(a) Short title.—This Act may be cited as the “VA Clinician Appreciation, Recruitment, Education, Expansion, and Retention Support (CAREERS) Act of 2023”.

(b) Table of contents.—The table of contents for this Act is as follows:

Sec. 1. Short title; table of contents.

(a) In general.—The Secretary of Veterans Affairs shall pay the costs of any licensing examinations and certifications required by the Secretary for any current recipient of a covered health professional scholarship from the Department of Veterans Affairs.

(b) Licensing examinations and certifications.—Subsection (a) shall apply to the payment of costs for—

(1) the United States Medical Licensing Examination Step 1, Step 2, and Step 3;

(2) the National Council Licensure Exam;

(3) the National Board Dental Examination;

(4) the National Board Dental Hygiene Examination;

(5) the Dental Licensure Objective Structured Clinical Examination and Integrated National Board Dental Examination;

(6) the National Licensing Exams for Registered Nurses, Nurse Practitioners, and Certified Registered Nurse Anesthetists;

(7) the American Podiatric Medical Licensing Exam;

(8) the National Board of Examiners in Optometry Exam;

(9) the Physician Assistant National Certification Exam;

(10) the Examination for Professional Practice in Psychology;

(11) the Academy for Certification of Vision Rehabilitation and Education Professionals certification examinations;

(12) the Association of Social Workers Boards Exam; and

(13) such other licensing examinations and certifications as the Secretary considers appropriate.

(c) Report to Congress.—Not later than one year after the date of the enactment of this Act, and not less frequently than annually thereafter, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the implementation of this section that includes the following data for each State and territory of the United States for the one-year period preceding the date of the report:

(1) Utilization by the Secretary of the requirement under subsection (a) broken down by position and career type.

(2) Number of times each examination or certification described in subsection (b) was paid for by the Department and total funds expended by the Department for each such examination or certification.

(d) Covered health professional scholarship defined.—In this section, the term “covered health professional scholarship” means—

(1) the Department of Veterans Affairs Health Professional Scholarship Program under subchapter II of chapter 76 of title 38, United States Code;

(2) the Department of Veterans Affairs Employee Incentive Scholarship Program under subchapter VI of such chapter, including—

(A) the National Nursing Education Initiative; and

(B) the VA National Education for Employees Program;

(3) the Department of Veterans Affairs Readjustment Counseling Service Scholarship Program under subchapter IX of such chapter;

(4) the Visual Impairment and Orientation and Mobility Professionals Scholarship Program under chapter 75 of such title;

(5) the Veterans Healing Veterans Medical Access and Scholarship Program under section 304 of the VA MISSION Act of 2018 (Public Law 115–182; 38 U.S.C. 7601 note);

(6) the Physician Assistant Education and Training Pilot Program for Former Members of The Armed Forces under section 246 of division J of the Consolidated Appropriations Act of 2018 (Public Law 115–141; 38 U.S.C. 7601 note); and

(7) such other programs as the Secretary considers appropriate.

(a) Rural geriatrics team training.—The Secretary of Veterans Affairs shall expand the Rural Interdisciplinary Team Training program of the Department of Veterans Affairs to not fewer than one rural site in each Veterans Integrated Service Network of the Department and ensure access at such sites to learning opportunities through the Geriatric Scholars Program of the Department.

(b) Training on caring for veterans with memory loss.—

(1) IN GENERAL.—The Secretary shall provide continuing professional education for clinical staff of the Department who provide care for veterans with Alzheimer’s disease and dementia.

(2) IMPLEMENTATION.—The Secretary shall implement the continuing professional education required under paragraph (1) in consultation with the Office of Rural Health of the Department of Veterans Affairs established under section 7308 of title 38, United States Code, in order to ensure equitable access to learning opportunities for employees of the Department in rural and highly rural areas.

