S. 141 — what changed

added “(o) Outreach regarding availability of care and services

added “(1) The Secretary shall conduct outreach to inform veterans of the following:

added “(A) The conditions for care or services under subsections (d) and (e).

added “(B) How to request such care or services.

added “(C) How to appeal a denial of a request for such care or services using the clinical appeals process of the Veterans Health Administration.

added “(2) Upon enrollment of a veteran in the system of annual patient enrollment established and operated under section 1705 of this title, and not less frequently than every two years thereafter, the Secretary shall inform the veteran of information described in paragraph (1).

added “(3) The Secretary shall ensure that information described in paragraph (1) is—

added “(A) publicly displayed in each medical facility of the Department;

added “(B) prominently displayed on a website of the Department; and

added “(C) included in other outreach campaigns and activities conducted by the Secretary.”

added “(p) Annual review and report on waivers of payment rates

added “(1) On an annual basis, the Secretary shall—

added “(A) conduct a review of waivers of payment rates under subsection (i) for Third Party Administrators to identify whether such waivers help to alleviate community-specific challenges, including scarcity of medical services associated with access to health care; and

added “(B) submit to Congress a report on the results of such review.

added “(2) Each report under paragraph (1)(B) shall include, with respect to the period covered by the report—

added “(A) a statement, disaggregated by region, of the total number of waivers described in subparagraph (A) of such paragraph requested by Third Party Administrators;

added “(B) a statement of the total number of such waivers that were—

added “(i) granted by the Secretary;

added “(ii) denied by the Secretary; or

added “(iii) withdrawn by a Third Party Administrator;

added “(C) a description of the process for the review required under paragraph (1);

added “(D) a statement, disaggregated by region, of the average time to process such waivers;

added “(E) an assessment, disaggregated by region, of the extent to which such waivers that were granted by the Secretary improved access to health care for covered veterans; and

added “(F) a description of trends, if any, identified by the Secretary with respect to such waivers.

added “(3) In this subsection, the term Third Party Administrator has the meaning given such term in section 1703B of this title.”

added “(B) The Secretary shall ensure that the standards for quality established under paragraph (1) are comparable to industry standards to ensure there is adequate data transference between care furnished by the Department and care furnished by a non-Department provider.”

added “(v) Outcomes relating to patient quality of life.”

added “(5) When collecting, considering, and applying data related to patient care for purposes of establishing standards for quality under paragraph (1), the Secretary shall ensure no metric is being over or under analyzed.

added “(6) In establishing standards for quality under paragraph (1), the Secretary shall—

added “(A) utilize the most up-to-date practices for extracting and analyzing relevant data;

added “(B) utilize all relevant data available to the Secretary;

added “(C) ensure the most efficient use of time and resources related to the use of data scientists employed by the Department; and

added “(D) collaborate, as appropriate, with entities specified in paragraph (4).

added “(7)

added “(A) Not less frequently than once every five years, the Secretary shall update the standards for quality established under paragraph (1) pursuant to the requirements for the establishment of such standards under this subsection.

added “(B) Not later than 30 days after any date on which the Secretary updates, pursuant to subparagraph (A), the standards for quality under paragraph (1), the Secretary shall submit to the appropriate committees of Congress a report on such updated standards for quality.”

added “(2)

added “(A) The total cost of providing services or in-kind assistance in the case of any veteran described in subparagraph (B) for any fiscal year under the program may exceed 100 percent of the cost that would otherwise have been incurred as specified in paragraph (1) if the Secretary determines, based on a consideration of clinical need, geographic market factors, and such other matters as the Secretary may prescribe through regulation, that such higher total cost is in the best interest of the veteran.

added “(B) A veteran described in this subparagraph is a veteran with amyotrophic lateral sclerosis, a spinal cord injury, or a condition the Secretary determines to be similar to such conditions.”

added Section 1720C of title 38, United States Code, as amended by section 120, is further amended by adding at the end the following new subsection:

added “(f) In furnishing services to a veteran under the program conducted pursuant to subsection (a), if a medical center of the Department through which such program is administered is located in a geographic area in which services are available to the veteran under a PACE program (as such term is defined in sections 1894(a)(2) and 1934(a)(2) of the Social Security Act (42 U.S.C. 1395eee(a)(2); 1396u–4(a)(2))), the Secretary shall seek to enter into an agreement with the PACE program operating in that area for the furnishing of such services.”

added Subchapter II of chapter 17 of title 38, United States Code, is amended by adding at the end the following new section (and conforming the table of sections at the beginning of such chapter accordingly):

added “1720K. Grants or contracts to provide mental health support to family caregivers of veterans

added “(a) Authority—The Secretary may award grants or contracts to carry out, coordinate, improve, or otherwise enhance mental health counseling, treatment, or support to the family caregivers of veterans participating in the family caregiver program.

added “(b) Application

added “(1) To be eligible for a grant or contract under this section, an entity shall submit to the Secretary an application therefor at such time, in such manner, and containing such information as the Secretary may require.

added “(2) Each application submitted under paragraph (1) shall include the following:

added “(A) A detailed plan for the use of the grant or contract.

added “(B) A description of the programs or efforts through which the entity will meet the outcome measures developed by the Secretary under subsection (f).

added “(C) A description of how the entity will distribute grant or contract amounts equitably among areas with varying levels of urbanization.

added “(D) A plan for how the grant or contract will be used to meet the unique needs of veterans residing in rural areas, Native American, Native Hawaiian, or Alaska Native veterans, elderly veterans, women veterans, and veterans from other underserved communities.

added “(c) Distribution—The Secretary shall seek to ensure that grants and contracts awarded under this section are equitably distributed among entities located in States with varying levels of urbanization.

added “(d) Priority—The Secretary shall prioritize awarding grants or contracts under this section that will serve the following areas:

added “(1) Areas with high rates of veterans enrolled in the family caregiver program.

added “(2) Areas with high rates of—

added “(A) suicide among veterans; or

added “(B) referrals to the Veterans Crisis Line.

added “(e) Required activities—Any grant or contract awarded under this section shall be used—

added “(1) to expand existing programs, activities, and services;

added “(2) to establish new or additional programs, activities, and services; or

added “(3) for travel and transportation to facilitate carrying out paragraph (1) or (2).

added “(f) Outcome measures

added “(1) The Secretary shall develop and provide to each entity that receives a grant or contract under this section written guidance on the following:

added “(A) Outcome measures.

added “(B) Policies of the Department.

added “(2) In developing outcome measures under paragraph (1), the Secretary shall consider the following goals:

added “(A) Increasing the utilization of mental health services among family caregivers of veterans participating in the family caregiver program.

added “(B) Reducing barriers to mental health services among family caregivers of veterans participating in such program.

added “(g) Tracking requirements

added “(1) The Secretary shall establish appropriate tracking requirements with respect to the entities receiving a grant or contract under this section.

added “(2) Not less frequently than annually, the Secretary shall submit to Congress a report on such tracking requirements.

added “(h) Performance review—The Secretary shall—

added “(1) review the performance of each entity that receives a grant or contract under this section; and

added “(2) make information regarding such performance publicly available.

added “(i) Remediation plan

added “(1) In the case of an entity that receives a grant or contract under this section and does not meet the outcome measures developed by the Secretary under subsection (f), the Secretary shall require the entity to submit to the Secretary a remediation plan under which the entity shall describe how and when it plans to meet such outcome measures.

