,,ii  #aac? ,,congress  #a/ ,session    
,s4 #edc  ,,9 ,,! ,,s5ate ,,( ,,!       
,,unit$ ,,/ates  ,m>* #ac1 #bjac ,mr4   
,burr 7= himself & ,mr4 ,coburn7        
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,vet]ans' ,affairs  ,a ,,bill  ,to      
require ! ,secret>y ( ,vet]ans ,affairs 
to reorganize ! ,vet]ans ,integrat$     
,s]vice ,networks ( ! ,vet]ans ,heal?   
,adm9i/ration1 & = o!r purposes4  #a4   
,%ort title ,?is ,act may be cit$ z !   
,,visn ,reorganization ,act ( #bjac4    
#b4 ,adm9i/ration ( ,vet]ans ,integrat$ 
,s]vice ,networks  7a7 ,vet]ans         
,integrat$ ,s]vice ,networks  7#a7 ,9   
g5]al ,sub*apt] ,i ( *apt] #gc ( title  
#ch1 ,unit$ ,/ates ,code1 is am5d$ by   
add+ at ! end ! foll[+ new section3     
#gcaj4 ,vet]ans ,integrat$ ,s]vice      
,networks  7a7 ,organization ,!         
,secret>y %all organize ! ,vet]ans      
,heal? ,adm9i/ration 9 #ab              
geographically def9$ ,vet]ans ,integrat$
 ,s]vice ,networks4  7b7 ,alignm5t )    

mission ( ,dep>tm5t ,! ,secret>y %all   
ensure t ! /aff1 s]vices1 & programs (  
ea* ,vet]ans ,integrat$ ,s]vice ,network
 are align$ ) ! mission ( ! ,dep>tm5t & 
! specific heal? c>e requirem5ts ( ea*  
population ( vet]ans 9 ea* ,network4    
7c7 ,implem5tation ( ,national goals ,! 
,secret>y %all ensure t ea* ,vet]ans    
,integrat$ ,s]vice ,network takes       
appropriate measures to implem5t !      
national goals ( ! ,dep>tm5t )9 _!      
networks & associat$ m$ical c5t]s4  7d7 
,integrat$ heal? c>e sy/em ,! ,secret>y 
%all ensure t ea* ,vet]ans ,integrat$   
,s]vice ,network ma9ta9s a regional     
integrat$ heal?c>e sy/em by--  7#a7     
implem5t+ alliances ) su* o!r           
gov]nm5tal1 public1 & private heal? c>e 
organizations & practition]s z !        
,secret>y consid]s appropriate to meet !
 ne$s ( vet]ans 9 ! ,network2  7#b7     
provid+ ov]sight & managem5t (1 & tak+  
responsibility =1 a regional budget = ! 
activities ( ! ,vet]ans ,heal?          
,adm9i/ration 9 ! geographic area ( !   

,network t--  7,a7 is align$ ) ! budget 
guidel9es ( ! ,dep>tm5t & ! ,vet]ans    
,heal? ,adm9i/ration2 &  7,b7 is balanc$
 at ! end ( ea* fiscal ye>2  7#c7 us+   
national metrics to develop sy/ems to   
provide effective1 effici5t1 & safe     
deliv]y ( heal? c>e t is rat$ z highly  
satisfactory by pati5ts & families (    
pati5ts2 &  7#d7 ensur+ high quality    
cl9ical programs & s]vices are r5d]$ 9 &
 ?r\gh--  7,a7 ! m$ical c5t]s &         
outpati5t cl9ics ( ! ,dep>tm5t t are    
locat$ 9 ! ,network2 &  7,b7 o!r        
non-,dep>tm5t cl9ical or heal? c>e      
deliv]y sett+s locat$ 9 ! ,network4  7e7
 ,r$uction 9 duplicate functions ,!     
,secret>y %all ensure t ! ,vet]ans      
,integrat$ ,s]vice ,networks id5tify &  
r$uce1 :5ev] practicable1 ! duplication 
( functions 9 cl9ical1 adm9i/rative1 &  
op]ational processes & practices ( !    
,vet]ans ,heal? ,adm9i/ration4  7f7     
,collaboration & coop]ation ,! ,secret>y
 %all ensure t ea* ,vet]an ,integrat$   
,s]vice ,network--  7#a7 works to a*ieve

