(A)

in subsection (a)(1)—

(B)

by striking subsection (c) and redesignating subsections (d) and (e) as subsections (c) and (d), respectively; and

(C)

in subsection (d), as redesignated, by striking paragraphs (3) and (4).

(A)

by inserting (i) before The remarriage;

(B)

in clause (i), as designated by subparagraph (A), by striking Notwithstanding the previous sentence and inserting the following:

(ii)

Notwithstanding clause (i); and

(C)

by adding at the end the following new clause:

(iii)

Notwithstanding clause (ii), the remarriage of a surviving spouse shall not bar the furnishing of benefits under section 1311 or 1562 of this title to the surviving spouse of a veteran.; and

(A)

by striking subparagraph (A); and

(B)

by renumbering subparagraphs (B) through (E) as subparagraphs (A) through (D), respectively.

(A) In general

Section 1114 of title 38, United States Code, is amended by adding at the end the following new subsection:

(u)

In the case of a veteran eligible for a monthly aid and attendance allowance under subsection (r) or subsection (t) of this section, the Secretary shall, in addition to the total amount of compensation for which the veteran is eligible under this section, pay the veteran a supplemental monthly allowance at the rate of $833.33.

(B) Effective date; applicability

Subsection (u) of such section (as added by subparagraph (A)) shall take effect on December 1, 2026, and shall apply to months beginning on or after such date.

(A) Expanded definition of active duty for purposes of housing loans

Section 3701(b) of title 38, United States Code, is amended by adding at the end the following new paragraph:

(9)

The term active duty has the meanings as follows:

(A)

In the case of members of the regular components of the Armed Forces, the meaning given such term in section 101(21)(A).

(B)

In the case of members of the reserve components of the Armed Forces—

(i)

service on active duty (as defined in section 101(d) of title 10), inactive-duty training (as defined in section 101(d) of title 10), or annual training duty; or

(ii)

service on active duty under a call or order to active duty under section 688, 12301(a), 12301(d), 12301(g), 12301(h), 12302, 12304, 12304a, or 12304b of title 10 or section 713 of title 14, but not including inactive duty training (as defined in section 101(d) of title 10) or annual training duty.

(C)

In the case of a member of the Army National Guard of the United States or Air National Guard of the United States, in addition to service described in subparagraph (B), full-time service—

(i)

in the National Guard of a State for the purpose of organizing, administering, recruiting, instructing, or training the National Guard;

(ii)

in the National Guard when performing full-time National Guard duty (as defined in section 101 of title 32); or

(iii)

in the National Guard when performing active duty (as defined in section 101 of title 32).

(B) Retroactive applicability to service performed

The amendments made by this subsection shall apply with respect to any service performed on or after September 11, 2001.

(A) Expansion to individuals with at least 14 days of service

Section 3701(b) of title 38, United States Code, is amended by inserting after paragraph (7) the following new paragraph:

(8)

The term veteran also includes, for purposes of home loans (subject to the additional loan fee in section 3729(b)(4)(J) of this title), an individual who—

(A)

is not otherwise eligible for the benefits of this chapter;

(B)

has completed a total service of at least 14 days on active duty under paragraph (B) or (C) of paragraph (9); and

(C)

following completion of such service, continued to serve until the completion of entry level and skill training (as defined in section 3301(3) of this title).

(B) Basic entitlement

Section 3702(a)(2) of title 38, United States Code, is amended by adding at the end the following:

(H)

Each individual described in section 3701(b)(8) of this title.

(C) Additional loan fee for such individuals

Section 3729(b)(4) of title 38, United States Code, is amended by adding at the end the following new subparagraph:

(J)

In the case of a housing loan in which the veteran has eligibility under section 3701(b)(8) of this title and does not otherwise have eligibility, the loan fee table in paragraph (2) shall be applied to the veteran or other obligor (as applicable) by adding 1.00 to the percentage in the table.

(D) Notification to personnel

The Secretary of Veterans Affairs shall provide information about this benefit to the Secretary of Defense to ensure that each member of a reserve component or a member of the Army National Guard of the United States or Air National Guard of the United States who completes entry level and skill training (as defined in section 3301(3) of title 38, United States Code) after the date of the enactment of this Act is notified of their eligibility for housing loan benefits under chapter 37 of such title, including eligibility (subject to the additional loan fee) under section 3701(b)(8) of such title.

(A) In general

Section 5109B of title 38, United States Code, is amended—

(B) Deadline

The Secretary of Veterans Affairs shall submit the first report required by subsection (b) of section 5109B of such title (as added by subparagraph (A)) by not later than one year after the date of the enactment of this Act.

(A) In general

Chapter 51 of title 38, United States Code, is amended by inserting after section 5109B the following new section:

5109C. Requirement to track and maintain information on certain claims for benefits; notice of certain assignments

(a) In general

The Secretary shall use technology to track and maintain information (including information with respect to timeliness) on—

(1)

claims for benefits under the laws administered by the Secretary (including issues within such claims) that are—

(A)

continuously pursued in accordance with—

(i)

sections 5104C(a) and 5110(a)(2) of this title; or

(ii)

any other policy established by the Secretary;

(B)

filed in the National Work Queue (or any successor system) but have not been assigned to an office of the Veterans Benefits Administration for adjudication;

(C)

afforded expeditious treatment by the Veterans Benefits Administration pursuant to section 5109B of this title or any other policy established by the Secretary;

(D)

remanded by the Board of Veterans’ Appeals to the Secretary pursuant to section 7104 of this title; or

(E)

pending a hearing by the Board of Veterans’ Appeals under section 7107 of this title;

(2)

instances in which an adjudicator of the Veterans Benefits Administration does not comply with a relevant decision of the Board of Veterans’ Appeals to remand a claim for benefits under the laws administered by the Secretary (or an issue within such a claim), including any such instance in which the relevant decision concerned a failure on the part of the agency of original jurisdiction to satisfy the duty of the Secretary to assist under section 5103A of this title;

(3)

supplemental claims under section 5108 of this title that are filed—

(A)

in accordance with section 5104C(a) and section 5110(a)(2) of this title; and

(B)

after the date of the applicable final decision of the Secretary with respect to a claim for benefits under the laws administered by the Secretary (or an issue within such a claim); and

(4)

first notices submitted to the Secretary of the death of individuals in receipt of benefits under the laws administered by the Secretary, disaggregated by such individuals who were—

(A)

assigned a fiduciary; and

(B)

not assigned a fiduciary.

(b) Annual report

(1)

The Secretary shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate an annual report that includes all information maintained and tracked pursuant to subsection (a).

(2)

The first report required by paragraph (1) shall be submitted by not later than one year after the date of the enactment of the Take Care of America’s Veterans Act.

(B) Clerical amendment

The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 5109B the following new item:

(A) Authority to aggregate certain claims

(B) Requirement to ensure substantial compliance with certain decisions

Such section is further amended—

(C) Definition of aggregate; report

Such section is further amended by adding at the end the following new subsections:

(h)

Not later than three years after the date on which the Secretary of Veterans Affairs completes the development of the policies and procedures required under paragraph (7)(D)(i)(II), and every five years thereafter, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the aggregation of claims by the Board under subsection (a). Each such report shall include—

(1)

an identification of each instance in which the Board aggregated appeals during the period covered by the report, including, for each such instance, the number of appeals that were aggregated;

(2)

an assessment of whether the aggregation of appeals has contributed to improved efficiency at the Board with issuing decisions on appeals; and

(3)

such other matters as the Secretary determines appropriate.

(i)

In this section, the term aggregate—

(1)

means any practice or procedure to collect common issues, claims, or appeals by multiple parties for the purposes of resolving such issues, claims, or appeals; and

(2)

includes the use of joinder, consolidation, intervention, class actions, and any other multiparty proceedings.

