S. 3466 — Honor Our Promise to Veterans Act of 2025

This section establishes requirements under new section 1706B of title 38, United States Code, for the Department of Veterans Affairs (VA) to schedule veterans' appointments for health care services, including community care under the Veterans Community Care Program (section 1703). Specifically, it requires (1) non-urgent appointments to be scheduled no later than 7 days after a VA clinician determines the need for care or the veteran requests care; and (2) urgent care appointments to be completed no later than 48 hours after the same triggers. (As background, the Veterans Community Care Program allows eligible veterans to receive care from non-VA providers when VA facilities cannot offer it within specified wait-time standards or other criteria.) The section further requires VA to submit quarterly reports to the congressional Veterans' Affairs Committees on average community care scheduling times at each VA medical facility, disaggregated by primary care, mental health care, and specialty care types, including explanations for any excluded data. Facilities with averages exceeding 7 days must submit to the Under Secretary for Health, within 30 days of each report, (1) an analysis of causes (e.g., staffing shortages, insufficient provider networks, appointment surges); (2) a remediation plan to achieve 7-day averages or less; and (3) mitigation explanations, with the Under Secretary required to consult third-party network administrators on network insufficiencies. (Thus, the provision promotes accountability for timely access to care, particularly in community networks.) VA must comply within 180 days of enactment.

This section amends the community care program (38 U.S.C. § 1703), which furnishes hospital care, medical services, and extended care services to enrolled veterans and certain other eligible veterans through non-Department of Veterans Affairs (VA) providers when VA cannot meet access standards, as follows: (1) requires, in determining whether VA can furnish such care within designated access standards, that a telehealth appointment be considered available if the veteran accepts telehealth or it is the only option, subject to new subsection (r) (adds new § 1703(d)(5)); (2) limits a covered veteran's ability to seek authorized care via telehealth through a community provider to circumstances in which such telehealth is unavailable through VA, the VA wait time for telehealth is longer, or the veteran has already established related in-person care through that provider (inserts new § 1703(q)(1)); and (3) requires VA, when discussing care options, to inform the veteran of telehealth availability through a VA facility or non-VA provider if appropriate for the care sought (inserts new § 1703(q)(2)). This section further applies the same telehealth limitations to veterans authorized for care from non-VA providers under other VA community care authorities.

This section establishes a new section 1704B of title 38, U.S. Code, requiring the Secretary of Veterans Affairs, to the greatest extent practicable, to provide veterans—for each episode of care sought—information on current wait times and average driving times disaggregated by in-person care at VA facilities, VA telehealth, in-person care at the nearest suitable non-VA facility under a section 1703 agreement, and telehealth via the shortest-wait non-VA provider under such an agreement; such information may be provided electronically, must be documented in the veteran's health record, and a veteran may opt out. The section further requires the Secretary to update the VA Access to Care website (or successor) not less frequently than weekly with (1) the information provided to veterans under subsection (a); (2) national average wait times for primary care, specialty care (including disaggregated outpatient in-person individual mental health care), and hospital care at VA and non-VA facilities; (3) total completed appointments disaggregated by completion within 30 days, more than 30 days, more than 90 days, or more than 180 days after request; and (4) historical data dating back 10 years if available for those data points and others required by specified laws (e.g., Veterans Access, Choice, and Accountability Act of 2014); and to provide quarterly briefings to the congressional Veterans' Affairs Committees on trends in the website data.

This section amends VA prompt payment requirements for claims submitted by health care entities and providers furnishing hospital care, medical services, or extended care services to veterans (38 U.S.C. 1703D) as follows: (1) revises denial notice language to direct the Secretary to "request additional missing information, if any," required to process the claim; (2) extends the claim submittal deadline to one year (from 180 days) after the date services are furnished, limits applicability to providers operating pursuant to a contract, agreement, or other arrangement, and prohibits such providers from seeking payment from the patient for untimely claims; and (3) authorizes the Secretary to suspend a provider from VA programs upon having reason to believe it submitted fraudulent claims (in addition to existing authority to bar providers determined to have done so).

This section establishes a program under which the Secretary of Veterans Affairs provides an “MST Aware” rating to qualifying community care providers under the Veterans Community Care Program (VCCP). (VCCP furnishes hospital care, medical services, and extended care services to covered veterans—i.e., VA-enrolled veterans or those otherwise eligible—through non-VA providers such as Medicare-participating providers, the Department of Defense, Indian Health Service, federally qualified health centers, and others meeting Secretary criteria.) To qualify for the rating, a provider must (1) complete core military sexual trauma (MST) training recommended or required for comparable VA employees or by the Office of Integrated Veteran Care (or successor) and other relevant modules determined by the Secretary; (2) complete core training on women veterans' treatment, such as under section 5203 of the Deborah Sampson Act of 2020 (P.L. 116-315); and (3) meet other criteria set by the Secretary. The Secretary determines recertification frequency and must develop a promotion plan offering incentives such as continuing medical education credits. Each third-party administrator must publish and update weekly on a public website a list of administered providers indicating “MST Aware” status, with the Secretary providing oversight and ensuring display in the Provider Profile Management System (or successor). Not later than one year after program establishment and annually thereafter, the Secretary reports to the Senate and House Veterans' Affairs Committees on training details, provider participation numbers (disaggregated by community care region, type, and specialty), training effectiveness, and promotion efforts.

