,,ii ,cal5d> ,no4 #gaf #aad? ,,congress 
#b;d ,session  ,s4 #dbe ,report ,no4    
#aad-cie ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$
 ,,/ates  ,febru>y #aj1 #bjae,mr4       
,boozman 7= himself1 ,mr4 ,te/]1 ,mr4   
,inh(e1 & ,mr4 ,s*um]7 introduc$ !      
foll[+ bill2 :i* 0 read twice & ref]r$  
to ! ,committee on ,vet]ans' ,affairs   
,decemb] #g1 #bjaf,report$ by ,mr4      
,isakson1 ) an am5dm5t & an am5dm5t to !
 title,strike out all aft] ! enact+     
clause & ins]t ! "p pr9t$ 9 italic  ,a  
,,bill  ,to am5d title #ch1 ,unit$      
,/ates ,code1 to provide = a five-ye>   
ext5sion to ! homeless vet]ans          
re9tegration programs & to provide      
cl>ification reg>d+ eligibility =       
s]vices "u su* programs4  #a4 ,%ort     
title ,?is ,act may be cit$ z !         
,homeless ,vet]ans' ,re9tegration       
,programs ,reau?orization ,act ( #bjae4 
#b4 ,reau?orization ( ,dep>tm5t (       
,vet]ans ,affairs homeless vet]ans      
re9tegration programs  7a7 ,five-,ye>   
ext5sion ( homeless vet]ans re9tegration

 programs ,section #bjba7;e77,f7 ( title
 #ch1 ,unit$ ,/ates ,code1 is am5d$ by  
/rik+ #bjae & ins]t+ #bjbj4  7b7        
,five-,ye> ext5sion ( homeless wom5     
vet]ans & homeless vet]ans ) *ildr5     
re9tegration grant program ,section     
#bjba;,a7f77#a7 ( su* title is am5d$ by 
/rik+ #bjae & ins]t+ #bjbj4  7c7        
,cl>ification ( eligibility = s]vices "u
 homeless vet]ans re9tegration programs 
,section #bjba7;a7 ( su* title is am5d$ 
by /rik+ re9tegration ( homeless vet]ans
 into ! labor =ce4 & ins]t+ ! foll[+3   
re9tegration into ! labor =ce (--  7#a7 
homeless vet]ans2  7#b7 vet]ans         
p>ticipat+ 9 ! ,dep>tm5t ( ,vet]ans     
,affairs support$ h\s+ program = :i*    
r5tal assi/ance is provid$ pursuant to  
section #h7o77#ai7 ( ! ,unit$ ,/ates    
,h\s+ ,act ( #aicg 7#db ,u4,s4,c4       
#adcg;f7o77#ai772  7#c7 ,indians :o are 
vet]ans & receiv+ assi/ance "u ! ,native
 ,am]ican ,h\s+ ,assi/ance & ,self      
,det]m9ation ,act ( #aiif 7#be ,u4,s4,c4
 #daja et seq472 &  7#d7 vet]ans :o are 

transition+ f be+ inc>c]at$4  4  #a4    
,%ort title2 table ( cont5ts  7a7 ,%ort 
title ,?is ,act may be cit$ z ! ,vet]ans
 ,homeless ,programs1 ,c>egiv] ,s]vices1
 & ,o!r ,improvem5ts ,act ( #bjae4  7b7 
,table ( cont5ts ,! table ( cont5ts =   
?is ,act is z foll[s3 ,sec4 #a4 ,%ort   
title2 table ( cont5ts4 ,,title         
,i--,b5efits ,sec4 #aja4 ,exp$it$ paym5t
 ( survivors b5efits4 ,sec4 #ajb4       
,increase 9 special p5sion = ,m$al (    
,honor recipi5ts4 ,,title               
,,ii--,education matt]s ,sec4 #bja4     
,re/oration ( entitlem5t to ,po/-#i_/aa 
,educational ,assi/ance = vet]ans       
affect$ by closures ( educational       
in/itutions4 ,sec4 #bjb4 ,modification &
 improvem5t ( transf] ( unus$           
,po/-#i_/aa ,educational ,assi/ance to  
family memb]s4 ,sec4 #bjc4 ,codification
 & improvem5t ( election process =      
,po/-#i_/aa ,educational ,assi/ance4    
,sec4 #bjd4 ,c5traliz$ report+ ( vet]an 
enrollm5t by c]ta9 gr\ps1 di/ricts1 &   
consortiums ( educational in/itutions4  

,sec4 #bje4 ,improv$ role ( ,/ate       
approv+ ag5cies 9 adm9i/ration ( vet]ans
 educational b5efits4 ,sec4 #bjf4       
,modification ( crit]ia us$ to approve  
c\rses = purposes ( vet]ans educational 
b5efits4 ,sec4 #bjg4 ,surveys =         
compliance ( educational in/itutions &  
tra9+ e/abli%m5ts ) requirem5ts relat+  
to adm9i/ration ( vet]ans educational   
b5efits4 ,sec4 #bjh4 ,modification (    
requirem5ts = approval = purposes (     
educational assi/ance provid$ by        
,dep>tm5t ( ,vet]ans ,affairs ( programs
 design$ to prep>e individuals =        
lic5sure or c]tification4 ,sec4 #bji4   
,expansion ( ,yell[ ,ribbon ,g4,i4      
,education ,enhancem5t ,program4 ,sec4  
#baj4 ,consid]ation ( c]ta9 "t sp5t     
receiv+ m$ical c>e f ,secret>y ( ,def5se
 z active duty = purposes ( eligibility 
= ,po/-#i_/aa ,educational ,assi/ance4  
,,title ,,iii--,homeless vet]ans matt]s 
,sec4 #cja4 ,expansion ( def9ition (    
homeless vet]an = purposes ( b5efits "u 
! laws adm9i/]$ by ! ,secret>y (        

,vet]ans ,affairs4 ,sec4 #cjb4 ,increas$
 p] diem paym5ts = transitional h\s+    
assi/ance t becomes p]man5t h\s+ =      
homeless vet]ans4 ,sec4 #cjc4 ,expansion
 ( ,dep>tm5t ( ,vet]ans ,affairs        
au?ority to provide d5tal c>e to        
homeless vet]ans4 ,sec4 #cjd4           
,cl>ification ( eligibility = s]vices "u
 homeless vet]ans re9tegration programs4
 ,sec4 #cje4 ,program to improve        
ret5tion ( h\s+ by =m]ly homeless       
vet]ans & vet]ans at risk ( becom+      
homeless4 ,sec4 #cjf4 ,pilot program on 
provision ( int5sive case managem5t     
int]v5tions to homeless vet]ans :o      
receive ! mo/ heal? c>e f ! ,dep>tm5t ( 
,vet]ans ,affairs4 ,sec4 #cjg4          
,e/abli%m5t ( ,national ,c5t] on        
,homelessness ,among ,vet]ans4 ,sec4    
#cjh4 ,p>tn]%ips ) public & private     
entities to provide legal s]vices to    
homeless vet]ans & vet]ans at risk (    
homelessness4 ,sec4 #cji4 ,adm9i/rative 
improvem5ts to grant & p] diem programs 
( ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4  

#caj4 ,repeal ( requirem5t = annual     
reports on assi/ance to homeless        
vet]ans4 ,sec4 #caa4 ,comptroll] ,g5]al 
( ! ,unit$ ,/ates /udy on homeless      
vet]ans programs ( ,dep>tm5t ( ,vet]ans 
,affairs4 ,sec4 #cab4 ,requirem5t =     
,dep>tm5t ( ,vet]ans ,affairs to assess 
compreh5sive s]vice programs = homeless 
vet]ans4 ,sec4 #cac4 ,report on outrea* 
relat+ to increas+ ! am\nt ( h\s+       
available to vet]ans4 ,,title           
,,iv--,heal? c>e matt]s ,sec4 #dja4     
,%ort title4 ,subtitle ,a--,employm5t ( 
directors & heal? c>e provid]s ,sec4    
#daa4 ,ext5sion ( p]iod = increase 9    
graduate m$ical education resid5cy      
positions at m$ical facilities ( !      
,dep>tm5t ( ,vet]ans ,affairs4 ,sec4    
#dab4 ,modification ( h\rs ( employm5t =
 physicians & physician assi/ants       
employ$ by ! ,dep>tm5t ( ,vet]ans       
,affairs4 ,sec4 #dac4 ,requirem5t t     
physician assi/ants employ$ by !        
,dep>tm5t ( ,vet]ans ,affairs receive   
competitive pay4 ,sec4 #dad4 ,e/abli%m5t

 ( positions ( ,directors ( ,vet]ans    
,integrat$ ,s]vice ,networks 9 ,(fice ( 
,"u ,secret>y = ,heal? ( ,dep>tm5t (    
,vet]ans ,affairs & modification (      
qualifications = ,m$ical ,directors4    
,sec4 #dae4 ,pay = ,m$ical ,directors & 
,directors ( ,vet]ans ,integrat$ ,s]vice
 ,networks4 ,sec4 #daf4 ,additional     
requirem5ts = hir+ ( heal? c>e provid]s 
by ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4 
#dag4 ,provision ( in=mation on heal?   
c>e provid]s ( ,dep>tm5t ( ,vet]ans     
,affairs to ,/ate m$ical bo>ds4 ,sec4   
#dah4 ,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 ,subtitle  
,b--,opioid !rapy & pa9 managem5t ,sec4 
#dba4 ,guidel9es on managem5t ( opioid  
!rapy by ,dep>tm5t ( ,vet]ans ,affairs &
 ,dep>tm5t ( ,def5se & implem5tation (  
su* guidel9es by ,dep>tm5t ( ,vet]ans   
,affairs4 ,sec4 #dbb4 ,improvem5t (     
opioid safety measures by ,dep>tm5t (   
,vet]ans ,affairs4 ,sec4 #dbc4          

,enhancem5t ( jo9t work+ gr\p on pa9    
managem5t ( ! ,dep>tm5t ( ,vet]ans      
,affairs & ! ,dep>tm5t ( ,def5se4 ,sec4 
#dbd4 ,e/abli%m5t ( pa9 managem5t bo>ds 
( ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4  
#dbe4 ,review1 inve/igation1 & report on
 use ( opioids 9 treatm5t by ,dep>tm5t (
 ,vet]ans ,affairs4 ,subtitle           
,c--,pati5t advocacy ,sec4 #dca4        
,e/abli%m5t ( ,(fice ( ,pati5t ,advocacy
 ( ! ,dep>tm5t ( ,vet]ans ,affairs4     
,sec4 #dcb4 ,community meet+s on improv+
 c>e f ,dep>tm5t ( ,vet]ans ,affairs4   
,sec4 #dcc4 ,improvem5t ( aw>5ess (     
pati5t advocacy program & pati5t bill ( 
rights ( ,dep>tm5t ( ,vet]ans ,affairs4 
,sec4 #dcd4 ,comptroll] ,g5]al ,report  
on ,pati5t ,advocacy ,program (         
,dep>tm5t ( ,vet]ans ,affairs4 ,subtitle
 ,d--,complem5t>y & integrative heal?   
,sec4 #dda4 ,expansion ( rese>* &       
education on & deliv]y ( complem5t>y &  
integrative heal? to vet]ans4 ,sec4     
#ddb4 ,pilot program on integration (   
complem5t>y & integrative heal? )9      

,dep>tm5t ( ,vet]ans ,affairs m$ical    
c5t]s4 ,subtitle ,e--,family c>egiv]s   
,sec4 #dea4 ,expansion ( family c>egiv] 
program ( ,dep>tm5t ( ,vet]ans ,affairs4
 ,sec4 #deb4 ,implem5tation ( in=mation 
te*nology sy/em ( ,dep>tm5t ( ,vet]ans  
,affairs to assess & improve ! family   
c>egiv] program4 ,sec4 #dec4            
,modifications to annual evaluation     
report on c>egiv] program ( ,dep>tm5t ( 
,vet]ans ,affairs4 ,sec4 #ded4 ,advisory
 committee on c>egiv] policy4 ,sec4     
#dee4 ,compreh5sive /udy on s]i\sly     
injur$ vet]ans & _! c>egiv]s4 ,subtitle 
,f--,heal? c>e agreem5ts ,sec4 #dfa4    
,au?orization ( agreem5ts betwe5 !      
,dep>tm5t ( ,vet]ans ,affairs &         
non-,dep>tm5t ext5d$ c>e provid]s4 ,sec4
 #dfb4 ,modification ( au?ority to ent] 
into agreem5ts ) ,/ate homes to provide 
nurs+ home c>e4 ,,title ,v--,o!r matt]s 
,sec4 #eja4 ,ext5sion ( tempor>y        
increase 9 numb] ( judges on ,unit$     
,/ates ,c\rt ( ,appeals = ,vet]ans      
,claims4 ,sec4 #ejb4 ,repeal            

inapplicability ( modification ( basic  
all[ance = h\s+ to b5efits "u laws      
adm9i/]$ by ,secret>y ( ,vet]ans        
,affairs4 ,sec4 #ejc4 ,dep>tm5t (       
,vet]ans ,affairs program ( int]nal     
audits4 ,sec4 #ejd4 ,improvem5t ( tra9+ 
= manag]s4  ,i ,b5efits  #aja4 ,exp$it$ 
paym5t ( survivors b5efits  7a7 ,9 g5]al
 ,section #eaja7;a77#a7 ( title #ch1    
,unit$ ,/ates ,code1 is am5d$--  7#a7 by
 /rik+ ,a specific & ins]t+ 7,a7 ,except
 z provid$ 9 subp>agraph 7,b71 a        
specific2 &  7#b7 by add+ at ! end !    
foll[+ new subp>agraph3  7,b7 7i7 ,!    
,secret>y may pay b5efits "u *apt]s #ac 
& #ae & sections #bcjb1 #bcjg1 & #eaba (
 ?is title to a survivor ( a vet]an :o  
has n fil$ a =mal claim if ! ,secret>y  
det]m9es t ! record conta9s suffici5t   
evid5ce to e/abli% ! entitlem5t ( !     
survivor to su* b5efits4  7ii7 ,=       
purposes ( ?is subp>agraph & section    
#eaaj ( ?is title1 ! date on :i* !      
,secret>y is notifi$ ( ! dea? ( ! vet]an
 %all be treat$ z ! date ( ! receipt ( !

 survivor's application = b5efits       
describ$ 9 clause 7i74  4  7b7          
,effective date ,! am5dm5ts made by     
subsection 7a7 %all apply ) respect to  
claims = b5efits bas$ on a dea? occurr+ 
on or aft] ! date ( ! enactm5t ( ?is    
,act4  #ajb4 ,increase 9 special p5sion 
= ,m$al ( ,honor recipi5ts  7a7 ,9 g5]al
 ,section #aefb7;a7 ( title #ch1 ,unit$ 
,/ates ,code1 is am5d$ by /rik+ #a1jjj &
 ins]t+ #c1jjj4  7b7 ,effective date    
7#a7 ,9 g5]al ,! am5dm5t made by        
subsection 7a7 %all take effect on !    
date t is--  7,a7 except z provid$ 9    
subp>agraph 7,b71 "o ye> aft] ! date ( !
 enactm5t ( ?is ,act2 &  7,b7 9 ! case t
 ! date t is "o ye> aft] ! date ( !     
enactm5t ( ?is ,act is n ! fir/ day ( a 
mon?1 ! fir/ day ( ! fir/ mon? beg9n+   
aft] ! date t is "o ye> aft] ! date ( ! 
enactm5t ( ?is ,act4  7#b7 ,delay (     
annual co/ ( liv+ adju/m5t  7,a7 ,9     
g5]al ,! ,secret>y %all n make an       
increase pursuant to section #aefb7;e7 (
 su* title effective ,decemb] #a1 #bjaf1

 if ! am5dm5t made by subsection 7a7    
takes effect be=e su* date4  7,b7       
,resumption ,9 ! case t ! ,secret>y1    
pursuant to subp>agraph 7,a71 does n    
make an increase pursuant to section    
#aefb7;e7 ( su* title effective ,decemb]
 #a1 #bjaf1 ! ,secret>y %all resume mak+
 increases pursuant to su* section ) !  
fir/ su* increase effective ,decemb] #a1
 #bjag4  ,,ii ,education matt]s  #bja4  
,re/oration ( entitlem5t to ,po/-#i_/aa 
,educational ,assi/ance = vet]ans       
affect$ by closures ( educational       
in/itutions  7a7 ,educational assi/ance 
7#a7 ,9 g5]al ,section #ccab ( title    
#ch1 ,unit$ ,/ates ,code1 is am5d$ by   
add+ at ! end ! foll[+ new subsection3  
7d7 ,discont9uation ( education due to  
closure ( educational in/itution  7#a7  
,9 g5]al ,any paym5t ( educational      
assi/ance describ$ 9 p>agraph 7#b7 %all 
n-- 7,a7 be *>g$ aga9/ any entitlem5t to
 educational assi/ance ( ! individual   
conc]n$ "u ?is *apt]2 or  7,b7 be c\nt$ 
aga9/ ! aggregate p]iod = :i* section   

#cfie ( ?is title limits ! individual's 
receipt ( educational assi/ance "u ?is  
*apt]4  7#b7 ,description ( paym5t (    
educational assi/ance ,subject to       
p>agraph 7#c71 ! paym5t ( educational   
assi/ance describ$ 9 ?is p>agraph is !  
paym5t ( su* assi/ance to an individual 
= pursuit ( a c\rse or c\rses "u ?is    
*apt] if ! ,secret>y f9ds t !           
individual--  7,a7 0 =c$ to discont9ue  
su* c\rse pursuit z a result ( a p]man5t
 closure ( an educational in/itution2 & 
7,b7 did n receive cr$it1 or lo/ tra9+  
"t1 t[>d completion ( ! program (       
education be+ pursu$ at ! "t ( su*      
closure4  7#c7 ,p]iod = :i* paym5t n    
*>g$ ,! p]iod = :i*1 by reason ( ?is    
subsection1 educational assi/ance is n  
*>g$ aga9/ entitlem5t or c\nt$ t[>d !   
applicable aggregate p]iod "u section   
#cfie ( ?is title %all n exce$ !        
aggregate (--  7,a7 ! portion ( ! p]iod 
( enrollm5t 9 ! c\rse or c\rses f :i* ! 
individual fail$ to receive cr$it or )  
respect to :i* ! individual lo/ tra9+   

"t1 z det]m9$ "u p>agraph 7#b77;,b71 &  
7,b7 ! p]iod by :i* a mon?ly /ip5d is   
ext5d$ "u section #cfhj7;a77#b77;,b7 (  
?is title4  4  7#b7 ,applicability      
,subsection 7d7 ( su* section1 z add$ by
 p>agraph 7#a71 %all apply ) respect to 
c\rses & programs ( education discont9u$
 z describ$ 9 p>agraph 7#b7 ( su*       
subsection 9 fiscal ye> #bjae or any    
fiscal ye> !reaft]4  7b7 ,mon?ly h\s+   
/ip5d  7#a7 ,9 g5]al ,section #cfhj7;a7 
( su* title is am5d$-- 7,a7 by /rik+ !  
matt] aft] p>agraph 7#c77;,b72  7,b7 9  
p>agraph 7#c71 by r$esignat+            
subp>agraphs 7,a7 & 7,b7 z clauses 7i7 &
 7ii71 respectively2  7,c7 by r$esignat+
 p>agraphs 7#a7 ?r\gh 7#c7 z            
subp>agraphs 7,a7 ?r\gh 7,c71           
respectively2  7,d7 9 ! matt] be=e      
subp>agraph 7,a71 z r$esignat$1 9 ! fir/
 s5t5ce1 by /rik+ ,paym5t ( & ins]t+    
7#a7 ,except z provid$ 9 p>agraph 7#b71 
paym5t (2 &  7,e7 by add+ at ! end !    
foll[+ new p>agraph 7#b73  7#b7 ,not)/&+
 p>agraph 7#a71 ! ,secret>y may1        

pursuant to su* regulations z !         
,secret>y %all prescribe1 cont9ue to pay
 all[ances to eligible vet]ans &        
eligible p]sons enroll$ 9 c\rses set =? 
9 p>agraph 7#a77;,a7--  7,a7 dur+ p]iods
 :5 s*ools are tempor>ily clos$ "u an   
e/abli%$ policy bas$ on an ,executive   
ord] ( ! ,presid5t or due to an em]g5cy 
situation1 except t ! total numb] (     
weeks = :i* all[ances may cont9ue to be 
s payable 9 any #ab-mon? p]iod may n    
exce$ f\r weeks2 or  7,b7 solely = !    
purpose ( aw>d+ a mon?ly h\s+ /ip5d     
describ$ 9 section #ccac ( ?is title1   
dur+ p]iods foll[+ a p]man5t s*ool      
closure1 except t paym5t ( su* a /ip5d  
may only be cont9u$ until ! e>li] (--   
7i7 ! date ( ! end ( ! t]m1 qu>t]1 or   
seme/] dur+ :i* ! s*ool closure occurr$2
 &  7ii7 ! date t is #d mon?s aft] !    
date ( ! s*ool closure4  4  7#b7 ,con=m+
 am5dm5t ,p>agraph 7#a77;,c77ii7 ( su*  
section1 z r$esignat$1 is am5d$ by /rik+
 describ$ 9 subclause 7,a7 ( ?is clause 
& ins]t+ describ$ 9 clause 7i74  #bjb4  

,modification & improvem5t ( transf] (  
unus$ ,po/-#i_/aa ,educational          
,assi/ance to family memb]s  7a7        
,eligibility requirem5ts ,subsection    
7b77#a7 ( section #ccai ( title #ch1    
,unit$ ,/ates ,code1 is am5d$--  7#a7 by
 /rik+ six ye>s & ins]t+ t5 ye>s2 &     
7#b7 by /rik+ f\r m ye>s & ins]t+ two m 
ye>s4  7b7 ,comm5cem5t ( use ,subsection
 7g77#a77;,a7 ( su* section is am5d$ by 
/rik+ six ye>s & ins]t+ t5 ye>s4  7c7   
,rate ( paym5t ,subsection 7h77#c77;,b7 
( su* section is am5d$ by ins]t+ be=e ! 
p]iod at ! end ! foll[+3 1 except t !   
am\nt ( ! mon?ly /ip5d describ$ 9       
subsection 7c77#a77;,b7 or              
7g77#c77;,a77ii7 ( section #ccac1 z !   
case may be1 %all be payable 9 an am\nt 
equal to #ej p]c5t ( ! am\nt ( su* /ip5d
 t w\ld o!rwise be payable "u ?is *apt] 
to ! individual mak+ ! transf]4  7d7    
,te*nical correction ,su* section is    
fur!r am5d$ by /rik+ arm$ =ces ea* place
 x appe>s & ins]t+ ,arm$ ,=ces4  7e7    
,applicability ,! am5dm5ts made by      

subsections 7a7 ?r\gh 7c7 %all apply )  
respect to an election to transf]       
entitlem5t "u section #ccai ( title #ch1
 ,unit$ ,/ates ,code1 t is made on or   
aft] ! date t is #ahj days aft] ! date (
 ! enactm5t ( ?is ,act4  #bjc4          
,codification & improvem5t ( election   
process = ,po/-#i_/aa ,educational      
,assi/ance  7a7 ,9 g5]al ,sub*apt] ,,iii
 ( *apt] #cc ( title #ch1 ,unit$ ,/ates 
,code1 is am5d$ by add+ at ! end !      
foll[+ new section3  #ccbf4 ,election to
 receive educational assi/ance  7a7     
,individuals eligible to elect          
p>ticipation 9 po/-#i_/aa educational   
assi/ance ,an individual may elect to   
receive educational assi/ance "u ?is    
*apt] if su* individual-- 7#a7 z (      
,augu/ #a1 #bjji--  7,a7 is entitl$ to  
basic educational assi/ance "u *apt] #cj
 ( ?is title & has us$1 b reta9s unus$1 
entitlem5t "u t *apt]2  7,b7 is entitl$ 
to educational assi/ance "u *apt] #ajg1 
#afjf1 or #afjg ( title #aj & has us$1 b
 reta9s unus$1 entitlem5t "u !          

