Mike Bost
Representative for Illinois · Republican · United States
“(B) Elements.--The Secretary, in coordination with participating critical access hospitals, shall ensure that any contract, agreement, or other arrangement entered into under subparagraph (A) establishes criteria, as the Secretary considers appropriate, to ensure-- (i) the provision of timely, safe, and high-quality health care services t…”
“(B) Elements.--The Secretary, in coordination with participating critical access hospitals, shall ensure that any contract, agreement, or other arrangement entered into under subparagraph (A) establishes criteria, as the Secretary considers appropriate, to ensure-- (i) the provision of timely, safe, and high-quality health care services t…”
“(a) In General.--Paragraph (2) of section 2306(h) of title 38, United States Code, is amended to read as follows: ``(2) If the Secretary furnishes an urn or commemorative plaque for an individual under paragraph (1), the Secretary may not provide for such individual a headstone or marker under this section, or any interment benefit under…”
“(a) In General.--Paragraph (2) of section 2306(h) of title 38, United States Code, is amended to read as follows: ``(2) If the Secretary furnishes an urn or commemorative plaque for an individual under paragraph (1), the Secretary may not provide for such individual a headstone or marker under this section, or any interment benefit under…”
“(d) Update of Information on Providers.--Not later than one year after the date of the enactment of this Act, the Secretary, through the Office of Integrated Veteran Care or successor office, shall develop a process to ensure that third party administrators regularly, not less frequently than quarterly-- (1) update their lists of communit…”
“(d) Update of Information on Providers.--Not later than one year after the date of the enactment of this Act, the Secretary, through the Office of Integrated Veteran Care or successor office, shall develop a process to ensure that third party administrators regularly, not less frequently than quarterly-- (1) update their lists of communit…”
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“(2) Limitation on new obligations after sunset.--Beginning on October 1, 2031, the Secretary may not initiate, award, enter into, renew, extend, or otherwise obligate funds for any new program, project, activity, contract, task order, or operational capability carried out pursuant to this section unless expressly authorized by a subsequent Act of Congress.”
“(f) Rule of Construction.--Nothing in this section shall be construed to require the public disclosure of classified information, controlled unclassified information, operational details, cybersecurity architecture, contingency planning information, mission-essential system design, or information otherwise protected from disclosure under Federal law or Executive Order. (g) Reauthorization and Sunset.-- (1) Reauthorization required.--The authority provided under this section to obligate or expend amounts appropriated pursuant to subsection (a) shall terminate on September 30, 2031, unless subsequently reauthorized by law.”
“(d) Limitation.--Funds made available under this section may not be used for any purpose unrelated to information technology modernization, cybersecurity, operational resilience, logistics modernization, communications modernization, digitization, or fraud prevention activities of the Department. (e) Supplement, Not Supplant.--Amounts made available under this section shall supplement and not supplant other amounts otherwise authorized to be appropriated for the Office of Information and Technology of the Department of Veterans Affairs.”
“(B) Not later than 30 days after the end of each fiscal quarter through September 30, 2031, the Secretary shall provide the Committees a briefing and written report on-- (i) obligations and expenditures to date, by category; (ii) progress against the implementation plan; (iii) any deviations from the plan and corrective actions; and (iv) updated projections for remaining funds. (C) The initial briefing under subparagraph (B) shall be in person and subsequent briefings may be virtual unless otherwise requested by the Committees. Reports under such subparagraph may include a classified annex.”
“(3) Detailed implementation plan and quarterly briefings.-- (A) Not later than 90 days after the date of enactment of this Act, the Secretary, acting through the Office of Information and Technology, shall submit to the Committees on Veterans' Affairs of the House of Representatives and the Senate a comprehensive implementation plan. The plan shall include-- (i) specific milestones, deliverables, and performance metrics for each category of activities in subsection (b); (ii) a zero trust architecture strategy with timelines and technical requirements; (iii) a detailed expenditure plan by fiscal quarter and by activity category; and (iv) any proposed interagency or private-sector partnerships.”
“(2) Not later than 90 days after the date of enactment of this Act, and annually thereafter until September 30, 2031, the Secretary shall provide to the Committees on Veterans' Affairs of the House of Representatives and the Senate a briefing and report on-- (A) activities carried out using funds made available under this section; (B) progress on improving cybersecurity, resiliency, continuity, logistics, communications, digitization, and mission assurance capabilities; and (C) coordination with other Federal agencies, as appropriate. Such reports may include a classified annex.”
