,i #aad? ,,congress #a/ ,session ,h4 ,r4 #djfc ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,novemb] #ah1 #bjae ,mr4 ,bilirakis 7= himself1 ,mr4 ,k9d1 ,miss ,rice ( ,new ,york1 ,mrs4 ,walorski1 ,mr4 ,mc,kinley1 ,mr4 ,bo/1 ,mr4 ,c(fman1 ,mr4 ,ross1 ,mr4 ,ryan ( ,ohio1 ,mrs4 ,radewag51 ,mr4 ,craw=d1 ,mr4 ,mica1 ,ms4 ,frankel ( ,florida1 ,ms4 ,ku/]1 ,mr4 ,mc,caul1 & ,mr4 ,walz7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,vet]ans' ,affairs1 & 9 addition to ! ,committee on ,arm$ ,s]vices1 = a p]iod to be subsequ5tly det]m9$ by ! ,speak]1 9 ea* case = consid]ation ( su* provisions z fall )9 ! jurisdiction ( ! committee conc]n$ ,a ,,bill ,to improve ! use by ! ,secret>y ( ,vet]ans ,affairs ( opioids 9 treat+ vet]ans1 to improve pati5t advocacy by ! ,secret>y1 & to exp& ! availability ( complem5t>y & integrative heal?1 & = o!r purposes4 #a4 ,%ort title2 table ( cont5ts 7a7 ,%ort title ,?is ,act may be cit$ z ! ,promot+ ,responsible ,opioid ,managem5t & ,incorporat+ ,sci5tific ,exp]tise ,act or ! ,jason ,simcakoski ,,promise ,act4 7b7 ,table ( cont5ts ,! table ( cont5ts = ?is ,act is z foll[s3 ,sec4 #a4 ,%ort title2 table ( cont5ts4 ,title ,i--,opioid ,!rapy & ,pa9 ,managem5t ,sec4 #aja4 ,guidel9es on managem5t ( opioid !rapy by ,dep>tm5t ( ,vet]ans ,affairs & ,dep>tm5t ( ,def5se & implem5tation ( su* guidel9es by ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4 #ajb4 ,improvem5t ( opioid safety measures by ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4 #ajc4 ,/r5g!n+ ( jo9t work+ gr\p on pa9 managem5t ( ! ,dep>tm5t ( ,vet]ans ,affairs & ! ,dep>tm5t ( ,def5se4 ,sec4 #ajd4 ,review1 inve/igation1 & report on use ( opioids 9 treatm5t by ,dep>tm5t ( ,vet]ans ,affairs4 ,title ,,ii--,pati5t ,advocacy ,sec4 #bja4 ,community meet+s on improv+ c>e furni%$ by ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4 #bjb4 ,improvem5t ( aw>5ess ( pati5t advocacy program & pati5t bill ( rights ( ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4 #bjc4 ,comptroll] g5]al report on pati5t advocacy program ( ,dep>tm5t ( ,vet]ans ,affairs4 ,title ,,iii--,complem5t>y & ,integrative ,heal? ,sec4 #cja4 ,expansion ( rese>* & education on & deliv]y ( complem5t>y & integrative heal? to vet]ans4 ,sec4 #cjb4 ,pilot program on integration ( complem5t>y alt]native m$ic9es & relat$ issues = vet]ans & family memb]s ( vet]ans4 ,title ,,iv--,fitness ( ,heal? ,c>e ,provid]s ,sec4 #dja4 ,additional requirem5ts = hir+ ( heal? c>e provid]s by ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4 #djb4 ,provision ( in=mation on heal? c>e provid]s ( ,dep>tm5t ( ,vet]ans ,affairs to ,/ate ,m$ical ,bo>ds4 ,sec4 #djc4 ,report on compliance by ,dep>tm5t ( ,vet]ans ,affairs ) reviews ( heal? c>e provid]s leav+ ! ,dep>tm5t or transf]r+ to o!r facilities4 ,title ,v--,o!r ,vet]ans ,matt]s ,sec4 #eja4 ,audit ( ,vet]ans ,heal? ,adm9i/ration programs ( ,dep>tm5t ( ,vet]ans ,affairs4 ,i ,opioid ,!rapy & ,pa9 ,managem5t #aja4 ,guidel9es on managem5t ( opioid !rapy by ,dep>tm5t ( ,vet]ans ,affairs & ,dep>tm5t ( ,def5se & implem5tation ( su* guidel9es by ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs & ! ,secret>y ( ,def5se %all jo9tly update ! ,,va_/,,dod ,cl9ical ,practice ,guidel9e = ,managem5t ( ,opioid ,!rapy = ,*ronic ,pa9 to include ! foll[+3 7#a7 ,9 accordance ) subsection 7b71 common recomm5d$ guidel9es = safely prescrib+ opioids = ! treatm5t ( *ronic1 non-canc] pa9 9 outpati5t sett+s z compil$ by ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion4 7#b7 ,enhanc$ guidance ) respect to-- 7,a7 ! adm9i/ration ( two or m drugs t may result 9 a life-limit+ drug-to-drug int]action1 includ+ b5zodiazep9es2 7,b7 ! treatm5t ( pati5ts ) curr5t acute psy*iatric in/ability or sub/ance use disord] or pati5ts at risk ( suicide2 & 7,c7 ! use ( opioid !rapy to treat m5tal heal? disord]s o!r ?an opioid use disord]4 7#c7 ,enhanc$ guidance ) respect to ! treatm5t ( pati5ts ) behaviors or comorbidities1 su* z po/-traumatic /ress disord]1 psy*iatric disord]s1 or a hi/ory ( sub/ance abuse or addiction1 t requires a consultation or comanagem5t ( opioid !rapy ) "o or m speciali/s 9 pa9 managem5t1 m5tal heal?1 or addictions4 7#d7 ,enhanc$ guidance ) respect to ! conduct by heal? c>e provid]s ( an effective assessm5t = pati5ts receiv+ opioid !rapy1 includ+ pati5ts on long-t]m opioid !rapy1 to det]m9e-- 7,a7 :e!r opioid !rapy is meet+ ! expect$ goals ( ! pati5t & heal? c>e provid] ( reliev+ pa91 improv+ function1 & provid+ pati5t satisfaction2 & 7,b7 :e!r opioid !rapy %\ld be cont9u$4 7#e7 ,guidance t ea* heal? c>e provid] ( ! ,dep>tm5t ( ,vet]ans ,affairs & ! ,dep>tm5t ( ,def5se1 be=e initiat+ opioid !rapy to treat a pati5t z "p ( ! compreh5sive assessm5t conduct$ by ! heal? c>e provid]1 use ! ,opioid ,!rapy ,risk ,report tool ( ! ,dep>tm5t ( ,vet]ans ,affairs 7or successor tool71 :i* %all include ! ability to access ! mo/ rec5t pati5t in=mation f ! prescription drug monitor+ program ( ea* ,/ate t has su* a program to assess ! risk = adv]se outcomes ( opioid !rapy = ! pati5t1 includ+ ) respect to ! concurr5t use ( controll$ sub/ances1 includ+ b5zodiazep9es4 7#f7 ,guidel9es to gov]n ! me?odologies us$ by heal? c>e provid]s ( ! ,dep>tm5t ( ,vet]ans ,affairs & ! ,dep>tm5t ( ,def5se to safely titrate & tap] opioid !rapy :5 adju/+ or discrim9at+ ! use ( opioid !rapy1 includ+ ) respect to-- 7,a7 prescription ( ! l[e/ effective dose bas$ on pati5t ne$2 7,b7 use ( opioid only = a limit$ p]iod ( "t2 & 7,c7 augm5tation ( opioid !rapy ) o!r pa9 managem5t !rapies & modalities4 7#g7 ,guidel9es ) respect to appropriate case managem5t = pati5ts receiv+ opioid !rapy :o transition betwe5 inpati5t & outpati5t heal? c>e sett+s1 :i* may include ! use ( c>e transition plans4 7#h7 ,guidel9es ) respect to appropriate transf] ( case managem5t responsibility = pati5ts receiv+ opioid !rapy :o transition f receiv+ c>e furni%$ by ! ,secret>y ( ,def5se to receiv+ c>e furni%$ by o!r heal? c>e provid]s aft] ! pati5t has be5 dis*>g$ or sep>at$ f ! ,arm$ ,=ces4 7#i7 ,enhanc$ /&>ds ) respect to ! use ( r\t9e & r&om ur9e drug te/s = all pati5ts be=e & dur+ opioid !rapy to help prev5t sub/ance abuse1 dep5d5ce1 & div]sion1 includ+-- 7,a7 t su* te/s occur n less frequ5tly ?an once ea* ye>2 & 7,b7 t heal? c>e provid]s appropriately int]pret & respond to ! results f su* te/s to tailor pa9 !rapy1 safegu>ds1 & risk managem5t /rategies to ea* pati5t4 7#aj7 ,guidance t heal? c>e provid]s discuss ) pati5ts1 be=e initiat+ opioid !rapy1 options = pa9 managem5t !rapies )\t ! use ( opioids & options to augm5t opioid !rapy ) o!r cl9ical & complem5t>y & integrative heal? s]vices to m9imize opioid dep5d5ce4 7b7 ,treatm5t ( c]ta9 guidel9es develop$ aft] deadl9e ,if ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion issues ! guidel9es describ$ 9 p>agraph 7#a7 ( subsection 7a7 aft] ! date on :i* ! ,secret>y ( ,vet]ans ,affairs & ! ,secret>y ( ,def5se jo9tly update ! ,,va_/,,dod ,cl9ical ,practice ,guidel9e = ,managem5t ( ,opioid ,!rapy = ,*ronic ,pa9 pursuant to su* subsection1 ! ,secret>ies %all jo9tly modify ! ,,va_/,,dod ,cl9ical ,practice ,guidel9e = ,managem5t ( ,opioid ,!rapy = ,*ronic ,pa9 to incorporate su* guidel9es ( ! ,director4 7c7 ,consultation be=e update ,be=e updat+ ! guidel9e "u subsection 7a71 ! ,secret>y ( ,vet]ans ,affairs & ! ,secret>y ( ,def5se %all jo9tly consult ) ! ,pa9 ,managem5t ,work+ ,gr\p ( ! ,dep>tm5t ( ,vet]ans ,affairs-,dep>tm5t ( ,def5se ,jo9t ,executive ,committee e/abli%$ by section #cbj ( title #ch1 ,unit$ ,/ates ,code4 7d7 ,def9itions ,9 ?is section3 7#a7 ,! t]m controll$ sub/ance has ! mean+ giv5 t t]m 9 section #ajb ( ! ,controll$ ,sub/ances ,act 7#ba ,u4,s4,c4 #hjb74 7#b7 ,! t]m ,/ate means ea* ( ! sev]al ,/ates1 t]ritories1 & possessions ( ! ,unit$ ,/ates1 ! ,di/rict ( ,columbia1 & ! ,commonweal? ( ,pu]to ,rico4 #ajb4 ,improvem5t ( opioid safety measures by ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,expansion ( opioid safety initiative ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all exp& ! ,opioid ,safety ,initiative ( ! ,dep>tm5t ( ,vet]ans ,affairs to include all m$ical facilities ( ! ,dep>tm5t4 7b7 ,pa9 managem5t education & tra9+ 7#a7 ,9 g5]al ,9 c>ry+ out ! ,opioid ,safety ,initiative ( ! ,dep>tm5t1 ! ,secret>y %all require all employees ( ! ,dep>tm5t responsible = prescrib+ opioids to receive education & tra9+ describ$ 9 p>agraph 7#b74 7#b7 ,education & tra9+ ,education & tra9+ describ$ 9 ?is p>agraph is education & tra9+ on pa9 managem5t & safe opioid prescrib+ practices = purposes ( safely & effectively manag+ pati5ts ) *ronic pa91 includ+ education & tra9+ on ! foll[+3 7,a7 ,! implem5tation ( & full compliance ) ! ,,va_/,,dod ,cl9ical ,practice ,guidel9e = ,managem5t ( ,opioid ,!rapy = ,*ronic ,pa91 includ+ any update to su* guidel9e4 7,b7 ,! use ( evid5ce-bas$ pa9 managem5t !rapies1 includ+ cognitive-behavioral !rapy1 non-opioid alt]natives1 & non-drug me?ods & proc$ures to manag+ pa9 & relat$ heal? conditions includ+ complem5t>y alt]native m$ic9es4 7,c7 ,scre5+ & id5tification ( pati5ts ) sub/ance use disord]1 includ+ drug-seek+ behavior1 be=e prescrib+ opioids1 assessm5t ( risk pot5tial = pati5ts develop+ an addiction1 & ref]ral ( pati5ts to appropriate addiction treatm5t pr(essionals if addiction is id5tifi$ or /rongly suspect$4 7,d7 ,communication ) pati5ts on ! pot5tial h>m associat$ ) ! use ( opioids & o!r controll$ sub/ances1 includ+ ! ne$ to safely /ore & dispose ( supplies relat+ to ! use ( opioids & o!r controll$ sub/ances4 7,e7 ,su* o!r education & tra9+ z ! ,secret>y consid]s appropriate to ensure t vet]ans receive safe & high-quality pa9 managem5t c>e f ! ,dep>tm5t4 7#c7 ,use ( exi/+ program ,9 provid+ education & tra9+ describ$ 9 p>agraph 7#b71 ! ,secret>y %all use ! ,int]discipl9>y ,*ronic ,pa9 ,managem5t ,tra9+ ,team ,program ( ! ,dep>tm5t 7or success program74 7c7 ,pa9 managem5t teams 7#a7 ,9 g5]al ,9 c>ry+ out ! ,opioid ,safety ,initiative ( ! ,dep>tm5t1 ! director ( ea* m$ical facility ( ! ,dep>tm5t %all id5tify & designate a pa9 managem5t team ( heal? c>e pr(essionals1 :i* may include bo>d c]tifi$ pa9 m$ic9e speciali/s1 responsible = coord9at+ & ov]see+ pa9 managem5t !rapy at su* facility = pati5ts exp]i5c+ acute & *ronic pa9 t is non-canc] relat$4 7#b7 ,e/abli%m5t ( protocols 7,a7 ,9 g5]al ,9 consultation ) ! ,directors ( ea* ,vet]ans ,integrat$ ,s]vice ,network1 ! ,secret>y %all e/abli% /&>d protocols = ! designation ( pa9 managem5t teams at ea* m$ical facility )9 ! ,dep>tm5t4 7,b7 ,consultation on prescription ( opioids ,ea* protocol e/abli%$ "u subp>agraph 7,a7 %all ensure t any heal? c>e provid] )\t exp]tise 9 prescrib+ analgesics or :o has n complet$ ! education & tra9+ "u subsection 7b71 includ+ a m5tal heal? c>e provid]1 does n prescribe opioids to a pati5t unless t heal? c>e provid]-- 7i7 consults ) a heal? c>e provid] ) pa9 managem5t exp]tise or :o is on ! pa9 managem5t team ( ! m$ical facility2 & 7ii7 ref]s ! pati5t to ! pa9 managem5t team = any subsequ5t prescriptions & relat$ !rapy4 7#c7 ,report 7,a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( enactm5t ( ?is ,act1 ! director ( ea* m$ical facility ( ! ,dep>tm5t %all submit to ! ,"u ,secret>y = ,heal? & ! director ( ! ,vet]ans ,integrat$ ,s]vice ,network 9 :i* ! m$ical facility is locat$ a report id5tify+ ! heal? c>e pr(essionals t h be5 designat$ z memb]s ( ! pa9 managem5t team at ! m$ical facility pursuant to p>agraph 7#a74 7,b7 ,elem5ts ,ea* report submitt$ "u subp>agraph 7,a7 ) respect to a m$ical facility ( ! ,dep>tm5t %all include-- 7i7 a c]tification z to :e!r all memb]s ( ! pa9 managem5t team at ! m$ical facility h complet$ ! education & tra9+ requir$ "u subsection 7b72 & 7ii7 a plan = ! managem5t & ref]ral ( pati5ts to su* pa9 managem5t team if heal? c>e provid]s )\t exp]tise 9 prescrib+ analgesics prescribe opioid m$ications to treat acute & *ronic pa9 t is non-canc] relat$4 7d7 ,track+ & monitor+ ( opioid use 7#a7 ,prescription drug monitor+ programs ( /ates ,9 c>ry+ out ! ,opioid ,safety ,initiative & ! ,opioid ,!rapy ,risk ,report tool ( ! ,dep>tm5t1 ! ,secret>y %all-- 7,a7 ensure access by heal? c>e provid]s ( ! ,dep>tm5t to in=mation on controll$ sub/ances1 includ+ opioids & b5zodiazep9es1 prescrib$ to vet]ans :o receive c>e outside ! ,dep>tm5t ?r\gh ! prescription drug monitor+ program ( ea* ,/ate ) su* a program1 includ+ by seek+ to ent] into memor&a ( und]/&+ ) ,/ates to all[ %>$ access ( su* in=mation betwe5 ,/ates & ! ,dep>tm5t2 7,b7 include su* in=mation 9 ! ,opioid ,!rapy ,risk ,report2 & 7,c7 require heal? c>e provid]s ( ! ,dep>tm5t to submit to ! prescription drug monitor+ program ( ea* ,/ate in=mation on prescriptions ( controll$ sub/ances receiv$ by vet]ans 9 t ,/ate "u ! laws adm9i/]$ by ! ,secret>y4 7#b7 ,report on track+ ( data on opioid use ,n lat] ?an #ah mon?s 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 report on ! feasibility & advisability ( improv+ ! ,opioid ,!rapy ,risk ,report tool ( ! ,dep>tm5t to all[ = m advanc$ real-"t track+ ( & access to data on-- 7,a7 ! key cl9ical indicators ) respect to ! totality ( opioid use by vet]ans2 7,b7 concurr5t prescrib+ by heal? c>e provid]s ( ! ,dep>tm5t ( opioids 9 diff]5t heal? c>e sett+s1 includ+ data on concurr5t prescrib+ ( opioids to treat m5tal heal? disord]s o!r ?an opioid use disord]2 & 7,c7 mail-ord] prescriptions ( opioid prescrib$ to vet]ans "u ! laws adm9i/]$ by ! ,secret>y4 7e7 ,availability ( opioid receptor antagoni/s 7#a7 ,increas$ availability & use 7,a7 ,9 g5]al ,! ,secret>y %all maximize ! availability ( opioid receptor antagoni/s approv$ by ! ,food & ,drug ,adm9i/ration1 includ+ naloxone1 to vet]ans4 7,b7 ,availability1 tra9+1 & di/ribut+ ,9 c>ry+ out subp>agraph 7,a71 n lat] ?an #ij days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all-- 7i7 equip ea* ph>macy ( ! ,dep>tm5t ) opioid receptor antagoni/s approv$ by ! ,food & ,drug ,adm9i/ration to be disp5s$ to outpati5ts z ne$$2 & 7ii7 exp& ! ,ov]dose ,education & ,naloxone ,di/ribution program ( ! ,dep>tm5t to ensure t all vet]ans 9 receipt ( heal? c>e "u laws adm9i/]$ by ! ,secret>y :o are at risk ( opioid ov]dose may access su* opioid receptor antagoni/s & tra9+ on ! prop] adm9i/ration ( su* opioid receptor antagoni/s4 7,c7 ,vet]ans :o are at risk ,= purposes ( subp>agraph 7,b71 vet]ans :o are at risk ( opioid ov]dose include-- 7i7 vet]ans receiv+ long-t]m opioid !rapy2 7ii7 vet]ans receiv+ opioid !rapy :o h a hi/ory ( sub/ance use disord] or prior in/ances ( ov]dose2 & 7iii7 vet]ans :o are at risk z det]m9$ by a heal? c>e provid] :o is treat+ ! vet]an4 7#b7 ,report ,n lat] ?an #abj 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 report on c>ry+ out p>agraph 7#a71 includ+ an assessm5t ( any rema9+ /eps to be c>ri$ out by ! ,secret>y to c>ry out su* p>agraph4 7f7 ,inclusion ( c]ta9 in=mation & capabilities 9 opioid !rapy risk report tool ( ! ,dep>tm5t 7#a7 ,in=mation ,! ,secret>y %all include 9 ! ,opioid ,!rapy ,risk ,report tool ( ! ,dep>tm5t-- 7,a7 in=mation on ! mo/ rec5t "t ! tool 0 access$ by a heal? c>e provid] ( ! ,dep>tm5t ) respect to ea* vet]an2 & 7,b7 in=mation on ! results ( ! mo/ rec5t ur9e drug te/ = ea* vet]an4 7#b7 ,capabilities ,! ,secret>y %all include 9 ! ,opioid ,!rapy ,risk ,report tool ! ability ( ! heal? c>e provid]s ( ! ,dep>tm5t to det]m9e :e!r a heal? c>e provid] ( ! ,dep>tm5t prescrib$ opioids to a vet]an )\t *eck+ ! in=mation 9 ! tool ) respect to ! vet]an4 7g7 ,notifications ( risk 9 comput]iz$ heal? record ,! ,secret>y %all modify ! comput]iz$ pati5t record sy/em ( ! ,dep>tm5t to ensure t any heal? c>e provid] t accesses ! record ( a vet]an1 reg>dless ( ! reason ! vet]an seeks c>e f ! heal? c>e provid]1 w be imm$iately notifi$ :e!r ! vet]an-- 7#a7 is receiv+ opioid !rapy & has a hi/ory ( sub/ance use disord] or prior in/ances ( ov]dose2 7#b7 has a hi/ory ( opioid abuse2 or 7#c7 is at risk ( becom+ an opioid abus] z det]m9$ by a heal? c>e provid] :o is treat+ ! vet]an4 7h7 ,def9itions ,9 ?is section3 7#a7 ,! t]m controll$ sub/ance has ! mean+ giv5 t t]m 9 section #ajb ( ! ,controll$ ,sub/ances ,act 7#ba ,u4,s4,c4 #hjb74 7#b7 ,! t]m ,/ate means ea* ( ! sev]al ,/ates1 t]ritories1 & possessions ( ! ,unit$ ,/ates1 ! ,di/rict ( ,columbia1 & ! ,commonweal? ( ,pu]to ,rico4 #ajc4 ,/r5g!n+ ( jo9t work+ gr\p on pa9 managem5t ( ! ,dep>tm5t ( ,vet]ans ,affairs & ! ,dep>tm5t ( ,def5se 7a7 ,9 g5]al ,n lat] ?an #ij days aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs & ! ,secret>y ( ,def5se %all ensure t ! ,pa9 ,managem5t ,work+ ,gr\p ( ! ,heal? ,executive ,committee ( ! ,dep>tm5t ( ,vet]ans ,affairs-,dep>tm5t ( ,def5se ,jo9t ,executive ,committee e/abli%$ "u section #cbj ( title #ch1 ,unit$ ,/ates ,code1 includes a focus on ! foll[+3 7#a7 ,! opioid prescrib+ practices ( heal? c>e provid]s ( ea* ,dep>tm5t4 7#b7 ,! ability ( ea* ,dep>tm5t to manage acute & *ronic pa9 among individuals receiv+ heal? c>e f ! ,dep>tm5t1 includ+ tra9+ heal? c>e provid]s ) respect to pa9 managem5t4 7#c7 ,! use by ea* ,dep>tm5t ( complem5t>y & integrative heal? & complem5t>y alt]native m$ic9es 9 treat+ su* individuals4 7#d7 ,! concurr5t use by heal? c>e provid]s ( ea* ,dep>tm5t ( opioids & prescription drugs to treat m5tal heal? disord]s1 includ+ b5zodiazep9es4 7#e7 ,! practice by heal? c>e provid]s ( ea* ,dep>tm5t ( prescrib+ opioids to treat m5tal heal? disord]s4 7#f7 ,! coord9ation 9 cov]age ( & consi/5t access to m$ications prescrib$ = pati5ts transition+ f receiv+ heal? c>e f ! ,dep>tm5t ( ,def5se to receiv+ heal? c>e f ! ,dep>tm5t ( ,vet]ans ,affairs4 7#g7 ,! ability ( ea* ,dep>tm5t to id5tify & treat sub/ance use disord]s among individuals receiv+ heal? c>e f t ,dep>tm5t4 7b7 ,coord9ation & consultation ,! ,secret>y ( ,vet]ans ,affairs & ! ,secret>y ( ,def5se %all ensure t ! work+ gr\p describ$ 9 subsection 7a7-- 7#a7 coord9ates ! activities ( ! work+ gr\p ) o!r relevant work+ gr\ps e/abli%$ "u section #cbj ( title #ch1 ,unit$ ,/ates ,code1 includ+ ! work+ gr\ps on evid5ce-bas$ practice1 pati5t safety1 ph>macy1 psy*ological heal?1 & psy*ological heal?2 7#b7 consults ) o!r relevant ,f$]al