‘(10) The term ‘other technical assistance’ 1
means services to assist a Native American veteran 2
to navigate the steps necessary for securing a mort-3
gage loan on trust land, including pre-development 4
activities related to utilities, identifying appropriate 5
residential construction services, and obtaining lease 6
clearances and title status reports from the applica-7
ble tribal organization or the Bureau of Indian Af-8
fairs. 9
‘‘(11) The term ‘tribally designated housing en-10
tity’ has the meaning given that term in section 4 11
of the Native American Housing Assistance and 12
Self-Determination Act of 1996 (25 U.S.C. 4103).’’. 13
(f) I
NTEREST RATEREDUCTION FINANCING 14
L
OAN.—Section 3729(b)(4)(F) of such title is amended 15
by striking ‘‘3762(h)’’ and inserting ‘‘3762(h)(1)’’. 16
(g) R
EGULATIONS.—Section 3761 of such title is 17
amended by adding at the end the following new sub-18
section: 19
‘‘(c) The Secretary shall prescribe such regulations 20
as may be necessary to carry out this subchapter.’’. 21 219 
•HR 8371 EH
SEC. 232. NATIVE COMMUNITY DEVELOPMENT FINANCIAL 1
INSTITUTION RELENDING PROGRAM. 2
(a) I
NGENERAL.—Subchapter V of chapter 37 of 3
title 38, United States Code, is amended by inserting after 4
section 3762 the following new section: 5
‘‘§ 3762A. Native community development financial 6
institution relending program 7
‘‘(a) P
URPOSE.—The Secretary may make a loan to 8
a Native community development financial institution for 9
the purpose of allowing the institution to relend loan 10
amounts to qualified Native American veterans, subject to 11
the requirements of this section. 12
‘‘(b) S
TANDARDS.—(1) The Secretary shall establish 13
standards to be used in evaluating whether to make a loan 14
to a Native community development financial institution 15
under this section. 16
‘‘(2) In establishing standards under paragraph (1), 17
the Secretary shall ensure that a Native community devel-18
opment financial institution— 19
‘‘(A) is able to originate and service loans for 20
single-family homes; 21
‘‘(B) is able to operate the relending program 22
in a manner consistent with the mission of the De-23
partment to serve veterans; and 24 220 
•HR 8371 EH
‘‘(C) uses loan amounts received under this sec-1
tion only for the purpose of relending, as described 2
in subsection (c), to Native American veterans. 3
‘‘(c) R
ELENDINGREQUIREMENTS.—(1) A Native 4
community development financial institution that receives 5
a loan under this section shall use the loan amounts to 6
make loans to Native American veterans residing on trust 7
land. 8
‘‘(2) A loan to a Native American veteran made by 9
a Native community development financial institution 10
under paragraph (1) shall— 11
‘‘(A) be limited either to the purpose of pur-12
chase, construction, or improvement of a dwelling lo-13
cated on trust land or to the refinance of an existing 14
mortgage loan for a dwelling on trust land, con-15
sistent with the requirements of section 3762(h) of 16
this title; and 17
‘‘(B) comply with such terms and conditions as 18
the Secretary determines are necessary to protect 19
against predatory lending, including the interest rate 20
charged on a loan to a Native American veteran. 21
‘‘(d) R
EPAYMENT.—A loan made to a Native commu-22
nity development financial institution under this section 23
shall— 24 221 
•HR 8371 EH
‘‘(1) be payable to the Secretary upon such 1
terms and conditions as are prescribed in regulations 2
pursuant to this subchapter; and 3
‘‘(2) bear interest at a rate of one percent. 4
‘‘(e) O
VERSIGHT.—Subject to notice and opportunity 5
for a hearing, whenever the Secretary finds with respect 6
to loans made under subsection (a) or (c) that any Native 7
community development financial institution has failed to 8
maintain adequate loan accounting records, to dem-9
onstrate proper ability to service loans adequately, or to 10
exercise proper credit judgment, or that such Native com-11
munity development financial institution has willfully or 12
negligently engaged in practices otherwise detrimental to 13
the interest of veterans or of the Government, the Sec-14
retary may take such actions as the Secretary determines 15
necessary to protect veterans or the Government, such as 16
requiring immediate repayment of any loans made under 17
subsection (a) and the assignment to the Secretary of 18
loans made under subsection (c). 19
‘‘(f) S
UNSET.—The Secretary may not make a loan 20
under this section after September 30, 2027.’’. 21
(b) C
LERICALAMENDMENT.—The table of sections 22
at the beginning of chapter 37 of such title is amended 23
by inserting after the item relating to section 3762 the 24
following new item: 25 222 
•HR 8371 EH
‘‘3762A. Native community development financial institution relending pro-
gram.’’. 