“(3) $150,000,000 for Resilient Communications and Digital Records Modernization -- For interoperable, survivable communications infrastructure, and targeted digitization/ automation of high-volume paper-based workflows (claims, correspondence, administrative records) to reduce fraud risk and improve continuity during degraded or emergency environments. Funds shall not be used for broad Electronic Health Record Modernization expansion. (c) Oversight and Protection of Sensitive Information.-- (1) The Secretary may obligate and expend amounts under this section in classified, controlled, or protected environments consistent with applicable law.”
“These systems shall support both routine veteran care operations and 4th Mission medical surge, patient movement, and emergency distribution requirements in consultation with the Secretary of Defense, the Administrator of the Federal Emergency Management Agency, and the heads of other Federal agencies. (2) $200,000,000 for Cybersecurity and Operational Resiliency -- For zero trust architecture implementation, threat detection, secure cloud hardening, endpoint protection, continuity of operations (COOP) platforms, and protection of mission-essential systems against cyber and physical disruptions. Funds shall prioritize high-risk legacy systems and medical device security.”
“(a) Authorization of Appropriations.--There is authorized to be appropriated, and there is appropriated, to the Secretary of Veterans Affairs $500,000,000 for fiscal year 2026, to remain available until September 30, 2031, for deposit into the accounts of the Office of Information and Technology of the Department of Veterans Affairs for the purposes described in subsection (b). (b) Use of Funds.--Funds shall be allocated and expended only as follows: (1) $150,000,000 for Enterprise Logistics and Supply Chain Visibility -- To develop and deploy integrated, real-time enterprise-wide logistics systems, inventory visibility, pharmaceutical tracking, and medical supply chain resiliency capabilities.”
“(k) Covered Veteran Defined.--In this section, the term ``covered veteran'' means a veteran who-- (1) is enrolled in the system of annual patient enrollment of the Department of Veterans Affairs established and operated under [[Page H4582]] section 1705(a) of title 38, United States Code; (2) has a spinal cord injury or disorder; and (3) is dependent upon others for bowel and bladder care while residing in non-institutional settings. TITLE IV--ORGANIZATION SEC. 401. AUTHORIZATION OF APPROPRIATIONS TO THE OFFICE OF INFORMATION AND TECHNOLOGY OF THE DEPARTMENT OF VETERANS AFFAIRS FOR CERTAIN PURPOSES.”
“(h) Continued Participation in Program.--If a covered veteran has been medically determined to require care under the program for a continuous period of three years or more, the veteran is deemed to require such care for life or until such time as the medical provider for such veteran determines the service is no longer needed. (i) Not Vendors or Contractors.--Family members and individually employed caregivers providing care to covered veterans under the program shall not be considered vendors or contractors for purposes of the program. (j) Limitation.--Care may not be provided under the program to a veteran who can perform the bowel and bladder functions of the veteran without assistance.”
“(B) Home health agencies.--Payment to a home health agency for care provided to a covered veteran under the program may not exceed the payment rates of the Department under section 17.4035 of title 38, Code of Federal Regulations (relating to payment rates and methodologies), or successor regulations. (g) Submission of Documentation.--Family members and individually employed caregivers providing care to covered veterans under the program shall provide such documentation and information in such format and under such terms as the Secretary may require as a condition of receiving payment under the program.”
“(f) Payment.-- (1) In general.--The Secretary shall provide a monthly stipend to family members and individually employed caregivers and payment to contracted home health agencies for care provided to covered veterans under the program. (2) Limitation.-- (A) Family members and individually employed caregivers.-- The stipend for a family member or individually employed caregiver for care provided to a covered veteran under the program-- (i) shall be determined by the Secretary; (ii) shall be based on the amount and degree of assistance provided; and (iii) may not exceed the fifth step of the applicable grade of the General Schedule hourly rate paid to nursing assistants who provide such care at the medical facility of the Department that is nearest to the residence of such veteran.”
