The Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act aims to enhance healthcare services and benefits for veterans through various programs. It includes initiatives to improve community care, support for caregivers, educational assistance, employment training, home loans, disability benefits, and homelessness services, while also enhancing oversight and investigations within the Department of Veterans Affairs.

During a specified two-year period, a veteran's eligibility for care under the Veterans Community Care Program will be determined by the veteran and their referring clinician, with the opportunity to correct any errors. Additionally, the Secretary of Veterans Affairs must report to Congress on the care provided each year of that period, including details like the amount, type, and cost of the care.

The bill requires the Secretary of Veterans Affairs to inform veterans about how to access and appeal for healthcare services under the Veterans Community Care Program. This information must be shared with veterans upon enrollment and every two years, displayed at medical facilities, shown on a Department website, and included in other outreach activities. Additionally, a report on these outreach efforts is due to Congress within two years.

The section amends a part of the U.S. Code to require the Secretary of Veterans Affairs to review and report annually on waivers of payment rates under the Veterans Community Care Program. The report must detail the number of waivers requested, granted, denied, or withdrawn, describe the review process, and assess how these waivers improve healthcare access for veterans.

The bill modifies the standards for quality of care in the Department of Veterans Affairs to align with industry standards, requires regular updates and consultation with relevant entities, and mandates reports to Congress to ensure improvements and transparency. It also calls for an audit by an external entity to assess data collection methods and provide recommendations for improving care quality.

The text describes a pilot program established by the Secretary of Veterans Affairs to enhance the Veterans Community Care Program. This program focuses on incentivizing healthcare providers to improve appointment scheduling, return medical records promptly, increase the timeliness and quality of care, and reduce no-show rates while offering opportunities for continued professional education related to veteran care.

The bill introduces a two-year pilot program led by the Secretary of Veterans Affairs aimed at streamlining the approval process for dental care by hiring general dentists and dental specialists within Veterans Affairs facilities. The program will be evaluated through initial and final reports that analyze its effectiveness, gather feedback, and suggest whether it should be extended or expanded based on its success.

The text outlines the requirement for the Department of Veterans Affairs to create a working group to develop a strategic plan for implementing a value-based healthcare system within the Veterans Health Administration. It also includes the establishment of a pilot program to test this strategic plan, involving certain geographically diverse areas, and requires reporting on the program's progress and outcomes to Congress.

The bill section mandates the Secretary of Veterans Affairs to create a plan, consulting with key health officials, to adopt national health information standards to improve coordination and sharing of health records between the Department of Veterans Affairs and community care providers, including those in rural areas. The bill also requires a plan to enable free electronic health record exchanges with third-party administrators, prioritizes rural providers, and necessitates periodic reports to Congress on the progress and challenges related to these plans.

The section outlines that within a year of the law's enactment, the Secretary of Veterans Affairs must report to Congress on how the Department is using value-based reimbursement models in the Veterans Community Care Program to ensure veterans receive high-quality care. The report should include an evaluation and any recommended legislative or administrative changes. It also clarifies that "Third Party Administrator" refers to entities managing provider networks under the program.

The section mandates that the Inspector General evaluates how well the Department of Veterans Affairs is managing the Veterans Community Care Program, including determining eligible veterans, informing them of their eligibility, and providing timely care. Furthermore, after every evaluation, the Inspector General must brief the relevant Veterans Affairs Committees in Congress about the findings.

The section requires the Comptroller General to prepare a report within one year on dental care provided to veterans through the Veterans Community Care Program. The report should assess how current payment rates affect the availability of dental services, the satisfaction of dental providers with the approval processes, and the procedures for urgent dental care.

The section amends a law to allow the total cost of noninstitutional care alternatives for certain veterans to exceed the previous limit of 65% to up to 100% of what nursing home care would have cost. For veterans with specific medical conditions like ALS or spinal cord injuries, costs can even exceed 100% if deemed necessary for their best interest.