This section directs the Secretary of Veterans Affairs to implement quality assurance measures for community care providers under the Veterans Community Care Program (i.e., the program under 38 U.S.C. 1703 that furnishes hospital care, medical services, and extended care services to covered veterans through non-Department providers such as Medicare-participating providers). Specifically, the section requires (1) third party administrators to perform automated monthly checks of all such providers against the HHS Office of Inspector General list of excluded individuals or entities using social security number, date of birth, and other unique identifiers; (2) the Office of Integrated Veteran Care to revise provider exclusion standard operating procedures within 90 days of enactment to require automated matching against General Services Administration System for Award Management exclusions using taxpayer identification number and national provider identifier; (3) the Under Secretary for Health to develop, within 90 days of enactment, a process to identify Department providers terminated, retired, or resigned for quality of care concerns (or under investigation therefor) and prevent their participation in the program; and (4) the Office of Integrated Veteran Care to develop, within 180 days of enactment, a process requiring third party administrators to update provider lists at least monthly with accurate contact information, annotations for providers not accepting patients, and removals of excluded or terminated providers.

This section establishes training requirements for non-Department (community) health care providers furnishing care to veterans under the community care program (subchapter I of 38 U.S.C. ch. 17). Covered training consists of Department modules—or comparable ones—on military culture, post-traumatic stress disorder, suicide evaluation and management, preventing suicide through lethal means safety, traumatic brain injury, and opioid safety, offered to qualify for continuing education credits. Providers must complete initial training within the same timeframe as newly hired Department providers (or substantially similar training), with recurring or new training on the same schedule as Department providers; existing providers as of enactment of the Honor Act of 2025 have until one year after enactment. Non-compliant providers may furnish care only under direct supervision by a comparably or more highly licensed trained provider; after 180 days past the due date, they become ineligible to provide care or participate in provider networks until completion and are barred from reapplying for at least 180 days. (Thus, the Provider Profile Management System—or successor—must reflect training status, and third-party administrators must publish it weekly on public websites.)

This section requires each Third Party Administrator (TPA) for VA community care contracts to publish annually, beginning one year after enactment of the Honor Act of 2025, an overview on a publicly available and user-friendly website of network adequacy waivers it requested under 38 U.S.C. 1703B(f)(3)(A) and that the VA approved, including services and geographic locations with active waivers. (Network adequacy standards ensure veterans' timely access to care via community providers; waivers provide flexibility when full compliance is infeasible.)

This section revises termination authorities under the Department of Veterans Affairs (VA) community care contracting program (38 U.S.C. § 1703(h)) and requires specified provisions in related contracts. Specifically, with respect to termination, it (1) permits the VA Secretary to terminate contracts upon notification to congressional committees for substantial noncompliance with contract or statutory provisions, failure to meet access or quality standards, veteran health care needs, or alternative coverage arrangements; (2) requires mandatory termination if the entity is excluded from federal health care programs (as defined in 42 U.S.C. § 1320a-7b(f)), convicted of a felony or other serious offense posing risk to veterans or VA interests, listed as excluded in the System for Award Management, or noncompliant with contract provisions on training or medical record return, subject to a possible one-year waiver reported to Congress within 30 days; and (3) requires public listing by VA or a third-party administrator of ineligible entities. The section further requires contracts or agreements between VA and third-party administrators, or between administrators and providers, to include (1) notice of federal law compliance obligations and penalties for false claims or concealment; (2) provider confirmation of accreditation for specialized services and use of qualified staff; and (3) identification and licensure proof for individuals providing such services.

This section establishes authority for the Office of Inspector General of the Department of Veterans Affairs (VA) to audit any entity providing community care (i.e., care by non-VA providers) under VA-administered laws. The authority includes unannounced visits, audits, investigations, and document requests without subpoena, for purposes including ensuring conformance with VA standards of care, safety inspections, legal compliance, and contractual obligations; it also requires notification of this authority in provider handbooks of third-party administrators.

This section requires covered health care providers under the Veterans Community Care Program (i.e., providers specified in 38 U.S.C. §1703(c), such as Medicare-participating providers, that the Secretary determines have sufficient resources) to electronically submit specified data (i.e., data required under 38 U.S.C. §1703C(a)(3)) to the Secretary beginning one year after enactment of this Act and excludes non-compliant covered providers from program participation. (1) It authorizes the Secretary to determine data types by provider and waive requirements where submittal would be inappropriate or irrelevant; (2) encourages non-covered providers under §1703(c) to submit such data voluntarily; and (3) directs each third party administrator to publish and maintain a weekly-updated public website listing administered covered providers that have submitted data and are designated by the Secretary as high-performing, requires the Provider Profile Management System (or successor) to display such designations, and directs Department employees to consult these lists or systems when scheduling veteran care and share high-performing status with the veteran.