(c) NATIVEAMERICANVETERANHOUSINGLOAN 1
P
ROGRAMACCOUNT.—Section 3763 of such title is 2
amended by adding at the end the following new sub-3
section: 4
‘‘(c) Of amounts available in the Account, the Sec-5
retary may use for loans made under section 3762A of 6
this title— 7
‘‘(1) in fiscal year 2025, not more than 8
$5,000,000; and 9
‘‘(2) in any fiscal year after fiscal year 2025, 10
an amount determined necessary by the Secretary to 11
meet the demand for such loans.’’. 12
TITLE III—DISABILITY AND 13
MEMORIAL AFFAIRS MATTERS 14
SEC. 301. BURIAL ALLOWANCE FOR CERTAIN VETERANS 15
WHO DIE AT HOME WHILE IN RECEIPT OF 16
HOSPICE CARE FURNISHED BY DEPARTMENT 17
OF VETERANS AFFAIRS. 18
(a) I
NGENERAL.—The Secretary of Veterans Affairs 19
shall treat a veteran described in subsection (b) as a vet-20
eran described in subparagraph (A) of section 2303(a)(2) 21
of title 38, United States Code. 22
(b) V
ETERANDESCRIBED.—A veteran described in 23
this subsection is a veteran who dies in a home or other 24 223 
•HR 8371 EH
setting at which the deceased veteran was, at the time of 1
death, receiving hospice care pursuant to section 1717(a) 2
of such title if such care was directly preceded by the Sec-3
retary furnishing to the veteran hospital care or nursing 4
home care described in clause (ii) of such subparagraph. 5
(c) E
FFECTIVEDATE; APPLICABILITY.—This section 6
shall apply with respect to deaths that occur— 7
(1) on or after the date that is 180 days after 8
the date of the enactment of this Act; and 9
(2) before October 1, 2026. 10
SEC. 302. AUTHORITY FOR SECRETARY OF VETERANS AF-11
FAIRS TO AWARD GRANTS TO STATES AND IN-12
DIAN TRIBES TO IMPROVE OUTREACH TO 13
VETERANS. 14
(a) I
NGENERAL.—Chapter 63 of title 38, United 15
States Code, is amended— 16
(1) by redesignating sections 6307 and 6308 as 17
sections 6308 and 6309, respectively; and 18
(2) by inserting after section 6306 the following 19
new section 6307: 20
‘‘§ 6307. Grants to States and Indian Tribes to im-21
prove outreach to veterans 22
‘‘(a) P
URPOSE.—It is the purpose of this section to 23
provide for assistance by the Secretary to States and In-24
dian Tribes to carry out programs that improve covered 25 224 
•HR 8371 EH
outreach and assistance to veterans and the spouses, chil-1
dren, and parents of veterans, to ensure that such individ-2
uals are fully informed about, and assisted in applying for, 3
any veterans and veterans-related benefits and programs 4
(including veterans programs of a State or Indian Tribe) 5
for which they may be eligible and facilitate opportunities 6
for such individuals to receive competent, qualified serv-7
ices in the preparation, presentation and prosecution of 8
veterans benefits claims. 9
‘‘(b) A
UTHORITY.—The Secretary may award grants 10
to States and Indian Tribes— 11
‘‘(1) to carry out, coordinate, improve, or other-12
wise enhance— 13
‘‘(A) covered outreach activities; or 14
‘‘(B) activities to assist in the development 15
and submittal of claims for veterans and vet-16
erans-related benefits; or 17
‘‘(2) to increase the number of county or Tribal 18
veterans service officers serving in the State by hir-19
ing new, additional such officers. 20
‘‘(c) A
PPLICATION.—(1) To be eligible for a grant 21
under this section, a State or Indian Tribe shall submit 22
to the Secretary an application therefor at such time, in 23
such manner, and containing such information as the Sec-24
retary may require. 25 225 
•HR 8371 EH
‘‘(2) Each application submitted under paragraph (1) 1
shall include the following: 2
‘‘(A) A detailed plan for the use of the grant. 3
‘‘(B) A description of the programs through 4
which the State or Indian Tribe will meet the out-5
come measures developed by the Secretary under 6
subsection (j). 7
‘‘(C) A description of how the State or Indian 8
Tribe will distribute grant amounts equitably among 9
counties or Tribal lands with varying levels of urban-10
ization. 11
‘‘(D) A plan for how the grant will be used to 12
meet the unique needs of American Indian veterans, 13
Alaska Native veterans, or Native Hawaiian vet-14
erans, elderly veterans, and veterans from other un-15
derserved communities. 16
‘‘(d) D
ISTRIBUTION.—The Secretary shall seek to en-17
sure that grants awarded under this section are equitably 18
