Take Care of America’s Veterans Act

This section amends existing law to allow military retirees with combat-related disabilities to receive both their retired pay and veterans' disability compensation concurrently, without reduction. This applies to both career retirees (20+ years of service) and disability retirees with less than 20 years of service, with specific calculations for the latter to ensure they receive an equivalent benefit.

This section modifies the rules for Dependency and Indemnity Compensation (DIC) and Survivor Benefit Plan (SBP) annuities for surviving spouses. It ensures that a surviving spouse's remarriage does not bar them from receiving DIC or SBP benefits, particularly for survivors of members who die on active duty. It also expands TRICARE eligibility to remarried widows/widowers whose subsequent marriage has ended.

This section increases the monthly aid and attendance allowance for eligible veterans by $833.33 and mandates a 1% increase in Dependency and Indemnity Compensation (DIC) rates in addition to Social Security cost-of-living adjustments for three years. It also modifies housing loan fees for certain loans and retroactively expands housing loan eligibility for Reserve and National Guard members who served at least 14 days on active duty and completed entry-level training.

This section prohibits the denial of a veteran's claim solely because they failed to appear for a medical examination. It mandates annual reports on the length of claims adjudications and appeals, including remands from the Board of Veterans' Appeals (BVA). It also requires guidelines for advancing cases on the BVA docket, tracking of certain claims, and expands the jurisdiction of the Court of Appeals for Veterans Claims (CAVC) to include class certification requests and limited remands to the BVA.

This section mandates revisions to the VA's schedule for rating disabilities. For sleep apnea, it establishes specific criteria for 0%, 10%, 50%, and 100% disability ratings based on symptoms, treatment effectiveness, comorbid conditions, and end-organ damage. For tinnitus, it generally prohibits a separate compensable rating, allowing a 10% rating only when associated with service-connected hearing loss that is otherwise noncompensable. Importantly, it protects existing ratings from being reduced.

This section enhances the processing of claims related to military sexual trauma (MST). It requires the Secretary to advise veterans of credible corroborating evidence needed for MST claims and provide an opportunity to furnish it, prohibiting denial solely for lack of such evidence without this step. It mandates that all MST claims be reviewed by specialized teams, requires annual review of MST policies by medical professionals, and establishes a performance dashboard for MST claims data. It also standardizes contact information and service eligibility notices for MST survivors in all written communications from the VA.

This section makes several changes to veterans' educational assistance programs. It accelerates the repayment of Post-9/11 GI Bill contributions for certain individuals, ensuring payment within 60 days of entitlement exhaustion. It expands the definition of eligible independent study programs to include those from accredited higher education institutions that require regular and substantive interaction, with oversight requirements. It also provides more options for service members to manage their education (withdraw, leave of absence, or agreement to complete) when called to covered service.

This section expands the VET-TEC (Veteran Employment Through Technology Education Courses) program to include "emerging technologies" in addition to "high technology." It specifically identifies technologies of critical importance, such as artificial intelligence and semiconductor manufacturing, as emerging technologies. It also revises the employment rate calculation for VET-TEC programs, requiring it to be expressed as a percentage of individuals employed 180 days after completion, excluding employment by the program provider or its affiliates as an instructor.

This section extends medical care coverage for primary caregivers of veterans for 180 days after the veteran's discharge from the VA's Program of Comprehensive Assistance for Family Caregivers. It also provides employment assistance to these caregivers, including reimbursement for certification/relicensure fees (up to $1,000 lifetime), access to VA training modules, and coordination with DoD and Labor for existing employment resources. Additionally, it expands available services to include retirement planning and assistance returning to the workforce upon discharge from the caregiver program, and bereavement counseling for caregivers following the veteran's death.

This section establishes two grant programs related to chronic mild Traumatic Brain Injury (mTBI). The 'TBI Innovation Grant Program' awards grants to eligible entities (nonprofits, academic institutions, non-VA providers) for developing, implementing, and evaluating neurorehabilitation treatments for chronic mTBI, with a focus on patient-centered, non-pharmacological therapies. The second program awards research grants for independent third-party studies on mTBI treatments, administered by an independent organization, with specific funding categories and reporting requirements.