added “(2) The Secretary may not award a subsequent grant or contract under this section to an entity described in paragraph (1) unless the Secretary approves the remediation plan submitted by the entity under such paragraph.

added “(j) Maximum amount—The amount of a grant or contract awarded under this section may not exceed 10 percent of amounts made available for grants or contracts under this section for the fiscal year in which the grant or contract is awarded.

added “(k) Supplement, not supplant—Any grant or contract awarded under this section shall be used to supplement and not supplant funding that is otherwise available through the Department to provide mental health support among family caregivers of veterans participating in the family caregiver program.

added “(l) Outreach to family caregivers—The Secretary shall include, in the outreach materials regularly provided to a family caregiver who participates in the family caregiver program, notice of mental health support provided by recipients of grants or contracts under this section that are located in the relevant Veterans Integrated Service Network.

added “(m) Funding

added “(1) Amounts for the activities of the Department under this section shall be budgeted and appropriated through a separate appropriation account.

added “(2) In the budget justification materials submitted to Congress in support of the budget of the Department for any fiscal year (as submitted with the budget of the President under section 1105(a) of title 31), the Secretary shall include a separate statement of the amount requested to be appropriated for that fiscal year for the account specified in paragraph (1).

added “(n) Authorization of appropriations—There is authorized to be appropriated to the Secretary, for each of fiscal years 2025 and 2026, $10,000,000 to carry out this section.

added “(o) Definitions—In this section:

added “(1) The terms caregiver and family caregiver have the meanings given those terms in section 1720G of this title.

added “(2) The term family caregiver program means the program of comprehensive assistance for family caregivers under section 1720G of this title.

added “(3) The term Veterans Crisis Line means the toll-free hotline for veterans established under section 1720F of this title.”

added “1720L. Home- and community-based services: programs

added “(a) In general—In furnishing noninstitutional alternatives to nursing home care pursuant to the authority of section 1720C of this title (or any other authority under this chapter or other provision of law administered by the Secretary of Veterans Affairs), the Secretary shall carry out each of the programs specified in this section in accordance with such relevant authorities except as otherwise provided in this section.

added “(b) Veteran-Directed Care program

added “(1) The Secretary of Veterans Affairs, in collaboration with the Secretary of Health and Human Services, shall carry out a program to be known as the “Veteran-Directed Care program”. Under such program, the Secretary of Veterans Affairs may enter into agreements with the providers described in paragraph (2) to provide to eligible veterans funds, to the extent practicable, to obtain such in-home care services and related items that support clinical need and improve quality of life, as may be determined appropriate by the Secretary of Veterans Affairs and selected by the veteran, including through the veteran hiring individuals to provide such services and items or directly purchasing such services and items.

added “(2) The providers described in this paragraph are the following:

added “(A) An Aging and Disability Resource Center, an area agency on aging, or a State agency.

added “(B) A center for independent living.

added “(C) An Indian tribe or tribal organization receiving assistance under title VI of the Older Americans Act of 1965 (42 U.S.C. 3057 et seq.).

added “(D) Any other entity that the Secretary, in consultation with the Secretary of Health and Human Services, determines appropriate.

added “(3) In carrying out the Veteran-Directed Care program, the Secretary of Veterans Affairs shall—

added “(A) administer such program through each medical center of the Department of Veterans Affairs;

added “(B) seek to ensure the availability of such program in American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, the Commonwealth of Puerto Rico, the Virgin Islands of the United States, and any other territory or possession of the United States, to the extent practicable; and

added “(C) seek to ensure the availability of such program for eligible veterans who are Native American veterans receiving care and services furnished by the Indian Health Service, a tribal health program, an Urban Indian organization, or (in the case of a Native Hawaiian veteran) a Native Hawaiian health care system, to the extent practicable.

added “(4) If a veteran participating in the Veteran-Directed Care program is hospitalized, the veteran may continue to use funds under the program during a period of hospitalization in the same manner that the veteran would be authorized to use such funds under the program if the veteran were not hospitalized.

added “(c) Homemaker and Home Health Aide program

added “(1) The Secretary shall carry out a program to be known as the “Homemaker and Home Health Aide program” under which the Secretary may enter into agreements with home health agencies to provide to eligible veterans such home health aide services as may be determined appropriate by the Secretary.

added “(2) In carrying out the Homemaker and Home Health Aide program, the Secretary shall—

added “(A) administer such program in the locations specified in subparagraph (A) of subsection (b)(3);

added “(B) seek to ensure the availability of such program in the locations specified in subparagraph (B) of subsection (b)(3); and

added “(C) seek to ensure the availability of such program for the veteran populations specified in subparagraph (C) of subsection (b)(3).

added “(d) Home-Based Primary Care program—The Secretary shall carry out a program to be known as the “Home-Based Primary Care program” under which the Secretary may furnish to eligible veterans in-home health care, the provision of which is overseen by a provider of the Department.

added “(e) Purchased Skilled Home Care program—The Secretary shall carry out a program to be known as the “Purchased Skilled Home Care program” under which the Secretary may furnish to eligible veterans such in-home care services as may be determined appropriate and selected by the Secretary for the veteran.

added “(f) Caregiver support

added “(1) With respect to a resident eligible caregiver of a veteran participating in a program under this section, the Secretary shall—

added “(A) if the veteran meets the requirements of a covered veteran under section 1720G(b) of this title, provide to such caregiver the option of enrolling in the program of general caregiver support services under such section;

added “(B) provide to such caregiver covered respite care of not less than 30 days annually; and

added “(C) conduct on an annual basis (and, to the extent practicable, in connection with in-person services provided under the program in which the veteran is participating), a wellness contact of such caregiver.

added “(2) Covered respite care provided to a resident eligible caregiver of a veteran under paragraph (1) may exceed 30 days annually if such extension is requested by the resident eligible caregiver or veteran and determined medically appropriate by the Secretary.

added “(g) Rule of construction—Nothing in this section shall be construed to limit the authority of the Secretary to carry out programs providing home- and community-based services under any other provision of law.

added “(h) Definitions—In this section:

added “(1) The terms Aging and Disability Resource Center, area agency on aging, and State agency have the meanings given those terms in section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002).

added “(2) The terms caregiver and family caregiver, with respect to a veteran, have the meanings given those terms, respectively, under subsection (e) of section 1720G of this title with respect to an eligible veteran under subsection (a) of such section or a covered veteran under subsection (b) of such section, as the case may be.

added “(3) The term center for independent living has the meaning given that term in section 702 of the Rehabilitation Act of 1973 (29 U.S.C. 796a).

added “(4) The term covered respite care has the meaning given such term in section 1720G(d) of this title.

added “(5) The term eligible veteran means any veteran—

added “(A) for whom the Secretary determines participation in a specific program under this section is medically necessary to promote, preserve, or restore the health of the veteran; and

added “(B) who absent such participation would be at increased risk for hospitalization, placement in a nursing home, or emergency room care.

added “(6) The term home health aide means an individual employed by a home health agency to provide in-home care services.

added “(7) The term in-home care service means any service, including a personal care service, provided to enable the recipient of such service to live at home.

added “(8) The terms Indian tribe and tribal organization have the meanings given those terms in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 5304).

added “(9) The terms Native American and Native American veteran have the meanings given those terms in section 3765 of this title.