applicable *apt]2  7,c7 is entitl$ to   
basic educational assi/ance "u *apt] #cj
 ( ?is title b has n us$ any entitlem5t 
"u t *apt]2  7,d7 is entitl$ to         
educational assi/ance "u *apt] #ajg1    
#afjf1 or #afjg ( title #aj b has n us$ 
any entitlem5t "u su* *apt]2  7,e7 is a 
memb] ( ! ,arm$ ,=ces :o is eligible =  
receipt ( basic educational assi/ance "u
 *apt] #cj ( ?is title & is mak+        
contributions t[>d su* assi/ance "u     
section #cjaa7;b7 or #cjab7;c7 ( ?is    
title2 or  7,f7 is a memb] ( ! ,arm$    
,=ces :o is n entitl$ to basic          
educational assi/ance "u *apt] #cj ( ?is
 title by reason ( an election "u       
section #cjaa7;c77#a7 or #cjab7;d77#a7 (
 ?is title2 &  7#b7 z ( ! date ( !      
individual's election "u ?is p>agraph1  
meets ! requirem5ts = entitlem5t to     
educational assi/ance "u ?is *apt]4  7b7
 ,cessation ( contributions t[>d ,,gi   
bill ,effective z ( ! fir/ mon? beg9n+  
on or aft] ! date ( an election "u      
subsection 7a7 ( an individual describ$ 

by p>agraph 7#a77;,e7 ( t subsection1 ! 
obligation ( ! individual to make       
contributions "u section #cjaa7;b7 or   
#cjab7;c7 ( ?is title1 z applicable1    
%all cease1 & ! requirem5ts ( su*       
section %all be deem$ to be no long]    
applicable to ! individual4  7c7        
,revocation ( rema9+ transf]r$          
entitlem5t  7#a7 ,election to revoke    
,if1 on ! date an individual describ$ 9 
p>agraph 7#a77;,a7 or 7#a77;,c7 (       
subsection 7a7 makes an election "u t   
subsection1 a transf] ( ! entitlem5t ( !
 individual to basic educational        
assi/ance "u section #cjbj ( ?is title  
is 9 effect & a numb] ( mon?s ( !       
entitlem5t s transf]r$ rema9 unutiliz$1 
! individual may elect to revoke all or 
a portion ( ! entitlem5t s transf]r$ t  
rema9s unutiliz$4  7#b7 ,availability ( 
revok$ entitlem5t ,any entitlem5t revok$
 by an individual "u ?is p>agraph %all  
no long] be available to ! dep5d5t to   
:om transf]r$1 b %all be available to ! 
individual in/ead = educational         

assi/ance "u *apt] #cc ( ?is title 9    
accordance ) ! provisions ( ?is section4
  7#c7 ,availability ( unrevok$         
entitlem5t ,any entitlem5t describ$ 9   
p>agraph 7#a7 t is n revok$ by an       
individual 9 accordance ) t p>agraph    
%all rema9 available to ! dep5d5t or    
dep5d5ts conc]n$ 9 accordance ) ! curr5t
 transf] ( su* entitlem5t "u section    
#cjbj ( ?is title4  7d7 ,po/-#i_/aa     
educational assi/ance  7#a7 ,9 g5]al    
,subject to p>agraph 7#b7 & except z    
provid$ 9 subsection 7e71 an individual 
mak+ an election "u subsection 7a7 %all 
be entitl$ to educational assi/ance "u  
?is *apt] 9 accordance ) ! provisions ( 
?is *apt]1 in/ead ( basic educational   
assi/ance "u *apt] #cj ( ?is title1 or  
educational assi/ance "u *apt] #ajg1    
#afjf1 or #afjg ( title #aj1 z          
applicable4  7#b7 ,limitation on        
entitlem5t = c]ta9 individuals ,9 ! case
 ( an individual mak+ an election "u    
subsection 7a7 :o is describ$ by        
p>agraph 7#a77;,a7 ( t subsection1 !    

numb] ( mon?s ( entitlem5t ( !          
individual to educational assi/ance "u  
?is *apt] %all be ! numb] ( mon?s equal 
to--  7,a7 ! numb] ( mon?s ( unus$      
entitlem5t ( ! individual "u *apt] #cj (
 ?is title1 z ( ! date ( ! election1    
plus  7,b7 ! numb] ( mon?s1 if any1 (   
entitlem5t revok$ by ! individual "u    
subsection 7c77#a74  7e7 ,cont9u+       
entitlem5t to educational assi/ance n   
available "u #i_/aa assi/ance program   
7#a7 ,9 g5]al ,9 ! ev5t educational     
assi/ance to :i* an individual mak+ an  
election "u subsection 7a7 w\ld be      
entitl$ "u *apt] #cj ( ?is title1 or    
*apt] #ajg1 #afjf1 or #afjg ( title #aj1
 z applicable1 is n au?oriz$ to be      
available to ! individual "u !          
provisions ( ?is *apt] ! individual %all
 rema9 entitl$ to su* educational       
assi/ance 9 accordance ) ! provisions ( 
! applicable *apt]4  7#b7 ,*>ge = use ( 
entitlem5t ,! utilization by an         
individual ( entitlem5t "u p>agraph 7#a7
 %all be *>geable aga9/ ! entitlem5t ( !

 individual to educational assi/ance "u 
?is *apt] at ! rate ( "o mon? (         
entitlem5t "u ?is *apt] = ea* mon? (    
entitlem5t utiliz$ by ! individual "u   
p>agraph 7#a7 7z det]m9$ z if su*       
entitlem5t 7 utiliz$ "u ! provisions (  
*apt] #cj ( ?is title1 or *apt] #ajg1   
#afjf1 or #afjg ( title #aj1 z          
applicable74  7f7 ,additional po/-#i_/aa
 assi/ance = memb]s hav+ made           
contributions t[>d ,,gi bill  7#a7      
,additional assi/ance ,9 ! case ( an    
individual mak+ an election "u          
subsection 7a7 :o is describ$ by        
subp>agraph 7,a71 7,c71 or 7,e7 (       
p>agraph 7#a7 ( t subsection1 ! am\nt ( 
educational assi/ance payable to !      
individual "u ?is *apt] z a mon?ly /ip5d
 payable "u p>agraph 7#a77;,b7 ( section
 #ccac7;c7 ( ?is title1 or "u p>agraphs 
7#b7 ?r\gh 7#g7 ( t section 7z          
applicable71 %all be ! am\nt o!rwise    
payable z a mon?ly /ip5d "u ! applicable
 p>agraph increas$ by ! am\nt equal to--
  7,a7 ! total am\nt ( contributions    

t[>d basic educational assi/ance made by
 ! individual "u section #cjaa7;b7 or   
#cjab7;c7 ( ?is title1 z ( ! date ( !   
election1 multipli$ by  7,b7 !          
fraction-- 7i7 ! num]ator ( :i* is--    
7,i7 ! numb] ( mon?s ( entitlem5t to    
basic educational assi/ance "u *apt] #cj
 ( ?is title rema9+ to ! individual at !
 "t ( ! election2 plus  7,,ii7 ! numb] (
 mon?s1 if any1 ( entitlem5t "u *apt]   
#cj revok$ by ! individual "u subsection
 7c77#a72 &  7ii7 ! d5om9ator ( :i* is  
#cf mon?s4  7#b7 ,mon?s ( rema9+        
entitlem5t = c]ta9 individuals ,9 ! case
 ( an individual cov]$ by p>agraph 7#a7 
:o is describ$ by subsection            
7a77#a77;,e71 ! numb] ( mon?s (         
entitlem5t to basic educational         
assi/ance rema9+ to ! individual =      
purposes ( p>agraph 7#a77;,b77i77,,ii7  
%all be #cf mon?s4  7#c7 ,tim+ ( paym5t 
,! am\nt payable ) respect to an        
individual "u p>agraph 7#a7 %all be paid
 to ! individual toge!r ) ! la/ paym5t (
 ! mon?ly /ip5d payable to ! individual 

"u p>agraph 7#a77;,b7 ( section         
#ccac7;c7 ( ?is title1 or "u p>agraphs  
7#b7 ?r\gh 7#g7 ( t section 7z          
applicable71 be=e ! exhau/ion ( !       
individual's entitlem5t to educational  
assi/ance "u ?is *apt]4  7g7 ,cont9u+   
entitlem5t to additional assi/ance =    
critical skills or speciality &         
additional s]vice ,an individual mak+ an
 election "u subsection 7a77#a7 :o1 at !
 "t ( ! election1 is entitl$ to increas$
 educational assi/ance "u section       
#cjae7;d7 ( ?is title1 or section       
#afaca7;i7 ( title #aj1 or supplem5tal  
educational assi/ance "u sub*apt] ,,iii 
( *apt] #cj ( ?is title1 %all rema9     
entitl$ to su* increas$ educational     
assi/ance or supplem5tal educational    
assi/ance 9 ! utilization ( entitlem5t  
to educational assi/ance "u ?is *apt]1 9
 an am\nt equal to ! qu>t]1 seme/]1 or  
t]m1 z applicable1 equival5t ( ! mon?ly 
am\nt ( su* increas$ educational        
assi/ance or supplem5tal educational    
assi/ance payable ) respect to !        

individual at ! "t ( ! election4  7h7   
,alt]native election by ,secret>y  7#a7 
,9 g5]al ,9 ! case ( an individual :o1  
on or aft] ,janu>y #a1 #bjaf1 submits to
 ! ,secret>y an election "u ?is section 
t ! ,secret>y det]m9es is cle>ly aga9/ !
 int]e/s ( ! individual1 or :o fails to 
make an election "u ?is section1 !      
,secret>y may make an alt]native        
election on behalf ( ! individual t !   
,secret>y det]m9es is 9 ! be/ int]e/s ( 
! individual4  7#b7 ,notice ,if !       
,secret>y makes an election on behalf ( 
an individual "u ?is subsection1 !      
,secret>y %all notify ! individual by n 
lat] ?an sev5 days aft] mak+ su*        
election & %all provide ! individual ) a
 #cj-;day p]iod1 beg9n+ on ! date ( !   
individual's receipt ( su* notice1 dur+ 
:i* ! individual may modify or revoke ! 
election made by ! ,secret>y on !       
individual's behalf4 ,! ,secret>y %all  
include1 z "p ( su* notice1 a cle>      
/atem5t ( :y ! alt]native election made 
by ! ,secret>y is 9 ! be/ int]e/s ( !   

individual z comp>$ to ! election       
submitt$ by ! individual4 ,! ,secret>y  
%all provide ! notice requir$ "u ?is    
p>agraph by electronic means :5ev]      
possible4  7i7 ,irrevocability (        
elections ,an election "u subsection 7a7
 or 7c77#a7 is irrevocable4  4  7b7     
,cl]ical am5dm5t ,! table ( sections at 
! beg9n+ ( su* *apt] is am5d$ by add+ at
 ! end ! foll[+ new item3  #ccbf4       
,election to receive educational        
assi/ance4  4  7c7 ,con=m+ repeal       
,subsection 7c7 ( section #ejjc ( !     
,po/-#i_/aa ,vet]ans ,educational       
,assi/ance ,act ( #bjjh 7,public ,law   
#aaj-beb2 #ch ,u4,s4,c4 #ccja note7 is  
h]eby repeal$4  #bjd4 ,c5traliz$ report+
 ( vet]an enrollm5t by c]ta9 gr\ps1     
di/ricts1 & consortiums ( educational   
in/itutions  7a7 ,9 g5]al ,section      
#cfhd7;a7 ( title #ch1 ,unit$ ,/ates    
,code1 is am5d$-- 7#a7 9 p>agraph 7#a71 
by ins]t+ #cb1 #cc1 aft] #ca12 &  7#b7  
by add+ at ! end ! foll[+ new p>agraph3 
7#d7 ,= purposes ( ?is subsection1 ! t]m

 educational in/itution may include a   
gr\p1 di/rict1 or consortium ( sep>ately
 accr$it$ educational in/itutions locat$
 9 ! same ,/ate t are organiz$ 9 a mann]
 t facilitates ! c5traliz$ report+ ( !  
enrollm5ts 9 su* gr\p1 di/rict1 or      
consortium ( in/itutions4  4  7b7       
,effective date ,! am5dm5ts made by     
subsection 7a7 %all apply ) respect to  
reports submitt$ on or aft] ! date ( !  
enactm5t ( ?is ,act4  #bje4 ,improv$    
role ( ,/ate approv+ ag5cies 9          
adm9i/ration ( vet]ans educational      
b5efits  7a7 ,approval ( c]ta9 c\rses   
,section #cfgb7;b77#b77;,a7 ( title #ch1
 ,unit$ ,/ates ,code1 is am5d$ by /rik+ 
! foll[+ & all t foll[s ?r\gh ! colon & 
ins]t+ ! foll[+3 a program ( education  
is deem$ to be approv$ = purposes ( ?is 
*apt] if a ,/ate approv+ ag5cy det]m9es 
t ! program is "o ( ! foll[+ programs34 
7b7 ,approval ( o!r c\rses ,section     
#cfge ( su* title am5d$-- 7#a7 9        
subsection 7a77#a7--  7,a7 by /rik+ ,!  
,secret>y or a ,/ate approv+ ag5cy &    

ins]t+ ,a ,/ate approv+ ag5cy1 or !     
,secret>y :5 act+ 9 ! role ( a ,/ate    
approv+ ag5cy12 &  7,b7 by /rik+ (f]$ by
 propriet>y =-pr(it educational         
in/itutions & ins]t+ n cov]$ by section 
#cfgb ( ?is title2 &  7#b7 9 subsection 
7b7-- 7,a7 9 ! matt] be=e p>agraph 7#a71
 by /rik+ ! ,secret>y or ! ,/ate approv+
 ag5cy & ins]t+ ! ,/ate approv+ ag5cy1  
or ! ,secret>y :5 act+ 9 ! role ( a     
,/ate approv+ ag5cy12 &  7,b7 9 p>agraph
 7#a71 by /rik+ ! ,secret>y or ! ,/ate  
approv+ ag5cy & ins]t+ ! ,/ate approv+  
ag5cy1 or ! ,secret>y :5 act+ 9 ! role (
 a ,/ate approv+ ag5cy4  #bjf4          
,modification ( crit]ia us$ to approve  
c\rses = purposes ( vet]ans educational 
b5efits  7a7 ,nonaccr$it$ c\rses        
,section #cfgf7;c77#ad7 ( title #ch1    
,unit$ ,/ates ,code1 is am5d$ by ins]t+ 
be=e ! p]iod ! foll[+3 if ! ,secret>y1 9
 consultation ) ! ,/ate approv+ ag5cy & 
pursuant to regulations prescrib$ to    
c>ry out ?is p>agraph1 det]m9es su*     
crit]ia are necess>y & treat public1    

private1 & propriet>y =-pr(it           
educational in/itutions equitably4  7b7 
,accr$it$ c\rses ,section #cfge7;b77#c7 
( su* title is am5d$ by /rik+ & 7#c7 &  
ins]t+ 7#c71 & 7#ad74  7c7 ,application 
,! am5dm5t made by subsection 7a7 %all  
apply ) respect to--  7#a7 crit]ia      
develop$ pursuant to p>agraph 7#ad7 (   
subsection 7c7 ( section #cfgf ( title  
#ch1 ,unit$ ,/ates ,code1 on or aft]    
,janu>y #a1 #bjac2 &  7#b7 an           
inve/igation conduct$ "u su* subsection 
t is cov]$ by a reimbursem5t ( exp5ses  
paid by ! ,secret>y ( ,vet]ans ,affairs 
to a ,/ate pursuant to section #cfgd (  
su* title on or aft] ,octob] #a1 #bjae4 
#bjg4 ,surveys = compliance (           
educational in/itutions & tra9+         
e/abli%m5ts ) requirem5ts relat+ to     
adm9i/ration ( vet]ans educational      
b5efits  7a7 ,9 g5]al ,section #cfic (  
title #ch1 ,unit$ ,/ates ,code1 is      
am5d$-- 7#a7 by /rik+ subsection 7a7 &  
ins]t+ ! foll[+ new subsection 7a73  7a7
 7#a7 7,a7 ,except z provid$ 9          

subsection 7b71 ! ,secret>y %all conduct
 an annual compliance survey (          
educational in/itutions & tra9+         
e/abli%m5ts (f]+ "o or m c\rses approv$ 
= ! enrollm5t ( eligible vet]ans or     
p]sons if at lea/ #bj su* vet]ans or    
p]sons are enroll$ 9 any su* c\rse4     
7,b7 ,! ,secret>y %all--  7i7 design !  
compliance surveys to ensure t su*      
in/itutions or e/abli%m5ts1 z ! case may
 be1 & approv$ c\rses are 9 compliance )
 all applicable provisions ( *apt]s #cj 
?r\gh #cf ( ?is title2  7ii7 survey ea* 
su* educational in/itution & tra9+      
e/abli%m5t n less ?an once dur+ e       
two-ye> p]iod2 &  7iii7 assign n few]   
?an "o education compliance speciali/ to
 "w on compliance surveys 9 any ye> =   
ea* #dj compliance surveys requir$ to be
 made "u ?is section = su* ye>4  7#b7 ,!
 ,secret>y1 9 consultation ) ! ,/ate    
approv+ ag5cies1 %all-- 7,a7 annually   
det]m9e ! p>amet]s ( ! surveys requir$  
"u p>agraph 7#a72 &  7,b7 n lat] ?an    
,septemb] #a ( ea* ye>1 make available  

to ! ,/ate approv+ ag5cies a li/ ( !    
educational in/itutions & tra9+         
e/abli%m5ts t w be survey$ dur+ ! fiscal
 ye> foll[+ ! date ( mak+ su* li/       
available4  2 &  7#b7 by add+ at ! end !
 foll[+ new subsection3  7c7 ,9 ?is     
section1 ! t]ms educational in/itution &
 tra9+ e/abli%m5t h ! mean+ giv5 su*    
t]ms 9 section #cdeb ( ?is title4  4    
7b7 ,con=m+ am5dm5ts ,subsection 7b7 (  
su* section is am5d$-- 7#a7 by /rik+    
subsection 7a7 ( ?is section = an annual
 compliance survey & ins]t+ subsection  
7a77#a7 = a compliance survey2  7#b7 by 
/rik+ in/itution & ins]t+ educational   
in/itution or tra9+ e/abli%m5t2 &  7#c7 
by /rik+ in/itution's demon/rat$ record 
( compliance & ins]t+ record (          
compliance ( su* in/itution or          
e/abli%m5t4  #bjh4 ,modification (      
requirem5ts = approval = purposes (     
educational assi/ance provid$ by        
,dep>tm5t ( ,vet]ans ,affairs ( programs
 design$ to prep>e individuals =        
lic5sure or c]tification  7a7 ,approval 

( non-,accr$it$ c\rses ,subsection 7c7 (
 section #cfgf ( title #ch1 ,unit$      
,/ates ,code1 z am5d$ by section #bjf1  
is fur!r am5d$--  7#a7 by r$esignat+    
p>agraph 7#ad7 z p>agraph 7#af72 &  7#b7
 by ins]t+ aft] p>agraph 7#ac7 ! foll[+ 
new p>agraphs3  7#ad7 ,9 ! case ( a     
c\rse design$ to prep>e an individual = 
lic5sure or c]tification 9 a ,/ate1 !   
c\rse--  7,a7 meets any in/ructional    
curriculum lic5sure or c]tification     
requirem5ts ( su* ,/ate2 &  7,b7 9 !    
case ( a c\rse design$ to prep>e an     
individual = lic5sure to practice law 9 
a ,/ate1 is accr$it$ by an accr$it+     
ag5cy or association recogniz$ by !     
,secret>y ( ,education "u subp>t #b ( "p
 ,h ( title ,,iv ( ! ,high] ,education  
,act ( #aife 7#bj ,u4,s4,c4 #ajii;b74   
7#ae7 ,9 ! case ( a c\rse design$ to    
prep>e an individual = employm5t        
pursuant to /&>ds develop$ by a bo>d or 
ag5cy ( a ,/ate 9 an occupation t       
requires approval1 lic5sure1 or         
c]tification1 ! c\rse--  7,a7 meets su* 

/&>ds2 &  7,b7 9 ! case ( a c\rse       
design$ to prep>e an individual =       
lic5sure to practice law 9 a ,/ate1 is  
accr$it$ by an accr$it+ ag5cy or        
association recogniz$ by ! ,secret>y (  
,education "u subp>t #b ( "p ,h ( title 
,,iv ( ! ,high] ,education ,act ( #aife 
7#bj ,u4,s4,c4 #ajii;b74  4  7b7        
,exceptions ,su* section is fur!r am5d$ 
by add+ at ! end ! foll[+ new           
subsection3  7f7 7#a7 ,! ,secret>y may  
waive ! requirem5ts ( p>agraph 7#ad7 or 
7#ae7 ( subsection 7c7 9 ! case ( a     
c\rse ( education (f]$ by an educational
 in/itution 7ei!r accr$it$ or n         
accr$it$7 if ! ,secret>y det]m9es all ( 
! foll[+3  7,a7 ,! c\rse did n meet !   
requirem5ts ( su* p>agraph at any "t    
dur+ ! two-ye> p]iod prec$+ ! date ( !  
waiv]4  7,b7 ,! waiv] fur!rs ! purposes 
( ! educational assi/ance programs      
adm9i/]$ by ! ,secret>y or w\ld fur!r ! 
education int]e/s ( individuals eligible
 = assi/ance "u su* programs4  7,c7 ,!  
educational in/itution does n provide   

any commission1 bonus1 or o!r inc5tive  
paym5t bas$ directly or indirectly on   
success 9 secur+ enrollm5ts or f9ancial 
aid to any p]sons or entities engag$ 9  
any /ud5t recruit+ or admission         
activities or 9 mak+ decisions reg>d+ ! 
aw>d ( /ud5t f9ancial assi/ance1 except 
= ! recruitm5t ( =eign /ud5ts resid+ 9  
=eign c\ntries :o are n eligible to     
receive ,f$]al /ud5t assi/ance4  7#b7 ,n
 lat] ?an #cj days aft] ! date on :i* ! 
,secret>y issues a waiv] "u p>agraph    
7#a71 ! ,secret>y %all submit to        
,congress notice ( su* waiv] & a        
ju/ification = issu+ su* waiv]4  4  7c7 
,approval ( accr$it$ c\rses ,section    
#cfge7;b77#c7 ( su* title1 z am5d$ by   
section #bjf1 is fur!r am5d$-- 7#a7 by  
/rik+ & 7#ad7 & ins]t+ 7#ad71 7#ae71 &  
7#af72 &  7#b7 by ins]t+ be=e ! p]iod at
 ! end ! foll[+3 7or1 ) respect to su*  
p>agraphs 7#ad7 & 7#ae71 ! requirem5ts  
"u su* p>agraphs are waiv$ pursuant to  
subsection 7f77#a7 ( section #cfgf ( ?is
 title74  7d7 ,approval ( accr$it$ /&>d 

college degree programs (f]$ at public  
or n-=-pr(it educational in/itutions    
,section #cfgb7;b77#b7 ( su* title is   
am5d$-- 7#a7 9 subp>agraph 7,a77i71 by  
/rik+ ,an accr$it$ & ins]t+ ,except z   
provid$ 9 subp>agraph 7,c71 an accr$it$2
 &  7#b7 by add+ at ! end ! foll[+ new  
subp>agraph3  7,c7 ,a c\rse t is        
describ$ 9 bo? subp>agraph 7,a77i7 ( ?is
 p>agraph & 9 p>agraph 7#ad7 or 7#ae7 ( 
section #cfgf7;c7 ( ?is title %all n be 
deem$ to be approv$ = purposes ( ?is    
*apt] unless--  7i7 a ,/ate approv+     
ag5cy1 or ! ,secret>y :5 act+ 9 ! role (
 a ,/ate approv+ ag5cy1 det]m9es t !    
c\rse meets ! applicable crit]ia 9 su*  
p>agraphs2 or  7ii7 ! ,secret>y issues a
 waiv] = su* c\rse "u section           
#cfgf7;f77#a7 ( ?is title4  4  7e7      
,disapproval ( c\rses ,section #cfgi (  
su* title is am5d$ by add+ at ! end !   
foll[+ new subsection3  7d7 ,not)/&+ any
 o!r provision ( ?is *apt]1 ! ,secret>y 
or ! applicable ,/ate approv+ ag5cy %all
 disapprove a c\rse ( education describ$