This section directs the Secretary of Veterans Affairs to prescribe regulations providing full practice authority to physician assistants (as defined in 42 U.S.C. 1395x(aa)(5)(A)) and other licensed Department of Veterans Affairs health care professionals the Secretary considers appropriate based on their education, training, and certification. Such regulations may be subject to (1) limitations imposed by the Controlled Substances Act (21 U.S.C. 801 et seq.); (2) any state licensure limitation on prescribing or administering controlled substances; and (3) other limitations under applicable VA laws and policies.

This section reclassifies psychologists from the list of health care occupations in 38 U.S.C. 7401(3) to the list in 38 U.S.C. 7401(1), designating them as Title 38 hybrid personnel eligible for the appointment, pay, and other authorities applicable to physicians, dentists, podiatrists, chiropractors, and similar professionals. (As background, Title 38 hybrid status provides performance-based pay outside the General Schedule, with higher salary caps to aid VA recruitment and retention of specialized health care providers.) This section also authorizes the Department of Veterans Affairs to contract for scarce medical specialist services with psychologists.

This section directs the Secretary of Veterans Affairs, through the Office of Integrated Veteran Care, to establish a formal lessons-learned process, consistent with leading practices, for contracts under the Veterans Community Care Program (i.e., program under 38 U.S.C. §1703 authorizing hospital care, medical services, and extended care services for covered veterans through non-Department providers) to inform future contracting plans and ongoing oversight. The Secretary must submit a report on the process to the Senate and House Committees on Veterans’ Affairs not later than 180 days after enactment.

This section directs the Secretary of Veterans Affairs to analyze the impact of spending under the Veterans Community Care Program—under which eligible veterans may elect to receive hospital care and medical services from community providers when the Department of Veterans Affairs cannot provide such care timely or meet the veteran's needs—on budgets of individual VA medical centers and Veterans Integrated Service Networks for FY2020 through FY2025. The analysis must include (1) a breakdown of Veterans Equitable Resource Allocations to medical centers for the Medical Services, Medical Community Care, Medical Support and Compliance, and Medical Facilities accounts for each fiscal year; (2) the top 10 services sought under the program at each medical center for each fiscal year; (3) the number of full-time equivalent employees dedicated to local offices of the Office of Integrated Veteran Care; (4) to the extent possible, a breakdown by medical center of patients' health care coverage, including private insurance, Medicare, or Medicaid; and (5) the administrative fee per claim, or aggregate fees, for program care at each medical center. The Secretary must submit a report on the analysis to the Senate and House Committees on Veterans' Affairs not later than one year after enactment of this Act.

This section directs the Secretary of Veterans Affairs to conduct a study assessing the feasibility and advisability of maximizing opportunities to bill private health insurers of veterans for recoverable claims. The study must (1) consider aligning and prioritizing claims processing to meet private insurers' filing deadlines, (2) evaluate strengthening information systems controls to ensure complete and accurate claims transfer between payment systems, the Consolidated Patient Account Centers workflow tool, and VistA patient files, and (3) determine if staffing and workload are sufficient for anticipated claims volume and outline any needed changes. The Secretary must submit a report on the study to the Senate and House Committees on Veterans’ Affairs not later than one year after enactment of this Act.

This section directs the Secretary of Veterans Affairs to (1) contract with an independent entity to conduct a comprehensive review of existing authorities to reimburse emergency treatment costs (including transportation) for veterans, assess potential modifications to streamline processes and reduce veteran confusion, and complete the review within one year after enactment after considering stakeholder input; (2) analyze inpatient emergency care spending under the Veterans Community Care Program (i.e., the program under 38 U.S.C. §1703 that furnishes hospital care, medical services, and extended care services to enrolled or eligible covered veterans through non-Department providers such as Medicare-participating providers), including assessments of repatriating veterans when medically appropriate, requiring third-party administrators to notify the Department of inpatient admissions or high-cost procedures, and implementing intensive case management to reduce costs, and submit a report to the congressional Veterans' Affairs Committees and publish it publicly within one year after enactment; and (3) submit a report to the congressional Veterans' Affairs Committees within 180 days after enactment assessing the feasibility and advisability of standardizing and expanding tele-emergency care Department-wide, including implementation timelines, staffing needs, required legislative changes, potential cost savings, and impacts on care quality and coordination.

This section directs the Inspector General of the Department of Veterans Affairs (VA) to review the quality and availability of dialysis care furnished at VA facilities or authorized through non-VA providers, incorporating input from stakeholders such as veterans service organizations and labor organizations, and to publish a report with recommendations not later than 18 months after enactment. The review must assess (1) VA dialysis facilities' capacity, utilization, staffing and vacancy levels, and volume of care provided via non-VA providers in their catchment areas; and (2) non-VA providers' conformance to VA standards, patient safety, legal compliance, staffing levels, changes in veterans' access and utilization, billing practices, and other relevant topics. This section further requires the VA Secretary to submit reports to the congressional Veterans' Affairs Committees on implementation of the Inspector General's recommendations, beginning not later than 120 days after the report's publication and quarterly thereafter until all recommendations are closed. It mandates immediate remediation and enforcement, including penalties, of any contract or legal violations identified; directs the Inspector General to conduct a follow-up review of ongoing violations one year after the initial report and submit findings to the Secretary and congressional committees; and requires the Secretary to impose financial penalties commensurate with unresolved violations.

