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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“(6) Prohibition on expansion of services.--Nothing in this section shall be construed to authorize the expansion of compensation or healthcare benefits furnished by the Department to the descendants of members of the Armed Forces. (b) Program for Monitoring Health of Descendants of Veterans and Members of the Armed Forces Subjected to Toxic Exposure in the Armed Forces.-- (1) In general.--The Secretary of Veterans Affairs shall use the results of the literature review conducted under subsection (a)(2)(A) to establish a health monitoring or screening program for descendants of toxic-exposed veterans and toxic-exposed members of the Armed Forces, to assist in identifying potential patterns or signals, supporting public health surveillance, and facilitating epidemiologic and clinical research related to birth defects.”
“(C) Plan.-- (i) In general.--Not later than 180 days after the date of the enactment of this Act, the Agency shall submit to the Secretary and to the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives a plan describing the Agency's proposed approach to carrying out the literature review under paragraph (2)(A). (ii) Contents.--The plan submitted pursuant to clause (i) shall include-- (I) the scope and key research questions to be addressed; and (II) the methodology to be used in identifying, evaluating, and synthesizing relevant scientific and medical literature. (5) Consultation.--The Agency shall carry out the services covered by this subsection in consultation with such Federal, State, and research partners as the Agency and the Secretary jointly consider appropriate.”
“(3) Sunset.--On the date that is 7 years after the date of enactment of this Act. (4) Literature review.-- (A) In general.--In carrying out the literature review under paragraph (2)(A), the Agency shall review available literature to determine the association between military toxic exposures and the incidence or prevalence of birth defects among the descendants of toxic-exposed veterans and toxic-exposed members of the Armed Forces. (B) Report.--Not later than one year after the date of the enactment of this Act, the Agency shall submit to the Secretary, the [[Page H4579]] Committee on Veterans' Affairs of the Senate, and the Committee on Veterans' Affairs of the House of Representatives a report containing the findings of the Agency with respect to the activities of the Agency under paragraph (2)(A).”
“(2) Services.--Under a contract or agreement between the Secretary and the Agency under this section, the Agency shall-- (A) conduct a literature review on the health effects on descendants of toxic-exposed veterans and toxic-exposed members of the Armed Forces from their toxic exposure and identify any gaps in knowledge or research on such topic; (B) not later than 180 days after completing the literature review under subparagraph (A) establish and maintain a publicly available report with information on-- (i) the findings of the Agency with respect to such literature review; and (ii) the ongoing research and activities directed by the Agency, including a review of all relevant data to determine the strength of evidence for a positive association between a health condition researched and a toxic exposure based on the categories set forth under section 1173(c)(2) of title 38, United States Code; and (C) not later than 30 days after the date on which the first review is published under subparagraph (B) and not less frequently than once every year thereafter, publish a new report containing the information made available under clause (ii) of such subparagraph.”
“(a) Research on Diagnosis and Treatment of Health Conditions of Descendants of Individuals Exposed to Toxic Substances While Serving in Armed Forces.-- (1) Contract or agreement.--The Secretary of Veterans Affairs shall enter into a contract or interagency agreement with the Agency for Toxic Substances and Disease Registry (in this section referred to as the ``Agency'') to perform the services covered by this section.”
“(2) Definitions.--In this subsection: (A) Military sexual trauma.--The term ``military sexual trauma'' has the meaning given such term in section 1166(d)(2) of title 38, United States Code. (B) Service academy.--The term ``service academy'' means any of the following: (i) The United States Military Academy. (ii) The United States Naval Academy. (iii) The United States Air Force Academy. (iv) The United States Coast Guard Academy. (v) The United States Merchant Marine Academy. SEC. 327. RESEARCH ON HEALTH CONDITIONS OF DESCENDANTS OF TOXIC-EXPOSED VETERANS.”
“(b) Care Relating to Military Sexual Trauma for Individuals Who Withdraw From or Otherwise Do Not Complete Service at Service Academies.-- (1) In general.--The Secretary of Veterans Affairs, in coordination with the Secretary of Defense, the Secretary of Homeland Security, and the Secretary of Transportation, shall ensure that each individual who withdraws from, or otherwise does not complete service at, a service academy is provided-- (A) information on the potential eligibility of such individual for care and counseling relating to military sexual trauma provided through the Department of Veterans Affairs; and (B) the option to receive copies of-- (i) the individual's service treatment records or military personnel records that document military sexual trauma; (ii) reporting forms of the Department of Defense, the Department of Homeland Security, or the Department of Transportation on sexual assault or sexual harassment for which the individual was the victim; and (iii) any investigative reports into military sexual trauma that occurred during the individual's service in the Armed Forces and for which the individual was the victim, which are in the possession of the Department of Defense, the Department of Homeland Security, or the Department of Transportation.”