(c) Expansion of Geriatric Patient Aligned Care Team model and Geriatric and Palliative Specialty Services.—

(1) IN GENERAL.—The Secretary shall expand the Geriatrics Patient Aligned Care Team model and the geriatric and palliative specialty services of the Department of Veterans Affairs—

(A) to every medical center of the Department;

(B) to any community-based outpatient clinic at which such expansion is determined by the Secretary to be feasible and needed; and

(C) to provide access to all veterans that need those services, including through implementing Geriatric and Palliative Specialty Consultative Clinical Resource Hubs to meet the needs of the aging veteran population.

(2) WAIVER OF EXPANSION TO MEDICAL CENTERS.—The Secretary may waive the application of the requirements under paragraph (1)(A) with respect to a medical center if the Secretary determines that the medical center does not have the capacity or need to implement a Geriatrics Patient Aligned Care Team model or to provide geriatric and palliative specialty services, as the case may be.

(3) STUDY.—The Secretary shall conduct a study on the variations in the structure and model consistency of the Geriatrics Patient Aligned Care Team model and delivery and utilization of geriatric and palliative care throughout the Department and how those variations impact quality of care and patient outcomes.

(d) Report to Congress.—

(1) IN GENERAL.—Not later than two years after the date of the enactment of this Act, and not less frequently than annually thereafter for the following five years, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the implementation of this section.

(2) INCLUSION OF INFORMATION ON WAIVERS.—The Secretary shall include in the report required by paragraph (1) an identification of any medical center of the Department in receipt of a waiver under subsection (c)(2) and the reason for the waiver.

(e) Definitions.—In this section, the terms “rural” and “highly rural” have the meanings given those terms under the Rural-Urban Commuting Areas (RUCA) coding system of the Department of Agriculture.

(a) In general.—Not later than two years after the date of the enactment of this Act, the Secretary of Veterans Affairs shall complete a study on barriers to hiring and retaining staff at community living centers of the Department of Veterans Affairs and best practices for improving recruitment and retention of such staff, with an emphasis on nursing staff.

(b) Report to Congress.—Not later than 180 days after completion of the study under subsection (a), the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report—

(1) summarizing key findings with respect to barriers to hiring and retaining staff at community living centers of the Department and best practices for improving recruitment and retention of such staff, including any barriers or best practices specific to rural areas; and

(2) including recommendations for such administrative action as the Secretary considers appropriate.

(a) Notification.—

(1) IN GENERAL.—Not later than 90 days after detailing a director of a medical center of the Department of Veterans Affairs to a different position within the Department, the Secretary of Veterans Affairs shall notify the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives of such detail.

(2) MATTERS TO BE INCLUDED.—The notification required by paragraph (1) shall include, with respect to a director of a medical center who is detailed to a different position within the Department, the following information:

(A) The location at which the director is detailed.

(B) The position title of the detail.

(C) The estimated time the director is expected to be absent from their duties at the medical center.

(D) Such other information as the Secretary may determine appropriate.

(b) Appointment of acting director.—Not later than 120 days after detailing a director of a medical center of the Department to a different position within the Department, the Secretary shall appoint an individual as acting director of such medical center with all of the authority and responsibilities of the detailed director.

(c) Update on detail.—Not later than 120 days after detailing a director of a medical center of the Department to a different position within the Department, and not less frequently than every 30 days thereafter while the detail is in effect or while the director position at the medical center is vacant, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives an update regarding the status of the detail.

(d) Return to position or reassignment.—

(1) IN GENERAL.—Except as provided in paragraph (2), not later than 180 days after detailing a director of a medical center of the Department to a different position within the Department, for a reason other than an ongoing investigation or administrative action with respect to the director, the Secretary shall—

(A) return the individual to the position as director of the medical center; or

(B) reassign the individual from the position as director of the medical center and begin the process of hiring a new director for such position.