added “(10) The terms Native Hawaiian and Native Hawaiian health care system have the meanings given those terms in section 12 of the Native Hawaiian Health Care Improvement Act (42 U.S.C. 11711).

added “(11) The terms tribal health programs and Urban Indian organizations have the meanings given those terms in section 4 of the Indian Health Care Improvement Act (25 U.S.C. 1603).

added “(12) The term resident eligible caregiver means an individual who—

added “(A) is a caregiver, or a family caregiver, of a veteran and resides with that veteran; and

added “(B) has not entered into a contract, agreement, or other arrangement for such individual to act as a caregiver for that veteran unless such individual is a family member of the veteran or is furnishing caregiver services through a medical foster home.”

added “(14)

added “(A) In the case of a veteran or caregiver who seeks services under this subsection and is denied such services, or a veteran or the family caregiver of a veteran who is discharged from the program under this subsection, the Secretary shall—

added “(i) if the veteran meets the requirements of a covered veteran under subsection (b), provide to such caregiver the option of enrolling in the program of general caregiver support services under such subsection;

added “(ii) assess the veteran or caregiver for participation in any other available program of the Department for home- and community-based services (including the programs specified in section 1720L of this title) for which the veteran or caregiver may be eligible and, with respect to the veteran, store (and make accessible to the veteran) the results of such assessment in the electronic medical record of the veteran; and

added “(iii) provide to the veteran or caregiver written information on any such program identified pursuant to the assessment under clause (ii), including information about facilities, eligibility requirements, and relevant contact information for each such program.

added “(B) The Secretary shall, to the extent practicable, provide to a veteran or family caregiver the option of obtaining clinically appropriate services under any other available program of the Department for home- and community-based services (including the programs specified in section 1720L of this title) for which the veteran or family caregiver may be eligible prior to discharging the veteran or family caregiver from the program under this subsection.

added “(C) For each veteran or family caregiver who is discharged from the program under this subsection, a caregiver support coordinator shall provide for a smooth and personalized transition from such program to an appropriate program of the Department for home- and community-based services (including the programs specified in section 1720L of this title), including by integrating caregiver support across programs.”

added “(III) covered respite care of not less than 30 days annually;”

added “(iii) Covered respite care of not less than 30 days annually.”

added “(2) The term covered respite care means, with respect to a caregiver of a veteran, respite care under section 1720B of this title that—

added “(A) is medically and age appropriate for the veteran (including 24-hour per day care of the veteran commensurate with the care provided by the caregiver); and

added “(B) includes in-home care.”

added Section 1720G(a) of title 38, United States Code, as amended by section 124, is further amended—

added “(I) submits an application for the program established under paragraph (1); or

added “(II) is being reassessed for eligibility to continue in such program.”

added “(15)

added “(A) Not less frequently than annually, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a comprehensive report on the program required by paragraph (1) that includes, with respect to the one-year period preceding the date of the submission of such report, the following:

added “(i) The number of applications received for such program.

added “(ii) The number, disaggregated by race, sex, and era and branch of service in the Armed Forces of the applicant, of—

added “(I) approvals of such applications; and

added “(II) denials of such applications.

added “(iii) The number of reassessments conducted for such program.

added “(iv) An identification of each decision made with respect to a reassessment conducted for such program, disaggregated by decisions resulting in—

added “(I) disenrollment, including removal, discharge, or voluntary withdrawal;

added “(II) tier reduction; and

added “(III) tier continuation.

added “(v) The number of appeals of decisions made with respect to such program, disaggregated by type of appeal.

added “(vi) With respect to each appeal described in clause (v), the decision rendered, if any.

added “(vii) A description of all tools used in assessments conducted for such program, including an explanation of how and by whom such tools are administered.

added “(viii) A description of procedures used under such program for reviewing and integrating clinical records from health care providers that includes an explanation of how such records are used in determinations of eligibility for such program.

added “(ix) A description of procedures available under such program for health care providers to communicate medical opinions to the teams conducting assessments to determine eligibility for such program, including health care providers in the private sector and health care providers specified in subsection (c) of section 1703 of this title.

added “(x) A description of information technology systems and processes used under such program to upload and integrate all clinical records from all non-Department providers, including providers in the private sector and providers under the Veterans Community Care Program established under such section.

added “(B) The Secretary shall ensure that all data included in a report under subparagraph (A)—

added “(i) relating to a decision made under the program required by paragraph (1), are disaggregated by the specific reason for the decision;

added “(ii) relating to a veteran, include comprehensive demographic information of the veteran, including the time period of the injuries, if any, of the veteran and the Veterans Integrated Service Network in which the veteran is located; and

added “(iii) with respect to eligibility determinations relating to a serious injury of a veteran, specify—

added “(I) how many such determinations relate to the ability of the veteran to perform activities of daily living; and

added “(II) how many such determinations relate to the need of a veteran for supervision and protection.

added “(C) The Secretary shall provide the data under paragraph (B) pursuant to Federal laws and in a manner that is wholly consistent with applicable Federal privacy and confidentiality laws, including the Privacy Act (5 U.S.C. 552a), the Health Insurance Portability and Accountability Act (Public Law 104–191; 42 U.S.C. 201 note) and regulations (title 45, Code of Federal Regulations, parts 160 and 164, or successor regulations), and sections 5701, 5705, and 7332 of this title to ensure that the provided data, or some portion of the data, will not undermine the anonymity of a veteran.”

added In this subtitle:

added “1703G. Quarterly report on referrals for non-Department health care

added “The Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a quarterly report containing, with respect to referrals for non-Department health care originating from a medical facility of the Department during the quarter preceding the date of the submission of the report, a measurement of, for each such medical facility—

added “(1) the period of time between—

added “(A) the date on which a clinician employed by the Department determines that a veteran requires care, or a veteran presents to the Department requesting care, and the date on which the referral for care is sent to a non-Department health care provider;

added “(B) the date on which such referral is sent to a non-Department health care provider and the date on which such non-Department health care provider accepts such referral;

added “(C) the date on which such non-Department health care provider accepts such referral and the date on which such referral is completed;

added “(D) the date on which such referral is completed and the date on which an appointment with a non-Department health care provider is made; and

added “(E) the date on which such an appointment is made and the date on which such appointment occurs; and

added “(2) any other period of time that the Secretary determines necessary.”

added Section 7306 of title 38, United States Code, is amended—

added “(7) The Secretary shall ensure that each physician, podiatrist, optometrist, and dentist in the Veterans Health Administration is—

added “(A) advised, on an annual basis, of the criteria described in subparagraph (F) of paragraph (4);

added “(B) evaluated in accordance with such criteria; and

added “(C) compensated in accordance with—

added “(i) applicable assignment and pay levels, subject to relevant pay limitations; and

added “(ii) the extent to which such criteria are met.

added “(8) Not later than 120 days after the end of each fiscal year, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report that includes the following:

added “(A) A list of each facility and specialty that conducted an evaluation of pay during the period covered by the report.

added “(B) For each evaluation described in subparagraph (A)—

added “(i) a list of occupations for which pay was evaluated, disaggregated by medical specialty, number of authorized full-time employees, and onsite full-time employees as of the date of the evaluation;

added “(ii) the date such evaluation was completed;

added “(iii) whether a market pay adjustment was made following the evaluation per each occupation and specialty evaluated;

added “(iv) whether applicable employees were notified of such evaluation;

added “(v) whether local labor partners were notified of such evaluation; and

added “(vi) in the case of an evaluation that resulted in an adjustment of pay—

added “(I) the date such adjustment—

added “(aa) was implemented; and

added “(bb) became effective; and

added “(II) the percentage of employees of each occupation and specialty for which pay was adjusted pursuant to such evaluation.

