,,ii  #aacth ,,congress  #ast ,session  
,s4 #heb  ,,in ,,the ,,senate ,,of ,,the
 ,,united ,,states  ,april #be1 #bjac   
,mr4 ,sanders introduced the following  
bill2 which was read twice and referred 
to the ,committee on ,veterans' ,affairs
  ,a ,,bill  ,to improve health care    
furnished by the ,department of         
,veterans ,affairs by increasing access 
to complementary and alternative        
medicine and other approaches to        
wellness and preventive care1 and for   
other purposes4  #a4 ,short title ,this 
,act may be cited as the ,veterans'     
,health ,promotion ,act of #bjac4  #b4  
,designation and operation of centers of
 ,innovation for complementary and      
alternative medicine in health care     
research1 education1 and clinical       
activities  7a7 ,designation and        
operation of centers of innovation      
,subchapter ,,ii of chapter #gc of title
 #ch1 ,united ,states ,code1 is amended 
by adding at the end the following new  
section3  #gccj;,b4 ,centers of         

innovation for complementary and        
alternative medicine in health care     
research1 education1 and clinical       
activities  7a7 ,designation and        
operation ,the ,secretary1 acting       
through the ,director of the ,office of 
,patient ,centered ,care for ,cultural  
,transformation1 shall designate and    
operate at least one center of          
innovation for complementary and        
alternative medicine in health research1
 education1 and clinical activities in  
each ,veterans ,integrated ,service     
,networks4  7b7 ,functions ,the         
functions of the centers of innovation  
designated and operated under subsection
 7a7 are as follows3  7#a7 ,to conduct  
research on the furnishing of           
complementary and alternative medicine  
in health care4  7#b7 ,to develop       
specific models to be used by the       
,department in furnishing services to   
veterans consisting of complementary and
 alternative medicine4  7#c7 ,to provide
 education and training for health care 

professionals of the ,department on--   
7,a7 the furnishing of services         
consisting of complementary and         
alternative medicine to veterans2 or    
7,b7 providing referrals to veterans for
 the receipt of such services4  7#d7 ,to
 develop and implement innovative       
clinical activities and systems of care 
for the ,department for the furnishing  
of services consisting of complementary 
and alternative medicine to veterans4   
7c7 ,geographic dispersion ,the         
,secretary shall ensure that the centers
 designated and operated under this     
section are located at health care      
facilities that are geographically      
dispersed throughout the ,united        
,states4  7d7 ,funding  7#a7 ,there is  
authorized to be appropriated to the    
,secretary such sums as may be necessary
 for the support of the research and    
education activities of the centers     
operated under this section4  7#b7      
,activities of clinical and scientific  
investigation at each center operated   

under this section--  7,a7 shall be     
eligible to compete for the award of    
funding from funds appropriated for the 
,medical and ,prosthetics ,research     
,account2 and  7,b7 shall receive       
priority in the award of funding from   
such account to the extent that funds   
are awarded to projects for research on 
the care of rural veterans4  7e7        
,complimentary and alternative medicine 
defined ,in this section1 the term      
complimentary and alternative medicine  
shall have the meaning given that term  
in regulations the ,secretary shall     
prescribe for purposes of this section1 
which shall1 to the degree practicable1 
be consistent with the meaning given    
such term by the ,secretary of ,health  
and ,human ,services4  4  7b7 ,clerical 
amendment ,the table of sections at the 
beginning of chapter #gc of such title  
is amended by inserting after the item  
relating to section #gccj;,a the        
following new item3  #gccj;,b4 ,centers 
of ,innovation for complementary and    