(2) WAIVER.—

(A) IN GENERAL.—The Secretary may waive the requirement under paragraph (1) with respect to an individual for successive 90-day increments for a total period of not more than 540 days from the original date the individual was detailed away from their position as director of a medical center.

(B) NOTIFICATION.—Not later than 30 days after exercising a waiver under subparagraph (A), the Secretary shall notify Congress of the waiver and provide to Congress information as to why the waiver is necessary.

(a) Market pay.—

(1) IN GENERAL.—Section 7431 of title 38, United States Code, is amended—

(A) by striking subsections (a), (b), and (d);

(B) by redesignating subsections (c), (e), (f), (g), and (h) as subsections (a), (b), (c), (d), and (e), respectively;

(C) by inserting “optometrists,” after “podiatrists,” each place it appears;

(D) by inserting “optometrist” after “podiatrist,” each place it appears;

(E) in subsection (a), as redesignated by subparagraph (B), in the matter preceding paragraph (1), by striking “One element of pay for physicians, podiatrists, and dentists shall be base pay. Base pay shall meet the following requirements:” and inserting “Pay of physicians, podiatrists, optometrists, and dentists in the Veterans Health Administration shall consist of base pay, which shall meet the following requirements:”;

(F) in subsection (b), as so redesignated—

(i) in the subsection heading, by striking “total” and inserting “market”;

(ii) in paragraph (1)(A)—

(I) by striking “annual” each place it appears and inserting “market”; and

(II) by inserting “, optometrists,” after “podiatrists”;

(iii) by striking paragraphs (2) and (3);

(iv) by redesignating paragraph (4) as paragraph (2);

(v) in paragraph (2), as redesignated by clause (iv), by striking “Except as provided in sections 7404A(c) and 7410(a)(2) of this title, in no case may the total amount of compensation” and inserting “The total amount of market pay under subsection (a)”;

(vi) by inserting “may not” before “exceed”; and

(vii) by adding at the end the following new paragraphs:

“(3) Notwithstanding any compensation or pay limitations under this title or title 5, the Secretary may authorize the Under Secretary for Health to pay physicians, podiatrists, and dentists—

“(A) awards authorized under this title;

“(B) advance payments, recruitment or relocation bonuses, and retention allowances authorized under section 7410(a) of this title or as otherwise provided by law;

“(C) incentives or bonuses under section 706 of this title or as otherwise provided by law; and

“(D) earnings from fee-basis appointments under section 7405(a)(2) of this title.

“(4) (A) The Secretary may waive any pay limitation described in this section (to include tier limitations) if the Secretary determines it is necessary for the recruitment or retention of critical health care personnel, as determined by the Secretary.

“(B) The Secretary may prescribe requirements, limitations, and other considerations for waivers under subparagraph (A).”;

(G) in subsection (c), as so redesignated, by striking “subsections (b) and (c) of”;

(H) in subsection (d), as so redesignated—

(i) in paragraph (1), by striking “subsection (c)” and inserting “subsection (a)”; and

(ii) by adding at the end the following new paragraph:

“(3) An individual receiving market pay under subsection (a) may not receive a non-foreign cost of living allowance under section 5941 of title 5.”; and

(I) in subsection (e), as so redesignated, by striking “subsection (c), (d), or (e) except for the responsibilities of the Secretary under subsection (e)(1)” and inserting “subsections (a) or (b) except for the responsibilities of the Secretary under subsection (b)(1)”.

(2) CONFORMING AMENDMENTS.—

(A) INCENTIVES FOR RECRUITMENT.—Section 706(d)(6) of title 38, United States Code, is amended by striking “total amount of compensation under section 7431(e)(4)” and inserting “total amount of market pay under section 7431”.

(B) AWARDS.—Section 7404A(c) of such title is amended by striking “the limitation under section 7431(e)(4)” and inserting “a limitation under section 7431”.

(C) ADDITIONAL PAY AUTHORITIES.—Section 7410(a)(2) of such title is amended by striking “the limitation under section 7431(e)(4)” and inserting “a limitation under section 7431”.