 9 p>agraph 7#ad7 or 7#ae7 ( section    
#cfgf7;c7 ( ?is title unless !          
educational in/itution provid+ ! c\rse (
 education--  7#a7 publicly discloses   
any conditions or additional            
requirem5ts1 includ+ tra9+1 exp]i5ce1 or
 exam9ations1 requir$ to obta9 ! lic5se1
 c]tification1 or approval = :i* ! c\rse
 ( education is design$ to provide      
prep>ation2 &  7#b7 makes ea* disclosure
 requir$ by p>agraph 7#a7 9 a mann] t ! 
,secret>y consid]s prom95t4  4  7f7     
,applicability ,if aft] enrollm5t 9 a   
c\rse ( education t is subject to       
disapproval by reason ( an am5dm5t made 
by ?is ,act1 an individual pursues "o or
 m c\rses ( education at ! same         
educational in/itution :ile rema9+      
cont9u\sly enroll$ 7o!r ?an dur+        
regul>ly s*$ul$ breaks betwe5 c\rses1   
seme/]s1 or t]ms7 at t in/itution1 any  
c\rse s pursu$ by ! individual at t     
in/itution :ile s cont9u\sly enroll$    
%all n be subject to disapproval by     
reason ( su* am5dm5t4  #bji4 ,expansion 

( ,yell[ ,ribbon ,g4,i4 ,education      
,enhancem5t ,program  7a7 ,9 g5]al      
,section #ccag7;a7 ( title #ch1 ,unit$  
,/ates ,code1 is am5d$ by /rik+ 9       
p>agraphs 7#a7 & 7#b7 & ins]t+ 9        
p>agraphs 7#a71 7#b71 & 7#i74  7b7      
,effective date ,! am5dm5t made by      
subsection 7a7 %all apply ) respect to  
academic ye>s beg9n+ aft] ! date t is "o
 ye> aft] ! date ( ! enactm5t ( ?is     
,act4  #baj4 ,consid]ation ( c]ta9 "t   
sp5t receiv+ m$ical c>e f ,secret>y (   
,def5se z active duty = purposes (      
eligibility = ,po/-#i_/aa ,educational  
,assi/ance  7a7 ,9 g5]al ,section       
#ccja7a77;,b7 ( title #ch1 ,unit$ ,/ates
 ,code1 is am5d$ by ins]t+ #abcja7;h71  
aft] #abcja7;g714  7b7 ,effective date  
,! am5dm5t made by subsection 7a7 %all  
take effect on ! date t is "o ye> aft] !
 date ( ! enactm5t ( ?is ,act & %all    
apply ) respect to assi/ance provid$ "u 
*apt] #cc ( su* title on & aft] ! date t
 is "o ye> aft] ! date ( ! enactm5t (   
?is ,act4  ,,iii ,homeless vet]ans      

matt]s  #cja4 ,expansion ( def9ition (  
homeless vet]an = purposes ( b5efits "u 
! laws adm9i/]$ by ! ,secret>y (        
,vet]ans ,affairs ,section #bjjb7a7 (   
title #ch1 ,unit$ ,/ates ,code1 is am5d$
 by /rik+ 9 section #ajc7;a7 ( !        
,mc,kinney-,v5to ,homeless ,assi/ance   
,act 7#db ,u4,s4,c4 #aacjb7;a77 & ins]t+
 9 subsection 7a7 or 7b7 ( section #ajc 
( ! ,mc,kinney-,v5to ,homeless          
,assi/ance ,act 7#db ,u4,s4,c4 #aacjb74 
#cjb4 ,increas$ p] diem paym5ts =       
transitional h\s+ assi/ance t becomes   
p]man5t h\s+ = homeless vet]ans ,section
 #bjab7;a77#b7 ( title #ch1 ,unit$      
,/ates ,code1 is am5d$--  7#a7 by       
r$esignat+ subp>agraphs 7,b7 ?r\gh 7,d7 
z subp>agraphs 7,c7 ?r\gh 7,e71         
respectively2  7#b7 9 subp>agraph 7,c71 
z r$esignat$1 by /rik+ 9 subp>agraph    
7,d7 & ins]t+ 9 subp>agraph 7,e72  7#c7 
9 subp>agraph 7,d71 z r$esignat$1 by    
/rik+ "u subp>agraph 7,b7 & ins]t+ "u   
subp>agraph 7,c72  7#d7 9 subp>agraph   
7,e71 z r$esignat$1 by /rik+ 9          

subp>agraphs 7,b7 & 7,c7 & ins]t+ 9     
subp>agraphs 7,c7 & 7,d72 &  7#e7 9     
subp>agraph 7,a7--  7,a7 by /rik+ ,!    
rate & ins]t+ ,except z o!rwise provid$ 
9 subp>agraph 7,b71 ! rate2 &  7,b7 by  
/rik+ "u subp>agraph 7,b7 & all t foll[s
 ?r\gh ! end & ins]t+ ! foll[+3 8"u     
subp>agraph 7,c74  7,b7 7i7 ,except z   
provid$ 9 clause 7ii71 9 no case may !  
rate det]m9$ "u ?is p>agraph exce$ !    
rate au?oriz$ = ,/ate homes = domicili>y
 c>e "u subsection 7a77#a77;,a7 (       
section #agda ( ?is title1 z ! ,secret>y
 may increase f "t to "t "u subsection  
7c7 ( t section4  7ii7 ,9 ! case (      
s]vices furni%$ to a homeless vet]an :o 
is plac$ 9 h\s+ t w become p]man5t h\s+ 
= ! vet]an ^u t]m9ation ( ! furni%+ (   
su* s]vices to su* vet]an1 ! maximum    
rate ( p] diem au?oriz$ "u ?is section  
is #aej p]c5t ( ! rate describ$ 9 clause
 7i74  4  #cjc4 ,expansion ( ,dep>tm5t (
 ,vet]ans ,affairs au?ority to provide  
d5tal c>e to homeless vet]ans  7a7 ,9   
g5]al ,subsection 7b7 ( section #bjfb ( 

title #ch1 ,unit$ ,/ates ,code1 is am5d$
 to read z foll[s3  7b7 ,eligible       
vet]ans  7#a7 ,subsection 7a7 applies to
 a vet]an :o--  7,a7 is enroll$ = c>e "u
 section #agje7;a7 ( ?is title2 &  7,b7 
= a p]iod ( #fj consecutive days1 is    
receiv+--  7i7 assi/ance "u section     
#h7o7 ( ! ,unit$ ,/ates ,h\s+ ,act (    
#aicg 7#db ,u4,s4,c4 #adcg;f7o772 or    
7ii7 c>e 7directly or by contract7 9 any
 ( ! foll[+ sett+s3  7,i7 ,a domicili>y 
"u section #agaj ( ?is title4  7,,ii7 ,a
 !rapeutic resid5ce "u section #bjcb (  
?is title4  7,,iii7 ,community          
resid5tial c>e coord9at$ by ! ,secret>y 
"u section #agcj ( ?is title4  7,,iv7 ,a
 sett+ = :i* ! ,secret>y provides funds 
= a grant & p] diem provid]4  7#b7 ,=   
purposes ( p>agraph 7#a71 9 det]m9+ :e!r
 a vet]an has receiv$ assi/ance or c>e =
 a p]iod ( #fj consecutive days1 !      
,secret>y may disreg>d breaks 9 !       
cont9uity ( assi/ance or c>e = :i* !    
vet]an is n responsible4  4  7b7        
,effective date ,subsection 7a7 %all    

take effect on ! date t is "o ye> aft] !
 date ( ! enactm5t ( ?is ,act4  #cjd4   
,cl>ification ( eligibility = s]vices "u
 homeless vet]ans re9tegration programs 
,section #bjba7;a7 ( title #ch1 ,unit$  
,/ates ,code1 is am5d$ by /rik+         
re9tegration ( homeless vet]ans into !  
labor =ce4 & ins]t+ ! foll[+3           
re9tegration into ! labor =ce (--  7#a7 
homeless vet]ans2  7#b7 vet]ans         
p>ticipat+ 9 ! ,dep>tm5t ( ,vet]ans     
,affairs support$ h\s+ program = :i*    
r5tal assi/ance is provid$ pursuant to  
section #h7o77#ai7 ( ! ,unit$ ,/ates    
,h\s+ ,act ( #aicg 7#db ,u4,s4,c4       
#adcg;f7o77#ai772  7#c7 ,indians :o are 
vet]ans & receiv+ assi/ance "u ! ,native
 ,am]ican ,h\s+ ,assi/ance & ,self      
,det]m9ation ,act ( #aiif 7#be ,u4,s4,c4
 #daja et seq472 &  7#d7 vet]ans :o are 
transition+ f be+ inc>c]at$4  4  #cje4  
,program to improve ret5tion ( h\s+ by  
=m]ly homeless vet]ans & vet]ans at risk
 ( becom+ homeless  7a7 ,program requir$
  7#a7 ,9 g5]al ,sub*apt] ,,ii ( *apt]  

#bj ( title #ch1 ,unit$ ,/ates ,code1 is
 am5d$--  7,a7 by r$esignat+ section    
#bjac z section #bjad2 &  7,b7 by ins]t+
 aft] section #bjab ! foll[+ new section
 #bjac3  #bjac4 ,program to improve     
ret5tion ( h\s+ by =m]ly homeless       
vet]ans & vet]ans at risk ( becom+      
homeless  7a7 ,program requir$ ,!       
,secret>y %all c>ry out a program "u :i*
 ! ,secret>y %all provide case managem5t
 s]vices to improve ! ret5tion ( h\s+ by
 vet]ans :o 7 previ\sly homeless & are  
transition+ to p]man5t h\s+ & vet]ans :o
 are at risk ( becom+ homeless4  7b7    
,grants  7#a7 ,! ,secret>y %all c>ry out
 ! program ?r\gh ! aw>d ( grants4  7#b7 
7,a7 ,9 aw>d+ grants "u p>agraph 7#a71 !
 ,secret>y %all give priority to        
organizations t demon/rate a capability 
to provide case managem5t s]vices z     
describ$ 9 subsection 7a71 p>ticul>ly   
organizations t are successfully provid+
 or h successfully provid$ transitional 
h\s+ s]vices us+ am\nts provid$ by !    
,secret>y "u sections #bjab & #bjfa (   

?is title4  7,b7 ,9 giv+ priority "u    
subp>agraph 7,a71 ! ,secret>y %all give 
extra priority to an organization       
describ$ 9 su* subp>agraph t--  7i7     
volunt>ily /ops receiv+ am\nts provid$  
by ! ,secret>y "u sections #bjab & #bjfa
 ( ?is title2 &  7ii7 conv]ts a facility
 t ! organization us$ to provide        
transitional h\s+ s]vices into a        
facility t ! organization uses to       
provide p]man5t h\s+ t meets h\s+       
quality /&>ds e/abli%$ "u section       
#h7o77#h77;,b7 ( ! ,unit$ ,/ates ,h\s+  
,act ( #aicg 7#db ,u4,s4,c4             
#adcg;f7o77#h77;,b774  7,c7 ,9 any case 
9 :i* a facility1 ) respect to :i* a    
p]son receiv$ a grant = con/ruction1    
rehabilitation1 or acquisition "u       
section #bjaa ( ?is title1 is conv]t$ z 
describ$ 9 subp>agraph 7,b77ii71 su*    
conv]sion %all be consid]$ to h be5     
c>ri$ out pursuant to ! ne$s ( !        
,dep>tm5t & su* p]son %all n be consid]$
 9 non-compliance ) ! t]ms ( su* grant  
by reason ( su* conv]sion4  4  7#b7     

,cl]ical am5dm5t ,! table ( sections at 
! beg9n+ ( *apt] #bj ( su* title is     
am5d$ by /rik+ ! item relat+ to section 
#bjac & ins]t+ ! foll[+ new items3      
#bjac4 ,program to improve ret5tion (   
h\s+ by =m]ly homeless vet]ans & vet]ans
 at risk ( becom+ homeless4#bjad4       
,au?orization ( appropriations4  4  7b7 
,regulations ,n lat] ?an "o ye> aft] !  
date ( ! enactm5t ( ?is ,act1 !         
,secret>y ( ,vet]ans ,affairs %all      
prescribe regulations to c>ry out       
section #bjac ( su* title1 z add$ by    
subsection 7a77#a77;,b74  7c7 ,report   
7#a7 ,9 g5]al ,n lat] ?an ,june #a1     
#bjai1 ! ,secret>y %all submit to !     
,committee on ,vet]ans' ,affairs ( !    
,s5ate & ! ,committee on ,vet]ans'      
,affairs ( ! ,h\se ( ,repres5tatives a  
report on ! program requir$ by section  
#bjac ( su* title1 z add$ by subsection 
7a77#a77;,b74  7#b7 ,cont5ts ,! report  
submitt$ "u p>agraph 7#a7 %all include  
assessm5ts ( ! foll[+3 7,a7 ,! p]c5tage 
( vet]ans :o receiv$ case managem5t     

s]vices "u ! program :o 7 able to reta9 
p]man5t h\s+ by ! end ( ! program1      
disaggregat$ by ea* recipi5t ( a grant  
"u su* section4  7,b7 ,! p]c5tage (     
vet]ans :o receiv$ case managem5t       
s]vices "u ! program :o 7 n 9 p]man5t   
h\s+ at ! end ( ! program1 disaggregat$ 
by h\s+ /atus & reason = fail+ to reta9 
p]man5t h\s+ "u ! program4  7,c7 ,! use 
by vet]ans :o receiv$ case managem5t    
s]vices "u ! program ( h\s+ assi/ance   
furni%$ by ! ,dep>tm5t ( ,vet]ans       
,affairs1 includ+ a comp>ison ( ! use ( 
su* assi/ance by su* vet]ans be=e & aft]
 receiv+ su* s]vices4  7,d7 ,an         
assessm5t ( ! employm5t /atus ( vet]ans 
:o receiv$ case managem5t s]vices "u !  
program1 includ+ a comp>ison ( !        
employm5t /atus ( su* vet]ans be=e &    
aft] receiv+ su* s]vices4  #cjf4 ,pilot 
program on provision ( int5sive case    
managem5t int]v5tions to homeless       
vet]ans :o receive ! mo/ heal? c>e f !  
,dep>tm5t ( ,vet]ans ,affairs  7a7      
,pilot program requir$ ,n lat] ?an      

,septemb] #a1 #bjaf1 ! ,secret>y (      
,vet]ans ,affairs %all comm5ce a pilot  
program to assess ! feasibility &       
advisability ( provid+ int5sive case    
managem5t int]v5tions to cov]$ vet]ans4 
7b7 ,cov]$ vet]ans ,= purposes ( ! pilot
 program1 a cov]$ vet]an is a vet]an :o 
is enroll$ 9-- 7#a7 ! homeless regi/ry (
 ! ,dep>tm5t2 &  7#b7 ! sy/em ( annual  
pati5t enrollm5t e/abli%$ & op]at$ by ! 
,secret>y "u section #agje7;a7 ( title  
#ch1 ,unit$ ,/ates ,code4  7c7 ,location
  7#a7 ,9 g5]al ,! ,secret>y %all c>ry  
out ! pilot program at n few] ?an six   
locations select$ by ! ,secret>y =      
purposes ( ! pilot program z foll[s3    
7,a7 ,n few] ?an ?ree locations 9 cities
 t h ! l>ge/ populations ( homeless     
vet]ans 9 ! ,unit$ ,/ates4  7,b7 ,n few]
 ?an ?ree locations 9 suburban or rural 
sett+s4  7#b7 ,int]action & coord9ation 
) community organizations ,9 select+    
locations "u p>agraph 7#a71 ! ,secret>y 
%all only select locations 9 areas 9 :i*
 ! ,secret>y det]m9es t !re is a high   

degree ( int]action & coord9ation betwe5
 ! ,dep>tm5t & community organizations t
 provide h\s+ & social s]vices =        
vet]ans1 su* z outrea*1 employm5t1 &    
f9ancial assi/ance = homeless vet]ans1  
vet]ans at risk ( becom+ homeless1 &    
l[-income vet]ans4  7d7 ,provision (    
int5sive case managem5t int]v5tions     
7#a7 ,m9imum numb] ( vet]ans to receive 
int]v5tions ,9 c>ry+ out ! program at   
ea* location select$ "u subsection 7c71 
! ,secret>y %all provide int5sive case  
managem5t int]v5tions to n few] ?an #bj 
cov]$ vet]ans at ea* su* location :o !  
,secret>y det]m9es are ! cov]$ vet]ans  
at su* location :o receive ! mo/ heal?  
c>e & relat$ s]vices furni%$ by !       
,dep>tm5t ( ,vet]ans ,affairs4  7#b7    
,nature ( int]v5tions ,! int5sive case  
managem5t int]v5tions provid$ to cov]$  
vet]ans "u p>agraph 7#a7 %all include   
assi/ance ) ga9+ & ma9ta9+ access to su*
 h\s+ & s]vices1 includ+ b5efits &      
s]vices to :i* cov]$ vet]ans may be     
entitl$ or eligible "u ! laws adm9i/]$  

by ! ,secret>y1 z may be necess>y to    
improve ! /ability ( _! h\s+ & !        
appropriat5ess ( ! heal? c>e t !y       
receive4  7e7 ,report  7#a7 ,9 g5]al ,n 
lat] ?an ,decemb] #a1 #bjah1 ! ,secret>y
 %all submit to ! ,committee on         
,vet]ans' ,affairs ( ! ,s5ate & !       
,committee on ,vet]ans' ,affairs ( !    
,h\se ( ,repres5tatives a report on !   
pilot program c>ri$ out "u ?is section4 
7#b7 ,cont5ts ,! report submitt$ "u     
p>agraph 7#a7 %all include assessm5ts ( 
! foll[+3 7,a7 ,! types & frequ5cies (  
int5sive case managem5t int]v5tions     
provid$ "u ! pilot program4  7,b7 ,!    
h\s+ /atus ( ea* vet]an :o receiv$ an   
int5sive case managem5t int]v5tion "u ! 
pilot program4  7,c7 ,! employm5t /atus 
( ea* vet]an :o receiv$ an int5sive case
 managem5t int]v5tion "u ! pilot        
program1 includ+ a comp>ison ( !        
employm5t /atus ( su* vet]an be=e & aft]
 receiv+ su* int]v5tion4  7,d7 ,! use by
 vet]ans :o receiv$ int5sive case       
managem5t int]v5tions "u ! pilot program

 ( heal? c>e & relat$ s]vices furni%$ by
 ! ,dep>tm5t ( ,vet]ans ,affairs & !    
co/s incurr$ by ! ,dep>tm5t 9 furni%+   
su* c>e & s]vices1 includ+ a comp>ison (
 ! use by su* vet]ans ( su* c>e &       
s]vices & ! co/s incurr$ f furni%+ su*  
c>e & s]vices be=e & aft] receiv+ su*   
int]v5tions4  7,e7 ,! numb] ( vet]ans :o
 receiv$ int5sive case managem5t        
int]v5tions "u ! pilot program1         
disaggregat$ by :e!r ! int5sive case    
managem5t int]v5tion 0 provid$ 9 a      
location describ$ 9 subp>agraph 7,a7 or 
7,b7 ( subsection 7c77#a74  7,f7 ,! co/s
 incurr$ by ! ,dep>tm5t 9 c>ry+ out !   
pilot program1 disaggregat$ by provision
 ( int5sive case managem5t int]v5tions 9
 locations describ$ 9 subp>agraphs 7,a7 
& 7,b7 ( su* subsection4  7,g7 ,an      
e/imate ( ! co/s ! ,dep>tm5t w\ld h     
incurr$ = ! provision ( heal? c>e &     
associat$ s]vices to cov]$ vet]ans b = !
 provision ( int5sive case managem5t    
int]v5tions "u ! pilot program1         
disaggregat$ by provision ( int5sive    

case managem5t int]v5tions 9 locations  
describ$ 9 subp>agraphs 7,a7 & 7,b7 (   
subsection 7c77#a74  #cjg4 ,e/abli%m5t (
 ,national ,c5t] on ,homelessness ,among
 ,vet]ans  7a7 ,9 g5]al ,sub*apt] ,,vii 
( *apt] #bj ( title #ch1 ,unit$ ,/ates  
,code1 is am5d$ by add+ at ! end !      
foll[+ new section3  #bjfg4 ,national   
,c5t] on ,homelessness ,among ,vet]ans  
7a7 ,9 g5]al  7#a7 ,! ,secret>y %all    
e/abli% & op]ate a c5t] to c>ry out !   
functions describ$ 9 subsection 7b74    
7#b7 ,! c5t] e/abli%$ "u p>agraph 7#a7  
%all be kn[n z ! ,national ,c5t] on     
,homelessness ,among ,vet]ans4  7#c7 ,to
 ! degree practicable1 ! ,secret>y %all 
op]ate ! c5t] e/abli%$ "u p>agraph 7#a7 
indep5d5tly ( ! o!r programs ( !        
,dep>tm5t t address homelessness among  
vet]ans4  7b7 ,functions ,! functions   
describ$ 9 ?is subsection are z foll[s3 
7#a7 ,to c>ry out & promote rese>* into 
! causes & contribut+ factors to vet]an 
homelessness4  7#b7 ,to assess !        
effectiv5ess ( programs ( ! ,dep>tm5t to

 meet ! ne$s ( homeless vet]ans4  7#c7  
,to id5tify & dissem9ate be/ practices )
 reg>d to h\s+ /abilization1 income     
support1 employm5t assi/ance1 community 
p>tn]%ips1 & su* o!r matt]s z !         
,secret>y consid]s appropriate ) respect
 to address+ vet]an homelessness4  7#d7 
,to integrate evid5ce-bas$ & be/        
practices1 policies1 & programs into    
programs ( ! ,dep>tm5t = homeless       
vet]ans & vet]ans at risk ( homelessness
 & to ensure t ! /aff ( ! ,dep>tm5t &   
community p>tn]s c implem5t su*         
practices1 policies1 & programs4  7#e7  
,to s]ve z a res\rce c5t] =1 & promote &
 seek to coord9ate ! ex*ange ( in=mation
 reg>d+1 all rese>* & tra9+ activities  
c>ri$ out by ! ,dep>tm5t & by o!r ,f$]al
 & non-,f$]al entities ) respect to     
vet]an homelessness4  4  7b7 ,cl]ical   
am5dm5t ,! table ( sections at ! beg9n+ 
( *apt] #bj ( su* title is am5d$ by     
ins]t+ aft] ! item relat+ to section    
#bjff ! foll[+ new item3  #bjfg4        
,national ,c5t] on ,homelessness ,among 