added “(C) A list of facilities of the Department that have not conducted an evaluation of market pay, pursuant to paragraph (5), during the 18-month-period that precedes the date of the submission of such report.”

added “(5) Notwithstanding any compensation or pay limitations under this title or title 5, the Secretary may authorize the Under Secretary for Health to pay physicians, podiatrists, optometrists, and dentists—

added “(A) awards authorized under this title;

added “(B) advance payments, recruitment or relocation bonuses, and retention allowances authorized under section 7410(a) of this title or as otherwise provided by law;

added “(C) incentives or bonuses under section 706 of this title or as otherwise provided by law; and

added “(D) earnings from fee-basis appointments under section 7405(a)(2) of this title.

added “(6)

added “(A) The Secretary may waive any pay limitation described in this section (including tier limitations) that the Secretary determines necessary for the recruitment or retention of critical health care personnel whom the Secretary determines would provide direct patient care.

added “(B) Priority for such waivers shall be given for positions, locations, and care provided through agreements that are costly to the Department.

added “(C) The Chief Human Capital Officer of the Department, the Chief Financial Officer of the Department, and the Office of the General Counsel of the Department shall review any waiver issued under subparagraph (A).

added “(D) During the period the authority under subparagraph (A) is effective, the Secretary may not issue more than 300 waivers under such subparagraph.

added “(E) The Secretary may prescribe requirements, limitations, and other considerations for waivers under such subparagraph.

added “(F) Not later than 180 days after the date of the enactment of the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act, and annually thereafter, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report that includes—

added “(i) any updates to the requirements, limitations, and considerations prescribed under subparagraph (B) during the period covered by the report;

added “(ii) a description of the findings of each review, if any, conducted pursuant to subparagraph (C);

added “(iii) a description of each waiver under subparagraph (A) in effect as of the date of the submission of the report, including the—

added “(I) duty location, position, specialty, market and performance considerations for the waiver; and

added “(II) impact, if any, of the waiver on care furnished by the Department pursuant to an agreement regarding the geographic area; and

added “(iv) a list of any separation actions during the period covered by the report with respect to a position for which a waiver under subparagraph (A) is in effect.

added “(G) The authority of the Secretary under subparagraph (A) shall terminate on the last day of the third full fiscal year following the date of the enactment of the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act.”

added Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall establish, on an Internet website of the Department, a health education portal that includes interactive educational modules to ensure veterans enrolled in the patient enrollment system of the Department of Veterans Affairs established and operated under section 1705(a) of title 38, United States Code, understand the basic health care eligibilities and entitlements of veterans under the laws administered by the Secretary, including under the Veterans Community Care Program under section 1703 of such title.

added 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 the House of Representatives a report, for each medical center or other relevant health care facility of the Department of Veterans Affairs, that includes—

added There is authorized to be appropriated to the Secretary of Veterans Affairs $5,000,000 for fiscal year 2025 for the Office of Women’s Health of the Department of Veterans Affairs under section 7310 of title 38, United States Code, to be used by the Secretary to expand access of women veterans to—

added Section 3311(f) of title 38, United States Code, is amended—

added Subsection (i) of section 3319 of title 38, United States Code, is amended—

added Section 3673A(d) of title 38, United States Code, is amended by striking “one business day” and inserting “two business days”.

added Paragraph (4) of section 3675(b) of title 38, United States Code, is amended to read as follows:

added “(4) The educational institution—

added “(A) is approved and participates in a program under title IV of the Higher Education Act of 1965 (20 U.S.C. 1070 et seq.); or

added “(B) does not participate in such a program and the Secretary has waived the requirement under this paragraph with respect to the educational institution, and submits to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives notice of such waiver, because the Secretary determines that the educational institution—

added “(i) elects not to participate in such a program;

added “(ii) cannot participate in such a program; or

added “(iii) is in the process of making a good-faith effort to submit an initial application for approval to participate in such a program, except that a waiver under this clause may not be provided for a period of longer than 36 months.”

added “(5) The educational institution agrees to, not later than 30 days after any date on which such educational institution becomes subject to an action or event described in section 3673(e)(3) of this title, submit to the State approving agency, or the Secretary when acting in the role of a State approving agency, a notification of such action or event in such form and containing such information as the Secretary determines appropriate.”

added “(14) The institution agrees to, not later than 30 days after any date on which such institution becomes subject to an action or event described in section 3673(e)(3) of this title, submit to the State approving agency, or the Secretary when acting in the role of a State approving agency, a notification of such action or event in such form and containing such information as the Secretary determines appropriate.”

added “(I) Comply with the notification requirements under sections 3675(b)(5) and 3676(c)(14) of this title, when applicable.”

added “(6) The educational institution makes available to each eligible person or veteran a copy of the person or veteran’s official transcript in a digital format.”

added “(17) In the case of a course that leads to a standard college degree, the educational institution satisfies the requirements of section 3675(b)(6) of this title.”

added “(B) For purposes of providing a monthly housing stipend described in section 3313(c) to an eligible veteran or eligible person for whom the Secretary is providing educational assistance under chapter 33 of this title during a period that is the last semester, term, or academic period pursuant to subparagraph (A), the Secretary shall treat the veteran or person as pursuing a program of education on a full-time basis.”

added “(i) the commercial driver education program offered at the branch by the educational institution is approved for purposes of this chapter by a State approving agency (or the Secretary when acting in the role of a State approving agency); and

added “(ii)

added “(I) such branch is located in a State in which such educational institution offers such commercial driver education program at another branch of such educational institution; or

added “(II) such branch—

added “(aa) has been operating for at least one year; and

added “(bb) offers such commercial driver education program, using the same curriculum as another branch of such educational institution.”

added “(D) The Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a notification not later than 30 days after the Secretary grants an exemption under subparagraph (A). Such notification shall identify the educational institution, and the branch thereof, granted such exemption.”

added “(3) Regulations—In prescribing any regulation to carry out the amendments made by subsection (a), the Secretary of Veterans Affairs shall consult with State approving agencies designated under section 3671 of such title.

added “(4) GAO study—Not later than 365 days after the applicability date under paragraph (2), the Comptroller General of the United States shall—

added “(A) conduct a study to—

added “(i) determine the effects of the amendments made by subsection (a); and

added “(ii) the feasibility and advisability of similarly amending the rules for approval of programs of education for other vocational programs of education; and

added “(B) submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the findings of the Comptroller General with respect to such study.”

added “3698A. Provision of certificates of eligibility and award letters using electronic means

added “(a) Requirement—Except as provided by subsection (b), the Secretary shall provide to an individual the following documents using electronic means:

added “(1) A certificate of eligibility for the entitlement of the individual to covered educational assistance.

added “(2) An award letter regarding the authorization of the individual to receive covered educational assistance.

added “(b) Election to opt out—An individual may elect to receive the documents specified in subsection (a) by mail rather than through electronic means under subsection (a). An individual may revoke such an election at any time, by means prescribed by the Secretary.