(D) PAY OF UNDER SECRETARY FOR HEALTH.—Section 7432(b)(1) of such title is amended—

(i) by inserting “, podiatrist, optometrist,” after “physician”; and

(ii) by striking “7431(c)” and inserting “7431”.

(E) ADMINISTRATIVE MATTERS.—Section 7433 of such title is amended by inserting “optometrists,” after “physicians,” each place it appears.

(F) COMPETITIVE PAY.—Section 7451(a)(2)(C) of such title is amended by inserting “optometrist,” after “physician,”.

(G) COMPENSATION AND PROFESSIONAL STANDARDS FOR CERTAIN MEDICAL OFFICERS.—Section 27(b) of the Central Intelligence Agency Act of 1949 (50 U.S.C. 3528(b)) is amended by striking “section 7431(e)(1)(C)” and inserting “section 7431(b)(1)(C)”.

(3) CLERICAL AMENDMENTS.—

(A) SECTION HEADING.—

(i) IN GENERAL.—The heading for section 7431 of title 38, United States Code is amended to read as follows:

(ii) TABLE OF SECTIONS.—The table of sections at the beginning of subchapter III of chapter 74 of title 38, United States Code, is amended by striking the item relating to section 7431 and inserting the following new item:

“7431. Market pay.”.

(B) SUBCHAPTER HEADING.—

(i) IN GENERAL.—The heading for subchapter III of chapter 74 of such title is amended to read as follows:

(ii) TABLE OF SECTIONS.—The table of sections at the beginning of chapter 74 of such title is amended by striking the item relating to subchapter III and inserting the following new item:

(4) APPLICATION.—

(A) IN GENERAL.—The amendments made by this subsection shall apply to any pay period of the Department of Veterans Affairs beginning on or after the date that is 30 days after the date of the enactment of this Act.

(B) PERFORMANCE PAY FOR YEAR OF ENACTMENT.—The Secretary of Veterans Affairs may pay performance pay under section 7431(d) of title 38, United States Code, as in effect on the day before the date of the enactment of this Act, for the calendar year in which this Act is enacted.

(b) Modification and clarification of pay grade for optometrists.—Section 7404 of such title is amended—

(1) in subsection (a)(2)(A), by striking “podiatrists, and dentists” and inserting “podiatrists, optometrists, and dentists”; and

(2) in the list in subsection (b)—

(A) by striking “PODIATRIST (DPM), AND DENTIST” and inserting “PODIATRIST (DPM), OPTOMETRIST (OD), AND DENTIST”; and

(B) by striking “CLINICAL CHIROPRACTOR AND OPTOMETRIST SCHEDULE,” and inserting “CLINICAL CHIROPRACTOR SCHEDULE”.

(c) Retroactive authority for compensation.—

(1) IN GENERAL.—The Secretary of Veterans Affairs is retroactively authorized to pay to a covered employee the amount of compensation that was authorized to be paid to the employee during the period specified in paragraph (2) but was deferred and paid to the employee in the calendar year following the calendar year in which it was authorized to be paid because it exceeded $400,000 in a calendar year.

(2) PERIOD SPECIFIED.—The period specified in this paragraph is the period beginning on January 8, 2006, and ending on December 31, 2017.

(3) ADDITIONAL PERIOD.—Compensation authorized under this subsection shall not be included in the calculation of any aggregate limit on compensation for a covered employee for the year in which it is paid.

(4) CHARGING OF COMPENSATION.—Compensation authorized under this subsection shall be charged to the appropriate medical care appropriation account of the Department of Veterans Affairs for the fiscal year in which the work was performed except as follows:

(A) In the case of an account that has closed pursuant to section 1552 of title 31, United States Code, the compensation shall be charged to a current appropriation account in accordance with section 1553 of such title.