“(e) Supportive Medical Training and Qualifications.-- (1) In general.--The Secretary shall provide to each family member or individually employed caregiver providing care to a covered veteran under the program necessary supportive medical training to participate in and receive payment by the Secretary for the provision of such care. (2) Qualifications.--The Secretary shall establish such requirements, conditions, and qualifications for providers of care under the program as necessary to provide clinically appropriate bowel and bladder care to covered veterans and to ensure the financial and administrative integrity of the program.”
“(3) Individualized assessment.--The Secretary shall conduct an individualized assessment with respect to a covered veteran to determine the number of hours of bowel and bladder care needed by such veteran under the program. (4) Denial of care.--Before denying bowel and bladder care for any covered veteran under the program, the Secretary shall first obtain review of and concurrence with respect to such denial from a designated Spinal Cord Injuries and Disorders Center of the Department. (d) Coordination of Care and Benefits.--The Secretary shall ensure the program is coordinated with other programs and benefits of the Department for which the covered veteran is eligible to ensure that covered veterans and caregivers receive appropriate support without duplicating benefits or services.”
“(b) In General.--The Secretary of Veterans Affairs shall establish a program to address the bowel and bladder care needs of covered veterans (in this section referred to as the ``program''). (c) Provision of Care.-- (1) Clinical need.--The Secretary shall provide bowel and bladder care under the program to covered veterans based on clinical need, which may include covered veterans receiving aid and attendance benefits from the Department of Veterans Affairs. (2) Caregiver or agency.--A covered veteran may receive bowel and bladder care under the program through a qualified family member, an individually employed caregiver, or a contracted home health agency.”
“(D) Family caregivers and individually employed caregivers provide life-sustaining care for the bowel and bladder care needs of veterans that allow them to live in their communities. (2) Sense of congress.--It is the sense of Congress that-- (A) family caregivers and individually employed caregivers should not be subjected to self-employment taxes and treated as vendors or contractors for the veterans to whom they provide care; (B) veterans should not be forced to finish their bowel and bladder care needs in a set period of time that does not consider their individual needs; and (C) veterans should not be subjected to ongoing clinical determinations regarding their bowel and bladder care needs absent a decision by their medical care provider that such care is no longer needed.”
“(a) Findings; Sense of Congress.-- (1) Findings.--Congress finds the following: (A) Bowel care and bladder care are supportive and necessary medical services for veterans with spinal cord injuries and disorders when they are unable to manage their bowel and bladder functions independently. (B) Inadequate care will lead to complications and problems such as autonomic dysreflexia that can be potentially life- threatening and result in illness and hospitalization. (C) Bowel care and bladder care are essential to support veterans with spinal cord injuries and disorders in non- institutional settings, improve quality of life, optimize health, and prevent complications from neurogenic bowel and bladder.”
“(c) Notification.--Not later than 60 days after making a waiver, modification, or substitution relating to the project under subsection (a), including a waiver under subsection (b), the Secretary shall submit to the appropriate committees of Congress a notification describing the waiver, modification, or substitution and the reason for such waiver, modification, or substitution. (d) Authorization of Appropriations.--There is authorized to be appropriated to the Secretary of Veterans Affairs for the Construction, Major Projects account $1,641,570,000 for the project under subsection (a), to remain available until expended. SEC. 333. BOWEL AND BLADDER CARE PROGRAM OF DEPARTMENT OF VETERANS AFFAIRS.”
“(a) In General.--The Secretary of Veterans Affairs shall carry out a major medical facility project for the replacement of a medical center, a new central utility plant, a replacement multi-specialty outpatient clinic, and associated parking in Indianapolis, Indiana. (b) Non-Department Federal Entity Waiver.--In order to reduce cost and expedite timelines, the Secretary may waive the requirements under section 8103(e) of title 38, United States Code, and section 1096 of the National Defense Authorization Act for Fiscal Year 2016 (Public Law 114-92; 38 U.S.C. 8103 note) for a non-Department Federal entity to be engaged in project management and other activities for the project under subsection (a).”