added “(c) Covered educational assistance—In this section, the term “covered educational assistance” means educational assistance under chapter 30, 33, or 35 of this title, or section 3699C of this title.”

added Section 3699(c)(2) of title 38, United States Code, is amended by striking subparagraph (C) and inserting the following new subparagraph (C):

added “(C) This paragraph, including clauses (ii) and (iii) of subparagraph (A), shall apply with respect to the closure or discontinuation of a course or program of education, as described in subsection (b)(1), that occurs during the period beginning on August 1, 2021, and ending on September 30, 2025.”

added “3699C. High technology program

added “(a) Establishment

added “(1) The Secretary shall carry out a program under which the Secretary provides covered individuals with the opportunity to enroll in high technology programs of education that the Secretary determines provide training or skills sought by employers in a relevant field or industry.

added “(2) Not more than 4,000 covered individuals may participate in the program under this section in any fiscal year.

added “(b) Amount of assistance

added “(1) The Secretary shall provide, to each covered individual who pursues a high technology program of education under this section, educational assistance in amounts equal to the amounts provided under section 3313(c)(1) of this title, including, except as provided in paragraph (3), with respect to the housing stipend described in that section and in accordance with the treatment of programs that are distance learning and programs that are less than half-time.

added “(2) Under paragraph (1), the Secretary shall provide such amounts of educational assistance to a covered individual for each of the following:

added “(A) A high technology program of education.

added “(B) A second such program if—

added “(i) the second such program begins at least 18 months after the covered individual graduates from the first such program; and

added “(ii) the covered individual uses educational assistance under chapter 33 of this title to pursue the second such program.

added “(3) No covered individual may receive a housing stipend under this subsection for any month if such individual is in receipt of a housing stipend under chapter 33 of this title for that month.

added “(c) Contracts

added “(1) For purposes of carrying out subsection (a), the Secretary shall seek to enter into contracts with any number of qualified providers of high technology programs of education for the provision of such programs to covered individuals. Each such contract shall provide for the conditions under which the Secretary may terminate the contract with the provider and the procedures for providing for the graduation of students who were enrolled in a program provided by such provider in the case of such a termination.

added “(2) A contract under this subsection shall provide that the Secretary shall pay to a provider—

added “(A) upon the enrollment of a covered individual in the program, 25 percent of the cost of the tuition and other fees for the program of education for the individual;

added “(B) upon graduation of the individual from the program, 25 percent of such cost; and

added “(C) 50 percent of such cost upon—

added “(i) the successful employment of the covered individual for a period—

added “(I) of 180 days in the field of study of the program; and

added “(II) that begins not later than 180 days following graduation of the covered individual from the program;

added “(ii) the employment of the individual by the provider for a period of one year; or

added “(iii) the enrollment of the individual in a program of education to continue education in such field of study.

added “(3) For purposes of this section, a provider of a high technology program of education is qualified if—

added “(A) the provider employs instructors whom the Secretary determines are experts in their respective fields in accordance with paragraph (5);

added “(B) the provider has successfully provided the high technology program for at least one year;

added “(C) the provider does not charge tuition and fees to a covered individual who receives assistance under this section to pursue such program that are higher than the tuition and fees charged by such provider to another individual; and

added “(D) the provider meets the approval criteria developed by the Secretary under paragraph (4).

added “(4)

added “(A) The Secretary shall prescribe criteria for approving providers of a high technology program of education under this section.

added “(B) In developing such criteria, the Secretary may consult with State approving agencies.

added “(C) Such criteria are not required to meet the requirements of section 3672 of this title.

added “(D) Such criteria shall include the job placement rate, in the field of study of a program of education, of covered individuals who complete such program of education.

added “(5) The Secretary shall determine whether instructors are experts under paragraph (3)(A) based on evidence furnished to the Secretary by the provider regarding the ability of the instructors to—

added “(A) identify professions in need of new employees to hire, tailor the programs to meet market needs, and identify the employers likely to hire graduates;

added “(B) effectively teach the skills offered to covered individuals;

added “(C) provide relevant industry experience in the fields of programs offered to incoming covered individuals; and

added “(D) demonstrate relevant industry experience in such fields of programs.

added “(6) In entering into contracts under this subsection, the Secretary shall give preference to a provider of a high technology program of education—

added “(A) from which at least 70 percent of graduates find full-time employment in the field of study of the program during the 180-day period beginning on the date the student graduates from the program; or

added “(B) that offers tuition reimbursement for any student who graduates from such a program and does not find employment described in subparagraph (A).

added “(d) Effect on other entitlement

added “(1) If a covered individual enrolled in a high technology program of education under this section has remaining entitlement to educational assistance under chapter 30, 32, 33, 34, or 35 of this title, such entitlement shall be charged at the rate of one month of such entitlement for each month of educational assistance provided under this section.

added “(2) If a covered individual enrolled in a high technology program of education under this section does not have remaining entitlement to educational assistance under chapter 30, 32, 33, 34, or 35 of this title, any educational assistance provided to such individual under this section shall be provided in addition to the entitlement that the individual has used.

added “(3) The Secretary may not consider enrollment in a high technology program of education under this section to be assistance under a provision of law referred to in section 3695 of this title.

added “(4)

added “(A) An application for enrollment in a high technology program of education under this section shall include notice of the requirements relating to use of entitlement under paragraphs (1) and (2), including—

added “(i) in the case of the enrollment of an individual referred to under paragraph (1), the amount of entitlement that is typically charged for such enrollment;

added “(ii) an identification of any methods that may be available for minimizing the amount of entitlement required for such enrollment; and

added “(iii) an element requiring applicants to acknowledge receipt of the notice under this subparagraph.

added “(B) If the Secretary approves the enrollment of a covered individual in a high technology program of education under this section, the Secretary shall deliver electronically to the individual an award letter that provides notice of such approval and includes specific information describing how paragraphs (1) and (2) will be applied to the individual if the individual chooses to enroll in the program.

added “(e) Requirements for educational institutions

added “(1) The Secretary shall not approve the enrollment of any covered individual, not already enrolled, in any high technology programs of education under this section for any period during which the Secretary finds that more than 85 percent of the students enrolled in the program are having all or part of their tuition, fees, or other charges paid to or for them by the educational institution or by the Department of Veterans Affairs under this title or under chapter 1606 or 1607 of title 10, except with respect to tuition, fees, or other charges that are paid under a payment plan at an educational institution that the Secretary determines has a history of offering payment plans that are completed not later than 180 days after the end of the applicable term, quarter, or semester.

added “(2) The Secretary may waive a requirement of paragraph (1) if the Secretary determines, pursuant to regulations which the Secretary shall prescribe, such waiver to be in the interest of the covered individual and the Federal Government. Not later than 30 days after the Secretary waives such a requirement, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report regarding such waiver.

added “(3)

added “(A)

added “(i) The Secretary shall establish and maintain a process by which an educational institution may request a review of a determination that the educational institution does not meet the requirements of paragraph (1).

added “(ii) The Secretary may consult with a State approving agency regarding such process or such a review.

added “(iii) Not later than 180 days after the Secretary establishes or revises a process under this subparagraph, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report regarding such process.

added “(B) An educational institution that requests a review under subparagraph (A)—

added “(i) shall request the review not later than 30 days after the start of the term, quarter, or semester for which the determination described in subparagraph (A) applies; and

added “(ii) may include any information that the educational institution believes the Department should have taken into account when making the determination, including with respect to any mitigating circumstances.