 maximum effectiv5ess 9 pati5t c>e &    
safety1 graduate m$ical education1 &    
rese>*2 &  7#b7 assesses ! consolidation
 or realignm5t ( in/itutional functions1
 includ+ capital asset1 safety1 &       
op]ational support functions1 9         
collaboration & coop]ation ) o!r        
,vet]ans ,integrat$ ,s]vice ,networks & 
! foll[+ (fices or entities )9 !        
geographical area ( ! ,network3  7,a7 ,!
 (fices ( ! ,vet]ans ,b5efits           
,adm9i/ration & ! ,national ,cemet]y    
,adm9i/ration4  7,b7 ,! (fices1         
in/allations1 & facilities ( ! ,dep>tm5t
 ( ,def5se1 includ+ ! (fices1           
in/allations1 & facilities ( ea* bran* (
 ! ,arm$ ,=ces & ! res]ve compon5ts ( ! 
,arm$ ,=ces4  7,c7 ,! (fices1           
in/allations1 & facilities ( ! ,coa/    
,gu>d4  7,d7 ,(fices ( ,/ate & local    
ag5cies t h a mission to provide        
assi/ance to vet]ans4  7,e7 ,m$ical     
s*ools & o!r affiliates4  7,f7 ,(fices (
 ,congress1 (fices ( ,/ate & local      
elect$ (ficials1 & o!r gov]nm5t (fices4 

7,g7 ,f$]al1 ,/ate & local em]g5cy      
prep>$ness organizations4  7,h7         
,community & fai?-bas$ organizations4   
7,i7 ,su* o!r (fices ( ! ,f$]al         
,gov]nm5t z ! ,secret>y consid]s        
appropriate4  7g7 ,developm5t & %>+ (   
innovations & practices ,! ,secret>y    
%all ensure t ! ,vet]ans ,integrat$     
,s]vice ,networks develop & %>e         
innovations & be/ practices ) ea* o!r at
 ! local1 regional1 & national levels4  
7h7 ,headqu>t]s  7#a7 ,! ,secret>y %all 
ensure t ea* ,vet]ans ,integrat$ ,s]vice
 ,network has only "o headqu>t]s (fice4 
7#b7 ,! location ( a headqu>t]s (fice = 
a ,vet]ans ,integrat$ ,s]vice ,network  
%all be det]m9$ by ! ,secret>y &        
co-locat$ ) a ,dep>tm5t ( ,vet]ans      
,affairs m$ical c5t]4  7#c7 7,a7 ,!     
,secret>y may employ or contract = !    
s]vices ( n m ?an #fe full "t equival5t 
employees & contractors at ! headqu>t]s 
( ea* ,vet]ans ,integrat$ ,s]vice       
,network4  7,b7 ,n less frequ5tly ?an   
once ea* ye>1 ! ,secret>y %all submit to

