Modification of requirements for Center for Innovation for Care and Payment of the Department of Veterans Affairs and requirement for pilot program

(a) In general Section 1703E of title 38, United States Code, is amended— (1) in subsection (a)— (A) in paragraph (1), by striking within the Department and inserting within the Office of the Secretary; (B) in paragraph (2), by striking may and inserting shall; and (C) in paragraph (3)— (i) in subparagraph (A), by striking; and and inserting a semicolon; (ii) in subparagraph (B), by striking the period at the end and inserting; or; and (iii) by adding at the end the following new subparagraph: (C) increase productivity, efficiency, and modernization throughout the Department.; (2) by striking subsection (d) and inserting the following new subsection (d): (d) Budgetary line item The Secretary shall include in the budget justification materials submitted to Congress in support of the budget of the Department of Veterans Affairs for a fiscal year (as submitted with the budget of the President under section 1105(a) of title 31) specific identification, as a budgetary line item, of the amounts required to carry out this section.; (3) in subsection (f)— (A) in paragraph (1), by striking in subchapters I, II, and III of this chapter and inserting of this title, of title 38, Code of Federal Regulations, and of any handbooks, directives, or policy documents of the Department; and (B) in paragraph (2), in the matter preceding subparagraph (A), by striking waiving any authority and inserting waiving any provision of this title; (4) in subsection (g)(1), by inserting fewer than three or before more than 10; (5) in subsection (i)— (A) in paragraph (1), by striking the Under Secretary for Health and the Special Medical Advisory Group established pursuant to section 7312 of this title and inserting the Under Secretary for Health, the Special Medical Advisory Group established pursuant to section 7312 of this title, the Office of Integrated Veteran Care (or successor office), the Office of Finance (or successor office), the Veteran Experience Office (or successor office), the Office of Enterprise Integration (or successor office), and the Office of Information and Technology (or successor office); and (B) in paragraph (2), by striking representatives of relevant Federal agencies, and clinical and analytical experts with expertise in medicine and health care management and inserting representatives of relevant Federal agencies, nonprofit organizations, and other public and private sector entities, including those with clinical and analytical experts with expertise in medicine and health care management; and (6) by adding at the end the following new subsection: (k) Report on activities of Center for Innovation for Care and Payment Not less frequently than annually, the Secretary shall submit to Congress a report that contains, for the one-year period preceding the date of the report— (1) a full accounting of the activities, staff, budget, and other resources and efforts of the Center; and (2) an assessment of the outcomes of the efforts of the Center.. (b) Comptroller General Report Not later than 18 months after the date of the enactment of this Act, the Comptroller General of the United States shall submit to Congress a report— (1) on the efforts of the Center for Innovation for Care and Payment of the Department of Veterans Affairs in fulfilling the objectives and requirements under section 1703E of title 38, United States Code, as amended by subsection (a); and (2) containing such recommendations as the Comptroller General considers appropriate. (c) Pilot program (1) In general Not later than one year after the date of the enactment of this Act, the Center for Innovation for Care and Payment of the Department of Veterans Affairs under section 1703E of title 38, United States Code, shall establish a three-year pilot program in not fewer than five locations to allow veterans enrolled in the system of annual patient enrollment of the Department established and operated under section 1705(a) of such title to access outpatient mental health and substance use services through health care providers specified under section 1703(c) of such title without referral or pre-authorization. (2) Priority In selecting sites for the pilot program under paragraph (1), the Secretary shall prioritize sites in the following areas: (A) Areas with varying degrees of urbanization, including urban, rural, and highly rural areas. (B) Areas with high rates of suicide among veterans. (C) Areas with high rates of overdose deaths among veterans. (D) Areas with high rates of calls to the Veterans Crisis Line. (E) Areas with long wait times for mental health and substance use services at facilities of the Department. (F) Areas with outpatient mental health and substance use programs that utilize a value-based care model, to the extent practicable. (3) Elements The Secretary, in implementing the pilot program under paragraph (1), shall ensure the Department has a care coordination system in place that includes— (A) knowledge sharing, including the timely exchange of medical documentation; (B) assistance with transitions of care, including the potential need for inpatient or residential psychiatric services, substance use detoxification services, post-detoxification step-down services, and residential rehabilitation programs; (C) continuous assessment of patient needs and goals; and (D) creating personalized, proactive care plans. (4) Oversight and outcomes The Secretary shall develop appropriate metrics and measures— (A) to track and oversee sites at which the pilot program under paragraph (1) is carried out; (B) to monitor patient safety and outcomes under the pilot program; and (C) to assess and mitigate any barriers to extending the pilot program across the entire Veterans Health Administration. (5) Annual report (A) In general Not later than one year after the commencement of the pilot program under paragraph (1), and not less frequently than annually thereafter during the duration of the pilot program, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and Committee on Veterans’ Affairs of the House of Representatives a report on the pilot program, which shall include the following: (i) The number of unique veterans who participated in the pilot program. (ii) The number of health care providers who participated in the pilot program. (iii) An assessment of the effectiveness of the pilot program in increasing access to, and improving outcomes for, mental health and substance use treatment services. (iv) The cost of the pilot program. (v) Such other matters as the Secretary considers appropriate. (B) Final report The Secretary shall include in the final report submitted under subparagraph (A), in addition to the requirements under such subparagraph, the assessment by the Secretary of the feasibility and advisability of extending the pilot program across the entire Veterans Health Administration, including a plan, timeline, and required resources for such an extension. (6) Veterans crisis line defined In this subsection, the term Veterans Crisis Line means the toll-free hotline for veterans established under section 1720F(h) of title 38, United States Code.