“1166 note) is amended-- (1) in subsection (a)(1)-- (A) in subparagraph (C), by striking ``; and'' and inserting a semicolon; and (B) by striking subparagraph (D) and inserting the following: ``(D) the contact information for the nearest military sexual trauma coordinator for the veteran at the Veterans Benefits Administration and a description of the assistance such coordinator can provide; ``(E) the contact information for the nearest military sexual trauma coordinator for the veteran at the Veterans Health Administration and a description of the assistance such coordinator can provide; ``(F) the types of services that individuals who have experienced military sexual trauma are eligible to receive from the Department of Veterans Affairs, such as mental health counseling from providers trained in military sexual trauma issues and peer support services, including the nearest locations where such services are furnished, including the nearest Readjustment Counseling Service location, and the contact information for the providers of such services; and ``(G) such other information on services, care, or resources for military sexual trauma as the Secretary determines appropriate.''; and (2) in subsection (d)-- (A) in paragraph (3)-- (i) in subparagraph (B), by striking ``; and'' and inserting a semicolon; (ii) in subparagraph (C), by striking the period and inserting ``; and''; and (iii) by adding at the end the following: ``(D) submitting a claim for disability compensation to the Veterans Benefits Administration for a disability relating to military sexual trauma.''; and (B) by amending paragraph (5) to read as follows: ``(5) The term `military sexual trauma' with respect to eligibility for health care, has the meaning given such term in section 1166(d)(2) of title 38, United States Code.''.”
“(a) Connection to Veterans Health Administration When a Disability Claim Related to Military Sexual Trauma Is Submitted to Veterans Benefits Administration.--Section 2 of the MST Claims Coordination Act (Public Law 117-303; 38 U.S.C.”
“(b) Clerical Amendment.--The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 119 the following new item: ``120. Veterans Health Administration Policy Advisory Commission.''. (c) Initial Appointment.--Not later than 280 days after the date on which amounts are first appropriated to the Veterans Health Administration Policy Advisory Commission established under section 120 of title 38, United States Code, as added by subsection (a), the Comptroller General of the United States shall make initial appointments of members to the Commission under subsection (b)(1) of such section. SEC. 326. ACCESS TO HEALTH CARE.”
“``(l) Termination.-- ``(1) The Commission shall terminate on September 30, 2032. ``(2) Not later than 1 year before the date of termination under paragraph (1), the Commission shall submit to the Committees on Veterans' Affairs of the House of Representatives and the Senate a final assessment on whether the Commission should be continued, modified, or allowed to terminate. ``(3) A member of the Commission shall be appointed under subsection (b)(1) for a term of 5 years, except that the Comptroller General shall designate staggered terms for the members first appointed. ``(4) No funds may be obligated by the Commission after the date of termination under paragraph (1), except for activities necessary to close out the operations of the Commission.''.”
“``(i) Detail of Federal Employees.--An employee of the Federal Government may be detailed to the Commission without reimbursement and without interruption or loss of civil service status or privileges. ``(j) Access of Congressional Support Agencies to Information.--The Commission shall provide to the Comptroller General, the Congressional Research Service, and the Congressional Budget Office unrestricted access to all deliberations, records, and nonproprietary data of the Commission not later than 30 days after such access is requested. ``(k) Authorization of Appropriations.--The Commission shall submit requests for appropriations in the same manner as the Comptroller General submits requests for appropriations, but amounts appropriated for the Commission shall be separate from amounts appropriated for the Comptroller General.”
“``(2) Physician comparability allowance for personnel.--The Commission may provide a physician comparability allowance to physicians serving as personnel of the Commission in the same manner as physicians of the Federal Government may be provided such an allowance by an agency under section 5948 of title 5, and for such purpose, subsection (i) of such section shall apply to the Commission in the same manner as it applies to the Tennessee Valley Authority. ``(3) Treatment of personnel.--For purposes of pay (other than pay of members of the Commission) and employment benefits, rights, and privileges, all personnel of the Commission shall be treated as if they were employees of the United States Senate.”