“(c) Notification.--Not later than 60 days after making a waiver, modification, or substitution relating to the project under subsection (a), including a waiver under subsection (b), the Secretary shall submit to the appropriate committees of Congress a notification describing the waiver, modification, or substitution and the reason for such waiver, modification, or substitution. (d) Authorization of Appropriations.--There is authorized to be appropriated to the Secretary of Veterans Affairs for the Construction, Major Projects account $30,000,000 for the project under subsection (a) to remain available until expended. SEC. 332. AUTHORIZATION OF MAJOR MEDICAL FACILITY PROJECT OF DEPARTMENT OF VETERANS AFFAIRS FOR FISCAL YEAR 2027 IN INDIANAPOLIS, INDIANA.”
“(a) In General.--The Secretary of Veterans Affairs shall carry out a major medical facility project for the acquisition of land for a new Department of Veterans Affairs health care facility in San Antonio, Texas. (b) Non-Department Federal Entity Waiver.--In order to reduce cost and expedite timelines, the Secretary may waive the requirements under section 8103(e) of title 38, United States Code, and section 1096 of the National Defense Authorization Act for Fiscal Year 2016 (Public Law 114-92; 38 U.S.C. 8103 note) for a non-Department Federal entity to be engaged in project management and other activities for the project under subsection (a).”
“``(b) Prohibition on Withholding Information.--The Secretary may not withhold information under subsection (a) from the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives solely on the basis that the information is predecisional, deliberative, advisory, procurement-sensitive, or subject to an internal policy or directive of the Department.''. (2) Clerical amendment.--The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 8106 the following new item: ``8107. Access to information for medical facility construction projects and leases.''. SEC. 331. AUTHORIZATION OF MAJOR MEDICAL FACILITY PROJECT OF DEPARTMENT OF VETERANS AFFAIRS FOR FISCAL YEAR 2027 IN SAN ANTONIO, TEXAS.”
“Access to information for medical facility construction projects and leases ``(a) In General.--For any major construction project, lease, or enhanced-use lease for a medical facility of the Department, the Secretary shall ensure that the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives are provided timely access to all information, records, documents, data, analyses, communications, contracts, agreements, project schedules, cost estimates, memoranda, briefings, reports, and other materials relating to the project or lease.”
“(5) Appropriate committees of congress defined.--In this section the term ``appropriate committees of Congress'' means-- (A) the Committee on Veterans' Affairs and the Committee on Appropriations of the Senate; and (B) the Committee on Veterans' Affairs and the Committee on Appropriations of the House of Representatives. (b) Access to Information for Medical Facility Construction Projects and Leases.-- (1) In general.--Subchapter I of chapter 81 of title 38, United States Code, is amended by inserting after section 8106 the following: [[Page H4581]] ``Sec. 8107.”
“8103 note) for a non-Department Federal entity to be engaged in project management and other activities for the project under paragraph (1). (3) Notification.--Not later than 60 days after making a waiver, modification, or substitution relating to the project under subsection (a), including a waiver under paragraph (2), the Secretary shall submit to the appropriate committees of Congress a notification describing the waiver, modification, or substitution and the reason for such waiver, modification, or substitution. (4) Authorization of appropriations.--There is authorized to be appropriated to the Secretary of Veterans Affairs for the Construction, Major Projects account $1,180,000,000 for the project under paragraph (1), to remain available until expended.”
“(a) Authorization of Major Medical Facility Project of Department of Veterans Affairs for Fiscal Year 2027 in Manchester, New Hampshire.-- (1) In general.--The Secretary of Veterans Affairs shall carry out a major medical facility project for the replacement of a medical center, a new central utility plant, a community living center, a residential rehabilitation treatment facility, associated parking, and demolition of existing buildings in Manchester, New Hampshire. (2) Non-department federal entity waiver.--In order to reduce cost and expedite timelines, the Secretary may waive the requirements under section 8103(e) of title 38, United States Code, and section 1096 of the National Defense Authorization Act for Fiscal Year 2016 (Public Law 114-92; 38 U.S.C.”
“(j) Authorization of Appropriations.--There is authorized to be appropriated to carry out this section $10,000,000 for each of the three consecutive fiscal years beginning the fiscal year in which the pilot program is established under subsection (a). (k) Termination.-- (1) The authority to carry out a pilot program under this section shall terminate on September 30, 2029. (2) No funds may be obligated by the Secretary to carry out a pilot program under this section after the date of termination in paragraph (1), except for activities necessary to close operations of such pilot program. SEC. 330. AUTHORIZATION OF MAJOR MEDICAL FACILITY PROJECT OF DEPARTMENT OF VETERANS AFFAIRS FOR FISCAL YEAR 2027 IN MANCHESTER, NEW HAMPSHIRE.”