This section establishes a three-year pilot program for the VA to award grants to eligible non-profit mental health care providers. These grants are for delivering evidence-based mental health care to veterans, either in-person or via telehealth. Funds can be used to operate or expand facilities, encourage VA enrollment, and support non-billable activities like outreach and care coordination. Importantly, grant recipients cannot charge eligible veterans and can use funds to provide care to uninsured or otherwise ineligible individuals, as well as spouses and dependents when integral to the veteran's clinical outcome.

This section establishes a pilot program for an interoperable community integration platform to coordinate local support services for veterans through governmental and non-governmental organizations. The platform will connect veterans with covered services (e.g., housing, nutrition, transportation, job training) and allow covered entities to identify veterans in need. It also mandates the VA to collect information related to social determinants of health (SDOH) from enrolled veterans as part of routine screenings, using standardized ICD-10 codes, with informed consent.

This section requires the VA to establish a "Prosthetic and Rehabilitative Items and Services Formulary" to standardize the provision of these items. The Formulary must be publicly available, updated periodically, and ensure all included items are available at VA facilities. It also mandates an exceptions process for medically necessary non-formulary items, with prior authorization for procurement. Furthermore, it requires the implementation of an enterprise electronic ordering system for prosthetic and rehabilitative items across all VA medical centers within three years, aiming to automate ordering, provide visibility of pricing, and monitor compliance with national contracts.

This section establishes a three-year pilot program to coordinate, navigate, and manage care and benefits for veterans enrolled in both VA and Medicare. The program aims to improve access, satisfaction, quality, and reduce costs and care gaps. It will be carried out in 3-5 Veterans Integrated Service Networks (VISNs) with significant numbers of dual-eligible veterans, including rural and medically underserved areas. Each participating veteran will be assigned a case manager to coordinate care plans and navigate both systems. The Secretary may contract with private sector entities for assistance.

This section establishes a 17-member Veterans Health Administration (VHA) Policy Advisory Commission, appointed by the Comptroller General, with at least two members being veterans. The Commission's duties include reviewing VHA operations (e.g., IT, referrals, access, quality, workforce, budget, research, interaction with other health programs) and submitting annual reports with recommendations to Congress. The Commission is advisory only and terminates on September 30, 2032.

This section mandates the VA to contract with the Agency for Toxic Substances and Disease Registry (ATSDR) to conduct a literature review on the health effects on descendants of toxic-exposed veterans and service members, identifying knowledge gaps. ATSDR must maintain a publicly available report on its findings and ongoing research. The VA will use these results to establish a health monitoring or screening program for descendants, focusing on birth defects, leveraging government datasets, and recruiting participants. Both the research and monitoring programs sunset after seven years, and explicitly state they do not authorize expansion of compensation or healthcare benefits to descendants.

This section requires the VA to furnish annual preventative health evaluations to veterans with spinal cord injury or disorder (SCI/D) who elect to undergo them. These evaluations must assess risks for health complications, chronic pain management, dietary/weight management, and prosthetic/assistive technology needs, including spinal cord neuromodulation technology. The VA must consult with SCI/D experts and manufacturers in developing guidance and ensure veterans are informed of the evaluation. It also mandates biennial reports to Congress on assistive technology use and evaluation rates.

This section establishes a three-year pilot program for the VA to award competitive grants to non-profit entities to provide service dogs to eligible veterans. Eligible veterans must have disabilities such as blindness, mobility issues, hearing loss, PTSD, TBI, or other conditions where a service dog is clinically optimal. The grants cover dog training, veteran training, and support services. The VA will also provide commercially available veterinary insurance for these service dogs, which continues even if the pilot program ends. The program is authorized $10 million annually for three years.

This section authorizes a major medical facility project for the VA in Manchester, New Hampshire, for fiscal year 2027. The project includes 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. It authorizes $1.18 billion for this project and allows the Secretary to waive certain federal requirements for non-Department federal entities involved in project management to reduce cost and expedite timelines.

This section establishes a VA program to address the bowel and bladder care needs of covered veterans (those with SCI/D dependent on others for care in non-institutional settings). Care is provided based on clinical need, potentially including veterans receiving aid and attendance benefits, through qualified family members, individually employed caregivers, or contracted home health agencies. The VA must conduct individualized assessments for care hours and provide necessary medical training to caregivers. Family members and individually employed caregivers receive a monthly stipend (up to the fifth step of a nursing assistant's General Schedule hourly rate), and home health agencies are paid at VA rates. Veterans needing care for three or more years are deemed to require it for life.