alternative medicine in health care     
research1 education1 and clinical       
activities4  4  #c4 ,pilot program on   
establishment of complementary and      
alternative medicine centers within     
,department of ,veterans ,affairs       
medical centers  7a7 ,pilot program     
required ,commencing not later than #ahj
 days after the date of the enactment of
 this ,act1 the ,secretary of ,veterans 
,affairs shall carry out1 through the   
,office of ,patient ,centered ,care and 
,cultural ,transformation of the        
,department of ,veterans ,affairs1 a    
pilot program to assess the feasibility 
and advisability of establishing        
complementary and alternative medicine  
centers within ,department medical      
centers to promote the use and          
integration of complementary and        
alternative medicine services for mental
 health diagnoses and pain management4  
7b7 ,duration of program ,the pilot     
program shall be carried out during the 
three-year period beginning on the date 

of the commencement of the pilot        
program4  7c7 ,locations  7#a7 ,in      
general ,the ,secretary shall carry out 
the pilot program by establishing not   
fewer than #ae complementary and        
alternative medicine centers in #ae     
separate ,department medical centers as 
follows3  7,a7 ,five ,department medical
 centers designated by the ,secretary as
 polytrauma centers4  7,b7 ,ten         
,department medical centers not         
designated by ,secretary as polytrauma  
centers4  7#b7 ,considerations ,in      
selecting locations for the pilot       
program1 the ,secretary shall consider  
the feasibility and advisability of     
selecting locations in--  7,a7 rural    
areas2  7,b7 areas that are not in close
 proximity to an active duty military   
installation2 and  7,c7 areas           
representing different geographic       
locations1 such as census tracts        
established by the ,bureau of the       
,census4  7d7 ,provision of services    
,under the pilot program1 the ,secretary

 shall provide covered services to      
covered veterans through the            
complementary and alternative medicine  
centers established under subsection    
7c77#a74  7e7 ,covered veterans ,for    
purposes of the pilot program1 a covered
 veteran is any veteran who has--  7#a7 
a mental health condition diagnosed by a
 clinician of the ,department2 or  7#b7 
a pain condition for which the veteran  
has received a pain management plan from
 a clinician of the ,department4  7f7   
,covered services  7#a7 ,in general ,for
 purposes of the pilot program1 covered 
services are services consisting of     
complementary or alternative medicine4  
7#b7 ,administration of services        
,covered services shall be administered 
under the pilot program as follows3     
7,a7 ,covered services shall be         
administered by clinicians who          
exclusively provide services consisting 
of complementary or alternative         
medicine4  7,b7 ,covered services shall 
be included as part of the ,patient     

,aligned ,care ,teams initiative of the 
,office of ,patient ,care ,services1    
,primary ,care ,program ,office4  7,c7  
,covered services shall be made         
available to both--  7i7 covered        
veterans with mental health conditions  
or pain conditions described in         
subsection 7e7 who have received        
traditional treatments from the         
,department for such conditions2 and    
7ii7 covered veterans with mental health
 conditions or pain conditions described
 in subsection 7e7 who have not received
 traditional treatments from the        
,department for such conditions4  7g7   
,voluntary participation ,the           
participation of a veteran in the pilot 
program shall be at the election of the 
veteran and in consultation with a      
clinician of the ,department4  7h7      
,reports to ,congress  7#a7 ,quarterly  
reports ,not later than #ij days after  
the date of the commencement of the     
pilot program and not less frequently   
than once every #ij days thereafter for 

the duration of the pilot program1 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 efforts
 of the ,secretary to carry out the     
pilot program1 including a description  
of the outreach conducted by the        
,secretary to veterans and community    
organizations to inform such            
organizations about the pilot program4  
7#b7 ,final report  7,a7 ,in general    
,not later than #ahj days after the     
completion of the pilot program1 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 pilot  
program4  7,b7 ,contents ,the report    
submitted under subparagraph 7,a7 shall 
include the following3  7i7 ,the        
findings and conclusions of the         
,secretary with respect to the pilot    