“(D) Post-traumatic stress disorder. (E) Traumatic brain injury. (F) Any other disability, condition, or diagnosis for which the Secretary determines, based on medical judgment, that it is optimal for the veteran to manage the disability, condition, or diagnosis and live independently through the assistance of a service dog. (3) Pilot program.--The term ``pilot program'' means the pilot program required by subsection (a)(1). (4) Service dog.--The term ``service dog'' means any dog that is individually trained to do work or perform tasks that are-- (A) for the benefit of a veteran with a disability, condition, or diagnosis described in paragraph (2); and (B) directly related to the disability, condition, or diagnosis of the veteran.”
“(i) Definitions.--In this section: (1) Eligible veteran.--The term ``eligible veteran'' means a veteran (as defined in section 101 of title 38, United States Code) who-- (A) as determined by a physician, has one or more disabilities, conditions, or diagnoses described in paragraph (2); and (B) is enrolled in the system of annual patient enrollment of the Department of Veterans Affairs established and operated under section 1705(a) of title 38, United States Code, or is otherwise entitled to receive such care and services under subsection (c)(2) of such section. (2) Disability, condition, diagnosis described.--A disability, condition, or diagnosis described in this subparagraph is any of the following: (A) Blindness or visual impairment. (B) Loss of use of a limb, paralysis, or other significant mobility issue. (C) Loss of hearing.”
“(h) Oversight and Monitoring.--The Secretary-- (1) may require each recipient of a grant under this section to provide, in such form as may be prescribed by the Secretary, such reports or answers in writing to specific questions, surveys, or questionnaires as the Secretary determines necessary to carry out the pilot program; (2) shall establish such oversight and monitoring requirement as the Secretary determines appropriate to ensure that grant amounts awarded under this section are used appropriately; and (3) may take such actions as the Secretary determines necessary and according to the terms of the grant agreement to address any issues identified through the enforcement of such requirements.”
“(2) Continuation.--If the Secretary provides a veterinary insurance policy to a veteran under paragraph (1), the Secretary shall continue to provide the policy to the veteran without regard to the continuation or termination of the pilot program. (g) Training and Technical Assistance.--The Secretary may provide training and technical assistance regarding grant application and administration to recipients of grants under this section.”
“(e) Requirements for Grant Recipients.-- (1) Notifications and information.--A recipient of a grant under this section shall-- (A) notify each veteran who receives a service dog through such grant that the service dog is being paid for, in whole or in part, by the Department of Veterans Affairs; and (B) inform each such veteran of the benefits and services available from the Secretary for the veteran and the service dog. (2) Prohibition on certain fees.--A recipient of a grant under this section may not charge a fee to a veteran receiving a service dog through such grant. (f) Veterinary Insurance.-- (1) In general.--The Secretary shall provide to each veteran who receives a service dog through a grant under this section a commercially available veterinary insurance policy for the service dog.”
“(B) Covered program defined.--In this paragraph, the term ``covered program'' means a program under which-- (i) service dogs are provided to participants in the program; and (ii) only eligible veterans are allowed to participate in the program. (2) Administrative expenses.--The Secretary may establish a maximum amount for each grant awarded under this section that may be used by the recipient of the grant to cover administrative expenses. (3) Other conditions and limitations.--The Secretary may establish other conditions or limitations on the use of grant amounts under this section.”
“(2) Agreement required.--Before the provision of any grant amounts to a nonprofit entity selected to receive a grant under this section, the Secretary shall enter into an agreement, containing such terms, conditions, and limitations as the Secretary determines appropriate, with such entity. (3) Maximum grant amount.--A grant awarded to a nonprofit entity under this section may not exceed $2,000,000 in a fiscal year. (4) Payments.--The Secretary shall establish intervals of payment for the administration of each grant awarded under this section. (d) Use of Funds.-- (1) In general.-- (A) Requirement.--A recipient of a grant under this section shall use the grant amounts to plan, develop, implement, and manage one or more covered programs.”