added “(f) Annual reports—Not later than one year after the date of the enactment of this section, and annually thereafter until the termination date specified in subsection (i), the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the operation of program under this section during the year covered by the report. Each such report shall include each of the following:

added “(1) The number of covered individuals enrolled in the program, disaggregated by type of educational institution, during the year covered by the report.

added “(2) The number of covered individuals who completed a high technology program of education under the program during the year covered by the report.

added “(3) The average employment rate of covered individuals who completed such a program of education during such year, as of 180 days after the date of completion.

added “(4) The average length of time between the completion of such a program of education and employment.

added “(5) The total number of covered individuals who completed a program of education under the program and who, as of the date of the submission of the report, are employed in a position related to technology.

added “(6) The average salary of a covered individual who completed a program of education under the program and who is employed in a position related to technology, in various geographic areas determined by the Secretary.

added “(7) The average salary of all individuals employed in positions related to technology in the geographic areas determined under subparagraph (F), and the difference, if any, between such average salary and the average salary of a covered individual who completed a program of education under the program and who is employed in a position related to technology.

added “(8) The number of covered individuals who completed a program of education under the program and who subsequently enrolled in a second program of education under the program.

added “(g) Collection of information; consultation

added “(1) The Secretary shall develop practices to use to collect information about covered individuals and providers of high technology programs of education.

added “(2) For the purpose of carrying out program under this section, the Secretary may consult with providers of high technology programs of education and may establish an advisory group made up of representatives of such providers, private employers in the technology field, and other relevant groups or entities, as the Secretary determines necessary.

added “(h) Definitions—In this section:

added “(1) The term covered individual means any of the following:

added “(A) A veteran whom the Secretary determines—

added “(i) served an aggregate of at least 36 months on active duty in the Armed Forces (including service on active duty in entry level and skill training) and was discharged or released therefrom under conditions other than dishonorable; and

added “(ii) has not attained the age of 62.

added “(B) A member of the Armed Forces that the Secretary determines will become a veteran described in subparagraph (A) fewer than 180 days after the date of such determination.

added “(2) The term high technology program of education means a program of education—

added “(A) offered by a public or private educational institution;

added “(B) if offered by an institution of higher learning, that is provided directly by such institution rather than by an entity other than such institution under a contract or other agreement;

added “(C) that does not lead to a degree;

added “(D) that has a term of not less than six and not more than 28 weeks; and

added “(E) that provides instruction in computer programming, computer software, media application, data processing, or information sciences.

added “(i) Termination—The Secretary may not provide educational assistance under this section for a high technology program of education that begins after September 30, 2027.”

added “(d) Housing stipend

added “(1) In general—Except as provided under paragraph (2), the Secretary shall pay to each eligible veteran (not including an individual described in the second sentence of subsection (b)) who is enrolled in a high technology program of education under the pilot program on a full-time or part-time basis a monthly housing stipend equal to the product—

added “(A) of—

added “(i) in the case of a veteran pursuing resident training, the monthly amount of the basic allowance for housing payable under section 403 of title 37, United States Code, for a member with dependents in pay grade E–5 residing in the military housing area that encompasses all or the majority portion of the ZIP code area in which is located the campus of the institution where the individual physically participates in a majority of classes; or

added “(ii) in the case of a veteran pursuing a program of education through distance learning, a monthly amount equal to 50 percent of the national average of the monthly amount of the basic allowance for housing payable under section 403 of title 37, United States Code, for a member with dependents in pay grade E–5, multiplied by

added “(B) the lesser of—

added “(i) 1.0; or

added “(ii) the number of course hours borne by the individual in pursuit of the program of education involved, divided by the minimum number of course hours required for full-time pursuit of such program of education, rounded to the nearest multiple of 10.

added “(2) Bar to dual eligibility—No covered individual may receive a housing stipend under this subsection for any month if such individual is in receipt of a housing stipend under chapter 33 of title 38, United States Code, for that month.”

added “(h) Termination—The Secretary may not, under this section, pay a provider for a high technology program of education that begins after September 30, 2024.”

added “(4) Any independent study program except—

added “(A) an independent study program (including such a program taken over open circuit television) that—

added “(i) is accredited by an accrediting agency or association recognized by the Secretary of Education under subpart 2 of part H of title IV of the Higher Education Act of 1965 (20 U.S.C. 1099b);

added “(ii) leads to—

added “(I) a standard college degree;

added “(II) a certificate that reflects educational attainment offered by an institution of higher learning; or

added “(III) a certificate that reflects graduation from a course of study offered by—

added “(aa) an area career and technical education school (as defined in subparagraphs (C) and (D) of section 3(3) of the Carl D. Perkins Career and Technical Education Act of 2006 (20 U.S.C. 2302(3))) that provides education at the postsecondary level; or

added “(bb) a postsecondary vocational institution (as defined in section 102(c) of the Higher Education Act of 1965 (20 U.S.C. 1002(c))) that provides education at the postsecondary level; and

added “(iii) in the case of a program described in clause (ii)(III)—

added “(I) provides training aligned with the requirements of employers in the State or local area where the program is located, which may include in-demand industry sectors or occupations;

added “(II) provides a student, upon graduation from the program, with a recognized postsecondary credential that is recognized by employers in the relevant industry, which may include a credential recognized by industry or sector partnerships in the State or local area where the industry is located; and

added “(III) meets such content and instructional standards as may be required to comply with the criteria under section 3676(c)(14) and (15) of this title; or

added “(B) an online high technology program of education (as defined in subsection (h)(2) of section 3699C of this title)—

added “(i) the provider of which has entered into a contract with the Secretary under subsection (c) of such section;

added “(ii) that has been provided to covered individuals (as defined in subsection (h)(1) of such section) under such contract for a period of at least five years;

added “(iii) regarding which the Secretary has determined that the average employment rate of covered individuals who graduated from such program of education is 65 percent or higher for the year preceding such determination; and

added “(iv) that satisfies the requirements of subsection (e) of such section.”

added “(8) Paragraph (1) shall not apply to the enrollment of a veteran in an online high technology program described in subsection (a)(4)(B).”

added “3699D. Notice of changes to policies and guidance relating to educational assistance programs

added “In the case of any change to any policy or guidance provided by the Secretary that relates to any educational assistance program of the Department, the Secretary may not implement the change before the date that is 90 days after the date on which the Secretary makes available to students, educational institutions, and the Committees on Veterans’ Affairs of the Senate and House of Representatives notice of, and justification for, the change.”

added Not later than 90 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall update the payment system of the Department of Veterans Affairs to allow for electronic fund transfer of educational assistance, administered by the Secretary, to a foreign institution of higher education that—

added “(B) for each individual described in subsection (a) seeking information provided under subsection (b)(5), the name of each Federal student aid program, and a description of each such program, from which the individual may receive educational assistance; and”

added “(v) the average annual cost and the total cost to earn an associate’s degree and a bachelor’s degree, with available cost information on any other degree or credential the institution awards;”

added “(I) the type of beneficiary of educational assistance;

added “(II) individuals who received a credential and individuals who did not; and

added “(III) individuals using educational assistance under laws administered by the Secretary and individuals who are not;”

added “(xvi) the number of veterans or members who completed covered education at the institution leading to—

added “(I) a degree, disaggregated by type of program, including—

added “(aa) an associate degree;

added “(bb) a bachelor’s degree; and

added “(cc) a postbaccalaureate degree; and

added “(II) a certificate or professional license, disaggregated by type of certificate or professional license;

added “(xvii) programs available and the average time for completion of each program;

added “(xviii) employment rate and median income of graduates of the institution in general two and five years after graduation, disaggregated by—

added “(I) specific program; and

added “(II) individuals using educational assistance under laws administered by the Secretary and individuals who are not; and

added “(xix) the number of individuals using educational assistance under laws administered by the Secretary who are enrolled in the both the institution and specific program per year.”