program1 including with respect to the  
utilization and efficacy of the         
complementary and alternative medicine  
centers established under the pilot     
program4  7ii7 ,such recommendations for
 the continuation or expansion of the   
pilot program as the ,secretary         
considers appropriate4  #d4 ,pilot      
program on use of wellness programs as  
complementary approach to mental health 
care for veterans and family members of 
veterans  7a7 ,pilot program required   
7#a7 ,in general ,the ,secretary of     
,veterans ,affairs shall carry out a    
pilot program through the award of      
grants to public or private nonprofit   
entities to assess the feasibility and  
advisability of using wellness programs 
to complement the provision of mental   
health care to veterans and family      
members eligible for counseling under   
section #agab;,a7a77#a77;,c7 of title   
#ch1 ,united ,states ,code4  7#b7       
,matters to be addressed ,the pilot     
program shall be carried out so as to   

assess the following3  7,a7 ,means of   
improving coordination between ,federal1
 ,state1 local1 and community providers 
of health care in the provision of      
mental health care to veterans and      
family members described in paragraph   
7#a74  7,b7 ,means of enhancing         
outreach1 and coordination of outreach1 
by and among providers of health care   
referred to in subparagraph 7,a7 on the 
mental health care services available to
 veterans and family members described  
in paragraph 7#a74  7,c7 ,means of using
 wellness programs of providers of      
health care referred to in subparagraph 
7,a7 as complements to the provision by 
the ,department of ,veterans ,affairs of
 mental health care to veterans and     
family members described in paragraph   
7#a74  7,d7 ,whether wellness programs  
described in subparagraph 7,c7 are      
effective in enhancing the quality of   
life and well-being of veterans and     
family members described in paragraph   
7#a74  7,e7 ,whether wellness programs  

described in subparagraph 7,c7 are      
effective in increasing the adherence of
 veterans described in paragraph 7#a7 to
 the primary mental health services     
provided such veterans by the           
,department4  7,f7 ,whether wellness    
programs described in subparagraph 7,c7 
have an impact on the sense of wellbeing
 of veterans described in paragraph 7#a7
 who receive primary mental health      
services from the ,department4  7,g7    
,whether wellness programs described in 
subparagraph 7,c7 are effective in      
encouraging veterans receiving health   
care from the ,department to adopt a    
more healthy lifestyle4  7b7 ,duration  
,the ,secretary shall carry out the     
pilot program for a period of three     
years beginning on the date that is #ij 
days after the date of the enactment of 
this ,act4  7c7 ,locations ,the         
,secretary shall carry out the pilot    
program at facilities of the ,department
 providing mental health care services  
to veterans and family members described

 in subsection 7a77#a74  7d7 ,grant     
proposals  7#a7 ,in general ,a public or
 private nonprofit entity seeking the   
award of a grant under this section     
shall submit an application therefor to 
the ,secretary in such form and in such 
manner as the ,secretary may require4   
7#b7 ,application contents ,each        
application submitted under paragraph   
7#a7 shall include the following3  7,a7 
,a plan to coordinate activities under  
the pilot program1 to the extent        
possible1 with the ,federal1 ,state1 and
 local providers of services for        
veterans to enhance the following3  7i7 
,awareness by veterans of benefits and  
health care services provided by the    
,department4  7ii7 ,outreach efforts to 
increase the use by veterans of services
 provided by the ,department4  7iii7    
,educational efforts to inform veterans 
of the benefits of a healthy and active 
lifestyle4  7,b7 ,a statement of        
understanding from the entity submitting
 the application that1 if selected1 such

 entity will be required to report to   
the ,secretary periodically on          
standardized data and other performance 
data necessary to evaluate individual   
outcomes and to facilitate evaluations  
among entities participating in the     
pilot program4  7,c7 ,other requirements
 that the ,secretary may prescribe4  7e7
 ,grant uses  7#a7 ,in general ,a public
 or private nonprofit entity awarded a  
grant under this section shall use the  
award for purposes prescribed by the    
,secretary4  7#b7 ,eligible veterans and
 family ,in carrying out the purposes   
prescribed by the ,secretary in         
paragraph 7#a71 a public or private     
nonprofit entity awarded a grant under  
this section shall use the award to     
furnish services only to individuals    
specified in section                    
#agab;,a7a77#a77;,c7 of title #ch1      
,united ,states ,code4  7f7 ,reports    
7#a7 ,periodic reports  7,a7 ,in general
 ,not later than #ahj days after the    
date of the enactment of this ,act1 and 