distributed among States and Indian Tribes with varying 19
levels of urbanization. 20
‘‘(e) S
ET-ASIDE.—Of the amounts authorized to be 21
appropriated or otherwise made available for grants under 22
this section for any fiscal year, the Secretary shall ensure 23
that not less than five percent is used to make grants to 24
Indian Tribes. 25 226 
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‘‘(f) PRIORITY.—The Secretary shall prioritize 1
awarding grants under this section that will serve the fol-2
lowing areas: 3
‘‘(1) Areas with a critical shortage of county or 4
Tribal veterans service officers. 5
‘‘(2) Areas with high rates of— 6
‘‘(A) suicide among veterans; or 7
‘‘(B) referrals to the Veterans Crisis Line. 8
‘‘(g) U
SE OFCOUNTY ORTRIBALVETERANSSERV-9
ICEOFFICERS.—A State or Indian Tribe that receives a 10
grant under this section to carry out an activity described 11
in subsection (b)(1) shall carry out the activity through— 12
‘‘(1) a county or Tribal veterans service officer 13
of the State; or 14
‘‘(2) if the State or Indian Tribe does not have 15
a county or Tribal veterans service officer, or if the 16
county or Tribal veterans service officers of the 17
State or Indian Tribe cover only a portion of that 18
State or Indian Tribe, an appropriate entity of a 19
State, local, or Tribal government, as determined by 20
the Secretary. 21
‘‘(h) R
EQUIREDACTIVITIES.—Any grant awarded 22
under this section shall be used— 23
‘‘(1) to expand existing programs, activities, 24
and services; 25 227 
•HR 8371 EH
‘‘(2) to hire new, additional county or Tribal 1
veterans service officers; or 2
‘‘(3) for travel and transportation to facilitate 3
carrying out paragraph (1) or (2). 4
‘‘(i) A
UTHORIZEDACTIVITIES.—A grant under this 5
section may be used to provide education and training, in-6
cluding on-the-job training, for State, county, local, and 7
Tribal government employees who provide (or when 8
trained will provide) covered outreach services in order for 9
those employees to obtain accreditation in accordance with 10
procedures approved by the Secretary. 11
‘‘(j) O
UTCOMEMEASURES.—(1) The Secretary shall 12
develop and provide to each State or Indian Tribe that 13
receives a grant under this section written guidance on 14
the following: 15
‘‘(A) Outcome measures. 16
‘‘(B) Policies of the Department. 17
‘‘(2) In developing outcome measures under para-18
graph (1), the Secretary shall consider the following goals: 19
‘‘(A) Increasing the use of veterans and vet-20
erans-related benefits, particularly among vulnerable 21
populations. 22
‘‘(B) Increasing the number of county and 23
Tribal veterans service officers recognized by the 24 228 
•HR 8371 EH
Secretary for the representation of veterans under 1
chapter 59 of this title. 2
‘‘(k) T
RACKINGREQUIREMENTS.—(1) With respect 3
to each grant awarded under this section, the Secretary 4
shall track the use of veterans and veterans-related bene-5
fits among the population served by the grant, including 6
the average period of time between the date on which a 7
veteran applies for such a benefit and the date on which 8
the veteran receives the benefit, disaggregated by type of 9
benefit. 10
‘‘(2) Not less frequently than annually during the life 11
of the grant program established under this section, the 12
Secretary shall submit to Congress a report on— 13
‘‘(A) the information tracked under paragraph 14
(1); 15
‘‘(B) how the grants awarded under this section 16
serve the unique needs of American Indian veterans, 17
Alaska Native veterans, or Native Hawaiian vet-18
erans, elderly veterans, and veterans from other un-19
derserved communities; and 20
‘‘(C) other information provided by States and 21
Indian Tribes pursuant to the grant reporting re-22
quirements. 23
‘‘(l) P
ERFORMANCEREVIEW.—The Secretary shall— 24 229 
•HR 8371 EH
‘‘(1) review the performance of each State or 1
Indian Tribe that receives a grant under this sec-2
tion; and 3
‘‘(2) make information regarding such perform-4
ance publicly available. 5
‘‘(m) R
EMEDIATIONPLAN.—(1) In the case of a 6
State or Indian Tribe that receives a grant under this sec-7
tion and does not meet the outcome measures developed 8
by the Secretary under subsection (j), the Secretary shall 9