,vet]ans4  4  #cjh4 ,p>tn]%ips ) public 
& private entities to provide legal     
s]vices to homeless vet]ans & vet]ans at
 risk ( homelessness  7a7 ,9 g5]al      
,*apt] #bj ( title #ch1 ,unit$ ,/ates   
,code1 is am5d$ by ins]t+ aft] section  
#bjbb ! foll[+ new section3  #bjbb;,a4  
,p>tn]%ips ) public & private entities  
to provide legal s]vices to homeless    
vet]ans & vet]ans at risk ( homelessness
  7a7 ,p>tn]%ips au?oriz$ ,subject to ! 
availability ( funds = t purpose1 !     
,secret>y may ent] into p>tn]%ips )     
public or private entities to fund a    
portion ( ! g5]al legal s]vices specifi$
 9 subsection 7c7 t are provid$ by su*  
entities to homeless vet]ans & vet]ans  
at risk ( homelessness4  7b7 ,locations 
7#a7 ,! ,secret>y %all ensure t1 to !   
ext5t practicable1 p>tn]%ips "u ?is     
section are made ) entities equitably   
di/ribut$ across ! geographic regions ( 
! ,unit$ ,/ates1 includ+ rural          
communities1 tribal l&s ( ! ,unit$      
,/ates1 ,native ,am]icans1 & tribal     

organizations4  7#b7 ,9 ?is subsection1 
! t]ms ,native ,am]ican & tribal        
organization h ! mean+s giv5 su* t]ms 9 
section #cgfe ( ?is title4  7c7 ,legal  
s]vices ,legal s]vices specifi$ 9 ?is   
subsection include legal s]vices provid$
 by public or private entities t address
 ! ne$s ( homeless vet]ans & vet]ans at 
risk ( homelessness1 su* z ! foll[+3    
7#a7 ,legal s]vices relat$ to h\s+1     
includ+ eviction def5se & repres5tation 
9 l&lord-t5ant cases4  7#b7 ,legal      
s]vices relat$ to family law1 includ+   
assi/ance 9 c\rt proce$+s = *ild        
support1 divorce1 & e/ate plann+4  7#c7 
,legal s]vices relat$ to income support1
 includ+ assi/ance 9 obta9+ public      
b5efits4  7#d7 ,legal s]vices relat$ to 
crim9al def5se1 includ+ def5se 9 matt]s 
symptomatic ( homelessness1 su* z out/&+
 w>rants1 f9es1 & driv]'s lic5se        
revocation1 to r$uce recidivism &       
facilitate ! ov]com+ ( re5try ob/acles 9
 employm5t or h\s+4  7d7 ,consultation  
,9 develop+ & c>ry+ out p>tn]%ips "u ?is

 section1 ! ,secret>y %all1 to ! ext5t  
practicable1 consult ) public & private 
entities--  7#a7 = assi/ance 9 id5tify+ 
& contact+ organizations describ$ 9     
subsection 7c72 &  7#b7 to coord9ate    
appropriate outrea* relation%ips ) su*  
organizations4  7e7 ,reports ,!         
,secret>y may require entities t h ent]$
 into p>tn]%ips "u ?is section to submit
 to ! ,secret>y p]iodic reports on legal
 s]vices provid$ to homeless vet]ans &  
vet]ans at risk ( homelessness pursuant 
to su* p>tn]%ips4  4  7b7 ,cl]ical      
am5dm5t ,! table ( sections at ! beg9n+ 
( *apt] #bj ( su* title is am5d$ by add+
 aft] ! item relat+ to section #bjbb !  
foll[+ new item3  #bjbb;,a4 ,p>tn]%ips )
 public & private entities to provide   
legal s]vices to homeless vet]ans &     
vet]ans at risk ( homelessness4  4      
#cji4 ,adm9i/rative improvem5ts to grant
 & p] diem programs ( ,dep>tm5t (       
,vet]ans ,affairs ,section #bjab ( title
 #ch1 ,unit$ ,/ates ,code1 is am5d$--   
7#a7 9 subsection 7a77#a71 9 ! matt]    

be=e subp>agraph 7,a71 by ins]t+ &      
except z o!rwise provid$ 9 ?is section  
aft] su* purpose2 &  7#b7 by add+ at !  
end ! foll[+ new subsection3  7e7       
,review & conditional r5ewal  7#a7 ,ea* 
ye>1 ! ,secret>y %all review ea* grant  
recipi5t & eligible entity t receiv$ a  
p] diem paym5t "u ?is section = a s]vice
 furni%$ to a vet]an dur+ ! "o-ye> p]iod
 prec$+ ! review to evaluate ! p]=mance 
( ! grant recipi5t or eligible entity   
dur+ t p]iod ) respect to--  7,a7 !     
success ( ! grant recipi5t or eligible  
entity 9 assi/+ vet]ans to obta91       
transition into1 & reta9 p]man5t h\s+2 &
  7,b7 increas+ ! income ( vet]ans1 :e!r
 by help+ vet]ans obta9 employm5t or by 
help+ vet]ans obta9 income-relat$       
b5efits to :i* su* vet]ans may be       
eligible or entitl$4  7#b7 ,= any grant 
recipi5t or eligible entity ^: p]=mance 
0 evaluat$ = a ye> "u p>agraph 7#a71 !  
,secret>y may only provide p] diem "u   
?is section to t grant recipi5t or      
eligible entity 9 ! foll[+ ye> if !     

,secret>y det]m9es t su* p]=mance m]its 
cont9u$ receipt ( p] diem "u ?is        
section4  7#c7 ,! ,secret>y %all e/abli%
 uni=m p]=mance t>gets ?r\gh\t ! ,unit$ 
,/ates = all grant recipi5ts & eligible 
entities t receive p] diem paym5ts "u   
?is section = purposes ( evaluat+ !     
p]=mance ( ea* su* grant recipi5t &     
eligible entity "u ?is subsection4  4   
#caj4 ,repeal ( requirem5t = annual     
reports on assi/ance to homeless vet]ans
  7a7 ,9 g5]al ,section #bjfe ( title   
#ch1 ,unit$ ,/ates ,code1 is h]eby      
repeal$4  7b7 ,cl]ical am5dm5t ,! table 
( sections at ! beg9n+ ( *apt] #bj ( su*
 title is am5d$ by /rik+ ! item relat+  
to section #bjfe4  #caa4 ,comptroll]    
,g5]al ( ! ,unit$ ,/ates /udy on        
homeless vet]ans programs ( ,dep>tm5t ( 
,vet]ans ,affairs  7a7 ,9 g5]al ,n lat] 
?an #bgj days aft] ! date ( ! enactm5t (
 ?is ,act1 ! ,comptroll] ,g5]al ( !     
,unit$ ,/ates %all complete a /udy (    
programs ( ! ,dep>tm5t ( ,vet]ans       
,affairs t provide assi/ance to homeless

 vet]ans4  7b7 ,elem5ts ,! /udy requir$ 
by subsection 7a7 %all include ! foll[+3
 7#a7 ,an assessm5t ( :e!r programs     
describ$ 9 subsection 7a7 are meet+ !   
ne$s ( vet]ans :o are eligible =        
assi/ance provid$ by su* programs1      
includ+ any gaps or duplication 9 !     
provision ( s]vices4  7#b7 ,a review (  
rec5t ef=ts ( ! ,secret>y ( ,vet]ans    
,affairs to improve ! privacy1 safety1 &
 security ( female vet]ans receiv+      
assi/ance f su* programs4  #cab4        
,requirem5t = ,dep>tm5t ( ,vet]ans      
,affairs to assess compreh5sive s]vice  
programs = homeless vet]ans  7a7 ,9     
g5]al ,n lat] ?an "o ye> aft] ! date ( !
 enactm5t ( ?is ,act1 ! ,secret>y (     
,vet]ans ,affairs %all--  7#a7 assess & 
measure ! capacity ( programs = :i*     
entities receive grants "u section #bjaa
 ( title #ch1 ,unit$ ,/ates ,code1 or p]
 diem paym5ts "u section #bjab or #bjfa 
( su* title2 &  7#b7 assess su* programs
 ) respect to-- 7,a7 h[ well !y a*ieve  
_! /at$ goals at a national level2  7,b7

 placem5ts 9 p]man5t h\s+2  7,c7        
placem5ts 9 employm5t2 &  7,d7 increases
 9 ! regul> income ( p>ticipants 9 !    
programs4  7b7 ,assessm5t at national & 
local levels ,9 assess+ & measur+ "u    
subsection 7a77#a71 ! ,secret>y %all    
develop & use tools to exam9e ! capacity
 ( programs describ$ 9 su* subsection at
 bo? ! national & local level 9 ord] to 
assess ! foll[+3  7#a7 ,:e!r suffici5t  
capacity exi/s to meet ! ne$s ( homeless
 vet]ans 9 ea* geographic area4  7#b7   
,:e!r exi/+ capacity meets ! ne$s ( !   
subpopulations ( homeless vet]ans locat$
 9 ea* geographic area4  7#c7 ,! am\nt (
 capacity t recipi5ts ( grants "u       
sections #bjaa & #bjfa & p] diem paym5ts
 "u section #bjab ( su* title h to      
provide s]vices = :i* ! recipi5ts are   
eligible to receive p] diem "u section  
#bjab7;a77#b77;,b77ii7 ( title #ch1     
,unit$ ,/ates ,code1 z add$ by section  
#cjb7e77;,b74  7c7 ,consid]ation ( o!r  
res\rces ,9 assess+ & measur+ programs  
"u subsection 7a77#a71 ! ,secret>y %all 

consid] ! availability to su* programs (
 res\rces made available to su* programs
 & to homeless vet]ans1 includ+ res\rces
 provid$ by ! ,dep>tm5t ( ,vet]ans      
,affairs & by entities o!r ?an !        
,dep>tm5t4  7d7 ,use ( in=mation ,!     
,secret>y %all use ! in=mation collect$ 
"u ?is section z foll[s3  7#a7 ,to set  
specific goals to ensure t programs     
describ$ 9 subsection 7a7 are           
effectively s]v+ ! ne$s ( homeless      
vet]ans4  7#b7 ,to assess :e!r programs 
describ$ 9 subsection 7a7 are meet+     
goals set "u p>agraph 7#a74  7#c7 ,to   
in=m fund+ allocations = programs       
describ$ 9 subsection 7a74  7#d7 ,to    
improve ! ref]ral ( homeless vet]ans to 
programs describ$ 9 subsection 7a74  7e7
 ,report ,n lat] ?an #ahj days aft] !   
date on :i* ! assessm5t requir$ by      
subsection 7a7 is complet$1 ! ,secret>y 
%all submit to ! ,committee on ,vet]ans'
 ,affairs ( ! ,s5ate & ! ,committee on  
,vet]ans' ,affairs ( ! ,h\se (          
,repres5tatives a report on su*         

assessm5t & su* recomm5dations =        
legislative & adm9i/rative action z !   
,secret>y may h to improve ! programs & 
p] diem paym5ts describ$ 9 subsection   
7a74  #cac4 ,report on outrea* relat+ to
 increas+ ! am\nt ( h\s+ available to   
vet]ans ,n lat] ?an "o ye> 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 describ+ & assess+ ! outrea*     
conduct$ by ! ,secret>y to realtors1    
l&lords1 prop]ty managem5t companies1 & 
develop]s to educate !m ab\t ! h\s+ ne$s
 ( vet]ans & ! b5efits ( hav+ vet]ans z 
t5ants4  ,,iv ,heal? c>e matt]s  #dja4  
,%ort title ,?is title may be cit$ z !  
,jason ,simcakoski ,memorial ,act4  ,a  
,employm5t ( directors & heal? c>e      
provid]s  #daa4 ,ext5sion ( p]iod =     
increase 9 graduate m$ical education    
resid5cy positions at m$ical facilities 
( ! ,dep>tm5t ( ,vet]ans ,affairs  7a7  

,9 g5]al ,p>agraph 7#b7 ( section       
#cja7;b7 ( ! ,vet]ans ,access1 ,*oice1 &
 ,acc\ntability ,act ( #bjad 7,public   
,law #aac-adf2 #ch ,u4,s4,c4 #gcjb note7
 is am5d$--  7#a7 9 ! p>agraph head+1 by
 /rik+ ,five-ye> & ins]t+ ,t5-ye>2 &    
7#b7 9 subp>agraph 7,a71 by /rik+ #e-ye>
 p]iod & ins]t+ #aj-ye> p]iod4  7b7     
,report ,p>agraph 7#c77;,a7 ( su*       
section is am5d$ by /rik+ until #bjai & 
ins]t+ until #bjbd4  #dab4 ,modification
 ( h\rs ( employm5t = physicians &      
physician assi/ants employ$ by !        
,dep>tm5t ( ,vet]ans ,affairs ,section  
#gdbc7;a7 ( title #ch1 ,unit$ ,/ates    
,code1 is am5d$--  7#a7 by /rik+ 7a7 ,! 
h\rs & ins]t+ 7a77#a7 ,except z provid$ 
9 p>agraph 7#b71 ! h\rs2 &  7#b7 by add+
 at ! end ! foll[+ new p>agraph3  7#b7  
,! ,secret>y may modify ! h\rs (        
employm5t = a physician or physician    
assi/ant appo9t$ 9 ! ,adm9i/ration "u   
any provision ( ?is *apt] on a full-"t  
basis to be m ?an or less ?an #hj h\rs 9
 a biweekly pay p]iod if ! total h\rs ( 

employm5t = su* employee 9 a cal5d> ye> 
does n exce$ #b1jhj h\rs4  4  #dac4     
,requirem5t t physician assi/ants       
employ$ by ! ,dep>tm5t ( ,vet]ans       
,affairs receive competitive pay  7a7 ,9
 g5]al ,section #gdea7;a77#b7 ( title   
#ch1 ,unit$ ,/ates ,code1 is am5d$--    
7#a7 by r$esignat+ subp>agraph 7,b7 z   
subp>agraph 7,c72  7#b7 by ins]t+ aft]  
subp>agraph 7,a7 ! foll[+ new           
subp>agraph 7,b73  7,b7 ,physician      
assi/ant4  2 &  7#c7 9 subp>agraph 7,c71
 z r$esignat$ by p>agraph 7#a71 by /rik+
 & regi/]$ nurse & ins]t+ regi/]$ nurse1
 & physician assi/ant4  7b7 ,effective  
date ,! am5dm5ts made by subsection 7a7 
%all take effect on ! date t is "o ye>  
aft] ! date ( ! enactm5t ( ?is ,act4    
#dad4 ,e/abli%m5t ( positions (         
,directors ( ,vet]ans ,integrat$ ,s]vice
 ,networks 9 ,(fice ( ,"u ,secret>y =   
,heal? ( ,dep>tm5t ( ,vet]ans ,affairs &
 modification ( qualifications = ,m$ical
 ,directors ,section #gcjf7;a77#d7 (    
title #ch1 ,unit$ ,/ates ,code1 is      

am5d$-- 7#a7 by ins]t+ & ,directors (   
,vet]ans ,integrat$ ,s]vice ,networks   
aft] ,su* ,m$ical ,directors2 &  7#b7 by
 /rik+ 1 :o %all be ei!r a qualifi$     
doctor ( m$ic9e or a qualifi$ doctor (  
d5tal surg]y or d5tal m$ic9e4  #dae4    
,pay = ,m$ical ,directors & ,directors (
 ,vet]ans ,integrat$ ,s]vice ,networks  
7a7 ,9 g5]al ,*apt] #gd ( title #ch1    
,unit$ ,/ates ,code1 is am5d$ by add+ at
 ! end ! foll[+ new sub*apt]3  ,,vii    
,pay = ,m$ical ,directors & ,directors (
 ,vet]ans ,integrat$ ,s]vice ,networks  
#gdha4 ,pay = ,m$ical ,directors &      
,directors ( ,vet]ans ,integrat$ ,s]vice
 ,networks  7a7 ,elem5ts ( pay ,pay = a 
,m$ical ,director or ,director ( a      
,vet]ans ,integrat$ ,s]vice ,network    
appo9t$ "u section #gcjf7;a77#d7 ( ?is  
title 79 ?is section ref]r$ to z a      
,director7 %all consi/ ( basic pay set  
=? "u section #gdjd7;a7 ( ?is title &   
m>ket pay det]m9$ "u subsection 7b74    
7b7 ,m>ket pay  7#a7 ,ea* ,director is  
eligible = m>ket pay det]m9$ "u ?is     

subsection4  7#b7 ,! am\nt ( m>ket pay  
payable to a ,director "u ?is section   
%all be det]m9$ by ! ,secret>y on a     
case-by-case basis & %all consi/ ( pay  
int5d$ to reflect ne$s ( ! ,dep>tm5t )  
respect to ! recruitm5t & ret5tion 7z   
det]m9$ by ! ,secret>y7 ( su* ,director4
  7#c7 ,9 det]m9+ ! am\nt ( m>ket pay   
payable to a ,director "u ?is section1 !
 ,secret>y %all--  7,a7 consult n less  
?an two national surveys on pay =       
hospital directors1 m$ical facility     
directors1 or o!r simil> positions1 :e!r
 prep>$ by private1 public1 or          
quasi-public entities1 to make a g5]al  
assessm5t ( ! range ( pot5tial pay = !  
,director2 &  7,b7 take into acc\nt--   
7i7 ! exp]i5ce ( ! ,director 9 manag+   
facilities or program (fices ( !        
,dep>tm5t1 includ+ ! complexity ( su*   
facilities or (fices2  7ii7 ! complexity
 ( ! facility or facilities to be manag$
 by ! ,director2  7iii7 ! labor m>ket1 9
 su* geographic area z ! ,secret>y      
consid]s relevant1 = hospital directors1

 m$ical facility directors1 & o!r simil>
 positions2  7iv7 ! exp]i5ce ( !        
,director 9 manag+ m$ical facilities =  
o!r ,f$]al ag5cies1 private entities1 or
 non-pr(it entities2 &  7v7 su* o!r     
consid]ations z ! ,secret>y consid]s    
appropriate4  7#d7 7,a7 ,! ,secret>y    
%all evaluate ! am\nt ( m>ket pay       
payable to a ,director "u ?is section n 
less frequ5tly ?an once e two ye>s & may
 adju/ ! m>ket pay payable to su*       
,director z a result ( su* evaluation4  
7,b7 ,a ,director ^: m>ket pay is       
evaluat$ "u subp>agraph 7,a7 %all       
receive writt5 notice ( ! results ( su* 
evaluation4  7c7 ,requirem5ts &         
limitations on total pay  7#a7 ,n less  
frequ5tly ?an once e two ye>s1 !        
,secret>y %all set =? a ,dep>tm5t-wide  
m9imum & maximum am\nt = total annual   
pay "u subsection 7a7 t may be paid to a
 ,director & %all publi% ea* su* am\nt 9
 ! ,f$]al ,regi/]4  7#b7 ,! m9imum &    
maximum am\nts set =? "u p>agraph 7#a7  
%all take effect n e>li] ?an ! date t is

 #fj days aft] ! publication ( su*      
am\nts "u su* p>agraph4  7#c7 ,! sum ( !
 basic pay set =? "u section #gdjd7;a7 (
 ?is title & m>ket pay det]m9$ "u       
subsection 7b7 = a ,director = a cal5d> 
ye>--  7,a7 may n be less ?an ! mo/     
rec5t m9imum am\nt set =? "u p>agraph   
7#a7 be=e ! beg9n+ ( su* cal5d> ye>2 &  
7,b7 may n be m ?an ! mo/ rec5t maximum 
am\nt set =? "u su* p>agraph be=e !     
beg9n+ ( su* cal5d> ye>4  7#d7 ,! total 
am\nt ( comp5sation paid to a ,director 
"u ?is title 9 any cal5d> ye> may n     
exce$ ! am\nt ( annual comp5sation      
7exclud+ exp5ses7 ( ! ,presid5t "u      
section #ajb ( title #c4  7#e7 ,!       
,secret>y may n delegate to an (fic] or 
employee ( ! ,dep>tm5t ! requirem5t ( ! 
,secret>y to set =? a ,dep>tm5t-wide    
m9imum & maximum am\nt "u p>agraph 7#a74
  7d7 ,treatm5t ( pay ,pay "u ?is       
section %all be consid]$ pay = all      
purposes1 includ+ retirem5t b5efits "u  
*apt]s #hc & #hd ( title #e & o!r       
b5efits4  7e7 ,ancill>y effects (       

decreases 9 pay  7#a7 ,a decrease 9 pay 
( a ,director result+ f an adju/m5t 9 ! 
am\nt ( m>ket pay ( ! ,director "u      
subsection 7b7 %all n be treat$ z an    
adv]se action4  7#b7 ,a decrease 9 !    
am\nt ( pay ( a ,director result+ f an  
involunt>y reassignm5t 9 connection ) a 
discipl9>y action tak5 aga9/ ! ,director
 is n subject to appeal or judicial     
review4  4  7b7 ,cl]ical am5dm5t ,!     
table ( sections at ! beg9n+ ( *apt] #gd
 ( su* title is am5d$ by add+ at ! end !
 foll[+3  ,sub*apt] ,,vii4 ,pay =       
,m$ical ,directors & ,directors (       
,vet]ans ,integrat$ ,s]vice ,networks   
#gdha4 ,pay = ,m$ical ,directors &      
,directors ( ,vet]ans ,integrat$ ,s]vice
 ,networks4  4  7c7 ,effective date ,!  
am5dm5ts made by ?is section %all take  
effect on ! date t is "o ye> aft] ! date
 ( ! enactm5t ( ?is ,act4  #daf4        
,additional requirem5ts = hir+ ( heal?  
c>e provid]s by ,dep>tm5t ( ,vet]ans    
,affairs  7a7 ,9 g5]al ,! ,secret>y (   
,vet]ans ,affairs %all1 z "p ( ! hir+   

process = ea* heal? c>e provid] consid]$
 = a position at ! ,dep>tm5t ( ,vet]ans 
,affairs aft] ! date ( ! enactm5t ( ?is 
,act1 require f ! m$ical bo>d ( ea*     
,/ate 9 :i* ! heal? c>e provid] holds or
 has held a m$ical lic5se--  7#a7       
in=mation on any violation ( !          
requirem5ts ( ! m$ical lic5se ( ! heal? 
c>e provid]2 &  7#b7 in=mation on :e!r !
 heal? c>e provid] has ent]$ into any   
settlem5t agreem5t = a discipl9>y *>ge  
relat+ to ! practice ( m$ic9e by ! heal?
 c>e provid]4  7b7 ,regulations ,!      
,secret>y %all prescribe regulations to 
c>ry out ?is section4  #dag4 ,provision 
( in=mation on heal? c>e provid]s (     
,dep>tm5t ( ,vet]ans ,affairs to ,/ate  
m$ical bo>ds  7a7 ,9 g5]al ,not)/&+     
section #eeb;a ( title #e1 ,unit$ ,/ates
 ,code1 ! ,secret>y ( ,vet]ans ,affairs 
%all1 ) respect to ea* heal? c>e provid]
 ( ! ,dep>tm5t ( ,vet]ans ,affairs t has
 violat$ a requirem5t ( _! m$ical       
lic5se1 provide to ! m$ical bo>d ( ea*  
,/ate 9 :i* ! heal? c>e provid] is      

lic5s$ or practices all relevant        
in=mation conta9$ 9 ! ,/ate ,lic5s+     
,bo>d ,report+ ,file or any successor   
file ( ! ,dep>tm5t ) respect to su*     
violation4  7b7 ,no reque/ requir$ ,!   
,secret>y %all provide ! in=mation      
requir$ 9 subsection 7a7 to a m$ical    
bo>d describ$ 9 su* subsection not)/&+ t
 su* bo>d may n h =mally reque/$ su*    
in=mation f ! ,dep>tm5t4  #dah4 ,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>tm5t or leaves !      