every #ahj days thereafter1 the         
,secretary shall submit to ,congress a  
report on the pilot program4  7,b7      
,report elements ,each report required  
by subparagraph 7,a7 shall include the  
following3  7i7 ,the findings and       
conclusions of the ,secretary with      
respect to the pilot program during the 
#ahj-;day period preceding the report4  
7ii7 ,an assessment of the benefits of  
the pilot program to veterans and their 
family members during the #ahj-;day     
period preceding the report4  7#b7      
,final report ,not later than #ahj days 
after the end of the pilot program1 the 
,secretary shall submit to ,congress a  
report detailing the recommendations of 
the ,secretary as to the advisability of
 continuing or expanding the pilot      
program4  7g7 ,wellness defined ,in this
 section1 the term wellness shall have  
the meaning given that term in          
regulations prescribed by the           
,secretary4  #e4 ,pilot program on      
health promotion for overweight and     

obese veterans through support of       
fitness center membership  7a7 ,pilot   
program required ,commencing not later  
than #ahj days after the date of the    
enactment of this ,act1 the ,secretary  
of ,veterans ,affairs shall1 through the
 ,national ,center for ,preventive      
,health1 carry out a pilot program to   
assess the feasibility and advisability 
of promoting health in covered veterans1
 including achieving a healthy weight   
and reducing risks of chronic disease1  
through support for fitness center      
membership4  7b7 ,covered veterans ,for 
purposes of this section1 a covered     
veteran is any veteran who--  7#a7 is   
determined by a clinician of the        
,department of ,veterans ,affairs to be 
overweight or obese as of the date of   
the commencement of the pilot program2  
and  7#b7 resides in a location that is 
more than #ae minutes driving distance  
from a fitness center at a facility of  
the ,department that would otherwise be 
available to the veteran for at least   

eight hours per day during five or more 
days per week4  7c7 ,duration of pilot  
program ,the pilot program shall be     
carried out during the two-year period  
beginning on the date of the            
commencement of the pilot program4  7d7 
,locations  7#a7 ,in general ,in        
carrying out the pilot program1 the     
,secretary shall select--  7,a7 not less
 than five medical centers of the       
,department at which the ,secretary     
shall cover the full reasonable cost of 
a fitness center membership for covered 
veterans within the catchment area of   
such centers2 and  7,b7 not less than   
five medical centers of the ,department 
at which the ,secretary shall cover half
 the reasonable cost of a fitness center
 membership for covered veterans within 
the catchment area of such centers4     
7#b7 ,considerations ,in selecting      
locations for the pilot program1 the    
,secretary shall consider the           
feasibility and advisability of         
selecting locations in the following    

areas3  7,a7 ,rural areas4  7,b7 ,areas 
that are not in close proximity to an   
active duty military installation4  7,c7
 ,areas in different geographic         
locations4  7e7 ,participation  7#a7    
,maximum number of participants ,the    
number of covered veterans who may      
participate in the pilot program at a   
location selected under subsection 7d7  
may not exceed #ajj4  7#b7 ,voluntary   
participation ,the participation of a   
covered veteran in the pilot program    
shall be at the election of the covered 
veteran in consultation with a clinician
 of the ,department4  7f7 ,membership   
payment  7#a7 ,in general ,except as    
provided in paragraph 7#b71 in carrying 
out the pilot program1 the ,secretary   
shall pay the following3  7,a7 ,the full
 reasonable cost of a fitness center    
membership for covered veterans within  
the catchment area of centers selected  
under subsection 7b77#a77;,a7 who are   
participating in the pilot program4     
7,b7 ,half the reasonable cost of a     