ag5cies1 includ+ ! ,c5t]s = ,disease ,control & ,prev5tion1 ) respect to ! activities ( ! work+ gr\p2 & 7#c7 consults ) ! ,dep>tm5t ( ,vet]ans ,affairs & ! ,dep>tm5t ( ,def5se ) respect to1 reviews1 & comm5ts on ! ,,va_/,,dod ,cl9ical ,practice ,guidel9e = ,managem5t ( ,opioid ,!rapy = ,*ronic ,pa91 or any successor guidel9e1 be=e any update to ! guidel9e is releas$4 7c7 ,consultations ,! ,secret>y ( ,vet]ans ,affairs & ! ,secret>y ( ,def5se %all ensure t ! work+ gr\p describ$ 9 subsection 7a7 is able to mean+fully consult ) respect to ! updat$ guidel9e requir$ "u subsection 7a7 ( section #aja1 z requir$ by subsection 7b7 ( su* section1 n lat] ?an #a ye> aft] ! date ( enactm5t ( ?is ,act4 #ajd4 ,review1 inve/igation1 & report on use ( opioids 9 treatm5t by ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,comptroll] g5]al report 7#a7 ,9 g5]al ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! ,opioid ,safety ,initiative ( ! ,dep>tm5t ( ,vet]ans ,affairs & ! opioid prescrib+ practices ( heal? c>e provid]s ( ! ,dep>tm5t4 7#b7 ,elem5ts ,! report submitt$ "u p>agraph 7#a7 %all include ! foll[+3 7,a7 ,recomm5dations on su* improvem5ts to ! ,opioid ,safety ,initiative ( ! ,dep>tm5t z ! ,comptroll] ,g5]al consid]s appropriate4 7,b7 ,in=mation ) respect to-- 7i7 dea?s result+ f s5t9el ev5ts involv+ vet]ans prescrib$ opioids by a heal? c>e provid] ( ! ,dep>tm5t2 7ii7 ov]all prescription rates & prescriptions indications ( opioids to treat non-canc]1 non-palliative1 & non-hospice c>e pati5ts2 7iii7 ! prescription rates & prescriptions indications ( b5zodiazep9es & opioids concomitantly by heal? c>e provid]s ( ! ,dep>tm5t2 7iv7 ! practice by heal? c>e provid]s ( ! ,dep>tm5t ( prescrib+ opioids to treat pati5ts )\t any pa91 includ+ to treat pati5ts ) m5tal heal? disord]s o!r ?an opioid use disord]2 & 7v7 ! effectiv5ess ( opioid !rapy = pati5ts receiv+ su* !rapy1 includ+ ! effectiv5ess ( long-t]m opioid !rapy4 7,c7 ,an evaluation ( processes ( ! ,dep>tm5t 9 place to ov]see opioid use among vet]ans1 includ+ proc$ures to id5tify & rem$y pot5tial ov]-prescrib+ ( opioids by heal? c>e provid]s ( ! ,dep>tm5t4 7,d7 ,an assessm5t ( ! implem5tation by ! ,secret>y ( ! ,,va_/,,dod ,cl9ical ,practice ,guidel9e = ,managem5t ( ,opioid ,!rapy = ,*ronic ,pa94 7b7 ,qu>t]ly progress report on implem5tation ( comptroll] g5]al recomm5dations ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ?is ,act1 & n lat] ?an #cj days aft] ! end ( ea* qu>t] !reaft]1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a progress report detail+ ! actions by ! ,secret>y dur+ ! p]iod cov]$ by ! report to address any out/&+ f9d+s & recomm5dations by ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates "u subsection 7a7 ) respect to ! ,vet]ans ,heal? ,adm9i/ration4 7c7 ,annual review ( prescription rates ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 & n less frequ5tly ?an annually = ! foll[+ five ye>s1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report1 ) respect to ea* m$ical facility ( ! ,dep>tm5t ( ,vet]ans ,affairs1 to collect & review in=mation on opioids prescrib$ by heal? c>e provid]s at ! facility to treat non-canc]1 non-palliative1 & non-hospice c>e pati5ts t conta9s1 = ! "o-ye> p]iod prec$+ ! submission ( ! report1 ! foll[+3 7#a7 ,! numb] ( pati5ts & ! p]c5tage ( ! pati5t population ( ! ,dep>tm5t :o 7 prescrib$ b5zodiazep9es & opioids concurr5tly by a heal? c>e provid] ( ! ,dep>tm5t4 7#b7 ,! numb] ( pati5ts & ! p]c5tage ( ! pati5t population ( ! ,dep>tm5t )\t any pa9 :o 7 prescrib$ opioids by a heal? c>e provid] ( ! ,dep>tm5t1 includ+ ^? :o 7 prescrib$ b5zodiazep9es & opioids concurr5tly4 7#c7 ,! numb] ( non-canc]1 non-palliative1 & non-hospice c>e pati5ts & ! p]c5tage ( su* pati5ts :o 7 treat$ ) opioids by a heal? c>e provid] ( ! ,dep>tm5t on an inpati5t-basis & :o also receiv$ prescription opioids by mail f ! ,dep>tm5t :ile be+ treat$ on an inpati5t-basis4 7#d7 ,! numb] ( non-canc]1 non-palliative1 & non-hospice c>e pati5ts & ! p]c5tage ( su* pati5ts :o 7 prescrib$ opioids concurr5tly by a heal? c>e provid] ( ! ,dep>tm5t & a heal? c>e provid] t is n heal? c>e provid] ( ! ,dep>tm5t4 7#e7 ,) respect to ea* m$ical facility ( ! ,dep>tm5t1 in=mation on opioids prescrib$ by heal? c>e provid]s at ! facility to treat non-canc]1 non-palliative1 & non-hospice c>e pati5ts1 includ+ in=mation on-- 7,a7 ! prescription rate at :i* ea* heal? c>e provid] at ! facility prescrib$ b5zodiazep9es & opioids concurr5tly to su* pati5ts & ! aggregate su* prescription rate = all heal? c>e provid]s at ! facility2 7,b7 ! prescription rate at :i* ea* heal? c>e provid] at ! facility prescrib$ b5zodiazep9es or opioids to su* pati5ts to treat conditions = :i* b5zodiazep9es or opioids are n approv$ treatm5t & ! aggregate su* prescription rate = all heal? c>e provid]s at ! facility2 7,c7 ! prescription rate at :i* ea* heal? c>e provid] at ! facility prescrib$ or disp5s$ mail-ord] prescriptions ( opioids to su* pati5ts :ile su* pati5ts 7 be+ treat$ ) opioids on an inpati5t-basis & ! aggregate ( su* prescription rate = all heal? c>e provid]s at ! facility2 & 7,d7 ! prescription rate at :i* ea* heal? c>e provid] at ! facility prescrib$ opioids to su* pati5ts :o 7 also concurr5tly prescrib$ opioids by a heal? c>e provid] t is n a heal? c>e provid] ( ! ,dep>tm5t & ! aggregate ( su* prescription rates = all heal? c>e provid]s at ! facility4 7#f7 ,) respect to ea* m$ical facility ( ! ,dep>tm5t1 ! numb] ( times a ph>maci/ at ! facility ov]rode a critical drug int]action w>n+ ) respect to an int]action betwe5 opioids & ano!r m$ication be=e disp5s+ su* m$ication to a vet]an4 7d7 ,inve/igation ( prescription rates ,if ! ,secret>y det]m9es t a prescription rate ) respect to a heal? c>e provid] or m$ical facility ( ! ,dep>tm5t conflicts ) or is o!rwise inconsi/5t ) ! /&>ds ( appropriate & safe c>e1 ! ,secret>y %all-- 7#a7 imm$iately notify ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives ( su* det]m9ation1 includ+ in=mation relat+ to su* det]m9ation1 prescription