 ! ,committee on ,vet]ans' ,affairs ( ! 
,s5ate & ! ,committee on ,vet]ans'      
,affairs ( ! ,h\se ( ,repres5tatives a  
report on employm5t at ! headqu>t]s (   
,vet]ans ,integrat$ ,s]vice ,networks   
dur+ ! mo/ rec5tly complet$ fiscal ye>4 
7,c7 ,ea* report submitt$ "u subp>agraph
 7,b7 %all include ! foll[+ = ! ye>     
cov]$ by ! report3  7i7 ,! numb] (      
individuals employ$ at ea* headqu>t]s ( 
a ,vet]ans ,integrat$ ,s]vice ,network4 
7ii7 ,! numb] ( individuals employ$ by !
 ,vet]ans ,heal? ,adm9i/ration 9 ea*    
,vet]ans ,integrat$ ,s]vice ,network :o 
are n employ$ at ! same location z !    
headqu>t]s ( ! ,network4  7iii7 ,! title
 = ea* position ( employm5t at a        
headqu>t]s ( a ,vet]ans ,integrat$      
,s]vice ,network4  7iv7 ,! title = ea*  
position ( employm5t ) ! ,vet]ans ,heal?
 ,adm9i/ration 9 ea* ,vet]ans ,integrat$
 ,s]vice ,network t is n at ! same      
location z ! headqu>t]s ( ! ,network4   
7v7 ,an assessm5t ( ! impact on ! budget
 ( ! ,dep>tm5t by ! employm5t (         

individuals at ! headqu>t]s ( ! ,vet]ans
 ,integrat$ ,s]vice ,networks4  7i7     
,tri5nial /ructure review1 reassessm5t1 
& report  7#a7 ,beg9n+ ?ree ye>s aft] ! 
date ( ! enactm5t ( ?is section & n less
 frequ5tly ?an once e ?ree ye>s !reaft]1
 ! ,secret>y %all conduct a review &    
assessm5t ( ! /ructure & op]ations ( !  
,vet]ans ,integrat$ ,s]vice ,networks4  
7#b7 ,n lat] ?an #ahj days aft] conduct+
 a review & assessm5t "u p>agraph 7#a71 
! ,secret>y %all submit to ! ,committee 
on ,vet]ans' ,affairs ( ! ,s5ate & !    
,committee on ,vet]ans' ,affairs ( !    
,h\se ( ,repres5tatives a report on su* 
review & assessm5t1 :i* %all include su*
 recomm5dations = legislative or        
regulatory action z ! ,secret>y consid]s
 appropriate to improve ! ,vet]ans      
,integrat$ ,s]vice ,networks4  4  7#b7  
,cl]ical am5dm5t ,! table ( sections at 
! beg9n+ ( *apt] #gc ( su* title is     
am5d$ by ins]t+ aft] ! item relat+ to   
section #gcji ! foll[+ new item3  #gcaj4
 ,vet]ans ,integrat$ ,s]vice ,networks4 

4  7b7 ,consolidation ( networks  7#a7  
,9 g5]al ,9 ord] to comply ) section    
#gcaj7;a7 ( title #ch1 ,unit$ ,/ates    
,code1 z add$ by subsection 7a71 n lat] 
?an "o ye> aft] ! date ( ! enactm5t (   
?is ,act1 ! ,secret>y ( ,vet]ans        
,affairs %all geographically realign &  
comb9e ! #ba ,vet]ans ,integrat$ ,s]vice
 ,networks 9 effect on ! day be=e ! date
 ( ! enactm5t ( ?is ,act into #ab       
geographically def9$ ,vet]ans ,integrat$
 ,s]vice ,networks z foll[s3  7,a7      
,vet]ans ,integrat$ ,s]vice ,network #a1
 ,vet]ans ,integrat$ ,s]vice ,network   
#b1 & ,vet]ans ,integrat$ ,s]vice       
,network #c %all be comb9$ into a s+le  
,vet]ans ,integrat$ ,s]vice ,network4   
7,b7 ,vet]ans ,integrat$ ,s]vice        
,network #d & ,vet]ans ,integrat$       
,s]vice ,network #e %all be comb9$ into 
a s+le ,vet]ans ,integrat$ ,s]vice      
,network4  7,c7 ,vet]ans ,integrat$     
,s]vice ,network #i & ,vet]ans          
,integrat$ ,s]vice ,network #aj %all be 
comb9$ into a s+le ,vet]ans ,integrat$  