(A)

by redesignating subsections (b) and (c) as subsections (d) and (e), respectively; and

(B)

by inserting after subsection (a) the following new subsections:

(b)

(1)

In an appeal over which the Court has jurisdiction pursuant to section 7266 of this title, if the appellant files a request for class certification pursuant to the rules prescribed by the Court pursuant to section 7264 of this title, the Court shall have supplemental jurisdiction over any claim for benefits under the laws administered by the Secretary—

(A)

filed by a claimant who satisfies the definition of the class contained in such request (including a claimant who has filed a claim for benefits under such laws that are specified in such request); and

(B)

regarding which—

(i)

the agency of original jurisdiction has issued a nonfinal decision; and

(ii)

the claimant has filed a notice of disagreement under section 5104C(a) or section 7105 of this title, including any case in which a claimant has filed a supplemental claim within one year of a Board decision under section 5110(a)(2)(D) and 5108 of this title following a notice of disagreement and decision of the Board.

(2)

A claimant may submit a request for administrative review of such a claim under section 5104C(a) of this title during the period beginning on the date on which the named claimant of the motion for class action review submits to the Court a motion for class action review and ending on the date that is 60 days after the later of the following dates:

(A)

The date on which the Court issues a final decision with respect to such claim.

(B)

The date on which the Court issues a final decision with respect to such motion for class action review.

(3)

In the case of a claimant whose claim is decided by the Board during the period when the Court is reviewing the motion for class action review the deadline for such claimant to file an appeal to the Court with respect to the decision of the Board shall be tolled if the Court denies the motion for class action review.

(c)

(1)

In the case of a claim for benefits under the laws administered by the Secretary, the Court may remand a matter to the Board of Veterans’ Appeals for the limited purpose of ordering the Board to address a question of law or fact if the Court determines the Board failed to—

(A)

address, in the relevant decision of the Board, an issue that—

(i)

the claimant or the representative of the claimant raised; or

(ii)

was reasonably raised by the evidentiary record of the claim; or

(B)

provide adequate reasons or bases for the decision of the Board with respect to such question.

(2)

The Court shall issue Rules that provide for each of the following:

(A)

When and how a party to an appeal (either the appellant or the Secretary) may request that the Court issue a limited remand.

(B)

The period of time within which the Board is required to issue a decision on the relevant question identified in a limited remand.

(C)

Guidelines for when the Court may grant a request for a limited remand.

(D)

Guidelines for when the Court may decide sua sponte to issue a limited remand without a request from any party.

(E)

A requirement that the parties to an appeal for which a limited remand is issued provide notice to the Court when the Board issues its decision on the relevant question identified in the limited remand.

(3)

With respect to any matter remanded to the Board pursuant to paragraph (1), the Court shall—

(A)

retain jurisdiction over such matter; and

(B)

stay the proceedings of the Court on such matter until the date on which the Board issues the decision required by such remand.

(A) Study

The Chairman of the Board of Veterans’ Appeals shall carry out a study to identify questions of law or fact the Board commonly considers when reviewing appeals pursuant to section 7104 of title 38, United States Code, for which precedential guidance would assist the Board in issuing final decisions on such appeals. The Chairman may use artificial intelligence and other technology in carrying out such study.

(B) Report

Not later than one year after the date of the enactment of this Act, the Chairman of the Board of Veterans Appeals shall submit to the Committees on Veterans Affairs of the House of Representatives and the Senate a report that includes the findings of the study required by subparagraph (A).

(A) Agreement

Not later than 30 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall seek to enter into an agreement with an FFRDC under which the FFRDC shall conduct an assessment of the feasibility of modifying the authority of the Board of Veterans’ Appeals established under chapter 71 of title 38, United States Code, to permit the Board to issue precedential decisions with respect to questions of law or fact arising in matters before the Board.

(B) Report; briefings

If the Secretary fails to finalize an agreement with an FFRDC under subparagraph (A) before the date that is 180 days after the date on which the Secretary enters negotiations with respect to such agreement, the Secretary shall—

(C) Assessment

An FFRDC that enters into an agreement under subparagraph (A) shall, in consultation with veterans service organizations, veterans’ and survivors’ advocate groups, relevant legal experts, and the Chair of the Administrative Conference of the United States (or the designee or designees of such Chair) submit to the Secretary a written assessment that includes the following:

(D) Report; implementation

(E) Definitions

In this paragraph:

(A) In general

Section 7101 of title 38, United States Code, is amended by adding at the end the following new subsection:

(f)

(1)

The Chairman shall carry out a program to ensure quality in the decisions of the Board. Under such program, the Chairman shall—

(A)

develop policies and procedures for—

(i)

measuring quality in such decisions;

(ii)

maintaining data and identifying trends with respect to—

(I)

errors in such decisions;

(II)

errors in decisions remanded or returned to the Board by the Court of Appeals for Veterans Claims; and

(III)

specific members of the Board that issued decisions that were subsequently vacated by the Court of Appeals for Veterans Claims; and

(iii)

ensuring any such decision of the Board to remand a claim for a benefit under a law administered by the Secretary is necessary under any applicable law or regulation;

(B)

with respect to a claim for such a benefit that is remanded to the Board by the Court of Appeals for Veterans Claims—

(i)

inform any employee of the Board responsible for drafting the decision of the Board with respect to such claim that such decision was remanded;

(ii)

provide any such employee with a copy of the relevant order of the Court of Appeals for Veterans Claims (including a copy of any accompanying joint motion for remand); and

(iii)

provide incentives to such employees to review such relevant orders and joint motions for remand; and

(C)

ensure, to the maximum extent practicable, that any error identified by the Board under such program is corrected before the date on which the Board issues the final decision associated with such error.

(2)

In developing policies and procedures to measure quality in decisions of the Board pursuant to clause (i) of subparagraph (A) of paragraph (1), the Chairman shall consider the data and trends maintained and identified pursuant to clause (ii) of such subparagraph.

(3)

The Chairman may use technology, including artificial intelligence, to maintain such data and identify such trends.

(4)

The Secretary shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate an annual report on the program required by this subsection that includes, with respect to the period covered by the report, an identification of—

(A)

elements, if any of the process of the Board for reviewing an appeal under this chapter that lead to errors in decisions of the Board; and

(B)

the most common reasons that a claim for a benefit under a law administered by the Secretary was remanded to such Board by the Court of Appeals for Veterans Claims.

(B) Deadline

The Secretary shall submit the first report required by paragraph (2) of such section (as added by subparagraph (A)) by not later than one year after the date of the enactment of this Act.

(A) Training program

(B) Performance reviews of members of the Board

Section 7101A of such title is amended—

(A) Information relating to decisions to remand

Section 7104 of such title is amended in subsection (d)—

(B) Notice of remanded decision for certain employees

Such section is further amended in—

(A) In general

Chapter 71 of title 38, United States Code, is amended by inserting after section 7114 the following new section:

7115. Annual report on Board of Veterans’ Appeals

The Chairman of the Board shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate an annual report that includes, for each decision of the Board to remand a claim for a benefit under a law administered by the Secretary to the Secretary for further adjudication during the period covered by the report, a statement of the reasons for such decision of the Board, disaggregated by decisions on—

(1)

claims with a rating decision dated on or after February 19, 2019; and

(2)

claims with a rating decision dated before such date.

(B) Deadlines

The Secretary shall submit the first reports required by subsections (a) and (b) of section 7115 of such title (as added by paragraph (1)) by not later than one year after the date of the enactment of this Act.

(C) Clerical amendment

The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 7114 the following new item:

(A) In general

Not later than six months after the date of the enactment of this Act, the Secretary of Veterans Affairs, in consultation with the Chairman of the Board of Veterans’ Appeals and the head of the Office of Administrative Review of the Veterans Benefits Administration, shall develop a plan to—

(B) Report

The Secretary shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report on such plan by not later than six months after the date of the enactment of this Act.