require the State or Indian Tribe to submit a remediation 10
plan under which the State shall describe how and when 11
it plans to meet such outcome measures. 12
‘‘(2) The Secretary may not award a subsequent 13
grant under this section to a State or Indian Tribe de-14
scribed in paragraph (1) unless the Secretary approves the 15
remediation plan submitted by the State or Indian Tribe. 16
‘‘(n) D
EFINITIONS.—In this section: 17
‘‘(1) The term ‘county or Tribal veterans serv-18
ice officer’ includes a local equivalent veterans serv-19
ice officer. 20
‘‘(2) The term ‘covered outreach’ means out-21
reach with respect to— 22
‘‘(A) benefits administered by the Under 23
Secretary for Benefits; or 24 230 
•HR 8371 EH
‘‘(B) similar benefits administered by a 1
State or Indian Tribe. 2
‘‘(3) The term ‘Indian Tribe’ has the meaning 3
given such term in section 4 of the Indian Self-De-4
termination and Education Assistance Act (25 5
U.S.C. 5304). 6
‘‘(4) The term ‘State’ includes the District of 7
Columbia, the Commonwealth of Puerto Rico, the 8
Commonwealth of the Northern Mariana Islands, 9
and any territory or possession of the United States. 10
‘‘(5) The term ‘Veterans Crisis Line’ means the 11
toll-free hotline for veterans established under sec-12
tion 1720F(h) of this title.’’. 13
(b) C
LERICALAMENDMENT.—The table of sections 14
at the beginning of chapter 63 of such title is amended 15
by striking the items relating to sections 6307 and 6308 16
and inserting the following new items: 17
‘‘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 18
authorized to be appropriated to the Secretary of Veterans 19
Affairs for each of fiscal years 2026 and 2027, 20
$10,000,000 to carry out section 6307 of title 28, United 21
States Code, as added by subsection (a). 22 231 
•HR 8371 EH
SEC. 303. DEFINITION OF SURVIVING SPOUSE. 1
Paragraph (3) of section 101 of title 38, United 2
States Code, is amended to read as follows: 3
‘‘(3) The term ‘surviving spouse’ means (except for 4
purposes of chapter 19 of this title) a person who was 5
the spouse of a veteran at the time of the veteran’s death, 6
and who lived with the veteran continuously from the date 7
of marriage to the date of the veteran’s death (except 8
where there was a separation which was due to the mis-9
conduct of, or procured by, the veteran without the fault 10
of the spouse) and who has not remarried.’’. 11
SEC. 304. ENSURING ONLY LICENSED HEALTH CARE PRO-12
FESSIONALS PERFORM MEDICAL DISABILITY 13
EXAMINATIONS UNDER CERTAIN DEPART-14
MENT OF VETERANS AFFAIRS PILOT PRO-15
GRAM. 16
(a) P
ROHIBITION ON USE OFCERTAINHEALTH 17
C
AREPROFESSIONALS.—Section 504(c)(1) of the Vet-18
erans’ Benefits Improvements Act of 1996 (Public Law 19
104–275; 38 U.S.C. 5101 note) is amended by inserting 20
‘‘only’’ before ‘‘a health care professional’’. 21
(b) R
EMEDIES.—The Secretary of Veterans Affairs 22
shall take such actions as the Secretary considers appro-23
priate to ensure compliance with section 504(c) of the Vet-24
erans’ Benefits Improvements Act of 1996 (Public Law 25 232 
•HR 8371 EH
104–275; 38 U.S.C. 5101 note), as amended by subsection 1
(a). 2
(c) A
NNUALREPORT.—Not later than one year after 3
the date of the enactment of this Act and not less fre-4
quently than once each year thereafter, the Secretary shall 5
submit to the Committee on Veterans’ Affairs of the Sen-6
ate and the Committee on Veterans’ Affairs of the House 7
of Representatives a report on— 8
(1) the conduct of the pilot program established 9
under section 504 of the Veterans’ Benefits Im-10
provements Act of 1996 (Public Law 104–275; 38 11
U.S.C. 5101 note); and 12
(2) the actions of the Secretary under sub-13
section (b). 14
(d) T
ECHNICALCORRECTIONS.—Section 504 of the 15
Veterans’ Benefits Improvements Act of 1996 (Public 16
Law 104–275; 38 U.S.C. 5101 note) is amended, in the 17
section heading, by striking ‘‘
PHYSICIANS’’ and inserting 18
‘‘
HEALTH CARE PROFESSIONALS ’’. 19 233 
•HR 8371 EH
SEC. 305. PROVISION OF INFORMATION REGARDING AN 1
AGENT OR ATTORNEY TO A LICENSED 2
HEALTH CARE PROFESSIONAL WHO PER-3
FORMS A MEDICAL DISABILITY EXAMINATION 4
UNDER CERTAIN DEPARTMENT OF VET-5
ERANS AFFAIRS PILOT PROGRAM. 6
(a) I
NGENERAL.—Section 504 of the Veterans’ Ben-7