,s]vice ,network4  7,d7 ,vet]ans        
,integrat$ ,s]vice ,network #aa &       
,vet]ans ,integrat$ ,s]vice ,network #ab
 %all be comb9$ into a s+le ,vet]ans    
,integrat$ ,s]vice ,network4  7,e7      
,vet]ans ,integrat$ ,s]vice ,network #ae
 & ,vet]ans ,integrat$ ,s]vice ,network 
#bc %all be comb9$ into a s+le ,vet]ans 
,integrat$ ,s]vice ,network4  7,f7      
,vet]ans ,integrat$ ,s]vice ,network #ag
 & ,vet]ans ,integrat$ ,s]vice ,network 
#ah %all be comb9$ into a s+le ,vet]ans 
,integrat$ ,s]vice ,network4  7,g7      
,vet]ans ,integrat$ ,s]vice ,network #ai
 & ,vet]ans ,integrat$ ,s]vice ,network 
#bj %all be comb9$ into a s+le ,vet]ans 
,integrat$ ,s]vice ,network4  7,h7      
,vet]ans ,integrat$ ,s]vice ,network #ba
 & ,vet]ans ,integrat$ ,s]vice ,network 
#bb %all be comb9$ into a s+le ,vet]ans 
,integrat$ ,s]vice ,network4  7#b7      
,consolidation ( headqu>t]s  7,a7 ,9    
g5]al ,except z provid$ 9 subsection    
7c71 = ea* set ( ,vet]ans ,integrat$    
,s]vice ,networks consolidat$ "u        

p>agraph 7#a71 ! ,secret>y %all reta9 "o
 ( ! headqu>t]s ( su* set 9 effect on ! 
day be=e ! date ( ! enactm5t ( ?is ,act 
9 ! same location z 9 effect on ! day   
be=e su* date & elim9ate any o!r        
headqu>t]s ( su* set to meet !          
requirem5ts ( section #gcaj7;h7 ( su*   
title1 z add$ by subsection 7a74  7,b7  
,reemploym5t assi/ance ,= ea* individual
 ^: position ( employm5t is elim9at$ z a
 result ( elim9at+ a headqu>t]s "u      
subp>agraph 7,a71 ! ,secret>y %all take 
su* measures z ! ,secret>y consid]s     
practicable to f9d a new position (     
employm5t = su* individual )9 !         
,dep>tm5t ( ,vet]ans ,affairs4  7#c7    
,implem5tation plan ,n lat] ?an #ahj    
days aft] ! date ( ! enactm5t ( ?is     
,act1 ! ,secret>y %all submit to !      
,committee on ,vet]ans' ,affairs ( !    
,s5ate & ! ,committee on ,vet]ans'      
,affairs ( ! ,h\se ( ,repres5tatives a  
plan to c>ry out ?is subsection4  7c7   
,relocation ( headqu>t]s  7#a7 ,9 g5]al 
,9 ! case ( a headqu>t]s (fice ( a      

,vet]ans ,integrat$ ,s]vice ,network t  
on ! day be=e ! date ( ! enactm5t ( ?is 
,act 0 9 a location t 0 n co-locat$ ) a 
,dep>tm5t ( ,vet]ans ,affairs m$ical    
c5t] & ! ,secret>y is engag$ 9 a lease =
 su* location1 ! ,secret>y may--  7,a7  
relocate su* headqu>t]s ^u ! expiration 
( su* lease s t su* headqu>t]s is       
co-locat$ z requir$ by section          
#gcaj7;h77#b7 ( su* title1 z add$ by    
subsection 7a72 or  7,b7 not)/&+ section
 #gcaj7;h77#b7 ( su* title1 z s add$1   
r5ew su* lease or ent] into a new lease 
to keep su* headqu>t]s 9 su* location4  
7#b7 ,report ,if ! ,secret>y r5ews a    
lease or engages 9 a new lease "u       
p>agraph 7#a77;,b71 ! ,secret>y %all    
submit to ! ,committee on ,vet]ans'     
,affairs ( ! ,s5ate & ! ,committee on   
,vet]ans' ,affairs ( ! ,h\se (          
,repres5tatives1 be=e r5ew+ su* lease or
 engag+ 9 su* lease1 a report describ+ !
 reasons = su* r5ewal or engagem5t4 ,su*
 report %all include ! foll[+3  7,a7 ,a 
li/ ( ,dep>tm5t ( ,vet]ans ,affairs     