The section states that if a veteran receives services from a Department of Veterans Affairs medical center located in an area with a Program of All-Inclusive Care for the Elderly (PACE), the Secretary should try to make an agreement with the local PACE program to provide those services.

The text outlines a new section added to the United States Code, allowing the Secretary of Veterans Affairs to give grants or contracts to organizations that provide mental health support to family caregivers of veterans. It details application requirements, funding distribution priorities, and performance evaluations, aiming to enhance the support system, particularly in underserved areas and among diverse veteran groups.

The U.S. Secretary of Veterans Affairs is authorized to give grants or contracts to improve mental health support for family caregivers of veterans, ensuring equitable distribution and priority for high-need areas. This includes establishing programs, tracking outcomes, and possibly approving remediation plans if goals aren't met. The funding, meant to supplement existing resources, is capped at 10% of the fiscal year's available funds and specifically budgeted, with $10 million authorized for 2025 and 2026.

The section outlines various programs to provide home- and community-based care for veterans, including the Veteran-Directed Care program, Homemaker and Home Health Aide program, Home-Based Primary Care program, and Purchased Skilled Home Care program, all aimed at offering noninstitutional alternatives to nursing home care. It also establishes procedures for staffing and administration of these programs, requires caregiver support services, and sets a deadline for improved administration within the Department of Veterans Affairs.

The text outlines various programs administered by the Secretary of Veterans Affairs to provide in-home and community-based services for eligible veterans. These programs aim to offer alternatives to nursing home care and include initiatives like the Veteran-Directed Care program, Homemaker and Home Health Aide program, Home-Based Primary Care program, Purchased Skilled Home Care program, and provide support for caregivers, ensuring services are tailored to the needs of veterans, especially those in remote or underserved areas.

The section outlines changes to the way the Department of Veterans Affairs coordinates services for veterans and their family caregivers, including providing options for alternative programs and ensuring a smooth transition when veterans or caregivers are denied or discharged from certain services. It also addresses the standardization of respite care across programs and calls for a review to improve communication with caregivers about available services.

The section outlines improvements to the program that offers comprehensive assistance to family caregivers of veterans. It mandates the Secretary of Veterans Affairs to submit an annual report to Congress detailing the program's application and reassessment processes, including demographic data on applicants, approval and denial rates, and the tools and procedures used to assess eligibility, while ensuring compliance with federal privacy and confidentiality laws.

The bill requires the Secretary of Veterans Affairs to start a three-year pilot program to provide home health services to veterans living in areas with a shortage of home health aides, possibly using nursing assistants for in-home care, and mandates a report on the program's results and potential continuation. Additionally, the Secretary must report on unspent funds from the Homemaker and Home Health Aide program and update guidance to help transition veterans who face service denials due to clinical or behavioral issues.

The proposed section of the bill mandates the creation of a pilot program by the Secretary of Veterans Affairs to provide assisted living services to certain eligible veterans in selected locations. This program, running until September 30, 2028, could be extended for two more years and aims to evaluate its effectiveness and veteran satisfaction, with reports submitted annually to Congress.

The section gives the Secretary of Veterans Affairs the authority to provide medicine, personal protective equipment, medical supplies, and other necessary resources to State homes. It also defines "personal protective equipment" and "State home" as used within this context.

The section describes a process that must be created by the Secretary of Veterans Affairs to recognize organizations and individuals who can help veterans, their families, and caregivers access the programs and services of the Veterans Health Administration. Feedback will be gathered to develop this process, and recognized organizations or individuals cannot charge fees for their assistance.

The bill section focuses on improving home- and community-based services for veterans, including reviews and assessments of existing programs and staff needs, setting goals for care accessibility and in-home specialty care, and collaborating with other health and labor departments. It outlines requirements for reporting to Congress on these efforts and highlights the need for new recommendations to address service shortages, particularly for Native American veterans and caregiver support.