efits Improvements Act of 1996 (Public Law 104–275; 38 8
U.S.C. 5101 note), as amended by section 304, is further 9
amended by adding at the end the following new sub-10
section: 11
‘‘(f) C
ERTAININFORMATIONPROVIDED TOHEALTH 12
C
AREPROFESSIONAL.—The Secretary shall provide to a 13
health care professional who performs an examination 14
under subsection (a), or a contractor performing a con-15
tract under such subsection, the contact information of 16
any agent or attorney recognized by the Secretary under 17
chapter 59 of title 38, United States Code, with regards 18
to a claim for benefits that gives rise to such examina-19
tion.’’. 20
(b) A
PPLICABILITY.—The amendment made by this 21
section shall apply to an examination described in sub-22
section (a) of such section that is performed on or after 23
the date of the enactment of this Act. 24 234 
•HR 8371 EH
SEC. 306. MODERNIZATION OF DEPARTMENT OF VETERANS 1
AFFAIRS DISABILITY BENEFIT QUESTION-2
NAIRES. 3
(a) R
EQUIREMENT FOR TRANSMISSION OFCERTAIN 4
I
NFORMATION INMACHINE-READABLEFORMAT.— 5
(1) R
EQUIREMENT.—Not later than 180 days 6
after enactment of this Act, the Secretary of Vet-7
erans Affairs shall require all disability benefit ques-8
tionnaire data collected in the course of medical dis-9
ability examinations made by covered non-Depart-10
ment providers to be transmitted to the Department 11
in a machine-readable format. 12
(2) I
SSUANCE OF STANDARDS .—Not later than 13
90 days after the date of the enactment of this Act, 14
the Secretary shall issue standards for the trans-15
mission of disability benefit questionnaire data in a 16
machine-readable format as required under para-17
graph (1). 18
(3) U
PDATES.—In making updates to disability 19
benefit questionnaires after the date specified in 20
paragraph (1), the Secretary shall— 21
(A) ensure that the updates are made in a 22
manner that allows for the data collected under 23
the questionnaires to be in a machine-readable 24
format as of the date on which the update goes 25
into effect; and 26 235 
•HR 8371 EH
(B) not later than 30 days before an up-1
date goes into effect, notify the covered non-De-2
partment providers (or the contractor per-3
forming a contract under section 504 of the 4
Veterans Benefits Improvement Act of 1996 5
(Public Law 104–275; 38 U.S.C. 5101 note)) 6
described in such paragraph of such updates. 7
(b) P
LAN FORINFORMATIONTECHNOLOGYSYSTEM 8
M
ODIFICATION.—Not later than 180 days after the date 9
of the enactment of this Act, the Secretary shall submit 10
to the Committees on Veterans’ Affairs of the Senate and 11
House of Representatives a plan to modify the information 12
technology systems and processes of the Department to 13
enable a non-Department health care professional, as-14
signed to or selected by a claimant, to transmit to the De-15
partment, in a machine-readable format, disability benefit 16
questionnaire data, including complete disability benefit 17
questionnaires rather than partial questionnaires or ele-18
ments of medical evidence. 19
(c) P
UBLICAVAILABILITY OFINFORMATION.—The 20
Secretary shall make publicly available on the internet 21
website of the Department referred to in section 5101(d) 22
of title 38, United States Code— 23
(1) a description of the standards issued under 24
subsection (a)(2); and 25 236 
•HR 8371 EH
(2) the plan required under subsection (b). 1
(d) D
EFINITIONS.—In this section: 2
(1) The term ‘‘claimant’’ has the meaning given 3
such term in section 5100 of title 38, United States 4
Code. 5
(2) The term ‘‘covered non-Department pro-6
vider’’ means a health care provider who— 7
(A) is not an employee of the Department 8
of Veterans Affairs; and 9
(B) pursuant to a contract under section 10
504 of the Veterans Benefits Improvement Act 11
of 1996 (Public Law 104–275; 38 U.S.C. 5101 12
note), as amended by sections 304 and 305, ex-13
amines a claimant for a medical disability. 14
SEC. 307. DEPARTMENT OF VETERANS AFFAIRS AUTO-15
MATIC PROCESSING OF CERTAIN CLAIMS 16
FOR TEMPORARY DISABILITY RATINGS. 17
(a) I
NGENERAL.—Not later than one year after the 18
date of the enactment of this Act, the Secretary of Vet-19
erans Affairs shall modify the information technology sys-20
tems of the Department of Veterans Affairs to use auto-21