“``(h) Compensation.-- ``(1) Members.-- ``(A) In general.--While conducting the business of the Commission (including travel time), a member of the Commission shall be entitled to compensation at the per diem equivalent of the rate provided for level IV of the Executive Schedule under section 5315 of title 5. ``(B) Travel expenses.--While conducting the business of the Commission away from home and the regular place of business of the member, a member may be allowed travel expenses, as authorized by the Chairman.”
“[[Page H4578]] ``(3) Information from federal agencies.-- ``(A) In general.--The Commission may secure directly from any relevant department or agency of the United States health care information the Chairman determines would be helpful to enable the Commission to carry out this section. ``(B) Timing.--Upon request of the Chairman, the head of a department or agency of the United States shall furnish information requested under subparagraph (A) to the Commission on an agreed upon schedule or not later than 180 days after the date of the request.”
“``(2) Data collection.--In order to carry out its functions, the Commission shall-- ``(A) utilize existing information, both published and unpublished, if possible, collected and assessed either by its own staff or under other arrangements made in accordance with this section; ``(B) to the maximum extent practicable, rely on existing data, reports, audits, evaluations, and assessments prepared by the Department, the Inspector General of the Department, the Government Accountability Office, the Congressional Research Service, the Congressional Budget Office, and other relevant Federal entities before entering into any contract or conducting original research; and ``(C) adopt procedures allowing any interested party to submit information for use by the Commission in making reports and recommendations.”
“The Commission shall serve solely in an advisory capacity to Congress and to the Department on matters expressly authorized under laws administered by the Secretary. ``(g) Powers of Commission.-- ``(1) In general.--The Commission may-- ``(A) employ and fix the compensation: ``(i) of an Executive Director (at a rate of pay not greater than that provided for level III of the Executive Schedule under section 5314 of title 5) who is confirmed by two-thirds vote by members of the Commission; and ``(ii) other such personnel as may be necessary to carry out the duties of the Commission, without regard to the provisions of title 5 governing appointments in the competitive service; ``(B) seek such assistance and support as may be required in the performance of its duties from appropriate departments and agencies of the United States or departments or agencies of a State; ``(C) enter into a contract or conduct original research only upon a written determination by the Chair and Vice Chair that comparable information is unavailable, insufficient, or outdated; ``(D) make advance, progress, and other payments that relate to the work of the Commission; ``(E) provide transportation and subsistence for individuals serving the Commission without compensation; and ``(F) prescribe such rules and regulations as the Commission determines necessary with respect to the internal organization and operation of the Commission.”
“``(9) Report.-- ``(A) In general.--By not later than March 15 of each year, the Commission shall submit to Congress a report containing the results and recommendations from the review conducted under paragraph (1). ``(B) Inclusion of recommendations.--A recommendation may be included in a report under subparagraph (A) if a simple majority of the members of the Commission vote to include the recommendation in the report. ``(10) Limitation.--Nothing in this section shall be construed to authorize the Commission to direct, control, approve, suspend, delay, or administer any program, policy, contract, personnel action, budgetary decision, clinical decision, or operational activity of the Department.”
“``(C) Special studies.--The Commission may conduct special studies requested by the chairman or ranking member of the Committee on Veterans' Affairs of the Senate or the Committee on Veterans' Affairs of the House of Representatives and as the Commission determines appropriate. ``(7) Coordination.--In carrying out reviews, preparing reports, and conducting studies under this section, the Commission shall, to the extent practicable, coordinate with the Inspector General of the Department to ensure the work of the Commission does not interfere with investigations or remediations underway by the Inspector General. ``(8) Budgetary considerations.--Before making any recommendations to Congress, the Commission shall examine the budget consequences of such recommendations, directly or through consultation with appropriate expert entities.”
“``(6) Consultation and additional reviews and studies.-- ``(A) Consultation.--In carrying out the requirements of this subsection, the Commission shall consult periodically with the chairmen and ranking members of the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives regarding the agenda of the Commission and progress towards achieving that agenda. ``(B) Additional reviews and reports.--The Commission may conduct additional reviews, and may submit additional reports to the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives, from time to time on such topics relating to the activities of the Commission as may be requested by the Chairman and members and as the Commission determines appropriate.”