This section appropriates $500 million for fiscal year 2026 to the VA's Office of Information and Technology, available until September 30, 2031. The funds are specifically allocated: $150 million for Enterprise Logistics and Supply Chain Visibility, $200 million for Cybersecurity and Operational Resiliency, and $150 million for Resilient Communications and Digital Records Modernization. It explicitly prohibits using these funds for broad Electronic Health Record Modernization expansion and requires detailed implementation plans and quarterly briefings to Congress.

This section renames the Chief Financial Officer position to Under Secretary for Management and Chief Financial Officer, making this individual the principal management and financial officer of the Department, reporting directly to the Secretary. This new Under Secretary will oversee the Office of Budget and other assigned offices, with duties including budget formulation, financial control, acquisition coordination, and compliance with federal financial laws. It also establishes a Deputy Assistant Secretary for Infrastructure and Construction and a Budget and Appropriations Affairs Office whose sole function is to provide accurate, timely, and certified financial information to Congress.

This section establishes a comprehensive acquisition reform framework. It designates an Assistant Secretary for Acquisition (also the Chief Acquisition Officer) to lead an Office of Acquisition, under which all major acquisition program offices will align. It mandates the appointment of Deputy Assistant Secretaries for Logistics, Procurement, and Acquisition/Program Management/Performance, and at least four Program Executive Officers for key areas (Medical, IT, Professional Services, Other). It also creates a Director of Cost Assessment and Program Evaluation, reporting directly to the Secretary, responsible for independent cost estimates and program evaluations for major acquisition programs. It requires organizational consolidation of all VA acquisition, procurement, and logistics activities under the Assistant Secretary for Acquisition.

This section requires the VA to ensure that calls made to veterans, beneficiaries, or claimants by VA employees or contractors use a single, well-known telephone number and caller identification branding that indicates the call is from or on behalf of the Department. Additionally, it mandates that the Veterans Health Administration (VHA) establish at least one call center in each of the six specified U.S. time zones (Eastern, Central, Mountain, Pacific, Alaska, Hawaii) to address concerns regarding health care appointments and referrals.

This section establishes a five-year program under the American Battle Monuments Commission (ABMC) to identify deceased Jewish service members mistakenly buried under Latin Crosses in overseas U.S. military cemeteries from World War I and World War II. The program will also contact their survivors and descendants. The ABMC is authorized to contract with non-profit organizations, prioritizing those with demonstrated expertise, for this purpose, with each contract for $500,000 annually.

This section codifies specific eligibility access standards for hospital care, medical services, and non-institutional extended care under the Veterans Community Care Program (VCCP). For primary care, mental health, and non-institutional extended care, appointments must be scheduled within 30 minutes average driving time and 20 days. For specialty care, it's 60 minutes and 28 days. It also sets screening and admission timelines for covered treatment programs. Importantly, it excludes telehealth appointments from VA's ability to meet these standards and includes a sunset clause after eight years, after which Congress must approve any changes to these standards via a joint resolution.

This section establishes a new subchapter in Title 38 to standardize the process for determining eligibility and admission to VA mental health residential rehabilitation treatment programs (covered treatment programs). It mandates a standardized screening process based on clinical need, with specific criteria for priority admission (e.g., severe symptoms, high risk of suicide/overdose, history of non-responsiveness to other treatments). It requires screening for TBI, consideration of veteran input for placement, and mandates non-Department care options if VA facilities cannot meet timely admission or placement requirements. It also includes provisions for performance metrics, oversight, transportation coverage, appeals, and real-time tracking of availability and wait times.

This section amends Title 38 to include psychologists alongside other medical professionals (like physicians, chiropractors, optometrists) in the list of health care professionals appointed under section 7401(1) of Title 38. This change elevates their status within the VA's personnel system, granting them the same appointment authority and inclusion in contracts for scarce medical specialist services as other direct patient care providers.

This section mandates the VA to establish a standardized, nationwide approval process for filling vacant employment positions, with specific approval windows for each step and delegation of authority for vacant or unavailable approvers. It also requires a standardized process for issuing tentative offers of employment that include a specified basic pay rate. The VA may contract with third parties for laboratory testing, background clearances, and other vetting procedures to improve quality or timeliness. Finally, it allows for electronic signatures on hiring, recruitment, and retention documents once a standardized process is developed.