rate1 & heal? c>e provid] or m$ical facility1 z ! case may be2 & 7#b7 ?r\gh ! ,(fice ( ! ,m$ical ,inspector ( ! ,vet]ans ,heal? ,adm9i/ration1 conduct a full inve/igation ( ! heal? c>e provid] or m$ical facility1 z ! case may be4 7e7 ,prescription rate def9$ ,9 ?is section1 ! t]m prescription rate means1 ) respect to a heal? c>e provid] or m$ical facility ( ! ,dep>tm5t1 ea* ( ! foll[+3 7#a7 ,! numb] ( pati5ts treat$ ) opioids by ! heal? c>e provid] or at ! m$ical facility1 z ! case may be1 divid$ by ! total numb] ( ph>macy us]s ( t heal? c>e provid] or m$ical facility4 7#b7 ,! av]age numb] ( morph9e equival5ts p] day prescrib$ by ! heal? c>e provid] or at ! m$ical facility1 z ! case may be1 to pati5ts be+ treat$ ) opioids4 7#c7 ,( ! pati5ts be+ treat$ ) opioids by ! heal? c>e provid] or at ! m$ical facility1 z ! case may be1 ! av]age numb] ( prescriptions ( opioids p] pati5t4 ,,ii ,pati5t ,advocacy #bja4 ,community meet+s on improv+ c>e furni%$ by ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,community meet+s 7#a7 ,m$ical c5t]s ,n lat] ?an #ij days aft] ! date ( ! enactm5t ( ?is ,act1 & n less frequ5tly ?an once e #ij days !reaft]1 ! ,secret>y %all ensure t ea* m$ical facility ( ! ,dep>tm5t ( ,vet]ans ,affairs ho/s a community meet+ op5 to ! public on improv+ heal? c>e furni%$ by ! ,secret>y4 7#b7 ,community bas$ outpati5t cl9ics ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 & n less frequ5tly ?an annually !reaft]1 ! ,secret>y %all ensure t ea* community bas$ outpati5t cl9ic ( ! ,dep>tm5t ho/s a community meet+ op5 to ! public on improv+ heal? c>e furni%$ by ! ,secret>y4 7b7 ,att5dance by ,director ( vet]ans integrat$ s]vice network or designee 7#a7 ,9 g5]al ,ea* community meet+ ho/$ by a m$ical facility or community bas$ outpati5t cl9ic "u subsection 7a7 %all be att5d$ by ! ,director ( ! ,vet]ans ,integrat$ ,s]vice ,network 9 :i* ! m$ical facility or community bas$ outpati5t cl9ic1 z ! case may be1 is locat$4 ,subject to p>agraph 7#b71 ! ,director may delegate su* att5dance only to an employee :o works 9 ! ,(fice ( ! ,director4 7#b7 ,att5dance by director ,ea* ,director ( a ,vet]ans ,integrat$ ,s]vice ,network %all p]sonally att5d n less ?an "o community meet+ "u subsection 7a7 ho/$ by ea* m$ical facility locat$ 9 ! ,vet]ans ,integrat$ ,s]vice ,network ea* ye>4 7c7 ,notice ,! ,secret>y %all notify ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate1 ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives1 & ea* ,memb] ( ,congress 7z def9$ 9 section #ajd7 :o repres5ts ! area 9 :i* ! m$ical facility is locat$ ( a community meet+ "u subsection 7a7 by n lat] ?an #aj days be=e su* community meet+ occurs4 #bjb4 ,improvem5t ( aw>5ess ( pati5t advocacy program & pati5t bill ( rights ( ,dep>tm5t ( ,vet]ans ,affairs ,n lat] ?an #ij days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all1 9 z _m prom95t locations z ! ,secret>y det]m9es appropriate to be se5 by ! l>ge/ p]c5tage ( pati5ts & family memb]s ( pati5ts at ea* m$ical facility ( ! ,dep>tm5t ( ,vet]ans ,affairs-- 7#a7 display ! purposes ( ! ,pati5t ,advocacy ,program ( ! ,dep>tm5t & ! contact in=mation = ! pati5t advocate at su* m$ical facility2 & 7#b7 display ! rights & responsibilities (-- 7,a7 pati5ts & family memb]s & pati5ts at su* m$ical facility2 & 7,b7 ) respect to community liv+ c5t]s & o!r resid5tial facilities ( ! ,dep>tm5t1 resid5ts & family memb]s ( resid5ts at su* m$ical facility4 #bjc4 ,comptroll] g5]al report on pati5t advocacy program ( ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,9 g5]al ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! ,pati5t ,advocacy ,program ( ! ,dep>tm5t ( ,vet]ans ,affairs 79 ?is section ref]r$ to z ! ,program74 7b7 ,elem5ts ,! report requir$ by subsection 7a7 %all include ! foll[+3 7#a7 ,a description ( ! ,program1 includ+-- 7,a7 ! purpose ( ! ,program2 7,b7 ! activities c>ri$ out "u ! ,program2 & 7,c7 ! suffici5cy ( ! ,program 9 a*iev+ ! purpose ( ! ,program4 7#b7 ,an assessm5t ( ! suffici5cy ( /aff+ ( employees ( ! ,dep>tm5t responsible = c>ry+ out ! ,program4 7#c7 ,an assessm5t ( ! suffici5cy ( ! tra9+ ( su* employees4 7#d7 ,an assessm5t (-- 7,a7 ! aw>5ess ( ! ,program among vet]ans & family memb]s ( vet]ans2 & 7,b7 ! use ( ! ,program by vet]ans & family memb]s ( vet]ans4 7#e7 ,su* recomm5dations & proposals = improv+ or modify+ ! ,program z ! ,comptroll] ,g5]al consid]s appropriate4 7#f7 ,su* o!r in=mation ) respect to ! ,program z ! ,comptroll] ,g5]al consid]s appropriate4 ,,iii ,complem5t>y & ,integrative ,heal? #cja4 ,expansion ( rese>* & education on & deliv]y ( complem5t>y & integrative heal? to vet]ans 7a7 ,e/abli%m5t ,!re is e/abli%$ a commission to be kn[n z ! ,creat+ ,options = ,vet]ans' ,exp$it$ ,recov]y or ! ,,cov] ,commission 79 ?is ,act ref]r$ to z ! ,commission74 ,! ,commission %all exam9e ! evid5ce-bas$ !rapy treatm5t model us$ by ! ,secret>y ( ,vet]ans ,affairs = treat+ m5tal heal? conditions ( vet]ans & ! pot5tial b5efits ( incorporat+ complem5t>y alt]native treatm5ts available 9 non-,dep>tm5t facilities 7z def9$ 9 section #agja ( title #ch1 ,unit$ ,/ates ,code74 7b7 ,duties ,! ,commission %all p]=m ! foll[+ duties3 7#a7 ,exam9e ! efficacy ( ! evid5ce-bas$ !rapy model us$ by ! ,secret>y = treat+ m5tal heal? illnesses ( vet]ans & id5tify areas to improve wellness-bas$ outcomes4 7#b7 ,conduct a pati5t-c5t]$ survey )9 ea* ( ! ,vet]ans ,integrat$ ,s]vice ,networks to exam9e-- 7,a7 ! exp]i5ce ( vet]ans ) ! ,dep>tm5t ( ,vet]ans ,affairs :5 seek+ m$ical assi/ance = m5tal heal? issues ?r\gh ! heal? c>e sy/em ( ! ,dep>tm5t2 7,b7 ! exp]i5ce ( vet]ans ) non-,dep>tm5t facilities & heal? pr(essionals = treat+ m5tal heal? issues2 7,c7 ! pref]5ce ( vet]ans reg>d+ available treatm5t = m5tal heal? issues & :i* me?ods ! vet]ans believe to be mo/ effective2 7,d7 ! exp]i5ce1 if any1 ( vet]ans ) respect to ! complem5t>y alt]native treatm5t !rapies describ$ 9 p>agraph 7#c72 7,e7 ! preval5ce ( prescrib+ prescription m$ication among vet]ans seek+ treatm5t ?r\gh ! heal? c>e sy/em ( ! ,dep>tm5t