“``(4) Issues regarding veteran health care delivery generally.--In carrying out the requirements of this subsection, the Commission shall review the effect of policies under this title on the delivery of health care services to veterans and assess the implications of changes in health care delivery for veterans under the laws administered by the Secretary. ``(5) Transmittal of certain reports.--If the Secretary or the Inspector General of the Department of Veterans Affairs submits to Congress (or a committee of Congress) a report that is required by law and that relates to policies for health care furnished under the laws administered by the Secretary, the Secretary shall transmit a copy of that report to the Commission.”
“1395 et seq.), the Medicaid program under title XIX of such Act (42 U.S.C. 1396 et seq.), the TRICARE program under chapter 55 of title 10, and commercial health care plans with care furnished by the Veterans Health Administration. ``(3) Use of existing data.--In carrying out the requirements of this subsection, the Commission, to the extent practicable, shall use existing data that has been compiled by the Department, compiled for the Department, or purchased by the Department, including-- ``(A) data described in subsection (c)(1) of section 1704A of this title; and ``(B) the results of the independent assessments conducted under such section.”
“``(D) The quality of health care furnished by the Department and through the Veterans Community Care Program. ``(E) Workforce issues, including workforce performance, recruitment, and retention factors. ``(F) Patient satisfaction and customer service at medical facilities of the Department and through the Veterans Community Care Program. ``(G) The training of health care providers and the standards of care at facilities of the Department and in the Veterans Community Care Program. ``(H) The long-term budgetary outlook of the Veterans Health Administration, as well as key components driving budgetary changes over time. ``(I) The research program of the Department, including both internal and external research. ``(J) The interaction of care under the Medicare program under title XVIII of the Social Security Act (42 U.S.C.”
“``(2) Topics to be reviewed.--In conducting a review under paragraph (1)(A), the Commission shall include periodic reviews of the following, taking into consideration other independent assessments in selecting topics to limit duplicative efforts: ``(A) Information technology infrastructure at medical facilities of the Department, including with respect to electronic health record systems. ``(B) Referrals to care at facilities of the Department and under the Veterans Community Care Program under section 1703 of this title, and factors impacting those referrals. ``(C) Access and wait times at medical facilities of the Department and under the Veterans Community Care Program, including both primary and specialty care, and factors impacting those wait times.”
“``(e) Chairman and Vice Chairman.--The Comptroller General shall designate one member of the Commission as Chairman and one member of the Commission as Vice Chairman, at the time of appointment of such member and for the term of appointment of such member, except that in the case of vacancy of the Chairmanship or Vice Chairmanship, the Comptroller General may designate another member for the remainder of that member's term. ``(f) Duties of the Commission.-- ``(1) Review.--The Commission shall-- ``(A) review operations at the Veterans Health Administration; and ``(B) prepare reports for Congress based on such review, including recommendations to Congress.”
“``(c) Period of Appointment; Vacancies.-- ``(1) Vacancies.-- ``(A) In general.--A vacancy on the Commission shall be filled in the manner in which the original appointment was made and shall be subject to any conditions that applied with respect to the original appointment. ``(B) Filling unexpired term.--An individual chosen to fill a vacancy shall be appointed for the unexpired term of the member replaced. ``(2) Expiration of terms.--The term of any member shall not expire before the date on which the member's successor takes office. ``(d) Meetings.-- ``(1) Frequency.--The Commission shall meet at the call of the Chairman, but not less frequently than once per year. ``(2) Quorum.--A majority of the members of the Commission shall constitute a quorum, but a lesser number of members may hold meetings.”
“``(B) Experience of members.--In appointing members under paragraph (1), the Comptroller General shall select individuals from backgrounds that reflect the broad diversity of health care received by veterans, including nonprofit health systems, public and private health systems, care furnished by the Veterans Health Administration, and care furnished by the Department of Defense. ``(3) Ethical disclosure.--A member of the Commission shall be considered an employee of Congress whose compensation is disbursed by the Secretary of the Senate for purposes of applying subchapter I of chapter 131 of title 5, United States Code, except that a member of the Commission is required to file public financial disclosure reports without regard to their number of days of service or rate of pay.”