,dep>tm5t to det]m9e :e!r !re are any   
conc]ns1 compla9ts1 or allegations (    
violations relat+ to ! m$ical practice (
 ! heal? c>e provid]2 &  7#b7 to take   
appropriate action ) respect to any su* 
conc]n1 compla9t1 or allegation4  ,b    
,opioid !rapy & pa9 managem5t  #dba4    
,guidel9es on managem5t ( opioid !rapy  
by ,dep>tm5t ( ,vet]ans ,affairs &      
,dep>tm5t ( ,def5se & implem5tation (   
su* guidel9es by ,dep>tm5t ( ,vet]ans   
,affairs  7a7 ,guidel9es  7#a7 ,9 g5]al 
,n lat] ?an "o ye> aft] ! date ( !      
enactm5t ( ?is ,act1 ! ,secret>y (      
,vet]ans ,affairs & ! ,secret>y (       
,def5se %all jo9tly update ! ,,va_/,,dod
 ,cl9ical ,practice ,guidel9e =         
,managem5t ( ,opioid ,!rapy = ,*ronic   
,pa9 to include ! foll[+3  7,a7 ,except 
z provid$ 9 p>agraph 7#b71 guidel9es    
develop$ by ! ,c5t]s = ,disease ,control
 & ,prev5tion = safely prescrib+ opioids
 = ! treatm5t ( *ronic1 non-canc] pa9 9 
outpati5t sett+s ^u ! release ( su*     
guidel9es by ! ,c5t]s = ,disease        

,control & ,prev5tion4  7,b7 ,enhanc$   
guidance ) respect to absolute          
contra9dications = opioid !rapy1 includ+
 guidance ) respect to ! foll[+3  7i7 ,!
 coadm9i/ration ( drugs t are capable ( 
induc+ a life-limit+ drug-drug          
int]action1 includ+ b5zodiazep9es4  7ii7
 ,! treatm5t ( pati5ts ) curr5t acute   
psy*iatric in/ability or sub/ance use   
disord] or pati5ts at risk ( suicide4   
7iii7 ,! use ( opioid !rapy to treat    
pati5ts )\t any pa91 includ+ 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 require 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 effectiv5ess assessm5t =  
pati5ts receiv+ opioid !rapy1 includ+   

pati5ts on long-t]m opioid !rapy1 to    
det]m9e--  7i7 :e!r opioid !rapy is     
meet+ ! expect$ goals ( ! pati5t & heal?
 c>e provid] ( reliev+ pa9 & improv+    
function2 &  7ii7 :e!r opioid !rapy %\ld
 be cont9u$4  7,e7 ,requirem5ts t ea*   
heal? c>e provid] ( ! ,dep>tm5t (       
,vet]ans ,affairs1 be=e initiat+ opioid 
!rapy to treat a pati5t1 use ! ,opioid  
,!rapy ,risk ,report tool ( ! ,dep>tm5t1
 includ+ by access+ ! mo/ rec5t pati5t  
in=mation f ! prescription drug monitor+
 program ( ea* ,/ate1 z requir$ to be   
includ$ 9 su* tool "u section           
#dbb7;d77#a71 to assess ! risk = adv]se 
outcomes ( opioid !rapy = ! pati5t1     
includ+ ! concurr5t use ( controll$     
sub/ances su* z b5zodiazep9es1 z "p ( ! 
compreh5sive assessm5t conduct$ by !    
heal? c>e provid]4  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 discont9u+ ! use ( opioid     

!rapy1 includ+--  7i7 prescription ( !  
l[e/ effective dose bas$ on pati5t ne$2 
7ii7 use ( opioids only = a limit$ p]iod
 ( "t2 &  7iii7 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 ,enhanc$        
recomm5dations ) 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+ requirem5ts--  7i7 t  
su* te/s occur n less frequ5tly ?an once
 ea* ye>2 &  7ii7 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,i7 ,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  7#b7 ,treatm5t ( c]ta9       
guidel9es develop$ aft] deadl9e ,if !   
,c5t]s = ,disease ,control & ,prev5tion 
release ! guidel9es describ$ 9 p>agraph 
7#a77;,a7 aft] ! date on :i* ! ,secret>y
 ( ,vet]ans ,affairs & ! ,secret>y (    
,def5se jo9tly update ! ,,va_/,,dod     
,cl9ical ,practice ,guidel9e =          
,managem5t ( ,opioid ,!rapy = ,*ronic   
,pa91 z requir$ "u p>agraph 7#a71 !     
,secret>y ( ,vet]ans ,affairs & !       
,secret>y ( ,def5se %all jo9tly modify  
su* updat$ cl9ical practice guidel9e to 
include ! guidel9es describ$ 9 p>agraph 
7#a77;,a74  7b7 ,consultation be=e      
update ,be=e updat+ ! cl9ical practice  
guidel9e "u subsection 7a71 ! ,secret>y 
( ,vet]ans ,affairs & ! ,secret>y (     
,def5se %all jo9tly consult ) ! ,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 
,code4  7c7 ,controll$ sub/ance def9$ ,9
 ?is section1 ! t]m controll$ sub/ance  
has ! mean+ giv5 t t]m 9 section #ajb ( 
! ,controll$ ,sub/ances ,act 7#ba       
,u4,s4,c4 #hjb74  #dbb4 ,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   
pa9 & includes 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      
approa*es to manag+ pa9 & relat$ heal?  
conditions includ+ complem5t>y &        
integrative heal? s]vices4  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 safe1      
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>tm5t4    
7c7 ,pa9 managem5t teams  7#a7 ,9 g5]al 
,9 c>ry+ out ! ,opioid ,safety          
,initiative ( ! ,dep>tm5t1 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+ !rapy 
at su* facility = pati5ts exp]i5c+ acute
 & *ronic pa9 t is non-canc] relat$4    
7#b7 ,e/abli%m5t ( protocols  7,a7 ,9   
g5]al ,! director ( ea* ,vet]ans        
,integrat$ ,s]vice ,network %all e/abli%
 protocols = ! designation ( pa9        

managem5t teams at ea* m$ical facility  
)9 t ,vet]ans ,integrat$ ,s]vice        
,network4  7,b7 ,consultation on        
prescription ( opioids ,ea* protocol    
e/abli%$ = a m$ical facility "u         
subp>agraph 7,a7 %all ensure t any heal?
 c>e provid] )\t exp]tise 9 prescrib+   
analgesics or :o has n complet$ !       
education & tra9+ "u subsection 7b71 su*
 z 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$ical facility2 &  7ii7 ref]s 
! pati5t to t pa9 managem5t team = any  
subsequ5t prescriptions & relat$ !rapy4 
7#c7 ,report  7,a7 ,9 g5]al ,n lat] ?an 
"o ye> aft] ! date ( ! enactm5t ( ?is   
,act1 ! head ( ea* m$ical facility ( !  
,dep>tm5t %all submit to ! director ( ! 
,vet]ans ,integrat$ ,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$ical facility4  7,b7       
,elem5ts ,ea* report submitt$ "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*

 ,/ate1 includ+ by seek+ to ent] into   
memor&a ( und]/&+ ) ,/ates to all[ su*  
access2  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 #ahj days aft] ! date ( ! enactm5t (
 ?is ,act1 ! ,secret>y %all submit to   
,congress 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 include data on concurr5t       
prescrib+ ( opioids to treat m5tal heal?
 disord]s o!r ?an opioid use disord]2 & 

7,c7 mail-ord] prescriptions ( opioids  
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 increase !      
availability ( opioid receptor          
antagoni/s approv$ by ! ,food & ,drug   
,adm9i/ration1 su* z naloxone1 to       
vet]ans4  7,b7 ,availability1 tra9+1 &  
di/ribution ,9 c>ry+ out subp>agraph    
7,a71 ! ,secret>y %all1 n lat] ?an #ij  
days aft] ! date ( ! enactm5t ( ?is     
,act--  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 compliance ) p>agraph 7#a7 t  
includes an assessm5t ( any rema9+ /eps 
to be c>ri$ out by ! ,dep>tm5t to comply
 ) su* p>agraph4  7f7 ,inclusion ( c]ta9
 in=mation & capabilities 9 ,opioid     
,!rapy ,risk ,report tool  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        
,notification ( 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 ,controll$        
sub/ance def9$ ,9 ?is section1 ! t]m    

controll$ sub/ance has ! mean+ giv5 t   
t]m 9 section #ajb ( ! ,controll$       
,sub/ances ,act 7#ba ,u4,s4,c4 #hjb74   
#dbc4 ,enhancem5t ( 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 t       
,dep>tm5t1 includ+ tra9+ heal? c>e      
provid]s ) respect to pa9 managem5t4    
7#c7 ,! use by ea* ,dep>tm5t (          
complem5t>y & integrative heal? 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?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$4  7c7 ,consultation ,!       
,secret>y ( ,vet]ans ,affairs & !       
,secret>y ( ,def5se %all ensure t !     
work+ gr\p describ$ 9 subsection 7a7 is 
able to mean+fully consult ) respect to 
! updat$ guidel9e requir$ "u subsection 
7a7 ( section #dba1 z requir$ by        
subsection 7b7 ( su* section1 n lat] ?an
 "o ye> aft] ! date ( ! enactm5t ( ?is  
,act4  #dbd4 ,e/abli%m5t ( pa9 managem5t
 bo>ds ( ,dep>tm5t ( ,vet]ans ,affairs  
7a7 ,9 g5]al ,sub*apt] ,i ( *apt] #gc ( 
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 ,activities  
7#a7 ,ea* ,bo>d may-- 7,a7 consult )    
heal? c>e pr(essionals & o!r employees (
 ! ,dep>tm5t locat$ 9 ! ,vet]ans        
,integrat$ ,s]vice ,network cov]$ by !  
,bo>d1 pati5ts :o are be+ treat$ at     
m$ical facilities ( ! ,dep>tm5t locat$ 9
 su* ,vet]ans ,integrat$ ,s]vice        
,network1 & family memb]s ( su* pati5ts 
) respect to ! pa9 managem5t res\rces & 
be/ practices ( ! ,dep>tm5t2  7,b7      
ov]see compliance by ! heal? c>e        
pr(essionals & o!r employees ( !        
,dep>tm5t ) ! be/ practices ( !         
,dep>tm5t1 includ+ by issu+             
recomm5dations to improve compliance )  
^? be/ practices2  7,c7 provide ov]sight
 ( ! pa9 managem5t practices ( ! pa9    
managem5t teams ( ea* m$ical facility ( 
! ,dep>tm5t & ! heal? c>e pr(essionals &

 o!r employees ( ! ,dep>tm5t t are      
locat$ 9 ! ,vet]ans ,integrat$ ,s]vice  
,network cov]$ by ! ,bo>d2  7,d7 ho/    
educational ev5ts1 z ! ,bo>d consid]s   
appropriate1 = individuals specifi$ 9   
subp>agraph 7,a7 on pa9 managem5t &     
treatm5t t may include ! %>+ ( updat$   
rese>* & be/ practices f m$ical exp]ts1 
o!r heal? c>e sy/ems1 & su* o!r ,f$]al  
ag5cies z ! ,bo>d consid]s necess>y to  
c>ry out ?is subp>agraph2 &  7,e7 ho/   
public ev5ts1 z ! ,bo>d consid]s        
appropriate1 dur+ :i* heal? c>e         
pr(essionals discuss & %>e be/ practices
 on pa9 managem5t & complem5t>y &       
integrative heal?4  7#b7 7,a7 ,ea* ,bo>d
 may provide treatm5t recomm5dations =  
pati5ts ) 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 &   
assi/ 9 facilitat+ communication betwe5 
su* pati5ts & _! heal? c>e provid]s1    
reg>dless ( :e!r su* treatm5t is on an  
9-pati5t or out-pati5t basis1 & = :om a 

reque/ = su* recomm5dations1 subject to 
subp>agraph 7,c71 has be5 made by an    
individual describ$ 9 subp>agraph 7,b74 
7,b7 ,an individual describ$ 9 ?is      
subp>agraph is "o ( ! foll[+            
individuals3 7i7 ,! pati5t4  7ii7 ,!    
sp\se ( ! pati5t4  7iii7 ,a family memb]
 ( ! pati5t or ano!r 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 ) respect to ! pati5t4   
7iv7 ,a physician ( ! pati5t4  7v7 ,an  
employee ( ! m$ical facility ( !        
,dep>tm5t describ$ 9 subp>agraph 7,a74  
7,c7 ,an individual describ$ 9          
subp>agraph 7,b7 may n reque/ treatm5t  
recomm5dations "u subp>agraph 7,a7      
unless ! individual--  7i7 has reque/$  
treatm5t recomm5dations f ! pa9         
managem5t team ( ! m$ical facility ( !  
,dep>tm5t at :i* ! pati5t is receiv+    
treatm5t2 &  7ii7 has receiv$ treatm5t  
recomm5dations f su* team & is n        
satisfi$ ) ^? treatm5t recomm5dations4  

7,d7 ,treatm5t recomm5dations provid$ "u
 subp>agraph 7,a7 %all assi/ ! pati5t & 
heal? c>e provid] 9 det]m9+ ! be/       
treatm5t plan = ! pati5t & %all n       
dictate ! treatm5t plan us$ by ! heal?  
c>e provid]4  7#c7 ,bas$ on treatm5t    
recomm5dations develop$ "u p>agraph     
7#b77;,a71 consultations conduct$ "u    
p>agraph 7#a77;,a71 & educational &     
public ev5ts ho/$ "u subp>agraphs 7,d7 &
 7,e7 ( p>agraph 7#a71 ea* ,bo>d may    
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 cases ( complex cl9ical
 pa94  7#d7 7,a7 ,n lat] ?an ,janu>y #ca
 ( ea* ye>1 ! ,secret>y %all submit to !
 ,committee on ,vet]ans' ,affairs ( !   
,s5ate & ! ,committee on ,vet]ans'      
,affairs ( ! ,h\se ( ,repres5tatives a  
report t conta9s compreh5sive in=mation 
f ea* ,bo>d 7) all p]sonally id5tifiable
 in=mation ( pati5ts r$act$7 on pa9     
managem5t practices c>ri$ out 9 !       

,vet]ans ,integrat$ ,s]vice ,network    
cov]$ by ! ,bo>d4  7,b7 ,ea* report     
submitt$ by ! ,secret>y "u subp>agraph  
7,a7 %all include1 = ! ye> prec$+ !     
submittal ( ! report--  7i7 a summ>y &  
explanation ( ! treatm5t recomm5dations 
provid$ "u p>agraph #b7;,a7 dur+ su*    
ye>2 &  7ii7 ! recomm5dations = be/     
practices provid$ to heal? c>e          
pr(essionals "u p>agraph 7#c7 dur+ su*  
ye>4  7#e7 ,! ,f$]al ,advisory          
,committee ,act 7#e ,u4,s4,c4 ,app47    
%all n apply to any ,bo>d4  7c7         
,memb]%ip  7#a7 ,ea* ,bo>d %all include 
! foll[+ individuals appo9t$ by !       
,secret>y3  7,a7 ,a bo>d c]tifi$ pa9    
m$ic9e speciali/4  7,b7 ,a tra9$ &      
qualifi$ memb] ( ! prim>y c>e team ( a  
m$ical facility ( ! ,dep>tm5t ) exp]i5ce
 9 pa9 c>e1 su* z a nurse practition]4  
7,c7 ,a pa9 psy*ologi/4  7,d7 ,a pa9    
social work]4  7,e7 ,a cl9ical ph>maci/4
  7,f7 ,a pa9 po9t ( contact = a        
,vet]ans ,integrat$ ,s]vice ,network4   
7,g7 ,a physician ) addiction &         

psy*oph>macology exp]tise & exp]i5ce4   
7,h7 ,an alli$ heal? c>e pr(essional4   
7,i7 ,a cl9ician ) exp]tise 9           
complem5t>y & integrative heal?4  7,j7  
,a cl9ical behavioral !rapi/4  7,k7 ,a  
pati5t advocate4  7,l7 ,a repres5tative 
( ! labor int]e/s ( employees ( !       
,dep>tm5t :o are responsible = prescrib+
 drugs4  7,m7 ,two curr5t or =m] cl9ical
 pati5ts :o are repres5tative ( !       
demographic ( pati5ts s]v$ by ! ,vet]ans
 ,integrat$ ,s]vice ,network cov]$ by ! 
,bo>d4  7,n7 ,a family memb] ( a curr5t 
or =m] cl9ical pati5t :o is             
repres5tative ( ! demographic ( pati5ts 
s]v$ by ! ,vet]ans ,integrat$ ,s]vice   
,network cov]$ by ! ,bo>d4  7#b7 ,!     
,secret>y %all det]m9e ! t]ms ( s]vice (
 ! memb]s ( ea* ,bo>d1 tak+ into        
consid]ation ! cl9ical duties ( memb]s  
:o are employees ( ! ,dep>tm5t4  7#c7   
7,a7 ,memb]s ( ea* ,bo>d %all s]ve )\t  
pay &1 except z provid$ 9 subp>agraph   
7,b71 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  7,b7 ,memb]s may receive travel 
exp5ses1 includ+ p] diem 9 lieu (       
subsi/5ce1 = travel 9 connection ) _!   
duties z memb]s ( ! ,bo>d4  7,c7 7i7    
,except z provid$ 9 clause 7ii71 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  7ii7 ,!       
,secret>y %all ensure t c>ry+ out !     
duties ( ! ,bo>d does n prev5t any memb]
 :o has cl9ical duties z an employee ( !
 ,dep>tm5t f furni%+ direct cl9ical c>e 
z appropriate to ma9ta9 quality pati5t  
c>e4  7d7 ,p>ticipation ( c]ta9 memb]s  
7#a7 ,9 c>ry+ out ! activities ( a ,bo>d
 "u subsection 7b71 any memb] appo9t$ "u
 subsection 7c77#a7 solely bas$ on      
qualifications "u subp>agraph 7,k71     
7,l71 7,m71 or 7,n7 ( subsection        
7c77#a7--  7,a7 may n h access to       
specific in=mation id5tify+ a pati5t &  

o!r confid5tial in=mation relat+ to a   
pati5t2 &  7,b7 except z provid$ 9      
p>agraph 7#b71 may n p>ticipate 9       
provid+ treatm5t recomm5dations "u      
subsection 7b77#b77;,a74  7#b7 ,9 c>ry+ 
out ! activities ( ! ,bo>d "u subsection
 7b71 a memb] appo9t$ "u subsection     
7c77#a7 solely bas$ on qualifications "u
 subp>agraph 7,k7 ( subsection 7c77#a7  
may be pres5t dur+ ! provision (        
treatm5t recomm5dations "u subsection   
7b77#b77;,a7 ) ! cons5t & ^u ! reque/ ( 
! pati5t = :i* su* treatm5t             
recomm5dations are provid$ = purposes ( 
repres5t+ ! int]e/s ( ! pati5t4  7e7    
,employm5t protections ,no adv]se       
p]sonnel action may be made aga9/ an    
employee ( ! ,dep>tm5t 9 connection ) a 
communication by ! employee ) a memb] ( 
a ,bo>d relat+ to ! activities ( ! ,bo>d
 "u subsection 7b7 & any su*            
communication %all be cov]$ by !        
employm5t & :i/lebl[] protections       
o!rwise applicable to communications by 
employees ( ! ,dep>tm5t4  7f7 ,res\rces 

( ,dep>tm5t ,! ,secret>y %all make      
available to ea* ,bo>d ! res\rces &     
p]sonnel ( ! ,dep>tm5t necess>y = !     
,bo>d to c>ry out ! activities ( ! ,bo>d
 "u subsection 7b71 includ+ res\rces &  
p]sonnel ( ! ,g5]al ,c\nsel ( !         
,dep>tm5t4  4  7b7 ,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  #gcji;,a4 ,pa9 managem5t     
bo>ds4  4  7c7 ,effective date ,!       
am5dm5ts made by ?is section %all take  
effect on ! date t is "o ye> aft] ! date
 ( ! enactm5t ( ?is ,act4  #dbe4        
,review1 inve/igation1 & report on use (
 opioids 9 treatm5t by ,dep>tm5t (      
,vet]ans ,affairs  7a7 ,indep5d5t review
  7#a7 ,9 g5]al ,n lat] ?an two ye>s    
aft] ! date ( ! enactm5t ( ?is ,act1 !  
,secret>y ( ,vet]ans ,affairs %all ent] 
into a contract ) an indep5d5t entity ) 
exp]tise 9 assess+ cl9ical prescrib+    
practices to conduct an indep5d5t review
 ( ! ,opioid ,safety ,initiative ( !    