mation technology for claims for temporary disability rat-22
ings for veterans described in section 1156(a)(1)(C) of 23
title 38, United States Code. 24 237 
•HR 8371 EH
(b) ADDITIONALREQUIREMENTS.—In providing for 1
the automatic processing of claims as required under sub-2
section (a), the Secretary shall ensure that— 3
(1) medical evidence is obtained from the cor-4
porate data warehouse of the Department or other 5
sources of data, the Secretary determines appro-6
priate; 7
(2) employees of the Department continue to 8
determine whether a veteran is entitled to a tem-9
porary disability rating under section 1156(a)(1)(C) 10
of title 38, United States Code; and 11
(3) claims may be processed manually if the 12
evidence of record is not sufficient to decide the 13
claim or if the medical evidence is provided in a for-14
mat that is not compatible with the system devel-15
oped under subsection (a). 16
TITLE IV—HOMELESSNESS 17
MATTERS 18
SEC. 401. SHORT TITLE. 19
This title may be cited as the ‘‘Housing our Military 20
Veterans Effectively Act of 2024’’ or the ‘‘HOME Act of 21
2024’’. 22 238 
•HR 8371 EH
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, 2027, 133 14
percent)’’; and 15
(ii) by adding at the end the fol-16
lowing: 17
‘‘(iii) For each of fiscal years 2025 through 2027, 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-25 239 
•HR 8371 EH
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 2024, 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. 23 240 
•HR 8371 EH
‘‘(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 carry out the amendments made by 8
subsection (a) through interim guidance in advance of the 9
issuance of regulations for such purpose. 10
(c) S
TRATEGICPLAN.— 11
(1) I
N GENERAL.—Not later than September 12
30, 2025, the Secretary of Veterans Affairs shall 13
submit to the Committee on Veterans’ Affairs of the 14
Senate and the Committee on Veterans’ Affairs of 15
the House of Representatives a strategic plan for the 16
provision of grants and per diem payments for serv-17
ices furnished to homeless veterans under sections 18
2011 and 2012 of title 38, United 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 25 241 
•HR 8371 EH
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. 23 242 
•HR 8371 EH
(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. 25 243 
•HR 8371 EH
(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; 25 244 
•HR 8371 EH
(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 25 245 
•HR 8371 EH
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, 2027. 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 25 246 
•HR 8371 EH
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—OVERSIGHT AND 15
INVESTIGATIONS MATTERS 16
SEC. 501. DEPARTMENT OF VETERANS AFFAIRS EMPLOYEE 17
TRAINING REGARDING OFFICE OF INSPEC-18
TOR GENERAL. 19
(a) T
RAINING.—The Secretary of Veterans Affairs 20
shall require each employee of the Department of Veterans 21
Affairs who begins employment with the Department on 22
or after the date of the enactment of this Act to receive 23
training that the Inspector General of the Department 24
shall develop on the reporting of wrongdoing to, respond-25 247 
•HR 8371 EH
ing to requests from, and the duty of cooperating with 1
the Office of Inspector General of the Department. 2
(b) T
IMING OFTRAINING.—In carrying out sub-3
section (a), the Secretary shall require each employee of 4
the Department covered under such subsection to undergo 5
the training required by such subsection not later than 6
one year after the date on which the employee begins em-7
ployment with the Department. 8
(c) E
LEMENTS.—Training developed and required 9
under subsection (a) shall include the following: 10
(1) Definition of the role, responsibilities, and 11
legal authority of the Inspector General of the De-12
partment and the duties of employees of the Depart-13
ment for engaging with the Office of Inspector Gen-14
eral. 15
(2) Identification of Federal whistleblower pro-16
tection rights, including the right to report fraud, 17
waste, abuse, and other wrongdoing to Congress. 18
(3) Identification of the circumstances and 19
mechanisms for reporting fraud, waste, abuse, and 20
other wrongdoing to the Inspector General, including 21