The section requires the Comptroller General to deliver a report to Congress within a year on the mental health support available to caregivers of veterans. The report will evaluate the need for mental health support, the options and accessibility of such support through the Department of Veterans Affairs and in the community, caregiver awareness of available services, and any barriers to accessing mental health support for caregivers.

The Secretary is required to create and maintain a public website that serves as a central hub for information on specific programs. This website will offer details about each program, an assessment tool to help veterans and their caregivers understand eligibility, and a list of procedures for medical facility directors on determining veterans' eligibility and program participation. The site will also be updated regularly.

The section defines various terms related to programs and services provided by the Department of Veterans Affairs, such as "caregiver," "home- and community-based services," and specific care programs like "Home-Based Primary Care." It clarifies these terms using references to specific sections of the United States Code.

The section mandates that the Secretary of Veterans Affairs provide a quarterly report to Congress detailing the timeframes for veterans' referrals to non-Department health care providers, including various stages from referral to appointment completion. The first report is required 180 days after the enactment of this section.

The Secretary must provide a quarterly report to the Senate and House Committees on Veterans’ Affairs, detailing the time taken for various stages of referring veterans for health care services outside the Department, from the initial decision for non-Department care to the completion of appointments.

The section modifies the United States Code related to the Department of Veterans Affairs by removing a subsection and renumbering the subsequent subsections. It also updates a cross-reference in the newly labeled subsection.

The bill modifies pay limitations for physicians, podiatrists, optometrists, and dentists working for the Department of Veterans Affairs by including optometrists in relevant sections and establishing procedures for evaluating and adjusting market pay. It also allows for retroactive compensation for previously deferred payments and grants authority to waive pay caps to recruit critical healthcare personnel.

The Secretary of Veterans Affairs will pay or reimburse certain rural veterans for ambulance transportation costs up to $46,000, including air ambulance, to the nearest suitable hospital or care provider by September 30, 2026. This applies to veterans with specific service-connected disabilities, who cannot claim travel reimbursements elsewhere, and live far from Veterans Affairs medical centers in rural areas.

The document describes a two-year pilot program that the Department of Veterans Affairs will set up to provide dental care to specific veterans diagnosed with ischemic heart disease. This care will be offered in selected states, particularly in rural areas, using various methods like mobile clinics and home-based units, and reports will analyze the program's outcomes and costs.

The Secretary of Veterans Affairs is required to create a system that collects information from veterans about how they want to schedule healthcare appointments. This includes preferences on contact methods, scheduling assistance, provider choice, and preferred appointment times. These preferences will be documented, accessible to relevant staff, and piloted in selected regions before full implementation, incorporating feedback from users.

The section requires the Secretary of Veterans Affairs to create and implement a staffing model and performance metrics to ensure timely and effective care for veterans, with updates and reports to be provided to Congress and the Comptroller General. The Government Accountability Office (GAO) is also tasked with evaluating the Office of Integrated Veteran Care's performance in improving access to care and may recommend improvements.

The Secretary of Veterans Affairs must create an online health education portal for veterans within one year after the law is enacted. This portal will help veterans understand their basic health care rights and benefits under the Department of Veterans Affairs, including those under the Veterans Community Care Program.

The section requires the Secretary of Veterans Affairs to notify Congress within 90 days whenever a director of a Veterans Affairs medical center is moved to another position. It also mandates appointing an acting director within 120 days, providing periodic updates to Congress, and specifies that the original director should return or be reassigned within 180 days, unless a waiver is obtained for up to 540 days in total, with reasons for the waiver being reported to Congress.

The National Veteran Suicide Prevention Annual Report requires the Department of Veterans Affairs to regularly publish detailed reports on veteran suicide rates, including various demographic data and analyses of veterans' engagement with healthcare and benefits. Additionally, the act mandates independent assessments of these reports and instructs the development of a toolkit for better reporting and prevention of veteran suicides by state and local authorities, with a focus on collaboration and data accuracy.