This section expands eligibility for VA disability compensation or dependency and indemnity compensation under 38 U.S.C. §1151(a)—which treats qualifying additional disabilities or deaths of veterans as service-connected—for cases where the disability or death results from hospital care, a medical service, or an extended care service furnished by a non-Department (VA) provider under the Veterans Community Care Program (i.e., 38 U.S.C. §1703), if proximately caused by provider carelessness, negligence, lack of proper skill, error in judgment, or similar fault, or by an unforeseeable event. It also adds a new subsection (d) requiring offset of any civil judgment awarded against such a non-Department provider by the amount of VA compensation paid for the same disability or death.

This section eliminates one limitation—subparagraph (D)—on the Secretary of Veterans Affairs' authority to waive the statutory pay cap for critical health care personnel by striking 38 U.S.C. 7431(e)(6)(D) and redesignating subparagraphs (E) through (G) as (D) through (F), respectively. (As background, 38 U.S.C. 7431 authorizes above-Title 5 pay for VA physicians and dentists, including those in designated critical positions, subject to waiver of an overall pay limitation.)

This section increases the maximum amount of incentive pay for pharmacist executives in the Department of Veterans Affairs to $100,000 (from $40,000) and restructures the provision limiting such pay to exclude recruitment, relocation, or retention bonuses and critical skills incentives from the calculation of that cap.

This section modifies special pay authority for nurse executives in the Veterans Health Administration (VHA) by (1) delegating authority to the Under Secretary for Health to pay such special pay to VHA personnel who are nurse executives (previously held by the Secretary with limitations through the Central Office); and (2) requiring the Under Secretary for Health to define via regulations which VHA positions qualify as nurse executives.

This section includes Department of Veterans Affairs (VA) police officers, as defined in 38 U.S.C. §902, within the definition of law enforcement officer for retirement credit under the Civil Service Retirement System (CSRS) and Federal Employees Retirement System (FERS). (As background, law enforcement officer status provides enhanced retirement benefits, including a higher annuity accrual rate of 1.7% (instead of 1% or 1.1%) for the first 20 years of service and eligibility for retirement at age 50 with 20 years of service or age 57 with 30 years under FERS.) The amendments apply to individuals appointed as law enforcement officers on or after the date of enactment and to incumbents (i.e., those serving as VA police officers on the date of enactment who were appointed before that date) as follows: (1) service performed on or after enactment is creditable as law enforcement officer service; (2) prior service is creditable only if the incumbent elects in writing within 5 years of enactment or before separation, with the incumbent required to deposit the difference in employee retirement contributions plus interest (or accept an annuity reduction if partial) and the employing agency required to remit the difference in agency contributions plus interest ratably over 10 years; (3) incumbents are exempt from law enforcement officer mandatory separation for 3 years after enactment; and (4) the Office of Personnel Management Director must issue implementing regulations.

This section authorizes the Secretary of Veterans Affairs to establish a mentorship program pairing covered executive leaders (i.e., facility directors, chiefs of staff, associate directors of patient care services or general operations, assistant directors, deputy directors, or other executives as determined by the Secretary) at Department of Veterans Affairs (VA) medical centers (referred to as "mentees") with peer mentors from high-performing centers to share best practices and develop leadership skills. Mentees are eligible if they (1) have served less than one year in their position; (2) are at medical centers with poor performance on VA's Strategic Analytics for Improvement and Learning (SAIL) model (or successor), access-to-care data under 38 U.S.C. §1703C(a)(3) below community or Secretary-determined thresholds, or open Office of Inspector General recommendations over one year old; or (3) are recommended by their Veterans Integrated Service Network (VISN) director. Peer mentors must (1) hold or have held the same position title as the mentee for at least two years, (2) work at a medical center with above-average SAIL performance, and (3) report access-to-care data exceeding community levels. Not later than one year after enactment of this Act, and annually thereafter for three years, the Secretary must report to the congressional Veterans' Affairs Committees on program participation by medical center and eligibility criteria, communication facilitation efforts, participant feedback, and covered individual turnover rates.

This section requires the Secretary of Veterans Affairs, whenever possible and practicable, to issue postings for all possible clinicians or professionals who could fill a vacant position that may be filled by more than one type. The Secretary must consider this requirement particularly for hard-to-recruit, hard-to-retain, primary care, and mental health care positions.

This section establishes new hiring processes for the Department of Veterans Affairs (VA) by adding a new section 702 to 38 U.S.C. chapter 7, subchapter I. Specifically, it (1) requires a standardized, nationwide approval process for filling vacant positions—with approval windows for each step, automatic approval if any step exceeds five business days beyond its allotted time, delegation of authority if an approver is unavailable, and a total time not exceeding the Department's fill goal for that position; (2) requires a standardized process for creating, editing, and approving facility-specific hard-to-recruit or hard-to-retain lists, with related flexibilities applicable for 90 days after a position drops off the list; (3) requires a standardized process for issuing tentative offers of employment that specify a basic pay rate; (4) authorizes third-party contracts for candidate vetting such as laboratory testing and background checks; (5) authorizes electronic signatures on employment documents (e.g., SF 1152, SF 2823, SF 3102–FERS, and successors) under a standardized process; and (6) requires an employee community building program to connect VA employees nationwide in similar positions, offices, and programs.