,dep>tm5t ( ,vet]ans ,affairs & ! opioid
 prescrib+ practices ( heal? c>e        
provid]s ( ! ,dep>tm5t4  7#b7 ,report   
7,a7 ,9 g5]al ,n lat] ?an #cj days aft] 
complet+ ! indep5d5t review "u p>agraph 
7#a71 ! indep5d5t entity t c>ri$ out su*
 review %all submit to ! ,secret>y1 !   
,committee on ,vet]ans' ,affairs ( !    
,s5ate1 & ! ,committee on ,vet]ans'     
,affairs ( ! ,h\se ( ,repres5tatives a  
report on ! f9d+s & recomm5dations ( !  
indep5d5t entity ) respect to su*       
review4  7,b7 ,elem5ts ,! report        
submitt$ "u subp>agraph 7,a7 by !       
indep5d5t entity describ$ 9 su*         
subp>agraph--  7i7 %all include-- 7,i7  
recomm5dations on su* improvem5ts to !  
,opioid ,safety ,initiative ( !         
,dep>tm5t z ! indep5d5t entity consid]s 
appropriate2  7,,ii7 in=mation ) respect
 to-- 7aa7 dea?s result+ f s5t9el ev5ts 
involv+ vet]ans prescrib$ opioids by a  
heal? c>e provid] ( ! ,dep>tm5t2  7bb7  
ov]all prescription rates & prescription
 indications ( opioids at all m$ical    

facilities ( ! ,dep>tm5t to treat       
non-canc]1 non-palliative1 & non-hospice
 c>e pati5ts1 includ+ :e!r su*          
prescription rates = ea* m$ical facility
 or heal? c>e provid] ( ! ,dep>tm5t     
conflicts ) or is o!rwise inconsi/5t ) !
 /&>ds ( appropriate & safe c>e )       
respect to su* prescription rates2  7cc7
 ! prescription rates & prescription    
indications ( b5zodiazep9es & opioids   
concomitantly by heal? c>e provid]s ( ! 
,dep>tm5t1 includ+ :e!r su* prescription
 rates = ea* m$ical facility or heal?   
c>e provid] ( ! ,dep>tm5t conflicts ) or
 is o!rwise inconsi/5t ) ! /&>ds (      
appropriate & safe c>e ) respect to su* 
prescription rates2  7dd7 ! 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 &  7ee7 ! effectiv5ess ( opioid
 !rapy = pati5ts receiv+ su* !rapy1     
includ+ ! effectiv5ess ( long-t]m opioid
 !rapy2 &  7,,iii7 an assessm5t ( !     

compliance ( ! ,dep>tm5t ) ! ,,va_/,,dod
 ,cl9ical ,practice ,guidel9e =         
,managem5t ( ,opioid ,!rapy = ,*ronic   
,pa91 z updat$ "u section #dba7;a72 &   
7ii7 may include recomm5dations )       
respect to :e!r ! ,dep>tm5t %\ld        
implem5t policies relat+ to p]=mance    
managem5t1 su* z writt5 w>n+s or        
p]=mance improvem5t plans1 = heal? c>e  
provid]s ( ! ,dep>tm5t t are--  7,i7 n  
practic+ at a level meet+ or exce$+ !   
m9imum level /&>d ( c>e e/abli%$ by !   
,dep>tm5t2 &  7,,ii7 n foll[+ ! enhanc$ 
guidance ) respect to absolute          
contra9dications = opioid !rapy set =? 9
 ! ,,va_/,,dod ,cl9ical ,practice       
,guidel9e = ,managem5t ( ,opioid ,!rapy 
= ,*ronic ,pa91 z updat$ "u section     
#dba7;a74  7b7 ,annual review1          
inve/igation1 & report on opioid !rapy  
7#a7 ,annual review ( prescription rates
 ,n lat] ?an "o ye> aft] ! date ( !     
enactm5t ( ?is ,act1 & n less frequ5tly 
?an annually !reaft]1 ! ,secret>y (     
,vet]ans ,affairs %all1 ) respect to ea*

 m$ical facility ( ! ,dep>tm5t (        
,vet]ans ,affairs1 collect & review     
in=mation on opioids prescrib$ by heal? 
c>e provid]s at ! facility to treat     
non-canc]1 non-palliative1 & non-hospice
 c>e 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* opioids or    
b5zodiazep9es are n an 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
 rate = all heal? c>e provid]s at !     
facility4  7#b7 ,inve/igation (         
prescription rates  ,if ! ,secret>y     
det]m9es t a prescription rate describ$ 
9 p>agraph 7#a7 ) respect to a heal? c>e
 provid] or m$ical facility ( !         
,dep>tm5t conflicts ) or is o!rwise     
inconsi/5t ) ! /&>ds ( appropriate &    
safe c>e1 ! ,secret>y %all--  7,a7      
include in=mation relat+ to su*         
det]m9ation1 prescription rate1 & heal? 
c>e provid] or m$ical facility1 z ! case
 may be1 9 ! report submitt$ "u p>agraph
 7#c77;,f72  7,b7 ?r\gh ! ,(fice ( !    
,m$ical ,inspector ( ! ,vet]ans ,heal?  
,adm9i/ration1 conduct a full           
inve/igation ( ! heal? c>e provid] or   

m$ical facility1 z ! case may be2 &     
7,c7 imm$iately notify ! ,committee on  
,vet]ans' ,affairs ( ! ,s5ate1 !        
,committee on ,vet]ans' ,affairs ( !    
,h\se ( ,repres5tatives1 & ea* ,memb] ( 
! ,s5ate & ! ,h\se ( ,repres5tatives :o 
repres5ts ! area 9 :i* ! heal? c>e      
provid] or m$ical facility1 z ! case may
 be1 is locat$4  7#c7 ,report on opioid 
!rapy ,n lat] ?an "o ye> aft] ! date ( !
 enactm5t ( ?is ,act1 & n less frequ5tly
 ?an annually !reaft]1 ! ,secret>y %all 
submit to ! ,committee on ,vet]ans'     
,affairs ( ! ,s5ate & ! ,committee on   
,vet]ans' ,affairs ( ! ,h\se (          
,repres5tatives a report t conta9s1 = ! 
"o ye> p]iod prec$+ ! submittal ( !     
report1 ! foll[+3  7,a7 ,! numb] (      
pati5ts & ! p]c5tage ( ! pati5t         
population ( ! ,dep>tm5t ( ,vet]ans     
,affairs :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 a heal? c>e    
provid] ( ! ,dep>tm5t4  7,e7 ,) 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+ a
 m$ication to a vet]an4  7,f7 ,! results
 ( ! review conduct$ "u p>agraph 7#a7   
7includ+ a summ>y ( su* review at !     

,vet]ans ,integrat$ ,s]vice ,network    
level7 & ! inve/igation conduct$ "u     
p>agraph 7#b7 7includ+ in=mation        
describ$ 9 p>agraph 7#b77;,a771 compil$ 
9 su* a mann] z ! ,secret>y det]m9es    
appropriate to ensure t ! in=mation is  
easily accessible4  7,g7 ,an assessm5t (
 ! compliance ( ! ,dep>tm5t ) !         
,,va_/,,dod ,cl9ical ,practice ,guidel9e
 = ,managem5t ( ,opioid ,!rapy = ,*ronic
 ,pa91 includ+ any update to su*        
guidel9e4  7c7 ,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 at t      
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$ical facility1 z !    
case may be1 ! av]age numb] (           
prescriptions ( opioids p] pati5t4  ,c  
,pati5t advocacy  #dca4 ,e/abli%m5t (   
,(fice ( ,pati5t ,advocacy ( ! ,dep>tm5t
 ( ,vet]ans ,affairs  7a7 ,9 g5]al      
,sub*apt] ,i ( *apt] #gc ( title #ch1   
,unit$ ,/ates ,code1 z am5d$ by section 
#dbd7;a71 is fur!r am5d$ by add+ at !   
end ! foll[+ new section3  #gcji;,b4    
,(fice ( ,pati5t ,advocacy  7a7         
,e/abli%m5t ,!re is e/abli%$ 9 !        
,dep>tm5t )9 ! ,(fice ( ! ,"u ,secret>y 
= ,heal? an (fice to be kn[n z ! ,(fice 
( ,pati5t ,advocacy 79 ?is section      
ref]r$ to z ! ,(fice74  7b7 ,head  7#a7 
,! ,director ( ! ,(fice ( ,pati5t       
,advocacy %all be ! head ( ! ,(fice4    
7#b7 ,! ,director ( ! ,(fice ( ,pati5t  
,advocacy %all be appo9t$ by ! ,"u      
,secret>y = ,heal? f among individuals  
qualifi$ to p]=m ! duties ( ! position &
 %all report directly to ! ,"u ,secret>y
 = ,heal?4  7c7 ,function  7#a7 ,!      

function ( ! ,(fice is to c>ry out !    
,pati5t ,advocacy ,program ( !          
,dep>tm5t4  7#b7 ,9 c>ry+ out ! ,pati5t 
,advocacy ,program ( ! ,dep>tm5t1 !     
,director %all ensure t pati5t advocates
 ( ! ,dep>tm5t--  7,a7 advocate on      
behalf ( vet]ans ) respect to heal? c>e 
receiv$ & s\ght by vet]ans "u ! laws    
adm9i/]$ by ! ,secret>y2  7,b7 c>ry out 
! responsibilities specifi$ 9 subsection
 7d72 &  7,c7 receive tra9+ 9 pati5t    
advocacy4  7d7 ,pati5t advocacy         
responsibilities ,! responsibilities (  
ea* pati5t advocate at a m$ical facility
 ( ! ,dep>tm5t are ! foll[+3  7#a7 ,to  
resolve compla9ts by vet]ans ) respect  
to heal? c>e furni%$ "u ! laws adm9i/]$ 
by ! ,secret>y t _c be resolv$ at ! po9t
 ( s]vice or at a high] level easily    
accessible to ! vet]an4  7#b7 ,to pres5t
 at v>i\s meet+s & to v>i\s committees !
 issues exp]i5c$ by vet]ans 9 receiv+   
su* heal? c>e at su* m$ical facility4   
7#c7 ,to express to vet]ans _! rights & 
responsibilities z pati5ts 9 receiv+ su*

 heal? c>e4  7#d7 ,to manage ! ,pati5t  
,advocate ,track+ ,sy/em ( ! ,dep>tm5t  
at su* m$ical facility4  7#e7 ,to       
compile data at su* m$ical facility (   
compla9ts made by vet]ans ) respect to !
 receipt ( su* heal? c>e at su* m$ical  
facility & ! satisfaction ( vet]ans )   
su* heal? c>e at su* m$ical facility to 
det]m9e :e!r !re are tr5ds 9 su* data4  
7#f7 ,to ensure t a process is 9 place =
 ! di/ribution ( ! data compil$ "u      
p>agraph 7#e7 to appropriate lead]s1    
committees1 s]vices1 & /aff ( !         
,dep>tm5t4  7#g7 ,to id5tify1 n less    
frequ5tly ?an qu>t]ly1 opportunities =  
improvem5ts 9 ! furni%+ ( su* heal? c>e 
to vet]ans at su* m$ical facility bas$  
on compla9ts by vet]ans4  7#h7 ,to      
ensure t any significant compla9t by a  
vet]an ) respect to su* heal? c>e is    
br\ght to ! att5tion ( appropriate /aff 
( ! ,dep>tm5t to trigg] an assessm5t (  
:e!r !re ne$s to be a fur!r analysis ( !
 problem at ! facility-wide level4  7#i7
 ,to support any pati5t advocacy        

programs c>ri$ out by ! ,dep>tm5t4      
7#aj7 ,to ensure t all appeals & f9al   
decisions ) respect to ! receipt ( su*  
heal? c>e are ent]$ into ! ,pati5t      
,advocate ,track+ ,sy/em ( ! ,dep>tm5t4 
7#aa7 ,to und]/& all laws1 directives1 &
 o!r rules ) respect to ! rights &      
responsibilities ( vet]ans 9 receiv+ su*
 heal? c>e1 includ+ ! appeals processes 
available to vet]ans4  7#ab7 ,to ensure 
t vet]ans receiv+ m5tal heal? c>e1 or ! 
surrogate decision mak]s = su* vet]ans1 
are aw>e ( ! rights ( vet]ans to seek   
repres5tation f sy/ems e/abli%$ "u      
section #ajc ( ! ,protection & ,advocacy
 = ,m5tally ,ill ,individuals ,act (    
#aihf 7#db ,u4,s4,c4 #ajhjc7 to protect 
& advocate ! rights ( individuals )     
m5tal illness & to inve/igate incid5ts (
 abuse & neglect ( su* individuals4     
7#ac7 ,to fulfill requirem5ts e/abli%$  
by ! ,secret>y ) respect to ! inspection
 ( controll$ sub/ances4  7#ad7 ,to      
docum5t pot5tially ?reat5+ behavior &   
report su* behavior to appropriate      

au?orities4  7e7 ,tra9+ ,9 provid+ tra9+
 to pati5t advocates "u subsection      
7c77#b77;,c71 ! ,director %all ensure t 
su* tra9+ is consi/5t ?r\gh\t !         
,dep>tm5t4  7f7 ,controll$ sub/ance     
def9$ ,9 ?is section1 ! t]m controll$   
sub/ance has ! mean+ giv5 t t]m 9       
section #ajb ( ! ,controll$ ,sub/ances  
,act 7#ba ,u4,s4,c4 #hjb74  4  7b7      
,cl]ical am5dm5t ,! table ( sections at 
! beg9n+ ( *apt] #gc ( su* title1 z     
am5d$ by section #dbd7;b71 is fur!r     
am5d$ by add+ aft] ! item relat+ to     
section #gcji;,a ! foll[+ new item3     
#gcji;,b4 ,(fice ( ,pati5t ,advocacy4  4
  7c7 ,date fully op]ational ,!         
,secret>y ( ,vet]ans ,affairs %all      
ensure t ! ,(fice ( ,pati5t ,advocacy   
e/abli%$ 9 section #gcji;,b ( title #ch1
 ,unit$ ,/ates ,code1 z add$ by         
subsection 7a71 is fully op]ational n   
lat] ?an ! date t is "o ye> aft] ! date 
( ! enactm5t ( ?is ,act4  #dcb4         
,community meet+s on improv+ c>e f      
,dep>tm5t ( ,vet]ans ,affairs  7a7      

,community meet+s  7#a7 ,m$ical c5t]s ,n
 lat] ?an #ij days aft] ! date ( !      
enactm5t ( ?is ,act1 & n less frequ5tly 
?an once e #ij days !reaft]1 ea* m$ical 
c5t] ( ! ,dep>tm5t ( ,vet]ans ,affairs  
%all ho/ a community meet+ op5 to !     
public on improv+ heal? c>e f !         
,dep>tm5t4  7#b7 ,community bas$        
outpati5t cl9ics ,n lat] ?an "o ye> aft]
 ! date ( ! enactm5t ( ?is ,act1 & n    
less frequ5tly ?an annually !reaft]1 ea*
 community bas$ outpati5t cl9ic ( !     
,dep>tm5t %all ho/ a community meet+ op5
 to ! public on improv+ heal? c>e f !   
,dep>tm5t4  7b7 ,att5dance by ,director 
( ,vet]ans ,integrat$ ,s]vice ,network  
or designee  7#a7 ,9 g5]al ,subject to  
p>agraph 7#b71 ea* community meet+ ho/$ 
by a m$ical c5t] or community bas$      
outpati5t cl9ic "u subsection 7a7 %all  
be att5d$ by ! ,director ( ! ,vet]ans   
,integrat$ ,s]vice ,network 9 :i* !     
m$ical c5t] or community bas$ outpati5t 
cl9ic1 z ! case may be1 is locat$1 or an
 employee designat$ by ! ,director :o   

works 9 ! (fice ( ! ,director 4  7#b7   
,att5dance by ,director ,ea* ,director (
 a ,vet]ans ,integrat$ ,s]vice ,network 
%all att5d n less ?an "o community meet+
 "u subsection 7a7 ho/$ by ea* m$ical   
c5t] locat$ 9 ! ,vet]ans ,integrat$     
,s]vice ,network ea* ye>4  7c7 ,notice  
,ea* m$ical c5t] or community bas$      
outpati5t cl9ic ho/+ a community meet+  
%all s5d timely notice ( ! community    
meet+ to ! ,committee on ,vet]ans'      
,affairs ( ! ,s5ate1 ! ,committee on    
,vet]ans' ,affairs ( ! ,h\se (          
,repres5tatives1 & ea* ,memb] ( ! ,s5ate
 & ! ,h\se ( ,repres5tatives :o         
repres5ts ! area 9 :i* ! m$ical facility
 is locat$4  #dcc4 ,improvem5t ( aw>5ess
 ( pati5t advocacy program & pati5t bill
 ( rights ( ,dep>tm5t ( ,vet]ans        
,affairs ,n lat] ?an #ij days aft] !    
date ( ! enactm5t ( ?is ,act1 !         
,secret>y ( ,vet]ans ,affairs %all1 9 z 
_m prom95t locations z appropriate to be
 se5 by ! l>ge/ p]c5tage ( pati5ts &    
family memb]s ( pati5ts at ea* m$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$ical facility4  #dcd4 ,comptroll] 
,g5]al ,report on ,pati5t ,advocacy     
,program ( ,dep>tm5t ( ,vet]ans ,affairs
  7a7 ,9 g5]al ,n lat] ?an ?ree ye>s    
aft] ! date ( ! enactm5t ( ?is ,act1 !  
,comptroll] ,g5]al ( ! ,unit$ ,/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 ! ,program7 z c>ri$ out "u ! ,(fice
 ( ,pati5t ,advocacy ( ! ,dep>tm5t      

e/abli%$ 9 section #gcji;,b ( title #ch1
 ,unit$ ,/ates ,code1 z add$ by section 
#dca7;a74  7b7 ,elem5ts ,! report       
requir$ by subsection 7a7-- 7#a7 %all   
include--  7,a7 su* recomm5dations &    
proposals = improv+ or modify+ !        
,program z ! ,comptroll] ,g5]al consid]s
 appropriate2 &  7,b7 su* o!r in=mation 
) respect to ! ,program z ! ,comptroll] 
,g5]al consid]s appropriate2 &  7#b7 may
 include-- 7,a7 a description ( !       
,program1 includ+--  7i7 ! purposes ( ! 
,program2  7ii7 ! activities c>ri$ out  
"u ! ,program2 &  7iii7 ! suffici5cy ( !
 ,program 9 a*iev+ ! purposes ( !       
,program2  7,b7 an assessm5t ( !        
suffici5cy ( /aff+ ( employees ( !      
,dep>tm5t responsible = c>ry+ out !     
,program2  7,c7 an assessm5t ( !        
suffici5cy ( ! tra9+ ( su* employees2 & 
7,d7 an assessm5t (--  7i7 aw>5ess ( !  
,program among vet]ans & _! family      
memb]s2 &  7ii7 ! use ( ! ,program by   
vet]ans & _! family memb]s4  ,d         
,complem5t>y & integrative heal?  #dda4 

,expansion ( rese>* & education on &    
deliv]y ( complem5t>y & integrative     
heal? to vet]ans  7a7 ,developm5t ( plan
 ,to exp& rese>*1 education1 & deliv]y  
,n lat] ?an #ahj days aft] ! date ( !   
enactm5t ( ?is ,act1 ! ,secret>y (      
,vet]ans ,affairs %all develop a plan to
 exp& mat]ially & sub/antially ! scope (
 ! effectiv5ess ( rese>* & education on1
 & deliv]y & integration (1 complem5t>y 
& integrative heal? s]vices into ! heal?
 c>e s]vices provid$ to vet]ans4  7b7   
,elem5ts ,! plan requir$ by subsection  
7a7 %all provide = ! foll[+3 7#a7       
,rese>* on ! foll[+3  7,a7 ,!           
effectiv5ess ( v>i\s complem5t>y &      
integrative heal? s]vices1 includ+ !    
effectiv5ess ( su* s]vices integrat$ )  
cl9ical !rapies4  7,b7 ,approa*es to    
integrat+ complem5t>y & integrative     
heal? s]vices into o!r heal? c>e s]vices
 provid$ by ! ,dep>tm5t4  7#b7          
,education & tra9+ = heal? c>e          
pr(essionals ( ! ,dep>tm5t on ! foll[+3 
7,a7 complem5t>y & integrative heal?    

s]vices select$ by ! ,secret>y =        
purposes ( ! plan4  7,b7 ,appropriate   
uses ( su* s]vices4  7,c7 ,integration (
 su* s]vices into ! deliv]y ( heal? c>e 
to vet]ans4  7#c7 ,rese>*1 education1 & 
cl9ical activities on complem5t>y &     
integrative heal? at c5t]s ( innovation 
at m$ical c5t]s ( ! ,dep>tm5t4  7#d7    
,id5tification or developm5t ( metrics &
 outcome measures to evaluate !         
effectiv5ess ( ! provision & integration
 ( complem5t>y & integrative heal?      
s]vices into ! deliv]y ( heal? c>e to   
vet]ans4  7#e7 ,integration & deliv]y ( 
complem5t>y & integrative heal? s]vices 
) o!r heal? c>e s]vices provid$ by !    
,dep>tm5t4  7c7 ,consultation  7#a7 ,9  
g5]al ,9 c>ry+ out subsection 7a71 !    
,secret>y %all consult ) ! foll[+3 7,a7 
,! ,director ( ! ,national ,c5t] =      
,complem5t>y & ,integrative ,heal? ( !  
,national ,in/itutes ( ,heal?4  7,b7 ,! 
,commission] ( ,food & ,drugs4  7,c7    
,in/itutions ( high] education1 private 
rese>* in/itutes1 & individual rese>*]s 

) ext5sive exp]i5ce 9 complem5t>y &     
integrative heal? & ! integration (     
complem5t>y & integrative heal?         
practices into ! deliv]y ( heal? c>e4   
7,d7 ,nationally recogniz$ provid]s (   
complem5t>y & integrative heal?4  7,e7  
,su* o!r (ficials1 entities1 &          
individuals ) exp]tise on complem5t>y & 
integrative heal? z ! ,secret>y consid]s
 appropriate4  7#b7 ,scope (            
consultation ,! ,secret>y %all und]take 
consultation "u p>agraph 7#a7 9 c>ry+   
out subsection 7a7 ) respect to !       
foll[+3  7,a7 ,to develop ! plan4  7,b7 
,to id5tify specific complem5t>y &      
integrative heal? practices t1 on !     
basis ( rese>* f9d+s or promis+ cl9ical 
int]v5tions1 are appropriate to include 
z s]vices to vet]ans4  7,c7 ,to id5tify 
b>ri]s to ! effective provision &       
integration ( complem5t>y & integrative 
heal? s]vices into ! deliv]y ( heal? c>e
 to vet]ans1 & to id5tify me*anisms =   
ov]com+ su* b>ri]s4  7d7 ,complem5t>y & 
integrative heal? def9$ ,9 ?is section1 

! t]m complem5t>y & integrative heal?   
has ! mean+ giv5 t t]m by ! ,national   
,in/itutes ( ,heal?4  #ddb4 ,pilot      
program on integration ( complem5t>y &  
integrative heal? )9 ,dep>tm5t (        
,vet]ans ,affairs m$ical c5t]s  7a7     
,pilot program requir$ ,n lat] ?an #ahj 
days aft] ! completion ( ! developm5t ( 
! plan "u section #dda1 ! ,secret>y (   
,vet]ans ,affairs %all--  7#a7 c>ry out1
 ?r\gh ! ,(fice ( ,pati5t ,c5t]$ ,c>e & 
,cultural ,trans=mation ( ! ,dep>tm5t ( 
,vet]ans ,affairs1 a pilot program to   
assess ! feasibility & advisability (   
integrat+ ! deliv]y ( complem5t>y &     
integrative heal? s]vices select$ by !  
,secret>y ) o!r heal? c>e s]vices       
provid$ by ! ,dep>tm5t = vet]ans ) m5tal
 heal? conditions1 *ronic pa9           
conditions1 o!r *ronic conditions1 & su*
 o!r conditions z ! ,secret>y det]m9es  
appropriate2 &  7#b7 9 develop+ ! pilot 
program-- 7,a7 use ! plan develop$ "u   
section #dda2 &  7,b7 id5tify &1 to !   
ext5t practicable1 resolve b>ri]s to !  

provision ( complem5t>y & integrative   
heal? s]vices select$ by ! ,secret>y & !
 integration ( ^? s]vices ) o!r heal?   
c>e s]vices provid$ by ! ,dep>tm5t4  7b7
 ,duration ( pilot program ,! ,secret>y 
%all c>ry out ! pilot program dur+ !    
?ree-ye> p]iod beg9n+ on ! date t is    
#ahj days aft] ! completion ( !         
developm5t ( ! plan "u section #dda4    
7c7 ,locations  7#a7 ,9 g5]al ,!        
,secret>y %all c>ry out ! pilot program 
at n few] ?an #ae m$ical c5t]s ( !      
,dep>tm5t4  7#b7 ,polytrauma c5t]s ,n   
less ?an two ( ! m$ical c5t]s designat$ 
"u p>agraph 7#a7 %all be locat$ at      
polytrauma rehabilitation c5t]s ( !     
,dep>tm5t4  7#c7 ,m$ical c5t]s )        
prescription rate ( opioids t conflicts 
) c>e /&>ds  7,a7 ,9 g5]al ,9 select+   
m$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  7,b7           