This section mandates the VA Secretary to establish a telework policy within 180 days, in accordance with federal law. The policy can vary by location, specialty, and employee category. In developing the policy, the Secretary must assess staffing levels, exit survey data, availability of onsite workspace, productivity comparisons, private sector telework flexibilities, and duties requiring onsite work. Any changes to the policy require notification to affected employees and a report to Congress 90 days in advance, including the underlying analyses. An annual budgetary impact report is also required.

This section expands the authority for covered health care professionals (including VA employees and contractors working in VA facilities) to practice their profession and prescribe controlled substances via telemedicine across state lines. This is explicitly allowed "Notwithstanding any provision of law regarding the licensure of health care professionals or the prescribing of controlled substances," regardless of the professional's or patient's location, for treatment under Title 38. It clarifies that state laws inconsistent with this authority, including those incorporated by the Controlled Substances Act, are superseded.

This section requires the VA Secretary to develop and annually update a five-year strategic human capital plan by September 30, 2027. The plan must account for current and projected demand for benefits and services, disaggregated by various categories (e.g., facility, region, service type). It must include a workforce gap analysis (staffing levels, core competencies), an implementation plan with recruitment/retention goals (including for veterans/spouses), strategies to improve productivity, and goals to reduce time-to-hire. The Comptroller General will biennially review the plan.

This section requires the VA Secretary to provide notice to Congress and affected employees at least 60 days before commencing any reduction in force (RIF). The notice must include the total number of employees affected, details of affected offices (location, program, before/after staffing, services), a justification for the RIF (alignment with demand and human capital plan), budgetary effects, and an assessment of anticipated impacts on service delivery. Crucially, the Secretary may not carry out a RIF for any employee who has not received this notice, and any RIF in violation is deemed to have no force or effect until compliance.

This section modifies the VA's authority to share healthcare resources by streamlining agreements for acquiring physical space or common services (e.g., maintenance, utilities, security) from affiliated institutions or other entities. It allows the Secretary to enter into such contracts or agreements without competitive procedures and without regard to certain limitations applicable to VA leases, provided all obligations are funded through available appropriations or borne by the institution/entity. Multi-year space-sharing agreements must include a contingency on appropriations availability.

This section makes permanent the pilot program that allows the Department of Veterans Affairs to accept donations of facilities and related improvements. It also modifies the criteria for accepting donations, requiring that the donation aligns with a need identified in a Strategic Capital Investment Planning process priority list, a five-year development plan, a facility master plan, or an annual capital needs inventory of the Department, or any component or phase of such a need.

This section allows VA healthcare professionals (employees and contractors in VA facilities) to prescribe, deliver, distribute, and dispense controlled substances via telemedicine, including audio-only systems when necessary, even without an in-person medical examination. This authority explicitly overrides sections of the Controlled Substances Act and state licensure laws. Conditions include acting in professional practice, DEA registration, access to medical documentation from a prior in-person evaluation within two years, and review of state prescription drug monitoring programs (PDMPs). If PDMP data is unavailable, only a 7-day supply can be prescribed, with extensions if unavailability persists. This authority is limited to a six-month supply and terminates on September 30, 2031.

This section requires the VA Secretary to develop and implement a plan for an interactive, online self-service module for veterans enrolled in VA healthcare. This module would allow veterans to request appointments, track referrals, receive reminders, appeal and track decisions (for community care denials or VA care denials), compare wait times and driving times for VA vs. non-VA care, and view provider directories and claims information. The Secretary must submit an initial plan within 180 days and provide biannual updates for two years.

This section repeals the existing Center for Innovation for Care and Payment and establishes a new "Center for Innovation" within the VA. The new Center's purpose is to test innovative payment and service delivery models to reduce VA program expenditures while preserving or enhancing care quality. It will identify and test models (e.g., bundled payments, preventive care) that improve coordination, quality, and efficiency, giving preference to those addressing defined populations with care deficits. The Secretary can expand successful models through rulemaking if they reduce expenditures without reducing quality or improve quality without increasing expenditures, certified by the CFO as budget neutral. It also mandates a review of the Veterans Community Care Program by the Office of Management.