,i  #aacth ,,congress  #b;d ,session    
,h4 ,r4 #defa  ,,in ,,the ,,house ,,of  
,,representatives  ,may #a1 #bjad ,ms4  
,shea-,porter introduced the following  
bill2 which was referred to the         
,committee on ,veterans' ,affairs  ,a   
,,bill  ,to specify requirements for the
 next update of the current strategic   
plan for the ,office of ,rural ,health  
of the ,department of ,veterans ,affairs
 for improving access to1 and the       
quality of1 health care services for    
veterans in rural areas4  #a4 ,short    
title ,this ,act may be cited as the    
,rural ,veterans ,health ,care          
,improvement ,act of #bjad4  #b4        
,requirements in connection with next   
update of current strategic plan for    
,office of ,rural ,health of the        
,department of ,veterans ,affairs  7a7  
,requirements  7#a7 ,in general ,the    
first update of the ,strategic ,plan    
,refresh for ,fiscal ,years #bjab       
through #bjad of the ,office of ,rural  
,health of the ,department of ,veterans 

,affairs after the date of the enactment
 of this ,act1 whether an update or     
refresh of such ,strategic ,plan        
,refresh or a strategic plan to         
supersede such ,strategic ,plan         
,refresh1 shall be prepared in          
accordance with this section4  7#b7     
,consultation ,the ,director of the     
,office of ,rural ,health shall prepare 
the update in consultation with the     
following3  7,a7 ,the ,director of the  
,health ,care ,retention and            
,recruitment ,office of the ,department4
  7,b7 ,the ,director of the ,office of 
,quality and ,performance of the        
,department4  7,c7 ,the ,director of the
 ,office of ,care ,coordination         
,services of the ,department4  7b7      
,elements ,the update described in      
subsection 7a7 shall include1 for the   
period covered by the update1 the       
following3  7#a7 ,goals and objectives  
for the recruitment and retention by the
 ,veterans ,health ,administration of   
health care personnel in rural areas4   

7#b7 ,goals and objectives for ensuring 
timeliness and improving quality in the 
delivery of health care services by the 
,veterans ,health ,administration in    
rural areas through contract and        
fee-basis providers4  7#c7 ,goals and   
objectives for the implementation1      
expansion1 and enhanced use of          
telemedicine services by the ,veterans  
,health ,administration in rural areas1 
including through coordination with     
other appropriate offices of the        
,department4  7#d7 ,goals and objectives
 for ensuring the full and effective use
 of mobile outpatient clinics by the    
,veterans ,health ,administration for   
the provision of health care services in
 rural areas1 including goals and       
objectives for the use of such clinics  
on a fully mobile basis and for         
encouraging health care providers who   
provide services through such clinics to
 do so in rural areas4  7#e7 ,procedures
 for soliciting from each ,veterans     
,health ,administration facility that   

serves a rural area the following3  7,a7
 ,a statement of the clinical capacity  
of such facility4  7,b7 ,the procedures 
of such facility in the event of a      
medical1 surgical1 or mental health     
emergency outside the scope of the      
clinical capacity of such facility4     
7,c7 ,the procedures and mechanisms of  
such facility for the provision and     
coordination of health care for women   
veterans1 including procedures and      
mechanisms for coordination with local  
hospitals and health care facilities1   
oversight of primary care and fee-basis 
care1 and management of specialty care4 
7#f7 ,goals and objectives for the      
modification of the funding allocation  
mechanisms of the ,office of ,rural     
,health in order to ensure that the     
,office distributes funds to components 
of the ,department to best achieve the  
goals and objectives of the ,office and 
in a timely manner4  7#g7 ,goals and    
objectives for the coordination of1 and 
sharing of resources with respect to1   

the provision of health care services to
 veterans in rural areas between the    
,department of ,veterans ,affairs1 the  
,department of ,defense1 the ,indian    
,health ,service of the ,department of  
,health and ,human ,services1 and other 
,federal agencies1 as appropriate and   
prudent4  7#h7 ,specific milestones for 
the achievement of the goals and        
objectives developed for the update4    
7#i7 ,procedures for ensuring the       
effective implementation of the update4 
7c7 ,transmittal to ,congress ,not later
 than #ij days after the date of the    
issuance of the update described in     
subsection 7a71 the ,secretary of       
,veterans ,affairs shall transmit the   
update to ,congress1 together with such 
comments and recommendations in         
connection with the update as the       
,secretary considers appropriate4