(B) In the case of an expired account that has not closed, if charging the compensation to the expired account would cause such account to have a negative unliquidated or unexpended balance, the compensation may be charged to a current appropriation account available for the same purpose.

(5) DEFINITIONS.—In this subsection:

(A) COMPENSATION.—The term “compensation” means any pay, including salary, awards, and incentives.

(B) COVERED EMPLOYEE.—The term “covered employee” means a physician, podiatrist, optometrist, or dentist subject to market pay under section 7431 of title 38, United States Code, as amended by subsection (a).

(a) Increased pay cap.—

(1) IN GENERAL.—Subchapter I of chapter 74 of title 38, United States Code, is amended by adding at the end the following new section:

(2) CLERICAL AMENDMENT.—The table of sections at the beginning of such subchapter is amended by inserting after the item relating to section 7413 the following new item:

“7414. Pay for directors of medical centers and directors of Veterans Integrated Service Networks.”.

(b) Conforming amendments.—Section 7404(a)(1) of title 38, United States Code, is amended—

(1) in subparagraph (A)—

(A) by striking “(A) The annual” and inserting “The annual”; and

(B) by striking “and 7401(4)”; and

(2) by striking subparagraph (B).

(a) In general.—Subchapter I of chapter 74 of title 38, United States Code, as amended by section 202(a)(1), is further amended by adding at the end the following new section:

(b) Clerical amendment.—The table of sections at the beginning of such subchapter, as amended by section 202(a)(2), is further amended by inserting after the item relating to section 7414 the following new item:

“7415. Waiver of pay limitation for employees performing mission critical work.”.

Section 7410(b)(1) of title 38, United States Code, is amended by striking “$40,000” and inserting “$100,000”.

Section 7452(g) of title 38, United States Code, is amended—

(1) in paragraph (1), by striking “Department nurse executives, the Secretary may, in accordance with” and all that follows through the period at the end and inserting “nurse executives for the Veterans Health Administration, the Under Secretary for Health may pay special pay to personnel of the Veterans Health Administration who are nurse executives.”; and

(2) by adding at the end the following new paragraph:

“(5) The Under Secretary for Health shall define through regulations which positions of the Veterans Health Administration qualify as nurse executives for purposes of special pay under paragraph (1).”.

Not later than three years after the date of the enactment of this Act, the Inspector General of the Department of Veterans Affairs shall conduct a study and publish a report on—

(1) the use of direct hire authority by the Department;

(2) the contributions made by the use of such authority to filling vacancies within the Department; and

(3) any vulnerabilities or inconsistencies with respect to the use of such authority.

(a) Psychologists.—Paragraph (8)(C) of section 7402(b) of title 38, United States Code, is amended—

(1) by striking “individual psychologist for a period” and inserting “individual psychologist—

“(i) for a period”;

(2) by striking the period at the end and inserting “; or”; and

(3) by adding at the end the following new clause:

“(ii) for a reasonable period recommended by the Under Secretary for Health, not to exceed four years, during a public health emergency declared by the President, the Secretary of Health and Human Services, or such other authority as specified by the Secretary.”.

(b) Licensed professional mental health counselor.—Paragraph (11)(B) of such section is amended by striking the period at the end and inserting “, except that the Secretary may waive the requirement of licensure or certification for an individual professional mental health counselor for a reasonable period of time recommended by the Under Secretary for Health.”.

(a) Inclusion as physician.—

(1) IN GENERAL.—Section 7413 of title 38, United States Code, is amended—

(A) in the section heading, by inserting “and optometrists” after “podiatrists”;

(B) in subsection (a)—

(i) by striking “a doctor of podiatric medicine who is appointed as a podiatrist under section 7401(1) of this title” and inserting “a covered individual”; and

(ii) by striking “such section” and inserting “section 7401(1) of this title”; and

(C) by adding at the end the following new subsection:

“(c) Covered individual defined.—In this section, the term ‘covered individual’ means any of the following:

“(1) A doctor of podiatric medicine who is appointed as a podiatrist under section 7401(1) of this title.