The Secretary of Veterans Affairs is required to provide a report to Congress within one year, detailing the physical infrastructure needs of VA medical facilities for delivering dental care to eligible veterans. This includes identifying current and potential future infrastructure needs, such as building new facilities or renovating existing ones, especially if more veterans become eligible for dental care under possible new laws.

The section requires the Comptroller General of the United States to provide a report to congressional committees about the oral health care programs for veterans managed by the Department of Veterans Affairs. The report will look into several aspects such as technology issues, insurance implementation, barriers to expanding dental care, the use of teledentistry, and the demographics of veterans receiving dental care.

The Secretary of Veterans Affairs is required to review how patient referrals between Veterans Health Administration facilities are processed, focusing on identifying delays or bottlenecks. This review will examine the guidelines for interfacility consult management and the responsibilities of those involved, including the referral coordination team, and a report on the findings must be submitted to Congress within 180 days of the law's enactment.

The bill requires the Secretary of Veterans Affairs to create a plan that ensures a veteran can schedule a medical appointment during a phone call with the Department, aiming for prompt and sometimes same-day scheduling. Within a year of passing the bill, a report on this plan must be submitted to the relevant congressional committees.

The section authorizes $5,000,000 for 2025 to help the Department of Veterans Affairs provide mobile mammography services to women veterans. This funding will be used for mobile mammography projects, advanced equipment, and promoting these services.

The bill section temporarily extends the eligibility for the Marine Gunnery Sergeant John David Fry Scholarship to children and spouses of military members who die from a service-connected disability within 120 days after leaving service, provided they were honorably discharged. This change applies to deaths occurring at any time and covers academic terms starting between August 1, 2025, and October 1, 2027.

The bill amends Section 3311(f) of title 38 of the United States Code to remove the expiration date for the Marine Gunnery Sergeant John David Fry Scholarship for surviving spouses, ensuring that paragraphs are renumbered accordingly to maintain clarity.

The section modifies the rules about who is responsible for paying back educational assistance if someone doesn't complete the required service agreement. It states that the individual who transfers the benefit is solely responsible for the repayment unless certain conditions are met, in which case neither the individual nor the dependent needs to repay the overpayment.

The law changes the notice period that educational institutions must receive before risk-based surveys are conducted. Previously, they were given one business day, but now they must be given two business days.

The section outlines criteria for an educational institution's participation in federal student aid programs and its approval for educational assistance from the Department of Veterans Affairs. It specifies that an institution must either be approved under the Higher Education Act or have received a waiver due to specific circumstances, like choosing not to participate, being unable to participate, or actively working towards participation, but any waiver is limited to 36 months.

The text from the bill expands the Department of Veterans Affairs' oversight of educational institutions by requiring them to notify the State approving agency or the Secretary about certain events within 30 days. It also amends existing sections of the law to reflect this change and mandates the Secretary of Veterans Affairs to create a risk-based surveys database within 180 days of the law's enactment.

The section outlines that educational institutions offering programs approved by the Department of Veterans Affairs must provide digital copies of official transcripts to eligible students or veterans. These changes will take effect from August 1, 2025, and apply to academic periods starting on or after that date.

The section changes the law to allow veterans taking their final semester of school to receive a full monthly housing stipend as if they were full-time students, even if they are enrolled in fewer classes. This change will start applying from January 1, 2025.

The proposed changes to the Veteran Improvement Commercial Driver License Act of 2023 aim to update the approval process for commercial driver education programs by extending the time frame for implementation from 180 to 365 days, requiring consultation with State approving agencies, and mandating a GAO study to assess the impact and feasibility of similar amendments for other vocational programs. Additionally, these changes necessitate the Secretary of Veterans Affairs to notify Congress when granting certain exemptions and ensure the amendments apply retroactively to the date of the Act's enactment.

The bill adds a new section to the United States Code requiring the Secretary to provide individuals with electronic copies of certificates of eligibility and award letters for certain educational benefits. Individuals have the option to receive these documents by mail instead, and they can change their preference at any time.