making confidential complaints to the Inspector 22
General. 23
(4) Identification of the prohibitions and rem-24
edies that help to protect employees of the Depart-25 248 
•HR 8371 EH
ment from retaliation when reporting wrongdoing to 1
the Inspector General. 2
(5) Recognition of opportunities to engage with 3
staff of the Office of Inspector General to improve 4
programs, operations, and services of the Depart-5
ment. 6
(6) Notification of the authority of the Inspec-7
tor General to subpoena the attendance and testi-8
mony of witnesses, including former employees of 9
the Department, as necessary to carry out the duties 10
of the Office of Inspector General under section 312 11
of title 38, United States Code. 12
(d) D
ESIGN ANDUPDATE.—The Inspector General of 13
the Department shall design, and update as the Inspector 14
General considers appropriate, the training developed and 15
required by subsection (a). 16
(e) S
YSTEM.—The Secretary shall provide, via the 17
talent management system of the Department, or suc-18
cessor system, the training developed and required under 19
subsection (a). 20
(f) R
ELATION TOCERTAINTRAINING.—The Sec-21
retary shall ensure that training developed and required 22
under subsection (a) is separate and distinct from training 23
provided under section 733 of title 38, United States 24
Code. 25 249 
•HR 8371 EH
(g) NOTICE TOEMPLOYEES.—The Secretary shall 1
ensure that the Inspector General is afforded the oppor-2
tunity, not less frequently than twice each year and more 3
frequently if the Inspector General considers appropriate 4
under extraordinary circumstances, to use the electronic 5
mail system of the Department to notify all authorized 6
users of such system of the following: 7
(1) The roles and responsibilities of the employ-8
ees of the Department when engaging with the Of-9
fice of Inspector General. 10
(2) The availability of training provided under 11
subsection (a). 12
(3) How to access training provided under sub-13
section (a). 14
(4) Information about how to contact the Office 15
of Inspector General, including a link to any 16
website-based reporting form of the Office. 17
SEC. 502. ANNUAL REVIEW OF SECURITY AT COVERED FA-18
CILITIES OF THE DEPARTMENT OF VET-19
ERANS AFFAIRS. 20
(a) A
NNUALSURVEY.—Not later than one year after 21
the date of the enactment of this Act, and annually there-22
after for each of the following five fiscal years, the Sec-23
retary of Veterans Affairs, in coordination with the Direc-24
tor of the Office of Security and Law Enforcement of the 25 250 
•HR 8371 EH
Department of Veterans Affairs, shall conduct a survey 1
of the covered employees at each covered facility to collect 2
information regarding security. Each annual survey shall 3
include questions about— 4
(1) the type and frequency of criminal activity 5
experienced at the covered facility during the fiscal 6
year which most recently concluded including wheth-7
er or not the criminal activity was related to resi-8
dents at the facility or campus such as those in a 9
residential rehabilitation treatment program or en-10
hanced-use lease facility; 11
(2) the number of vacancies and number of 12
days vacant for Department police officers at the 13
covered facility at the time of the survey delineated 14
by recruitment status and stage; 15
(3) the availability and adequacy of covered 16
equipment; 17
(4) the availability and adequacy of resources, 18
classes, or other time set aside for training Depart-19
ment police officers who work at each covered facil-20
ity about any skill or tactic related to law enforce-21
ment, including the proper use of force, firearms 22
qualifications and training, procedures for respond-23
ing to an active threat, and any other training re-24
quired for Department police officers; 25 251 
•HR 8371 EH
(5) any security weakness at covered facilities; 1
(6) the relationship between the covered facility 2
(including the Department police officers who work 3
at the covered facility) and local, state, and federal 4
law enforcement agencies including what agreements 5
or memorandums of understanding exist between 6
each covered facility and external law enforcement 7
agencies; 8
(7) efforts by the personnel of the covered facil-9