This section requires the Secretary of Veterans Affairs to (1) establish a staffing model for each service or program within the Veterans Health Administration (VHA); (2) reevaluate each model not less frequently than every five years; (3) consult with the Comptroller General of the United States, the Department of Veterans Affairs Inspector General, labor representatives, veterans service organizations, and appropriate professional associations when establishing or reevaluating models; and (4) submit reports on such models or reevaluations to the congressional Committees on Veterans’ Affairs and Appropriations. The reports must include a description of each model, its application and rationale, the ratio of staff to veterans served, feedback obtained from consulted entities prior to submission, and any updates incorporating such feedback.

This section requires the Secretary of Veterans Affairs, not later than 180 days after enactment, to establish a telework policy for all Department of Veterans Affairs employees in accordance with 5 U.S.C. §6502 (which generally requires executive agencies to authorize telework for eligible employees subject to limitations such as prior discipline) and this section, under which telework is the default status except for exemptions based on the nature of an employee's work or ineligibility under §6502 as of enactment. The section further (1) directs a report to specified congressional committees, not later than one year after the policy's effective date, on annual savings from telework; (2) sets the initial policy's effective date as not later than 180 days after establishment and requires subsequent changes to take effect not less than one year after made, with notice to affected employees, committee reports, and public availability; and (3) provides that the policy supplants any conflicting presidential or Secretary memoranda.

This section establishes the Start and Stay at VA Program within the Department of Veterans Affairs (VA) Educational Assistance Program (chapter 76 of title 38, U.S. Code), under a new subchapter X. The program provides (1) scholarships under new section 7699C-1 covering reasonable education expenses—including tuition, fees, books, and laboratory expenses—for up to the credit equivalent of four full school years; and (2) lump sum education debt reduction under new section 7699C-2. Scholarship eligibility requires the applicant to be a VA employee serving as a medical support assistant, advanced medical support assistant, lead medical support assistant, or supervisory medical support assistant with at least two continuous years of service in such positions; to be accepted or enrolled in a course of education or training for a shortage occupation position (as determined by the VA Secretary), related to business, health care administration, or human resources, or leading to another degree or certification deemed appropriate by the Secretary; and to have an employment record demonstrating a high likelihood of successful completion and related employment. Scholarship agreements, in addition to standard requirements under section 7604 of title 38, U.S. Code, obligate recipients to full-time VA service in a shortage occupation position for a period equal to the scholarship duration (minimum one year), prorated for part-time study. Service may commence during the course if the recipient is employed in a qualifying position or is delayed until course completion or licensure (e.g., for medicine, nursing, or other health professions), with notice provided at least 60 days in advance.

This section establishes the Build and Maintain Department of Veterans Affairs Program as a new subchapter (XI) within VA's Educational Assistance Program (38 U.S.C. ch. 76). The program provides scholarships covering tuition, fees, books, and laboratory expenses to eligible students enrolled in courses qualifying them for VA employment as (1) heating, air conditioning, industrial, or boiler plant equipment mechanics; (2) boiler plant, utility systems, or air conditioning equipment operators; (3) general, biomedical, or industrial engineers; or (4) other infrastructure, maintenance, or facilities management positions deemed essential by the Secretary. Participants must agree to full-time VA service in such a position for a period of obligated service, which begins after course completion and any licensure or certification requirements (or as adjusted for part-time students, service during training, or further training). The Secretary may form partnerships with relevant training programs and schools; conduct outreach to Tribal Colleges and Universities (as defined in section 316 of the Higher Education Act of 1965, 20 U.S.C. 1059c), historically Black colleges and universities, rural high schools, community colleges, and military transition assistance programs for service members and spouses; and assign mentors. Program authority terminates 10 years after enactment of the Honor Act of 2025.

This section revises VA reimbursement for continuing professional education expenses (previously limited to up to $1,000 per year for full-time board-certified physicians and dentists appointed under 38 U.S.C. 7401(1)) to cover, at up to $1,000 per year, additional professionals under that subsection—podiatrists, chiropractors, optometrists, registered nurses, and physician assistants—and professionals appointed under 38 U.S.C. 7401(3), including licensed practical or vocational nurses (including nurse practitioners and advanced practice registered nurses), medical technologists, pharmacists, pharmacy technicians, psychologists, diagnostic radiologic technologists, and social workers. The section further (1) requires the VA Secretary to submit annual reports to the congressional veterans' affairs committees on program utilization, including by location, position title and specialty, average amounts claimed, and percent utilization; and (2) directs the Secretary to prioritize reimbursements for direct patient care providers (or decision-makers for such care) and for education related to employees' duties. (Thus, the revision broadens access to continuing education funding for a wider range of VA clinicians and support staff essential to veterans' health care delivery.)