,prescription rate def9$ ,9 ?is         
p>agraph1 ! t]m prescription rate means1
 ) respect to a m$ical c5t] ( !         
,dep>tm5t1 ea* ( ! foll[+3 7i7 ,! numb] 
( pati5ts treat$ ) opioids at ! m$ical  
c5t] divid$ by ! total numb] ( ph>macy  
us]s at ! m$ical c5t]4  7ii7 ,! av]age  
numb] ( morph9e equival5ts p] day       
prescrib$ at ! m$ical c5t] to pati5ts   
be+ treat$ ) opioids4  7iii7 ,( !       
pati5ts be+ treat$ ) opioids at ! m$ical
 c5t]1 ! av]age numb] ( prescriptions ( 
opioids p] pati5t4  7#d7 ,selection (   
locations ,9 c>ry+ out ! pilot program1 
! ,secret>y %all select locations t     
include ! foll[+ areas3  7,a7 ,rural    
areas4  7,b7 ,areas t are n 9 close     
proximity to an active duty milit>y     
in/allation4  7,c7 ,areas repres5t+     
diff]5t geographic locations1 su* z     
c5sus tracts e/abli%$ by ! ,bureau ( !  
,c5sus4  7d7 ,provision ( s]vices ,"u ! 
pilot program1 ! ,secret>y %all provide 
cov]$ s]vices to cov]$ vet]ans by       
integrat+ complem5t>y & integrative     

heal? s]vices ) o!r s]vices provid$ by !
 ,dep>tm5t at ! m$ical c5t]s designat$  
"u subsection 7c77#a74  7e7 ,cov]$      
vet]ans ,= purposes ( ! pilot program1 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 ,volunt>y          
p>ticipation ,! p>ticipation ( a vet]an 
9 ! pilot program %all be at ! election 
( ! vet]an & 9 consultation ) a cl9ician
 ( ! ,dep>tm5t4  7h7 ,report  7#a7 ,9   
g5]al ,n lat] ?an ?ree ye>s aft] ! date 
( ! comm5cem5t ( ! pilot program1 !     
,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 
submitt$ "u p>agraph 7#a7 %all include !
 foll[+3 7,a7 ,! f9d+s & conclusions ( !
 ,secret>y ) respect to ! pilot program1
 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 ,b>ri]s id5tifi$  
"u subsection 7a77#b77;,b7 t 7 n        
resolv$4  7,c7 ,su* recomm5dations = !  
cont9uation or expansion ( ! pilot      
program z ! ,secret>y consid]s          
appropriate4  7i7 ,complem5t>y &        
integrative heal? def9$ ,9 ?is section1 
! t]m complem5t>y & integrative heal?   
%all h ! mean+ giv5 t t]m 9 section     
#dda7;d74  ,e ,family c>egiv]s  #dea4   

,expansion ( family c>egiv] program (   
,dep>tm5t ( ,vet]ans ,affairs  7a7      
,family c>egiv] program  7#a7 ,expansion
 ( eligibility  7,a7 ,9 g5]al           
,subsection 7a77#b77;,b7 ( section      
#agbj;,g ( title #ch1 ,unit$ ,/ates     
,code1 is am5d$ to read z foll[s3  7,b7 
= assi/ance provid$ "u ?is subsection-- 
7i7 be=e ! date on :i* ! ,secret>y      
submits to ,congress a c]tification t ! 
,dep>tm5t has fully implem5t$ !         
in=mation te*nology sy/em requir$ by    
section #deb7;a7 ( ! ,jason ,simcakoski 
,memorial ,act1 has a s]i\s injury      
7includ+ traumatic bra9 injury1         
psy*ological trauma1 or o!r m5tal       
disord]7 incurr$ or aggravat$ 9 ! l9e ( 
duty 9 ! active milit>y1 naval1 or air  
s]vice on or aft] ,septemb] #aa1 #bjja2 
7ii7 dur+ ! two-ye> p]iod beg9n+ on !   
date specifi$ 9 clause 7i71 has a s]i\s 
injury 7includ+ traumatic bra9 injury1  
psy*ological trauma1 or o!r m5tal       
disord]7 incurr$ or aggravat$ 9 ! l9e ( 
duty 9 ! active milit>y1 naval1 or air  

s]vice--  7,i7 on or be=e ,may #g1      
#aige2 or  7,,ii7 on or aft] ,septemb]  
#aa1 #bjja2 or  7iii7 aft] ! date t is  
two ye>s aft] ! date specifi$ 9 clause  
7i71 has a s]i\s injury 7includ+        
traumatic bra9 injury1 psy*ological     
trauma1 or o!r m5tal disord]7 incurr$ or
 aggravat$ 9 ! l9e ( duty 9 ! active    
milit>y1 naval1 or air s]vice2 &  4     
7,b7 ,publication 9 ,f$]al ,regi/] ,n   
lat] ?an #cj days aft] ! date on :i* !  
,secret>y ( ,vet]ans ,affairs submits to
 ,congress ! c]tification describ$ 9    
subsection 7a77#b77;,b77i7 ( section    
#agbj;,g ( su* title1 z am5d$ by        
subp>agraph 7,a7 ( ?is p>agraph1 !      
,secret>y %all publi% ! date specifi$ 9 
su* subsection 9 ! ,f$]al ,regi/]4  7#b7
 ,expansion ( ne$$ s]vices 9 eligibility
 crit]ia ,subsection 7a77#b77;,c7 ( su* 
section is am5d$-- 7,a7 9 clause 7ii71  
by /rik+ 2 or & ins]t+ a semicolon2     
7,b7 by r$esignat+ clause 7iii7 z clause
 7iv72 &  7,c7 by ins]t+ aft] clause    
7ii7 ! foll[+ new clause 7iii73  7iii7 a

 ne$ = regul> or ext5sive in/ruction or 
sup]vision )\t :i* ! ability ( ! vet]an 
to function 9 daily life w\ld be s]i\sly
 impair$2 or  4  7#c7 ,expansion (      
s]vices provid$ ,subsection             
7a77#c77;,a77ii7 ( su* section is       
am5d$-- 7,a7 9 subclause 7,,iv71 by     
/rik+ 2 & & ins]t+ a semicolon2  7,b7 9 
subclause 7,v71 by /rik+ ! p]iod at !   
end & ins]t+ 2 &2 &  7,c7 by add+ at !  
end ! foll[+ new subclause3  7,,vi7     
?r\gh ! use ( contracts )1 or !         
provision ( grants to1 public or private
 entities-- 7aa7 f9ancial plann+ s]vices
 relat+ to ! ne$s ( injur$ vet]ans & _! 
c>egiv]s2 &  7bb7 legal s]vices1 includ+
 legal advice & consultation1 relat+ to 
! ne$s ( injur$ vet]ans & _! c>egiv]s4  
4  7#d7 ,modification ( /ip5d           
calculation ,subsection 7a77#c77;,c7 (  
su* section is am5d$-- 7,a7 by          
r$esignat+ clause 7iii7 z clause 7iv72 &
  7,b7 by ins]t+ aft] clause 7ii7 !     
foll[+ new clause 7iii73  7iii7 ,9      
det]m9+ ! am\nt & degree ( p]sonal c>e  

s]vices provid$ "u clause 7i7 ) respect 
to an eligible vet]an ^: ne$ = p]sonal  
c>e s]vices is bas$ 9 :ole or 9 "p on a 
ne$ = sup]vision or protection "u       
p>agraph 7#b77;,c77ii7 or regul>        
in/ruction or sup]vision "u p>agraph    
7#b77;,c77iii71 ! ,secret>y %all take   
into acc\nt ! foll[+3  7,i7 ,! assessm5t
 by ! family c>egiv] ( ! ne$s &         
limitations ( ! vet]an4  7,,ii7 ,! ext5t
 to :i* ! vet]an c function safely &    
indep5d5tly 9 ! abs5ce ( su* sup]vision1
 protection1 or in/ruction4  7,,iii7 ,! 
am\nt ( "t requir$ = ! family c>egiv] to
 provide su* sup]vision1 protection1 or 
in/ruction to ! vet]an4  4  7#e7        
,p]iodic evaluation ( ne$ = c]ta9       
s]vices ,subsection 7a77#c7 ( su*       
section is am5d$ by add+ at ! end !     
foll[+ new subp>agraph3  7,d7 ,9 provid+
 in/ruction1 prep>ation1 & tra9+ "u     
subp>agraph 7,a77i77,i7 & te*nical      
support "u subp>agraph 7,a77i77,,ii7 to 
ea* family c>egiv] :o is approv$ z a    
provid] ( p]sonal c>e s]vices = an      

eligible vet]an "u p>agraph 7#f71 !     
,secret>y %all p]iodically evaluate !   
ne$s ( ! eligible vet]an & ! skills ( ! 
family c>egiv] ( su* vet]an to det]m9e  
if additional in/ruction1 prep>ation1   
tra9+1 or te*nical support "u ^?        
subp>agraphs is necess>y4  4  7#f7 ,use 
( prim>y c>e teams ,subsection 7a77#e7 (
 su* section is am5d$1 9 ! matt] prec$+ 
subp>agraph 7,a71 by ins]t+ 79          
collaboration ) ! prim>y c>e team = !   
eligible vet]an to ! maximum ext5t      
practicable7 aft] evaluate4  7#g7       
,assi/ance = family c>egiv]s ,subsection
 7a7 ( su* section is am5d$ by add+ at !
 end ! foll[+ new p>agraph3  7#aa7 7,a7 
,9 provid+ assi/ance "u ?is subsection  
to family c>egiv]s ( eligible vet]ans1 !
 ,secret>y may ent] into contracts1     
provid] agreem5ts1 & memor&a ( und]/&+ )
 ,f$]al ag5cies1 ,/ates1 & private1     
nonpr(it1 & o!r entities to provide su* 
assi/ance to su* family c>egiv]s4  7,b7 
,! ,secret>y may provide assi/ance "u   
?is p>agraph only if su* assi/ance is   

reasonably accessible to ! family       
c>egiv] & is sub/antially equival5t or  
bett] 9 quality to simil> s]vices       
provid$ by ! ,dep>tm5t4  7,c7 ,!        
,secret>y may provide fair comp5sation  
to ,f$]al ag5cies1 ,/ates1 & o!r        
entities t provide assi/ance "u ?is     
p>agraph4  4  7b7 ,modification (       
def9ition ( p]sonal c>e s]vices         
,subsection 7d77#d7 ( su* section is    
am5d$-- 7#a7 9 subp>agraph 7,a71 by     
/rik+ indep5d5t2  7#b7 by r$esignat+    
subp>agraph 7,b7 z subp>agraph 7,d72 &  
7#c7 by ins]t+ aft] subp>agraph 7,a7 !  
foll[+ new subp>agraphs3  7,b7          
,sup]vision or protection bas$ on       
symptoms or residuals ( neurological or 
o!r impairm5t or injury4  7,c7 ,regul>  
or ext5sive in/ruction or sup]vision )\t
 :i* ! ability ( ! vet]an to function 9 
daily life w\ld be s]i\sly impair$4  4  
#deb4 ,implem5tation ( in=mation        
te*nology sy/em ( ,dep>tm5t ( ,vet]ans  
,affairs to assess & improve ! family   
c>egiv] program  7a7 ,implem5tation (   

new sy/em  7#a7 ,9 g5]al ,n lat] ?an    
,decemb] #ca1 #bjaf1 ! ,secret>y (      
,vet]ans ,affairs %all implem5t an      
in=mation te*nology sy/em t fully       
supports ! ,program & all[s = data      
assessm5t & compreh5sive monitor+ ( !   
,program4  7#b7 ,elem5ts ( sy/em ,!     
in=mation te*nology sy/em requir$ to be 
implem5t$ "u p>agraph 7#a7 %all include 
! foll[+3  7,a7 ,! ability to easily    
retrieve data t w all[ all aspects ( !  
,program 7at ! m$ical c5t] & aggregate  
levels7 & ! workload tr5ds = ! ,program 
to be assess$ & compreh5sively monitor$4
  7,b7 ,! ability to manage data )      
respect to a numb] ( c>egiv]s t is m ?an
 ! numb] ( c>egiv]s t ! ,secret>y       
expects to apply = ! ,program4  7,c7 ,! 
ability to integrate ! sy/em ) o!r      
relevant in=mation te*nology sy/ems ( ! 
,vet]ans ,heal? ,adm9i/ration4  7b7     
,assessm5t ( ,program  ,n lat] ?an #ahj 
days aft] implem5t+ ! sy/em describ$ 9  
subsection 7a71 ! ,secret>y %all1 ?r\gh 
! ,"u ,secret>y = ,heal?1 use data f !  

sy/em & o!r relevant data to conduct an 
assessm5t ( h[ key aspects ( ! ,program 
are /ructur$ & c>ri$ out4  7c7 ,ongo+   
monitor+ ( & modifications to ,program  
7#a7 ,monitor+ ,! ,secret>y %all use !  
sy/em implem5t$ "u subsection 7a7 to    
monitor & assess ! workload ( !         
,program1 includ+ monitor+ & assessm5t (
 data on--  7,a7 ! /atus ( applications1
 appeals1 & home visits 9 connection ) !
 ,program2 &  7,b7 ! use by c>egiv]s    
p>ticipat+ 9 ! ,program ( o!r support   
s]vices "u ! ,program su* z respite c>e4
  7#b7 ,modifications ,bas$ on !        
monitor+ & assessm5t conduct$ "u        
p>agraph 7#a71 ! ,secret>y %all id5tify 
& implem5t su* modifications to !       
,program z ! ,secret>y consid]s necess>y
 to ensure ! ,program is function+ z    
int5d$ & provid+ vet]ans & c>egiv]s     
p>ticipat+ 9 ! ,program ) s]vices 9 a   
timely mann]4  7d7 ,reports  7#a7       
,initial report  7,a7 ,9 g5]al ,n lat]  
?an #ij days aft] ! date ( ! enactm5t ( 
?is ,act1 ! ,secret>y %all submit to !  

,committee on ,vet]ans' ,affairs ( !    
,s5ate1 ! ,committee on ,vet]ans'       
,affairs ( ! ,h\se ( ,repres5tatives1 & 
! ,comptroll] ,g5]al ( ! ,unit$ ,/ates a
 report t includes--  7i7 ! /atus ( !   
plann+1 developm5t1 & deploym5t ( !     
sy/em requir$ to be implem5t$ "u        
subsection 7a71 includ+ any *anges 9 !  
timel9e = ! implem5tation ( ! sy/em2 &  
7ii7 an assessm5t ( ! ne$s ( family     
c>egiv]s ( vet]ans describ$ 9           
subp>agraph 7,b71 ! res\rces ne$$ = !   
inclusion ( su* family c>egiv]s 9 !     
,program1 & su* *anges to ! ,program z !
 ,secret>y consid]s necess>y to ensure !
 successful expansion ( ! ,program to   
include su* family c>egiv]s4  7,b7      
,vet]ans describ$ ,vet]ans describ$ 9   
?is subp>agraph are vet]ans :o are      
eligible = ! ,program "u clause 7ii7 or 
7iii7 ( section #agbj;,g7a77#b77;,b7 (  
title #ch1 ,unit$ ,/ates ,code1 z am5d$ 
by section #dea7;a77#a7 ( ?is ,act1     
solely due to a s]i\s injury 7includ+   
traumatic bra9 injury1 psy*ological     

trauma1 or o!r m5tal disord]7 incurr$ or
 aggravat$ 9 ! l9e ( duty 9 ! active    
milit>y1 naval1 or air s]vice be=e      
,septemb] #aa1 #bjja4  7#b7             
,notification by ,comptroll] ,g5]al ,!  
,comptroll] ,g5]al %all review ! report 
submitt$ "u p>agraph 7#a7 & notify !    
,committee on ,vet]ans' ,affairs ( !    
,s5ate & ! ,committee on ,vet]ans'      
,affairs ( ! ,h\se ( ,repres5tatives )  
respect to ! progress ( ! ,secret>y 9-- 
7,a7 fully implem5t+ ! sy/em requir$ "u 
subsection 7a72 &  7,b7 implem5t+ a     
process = us+ su* sy/em to monitor &    
assess ! ,program "u subsection 7c77#a7 
& modify ! ,program z consid]$ necess>y 
"u subsection 7c77#b74  7#c7 ,f9al      
report  7,a7 ,9 g5]al ,n lat] ?an       
,decemb] #ca1 #bjag1 ! ,secret>y %all   
submit to ! ,committee on ,vet]ans'     
,affairs ( ! ,s5ate1 ! ,committee on    
,vet]ans' ,affairs ( ! ,h\se (          
,repres5tatives1 & ! ,comptroll] ,g5]al 
a report on ! implem5tation (           
subsections 7a7 ?r\gh 7c74  7,b7        

,elem5ts ,! report requir$ by           
subp>agraph 7,a7 %all include ! foll[+3 
7i7 ,a c]tification by ! ,secret>y )    
respect to :e!r ! in=mation te*nology   
sy/em describ$ 9 subsection 7a7 has be5 
implem5t$4  7ii7 ,a description ( h[ !  
,secret>y has implem5t$ su* sy/em4      
7iii7 ,a description ( ! modifications  
to ! ,program1 if any1 t 7 id5tifi$ &   
implem5t$ "u subsection 7c77#b74  7iv7  
,a description ( h[ ! ,secret>y is us+  
su* sy/em to monitor ! workload ( !     
,program4  7e7 ,def9itions ,9 ?is       
section3  7#a7 ,active milit>y1 naval1  
or air s]vice ,! t]m active milit>y1    
naval1 or air s]vice has ! mean+ giv5 t 
t]m 9 section #aja ( title #ch1 ,unit$  
,/ates ,code4  7#b7 ,program ,! t]m     
,program means ! program ( compreh5sive 
assi/ance = family c>egiv]s "u section  
#agbj;,g7a7 ( title #ch1 ,unit$ ,/ates  
,code1 z am5d$ by section #dea ( ?is    
,act4  #dec4 ,modifications to annual   
evaluation report on c>egiv] program (  
,dep>tm5t ( ,vet]ans ,affairs  7a7      

,b>ri]s to c>e & s]vices ,subp>agraph   
7,a77iv7 ( section #aja7;c77#b7 ( !     
,c>egiv]s & ,vet]ans ,omnibus ,heal?    
,s]vices ,act ( #bjaj 7,public ,law     
#aaa-afc2 #ch ,u4,s4,c4 #agbj;,g note7  
is am5d$ by ins]t+ 1 includ+ a          
description ( any b>ri]s to access+ &   
receiv+ c>e & s]vices "u su* programs   
be=e ! semicolon4  7b7 ,suffici5cy (    
tra9+ = family c>egiv] program          
,subp>agraph 7,b7 ( su* section is      
am5d$-- 7#a7 9 clause 7i71 by /rik+ 2 & 
& ins]t+ a semicolon2  7#b7 9 clause    
7ii71 by /rik+ ! p]iod at ! end & ins]t+
 2 &2 &  7#c7 by add+ at ! end ! foll[+ 
new clause3  7iii7 an evaluation ( !    
suffici5cy & consi/5cy ( ! tra9+ provid$
 to family c>egiv]s "u su* program 9    
prep>+ family c>egiv]s to provide c>e to
 vet]ans "u su* program4  4  #ded4      
,advisory committee on c>egiv] policy   
7a7 ,e/abli%m5t ,!re is e/abli%$ 9 !    
,dep>tm5t ( ,vet]ans ,affairs an        
advisory committee on policies relat+ to
 c>egiv]s ( vet]ans 79 ?is section      

ref]r$ to z ! ,committee74  7b7         
,composition ,! ,committee %all be      
compos$ ( ! foll[+3 7#a7 ,a *air select$
 by ! ,secret>y ( ,vet]ans ,affairs4    
7#b7 ,a repres5tative f ea* ( ! foll[+  
ag5cies or organizations select$ by !   
head ( su* ag5cy or organization3  7,a7 
,! ,dep>tm5t ( ,vet]ans ,affairs4  7,b7 
,! ,dep>tm5t ( ,def5se4  7,c7 ,!        
,dep>tm5t ( ,heal? & ,human ,s]vices4   
7,d7 ,! ,dep>tm5t ( ,labor4  7,e7 ,!    
,c5t]s = ,m$ic>e & ,m$icaid ,s]vices4   
7#c7 ,n less ?an sev5 individuals :o are
 n employees ( ! ,f$]al ,gov]nm5t       
select$ by ! ,secret>y f among ! foll[+ 
individuals3  7,a7 ,academic exp]ts 9   
fields relat+ to c>egiv]s4  7,b7        
,cl9icians4  7,c7 ,c>egiv]s4  7,d7      
,individuals 9 receipt ( c>egiv]        
s]vices4  7,e7 ,su* o!r individuals )   
exp]tise t is relevant to ! duties ( !  
,committee z ! ,secret>y consid]s       
appropriate4  7c7 ,duties ,! duties ( ! 
,committee are z foll[s3 7#a7 ,to       
regul>ly review & recomm5d policies ( ! 