“``(b) Membership.-- ``(1) Composition.--The Commission shall be composed of 17 members appointed by the Comptroller General of the United States, of which not fewer than 2 shall be veterans. ``(2) Qualifications.-- ``(A) In general.--An individual is eligible for appointment to the Commission under paragraph (1) if the individual has significant expertise in operating or advising large [[Page H4577]] medical systems, including expertise in quality of care, staffing issues, health information technology, artificial intelligence in health care, medical research, and managed care plans and networks.”
“(g) Definitions.--In this section: (1) Covered medication.--The term ``covered medication'' means any opioid overdose rescue medication, such as naloxone. (2) Veteran.--The term ``veteran'' has the meaning given that term in section 101 of title 38, United States Code. SEC. 325. ESTABLISHMENT OF VETERANS HEALTH ADMINISTRATION POLICY ADVISORY COMMISSION. (a) In General.--Chapter 1 of title 38, United States Code, is amended by adding at the end the following new section: ``Sec. 120. Veterans Health Administration Policy Advisory Commission ``(a) Establishment.--There is established the Veterans Health Administration Policy Advisory Commission (in this section referred to as the `Commission').”
“(2) Elements.--The report required by paragraph (1) shall include the following: (A) The number of veterans who received a covered medication under the pilot program, disaggregated by those enrolled in the system of annual patient enrollment of the Department of Veterans Affairs under section 1705(a) of title 38, United States Code, and those not enrolled in such system. (B) An assessment of the feasibility of expanding the pilot program to provide covered medications to immediate family members of veterans. (C) Any considerations associated with continuing, expanding, or making permanent the pilot program. (D) Any other recommendations of the Secretary with respect to modifying or continuing the pilot program.”
“(e) Provision of Information.--The Secretary shall ensure that any individual who receives covered medication under the pilot program also receives-- (1) information about addiction services, suicide prevention services, mental health services, and other related services provided by the Department of Veterans Affairs; and (2) information on the use and application of covered medications. (f) Report.-- (1) In general.--Not later than 30 days before the completion of the pilot program under this section, the Secretary shall submit to Congress a report on the pilot program.”
“(d) Limitation on Use of Information.-- (1) In general.--In carrying out this section, the Secretary may only collect the personally identifiable information needed for prescribing covered medication under the pilot program, and any personally identifiable information collected under this section may be used solely for the purpose of delivering, evaluating, and enhancing the quality of health care. (2) Exclusion.--The Secretary may not use any personally identifiable information collected under this section-- (A) for the purpose of preventing a veteran from employment; (B) as evidence of a history of drug use; or (C) as evidence that an individual is an unlawful user of or addicted to any controlled substance.”
“(a) In General.--Commencing not later than 120 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall carry out a one-year pilot program under which the Secretary shall make covered medications available to any veteran at no charge (in this section referred to as the ``pilot program''). (b) Provision of Medication Prior to Confirmation of Status.--The Secretary may provide covered medication to an individual under the pilot program prior to confirming the status of the individual as a veteran if the individual provides contact information for the individual and a written self-attestation of veteran status. (c) Site Selection.--The Secretary shall prioritize carrying out the pilot program in geographical areas where data indicates a disproportionately high risk of overdose among the veteran population.”
“(3) Nonduplication and supplementation of efforts.--In carrying out activities under this section, the Secretary of Veterans Affairs shall ensure that such activities minimize duplication and supplement, not supplant, existing information-sharing efforts of the Department of Health and Human Services. (c) Sense of Congress on Additional Research Related to Menopause, Perimenopause, or Mid-life Women's Health.--It is the sense of Congress that the Secretary of Defense and the Secretary of Veterans Affairs should each conduct research related to menopause, perimenopause, or mid-life health regarding women who are members of the uniformed services or veterans. SEC. 324. PILOT PROGRAM ON PROVISION OF OPIOID RESCUE MEDICATIONS TO VETERANS.”
“(2) Report; strategic plan.--Not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall submit to Congress a report containing-- (A) the findings of the evaluation conducted under paragraph (1); (B) recommendations for improving professional training resources described in paragraph (1)(D) for covered providers; and (C) a strategic plan that-- (i) resolves the gaps in knowledge and research identified in the report; and (ii) identifies topics in need of further research relating to potential treatments for menopause-related symptoms of women who are members of the uniformed services or veterans.”