This section requires the Secretary of Veterans Affairs to pay the costs of specified licensing examinations and certifications—such as the United States Medical Licensing Examination (Steps 1, 2, and 3), National Council Licensure Examination, National Board Dental Examination, and National Board Dental Hygiene Examination—required by the Secretary for current recipients of covered health professional scholarships from the VA. (As background, these scholarships are components of or related to the Department of Veterans Affairs Health Professionals Educational Assistance Program, which recruits and retains health care professionals for VA service through scholarships, tuition reimbursement, stipends, and loan repayments.) The section also requires the Secretary to submit to the Senate and House Committees on Veterans' Affairs, not later than one year after enactment and annually thereafter, a report on implementation that includes, for each state and territory and for the preceding year: (1) utilization by position and career type; and (2) for each examination or certification, the number of times paid for by the VA and total funds expended. It defines covered health professional scholarships as those under (1) the VA Health Professional Scholarship Program; (2) the VA Employee Incentive Scholarship Program (including the National Nursing Education Initiative and VA National Education for Employees Program); (3) the VA Readjustment Counseling Service Scholarship Program; (4) the Visual Impairment and Orientation and Mobility Professionals Scholarship Program; (5) the Veterans Healing Veterans Medical Access and Scholarship Program; (6) the Physician Assistant Education and Training Pilot Program for Former Members of the Armed Forces; and (7) other programs deemed appropriate by the Secretary.

This section revises Department of Veterans Affairs (VA) personnel transparency requirements under Section 505 of the John S. McCain III, Daniel K. Akaka, and Samuel R. Johnson VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 (P.L. 115-182) as follows: (1) With respect to information publicly available on the VA website, it requires quarterly updates reflecting the most recent data on employee numbers; replaces reporting of vacancies with reporting of positions undergoing recruitment, disaggregated by occupation and recruitment stage (i.e., Manager Request Initiation Stage, recruitment stage, onboarding stage, waiting to start stage, or successors); eliminates references to potential hires; and adds reporting of positions vacated during the quarter without initiated recruitment actions, including vacancy dates and disaggregated by occupation. (2) It requires disaggregation of displayed information by departmental component, by medical facility for Veterans Health Administration (VHA) positions, and by regional office for Veterans Benefits Administration (VBA) positions. (3) It revises the VA Inspector General's duties to review website administration, develop related recommendations, and report findings and recommendations to the congressional Committees on Veterans' Affairs. (4) It replaces the existing subsection (b) with a requirement for the VA Secretary to submit an annual report to Congress describing steps and actions toward full staffing capacity (including improvements to VHA onboarding timelines exceeding the Time to Hire Model or successor and VBA time-to-hire exceeding Office of Personnel Management targets), additional funds needed, and legislative or administrative recommendations. The amendments apply beginning with the first update under Section 505(a)(3) after enactment. (Thus, the changes enhance hiring process visibility and accountability to address VA staffing shortages.)

This section directs the Secretary of Veterans Affairs, not later than 90 days after the date of enactment, to submit to the Committees on Veterans’ Affairs and Appropriations of the Senate and House of Representatives a report on (1) the implementation of, (2) the current status of, and (3) the status since inception of the Grow Our Own pilot program required by section 246 of the Military Construction, Veterans Affairs, and Related Agencies Appropriations Act, 2018 (division J of Public Law 115-141; 38 U.S.C. 7601 note).

This section directs the Secretary of Veterans Affairs, beginning not later than 180 days after enactment, to provide the Senate and House Committees on Veterans’ Affairs with data on graduate medical education programs, health profession scholarship programs, and other educational assistance programs within the Veterans Health Administration (VHA). The required data includes, for each program, (1) the number of active participants broken down by position or expected future position or licensure, (2) funds spent each fiscal year, (3) the number of participants who completed education and are fulfilling service requirements at VA, (4) the number who left the program before completing education or service requirements in the preceding year, (5) an overview of outreach to prospective participants, and (6) other information the Secretary considers appropriate; such data must be updated annually and may be included in another statutorily required report.

This section modifies restrictions in current law on the use of funds for land acquisition or advance planning activities for major medical facility projects of the Department of Veterans Affairs (VA) by authorizing such funds for land acquisition only for projects included in the VA's five-year development plan (or successor plan) submitted with the President's annual budget under 31 U.S.C. 1105(a). (Thus, land acquisition funding requires prior inclusion in this budget planning document, which outlines projected VA construction needs.)

This section requires the Secretary of Veterans Affairs, not later than 540 days after enactment, to ensure dedicated offices or entities and sufficient staff—including at each medical center—for the full life-cycle of capital asset management (i.e., facility planning, long-range capital planning, project execution, property disposal, engineering, maintenance, stakeholder input, and related functions) at local, regional, and central office levels. To the greatest extent practicable, the Secretary must assign these duties to distinct individuals or groups; designate a lead senior official for workforce integration, accountability, and monitoring within 180 days (with congressional notification); and establish a staffing model within one year that sets a minimum base level adjusted for workload volume and complexity, with regular updates. This section further requires appropriate professional certifications and qualifications for relevant personnel; specifies duties for medical center offices, such as developing catchment-area objectives, regional coordination, project delivery, infrastructure maintenance, and monitoring best practices; and extends requirements, to the extent practicable, to the largest medical facility in states or territories lacking a full-service medical center. (Thus, the provision aims to enhance efficient execution of VA capital assets—such as major/minor construction, leases, and nonrecurring maintenance—serving veterans' health care, cemeteries, and benefits without mandating workforce realignments.)

