,i  #aad? ,,congress  #a/ ,session  ,h4 
,r4 #afbh  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,m>* #be1 #bjae ,mr4  
,k9d 7= himself1 ,mr4 ,zeld91 & ,mr4    
,ribble7 introduc$ ! foll[+ bill2 :i* 0 
ref]r$ to ! ,committee on ,vet]ans'     
,affairs  ,a ,,bill  ,to am5d title #ch1
 ,unit$ ,/ates ,code1 to e/abli% 9 ea*  
,vet]ans ,integrat$ ,s]vice ,network a  
pa9 managem5t bo>d4  #a4 ,%ort title    
,?is ,act may be cit$ z ! ,vet]ans ,pa9 
,managem5t ,improvem5t ,act4  #b4       
,e/abli%m5t ( pa9 managem5t bo>ds (     
,dep>tm5t ( ,vet]ans ,affairs  7a7 ,9   
g5]al ,sub*apt] ,i ( title #ch1 ,unit$  
,/ates ,code1 is am5d$ by add+ at ! end 
! foll[+ new section3  #gcji;,a4 ,pa9   
managem5t bo>ds  7a7 ,e/abli%m5t ,!     
,secret>y %all e/abli% 9 ea* ,vet]ans   
,integrat$ ,s]vice ,network a ,pa9      
,managem5t ,bo>d 79 ?is section ref]r$  
to z a ,bo>d74  7b7 ,duties  7#a7  7,a7 
,ea* ,bo>d %all provide treatm5t        
recomm5dations = pati5ts describ$ 9     
subp>agraph 7,b7 ) complex cl9ical pa9  

:o are be+ treat$ at a m$ical facility (
 ! ,dep>tm5t locat$ 9 ! ,vet]ans        
,integrat$ ,s]vice ,network cov]$ by !  
,bo>d1 reg>dless ( :e!r su* treatm5t is 
on an 9-pati5t or out-pati5t basis4     
7,b7 ,a pati5t describ$ 9 ?is           
subp>agraph is a pati5t = :om a reque/ =
 treatm5t recomm5dations "u subp>agraph 
7,a7 has be5 made by--  7i7 ! pati5t2   
7ii7 ! sp\se ( ! pati5t2  7iii7 a family
 memb] ( ! pati5t or an individual if   
su* family memb] or individual has be5  
designat$ by ! pati5t to make heal? c>e 
decisions = ! pati5t or to receive heal?
 c>e in=mation ( ! pati5t2  7iv7 a      
physician ( ! pati5t2 or  7v7 an        
employee ( ! m$ical facility ( !        
,dep>tm5t describ$ 9 su* subp>agraph4   
7#b7 ,bas$ on treatm5t recomm5dations   
develop$ by ! ,bo>d "u p>agraph         
7#a77;,a71 ea* ,bo>d %all provide to    
heal? c>e pr(essionals ( ! ,dep>tm5t    
locat$ 9 ! ,vet]ans ,integrat$ ,s]vice  
,network cov]$ by ! ,bo>d recomm5dations
 on ! be/ practices reg>d+ pa9 managem5t

 9 complex cl9ical pa9 cases4  7#c7     
7,a7 ,ea* ,bo>d %all annually submit to 
! ,secret>y & ! ,"u ,secret>y = ,heal? a
 report on pa9 managem5t practices c>ri$
 out 9 ! ,vet]ans ,integrat$ ,s]vice    
,network cov]$ by ! ,bo>d4 ,su* report  
%all include1 = ! ye> cov]$ by ! report1
 ! foll[+3  7i7 ,! treatm5t             
recomm5dations provid$ "u p>agraph      
7#a77;,a71 includ+-- 7,i7 a summ>y ( su*
 recomm5dations2 &  7,,ii7 an           
explanation ( ! m]its ( ea* su*         
recomm5dation4  7ii7 ,! recomm5dations =
 be/ practices provid$ "u p>agraph 7#b71
 includ+--  7,i7 a summ>y ( su*         
recomm5dations2 &  7,,ii7 an explanation
 ( ! m]its ( ea* su* recomm5dation4     
7iii7 ,any o!r in=mation ! ,bo>d        
det]m9es appropriate4  7,b7 ,n lat] ?an 
,janu>y #ca ( ea* ye>1 ! ,secret>y %all 
submit to ! ,committees on ,vet]ans'    
,affairs ( ! ,h\se ( ,repres5tatives & !
 ,s5ate a report t conta9s ea* report   
submitt$ to ! ,secret>y "u subp>agraph  
7,a7 dur+ ! previ\s ye>4  7#d7 ,no ,bo>d