“(b) Evaluation of Certain Research Related to Menopause, Perimenopause, or Mid-life Women's Health.-- (1) In general.--The Secretary of Veterans Affairs shall evaluate-- (A) the results of completed research related to menopause, perimenopause, or mid-life women's health among women who are members of the uniformed services or veterans; (B) the status of such research that is ongoing; (C) any gaps in knowledge and research on-- (i) treatments for menopause-related symptoms, including hormone and non-hormone treatments; (ii) the safety and effectiveness of treatments for menopause-related symptoms; (iii) the impact of perimenopause and menopause on the mental health of women who are members of the uniformed services or veterans; (D) the availability of and uptake of professional training resources for covered providers relating to mid-life women's health with respect to the care, treatment, and management of perimenopause and menopausal symptoms, and related support services; and (E) the availability of and uptake of treatments for women who are members of the uniformed services or veterans who are experiencing perimenopause or menopause.”
“(5) Postmenopausal.--The term ``postmenopausal'' means the stage of a woman's life after a woman has been without a menstrual period for 12 months that lasts for the rest of a woman's life and reflects a time when women are at increased risk for osteoporosis and heart disease.”
“(3) Mid-life.--The term ``mid-life'' means a life stage that-- (A) coincides with the menopausal transition in women, which may be physical or emotional; (B) encompasses the late reproductive age, which can begin at approximately 35 years of age, to the late postmenopausal stages of reproductive aging, which can extend to approximately 65 years of age; and (C) often marks the onset of many chronic diseases. (4) Perimenopause.--The term ``perimenopause'' means the time during a woman's life when levels of the hormone estrogen fall unevenly in a woman's body and is also called the menopausal transition.”
“(2) Termination.--The Secretary is not required to submit a report under paragraph (1) on or after the date on which the Secretary confirms in a report submitted under such paragraph that each medical center of the Department contains a lactation space. SEC. 323. RESEARCH RELATED TO MENOPAUSE, PERIMENOPAUSE, AND MID-LIFE WOMEN'S HEALTH: REPORT; PLAN. (a) Definitions.--In this section: (1) Covered provider.--The term ``covered provider'' means a health care provider employed by the Department of Veterans Affairs. (2) Menopause.--The term ``menopause'' means the stage of a woman's life-- (A) when menstrual periods stop permanently and she can no longer get pregnant; and (B) that is not a disease state, but a normal part of aging for women.”
“(d) Report.-- (1) In general.--Not later than one year after the date of the enactment of this Act, and annually thereafter, the Secretary of Veterans Affairs shall submit to the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives a report on the progress of the Secretary in meeting the requirements under section 1720M of title 38, United States Code, as added by subsection (a), including-- (A) a list of which medical centers of the Department of Veterans Affairs currently have a lactation space; (B) a list of which medical centers of the Department do not have a lactation space; and (C) for each medical center listed under subparagraph (B), a description of actions the Department has taken to design and plan a lactation space and a timeline for such lactation space to be fully functional and open for use within the time periods specified under subsection (c).”
“(c) Implementation.--The Secretary of Veterans Affairs shall ensure that-- (1) not later than two years after the date of the enactment of this Act, not fewer than 80 percent of medical centers of the Department of Veterans Affairs are in compliance with section 1720M of title 38, United States Code, as added by subsection (a); and (2) not later than three years after such date of enactment, all medical centers of the Department are in compliance with such section.”
“``(c) Lactation Space Defined.--In this section, the term `lactation space' means a hygienic place, other than a bathroom, that-- ``(1) is shielded from view; ``(2) is free from intrusion; ``(3) is accessible to disabled individuals (including such individuals who use wheelchairs); ``(4) contains a chair and a working surface; ``(5) is easy to locate; ``(6) is clearly identified with signage; and ``(7) is available for use by women veterans and members of the public to express breast milk.''. (b) Clerical Amendment.--The table of sections at the beginning of such chapter is [[Page H4576]] amended by inserting after the item related to section 1720L the following new item: ``1720M. Lactation spaces in medical centers of the Department.''.”
“(11) The percentage of such Department and non-Department providers who undergo formal peer-review or clinical-quality review at least once every six months. SEC. 322. LACTATION SPACES IN MEDICAL CENTERS OF THE DEPARTMENT OF VETERANS AFFAIRS. (a) In General.--Subchapter II of chapter 17 of title 38, United States Code, is amended by adding at the end the following new section: ``Sec. 1720M. Lactation spaces in medical centers of the Department ``(a) Lactation Space Required.--The Secretary shall ensure that each medical center of the Department contains a lactation space. ``(b) No Unauthorized Entry.--Nothing in this section shall be construed to authorize an individual to enter a medical center of the Department or portion thereof that the individual is not otherwise authorized to enter.”