“(iii) Any additional support or services that will be provided for such dogs and eligible veterans. (iv) The plan for publicizing the availability of such service dogs through a marketing campaign that targets eligible veterans. (v) The commitment to have humane standards for animals. (vi) The demonstrated experience of the nonprofit entity in training service dogs in compliance with the requirements of the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.). (c) Award of Grants.-- (1) In general.--The Secretary shall award a grant to each nonprofit entity for which the Secretary has approved an application submitted under subsection (b)(1).”
“(b) Applications.-- (1) In general.--To be eligible to receive a grant under this section, a nonprofit entity shall submit an application to the Secretary at such time and in such manner as the Secretary may require. (2) Elements.--An application submitted by a nonprofit entity under paragraph (1) shall include the following: (A) A proposal for the provision of service dogs to eligible veterans, including how the nonprofit entity will communicate with the Secretary to ensure an increasing number of service dogs are provided to veterans. (B) A description of the following services or commitments to be provided by the nonprofit entity: (i) The training that will be provided to eligible veterans. (ii) The training of dogs that will serve as service dogs.”
“DEPARTMENT OF VETERANS AFFAIRS PILOT PROGRAM TO AWARD GRANTS FOR THE PROVISION OF SERVICE DOGS TO VETERANS. (a) In General.-- (1) Pilot program required.--Not later than 24 months after the date of the enactment of this Act, the Secretary of Veterans Affairs shall establish a pilot program under which the Secretary shall award grants, on a competitive basis based on the application elements listed in subsection (b)(2), to nonprofit entities to provide service dogs to eligible veterans. (2) Duration.--The Secretary shall carry out the pilot program during the three-year period beginning on the date on which the first grant is awarded under this section.”
“``(7) In this subsection, the term `assistive technology' means a powered medical device or electronic tool used to treat or alleviate symptoms or conditions caused by a spinal cord injury or disorder, including the following: ``(A) A personal mobility device, including a powered exoskeleton device. ``(B) A speech generating device. ``(C) A spinal cord neuromodulation technology, including non-invasive transcutaneous spinal stimulation using sensory (afferent) pathways, intended to improve voluntary motor function, autonomic function, independence, or quality of life. ``(D) Where clinically appropriate, and consistent with the prosthetic and sensory aids [[Page H4580]] policies of the Department, an implantable spinal cord stimulation system that is approved by the Food and Drug Administration.''. SEC. 329.”
“``(ii) for any assistive technology prescribed, an identification of the category of such technology, including spinal cord neuromodulation, and a summary of functional outcomes associated with the prescription of such technology, if available. ``(B) The year-to-year change (for the period covered by the report, including the two years immediately prior to the year the report is submitted) in the percent of veterans with a spinal cord injury or disorder who received an evaluation under this subsection. ``(6) In reviewing the performance metrics of a Veterans Integrated Service Network for any year beginning after the date that is one year after the date of the enactment of the Take Care of America's Veterans Act, the Secretary shall consider the provision of evaluations under paragraph (1).”
“``(5) Not later than one year after the date of the enactment of the Take Care of America's Veterans Act, and every two years thereafter, the Secretary shall submit to the Committees on Veterans' Affairs of the Senate and the House of Representatives a report that includes the following: ``(A) For the period covered by the report-- ``(i) the number of veterans who-- ``(I) received medical care or hospital services from the Department and used an assistive technology; ``(II) received medical care or hospital services from the Department and were assessed for the provision of an assistive technology; and ``(III) received medical care or hospital services from the Department and were prescribed an assistive technology.”
“``(B) Before issuing any guidance, rules, or regulations regarding the requirements set out in this subsection, the Secretary shall consult with manufacturers of assistive technologies and other entities relevant to the provision of assistive technologies if the guidance, rules, or regulations would directly affect such manufacturers or entities. ``(C) The Secretary shall ensure, to the extent possible, that any veteran known by the Secretary to have a spinal cord injury or disorder receives information annually about the evaluation available under this subsection and the benefits to the veteran of choosing to undergo the evaluation. ``(4) As the Secretary determines clinically appropriate, the Secretary may provide training, programming, remote monitoring, and follow-up for assistive technologies through telehealth.”