z rem$ies = address+ m5tal heal? issues2 & 7,f7 ! outrea* ef=ts ( ! ,secret>y reg>d+ ! availability ( b5efits & treatm5ts = vet]ans = address+ m5tal heal? issues1 includ+ by id5tify+ ways to r$uce b>ri]s to gaps 9 su* b5efits & treatm5ts4 7#c7 ,exam9e available rese>* on complem5t>y alt]native treatm5t !rapies = m5tal heal? issues & id5tify :at b5efits c\ld be made ) ! inclusion ( su* treatm5ts = vet]ans1 includ+ ) respect to-- 7,a7 music !rapy2 7,b7 equ9e !rapy2 7,c7 tra9+ & c>+ = s]vice dogs2 7,d7 yoga !rapy2 7,e7 acupuncture !rapy2 7,f7 m$itation !rapy2 7,g7 outdoor sports !rapy2 7,h7 hyp]b>ic oxyg5 !rapy2 7,i7 accel]at$ resolution !rapy2 7,j7 art !rapy2 7,k7 magnetic resonance !rapy2 & 7,l7 o!r !rapies ! ,commission det]m9es appropriate4 7#d7 ,/udy ! suffici5cy ( ! res\rces ( ! ,dep>tm5t to ensure ! deliv]y ( quality heal? c>e = m5tal heal? issues among vet]ans seek+ treatm5t )9 ! ,dep>tm5t4 7#e7 ,/udy ! curr5t treatm5ts & res\rces available )9 ! ,dep>tm5t & assess-- 7,a7 ! effectiv5ess ( su* treatm5ts & res\rces 9 decreas+ ! numb] ( suicides p] day by vet]ans2 7,b7 ! numb] ( vet]ans :o h be5 diagnos$ ) m5tal heal? issues2 7,c7 ! p]c5tage ( vet]ans us+ ! res\rces ( ! ,dep>tm5t :o h be5 diagnos$ ) m5tal heal? issues2 7,d7 ! p]c5tage ( vet]ans :o h complet$ c\nsel+ sessions (f]$ by ! ,dep>tm5t2 & 7,e7 ! ef=ts ( ! ,dep>tm5t to exp& complem5t>y alt]native treatm5ts viable to ! recov]y ( vet]ans ) m5tal heal? issues z det]m9$ by ! ,secret>y to improve ! effectiv5ess ( treatm5ts (f]$ ) ! ,dep>tm5t4 7c7 ,memb]%ip 7#a7 ,9 g5]al ,! ,commission %all be compos$ ( #aj memb]s1 appo9t$ z foll[s3 7,a7 ,two memb]s appo9t$ by ! ,speak] ( ! ,h\se ( ,repres5tatives1 at lea/ "o ( :om %all be a vet]an4 7,b7 ,two memb]s appo9t$ by ! ,m9ority ,lead] ( ! ,h\se ( ,repres5tatives1 at lea/ "o ( :om %all be a vet]an4 7,c7 ,two memb]s appo9t$ by ! ,majority ,lead] ( ! ,s5ate1 at lea/ "o ( :om %all be a vet]an4 7,d7 ,two memb]s appo9t$ by ! ,m9ority ,lead] ( ! ,s5ate1 at lea/ "o ( :om %all be a vet]an4 7,e7 ,two memb]s appo9t$ by ! ,presid5t1 at lea/ "o ( :om %all be a vet]an4 7#b7 ,qualifications ,memb]s ( ! ,commission %all be-- 7,a7 individuals :o are ( recogniz$ /&+ & di/9ction )9 ! m$ical community ) a backgr\nd 9 treat+ m5tal heal?2 7,b7 individuals ) exp]i5ce work+ ) ! milit>y & vet]an population2 & 7,c7 individuals :o d n h a f9ancial int]e/ 9 any ( ! complem5t>y alt]native treatm5ts review$ by ! ,commission4 7#c7 ,*airman ,! ,presid5t %all designate a memb] ( ! ,commission to be ! ,*airman4 7#d7 ,p]iod ( appo9tm5t ,memb]s ( ! ,commission %all be appo9t$ = ! life ( ! ,commission4 7#e7 ,vacancy ,a vacancy 9 ! ,commission %all be fill$ 9 ! mann] 9 :i* ! orig9al appo9tm5t 0 made4 7#f7 ,appo9tm5t deadl9e ,! appo9tm5t ( memb]s ( ! ,commission 9 ?is section %all be made n lat] ?an #ij days aft] ! date ( ! enactm5t ( ?is ,act4 7d7 ,p[]s ( commission 7#a7 ,meet+s 7,a7 ,initial meet+ ,! ,commission %all hold its fir/ meet+ n lat] ?an #cj days aft] a majority ( memb]s are appo9t$ to ! ,commission4 7,b7 ,meet+ ,! ,commission %all regul>ly meet at ! call ( ! ,*airman4 ,su* meet+s may be c>ri$ out ?r\gh ! use ( telephonic or o!r appropriate telecommunication te*nology if ! ,commission det]m9es t su* te*nology w all[ ! memb]s to communicate simultane\sly4 7#b7 ,he>+s ,! ,commission may hold su* he>+s1 sit & act at su* times & places1 take su* te/imony1 & receive evid5ce z ! ,commission consid]s advisable to c>ry out ! responsibilities ( ! ,commission4 7#c7 ,in=mation f f$]al ag5cies ,! ,commission may secure directly f any dep>tm5t or ag5cy ( ! ,f$]al ,gov]nm5t su* in=mation z ! ,commission consid]s necess>y to c>ry out ! duties ( ! ,commission4 7#d7 ,in=mation f nongov]nm5tal organizations ,9 c>ry+ out its duties1 ! ,commission may seek guidance ?r\gh consultation ) f\ndations1 vet]an s]vice organizations1 nonpr(it gr\ps1 fai?-bas$ organizations1 private & public in/itutions ( high] education1 & o!r organizations z ! ,commission det]m9es appropriate4 7#e7 ,commission records ,! ,commission %all keep an accurate & complete record ( ! actions & meet+ ( ! ,commission4 ,su* record %all be made available = public inspection & ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates may audit & exam9e su* record4 7#f7 ,p]sonnel records ,! ,commission %all keep an accurate & complete record ( ! actions & meet+s ( ! ,commission4 ,su* record %all be made available = public inspection & ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates may audit & exam9e su* records4 7#g7 ,comp5sation ( memb]s2 travel exp5ses ,ea* memb] %all s]ve )\t pay b %all receive travel exp5ses to p]=m ! duties ( ! ,commission1 includ+ p] diem 9 lieu ( sub/ances1 at rates au?oriz$ "u sub*apt] ,i ( *apt] #eg ( title #e1 ,unit$ ,/ates ,code4 7#h7 ,/aff ,! ,*airman1 9 accordance ) rules agre$ ^u ! ,commission1 may appo9t fix ! comp5sation ( a /aff director & su* o!r p]sonnel z may be necess>y to enable ! ,commission to c>ry out its functions1 )\t reg>d to ! provisions ( title #e1 ,unit$ ,/ates ,code1 gov]n+ appo9tm5ts 9 ! competitive s]vice1 )\t reg>d to ! provision ( *apt] #ea & sub*apt] ,,iii ( *apt] #ec ( su* title relat+ to classification & ,g5]al ,s*$ule pay rates1 except t no rate ( pay fix$ "u ?is p>agraph may exce$ ! equival5t ( t payable = a position at a level ,,iv ( ! ,executive ,s*$ule "u section #ecaf ( title #e1 ,unit$ ,/ates ,code4 7#i7 ,p]sonnel z f$]al employees 7,a7 ,9 g5]al ,! executive director & any p]sonnel ( ! ,commission are employees "u section #baje ( title #e1 ,unit$ ,/ates ,code1 = purpose ( *apt]s #fc1 #ha1 #hc1 #hd1 #he1 #hg1 #hi1 & #ij ( su* title4 7,b7 ,memb]s ( ! commission ,subp>agraph 7,a7 %all n be con/ru$ to apply to memb]s ( ! ,commission4 7#aj7 ,contract+ ,! ,commission may1 to su* ext5t & 9 su* am\nts z are provid$ 9 appropriations ,acts1 ent] into contracts to enable ! ,commission to dis*>ge ! duties ( ! ,commission "u ?is ,act4 7#aa7 ,exp]t & consultant s]vice ,! ,commission may procure ! s]vices ( exp]ts & consultants 9 accordance ) section #caji or title #e1 ,unit$ ,/ates ,code1 at rates n to exce$ ! daily rate paid to a p]son occupy+ a position at level ,,iv ( ! ,executive ,s*$ule "u section #caji ( title #e1 ,unit$ ,/ates ,code4 7#ab7 ,po/al s]vice ,! ,commission may use ! ,unit$ ,/ates mails 9 ! same mann] & "u ! same conditions z dep>tm5ts & ag5cies ( ! ,unit$ ,/ates4 7#ac7 ,physical facilities & equipm5t ,^u ! reque/ ( ! ,commission1 ! ,adm9i/rator ( ,g5]al ,s]vices %all provide to ! ,commission1 on a reimbursable basis1 ! adm9i/rative support s]vices necess>y = ! ,commission to c>ry out its responsibilities "u ?is ,act4 ,^! adm9i/rative s]vices may include human res\rce managem5t1 budget1 leas+ acc\nt+1 & payroll s]vices4 7e7 ,report 7#a7 ,int]im reports 7,a7 ,9 g5]al ,n lat] ?an #fj days aft] ! date on :i* ! ,commission fir/ meets1 & ea* #cj-;day p]iod !reaft] end+ on ! date on :i* ! ,commission submits ! f9al report "u p>agraph 7#b71 ! ,commission %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate & ! ,presid5t a report detail+ ! level ( coop]ation ! ,secret>y ( ,vet]ans ,affairs 7& ! heads ( o!r dep>tm5ts or ag5cies ( ! ,f$]al ,gov]nm5t7 has provid$ to ! ,commission4 7,b7 ,o!r reports ,9 c>ry+ out its duties1 at times t ! ,commission det]m9es appropriate1 ! ,commission %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate & any o!r appropriate entities an int]im report ) respect to ! f9d+s id5tifi$ by ! ,commission4 7#b7 ,f9al report ,n lat] ?an #ah mon?s aft] ! fir/ meet+ ( ! ,commission1 ! ,commission %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate1 ! ,presid5t1 & ! ,secret>y ( ,vet]ans ,affairs a f9al report on ! f9d+s ( ! ,commission4 ,su* report %all include ! foll[+3 7,a7 ,recomm5dations to implem5t 9 a feasible1 timely1 & co/ effici5t mann] ! solutions & rem$ies id5tifi$ )9 ! f9d+s ( ! ,commission pursuant to subsection 7b74 7,b7 ,an analysis ( ! evid5ce-bas$ !rapy model us$ by ! ,secret>y ( ,vet]ans ,affairs = treat+ vet]ans ) m5tal heal? c>e issues1 & an exam9ation ( ! preval5ce & efficacy ( prescription drugs z a means = treatm5t4 7,c7 ,! f9d+s ( ! pati5t-c5t]$ survey conduct$ )9 ea* ( ! ,vet]ans ,integrat$ ,s]vice ,networks pursuant to subsection 7b77#b74 7,d7 ,an exam9ation ( complem5t>y alt]native treatm5ts describ$ 9 subsection 7b77#c7 & ! pot5tial b5efits ( incorporat+ su* treatm5ts 9 ! !rapy models us$ by ! ,secret>y = treat+ vet]ans ) m5tal heal? issues4 7#c7 ,plan ,n lat] ?an #ij days aft] ! date on :i* ! ,commission submits ! f9al report "u p>agraph 7#b71 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a report on ! foll[+3 7,a7 ,an action plan = implem5t+ ! recomm5dations e/abli%$ by ! ,commission on su* solutions & rem$ies = improv+ wellness-bas$ outcomes = vet]ans ) m5tal heal? c>e issues4 7,b7 ,a feasible timeframe on :5 ! complem5t>y alt]native treatm5ts describ$ 9 subsection 7b77#c7 c be implem5t$ ,dep>tm5twide4 7,c7 ,) respect to ea* recomm5dation e/abli%$ by ! ,commission1 includ+ any complem5t>y alt]native treatm5t1 t ! ,secret>y det]m9es is n appropriate or feasible to implem5t1 a ju/ification = su* det]m9ation & an alt]native solution to improve ! efficacy ( ! !rapy models us$ by ! ,secret>y = treat+ vet]ans ) m5tal heal? issues4 7f7 ,t]m9ation ( commission ,! ,commission %all t]m9ate #cj days aft] ! ,commission submits ! f9al report "u subsection 7e77#b74 #cjb4 ,pilot program on integration ( complem5t>y alt]native m$ic9es & relat$ issues = vet]ans & family memb]s ( vet]ans 7a7 ,pilot program 7#a7 ,9 g5]al ,n lat] ?an #ahj days aft] ! date on :i* ! ,secret>y ( ,vet]ans ,affairs receives ! f9al report "u section #cja7;e71 ! ,secret>y %all comm5ce a pilot program to assess ! feasibility & advisability ( us+ wellness-bas$ programs 7z def9$ by ! ,secret>y7 to complem5t ! provision ( pa9 managem5t & relat$ heal? c>e s]vices1 includ+ m5tal heal? c>e s]vices1 to vet]ans4 7#b7 ,matt]s address$ ,9 c>ry+ out ! pilot program1 ! ,secret>y %all assess ! foll[+3 7,a7 ,means ( improv+ coord9ation betwe5 ,f$]al1 ,/ate1 local1 & community provid]s ( heal? c>e 9 ! provision ( pa9 managem5t & relat$ heal? c>e s]vices to vet]ans4 7,b7 ,means ( enhanc+ outrea*1 & coord9ation ( outrea*1 by & among provid]s ( heal? c>e ref]r$ to 9 subp>agraph 7,a7 on ! pa9 managem5t & relat$ heal? c>e s]vices available to vet]ans4 7,c7 ,means ( us+ wellness-bas$ programs ( provid]s ( heal? c>e ref]r$ to 9 subp>agraph 7,a7 z complem5ts to ! provision by ! ,dep>tm5t ( pa9 managem5t & relat$ heal? c>e s]vices to vet]ans4 7,d7 ,:e!r wellness-bas$ programs describ$ 9 subp>agraph 7,c7-- 7i7 are effective 9 enhanc+ ! quality ( life & well-be+ ( vet]ans2 7ii7 are effective 9 increas+ ! adh]5ce ( vet]ans to ! prim>y pa9 managem5t & relat$ heal? c>e s]vices provid$ su* vet]ans by ! ,dep>tm5t2 7iii7 h an effect on ! s5se ( well-be+ ( vet]ans :o receive prim>y pa9 managem5t & relat$ heal? c>e s]vices f ! ,dep>tm5t2 & 7iv7 are effective 9 enc\rag+ vet]ans receiv+ heal? c>e f ! ,dep>tm5t to adopt a m heal?y life/yle4 7b7 ,duration ,! ,secret>y %all c>ry out ! pilot program "u subsection 7a77#a7 = a p]iod ( ?ree ye>s4 7c7 ,locations 7#a7 ,facilities ,! ,secret>y %all c>ry out ! pilot program "u subsection 7a77#a7 at facilities ( ! ,dep>tm5t provid+ pa9 managem5t & relat$ heal? c>e s]vices1 includ+ m5tal heal? c>e s]vices1 to vet]ans4 ,9 select+ su* facilities to c>ry out ! pilot program1 ! ,secret>y %all select n few] ?an #ae m$ical c5t]s ( ! ,dep>tm5t1 ( :i* n few] ?an two %all be polytrauma rehabilitation c5t]s ( ! ,dep>tm5t4 7#b7 ,m$ical c5t]s ) prescription rates ( opioids t conflict ) c>e /&>ds ,9 select+ ! m$ical c5t]s "u p>agraph 7#a71 ! ,secret>y %all give priority to m$ical c5t]s ( ! ,dep>tm5t at :i* !re is a prescription rate ( opioids t conflicts ) or is o!rwise inconsi/5t ) ! /&>ds ( appropriate & safe c>e4 7d7 ,provision ( s]vices ,"u ! pilot program "u subsection 7a77#a71 ! ,secret>y %all provide cov]$ s]vices to cov]$ vet]ans by integrat+ complem5t>y & alt]native m$ic9es & integrative heal? s]vices ) o!r s]vices