“(9) The proportion of veterans described in paragraph (8) whose treatment progress is documented in their electronic health records as follows: (A) For inpatient, residential, and intensive outpatient programs, entry and exit symptom-assessment data and discharge summaries shall be recorded not later than one year following admission. (B) For outpatient programs, initial symptom-assessment data shall be entered not later than one month of intake, and follow-up data shall be recorded not later than one year thereafter. (10) The average elapsed time for such Department and non- Department providers, between receipt of referral for care or veteran outreach and completion of the initial appointment or admission.”
“(6) The extent to which veterans with co-occurring mental- health and substance-use conditions receive coordinated, integrated care addressing the full range of their clinical needs, regardless of provider affiliation. (7) Whether such Department and non-Department providers monitor and document health-outcome measures throughout the course of treatment and at regular intervals during the three years following the initiation of treatment. (8) The number of veterans receiving treatment from such Department and non-Department providers across all levels of care, including inpatient, residential, intensive outpatient, and standard outpatient programs.”
“(3) Identification of any gaps or delays in coordination between such Department and non-Department providers in responding to veterans seeking mental health or addiction therapy services, including the timeliness and completeness of health record exchange and communication of care plans. (4) Measures of patient satisfaction with care received from such Department and non-Department providers. (5) The number and percentage of such Department and non- Department providers who have completed Department or other accredited condition-specific training relevant to the veterans they treat, including training on military culture and trauma-informed care.”
“Symptom scores shall be obtained for-- (A) Post-traumatic stress disorder, using the Clinician- Administered PTSD Scale and the PTSD Checklist; (B) depression, using the Patient Health Questionnaire-9; (C) substance use disorder, using the Brief Addiction Monitor; and (D) suicidality, using the Columbia-Suicide Severity Rating Scale. (2) Treatment-fidelity scores, derived from electronic health record documentation, assessing the extent to which such Department and non-Department providers adhere to evidenced-based practices in delivering mental health and addiction therapy care, as measured against criteria established by the VA/DOD Clinical Practice Guidelines and other nationally recognized, evidence-based standards, including those of the American Society of Addiction Medicine and the American Psychiatric Association.”
“(b) Timing.--The Secretary shall ensure that the organization with which the Secretary enters into an agreement pursuant to subsection (a) completes the study and submits the required report not later than 18 months after the date on which the agreement is executed. (c) Elements.--The report submitted pursuant to subsection (a)(2) shall include an assessment of the following: (1) The degree of symptom improvement among veterans receiving care from such Department and non-Department providers across telehealth, in-patient, intensive outpatient, outpatient, and residential modalities. For each setting, symptom changes shall be measured between intake and discharge (for inpatient, intensive-outpatient, and residential programs) and between initiation of care and five months thereafter (for outpatient programs).”
“(a) In General.--Not later than 90 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall seek to enter into an agreement with an independent and objective academic organization or research institute with demonstrated expertise in evaluating health outcomes inside and outside the Department of Veterans Affairs under which that organization shall-- (1) conduct a comparative study, subject to applicable Federal privacy laws, that evaluates the quality of mental health and addiction therapy care furnished under laws administered by the Secretary, by providers of the Department and by non-Department providers, across a range of treatment modalities, including telehealth, in-patient, intensive out- patient, out-patient, and residential treatment; and (2) submit to the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives, and publish on a publicly available website, a report containing the final results of such study.”
“``(2) The term `Fisher House' means a housing facility that-- ``(A) is located at, or in proximity to, a Department medical facility; ``(B) is available for residential use on a temporary basis by patients of that facility and others described in subsection (b); and ``(C) is constructed by, and donated to the Secretary by, the Zachary and Elizabeth M. Fisher Armed Services Foundation or the Fisher House Foundation.''. SEC. 321. STUDY ON QUALITY OF MENTAL HEALTH AND ADDICTION THERAPY CARE PROVIDED BY HEALTH CARE PROVIDERS OF DEPARTMENT OF VETERANS AFFAIRS COMPARED TO NON-DEPARTMENT PROVIDERS.”