(A) Study

Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs, in consultation with the Office of the General Counsel of the Department of Veterans Affairs and the Chairman of the Board of Veterans’ Appeals, shall complete a study to identify—

(B) Report

Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report that includes—

(A) In general

Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall implement policies, processes, and technological capabilities, including in the National Work Queue (or successor system), to ensure that, in the case of any covered situation, a claims processors is made aware of, and assigned to address, such covered situation.

(B) Definitions

In this subsection:

(A)

A grade of disability of 0 percent shall be assigned for sleep apnea syndrome when the syndrome is asymptomatic, with or without treatment.

(B)

A grade of disability of 10 percent shall be assigned for sleep apnea syndrome when treatment yields incomplete relief.

(C)

A grade of disability of 50 percent shall be assigned for sleep apnea syndrome only if—

(D)

A grade of disability of 100 percent shall be assigned for sleep apnea syndrome only if there is also end-organ damage.

(A)

health care professional; and

(B)

contract.

(A)

without such a contract; or

(B)

unauthorized to enter into such a contract.

(A) In general

The study conducted under paragraph (1) shall include the following:

(B) Number of days to complete defined

For purposes of subparagraph (A)(i), the term number of days to complete means the number of days in the period—

(A)

The term covered medical disability examination means a medical nexus examination or medical opinion for the purposes of adjudicating a claim for a benefit under chapter 11 or 15 of title 38, United States Code, regardless of whether conducted by an employee or a contractor of the Department.

(B)

The terms rural and highly rural have the meanings given those terms under the rural-urban commuting areas coding system of the Department of Agriculture.

(A)

assessing the adequacy of covered medical disability examinations for claims adjudication;

(B)

determining the necessity of medical disability examinations where claims can be adjudicated based on existing evidence without ordering additional examinations;

(C)

relevant statutes, judicial decisions, regulations, and Department policies, including—

(D)

input from impacted Department employees, including duly appointed labor representatives.

(A) Board of Veterans’ Appeals

Section 7101(d)(2) of title 38, United States Code, is amended—

(B) United States Court of Appeals for Veterans Claims

Section 7288(b) of title 38, United States Code, is amended by adding at the end the following new paragraph:

(16)

A summary of recurring issues that result in remands.

(A)

a statistically significant sample of covered medical disability examinations completed by employees of the Department of Veterans Affairs; and

(B)

a statistically significant sample of covered medical disability examinations completed by each contractor that provides such examinations for the Department.

(A)

analyze the samples specified in paragraph (2); and

(B)

pursuant to such analysis, identify—

(A) In general

Except as provided for in subparagraph (B), if during a review under paragraph (1) the Secretary finds any covered medical disability examination to be not adequate for adjudicating a claim, the Secretary shall ensure the claimant examined by that examination—

(B) Exception

The Secretary is not required to furnish an additional examination under subparagraph (A) if the Secretary determines such an examination to be unnecessary for purposes of adjudicating the claim.

(A)

Systems and processes used by the Department enable seamless and clear communication of requirements between the claims processors who request medical disability examinations and the persons who conduct such examinations, including through a contract.

(B)

Medical disability examiners, including through a contract, have access to the medical records and claims information they need to conduct exams that are adequate for purposes of rating claims for benefits under laws administered by the Secretary.

(C)

Claimants or appellants for whom a medical disability examination is requested of the Department have agency in determining when and where the examination is conducted.

(D)

Claimants or appellants for whom a medical disability examination is requested of the Department have a seamless experience when scheduling their examinations without regard to who conducts the examinations.

(E)

The Department conducts customer satisfaction and experience surveys of claimants or appellants who attend medical disability examinations provided under laws administered by the Secretary.

(A) In general

Not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall implement, with input from the veteran community, an informative outreach program for veterans regarding the standard of proof for evaluation of claims relating to military sexual trauma, including requirements for a medical examination and opinion.

(B) Targeted outreach

In implementing the program under subparagraph (A), the Secretary shall, to the extent practicable, target outreach to veterans who submitted a claim relating to military sexual trauma that was denied.

(A) In general

The Secretary of Veterans Affairs shall establish a working group to review correspondence relating to military sexual trauma.

(B) Membership

The working group established under subparagraph (A) shall be composed of members who shall be appointed by the Secretary from among employees of the Department of Veterans Affairs who are experts in military sexual trauma and mental health, of whom—

(C) Duties

The working group established under subparagraph (A) shall—

(D) Individual who has experienced military sexual trauma defined

In this subsection, the term individual who has experienced military sexual trauma means—

(A) Notice to claimants of required information and evidence

Section 5103 of title 38, United States Code, is amended by adding at the end the following new subsection:

(c) Written communications to individuals who have experienced military sexual trauma

(1)

The Secretary shall ensure that any written communication under this section from the Department to an individual who has experienced military sexual trauma includes each of the following:

(A)

Contact information for each of the following:

(i)

The military sexual trauma coordinator of the Veterans Benefits Administration.

(ii)

The military sexual trauma coordinator of the Veterans Health Administration.

(iii)

The Veterans Crisis Line.

(iv)

The facility of the Veterans Health Administration closest to where the individual resides.

(v)

The Readjustment Counseling Service location closest to where the individual resides.

(B)

Information on the eligibility of the individual for services provided through the Readjustment Counseling Service location described in subparagraph (A)(v).

(2)

In this subsection:

(A)

The term individual who has experienced military sexual trauma means—

(i)

an individual who has filed a claim for compensation under chapter 11 of this title relating to military sexual trauma;

(ii)

a veteran who has been awarded compensation under such chapter relating to military sexual trauma; or

(iii)

a member of the Armed Forces (including a member of the National Guard or Reserves), a former member of the Armed Forces, or a veteran who is receiving care from the Department relating to military sexual trauma.

(B)

The term military sexual trauma has the meaning given that term in section 1166(d)(2) of this title.

(C)

The term Veterans Crisis Line means the toll-free hotline for veterans established under section 1720F(h) of this title.

(B) Decisions and notices of decisions

Section 5104 of title 38, United States Code, is amended by adding at the end the following new subsection:

(e)

(1)

The Secretary shall ensure that any written communication under this section from the Department to an individual who has experienced military sexual trauma includes each of the following:

(A)

Contact information for each of the following:

(i)

The military sexual trauma coordinator of the Veterans Health Administration.

(ii)

The Veterans Crisis Line.

(iii)

The facility of the Veterans Health Administration closest to where the individual resides.

(iv)

The Readjustment Counseling Service location closest to where the individual resides.

(B)

Information on the eligibility of the individual for services provided through the Readjustment Counseling Service location described in subparagraph (A)(iv).

(2)

The Secretary shall ensure that any written communication under this section from the Department to an individual who has experienced military sexual trauma that includes notification of an award of compensation under chapter 11 of this title relating to military sexual trauma includes—

(A)

the contact information described in paragraph (1); and

(B)

the contact information for the military sexual trauma coordinator of the Veterans Benefits Administration.

(3)

In this subsection:

(A)

The term individual who has experienced military sexual trauma means—

(i)

an individual who has filed a claim for compensation under chapter 11 of this title relating to military sexual trauma;

(ii)

a veteran who has been awarded compensation under such chapter relating to military sexual trauma; or

(iii)

a member of the Armed Forces (including a member of the National Guard or Reserves), a former member of the Armed Forces, or a veteran who is receiving care from the Department relating to military sexual trauma.

(B)

The term military sexual trauma has the meaning given that term in section 1166(d)(2) of this title.

(C)

The term Veterans Crisis Line means the toll-free hotline for veterans established under section 1720F(h) of this title.

(C) Higher-level review by the agency of original jurisdiction

Section 5104B of title 38, United States Code, is amended by adding at the end the following new subsection:

(f) Written communications to individuals who have experienced military sexual trauma

(1)

The Secretary shall ensure that any written communication under this section from the Department to an individual who has experienced military sexual trauma includes each of the following:

(A)

Contact information for each of the following:

(i)

The military sexual trauma coordinator of the Veterans Health Administration.