“``(3)(A) In maintaining, prescribing, or amending any guidance, rules, or regulations issued by the Department regarding the requirements set out in this subsection, the Secretary shall consult with-- ``(i) the spinal cord injury and disorder program managers of the Department; ``(ii) clinicians employed by the Department as specialists in spinal cord injuries and disorders; ``(iii) clinicians and technologists with demonstrated expertise in spinal cord neuromodulation therapies, including non-invasive transcutaneous approaches; and ``(iv) representatives of organizations recognized under section 5902 of this title.”
“``(E) An assessment with respect to the provision of assistive technology, including spinal cord neuromodulation technology (such as non-invasive transcutaneous spinal stimulation), that could help maximize the veteran's voluntary motor or autonomic function, independence, or mobility, including suitability for home use and need for training, programming, and remote follow-up.”
“``(2) The evaluation described in paragraph (1) shall include the following: ``(A) An assessment of any circumstance or condition the veteran is experiencing that indicates a risk for any health complication related to the spinal cord injury or disorder, including a risk of comorbidities. ``(B) An assessment regarding chronic pain and, if applicable, the management of chronic pain. ``(C) An assessment regarding dietary management and weight management. ``(D) An assessment regarding prosthetic equipment, including which prosthetic equipment the veteran needs, how well any existing prosthetic equipment is functioning considering the needs of the veteran, and any safety concerns regarding the prosthetic equipment in use by or recommended to the veteran.”
“(5) Toxic exposure.--The terms ``toxic exposure'' and ``toxic-exposed veteran'' have the meanings given such terms in section 101 of title 38, United States Code. SEC. 328. VETERANS SPINAL TRAUMA ACCESS TO NEW DEVICES ACT. Section 1706 of title 38, United States Code, is amended by adding at the end the following new subsection: ``(d)(1) In managing the provision of hospital care and medical services under section 1710(a) of this title, the Secretary shall furnish (through direct provision of service, referral, or a telehealth program operated by the Department) a preventative health evaluation annually to any veteran with a spinal cord injury or disorder who elects to undergo the evaluation.”
“(2) Relevant stakeholders.--The term ``relevant stakeholders'' means-- (A) public health experts with experience in developing and maintaining registries; (B) epidemiologists with experience in studying health effects of toxic exposure on the descendants of toxic-exposed veterans; (C) descendants of toxic-exposed veterans; and (D) veterans service organizations. (3) Toxic-exposed member of the armed forces.--The term ``toxic-exposed member of the Armed Forces'' means a member of the Armed Forces who was subject to a toxic exposure in line of duty in the active military, naval, air, or space service. (4) Toxic-exposed veteran.--The term ``toxic-exposed veteran'' means a veteran who was subject to a toxic exposure in line of duty in the active military, naval, air, or space service.”
“(7) Prohibition on expansion of services.--No information collected by this program shall be used to inform the expansion of compensation or healthcare benefits furnished by the Department to the descendants of members of the Armed Forces, unless otherwise authorized by another Act of Congress on a date after the passage of this legislation. (c) Definitions.--In this subsection: (1) Active military, naval, air, or space service.--The term ``active military, naval, air, or space service'' has the meaning given such term in section 101 of title 38, United States Code.”
“(4) Collection of information.--In administering the health monitoring program required by paragraph (1), the Secretary may collect, process, maintain, and consolidate information on birth defects among descendants of toxic-exposed veterans and toxic-exposed members of the Armed Forces, including biological samples, environmental factors, and personal and social factors. (5) Consultation.--The Secretary shall carry out the services covered by this section in consultation with such Federal, State, and research partners as the Department considers appropriate. (6) Sunset.--This section shall terminate on the date that is 7 years after the date of enactment of this Act.”
“(2) Requirements.--In carrying out the program required by paragraph (1), the Secretary shall-- (A) leverage Government data sets to improve the program; (B) recruit additional descendants; (C) consult with relevant stakeholders to develop a strategy to coordinate collection of information under the program; and (D) ensure data from the program is used to inform basic research, translational research, and epidemiological studies to help address data and knowledge gaps identified in the literature review conducted under subsection (a)(2)(A). (3) Mechanisms for administration.--The Secretary may administer the program required by paragraph (1) either directly or through such mechanisms as the Secretary considers appropriate, such as through the award of a grant or cooperative agreement.”