The section mandates that the Secretary must send certificates of eligibility and award letters for educational assistance electronically, unless an individual opts to receive them by mail. Individuals can choose to switch back to electronic delivery at any time.

The bill amends the U.S. Code to apply specific rules about how educational benefits are charged when a school closes or stops a program, impacting students who can't transfer credits. These changes are valid for closures or discontinuations between August 1, 2021, and September 30, 2025.

The bill establishes a program by the Department of Veterans Affairs that allows eligible veterans to enroll in high technology education programs that provide training for skills needed by employers. It outlines the process for providing educational assistance, defines qualifications for education providers, discusses how educational benefits affect other entitlements, sets requirements for educational institutions, and ensures annual reports are submitted to Congress on the program's operation.

The section establishes a program where up to 4,000 veterans or soon-to-be veterans can enroll in high technology programs to gain skills needed by employers, with the Secretary providing financial assistance and potentially making contracts with qualified educational providers. The program includes rules about educational assistance, contracts with providers, and criteria for program and instructor qualifications, while also setting reporting requirements and a termination date of September 30, 2027.

The bill introduces a rule requiring that any changes the Secretary of the Department of Veterans Affairs makes to policies or guidance on educational assistance programs cannot take effect until 90 days after informing students, educational institutions, and relevant Senate and House Committees about the changes and the reasons for them. Additionally, the bill updates the table of contents for the chapter to include this new section.

The Secretary must wait 90 days after notifying students, schools, and relevant congressional committees about any changes to educational assistance program policies before those changes can be put into effect.

The section requires the Secretary of Veterans Affairs to update their payment system within 90 days to enable sending educational assistance payments directly to foreign colleges that either don't have a U.S. employer ID or a domestic bank account, as long as they provide approved courses to eligible students.

The section improves the G.I. Bill Comparison Tool, ensuring it provides clear and anonymous information about educational assistance for veterans and their families. It also requires educational institutions to have a chance to respond to feedback, mandates the public availability of this feedback for at least six years, and mandates training for Department of Veterans Affairs staff on using the tool and counseling on educational benefits.

The section improves reemployment rights for members of the Armed Forces by updating various provisions in the law. This includes encouraging service in the uniformed services, prohibiting retaliation, expanding injunctive relief, increasing potential damages against employers, mandating attorney fees for successful reemployment cases, and requiring the Government Accountability Office to review and report on the effectiveness of these protections.

The text requires the Secretary of Labor to review and possibly update the Veterans' Employment and Training Service Investigations Manual every two years, starting one year after the law is enacted. After each review, a report describing any changes and a copy of the manual, with sensitive parts in a separate section, must be sent to the Veterans’ Affairs Committees in both the House and Senate.

The section mandates the Department of Veterans Affairs to submit reports about the Warrior Training Advancement Course (WARTAC), which helps military members transition to civilian jobs. It also requires establishing guidelines for employing veterans, a pilot program in the Department of the Interior to inform veterans about job openings, and encourages cooperation for veterans’ access to outdoor programs.

The section discusses improvements to the program for direct housing loans made by the Secretary of Veterans Affairs to Native American veterans. It includes provisions for ensuring these loans are used responsibly, partnerships with tribal organizations, refinancing options, expanding outreach, adequate staffing, as well as relevant definitions and regulatory guidelines.

The section establishes a program where the Secretary can provide loans to Native community development financial institutions, allowing them to offer loans to Native American veterans for housing on trust land. The loans must adhere to specific standards and purposes, including home purchase, construction, or improvement, and the program ends on September 30, 2027.

The section outlines a program where the Secretary can lend money to Native community development financial institutions so they can provide loans to Native American veterans living on trust land for home-related purposes, like buying, improving, or refinancing homes. The program ends on September 30, 2027, and includes rules to ensure fairness and protect veterans and the government from harmful practices.