(ii)

The Veterans Crisis Line.

(iii)

The facility of the Veterans Health Administration closest to where the individual resides.

(iv)

The Readjustment Counseling Service location closest to where the individual resides.

(B)

Information on the eligibility of the individual for services provided through the Readjustment Counseling Service location described in subparagraph (A)(iv).

(2)

The Secretary shall ensure that any written communication under this section from the Department to an individual who has experienced military sexual trauma that includes notification of an award of compensation under chapter 11 of this title relating to military sexual trauma includes—

(A)

the contact information described in paragraph (1); and

(B)

the contact information for the military sexual trauma coordinator of the Veterans Benefits Administration.

(3)

In this subsection:

(A)

The term individual who has experienced military sexual trauma means—

(i)

an individual who has filed a claim for compensation under chapter 11 of this title relating to military sexual trauma;

(ii)

a veteran who has been awarded compensation under such chapter relating to military sexual trauma; or

(iii)

a member of the Armed Forces (including a member of the National Guard or Reserves), a former member of the Armed Forces, or a veteran who is receiving care from the Department relating to military sexual trauma.

(B)

The term military sexual trauma has the meaning given that term in section 1166(d)(2) of this title.

(C)

The term Veterans Crisis Line means the toll-free hotline for veterans established under section 1720F(h) of this title.

(D) Board of Veterans’ Appeals

Section 7104 of title 38, United States Code, is amended by adding at the end the following new subsection:

(g)

(1)

The Secretary shall ensure that any written communication under this section from the Department to an individual who has experienced military sexual trauma include each of the following:

(A)

Contact information for each of the following:

(i)

The military sexual trauma coordinator of the Veterans Health Administration.

(ii)

The Veterans Crisis Line.

(iii)

The facility of the Veterans Health Administration closest to where the individual resides.

(iv)

The Readjustment Counseling Service location closest to where the individual resides.

(B)

Information on the eligibility of the individual for services provided through the Readjustment Counseling Service location described in subparagraph (A)(iv).

(2)

The Secretary shall ensure that any written communication under this section from the Department to an individual who has experienced military sexual trauma that includes notification of an award of compensation under chapter 11 of this title relating to military sexual trauma includes—

(A)

the contact information described in paragraph (1); and

(B)

the contact information for the military sexual trauma coordinator of the Veterans Benefits Administration.

(3)

In this subsection:

(A)

The term individual who has experienced military sexual trauma means—

(i)

an individual who has filed a claim for compensation under chapter 11 of this title relating to military sexual trauma;

(ii)

a veteran who has been awarded compensation under such chapter relating to military sexual trauma; or

(iii)

a member of the Armed Forces (including a member of the National Guard or Reserves), a former member of the Armed Forces, or a veteran who is receiving care from the Department relating to military sexual trauma.

(B)

The term military sexual trauma has the meaning given that term in section 1166(d)(2) of this title.

(C)

The term Veterans Crisis Line means the toll-free hotline for veterans established under section 1720F(h) of this title.

(A)

the quality of training provided to personnel of the Department of Veterans Affairs who review claims for disability compensation under chapter 11 of title 38, United States Code, for disabilities relating to military sexual trauma; and

(B)

the quality of the procedures of the Department for reviewing the accuracy of the processing of such claims.

(A)

With respect to the quality of training described in paragraph (1) of such subsection:

(B)

With respect to the quality of procedures described in paragraph (2) of such subsection:

(A) In general

Each year, the Under Secretary for Benefits of the Department of Veterans Affairs shall conduct a special focus review on the accuracy of the processing of claims for disability compensation under chapter 11 of title 38, United States Code, for disabilities relating to military sexual trauma.

(B) Elements

Each review conducted under subparagraph (A) shall include a review of the following:

(A)

in paragraph (1), by striking through 2027 and inserting until the date described in section 109(d)(4) of the Take Care of America’s Veterans Act; and

(B)

in paragraph (2), by adding at the end the following new subparagraph:

(I)

The findings of the most recent special focus review conducted under subsection (d)(1)(A) of section 109 of the Take Care of America’s Veterans Act, including—

(i)

the elements under subsection (d)(1)(B) of such section;

(ii)

the number of claims returned for reprocessing under subsection (d)(2) of such section; and

(iii)

the number of claims described in clause (ii) for which the decision relating to service-connection or entitlement to compensation changed as a result of reprocessing the claim.

(A)

Staff of the operations center for military sexual trauma of the Department of Veterans Affairs who have experience reviewing the quality of medical examinations in support of claims for disability compensation under chapter 11 of title 38, United States Code.

(B)

Staff of the Medical Disability Examination Office of the Department.

(C)

Veterans service officers who have experience with claims described in paragraph (1).

(D)

Medical examiners who have experience with such claims.

(E)

Staff of the Veterans Experience Office of the Department.

(F)

Such other individuals as the Secretary considers appropriate.

(A)

review the quality of medical examinations described in paragraph (1);

(B)

review the feasibility of minimizing re-examinations for conditions relating to military sexual trauma; and

(C)

submit to the Under Secretary for Benefits of the Department and the Secretary recommendations on how to—

(A)

The views of the working group on efforts by the Department to eliminate re-traumatization of individuals who file claims described in subsection (a).

(B)

Legislative proposals to improve the experience of such individuals in pursuing such claims.

(C)

The recommendations submitted under paragraph (3)(C).

(D)

The plan of the Under Secretary for Benefits of the Department and the Secretary to implement such recommendations.

(A)

review the recommendations submitted under paragraph (3)(C); and

(B)

implement the recommendations that, as determined by the Under Secretary and the Secretary, would improve the claims process for individuals who file claims described in paragraph (1).

(A)

Claims relating to military sexual trauma submitted to the Secretary for benefits under laws administered by the Secretary that have been submitted, completed, or appealed, including appeals pending at the agency of jurisdiction and at the Board of Veterans’ Appeals.

(B)

For comparison purposes with subparagraph (A), claims not relating to military sexual trauma submitted to the Secretary for benefits under laws administered by the Secretary that have been submitted, completed, or appealed.

(C)

Overall, cumulative information relating to claims relating to military sexual trauma submitted to the Secretary for benefits under laws administered by the Secretary, including the following:

(D)

The total number of claims relating to military sexual trauma submitted to the Secretary for benefits under laws administered by the Secretary.

(E)

The methods used for submittal of claims relating to military sexual trauma to the Secretary for benefits under laws administered by the Secretary.

(F)

The most frequent reasons the Secretary denies a claim relating to military sexual trauma submitted to the Secretary for a benefit under a law administered by the Secretary.

(G)

The most frequent conditions or disabilities for which a claim relating to military sexual trauma is denied.

(H)

The most frequent conditions or disabilities for which a claim relating to military sexual trauma is submitted to the Secretary for disability compensation under chapter 11 of title 38, United States Code, including the grant rate for such contentions.

(A)

Veterans Crisis Line contact information.

(B)

Information regarding the availability of services from military sexual trauma coordinators of the Veterans Health Administration.

(C)

Information regarding the availability of services from military sexual trauma coordinators of the Veterans Benefits Administration.

(D)

Information on availability of specialized care, services, and benefits from the Department for individuals who have experienced military sexual trauma.

(E)

Such additional information as the Secretary considers appropriate.

(A)

Not later than 2 years after the date of the enactment of this Act, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report detailing—

(B)

Not later than 180 days after the date of the enactment of this Act, the Secretary shall commence providing, on a quarterly basis, to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a quarterly briefing on the Department’s processing of military sexual trauma-related claims.

(A)

the Secretary of Veterans Affairs;

(B)

an expert in laws administered by the Secretary of Veterans Affairs;

(C)

a veterans service organization recognized under section 5902 of title 38, United States Code;

(D)

an entity that advocates for veterans; and

(E)

an entity that advocates for the survivors of veterans.