added “(B) The Secretary shall ensure that information provided pursuant to subsection (b)(5) is provided in a manner that is easy for, and accessible to, individuals described in subsection (a).

added “(C) In providing information pursuant to subsection (b)(5), the Secretary shall maintain the anonymity of individuals described in subsection (a) and, to the extent that a portion of any data would undermine such anonymity, ensure that such data is not made available pursuant to such subsection.”

added “(A) provides institutions of higher learning—

added “(i) up to 30 days to review and respond to feedback from individuals described in subsection (a) and address issues regarding the feedback before the feedback is published; and

added “(ii) if an institution of higher learning contests the accuracy of the feedback, the opportunity to challenge the inclusion of such data with an official appointed by the Secretary;”

added “(D) for each institution of higher learning that is approved under this chapter, retains, maintains, and publishes all of such feedback for not less than six years; and

added “(E) is easily accessible to individuals described in subsection (a) and to the general public.”

added “(2) A person bringing an action to enforce a provision of this chapter pursuant to subsection (a) shall be entitled to an injunction under paragraph (1) if such person demonstrates—

added “(A) a violation—

added “(i) of the provisions of this chapter; or

added “(ii) of the provisions of this chapter is threatened or is imminent;

added “(B) the harm to the person outweighs the injury to the employer;

added “(C) a likelihood of success on the merits of such action; and

added “(D) awarding such relief is in the public interest.

added “(3) The court may not deny a motion for injunctive relief on the basis that a party bringing an action to enforce a provision of this chapter may be awarded wages unearned due to an unlawful termination or denial of employment at the conclusion of such action.”

added “(C) The court may require the employer to pay the person the amount referred to in subparagraph (B) and interest on such amount, calculated at a rate of 3 percent per year.

added “(D) The court may require the employer to pay the person the greater of $50,000 or the amount equal to the amounts referred to in subparagraphs (B) and (C) as liquidated damages, if the court determines that the employer knowingly failed to comply with the provisions of this chapter.”

added “(3) In such Federal Circuit proceeding, the court shall award such person reasonable attorney fees, expert witness fees, and other litigation expenses if such person—

added “(A) prevails in such Federal Circuit proceeding; and

added “(B) is not represented by the Special Counsel in such Federal Circuit proceeding.”

added “(a) The Secretary may make a direct housing loan to a Native American veteran under this subchapter if the Secretary ensures the following:

added “(1) That each Native American veteran to whom the Secretary makes a direct housing loan under this subchapter—

added “(A) holds, possesses, or purchases using the proceeds of the loan a meaningful interest in a lot or dwelling (or both) that is located on trust land; and

added “(B) will purchase, construct, or improve (as the case may be) a dwelling on the lot using the proceeds of the loan.

added “(2) That each such Native American veteran will convey to the Secretary by an appropriate instrument the interest referred to in paragraph (1)(A) as security for a direct housing loan under this subchapter.

added “(3) That the Secretary, including the Secretary’s employees or agents, may enter upon the trust land for the purposes of carrying out such actions as the Secretary determines are necessary, including—

added “(A) to evaluate the advisability of the loan;

added “(B) to monitor any purchase, construction, or improvements carried out using the proceeds of the loan; and

added “(C) to manage any servicing or post-foreclosure activities, including acquisition, property inspections, and property management.

added “(4) That there are established standards and procedures that apply to the foreclosure of the interest conveyed by a Native American veteran pursuant to paragraph (2), including—

added “(A) procedures for foreclosing the interest; and

added “(B) procedures for the resale of the lot or dwelling (or both) purchased, constructed, or improved using the proceeds of the loan.

added “(5) That the loan is made in a responsible and prudent manner, subject to standards and procedures as are necessary for the reasonable protection of the financial interests of the United States.”

added “(b)

added “(1) To carry out the purpose of subsection (a), the Secretary may—

added “(A) enter into a memorandum of understanding with a tribal organization, other entity, or individual;

added “(B) rely on agreements or determinations of other Federal agencies to guarantee, insure, or make loans on trust land; and

added “(C) enter into other agreements or take such other actions as the Secretary determines necessary.

added “(2) If the Secretary determines that the requirements under subsection (a) are not being enforced by a tribal organization, other entity, or individual that is a party to any memorandum of understanding, agreement, or determination described in paragraph (1), the Secretary may cease making new direct housing loans to Native American veterans under this subchapter within the area of the authority of the tribal organization, other entity, or individual (as the case may be).”

added “(h) The Secretary may make direct loans to Native American veterans in order to enable such veterans to refinance existing mortgage loans for any of the following purposes:

added “(1) To refinance an existing loan made under this section, if the loan—

added “(A) meets the requirements set forth in subparagraphs (B), (C), and (E) of paragraph (1) of section 3710(e) of this title;

added “(B) will bear an interest rate at least one percentage point less than the interest rate borne by the loan being refinanced; and

added “(C) complies with paragraphs (2) and (3) of section 3710(e) of this title, except that for the purposes of this subsection the reference to subsection (a)(8) of section 3710 of this title in such paragraphs (2) and (3) shall be deemed to be a reference to this subsection.

added “(2) To refinance an existing mortgage loan not made under this section on a dwelling owned and occupied by the veteran as the veteran’s home, if all of the following requirements are met:

added “(A) The loan will be secured by the same dwelling as was the loan being refinanced.

added “(B) The loan will provide the veteran with a net tangible benefit.

added “(C) The nature and condition of the property is such as to be suitable for dwelling purposes.

added “(D) The amount of the loan does not exceed either of the following:

added “(i) 100 percent of the reasonable value of the dwelling, with such reasonable value determined under the procedures established by the Secretary under subsection (d)(2).

added “(ii) An amount equal to the sum of the balance of the loan being refinanced and such closing costs (including any discount points) as may be authorized by the Secretary to be included in the loan.

added “(E) Notwithstanding subparagraph (D), if a loan is made for both the purpose of this paragraph and to make energy efficiency improvements, the loan must not exceed either of the following:

added “(i) 100 percent of the reasonable value of the dwelling as improved for energy efficiency, with such reasonable value determined under the procedures established by the Secretary under subsection (d)(2).

added “(ii) The amount referred to under subparagraph (D)(ii), plus the applicable amount specified under section 3710(d)(2) of this title.

added “(F) The loan meets all other requirements the Secretary may establish under this subchapter.

added “(G) The existing mortgage being refinanced is a first lien on the property and secured of record.

added “(3) To refinance an existing mortgage loan to repair, alter, or improve a dwelling owned by the veteran and occupied by the veteran as the veteran’s home, if all of the following requirements are met:

added “(A) The loan will be secured by the same dwelling as was the loan being refinanced.