 %all n be subject to ! ,f$]al ,advisory
 ,committee ,act 7#e ,u4,s4,c4 ,app474  
7c7 ,memb]%ip  7#a7 ,ea* ,bo>d %all     
consi/ ( a numb] ( memb]s det]m9$       
appropriate by ! ,secret>y :o are       
appo9t$ by ! ,secret>y f among          
individuals :o h exp]i5ce z--  7,a7 a   
pr(essional 9 a field relat+ to pa9     
managem5t1 includ+ z-- 7i7 a bo>d       
c]tifi$ pa9 m$ic9e speciali/2  7ii7 a   
tra9$ & qualifi$ prim>y c>e pa9 *ampion2
  7iii7 a pa9 psy*ologi/2  7iv7 a pa9   
social work]2  7v7 a pa9 po9t ( contact 
= a ,vet]ans ,integrat$ ,s]vice         
,network2  7vi7 a psy*iatri/ ) addiction
 & psy*oph>macology exp]tise & exp]i5ce2
 or  7vii7 a heal? c>e pr(essional or a 
m5tal heal? c>e pr(essional2  7,b7      
cl9ical pati5ts2 or  7,c7 family memb]s 
( cl9ical pati5ts4  7#b7 ,! ,secret>y   
%all det]m9e ! t]ms ( s]vice ( ! memb]s4
  7#c7 ,memb]s %all s]ve )\t pay &1     
except z provid$ by ?is p>agraph1 memb]s
 :o are full-"t (fic]s or employees ( ! 
,unit$ ,/ates may n receive additional  

pay1 all[ances1 or b5efits by reason (  
_! s]vice on ! ,bo>d4 ,memb]s may       
receive travel exp5ses1 includ+ p] diem 
9 lieu ( subsi/5ce = travel 9 connection
 ) _! duties z memb]s ( ! ,bo>d4 ,any   
memb] :o has cl9ical duties z an (fic]  
or employee ( ! ,unit$ ,/ates %all be   
reliev$ ( su* duties dur+ p]iods 9 :i*  
su* relief is necess>y = ! memb] to c>ry
 out ! duties ( ! ,bo>d4  7d7 ,p[]s     
7#a7 ,ea* ,bo>d may hold he>+s1 sit &   
act at times & places1 take te/imony1 & 
receive evid5ce z ! ,bo>d det]m9es      
appropriate4  7#b7 ,ea* ,bo>d may secure
 directly f any dep>tm5t or ag5cy ( !   
,f$]al ,gov]nm5t in=mation necess>y to  
enable x to c>ry out ?is section4  7#c7 
,ea* ,bo>d may conduct site visits (    
m$ical facilities ( ! ,dep>tm5t to      
collect in=mation necess>y to enable x  
to c>ry out ?is section4  7#d7 ,!       
,secret>y %all provide to ea* ,bo>d     
adm9i/rative support s]vices necess>y = 
! ,bo>d to c>ry out ?is section4  4  7b7
 ,cl]ical am5dm5t ,! table ( sections at

 ! beg9n+ ( su* *apt] is am5d$ by ins]t+
 aft] ! item relat+ to section #gcji !  
foll[+ new item3  #gcji;,a4 ,pa9        
managem5t bo>ds4  4  7c7 ,report ,n lat]
 ?an ,decemb] #a1 #bjae1 ! ,secret>y (  
,vet]ans ,affairs %all submit to !      
,committees on ,vet]ans' ,affairs ( !   
,h\se ( ,repres5tatives & ! ,s5ate !    
approv$ cl9ical guidel9e1 h&book1       
directive1 policy1 or o!r guidance      
e/abli%$ to gov]n ! /epd[n me?odologies 
employ$ by cl9icians 9 m$ical facilities
 ( ! ,dep>tm5t to manage ! use ( opioid 
!rapies & associat$ prescrib+ practices4