fitness center membership for covered   
veterans within the catchment area of   
centers selected under subsection       
7b77#a77;,b7 who are participating in   
the pilot program4  7#b7 ,limitation    
,payment for a fitness center membership
 of a covered veteran may not exceed #ej
 per month of membership4  7g7 ,reports 
7#a7 ,periodic reports ,not later than  
#ij days after the date of the          
commencement of the pilot program and   
not less frequently than once every #ij 
days thereafter1 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 
activities carried out to implement the 
pilot program1 including outreach       
activities to veterans and community    
organizations4  7#b7 ,final report ,not 
later than #ahj days after the date of  
the completion of the pilot program1 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 pilot  
program detailing--  7,a7 the findings  
and conclusions of the ,secretary as a  
result of the pilot program2 and  7,b7  
recommendations for the continuation or 
expansion of the pilot program4  #f4    
,pilot program on health promotion for  
veterans through establishment of       
,department of ,veterans ,affairs       
fitness facilities  7a7 ,pilot program  
required ,commencing not later than #ahj
 days after the date of the enactment of
 this ,act1 the ,secretary of ,veterans 
,affairs shall carry out a pilot program
 to assess the feasibility and          
advisability of promoting health in     
covered veterans1 including achieving a 
healthy weight1 through establishment of
 ,department of ,veterans ,affairs      
fitness facilities4  7b7 ,covered       
veterans ,for purposes of this section1 
a covered veteran is any veteran who is 
enrolled in the system of annual patient

 enrollment established and operated by 
the ,secretary under section #agje of   
title #ch1 ,united ,states ,code4  7c7  
,duration of pilot program ,the pilot   
program shall be carried out during the 
three-year period beginning on the date 
of the commencement of the pilot        
program4  7d7 ,locations  7#a7 ,in      
general ,the ,secretary shall carry out 
the pilot program by establishing       
fitness facilities in ,department       
facilities as follows3  7,a7 ,in not    
fewer than five ,department of ,veterans
 ,affairs medical centers selected by   
the ,secretary for purposes of the pilot
 program4  7,b7 ,in not fewer than five 
outpatient clinics of the ,department   
selected by the ,secretary for purposes 
of the pilot program4  7#b7             
,considerations ,in selecting locations 
for the pilot program1 the ,secretary   
shall consider the feasibility and      
advisability of selecting locations in  
the following areas3  7,a7 ,rural areas4
  7,b7 ,areas that are not in close     

proximity to an active duty military    
installation4  7,c7 ,areas in different 
geographic locations4  7e7 ,limitation  
on expenses ,in establishing and        
supporting a fitness facility in a      
facility of the ,department under the   
pilot program1 the ,secretary may expend
 amounts as follows3  7#a7 ,for         
establishment and support of a fitness  
facility in a ,department of ,veterans  
,affairs medical center1 not more than  
#fj1jjj4  7#b7 ,for establishment and   
support of a fitness facility in an     
outpatient clinic of the ,department1   
not more than #dj1jjj4  7f7 ,renovations
 and purchases ,subject to subsection   
7e71 the ,secretary may1 in carrying out
 the pilot program1 make such           
renovations to physical facilities of   
the ,department and purchase such       
fitness equipment and supplies as the   
,secretary considers appropriate for    
purposes of the pilot program4  7g7     
,prohibition on assessment of user fees 
,the ,secretary may not assess a fee    