“(2) A doctor of optometry who is appointed as an optometrist under section 7401(1) of this title.”.

(2) CLERICAL AMENDMENT.—The table of sections at the beginning of subchapter I of chapter 74 of such title is amended by striking the item relating to section 7413 and inserting the following new item

“7413. Treatment of podiatrists and optometrists; clinical oversight standards.”.

(b) Clarification of role.—Section 7306 of such title is amended—

(1) in subsection (a)—

(A) in paragraph (6), by striking “, a Director of Dietetic Service, and a Director of Optometric Service” and inserting “and a Director of Dietetic Service”;

(B) by redesignating paragraph (12) as paragraph (13); and

(C) by inserting after paragraph (11) the following new paragraph (12):

“(12) An Executive Director of Optometric Service, who shall be a qualified doctor of optometry and who shall be responsible to the Under Secretary for Health for the operation of the Optometric Service.”;

(2) in subsection (b)(1), by inserting “optometry,” after “podiatric medicine,”; and

(3) in subsection (c), by striking “and (10)” and inserting “(10), and (12)”.

(a) Account for consolidation of certain annual leave.—

(1) IN GENERAL.—Notwithstanding any other provision of law, the Secretary of Veterans Affairs shall consolidate into one restored annual leave account all annual leave restored pursuant to section 6304(d)(1)(B) of title 5, United States Code, during calendar years 2020, 2021, and 2022 for covered employees who are employed by the Department of Veterans Affairs on the date of the enactment of this Act.

(2) ADDITIONAL CALENDAR YEARS.—The Secretary may consolidate into the annual leave account described in paragraph (1) annual leave restored pursuant to section 6304(d)(1)(B) of such title during calendar years not described in such paragraph with the approval of the Director of the Office of Personnel Management.

(b) Leave expiration.—Annual leave consolidated into the annual leave account described in subsection (a)(1) shall be used before the later of—

(1) January 9, 2027; and

(2) the applicable deadline pursuant to section 630.309 of title 5, Code of Federal Regulations, or successor regulation.

(c) Program of lump sum payments.—

(1) IN GENERAL.—Subject to the availability of appropriations, the Secretary may establish a program under which, during the period beginning on the date of the enactment of this Act and ending on January 9, 2027, a covered employee with annual leave described in subsection (a)(1) may elect to receive a single lump sum payment lin lieu of using such leave.

(2) TREATMENT OF LUMP SUM PAYMENTS.—A lump sum payment under a program established under paragraph (1) shall be treated as separate and apart from any lump sum payment of annual leave the covered employee may otherwise be entitled to upon separation from employment with the Department.

(d) Covered employee defined.—In this section, the term “covered employee” means an employee of the Department of Veterans Affairs who—

(1) was appointed under chapter 73 or 74 of title 38, United States Code, notwithstanding section 7421(a) of such title, section 7425(b) of such title, or any other provision of such chapter that impacts leave for such an employee;

(2) was appointed under chapter 78 of such title; or

(3) occupied any position under the jurisdiction of the Secretary of Veterans Affairs that is subject to the leave provisions of chapter 63 of title 5, United States Code.

(a) In general.—Section 7411 of title 38, United States Code, is amended to read as follows:

(b) Clerical amendment.—The table of sections at the beginning of subchapter I of chapter 74 of title 38, United States Code, is amended by striking the item relating to section 7411 and inserting the following new item:

“7411. Reimbursement of continuing professional education expenses.”.

SEC. 224. Inclusion of police officers of Department of Veterans Affairs as law enforcement officers.