(A)

the Secretary of Veterans Affairs;

(B)

an expert in laws administered by the Secretary of Veterans Affairs;

(C)

a veterans service organization recognized under section 5902 of title 38, United States Code;

(D)

an entity that advocates for veterans; and

(E)

an entity that advocates for survivors of veterans.

(A)

in paragraph (3), by striking together and all that follows through before and inserting not later than 60 days after; and

(B)

by adding at the end the following new paragraph:

(4) Additional assistance for an individual not eligible for a monthly housing stipend

In the case of an individual making an election under subsection (a) who is described by subparagraph (A), (C), or (E) of paragraph (1) of that subsection, and who is not eligible for a monthly stipend payable under section 3313(c) of this title, the educational assistance payable to the individual under this chapter shall be paid—

(A)

in a lump sum calculated by multiplying—

(i)

the total amount of contributions described in paragraph (1)(A) with regards to such individual; and

(ii)

the sum of the number of months described in subclauses (I) and (II) of paragraph (1)(B)(i) with regards to such individual; and

(B)

to the individual not later than 60 days after the exhaustion of the individual's entitlement to educational assistance under this chapter.

(A)

by striking paragraphs (2) through (7) and inserting paragraphs (2) through (6); and

(B)

in paragraph (1), in the heading, by inserting for an individual eligible for a monthly housing stipend after Additional assistance.

(A)

by inserting that requires regular and substantive interaction between students and instructors after course of study;

(B)

in item (aa), by striking ; or and inserting a semicolon;

(C)

in item (bb), by striking ; and and inserting ; or; and

(D)

by adding at the end by following new item:

(cc)

an institution of higher education, as such term is defined in section 102 of the Higher Education Act of 1965 (20 U.S.C. 1002), that is approved to participate or is participating in the student financial assistance programs authorized by title IV of that Act; and

(A)

the effectiveness of oversight activities conducted by the Department of Veterans Affairs and State approving agencies;

(B)

institutional compliance with applicable requirements under chapter 36 of title 38, United States Code;

(C)

participation and outcomes of veterans enrolled in programs approved pursuant to section 3680A(a)(4)(A)(ii)(III)(cc) of such title, as added by paragraph (1); and

(D)

any recommendations to improve oversight, program integrity, or educational outcomes for veterans.

(A)

by redesignating subsection (d) as subsection (e); and

(B)

by inserting, after subsection (c), the following new subsection (d):

(d) Agreement with institution concerned

A covered member may enter into an agreement under subsection (a) only if the covered member has completed at least half of a course of covered education.

(A)

by striking not more than 10 business days of notice;

(B)

by striking this section. and inserting this section—; and

(C)

by adding at the end the following new paragraphs:

(1)

in the case of an educational institution or training establishment with a time stamp database collection feature, not fewer than 10, and not more than 15, business days of notice; and

(2)

in the case of any other educational institution or training establishment, not more than 10 business days of notice.; and

(A)

the Veterans Health Administration;

(B)

the Veterans Benefits Administration; or

(C)

the seller.

(A)

The capacity of the office determined by the Secretary under such subsection, to carry out processing described in such subsection, including—

(B)

Recommendations to improve such processing.

(C)

Estimated costs to the United States to implement such recommendations.

(A)

by striking calling and inserting communicating with; and

(B)

by inserting through the use of tailored lines of communication, including mailings, text messaging, virtual chatting, and other electronic forms of messaging after Armed Forces; and

(A)

by inserting (A) before Within; and

(B)

by adding at the end the following new subparagraph:

(B)

The Secretary concerned shall ensure that a member described in subparagraph (A) receives preseparation counseling in the following amounts:

(i)

In the case of a member who has accepted an offer of full-time employment, or has enrolled in a program of education or vocational training, that shall commence after the member separates, retires, or is discharged, not fewer than three days.

(ii)

In the case of a member other than a member described in clause (i), not fewer than five days.

(A)

by striking Each Secretary concerned and inserting The Secretaries of Defense and Homeland Security; and

(B)

by striking pathways for members of the military department concerned and inserting pathways, standardized across the armed forces.

(A)

by striking the heading and inserting Transmission of Certain Information to Other Departments;

(B)

by inserting (1) before In the case; and

(C)

by adding at the end the following new paragraphs:

(2)

Before a member described in subsection (a) separates, retires, or is discharged, the Secretary concerned shall transmit to the Secretary of Veterans Affairs the Department of Defense Form DD–2648 regarding such member.

(3)

(A)

In the case of a member described in subsection (a) whom the Secretary determined as tier 3 status the Secretary concerned shall, before the member separates, retires, or is discharged, provide such member with the contact information of an employee of the Department of Veterans Affairs and an employee of the Department of Labor; and

(B)

Each employee described in subparagraph (A) shall contact the member described in such subparagraph not later than 60 days after such member separates, retires, or is discharged.

(C)

The Secretary of Veterans Affairs and the Secretary of Labor shall each submit to the Committees on Armed Services and on Veterans’ Affairs of the Senate and House of Representatives an annual report that identifies the number of times, and reasons why, an employee of the department under the jurisdiction of such Secretary failed to carry out subparagraph (B) in the year preceding the date of the report.

(D)

The Secretary of Defense and Secretary of Homeland Security shall prescribe regulations to ensure that, for purposes of this paragraph, each Secretary concerned uses the same definition of the term at risk for a difficult transition to civilian life.

(A)

The number of members who, in the course of such preseparation counseling, were referred to another Federal agency or department.

(B)

The Federal agencies or departments to which members were so referred.

(C)

The number of members who should have been, but were not, so referred, and reasons why such referrals did not occur.

(D)

The number of members who receive such preseparation counseling and apply for unemployment compensation under subchapter II of chapter 85 of title 5, United States Code.

(E)

The total amount of such unemployment compensation paid to members separating from the Armed Forces.

(F)

The frequency with which the commander of the military installation received a briefing regarding attendance of members in accordance with statutory requirements of the Transition Assistance Program.

(A)

differences in criteria for participation between the Armed Forces;

(B)

other differences in Skillbridge programs between the Armed Forces;

(C)

best practices in Skillbridge programs across the Armed Forces, including—

(D)

the feasibility of making Skillbridge programs uniform across the Armed Forces.

(A)

in the section heading by striking High technology and inserting High technology and emerging technology;

(B)

by striking high technology and inserting high technology or emerging technology each place such term appears; and

(C)

in subsection (c)(4) by adding at the end the following new subparagraph:

(E)

Such criteria shall also identify which technologies of critical importance, such as artificial intelligence and semiconductor manufacturing, shall be treated as emerging technologies for purposes of this section.

(A)

in the matter preceding paragraph (1) by inserting after House of Representatives the following: , and make available to the public,; and

(B)

in paragraph (3) by adding at the end the following: Such rate shall be calculated as a fraction, the denominator of which is the number of covered individuals who completed such a program during such year and the numerator of which is the number of individuals counted in the denominator who are employed on the date that is 180 days after the date on which the individual completed the program, and expressed as a percentage. Notwithstanding the previous sentence, the numerator shall not count a case in which the individual is employed by the same organization that was the provider of the individual’s program of education or a case in which the individual is employed, by a parent or affiliate of such organization, as an instructor for a substantially similar program of education. To the maximum extent practicable, the Secretary shall also report the rates of full-time employment, part-time employment, and self-employment.; and

(A)

in subclause (V), by striking ; and and inserting a semicolon;

(B)

in subclause (VI)—

(C)

by adding at the end the following new subclause:

(VII)

such instruction, preparation, training, and support as the Secretary considers appropriate to assist in transitioning away from caregiving during the 180-day period following the date on which the family caregiver is no longer participating in the program required by paragraph (1), unless such designation was revoked for fraud, abuse, or mistreatment, or other misconduct.