upon a covered veteran for use of a     
fitness facility established under the  
pilot program4  7h7 ,voluntary          
participation ,the participation of a   
covered veteran in the pilot program    
shall be at the election of the covered 
veteran4  7i7 ,reports  7#a7 ,periodic  
reports ,not later than #ij days after  
the date of the commencement of the     
pilot program and not less frequently   
than once every #ij days thereafter1 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 activities 
carried out to implement the pilot      
program1 including outreach activities  
to veterans and community organizations4
  7#b7 ,final report ,not later than    
#ahj days after the date of the         
completion of the pilot program1 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 pilot  
program detailing--  7,a7 the findings  
and conclusions of the ,secretary as a  
result of the pilot program2 and  7,b7  
recommendations for the continuation or 
expansion of the pilot program4  #g4    
,study of barriers encountered by       
veterans in receiving complementary and 
alternative medicine from ,department of
 ,veterans ,affairs  7a7 ,study required
 ,the ,secretary of ,veterans ,affairs  
shall conduct a comprehensive study of  
the barriers encountered by veterans in 
receiving complementary and alternative 
medicine from the ,department of        
,veterans ,affairs4 ,in conducting the  
study1 the ,secretary shall--  7#a7     
survey veterans who seek or receive     
hospital care or medical services       
furnished by the ,department1 as well as
 veterans who do not seek or receive    
such care or services2  7#b7 administer 
the survey to a representative sample of
 veterans from each ,veterans           

,integrated ,service ,network2 and  7#c7
 ensure that the sample of veterans     
surveyed is of sufficient size for the  
study results to be statistically       
significant4  7b7 ,elements of study ,in
 conducting the study required by       
subsection 7a71 the ,secretary shall    
study the following3  7#a7 ,the         
perceived barriers associated with      
obtaining complementary and alternative 
medicine services from the ,department4 
7#b7 ,the satisfaction of veterans with 
complementary and alternative medicine  
in primary care4  7#c7 ,the degree to   
which veterans are aware of eligibility 
requirements for1 and the scope of      
services available under1 complementary 
and alternative medicine furnished by   
the ,department4  7#d7 ,the             
effectiveness of outreach to veterans on
 the availability of complementary and  
alternative medicine for veterans4  7#e7
 ,such other barriers as the ,secretary 
considers appropriate4  7c7 ,discharge  
by contract ,the ,secretary shall enter 

into a contract with a qualified        
independent entity or organization to   
carry out the study required by this    
section4  7d7 ,mandatory review of data 
by certain ,department divisions  7#a7  
,in general ,the ,secretary shall ensure
 that the head of each division of the  
,department specified in paragraph 7#b7 
reviews the results of the study        
conducted under this section4 ,the head 
of each such division shall submit      
findings with respect to the study to   
the ,under ,secretary for ,health and to
 other pertinent program offices within 
the ,department with responsibilities   
relating to health care services for    
veterans4  7#b7 ,specified divisions    
,the divisions of the ,department       
specified in this paragraph are the     
following3  7,a7 ,the centers for       
innovation established under section    
#gccj;,b of title #ch1 ,united ,states  
,code1 as added by section #b4  7,b7    
,the ,health ,services ,research and    
,development ,service ,scientific ,merit

 ,review ,board4  7e7 ,reports  7#a7    
,report on implementation ,not later    
than #ahj days after the date of the    
enactment of this ,act1 the ,secretary  
shall submit to ,congress a report on   
the status of the implementation of this
 section4  7#b7 ,report on study  7,a7  
,in general ,not later than #de days    
after the date of the completion of the 
study1 the ,secretary shall submit to   
,congress a report on the study required
 by subsection 7a74  7,b7 ,contents ,the
 report required by subparagraph 7,a7   
shall include the following3  7i7       
,recommendations for such administrative
 and legislative proposals and actions  
as the ,secretary considers appropriate4
  7ii7 ,the findings of the head of each
 division of the ,department specified  
under subsection 7d77#b7 and of the     
,under ,secretary for ,health4  7f7     
,authorization of appropriations ,there 
is authorized to be appropriated to the 
,secretary #b1jjj1jjj to carry out this 
section4  #h4 ,complimentary and        

alternative medicine defined ,in this   
,act1 the term complimentary and        
alternative medicine shall have the     
meaning given such term under section   
#gccj;,b of title #ch1 ,united ,states  
,code1 as added by section #b4