This section directs the Secretary of Veterans Affairs, not later than one year after the date of enactment, to (1) develop meaningful and measurable goals and metrics to assess the performance of the department's capital asset management programs—including those carried out by non-Department federal entities under 38 U.S.C. 8103(e)(1), which authorizes certain leases of VA properties—to inform decisions on construction, leasing, acquisition, maintenance, and disposal of capital assets, aligned with departmental strategic plans, budgets, and the mission to serve veterans, their families, and caregivers; (2) develop an internal dashboard or other tool to monitor progress toward those goals; (3) establish and implement internal governance processes to improve performance; and (4) submit a report to the appropriate congressional committees on the goals, metrics, dashboard, and governance processes. The section further requires the dashboard to include metrics that evaluate capital asset management performance, guide improvements, and align with recommendations from the Comptroller General.

This section directs the Deputy Secretary of Veterans Affairs and the Under Secretary of Defense for Personnel and Readiness, not later than 180 days after enactment, to expand the membership of the Capital Asset Planning Committee—a subordinate entity of the Department of Veterans Affairs-Department of Defense Joint Executive Committee (which coordinates VA-DoD efforts on health care resource sharing, benefits, and transition assistance)—to include (1) at least one officer or employee of the Indian Health Service and (2) at least one officer or employee of the Department of Health and Human Services who is not from the Indian Health Service (to facilitate federal health infrastructure planning, coordination, and investment).

This section authorizes appropriations to the Secretary of Veterans Affairs for three accounts as follows: (1) Construction, Minor Projects account, $1 billion for FY2026 increasing annually to $5 billion for FY2030 through FY2037; (2) Construction, Major Projects account, $2 billion for FY2026 increasing annually to $7 billion for FY2031 through FY2037; and (3) grants for extended care facilities (i.e., state veteran nursing homes and domiciliaries), $300 million for FY2026 increasing to $600 million for FY2030 through FY2036. The section further requires that, for any fiscal year in which the President's budget requests less than these amounts, the VA secretary include in the budget submission (i) a detailed justification of funding sufficiency for VA infrastructure needs; (ii) identification of unfunded projects from the Strategic Capital Investment Planning process (for minor and major construction) or State Home Construction Grants Priority List (for grants); and (iii) a notation of whether requested amounts match those submitted by VA to the Office of Management and Budget.

This section directs the Secretary of Veterans Affairs, not later than two years after the date of enactment, to submit to the Committees on Veterans' Affairs of the Senate and House of Representatives a report on the resilience of mission-critical facilities, land, and other capital assets of the department to extreme weather events. The report must include (1) an assessment, disaggregated by state, territory, and asset type, of existing assets at highest risk from proximity to bodies of water or areas prone to flooding (including from rising sea levels), wildfires, tornadoes, hurricanes, storms, or other extreme weather; (2) strategies to improve resilience of such high-risk assets, including modifications to operations and maintenance; (3) recommendations for best practices, standards, and solutions for future placement, planning, renovation, leasing, purchase, construction, and disposal of assets to mitigate environmental risks, including an assessment of necessary additional resources; and (4) descriptions of (A) recommended legislative or administrative actions; (B) actions taken in the three fiscal years preceding the report and planned for the three fiscal years following to improve resilience of high-risk assets; (C) changes to department policies, directives, and procedures for future assets; (D) incorporation of resilience information into capital asset investment decisions; (E) changes to ensure asset availability for furnishing care and services under 38 U.S.C. 1785 (i.e., hospital care and medical services during and immediately following major disasters or emergencies declared under federal law) during or after a disaster or emergency; (F) estimated implementation costs; (G) estimated implementation timelines; and (H) other matters as determined appropriate by the Secretary.

This section revises section 8120 of title 38, United States Code, to require the Secretary of Veterans Affairs to submit reports to the appropriate congressional committees on Department capital asset investments, activities, and performance—not later than 30 days after the end of each fiscal year and every 60 days thereafter until the end of that fiscal year (replacing prior quarterly reports solely on non-Department super construction projects). The first report each fiscal year must include (1) summaries of completed capital asset projects from the prior fiscal year (covering types such as major construction, minor construction, non-recurring maintenance, leases, or disposals; estimated vs. actual costs; descriptions; locations; timelines; reasons for cost overrages exceeding 10% or delays exceeding 180 days; and actions to prevent recurrences), cancelled projects, prior-year obligations by project type from the medical facilities appropriation, projected current-year projects and obligations, best practices and impediments, progress metrics toward capital asset goals (to incorporate metrics from sec. 314(a)(1) of the Honor Act of 2025 beginning two years after enactment), and other matters; subsequent reports must update ongoing projects. Reports may address Federal requirements increasing project costs relative to the non-Federal sector. This section further revises reporting on super construction projects (as defined in 38 U.S.C. 8103(e)(3)) carried out by non-Department entities (per 38 U.S.C. 8103(e)(1)) to the same new schedule, requiring budgetary and scheduling status and actual cost/schedule variances as of the end of the most recent fiscal quarter for each such project. (Thus, these changes expand oversight of VA medical facilities projects serving veterans to multiple annual reports with detailed metrics and projections, while aligning non-Department project reporting to that cadence.)