added “(B) The nature and condition of the property is such as to be suitable for dwelling purposes, and the repair, alteration, or improvement substantially protects or improves the basic livability or utility of such property.

added “(C) The amount of the loan, including the costs of repairs, alterations, and improvements, does not exceed either of the following:

added “(i) 100 percent of the reasonable value of the dwelling as repaired, altered, or improved, with such reasonable value determined under the procedures established by the Secretary under subsection (d)(2).

added “(ii) An amount equal to the sum of—

added “(I) the balance of the loan being refinanced;

added “(II) the actual cost of repairs, alterations, or improvements; and

added “(III) such closing costs (including any discount points) as may be authorized by the Secretary to be included in the loan.

added “(D) The loan meets all other requirements the Secretary may establish under this subchapter.

added “(E) The existing mortgage loan being refinanced is a first lien on the property and secured of record.”

added “(G) Pursuant to subsection (g)(4), assisting Native American veterans in qualifying for mortgage financing by—

added “(i) partnering with local service providers, such as tribal organizations, tribally designated housing entities, Native community development financial institutions, and nonprofit organizations, for conducting outreach, homebuyer education, housing counseling, and post-purchase education; and

added “(ii) providing other technical assistance as needed.

added “(H) Attending conferences and conventions conducted by the network of Native community development financial institutions and other Native American homeownership organizations to provide information and training to Native community development financial institutions about the availability of the relending program under section 3762A of this title.”

added “(k) The Secretary shall assign a sufficient number of personnel of the Department dedicated to carrying out the authority of the Secretary under this subchapter, including construction and valuation specialists to assist with issues unique to new construction and renovations on trust land.”

added “(C) is located in the State of Alaska within a region established under section 7(a) of the Alaska Native Claims Settlement Act (43 U.S.C. 1606(a));”

added “(E) is defined by the Secretary of the Interior and recognized by the United States as land over which an Indian Tribe has governmental dominion; or

added “(F) is on any land that the Secretary determines is provided to Native American veterans because of their status as Native Americans.”

added “(6) The term community development financial institution has the meaning given that term in section 103 of the Community Development Banking and Financial Institutions Act of 1994 (12 U.S.C. 4702).

added “(7) The term Indian Tribe means any Indian tribe, band, nation, or other organized group or community, including any Alaska Native village or regional or village corporation as defined in or established pursuant to the Alaska Native Claims Settlement Act (43 U.S.C. 1601 et seq.), which is recognized as eligible for the special programs and services provided by the United States to Indians because of their status as Indians.

added “(8) The term Native community development financial institution means any entity—

added “(A) that has been certified as a community development financial institution by the Secretary of the Treasury;

added “(B) that is not less than 51 percent owned or controlled by Native Americans; and

added “(C) for which not less than 51 percent of the activities of the entity serve Native Americans.

added “(9) The term net tangible benefit shall have such meaning as the Secretary determines appropriate, but shall include the refinance of an interim construction loan.

added “(10) The term other technical assistance means services to assist a Native American veteran to navigate the steps necessary for securing a mortgage loan on trust land, including pre-development activities related to utilities, identifying appropriate residential construction services, and obtaining lease clearances and title status reports from the applicable tribal organization or the Bureau of Indian Affairs.

added “(11) The term tribally designated housing entity has the meaning given that term in section 4 of the Native American Housing Assistance and Self-Determination Act of 1996 (25 U.S.C. 4103).”

added “(c) The Secretary shall prescribe such regulations as may be necessary to carry out this subchapter.”

added “3762A. Native community development financial institution relending program

added “(a) Purpose—The Secretary may make a loan to a Native community development financial institution for the purpose of allowing the institution to relend loan amounts to qualified Native American veterans, subject to the requirements of this section.

added “(b) Standards

added “(1) The Secretary shall establish standards to be used in evaluating whether to make a loan to a Native community development financial institution under this section.

added “(2) In establishing standards under paragraph (1), the Secretary shall ensure that a Native community development financial institution—

added “(A) is able to originate and service loans for single-family homes;

added “(B) is able to operate the relending program in a manner consistent with the mission of the Department to serve veterans; and

added “(C) uses loan amounts received under this section only for the purpose of relending, as described in subsection (c), to Native American veterans.

added “(c) Relending requirements

added “(1) A Native community development financial institution that receives a loan under this section shall use the loan amounts to make loans to Native American veterans residing on trust land.

added “(2) A loan to a Native American veteran made by a Native community development financial institution under paragraph (1) shall—

added “(A) be limited either to the purpose of purchase, construction, or improvement of a dwelling located on trust land or to the refinance of an existing mortgage loan for a dwelling on trust land, consistent with the requirements of section 3762(h) of this title; and

added “(B) comply with such terms and conditions as the Secretary determines are necessary to protect against predatory lending, including the interest rate charged on a loan to a Native American veteran.

added “(d) Repayment—A loan made to a Native community development financial institution under this section shall—

added “(1) be payable to the Secretary upon such terms and conditions as are prescribed in regulations pursuant to this subchapter; and

added “(2) bear interest at a rate of one percent.

added “(e) Oversight—Subject to notice and opportunity for a hearing, whenever the Secretary finds with respect to loans made under subsection (a) or (c) that any Native community development financial institution has failed to maintain adequate loan accounting records, to demonstrate proper ability to service loans adequately, or to exercise proper credit judgment, or that such Native community development financial institution has willfully or negligently engaged in practices otherwise detrimental to the interest of veterans or of the Government, the Secretary may take such actions as the Secretary determines necessary to protect veterans or the Government, such as requiring immediate repayment of any loans made under subsection (a) and the assignment to the Secretary of loans made under subsection (c).

added “(f) Sunset—The Secretary may not make a loan under this section after September 30, 2027.”

added “(c) Of amounts available in the Account, the Secretary may use for loans made under section 3762A of this title—

added “(1) in fiscal year 2025, not more than $5,000,000; and

added “(2) in any fiscal year after fiscal year 2025, an amount determined necessary by the Secretary to meet the demand for such loans.”

added “6307. Grants to States and Indian Tribes to improve outreach to veterans

added “(a) Purpose—It is the purpose of this section to provide for assistance by the Secretary to States and Indian Tribes to carry out programs that improve covered outreach and assistance to veterans and the spouses, children, and parents of veterans, to ensure that such individuals are fully informed about, and assisted in applying for, any veterans and veterans-related benefits and programs (including veterans programs of a State or Indian Tribe) for which they may be eligible and facilitate opportunities for such individuals to receive competent, qualified services in the preparation, presentation and prosecution of veterans benefits claims.

added “(b) Authority—The Secretary may award grants to States and Indian Tribes—

added “(1) to carry out, coordinate, improve, or otherwise enhance—

added “(A) covered outreach activities; or

added “(B) activities to assist in the development and submittal of claims for veterans and veterans-related benefits; or

added “(2) to increase the number of county or Tribal veterans service officers serving in the State by hiring new, additional such officers.

added “(c) Application

added “(1) To be eligible for a grant under this section, a State or Indian Tribe shall submit to the Secretary an application therefor at such time, in such manner, and containing such information as the Secretary may require.

added “(2) Each application submitted under paragraph (1) shall include the following:

added “(A) A detailed plan for the use of the grant.

added “(B) A description of the programs through which the State or Indian Tribe will meet the outcome measures developed by the Secretary under subsection (j).