m$ical c5t]s 9 ! ,vet]ans ,integrat$    
,s]vice ,network ( ! headqu>t]s )       
und]utiliz$ build+s1 ! numb] ( su*      
build+s1 & ! total und]utiliz$ squ>e    
footage = ea* su* m$ical c5t]4  7,b7 ,! 
co/ ( ! curr5t lease 7! annual am\nt (  
r5t1 ! total co/ ov] ! life ( ! lease1 &
 ! total co/ p] squ>e foot7 & ! curr5t  
squ>e footage be+ leas$4  7,c7 ,! co/ ( 
! new lease 7! annual am\nt ( r5t1 !    
total co/ ov] ! life ( ! lease1 & !     
total co/ p] squ>e foot7 & ! squ>e      
footage to be leas$4  #c4 ,regional     
support c5t]s = ,vet]ans ,integrat$     
,s]vice ,networks  7a7 ,regional support
 c5t]s  7#a7 ,9 g5]al ,sub*apt] ,i (    
*apt] #gc ( title #ch1 ,unit$ ,/ates    
,code1 z am5d$ by section #b7;a71 is    
fur!r am5d$ by add+ at ! end ! foll[+   
new section3  #gcaj;,a4 ,regional       
support c5t]s = ,vet]ans ,integrat$     
,s]vice ,networks  7a7 ,e/abli%m5t ,!   
,secret>y %all e/abli% n m ?an f\r      
regional support c5t]s )9 ! ,vet]ans    
,heal? ,adm9i/ration to assess !        

effectiv5ess & effici5cy ( ! ,vet]ans   
,integrat$ ,s]vice ,networks4 ,! head ( 
ea* regional support c5t] %all report to
 ! ,"u ,secret>y ( ,heal?4  7b7         
,functions ,! functions ( ! regional    
support c5t]s e/abli%$ "u subsection 7a7
 are z foll[s3  7#a7 ,to assess !       
quality ( "w p]=m$ )9 f9ance op]ations &
 o!r compliance relat$ activities ( !   
,vet]ans ,integrat$ ,s]vice ,networks4  
7#b7 ,to assess h[ effectively &        
effici5tly ea* ,vet]ans ,integrat$      
,s]vice ,network conducts outrea* to    
vet]ans :o s]v$ 9 ,op]ation ,endur+     
,fre$om1 ,op]ation ,iraqi ,fre$om1      
,op]ation ,new ,dawn1 or ano!r cont+5cy 
op]ation 7z def9$ 9 section #aja ( title
 #aj74  7#c7 ,to assess h[ effectively &
 effici5tly ea* ,vet]ans ,integrat$     
,s]vice ,network conducts programs = !  
b5efit ( wom5 vet]ans4  7#d7 ,to assess 
h[ effectively & effici5tly ea* ,vet]ans
 ,integrat$ ,s]vice ,network conducts   
programs t address homelessness among   
vet]ans4  7#e7 ,to assess h[ effectively