(A)

in item (aa), by striking ; and and inserting a semicolon; and

(B)

by adding at the end the following new item:

(cc)

assistance returning to the workforce upon discharge or dismissal from the program required by paragraph (1) unless such designation was revoked for fraud, abuse, mistreatment, or other misconduct; and

(A) In general

Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs, in partnership with the Secretary of Labor, shall complete a study on the feasibility and advisability of conducting a returnship program to assist individuals who are designated as a primary provider of personal care services under section 1720G(a)(7)(A) of title 38, United States Code, or who were discharged from such program, in returning to the workforce.

(B) Report

Not later than 180 days after completion of the study under subparagraph (A), the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the study.

(A) In general

Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall complete a study on barriers and incentives to hiring individuals who were designated as a primary provider of personal care services under section 1720G(a)(7)(A) of title 38, United States Code, at facilities of the Department of Veterans Affairs to address staffing needs.

(B) Report

Not later than 180 days after completion of the study under subparagraph (A), the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the study, which shall include—

(A) In general

The Secretary of Veterans Affairs shall carry out a three-year program (to be known as the TBI Innovation Grant Program) under which the Secretary shall award grants to eligible entities described in paragraph (2) for the development, implementation, and evaluation of approaches and methodologies for prospective randomized control trials for neurorehabilitation treatments for the treatment of chronic mild traumatic brain injury (in this Act referred to as mTBI) in veterans.

(B) Relationship to other Department activities

The grant program required under subparagraph (A) shall be carried out in a manner that—

(A)

A nonprofit organization with demonstrated capability to conduct clinical trials and to deliver or research effective neurorehabilitation treatments for mTBI, including through patient care delivery.

(B)

An academic institution that conducts significant research on mTBI and has demonstrated capability to conduct clinical trials relating to neurorehabilitation treatments.

(C)

A non-Department health care provider with expertise in neurorehabilitative therapies and demonstrated capability to conduct clinical trials and to evaluate mTBI treatments through patient care delivery.

(D)

A partnership or consortium of two or more entities described in subparagraphs (A) through (C).

(A)

designing and testing novel or integrative treatments for mTBI that prioritize patient-centered care, including non-pharmacological therapies;

(B)

conducting clinical studies and assessments to measure the effectiveness of funded approaches to—

(C)

providing training for clinicians and outreach to veterans and their families to improve awareness and accessibility of innovative mTBI treatments, including information on available Department resources and pathways to access such resources; and

(D)

establishing partnerships with community organizations, academic institutions, and health care facilities, including, as practicable, coordination with Veterans Health Administration facilities to facilitate referral of eligible veterans, continuity of care, and dissemination of aggregate findings.

(A) Applications

An eligible entity desiring a grant under this subsection shall submit to the Secretary an application in such form, at such time, and containing such information and assurances as the Secretary determines appropriate, including a detailed description of—

(B) Priority

In awarding grants under this subsection, the Secretary shall give priority to eligible entities that have demonstrated the capacity to coordinate with the Department to facilitate referral and continuity of care for veterans who participate in activities carried out using grant funds.

(C) Periodic reports

As a condition of receiving a grant under this section, an eligible entity shall, not less frequently than annually during the grant period and not later than 180 days after the end of the grant period, submit to the Secretary a report that includes, with respect to the period covered by the report—

(D) Oversight; annual evaluations

The Secretary shall—

(E) Rule of construction

Nothing in this section shall be construed to authorize the Secretary to require prior approval of, or changes to, any clinical protocol, study design, outcome measures, or follow-up schedule of an eligible entity that receives a grant under this section, except as necessary to ensure compliance with applicable Federal laws and regulations relating to human subjects protections and patient safety.

(F) Enforcement authority

The Secretary may suspend, modify, or terminate a grant awarded under this section, if the Secretary determines that the recipient of such grant has failed to comply with reporting requirements under subparagraph (B) or other applicable terms and conditions of the grant.

(A) Available amounts

The Secretary may carry out the program under this section using amounts available to the Secretary for general mental health care programs, if the use of such amounts supplements, and does not supplant, amounts otherwise available for Department mental health and traumatic brain injury programs.

(B) Authorization of appropriations

There is authorized to be appropriated to the Secretary $10,000,000 for each of fiscal years 2026 through 2028 to carry out this section.

(A) Duration

The authority of the Secretary to carry out the grant program under this section shall terminate on the date that is three years after the date of the enactment of this Act, except that the Secretary may continue to use amounts made available to carry out this section after such date solely for the purpose of administering activities and obligations incurred before such termination date.

(B) Annual review

During such three-year period, the Secretary shall, on an annual basis, review the effectiveness of the grant program to determine the potential of such grant program for continuation or expansion.

(A)

A nonprofit organization that has demonstrated the capability to conduct clinical trials and to evaluate traumatic brain injury treatments through patient care delivery.

(B)

An academic institution that conducts significant research on traumatic brain injury and has demonstrated the capability to conduct clinical trials relating to neurorehabilitation treatments.

(C)

A partnership or consortium of two or more entities described in subparagraphs (A) and (B).

(A)

the research and treatment activities proposed to be carried out using grant funds;

(B)

the methodology to be used for such activities;

(C)

the expected outcomes of such activities;

(D)

how the eligible entity will coordinate, as practicable, with Veterans Health Administration facilities for referral and continuity of care for veterans who participate in activities carried out using grant funds, and for dissemination of aggregate findings;

(E)

the budget of the entity for the use of the grant, including a narrative justification and an identification of the estimated amount of grant funds to be used for administrative or overhead costs; and

(F)

assurances of compliance with applicable Federal laws and regulations relating to human subjects protections and patient safety.

(A) Grant categories

In carrying out the grant program under this subsection, each fiscal year the Secretary shall—

(B) Priority

Of the grants awarded under subparagraph (A)(i), the Secretary shall award not fewer than three to nonprofit organizations.

(C) Enforcement authority

The Secretary may suspend, modify, or terminate a grant awarded under this subsection, if the Secretary determines that the recipient of such grant has failed to comply with the applicable terms and conditions of the grant.

(A) In general

The Secretary shall seek to enter into an agreement with an independent organization that is not a component of the Department and that has demonstrated expertise in randomized controlled trials, neurorehabilitation outcomes evaluation, and research integrity, under which the organization agrees to—

(B) Rule of construction

Nothing in this section shall be construed to authorize the Secretary, or an independent organization that enters into an agreement with the Secretary under subparagraph (A), to require prior approval of, or changes to, any clinical protocol, study design, outcome measures, or follow-up schedule established by an eligible entity that receives a grant under this section, except as necessary to ensure compliance with applicable Federal laws and regulations relating to human subjects protections and patient safety.

(C) Report

An agreement under subparagraph (A) shall include a requirement that the independent organization submits to Congress and the Secretary a comprehensive report that includes—

(D) Surveys

The Secretary may conduct surveys of any independent organization that enters into an agreement with the Secretary under subparagraph (A) in order to assess the effectiveness of such organization in administering the research grant program under this subsection.

(A) Available amounts

The Secretary may use amounts available to the Secretary for the operating budget of the National Center for Posttraumatic Stress Disorder to carry out the research grant program under this subsection, if the use of such amounts supplements, and does not supplant, amounts otherwise available for Department programs and services.

(B) Authorization of appropriations

There is authorized to be appropriated to the Secretary $10,000,000 for each of fiscal years 2026 through 2028 to carry out this subsection.

(A)

means an organization described in section 501(c)(3) of the Internal Revenue Code of 1986 and exempt from taxation under section 501(a) of such Code; and

(B)

includes such an organization that is a hospital, nonprofit health system, academic medical center, or clinic that delivers neurorehabilitation care or conducts clinical research relating to mTBI.