(a) In general.—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 (Public Law 115–182; 38 U.S.C. 301 note) is amended—

(1) in subsection (a)—

(A) in paragraph (1)—

(i) in the matter before subparagraph (A), by striking “information,” and all that follows through “facility:” and inserting “information:”;

(ii) in subparagraph (B)—

(I) by inserting “(i)” before “The number”; and

(II) by adding at the end the following new clause:

“(ii) Information made available under this subparagraph shall be updated not less frequently than once each quarter to account for delays in data processing and shall reflect the most recently available data.”;

(iii) in subparagraph (C), by striking “vacancies, by occupation.” and inserting “positions currently undergoing a recruitment action, disaggregated by occupation and by stage of recruitment, including pre-posting, posting processing stage, recruitment stage, onboarding stage, and waiting to start stage, or successor stages if modified.”; and

(iv) by adding at the end the following new subparagraph:

“(F) The number of positions vacated that the Secretary as decided not to backfill, disaggregated by occupation.”;

(B) by redesignating paragraph (5) as paragraph (6);

(C) by inserting after paragraph (4) the following new paragraph (5):

“(5) DISPLAY OF INFORMATION.—The display of information made publicly available on an Internet website of the Department pursuant to paragraph (1), subject to subparagraph (D) of such paragraph, shall be disaggregated—

“(A) by departmental component;

“(B) in the case of information relating to Veterans Health Administration positions, by medical facility; and

“(C) in the case of information relating to Veterans Benefits Administration positions, by regional office.”; and

(D) in paragraph (6), as redesignated by subparagraph (B), by striking “shall” and all that follows and inserting “shall—

“(A) review the administration of the website required under paragraph (1);

“(B) develop recommendations relating to the improvement of such administration; and

“(C) submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report containing—

“(i) the findings of the Inspector General with respect to the most recent review conducted under subparagraph (A); and

“(ii) the recommendations most recently developed under subparagraph (B).”; and

(2) by amending subsection (b) to read as follows:

“(b) Annual report.—Each year, the Secretary shall submit to Congress an annual report that includes the following:

“(1) A description of the steps the Department is taking to achieve full staffing capacity.

“(2) A description of the actions the Department is taking to improve the onboard timeline for facilities of the Department, including—

“(A) in the case of facilities of the Veterans Health Administration, for facilities for which the duration of the onboarding process exceeds the metrics laid out in the Time to Hire Model of the Veterans Health Administration, or successor model; and

“(B) in the case of Veterans Benefits Administration, for regional offices that exceed the time-to-hire target of the Office of Personnel Management.

“(3) The amount of additional funds necessary to enable the Department to reach full staffing capacity.

“(4) Such recommendations for legislative or administrative action as the Secretary may have in order to achieve full staffing capacity at the Department.”.

(b) Effective date.—The amendments made by subsection (a) shall take effect on the date of the enactment of this Act and shall apply with respect to the first update under section 505(a)(3) of such Act beginning after the date of the enactment of this Act and each update thereafter.

(a) In general.—Not later than 18 months after the date of the enactment of this Act, the Comptroller General of the United States shall submit to the Committee on Veterans' Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on human resources modernization conducted by the Veterans Health Administration (in this section referred to as the “Administration”).

(b) Elements.—The report required by subsection (a) shall include an assessment of the following:

(1) The Human Resources Modernization Program of the Administration, including an assessment of the activities carried out under the Program, the results of those activities, and how the Administration measures the performance of those activities.

(2) The human resources information technology systems of the Administration, including the performance, accuracy, efficiency, and user-ability of those systems for human resources professionals, managers with hiring authority, and other employees of the Administration who use those systems.

(3) Metrics and timelines used to report hiring and vacancy data within the Administration, including recruitment and retention data.

(4) Trends in hiring, recruitment, retention, and vacancies among employees of the Administration.

(5) The use by the Administration of authorities and waivers for hiring flexibility, including an assessment of the standardization of use of such authorities and waivers within each Veterans Integrated Service Network.

(6) Training, development, and workload of human resources professionals of the Administration.

(7) Such other matters as the Comptroller General considers relevant.