The section allows veterans who die at home while receiving hospice care provided by the Department of Veterans Affairs to qualify for a burial allowance, similar to those who die in a VA hospital or nursing home. This benefit applies to deaths occurring 180 days after the Act's enactment and before October 1, 2026.

The section authorizes the Secretary of Veterans Affairs to award grants to U.S. states and Indian Tribes to improve outreach to veterans and their families, ensuring they are informed about and can apply for benefits they are eligible for. It outlines grant application requirements, priority areas for funding, and tracking and performance review protocols, with a set-aside for Indian Tribes and a focus on underserved communities.

The section establishes a program for the Secretary to provide grants to states and Indian Tribes to improve outreach and assistance for veterans and their families. It details the process for applying and distributing these grants, prioritizes areas with critical shortages of service officers or high rates of suicide, and sets requirements for performance tracking and remediation if outcomes are not met.

In this section, the term "surviving spouse" is defined as someone who was lawfully married to a veteran at the time of their death, lived with them from marriage until their death (unless separated due to the veteran's misconduct), and has not remarried.

The section ensures that only licensed health care professionals are allowed to perform medical disability examinations in a Department of Veterans Affairs pilot program. It requires the Secretary of Veterans Affairs to enforce this rule, report annually on the pilot program's progress, and make necessary technical updates to the related law.

The given section of the bill requires the Department of Veterans Affairs to give health care professionals and contractors the contact information of any agent or attorney handling a veteran’s benefits claim. This information will be provided whenever these professionals conduct a medical disability examination as part of a specific pilot program starting from the enactment date of this bill.

The bill requires the Department of Veterans Affairs to develop a way for medical data from non-VA providers about disability benefits to be sent in a machine-readable format within 180 days. It also requires the Secretary to update standards for this data, modify information systems for better data collection, and publicly share the information online.

The Secretary of Veterans Affairs must update the department's technology within one year to automatically handle claims for temporary disability ratings. They will ensure that necessary medical information is gathered, employees still evaluate entitlements, and manual processing is available if necessary data formats are incompatible with the system.

The section introduces Title 401 of a bill, which is called the “Housing our Military Veterans Effectively Act of 2024” or simply the “HOME Act of 2024.”

The section discusses amendments to the rules for per diem payments made by the Secretary of Veterans Affairs to support homeless veterans, allowing temporary increases and waivers in payment rates from 2024 to 2027. It mandates the Secretary to report to Congress about these payments and to create a strategic plan by September 2025 for providing grants and payments, considering various factors like service differences, costs of living, and veteran needs.

The section authorizes the Secretary of Veterans Affairs to use funds to support homeless veterans by providing essentials such as food, shelter, transportation, and communication devices. It also permits collaboration with organizations to use Department of Veterans Affairs land for veterans, requires regular reporting to Congress on the use of these funds, and sets a termination date for these actions on September 30, 2027.

The bill requires the Secretary of Veterans Affairs to make sure veterans have access to telehealth services if they are involved in related programs, by ensuring availability to veterans, case managers, and community service providers working with homeless veterans.

The Secretary is required to make sure that veterans who are part of certain programs have access to telehealth services they are eligible for. This includes making telehealth options available not only to the veterans themselves but also to case managers and community service providers working with homeless veterans.

The new law requires that every new employee at the Department of Veterans Affairs gets trained about the Office of Inspector General within their first year. The training covers topics like the role of the Inspector General, how to report problems without fear of punishment, and how employees can work with the office to improve services. The Inspector General will design and update this training and ensure it’s available separately from other training programs, while also using email to remind employees of these responsibilities and resources.

The text requires the Secretary of Veterans Affairs to conduct an annual survey of security at certain Veterans Affairs facilities to gather data on criminal activity, vacancies, equipment, training, and relations with law enforcement. It also mandates the Secretary to report survey results to Congress, addressing any identified security weaknesses and providing a plan for improvements, along with definitions of key terms used in the section.

The section changes the end date for certain housing loan fees in the United States Code from "November 29, 2031" to "June 9, 2034".