 & effici5tly ea* ,vet]ans ,integrat$   
,s]vice ,network consumes en]gy4  7#f7  
,to assess su* o!r matt]s conc]n+ !     
op]ations & activities ( ! ,vet]ans     
,integrat$ ,s]vice ,networks z !        
,secret>y consid]s appropriate4  7c7    
,/aff ,! ,secret>y may hire su*         
employees & contractors z ! ,secret>y   
consid]s appropriate to c>ry out !      
functions ( ! regional support c5t]s4   
7d7 ,location ( regional support c5t]s  
7#a7 ,except z provid$ 9 p>agraph 7#b71 
! location ( ea* regional support c5t]  
e/abli%$ "u subsection 7a7 %all be      
det]m9$ by ! ,secret>y & co-locat$ ) a  
,dep>tm5t ( ,vet]ans ,affairs m$ical    
c5t]4  7#b7 ,! ,secret>y may *oose a    
location = a regional support c5t]      
e/abli%$ "u subsection 7a7 t is n       
co-locat$ ) a ,dep>tm5t ( ,vet]ans      
,affairs m$ical c5t] if ! ,secret>y     
submits to ! ,committee on ,vet]ans'    
,affairs ( ! ,s5ate & ! ,committee on   
,vet]ans' ,affairs ( ! ,h\se (          
,repres5tatives1 be=e engag+ 9 a lease =

 su* location1 a report expla9+ !       
reasons = ! *oice ( ! ,secret>y ( a     
location = ! regional support c5t] t is 
n co-locat$ ) a ,dep>tm5t ( ,vet]ans    
,affairs m$ical c5t]4 ,su* report %all  
include ! foll[+3  7,a7 ,a li/ (        
,dep>tm5t ( ,vet]ans ,affairs m$ical    
c5t]s 9 ! ,vet]ans ,integrat$ ,s]vice   
,network ( ! regional support c5t] )    
und]utiliz$ build+s1 ! numb] ( all      
,vet]ans ,heal? ,adm9i/ration build+s 9 
su* ,network1 & ! total und]utiliz$     
squ>e footage = ea* m$ical c5t] 9 su*   
,network4  7,b7 ,9 ! case t ! ,secret>y 
engages 9 a lease = ! location ( !      
regional support c5t]1 ! co/ ( su* lease
 7! annual am\nt ( r5t1 ! total co/ ov] 
! life ( ! lease1 & ! total co/ p] squ>e
 foot7 & ! squ>e footage to be leas$4  4
  7#b7 ,cl]ical am5dm5t ,! table (      
sections at ! beg9n+ ( *apt] #gc ( su*  
title1 z am5d$ by section #b7;a77#b71 is
 fur!r am5d$ by ins]t+ aft] ! item      
relat+ to section #gcaj ! foll[+ new    
item3  #gcaj;,a4 ,regional support c5t]s

 = ,vet]ans ,integrat$ ,s]vice          
,networks4  4  7b7 ,initial /aff+ ,9    
provid+ = ! initial /aff ( ea* regional 
support c5t] e/abli%$ "u section        
#gcaj;,a7a7 ( title #ch1 ,unit$ ,/ates  
,code1 z add$ by subsection 7a71 !      
,secret>y ( ,vet]ans ,affairs %all1 to !
 ext5t practicable1 transf] employees :o
 7 employ$ 9 positions at headqu>t]s (  
,vet]ans ,integrat$ ,s]vice ,networks t 
cov]$ functions simil> to ^? describ$ 9 
section #gcaj;,a7b7 ( su* title1 z s    
add$1 f su* headqu>t]s to regional      
support c5t]s4  #d4 ,con/ruction ,no?+ 9
 ?is ,act %all be con/ru$ to require any
 *ange 9 ! location or type ( m$ical c>e
 or s]vice provid$ by a ,dep>tm5t (     
,vet]ans ,affairs m$ical c5t]1 a        
,dep>tm5t community-bas$ outpati5t      
cl9ic1 a c5t] = readju/m5t c\nsel+ &    
relat$ m5tal heal? s]vices = vet]ans "u 
section #agab;,a ( title #ch1 ,unit$    
,/ates ,code 7kn[n z a vet c5t]71 or    
ano!r facility t provides direct c>e or 
s]vices "u a law adm9i/]$ by ! ,secret>y

 ( ,vet]ans ,affairs4