provid$ by ! ,dep>tm5t at ! m$ical c5t]s select$ "u subsection 7c74 7e7 ,cov]$ vet]ans ,= purposes ( ! pilot program "u subsection 7a77#a71 a cov]$ vet]an is any vet]an :o-- 7#a7 has a m5tal heal? condition diagnos$ by a cl9ician ( ! ,dep>tm5t2 7#b7 exp]i5ces *ronic pa92 7#c7 has a *ronic condition be+ treat$ by a cl9ician ( ! ,dep>tm5t2 or 7#d7 is n describ$ 9 p>agraph 7#a71 7#b71 or 7#c7 & reque/s to p>ticipate 9 ! pilot program or is ref]r$ by a cl9ician ( ! ,dep>tm5t :o is treat+ ! vet]an4 7f7 ,cov]$ s]vices 7#a7 ,9 g5]al ,= purposes ( ! pilot program1 cov]$ s]vices are s]vices consi/+ ( complem5t>y & integrative heal? s]vices z select$ by ! ,secret>y4 7#b7 ,adm9i/ration ( s]vices ,cov]$ s]vices %all be adm9i/]$ "u ! pilot program z foll[s3 7,a7 ,cov]$ s]vices %all be adm9i/]$ by pr(essionals or o!r in/ructors ) appropriate tra9+ & exp]tise 9 complem5t>y & integrative heal? s]vices :o are employees ( ! ,dep>tm5t or ) :om ! ,dep>tm5t ent]s into an agreem5t to provide su* s]vices4 7,b7 ,cov]$ s]vices %all be includ$ z "p ( ! ,pati5t ,align$ ,c>e ,teams initiative ( ! ,(fice ( ,pati5t ,c>e ,s]vices1 ,prim>y ,c>e ,program ,(fice1 9 coord9ation ) ! ,(fice ( ,pati5t ,c5t]$ ,c>e & ,cultural ,trans=mation4 7,c7 ,cov]$ s]vices %all be made available to-- 7i7 cov]$ vet]ans :o h receiv$ conv5tional treatm5ts f ! ,dep>tm5t = ! conditions = :i* ! cov]$ vet]an seeks complem5t>y & integrative heal? s]vices "u ! pilot program2 & 7ii7 cov]$ vet]ans :o h n receiv$ conv5tional treatm5ts f ! ,dep>tm5t = su* conditions4 7g7 ,reports 7#a7 ,9 g5]al ,n lat] ?an #cj mon?s aft] ! date on :i* ! ,secret>y comm5ces ! pilot program "u subsection 7a77#a71 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! pilot program4 7#b7 ,elem5ts ,! report "u p>agraph 7#a7 %all include ! foll[+3 7,a7 ,! f9d+s & conclusions ( ! ,secret>y ) respect to ! pilot program "u subsection 7a77#a71 includ+ ) respect to-- 7i7 ! use & efficacy ( ! complem5t>y & integrative heal? s]vices e/abli%$ "u ! pilot program2 7ii7 ! outrea* conduct$ by ! ,secret>y to in=m vet]ans & community organizations ab\t ! pilot program2 & 7iii7 an assessm5t ( ! b5efit ( ! pilot program to cov]$ vet]ans 9 m5tal heal? diagnoses1 pa9 managem5t1 & treatm5t ( *ronic illness4 7,b7 ,id5tification ( any unresolv$ b>ri]s t imp$e ! ability ( ! ,secret>y to incorporate complem5t>y & integrative heal? s]vices ) o!r heal? c>e s]vices provid$ by ! ,dep>tm5t4 7,c7 ,su* recomm5dations = ! cont9uation or expansion ( ! pilot program z ! ,secret>y consid]s appropriate4 7h7 ,complem5t>y & integrative heal? def9$ ,9 ?is section1 ! t]m complem5t>y & integrative heal? %all h ! mean+ giv5 t t]m by ! ,national ,in/itutes ( ,heal?4 ,,iv ,fitness ( ,heal? ,c>e ,provid]s #dja4 ,additional requirem5ts = hir+ ( heal? c>e provid]s by ,dep>tm5t ( ,vet]ans ,affairs ,z "p ( ! hir+ process = ea* heal? c>e provid] consid]$ = a position at ! ,dep>tm5t ( ,vet]ans ,affairs aft] ! date ( ! enactm5t ( ! ,act1 ! ,secret>y ( ,vet]ans ,affairs %all require f ! m$ical bo>d ( ea* ,/ate 9 :i* ! heal? c>e provid] has a m$ical lic5se-- 7#a7 in=mation on any violation ( ! requirem5ts ( ! m$ical lic5se ( ! heal? c>e provid] dur+ ! #bj-ye> p]iod prec$+ ! consid]ation ( ! heal? c>e provid] by ! ,dep>tm5t2 & 7#b7 in=mation on :e!r ! heal? c>e provid] has ent]$ into any settlem5t agreem5t = ! discipl9>y *>ge relat+ to ! practice ( m$ic9e by ! heal? c>e provid]4 #djb4 ,provision ( in=mation on heal? c>e provid]s ( ,dep>tm5t ( ,vet]ans ,affairs to ,/ate ,m$ical ,bo>ds ,not)/&+ section #eeb;a ( title #e1 ,unit$ ,/ates ,code1 ) respect to ea* heal? c>e provid] ( ! ,dep>tm5t ( ,vet]ans ,affairs :o has violat$ a requirem5t ( ! m$ical lic5se ( ! heal? c>e provid]1 ! ,secret>y ( ,vet]ans ,affairs %all provide to ! m$ical bo>d ( ea* ,/ate 9 :i* ! heal? c>e provid] is lic5s$ detail$ in=mation ) respect to su* violation1 reg>dless ( :e!r su* bo>d has =mally reque/$ su* in=mation4 #djc4 ,report on compliance by ,dep>tm5t ( ,vet]ans ,affairs ) reviews ( heal? c>e provid]s leav+ ! ,dep>tm5t or transf]r+ to o!r facilities ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! compliance by ! ,dep>tm5t ( ,vet]ans ,affairs ) ! policy ( ! ,dep>tm5t-- 7#a7 to conduct a review ( ea* heal? c>e provid] ( ! ,dep>tm5t :o transf]s to ano!r m$ical facility ( ! ,dep>tm5t1 retires1 or is t]m9at$ to det]m9e :e!r !re are any conc]ns1 compla9ts1 or allegations ( violations relat+ to ! m$ical practice ( ! heal? c>e provid]2 & 7#b7 to take appropriate action ) respect to any su* conc]n1 compla9t1 or allegation4 ,v ,o!r ,vet]ans ,matt]s #eja4 ,audit ( ,vet]ans ,heal? ,adm9i/ration programs ( ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,audit ,! ,secret>y ( ,vet]ans ,affairs %all seek to ent] into a contract ) a nongov]nm5tal entity "u :i* ! entity %all conduct a audits ( ! programs ( ! ,vet]ans ,heal? ,adm9i/ration ( ! ,dep>tm5t ( ,vet]ans ,affairs to id5tify ways to improve ! furni%+ ( b5efits & heal? c>e adm9i/]$ by ! ,vet]ans ,heal? ,adm9i/ration to vet]ans & families ( vet]ans4 7b7 ,audit requirem5ts ,9 c>ry+ out ea* audit "u subsection 7a71 ! entity %all p]=m ! foll[+3 7#a7 ,five-ye> risk assessm5ts to id5tify ! functions1 /aff organizations1 & /aff (fices ( ! ,vet]ans ,heal? ,adm9i/ration t w\ld lead t[>ds ! greate/ improvem5t 9 furni%+ ( b5efits & heal? c>e to vet]ans & families ( vet]ans4 7#b7 ,developm5t ( plans t are in=m$ by ! risk assessm5t "u p>agraph 7#a7 to conduct audits ( ! functions1 /aff organizations1 & /aff (fices id5tifi$ "u p>agraph 7#a74 7#c7 ,conduct audits 9 accordance ) ! plans develop$ pursuant to p>agraph 7#b74 7c7 ,reports ,n lat] ?an #ij days aft] ! date on :i* ea* audit is complet$ "u subsection 7a71 ! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a report t includes-- 7#a7 a summ>y ( ! audit2 7#b7 ! f9d+s ( ! entity t conduct$ ! audit ) respect to ! audit2 & 7#c7 su* recomm5dations z ! ,secret>y det]m9es appropriate = legislative or adm9i/rative action to improve ! furni%+ ( b5efits & heal? c>e to vet]ans & families ( vet]ans4