(A)

by striking retention allowances and inserting retention bonuses; and

(B)

by striking the second comma after section 7401(1) of this title; and

(A)

in clause (iv), by striking the semi-colon at the end and inserting ; and;

(B)

by striking clause (v); and

(C)

by redesignating clause (vi) as clause (v); and

(A)

by redesignating subparagraphs (B) and (C) as subparagraphs (C) and (D), respectively; and

(B)

by inserting after subparagraph (A) the following new subparagraph (B):

(B)

coordinate with the Secretary to develop a plan for communication between the entity and local mental health providers of the Department regarding whether veterans receiving assistance under this section from the entity are attending appointments to ensure continuity of care;; and

(A)

in the matter preceding subparagraph (A), by inserting , or interested in receiving such grants, after this section; and

(B)

in subparagraph (A), by inserting , including training on how to properly use the Columbia Protocol (also known as the Columbia-Suicide Severity Rating Scale (C–SSRS)) and other screening tools selected by the Secretary after management; and

(A)

by redesignating clauses (iii) and (iv) as (v) and (vi), respectively; and

(B)

by adding the following new clauses (iii) and (iv):

(iii)

A description of the Secretary’s compliance with the requirement to train employees of the Department under subsection (g)(3).

(iv)

An optional description and inclusion of subjective or narrative stories of community or individual impact to allow grant recipients to share meaningful accomplishments.

(A)

by redesignating clause (xi) as clause (xii); and

(B)

by inserting after clause (x) the following new clause:

(xi)

Transportation and rideshare services for eligible individuals to use for appointments.

(A)

the Secretary of Veterans Affairs;

(B)

the Secretary of Defense; and

(C)

private entities.

(A)

An analysis of available research literature published after the review completed pursuant to section 702 of the Commander John Scott Hannon Veterans Mental Health Care Improvement Act (Public Law 116–171);

(B)

An assessment of the current parameters for research on the use by the Department of Veterans Affairs of hyperbaric oxygen therapy, including—

(C)

A comparative analysis of tests and questionnaires used to study post-traumatic stress disorder and traumatic brain injury in other research conducted by the Department of Veterans Affairs, other Federal agencies, and entities outside the Federal Government.

(D)

A market assessment of available hyperbaric oxygen therapy facilities or units within facilities to assess the most effective locations and practices, including—

(A)

the Joint Commission on Accreditation of Healthcare Organizations;

(B)

the Commission on Accreditation of Rehabilitation Facilities; or

(C)

any other nationally recognized accrediting body the Secretary determines appropriate; and

(A)

an identification of the outpatient facility or facilities where the mental health care services will be provided;

(B)

a plan for providing clinicians at each facility in receipt of grant funds with units of continuing education with respect to veterans issues; and

(C)

an identification of the percentage of the operating budget for each such facility that was provided through Federal grants during the fiscal year preceding the year during which the application is submitted.

(A)

to deliver evidence-based mental health care for veterans in person or via telehealth.

(B)

to operate or expand an existing outpatient mental health facility or establish a new outpatient mental health facility for the purpose of providing such care;

(C)

to encourage veterans who are eligible for enrollment in the patient enrollment system under section 1705 of title 38, United States Code, to enroll in such system and to receive medical services furnished by the Department of Veterans Affairs;

(D)

to support activities necessary to deliver or sustain care, including—

(E)

to support continuous quality improvement and outcomes measurement activities, including the collection and reporting of clinical outcomes and operational metrics; and

(F)

to support activities of the program that are not billable, reimbursable, or otherwise authorized by law, including—

(G)

to provide services to individuals for which reimbursement is not otherwise available, including such individuals who are—

(A)

charge an eligible veteran a fee associated with the receipt of mental health care funded by such grant;

(B)

refuse to provide mental health care to an eligible veteran on the basis that the veteran is not eligible for reimbursement for such care under another payer source; or

(C)

use grant funds to—

(A)

prohibit a grant recipient from seeking reimbursement from non-Department payers for mental health services provided by the grant recipient, except that grant funds shall not be used to supplant or duplicate a reimbursement otherwise available under Federal law; or

(B)

authorize double billing or duplicate payments for the same clinical service or unit of service.

(A)

family therapy;

(B)

couples therapy;

(C)

group therapy;

(D)

family psychoeducation; and

(E)

other counseling services the Secretary determines are clinically necessary.

(A)

are medically underserved;

(B)

have large veteran populations;

(C)

are located near military installations; or

(D)

have large numbers of veterans at high risk of suicide.

(A) In general

Except as provided in subparagraph (B), no grant under the pilot program for a facility for any fiscal year may exceed $1,500,000.

(B) Limitation

In the case of an outpatient mental health facility for which at least 50 percent of the operating budget of the facility for the preceding fiscal year was provided through Federal grants, no grant under the pilot program for the facility for any fiscal year may exceed the lesser of—

(A)

may apply for, and receive, grants for more than one facility of the recipient for any fiscal year; and

(B)

may apply for, and receive, a grant for a facility that has already received a grant under the pilot program.

(A)

the number of veterans who improved clinically based on relevant clinical evaluation metrics that the Secretary determines appropriate;

(B)

the degree of clinical improvement based on such relevant clinical evaluation metrics;

(C)

the total number of veterans participating in the program; and

(D)

any other outcome metrics as the Secretary determines appropriate.

(A)

the Committee on Veterans’ Affairs and the Committee on Appropriations of the Senate; and

(B)

the Committee on Veterans’ Affairs and the Committee on Appropriations of the House of Representatives.

(A)

occupational data of members of the Armed Forces who attempt suicide; and

(B)

outcomes of suicide prevention interventions among members of the Armed Forces.

(A)

sleep therapy;

(B)

blast-related gut health;

(C)

mobile diagnostics;

(D)

vestibular dysfunction and balance impairment;

(E)

autonomic nervous system dysregulation;

(F)

cumulative mild traumatic brain injury;

(G)

neuroinflammation and glial activation; and

(H)

any other issue determined appropriate by the Secretary.

(A)

how claims processors of the Department of Veterans Affairs should evaluate evidence that links such conditions to active military, naval, air, or space service; and

(B)

best practices regarding the evaluation of neurological injuries in examinations for benefits under chapters 11 or 15 of title 38, United States Code.

(A)

by inserting (1) before To the maximum extent practicable, the Secretary; and

(B)

by adding at the end the following new paragraph:

(2)

If the Secretary of Veterans Affairs elects not to enter into such an agreement or contract, notwithstanding paragraph (1), the Secretary and the Department of Veterans Affairs-Department of Defense Joint Executive Committee shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a written justification for such election.

(A)

withhold, screen, or alter responsive information;

(B)

delay or condition production on initial clearance or political review;

(C)

require a nondisclosure agreement unless required by law;

(D)

substitute summaries for requested 2 records; or

(E)

otherwise impede or interfere with direct transmission of information to the Committee on Veterans’ Affairs of the House of Representatives or the Senate.

(A)

a comprehensive inventory of all agreements under section 8111 of title 38, United States Code;

(B)

a standardized reimbursement methodology;

(C)

capacity assessments of Department of Veterans Affairs and Department of Defense facilities; and

(D)

identification of priority regions for expansion.

(A)

a description of use and effectiveness of agreements under such section;

(B)

a description of the role and output of the Joint Executive Committee under such section;

(C)

an evaluation of the effectiveness of coordination of care and sharing of resources by the Department of Veterans Affairs and the Department of Defense under such section; and

(D)

a description of any statutory, operational, or cultural barriers to the implementation of such section.

(A) VA physician, nurse practitioner, or physician assistant

Subject to subparagraph (B), a physician, nurse practitioner, or physician assistant employed by the Secretary of Veterans Affairs who is the primary care provider of a veteran who dies of natural causes shall certify the death of such veteran not later than two business days after such physician, nurse practitioner, or physician assistant learns of such death.

(B) Coroner or medical examiner

If a physician, nurse practitioner, or physician assistant described in subparagraph (A) cannot comply with such paragraph with respect to a death described in such paragraph, a coroner or medical examiner in the jurisdiction where such death occurred may certify such death.