This section directs the Secretary of Veterans Affairs to submit to the appropriate congressional committees, not later than one year after enactment, a report—disaggregated by medical center or other relevant Department health care facility—identifying physical infrastructure needs to support current and future long-term care needs and models of care for veterans. The report must include (1) infrastructure needs for women veterans, veterans with spinal cord injuries and diseases, traumatic brain injury, unique behavioral health needs, memory loss, and other groups with unique or projected needs; (2) Department plans to provide such care while building capacity if space is unavailable; (3) for needed projects, estimated individual and total costs and timelines upon funding; (4) potential modifications to infrastructure prioritization processes (e.g., Strategic Capital Investment Planning) to elevate projects supporting services unavailable or substandard from non-Department providers; and (5) indications of whether projects are best accomplished via smaller initiatives or larger medical facility replacements or new sites, developed in consultation with relevant Veterans Health Administration offices.

This section requires the Secretary of Veterans Affairs to submit to the appropriate congressional committees (Committees on Appropriations and Veterans' Affairs of the Senate and House) an initial report on the women veterans retrofit initiative (i.e., VA facility modifications prioritized under Section 5102(a) of the Deborah Sampson Act of 2020 to better serve women veterans) not later than one year after enactment of this Act. The report must identify (1) funding requested and provided for such retrofitting, (2) funded projects including obligated amounts, locations, descriptions, statuses, and completion timelines, and (3) unfunded projects including required funding and completion timelines if funded; annual updates must follow for 10 years or until all projects are completed, covering project progress and funding requested and provided.

This section requires the Secretary of Veterans Affairs to submit to Congress, not later than two years after the date of enactment, a report on the capital asset and information technology needs of the Department's research and development program. The report must include (1) a summary of required facilities and infrastructure, with per-project cost estimates, multi-year plans, and identification by project type (e.g., major construction, minor lease); (2) details on IT resources, projects, and needs disaggregated by funding category (e.g., development, operations and maintenance), with per-project cost estimates and multi-year plans for short-, medium-, and long-term functionality; and (3) other relevant matters to advance R&D functions, excluding human capital needs.

This section directs the Secretary of Veterans Affairs to review relevant authorities on capital asset management, including those in 38 U.S.C. 312A (which establishes the Director of Construction & Facilities Management, qualifications, and responsibilities for VA facilities planning, construction, leasing, maintenance, and procurement), and submit to Congress, not later than 270 days after enactment, a report assessing whether those authorities should be revised to better align with current and projected operational needs. The report must include (1) an assessment of reassigning statutorily or departmentally assigned functions from specified officials (e.g., Deputy Secretary, Director of Construction & Facilities Management, Under Secretary for Health) to other offices for improved efficiency and accountability; (2) an assessment of clearly assigning currently unassigned capital asset functions; (3) identification of needed new offices, structures, positions, or reporting lines, including views on consolidating all VA leasing and minor construction activities within the Office of Construction & Facilities Management; (4) an assessment of organizational and statutory changes for a single line of accountability over the full life-cycle of capital assets; (5) an assessment of modifying qualifications for the Director under 38 U.S.C. 312A(b)(1); (6) specific reasons for recommended changes or justification if none, including identification of the single responsible executive and office; and (7) necessary legislative or administrative actions.

This section directs the Secretary of Veterans Affairs, not later than one year after enactment, to submit to the appropriate congressional committees a report on actions the Department of Veterans Affairs is taking or plans to take to enhance prevention, detection, and reporting of waste, fraud, and abuse in VA capital asset projects (i.e., major construction, acquisition, and maintenance of facilities and equipment) by employees, contractors, or other involved parties. The report must include (1) an assessment of whether new or enhanced training is needed; (2) recommendations for legislative and administrative actions; and (3) other appropriate matters. In preparing the report, the Secretary must consult with the VA Inspector General and Comptroller General on best practices and may consult others.

This section directs the Comptroller General of the United States to submit to the appropriate congressional committees, not later than one year after enactment of this Act, a report evaluating the continued need for the Department of Veterans Affairs (VA) to use a non-VA federal entity for full project management services on super construction projects, as required by current law (38 U.S.C. 8103(e)(1)). (Super construction projects are major VA infrastructure projects, generally those with estimated costs exceeding $100 million.) The report must include (1) metrics or evaluation criteria for Congress to assess VA's management capabilities for such projects; (2) a description of VA's current cost arrangements and premiums paid to non-VA entities, along with potential savings from removing the requirement; and (3) other relevant matters on VA infrastructure project management.