ity to address and reduce criminal activity at, or in 10
close proximity to, the covered facility; and 11
(8) recommendations for the Secretary to better 12
address and reduce criminal activity at, or in close 13
proximity to, covered facilities so as to improve the 14
safety of veterans, employees, visitors, other author-15
ized personnel, and the surrounding community. 16
(b) R
EPORT.—Not later than 30 days after the end 17
of the next full Fiscal Year after the enactment of this 18
Act and for each of the following five fiscal years, the Sec-19
retary shall submit to each of the Committees on Vet-20
erans’ Affairs of the Senate and the House of Representa-21
tives a report regarding the results of the surveys con-22
ducted under subsection (a) during the previous fiscal 23
year. The report shall include— 24 252 
•HR 8371 EH
(1) the results of the annual survey described 1
under subsection (a) for the year covered by the re-2
port; 3
(2) an analysis, made in coordination with the 4
Director of the Office of Security and Law Enforce-5
ment of such Department, each director and police 6
chief of a Veterans Integrated Service Network, and 7
the directors and police chiefs of the medical centers 8
within the Veterans Integrated Service Network of 9
the results of the triannual security inspections con-10
ducted in prior fiscal year, to include a plan of ac-11
tion that describes how the Secretary plans to ad-12
dress any security weakness identified in the results 13
of the triannual security inspections and includes 14
clearly-stated goals with measurable benchmarks for 15
each goal and deadlines for each benchmark; and 16
(3) a list of all vacant positions for police chief 17
or deputy police chief at each covered facility during 18
the prior fiscal year, the number of individuals who 19
filled those positions over the two years prior to the 20
date of the survey, the number of days the positions 21
were vacant without someone serving in an acting 22
capacity, and the number of days the positions were 23
filled by individuals serving in an acting capacity. 24
(c) D
EFINITIONS.—In this section: 25 253 
•HR 8371 EH
(1) The term ‘‘covered equipment’’ means any 1
item issued by the Secretary of Veterans Affairs to 2
a Department police officer (including firearms, 3
weapons detecting technology, ballistic vests, body- 4
worn cameras, and radios) for use in the provision 5
of services under section 902 of title 38, United 6
States Code. 7
(2) The term ‘‘covered employee’’ means an em-8
ployee of the Department of Veterans Affairs who is 9
employed and responsible for security operations at 10
a covered facility including a covered facility’s police 11
chief, facility emergency management leader, facility 12
director, or person carrying out the responsibilities 13
of one of these positions in an acting capacity. 14
(3) The term ‘‘covered facility’’ means any fa-15
cility of the Department of Veterans Affairs where 16
Department police officers have jurisdiction. 17
(4) The term ‘‘Department police officer’’ is 18
used as such term as used in section 902 of title 38, 19
United States Code. 20
(5) The term ‘‘security weakness’’ means a defi-21
ciency in the facilities, staffing, or covered equip-22
ment at a covered facility that a covered employee 23
of the covered facility determines presents a risk to 24
the safety of visitors or staff, including an unsecured 25 254 
•HR 8371 EH
door, inoperable security camera, unsecured police 1
operations room, a lack of security presence at an 2
entrance to the covered facility, and a lack of secu-3
rity presence in an area of the covered facility or the 4
grounds of the covered facility that the director of 5
the covered facility determines requires an increased 6
security presence. 7
SEC. 503. MODIFICATION OF CERTAIN HOUSING LOAN 8
FEES. 9
The loan fee table in section 3729(b)(2) of title 38, 10
United States Code, is amended by striking ‘‘November 11
29, 2031’’ each place it appears and inserting ‘‘June 9, 12
2034’’. 13
Passed the House of Representatives November 18, 
2024. 
Attest: 
Clerk.   118
TH
CONGRESS 
2
D
S
ESSION
 
H. R. 8371 
AN ACT 
To make certain improvements in the laws adminis-
tered by the Secretary of Veterans Affairs, and 
for other purposes.