(A) In general

Not later than one year after the date of the enactment of this Act, and annually thereafter for the following five years, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report regarding compliance with paragraph (1).

(B) Elements

Each report required under subparagraph (A) shall include, with respect to the year preceding the date of the report, the following elements:

(A) In general

In carrying out the pilot program, the Secretary shall enter into contracts, agreements, or other arrangements with facilities participating in the pilot program to reimburse critical access hospitals and affiliated clinics for outpatient health care and medical services provided to eligible veterans.

(B) Elements

The Secretary, in coordination with participating critical access hospitals, shall ensure that any contract, agreement, or other arrangement entered into under subparagraph (A) establishes criteria, as the Secretary considers appropriate, to ensure—

(A) Eligible veterans

Not less frequently than annually during each year in which the pilot program is carried out, the Secretary shall conduct direct outreach to eligible veterans in areas in which the pilot program is carried out to notify such veterans of their ability to participate in the pilot program.

(B) Hospitals

The Secretary shall conduct direct outreach to critical access hospitals in areas in which the pilot program is carried out to notify those hospitals of their ability to participate in the pilot program.

(A)

administrative and technical challenges that arise from the pilot program;

(B)

care coordination and follow up with the veteran and the facility participating in the pilot program after an episode of care; and

(C)

timely records return following an episode of care.

(A) In general

Not later than one year after the date of the enactment of this Act, and annually thereafter for the duration of the pilot program, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans Affairs of the House of Representatives a report on the pilot program.

(B) Elements

(A) Critical access hospital

The term critical access hospital has the meaning given that term in section 1861(mm) of the Social Security Act (42 U.S.C. 1395x(mm)).

(B) Eligible veteran

The term eligible veteran means a veteran—

(A)

consult with health care providers that provide care in the community under the laws administered by the Secretary, State Offices of Rural Health, Tribal health authorities, and other relevant stakeholders in rural, highly rural, and frontier areas as the Secretary determines appropriate;

(B)

assess barriers to care in the community for veterans residing in rural and highly rural areas, including challenges with respect to—

(C)

list specific and measurable strategies and actions to address the barriers and challenges assessed under subparagraph (B), to include the consideration of—

(D)

assess legislative and regulatory barriers, if any, to addressing the barriers assessed under subparagraph (B).

(A)

opportunities to seek care through facilities and programs of the Department of Veterans Affairs, including via telehealth, existing programs provided through grantees or contractors of the Department, Vet Centers (as defined in section 1712A of title 38, United States Code), and volunteer programs and services for transportation;

(B)

opportunities to seek care though the Veterans Community Care Program under section 1703 of title 38, United States Code;

(C)

opportunities to seek care at critical access hospitals with contracts, partnerships, or agreements with the Department of Veterans Affairs; and

(D)

any other matters the Secretary considers appropriate.

(A)

conduct outreach to health care facilities and critical access hospitals in rural areas regarding—

(B)

seek to enter into contracts, partnerships, agreements, or other arrangements with health care facilities and critical access hospitals in rural areas.

(A)

permits veterans to identify and connect with covered entities that furnish covered services;

(B)

permits covered entities to identify and connect with veterans in need of covered services;

(C)

utilizes, to the extent practicable, existing interoperable technology networks;

(D)

prioritizes connectivity with appropriate existing technology networks developed by public or private organizations that comply with, as applicable, standards adopted by the Secretary of Health and Human Services under section 3004 of the Public Health Service Act (42 U.S.C. 300jj–14), for the provision of covered services;

(E)

ensures that—

(F)

is accessible by employees of the Department, covered entities, and veterans;

(G)

connects covered entities and veterans for purposes of communication, service coordination, and consumer assistance, referral and capacity management, outcome tracking and reporting, and related services; and

(H)

is accessible via a web-based platform for all veterans and via a non-web-based alternative platform or process for veterans who are unable to easily and reliably access the web-based platform.

(A) Initial locations

The Secretary shall carry out the pilot program at not fewer than five medical facilities of the Department of Veterans Affairs selected by the Secretary for purposes of the pilot program.

(B) Expansion

The Secretary may expand beyond initial sites for the pilot program selected under paragraph (1) not before two years after the date of enactment, not before thirty days after briefing the Committees on Veterans’ Affairs of the Senate and the House of the expansion plan, and after demonstrated success.

(C) Variety of facilities

In selecting facilities under subparagraph (A), the Secretary shall ensure the selection of a variety of different types of facilities, including—

(A) In general

The Secretary may require covered entities that seek to participate in the pilot program to submit to the Secretary an application therefore in such form, in such manner, and containing such commitments and information as the Secretary considers necessary to carry out this section.

(B) Review

(A) In general

The Secretary shall require veterans participating in the community integration platform under the pilot program to provide information regarding social determinants of health using the ICD–10 diagnostic codes Z55 through Z63 and Z75 (as in effect on the date of the enactment of this Act) in a standardized risk assessment or screening tool and such other information as the Secretary considers necessary to administer the pilot program.

(B) Informed consent

Information collected under the pilot program with respect to a veteran shall be obtained with the informed consent of the veteran and used solely for purposes of care coordination, service delivery, or program evaluation under the pilot program.

(C) Tracking of information

(A) Coordination with existing networks

In carrying out the pilot program, the Secretary shall coordinate with existing community networks.

(B) Coordination and integration with State medicaid programs

The Secretary may consult and coordinate with the Secretary of Health and Human Services and with States regarding existing Federal and State programs, but nothing in this section shall be construed to authorize the Secretary of Veterans Affairs to administer, direct, or modify a State Medicaid program or waiver.

(A) Report

Not later than three years after the commencement of the pilot program, the Secretary shall submit to the appropriate committees of Congress a report analyzing the needs of veterans for covered services reflected by the use of such services under the community integration platform under the pilot program, including an assessment of—

(B) Briefing on entities not selected

Not later than 180 days after the commencement of the pilot program, and not less frequently than once every 180 days thereafter until the conclusion of the pilot program, the Secretary shall brief the appropriate committees of Congress on the covered entities that submitted an application to participate in the pilot program but were not selected for participation and the reason those entities were not selected.

(A) Evaluation

The Comptroller General of the United States shall conduct an evaluation that measures the overall impact of the community integration platform established or enhanced under the pilot program with respect to—

(B) Report and recommendations

(A)

The Secretary may not use the pilot program established under subsection (a) to supplant services otherwise required to be furnished by the Department under title 38, United States Code.

(B)

No covered entity participating in the pilot program established under subsection (a) may receive access to personally identifiable information, protected health information, or social determinants information of a veteran without the veteran’s informed written consent, and such information may be used only for the specific referral or service authorized by the veteran.

(A) Appropriate committees of Congress

The term appropriate committees of Congress means the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives.

(B) Community integration platform

The term community integration platform means an interoperable platform or network of interoperable systems used to enable the coordination, alignment, and connection of covered entities and veterans at the local level for purposes of communication, service coordination, and referral management of covered services.

(C) Covered entity

The term covered entity means any of the following entities or providers that have entered into an agreement with the Secretary to participate in the pilot program:

(D) Covered services

The term covered services means any of the following:

(E) Secretary

The term Secretary means the Secretary of Veterans Affairs.

(F) State

The term State has the meaning given that term in section 101 of title 38, United States Code.

(A) In general

The information collected under subsection (a) shall include standardized definitions for identifying social determinants of health needs identified in the ICD–10 diagnostic codes Z55 through Z63 and Z75 (as in effect on the date of enactment of this Act).

(B) Incorporation of measures

Definitions included under subparagraph (A) with respect to identifying social determinants of health needs shall incorporate measures for quantifying the relative severity of any such social determinant of health need identified in an individual.

(A)

access by veterans to prosthetic and rehabilitative items and services;

(B)