,dep>tm5t ( ,vet]ans ,affairs relat+ to 
c>egiv]s ( vet]ans4  7#b7 ,to exam9e &  
advise ! implem5tation ( su* policies4  
7#c7 ,to evaluate ! effectiv5ess ( su*  
policies4  7#d7 ,to recomm5d /&>ds ( c>e
 = c>egiv] s]vices & respite c>e s]vices
 provid$ to a c>egiv] or vet]an by a    
non-pr(it or private sector entity4     
7#e7 ,to develop recomm5dations =       
legislative or adm9i/rative action to   
enhance ! provision ( s]vices to        
c>egiv]s & vet]ans1 includ+ elim9at+    
gaps 9 su* s]vices & elim9at+ disp>ities
 9 eligibility = su* s]vices4  7#f7 ,to 
make recomm5dations on coord9ation )    
,/ate & local ag5cies & relevant        
non-pr(it organizations on maximiz+ !   
use & effectiv5ess ( res\rces = c>egiv]s
 ( vet]ans4  7d7 ,reports  7#a7 ,annual 
report to ,secret>y  7,a7 ,9 g5]al ,n   
lat] ?an ,decemb] #ca1 #bjaf1 & n less  
frequ5tly ?an annually !reaft] until !  
t]m9ation date specifi$ 9 subsection    
7e71 ! *air ( ! ,committee %all submit  
to ! ,secret>y a report on policies &   

s]vices ( ! ,dep>tm5t ( ,vet]ans        
,affairs relat+ to c>egiv]s ( vet]ans4  
7,b7 ,elem5ts ,ea* report requir$ by    
subp>agraph 7,a7 %all include ! foll[+3 
7i7 ,an assessm5t ( ! policies ( !      
,dep>tm5t relat+ to c>egiv]s ( vet]ans &
 s]vices provid$ pursuant to su*        
policies z ( ! date ( submittal ( !     
report4  7ii7 ,a description ( any      
recomm5dations made by ! ,committee to  
improve ! coord9ation ( s]vices =       
c>egiv]s ( vet]ans betwe5 ! ,dep>tm5t & 
! entities specifi$ 9 subp>agraphs 7,b7 
?r\gh 7,e7 ( subsection 7b77#b7 & to    
elim9ate b>ri]s to ! effective use ( su*
 s]vices1 includ+ ) respect to          
eligibility crit]ia4  7iii7 ,an         
evaluation ( ! effectiv5ess ( !         
,dep>tm5t 9 provid+ s]vices = c>egiv]s (
 vet]ans4  7iv7 ,an evaluation ( !      
quality & suffici5cy ( s]vices =        
c>egiv]s ( vet]ans available f          
non-gov]nm5tal organizations4  7v7 ,a   
description ( any gaps id5tifi$ by !    
,committee 9 c>e or s]vices provid$ by  

c>egiv]s to vet]ans & recomm5dations =  
legislative or adm9i/rative action to   
address su* gaps4  7vi7 ,su* o!r matt]s 
or recomm5dations z ! *air consid]s     
appropriate4  7#b7 ,transmittal to      
,congress ,n lat] ?an #ij days aft] !   
receipt ( a report "u p>agraph 7#a71 !  
,secret>y %all transmit to ! ,committee 
on ,vet]ans' ,affairs ( ! ,s5ate & !    
,committee on ,vet]ans' ,affairs ( !    
,h\se ( ,repres5tatives a copy ( su*    
report1 toge!r ) su* comm5ts &          
recomm5dations conc]n+ su* report z !   
,secret>y consid]s appropriate4  7e7    
,t]m9ation ,! ,committee %all t]m9ate on
 ,decemb] #ca1 #bjba4  #dee4            
,compreh5sive /udy on s]i\sly injur$    
vet]ans & _! c>egiv]s  7a7 ,/udy requir$
 ,dur+ ! p]iod specifi$ 9 subsection    
7d71 ! ,secret>y ( ,vet]ans ,affairs    
%all provide = ! conduct by an indep5d5t
 entity ( a compreh5sive /udy on !      
foll[+3  7#a7 ,vet]ans :o h incurr$ a   
s]i\s injury or illness1 includ+ a m5tal
 heal? injury or illness4  7#b7         

,individuals :o are act+ z c>egiv]s =   
vet]ans4  7b7 ,elem5ts ,! compreh5sive  
/udy requir$ by subsection 7a7 %all     
include ! foll[+ ) respect to ea* vet]an
 includ$ 9 su* /udy3  7#a7 ,! heal? ( ! 
vet]an &1 if applicable1 ! impact ( !   
c>egiv] ( su* vet]an on ! heal? ( su*   
vet]an4  7#b7 ,! employm5t /atus ( !    
vet]an &1 if applicable1 ! impact ( !   
c>egiv] ( su* vet]an on ! employm5t     
/atus ( su* vet]an4  7#c7 ,! f9ancial   
/atus & ne$s ( ! vet]an4  7#d7 ,! use by
 ! vet]an ( b5efits available to su*    
vet]an f ! ,dep>tm5t ( ,vet]ans         
,affairs4  7#e7 ,su* o!r in=mation z !  
,secret>y consid]s appropriate4  7c7    
,contract ,! ,secret>y %all ent] into a 
contract ) an appropriate indep5d5t     
entity to conduct ! /udy requir$ by     
subsection 7a74  7d7 ,p]iod specifi$ ,! 
p]iod specifi$ 9 ?is subsection is !    
"o-ye> p]iod beg9n+ on ! date t is f\r  
ye>s aft] ! date specifi$ 9 section     
#agbj;,g7a77#b77;,b77i7 ( title #ch1    
,unit$ ,/ates ,code1 z am5d$ by section 

#dea7;a77#a7 ( ?is ,act4  7e7 ,report ,n
 lat] ?an #cj days aft] ! end ( ! p]iod 
specifi$ 9 subsection 7d71 ! ,secret>y  
%all submit to ! ,committee on ,vet]ans'
 ,affairs ( ! ,s5ate & ! ,committee on  
,vet]ans' ,affairs ( ! ,h\se (          
,repres5tatives a report on ! results ( 
! /udy requir$ by subsection 7a74  ,f   
,heal? c>e agreem5ts  #dfa4             
,au?orization ( agreem5ts betwe5 !      
,dep>tm5t ( ,vet]ans ,affairs &         
non-,dep>tm5t ext5d$ c>e provid]s  7a7  
,9 g5]al ,sub*apt] ,i ( *apt] #ag (     
title #ch1 ,unit$ ,/ates ,code1 is am5d$
 by add+ aft] section #agjc ! foll[+ new
 section3  #agjc;,a4 ,vet]ans ,ext5d$   
,c>e ,agreem5ts ) c]ta9 heal? c>e       
provid]s  7a7 ,agreem5ts to furni%      
ext5d$ c>e  7#a7 ,9 addition to !       
au?ority ( ! ,secret>y "u ?is *apt] to  
furni% ext5d$ c>e at facilities ( !     
,dep>tm5t & "u contracts or %>+         
agreem5ts ent]$ into "u au?orities o!r  
?an ?is section1 ! ,secret>y may furni% 
ext5d$ c>e ?r\gh ! use ( agreem5ts ent]$

 into "u ?is section4 ,an agreem5t ent]$
 into "u ?is section may be ref]r$ to z 
a ,vet]ans ,ext5d$ ,c>e ,agreem5t4  7#b7
 ,! ,secret>y may ent] into agreem5ts to
 furni% ext5d$ c>e "u ?is section )     
eligible provid]s t are c]tifi$ "u      
subsection 7d7 if ! ,secret>y is n      
feasibly able to furni% ext5d$ c>e at   
facilities ( ! ,dep>tm5t4  7#c7 ,an     
eligible provid]1 at its discretion1 may
 opt to ent] into an agreem5t "u ?is    
section in/ead ( a contract or %>+      
agreem5t "u au?orities o!r ?an ?is      
section4  7b7 ,receipt ( ext5d$ c>e     
7#a7 ,eligibility ( a vet]an = ext5d$   
c>e "u ?is section %all be det]m9$ z if 
su* c>e 7 furni%$ 9 a facility ( !      
,dep>tm5t & provisions ( ?is title      
applicable to vet]ans receiv+ ext5d$ c>e
 9 a facility ( ! ,dep>tm5t %all apply  
to vet]ans receiv+ su* c>e "u ?is       
section4  7#b7 ,9 c>ry+ out ?is section1
 ! ,secret>y-- 7,a7 may n direct vet]ans
 seek+ ext5d$ c>e to heal? c>e provid]s 
t h ent]$ into contracts or %>+         

agreem5ts "u au?orities o!r ?an ?is     
section2 &  7,b7 %all ensure t vet]ans h
 ! option to det]m9e :e!r to receive    
ext5d$ c>e f a heal? c>e provid]        
describ$ 9 subp>agraph 7,a7 or an       
eligible provid] t has ent]$ into an    
agreem5t "u ?is section4  7c7 ,eligible 
provid]s ,= purposes ( ?is section1 an  
eligible provid] is "o ( ! foll[+3 7#a7 
,a provid] ( s]vices t has enroll$ &    
ent]$ into a provid] agreem5t "u section
 #ahff7;a7 ( ! ,social ,security ,act   
7#db ,u4,s4,c4 #acie;cc7a774  7#b7 ,a   
physician or suppli] t has enroll$ &    
ent]$ into a p>ticipation agreem5t "u   
section #ahdb7;h7 ( su* ,act 7#db       
,u4,s4,c4 #acieu7h774  7#c7 ,a provid] (
 items & s]vices receiv+ paym5t "u a    
,/ate plan "u title ,,xix ( su* ,act    
7#db ,u4,s4,c4 #acif et seq47 or a waiv]
 ( su* a plan4  7#d7 ,a provid] t is--  
7,a7 an ,ag+ & ,disability ,res\rce     
,c5t]1 an area ag5cy on ag+1 or a ,/ate 
ag5cy 7z def9$ 9 section #ajb ( ! ,old] 
,am]icans ,act ( #aife 7#db ,u4,s4,c4   

#cjjb772 or  7,b7 a c5t] = indep5d5t    
liv+ 7z def9$ 9 section #gjb ( !        
,rehabilitation ,act ( #aigc 7#bi       
,u4,s4,c4 #gif;a774  7#e7 ,su* o!r heal?
 c>e provid]s z ! ,secret>y consid]s    
appropriate = purposes ( ?is section4   
7d7 ,c]tification ( eligible provid]s   
7#a7 ,! ,secret>y %all e/abli% a process
 = ! c]tification ( eligible provid]s "u
 ?is section t %all1 at a m9imum1 set =?
 ! foll[+4  7,a7 ,proc$ures = !         
submittal ( applications = c]tification 
& deadl9es = actions tak5 by ! ,secret>y
 ) respect to su* applications4  7,b7   
,/&>ds & proc$ures = approval & d5ial ( 
c]tification1 duration ( c]tification1  
revocation ( c]tification1 &            
rec]tification4  7,c7 ,proc$ures =      
assess+ eligible provid]s bas$ on ! risk
 ( fraud1 wa/e1 & abuse ( su* provid]s  
simil> to ! level ( scre5+ "u section   
#ahff7;j77#b77;,b7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#acie;cc7j77#b77;,b77 & ! /&>ds set =?  
"u section #i4ajd ( title #dh1 ,code (  

,f$]al ,regulations1 or any successor   
regulation4  7#b7 ,! ,secret>y %all d5y 
or revoke c]tification to an eligible   
provid] "u ?is subsection if ! ,secret>y
 det]m9es t ! eligible provid] is       
curr5tly--  7,a7 exclud$ f p>ticipation 
9 a ,f$]al heal? c>e program 7z def9$ 9 
section #aabh;,b7f7 ( ! ,social         
,security ,act 7#db ,u4,s4,c4           
#acbj;a-#g;b7f777 "u section #aabh or   
#aabh;,a ( ! ,social ,security ,act 7#db
 ,u4,s4,c4 #acbj;a-#g & #acbj;a-#g;a72  
or  7,b7 id5tifi$ z an exclud$ s\rce on 
! li/ ma9ta9$ 9 ! ,sy/em = ,aw>d        
,managem5t1 or any successor sy/em4  7e7
 ,t]ms ( agreem5ts ,ea* agreem5t ent]$  
into ) an eligible provid] "u ?is       
section %all include provisions requir+ 
! eligible provid] to d ! foll[+3  7#a7 
,to accept paym5t = ext5d$ c>e furni%$  
"u ?is section at rates e/abli%$ by !   
,secret>y = purposes ( ?is section1 :i* 
%all be1 to ! ext5t practicable1 ! rates
 paid by ! ,unit$ ,/ates = su* c>e to   
provid]s ( s]vices & suppli]s "u !      

,m$ic>e program "u title ,,xviii ( !    
,social ,security ,act 7#db ,u4,s4,c4   
#acie et seq474  7#b7 ,to accept paym5t 
"u p>agraph 7#a7 z paym5t 9 full =      
ext5d$ c>e furni%$ "u ?is section & to n
 seek any paym5t = su* c>e f ! recipi5t 
( su* c>e4  7#c7 ,to furni% "u ?is      
section only ! ext5d$ c>e au?oriz$ by ! 
,dep>tm5t "u ?is section unless !       
eligible provid] receives prior writt5  
cons5t f ! ,dep>tm5t to furni% ext5d$   
c>e outside ! scope ( su* au?orization4 
7#d7 ,to bill ! ,dep>tm5t = ext5d$ c>e  
furni%$ "u ?is section 9 accordance ) a 
me?odology e/abli%$ by ! ,secret>y =    
purposes ( ?is section4  7#e7 ,n to seek
 to recov] or collect f a heal?-plan    
contract or ?ird p>ty1 z ^? t]ms are    
def9$ 9 section #agbi ( ?is title1 = any
 ext5d$ c>e = :i* paym5t is made by !   
,dep>tm5t "u ?is section4  7#f7 ,to     
provide m$ical records = vet]ans furni%$
 ext5d$ c>e "u ?is section to !         
,dep>tm5t 9 a "t frame & =mat specifi$  
by ! ,secret>y = purposes ( ?is section4

  7#g7 ,to meet su* o!r t]ms &          
conditions1 includ+ quality ( c>e       
assurance /&>ds1 z ! ,secret>y may      
specify = purposes ( ?is section4  7f7  
,t]m9ation ( agreem5ts  7#a7 ,an        
eligible provid] may t]m9ate an agreem5t
 ) ! ,secret>y "u ?is section at su* "t 
& ^u su* notice to ! ,secret>y z !      
,secret>y may specify = purposes ( ?is  
section4  7#b7 ,! ,secret>y may t]m9ate 
an agreem5t ) an eligible provid] "u ?is
 section at su* "t & ^u su* notice to ! 
eligible provid] z ! ,secret>y may      
specify = purposes ( ?is section1 if !  
,secret>y--  7,a7 det]m9es t ! eligible 
provid] fail$ to comply sub/antially ) !
 provisions ( ! agreem5t or ) !         
provisions ( ?is section & ! regulations
 prescrib$ !reund]2  7,b7 det]m9es t !  
eligible provid] is-- 7i7 exclud$ f     
p>ticipation 9 a ,f$]al heal? c>e       
program 7z def9$ 9 section #aabh;,b7f7 (
 ! ,social ,security ,act 7#db ,u4,s4,c4
 #acbj;a-#g;b7f777 "u section #aabh or  
#aabh;,a ( ! ,social ,security ,act 7#db

 ,u4,s4,c4 #acbj;a-#g & #acbj;a-#g;a72  
or  7ii7 id5tifi$ z an exclud$ s\rce on 
! li/ ma9ta9$ 9 ! ,sy/em = ,aw>d        
,managem5t1 or any successor sy/em2     
7,c7 asc]ta9s t ! eligible provid] has  
be5 convict$ ( a felony or o!r s]i\s    
(f5se "u ,f$]al or ,/ate law & det]m9es 
t ! cont9u$ p>ticipation ( ! eligible   
provid] w\ld be detrim5tal to ! be/     
int]e/s ( vet]ans or ! ,dep>tm5t2 or    
7,d7 det]m9es t x is reasonable to      
t]m9ate ! agreem5t bas$ on ! heal? c>e  
ne$s ( a vet]an or vet]ans4  7g7        
,p]iodic review ( c]ta9 agreem5ts  7#a7 
,n less frequ5tly ?an once e two ye>s1 !
 ,secret>y %all review ea* ,vet]ans     
,ext5d$ ,c>e ,agreem5t ( mat]ial size   
ent]$ into dur+ ! two-ye> p]iod prec$+ !
 review to det]m9e :e!r x is feasible & 
advisable to furni% ! ext5d$ c>e furni%$
 "u su* agreem5t at facilities ( !      
,dep>tm5t or ?r\gh contracts or %>+     
agreem5ts ent]$ into "u au?orities o!r  
?an ?is section4  7#b7 7,a7 ,subject to 
subp>agraph 7,b71 a ,vet]ans ,ext5d$    

,c>e ,agreem5t is ( mat]ial size z      
det]m9$ by ! ,secret>y = purposes ( ?is 
section4  7,b7 ,a ,vet]ans ,ext5d$ ,c>e 
,agreem5t ent]$ into aft] ,septemb] #cj1
 #bjaf1 is ( mat]ial size if ! pur*ase (
 ext5d$ c>e "u ! agreem5t exce$s        
#a1jjj1jjj annually4 ,! ,secret>y may   
adju/ su* am\nt to acc\nt = *anges 9 !  
co/ ( heal? c>e bas$ ^u recogniz$ heal? 
c>e m>ket surveys & o!r available data &
 %all publi% any su* adju/m5ts 9 !      
,f$]al ,regi/]4  7h7 ,exclusion ( c]ta9 
,f$]al contract+ provisions  7#a7 ,an   
agreem5t "u ?is section may be ent]$    
into )\t reg>d to any law t w\ld require
 ! ,secret>y to use competitive         
proc$ures 9 select+ ! p>ty ) :i* to ent]
 into ! agreem5t4  7#b7 7,a7 ,except z  
provid$ 9 subp>agraph 7,b7 & unless     
o!rwise provid$ 9 ?is section or        
regulations prescrib$ pursuant to ?is   
section1 an eligible provid] t ent]s    
into an agreem5t "u ?is section is n    
subject to1 9 ! c>ry+ out ( ! agreem5t1 
any law t provid]s ( s]vices & suppli]s 

"u ! ,m$ic>e program "u title ,,xviii ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#acie et seq47 are n subject to4  7,b7  
,not)/&+ subp>agraph 7,a71 an eligible  
provid] t ent]s into an agreem5t "u ?is 
section %all be subject to all laws     
reg>d+ integrity1 e?ics1 fraud1 or t    
subject a p]son to civil or crim9al     
p5alties z if su* laws 7 incorporat$    
into its provid] agreem5ts4  7i7        
,quality ( c>e ,! ,secret>y %all e/abli%
 ?r\gh regulation a sy/em or sy/ems =-- 
7#a7 monitor+ ! quality ( ext5d$ c>e    
furni%$ to vet]ans "u ?is section2 &    
7#b7 assess+ ! quality ( ext5d$ c>e     
furni%$ by an eligible provid] "u ?is   
section prior to ! r5ewal ( a ,vet]ans  
,ext5d$ ,c>e ,agreem5t ) ! eligible     
provid]4  7j7 ,dispute resolution  7#a7 
,! ,secret>y %all e/abli% adm9i/rative  
proc$ures = eligible provid]s ) :i* !   
,secret>y has ent]$ an agreem5t "u ?is  
section to pres5t any dispute aris+ "u  
or relat$ to ! agreem5t4  7#b7 ,be=e us+
 any dispute resolution me*anism "u     

*apt] #ga ( title #da ) respect to a    
dispute aris+ "u an agreem5t "u ?is     
section1 an eligible provid] mu/ fir/   
exhau/ ! adm9i/rative proc$ures e/abli%$
 by ! ,secret>y "u p>agraph 7#a74  7k7  
,sunset ,! ,secret>y may n furni% ext5d$
 c>e ?r\gh ! use ( an agreem5t ent]$    
into "u ?is section aft] ! date t is two
 ye>s aft] ! date ( ! enactm5t ( !      
,jason ,simcakoski ,memorial ,act4  4   
7b7 ,regulations ,! ,secret>y ( ,vet]ans
 ,affairs %all prescribe an int]im f9al 
rule to c>ry out section #agjc;,a ( su* 
title1 z add$ by subsection 7a71 n lat] 
?an "o ye> aft] ! date ( ! enactm5t (   
?is ,act4  7c7 ,cl]ical am5dm5t ,! table
 ( sections at ! beg9n+ ( *apt] #ag (   
su* title is am5d$ by ins]t+ aft] ! item
 relat$ to section #agjc ! foll[+ new   
item3  #agjc;,a4 ,vet]ans ,ext5d$ ,c>e  
,agreem5ts ) c]ta9 heal? c>e provid]s4  
4  #dfb4 ,modification ( au?ority to    
ent] into agreem5ts ) ,/ate homes to    
provide nurs+ home c>e  7a7 ,use (      
agreem5ts  7#a7 ,9 g5]al ,p>agraph 7#a7 

( section #agde7;a7 ( title #ch1 ,unit$ 
,/ates ,code1 is am5d$1 9 ! matt] prec$+
 subp>agraph 7,a71 by /rik+ a contract  
7or agreem5t "u section #agbj7;c77#a7 ( 
?is title7 & ins]t+ an agreem5t4  7#b7  
,paym5t ,p>agraph 7#b7 ( su* section is 
am5d$ by /rik+ contract 7or agreem5t7   
ea* place x appe>s & ins]t+ agreem5t4   
7b7 ,exclusion ( c]ta9 ,f$]al contract+ 
provisions ,su* section is am5d$ by add+
 at ! end ! foll[+ new p>agraphs3  7#d7 
7,a7 ,an agreem5t "u p>agraph 7#a7 may  
be ent]$ into )\t reg>d to any law t    
w\ld require ! ,secret>y to use         
competitive proc$ures 9 select+ ! p>ty )
 :i* to ent] into ! agreem5t4  7,b7 7i7 
,except z provid$ 9 clause 7ii7 & unless
 o!rwise provid$ 9 ?is section or       
regulations prescrib$ pursuant to ?is   
section1 a ,/ate home t ent]s into an   
agreem5t "u p>agraph 7#a7 is n subject  
to1 9 ! c>ry+ out ( ! agreem5t1 any law 
t a provid] describ$ 9 subp>agraph 7,c7 
is n subject to "u ! orig9al ,m$ic>e    
fee-=-s]vice program "u p>ts ,a & ,b (  

title ,,xviii ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acie et seq47 or !     
,m$icaid program "u title ,,xix ( su*   
,act 7#db ,u4,s4,c4 #acif et seq474     
7ii7 ,not)/&+ clause 7i71 a ,/ate home t
 ent]s into an agreem5t "u p>agraph 7#a7
 %all be subject to all laws reg>d+     
integrity1 e?ics1 fraud1 or t subject a 
p]son to civil or crim9al p5alties z if 
su* laws 7 incorporat$ into its provid] 
agreem5ts4  7,c7 ,a provid] describ$ 9  
?is subp>agraph is "o ( ! foll[+3 7i7 ,a
 provid] ( s]vices t has enroll$ & ent]$
 into a provid] agreem5t "u section     
#ahff7;a7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #acie;cc7a774  7ii7 ,a   
physician or suppli] t has enroll$ &    
ent]$ into a p>ticipation agreem5t "u   
section #ahdb7;h7 ( su* ,act 7#db       
,u4,s4,c4 #acieu7h774  7iii7 ,a provid] 
( items & s]vices receiv+ paym5t "u a   
,/ate plan "u title ,,xix ( su* ,act    
7#db ,u4,s4,c4 #acif et seq47 or a waiv]
 ( su* a plan4  7#e7 ,! ,secret>y may n 
furni% nurs+ home c>e "u an agreem5t    

ent]$ into "u p>agraph 7#a7 aft] ! date 
t is two ye>s aft] ! date ( ! enactm5t (
 ! ,jason ,simcakoski ,memorial ,act4  4
  7c7 ,effective date ,! am5dm5ts made  
by ?is section %all apply to agreem5ts  
ent]$ into "u section #agde7;a7 ( su*   
title on & aft] ! date t is #cj days    
aft] ! date ( ! enactm5t ( ?is ,act4  ,v
 ,o!r matt]s  #eja4 ,ext5sion ( tempor>y
 increase 9 numb] ( judges on ,unit$    
,/ates ,c\rt ( ,appeals = ,vet]ans      
,claims  7a7 ,9 g5]al ,subsection       
7i77#b7 ( section #gbec ( title #ch1    
,unit$ ,/ates ,code1 is am5d$ by /rik+  
,janu>y #a1 #bjac & ins]t+ ,janu>y #a1  
#bjba4  7b7 ,report  7#a7 ,9 g5]al ,n   
lat] ?an ,june #cj1 #bjbj1 ! *ief judge 
( ! ,unit$ ,/ates ,c\rt ( ,appeals =    
,vet]ans ,claims %all submit to !       
,committee on ,vet]ans' ,affairs ( !    
,s5ate & ! ,committee on ,vet]ans'      
,affairs ( ! ,h\se ( ,repres5tatives a  
report on ! tempor>y expansions ( !     
,c\rt "u section #gbec ( title #ch1     
,unit$ ,/ates ,code4  7#b7 ,cont5ts ,!  

report requir$ by p>agraph 7#a7 %all    
include ! foll[+3 7,a7 ,an assessm5t ( !
 effect ( ! expansions on ensur+ appeals
 are h&l$ 9 a timely mann]4  7,b7 ,a    
description ( ! ways 9 :i* ! complexity 
levels ( ! appeals act$ on by ! ,c\rt   
may h *ang$ bas$ on s]vice dur+ rec5t   
conflicts comp>$ to ^? bas$ on s]vice f 
previ\s eras4  7,c7 ,a recomm5dation on 
:e!r ! numb] ( judges %\ld be adju/$ at 
! end ( ! tempor>y expansion p]iod1     
includ+ /ati/ics1 projections1 tr5d     
analyses1 & o!r in=mation to support !  
recomm5dation4  #ejb4 ,repeal           
inapplicability ( modification ( basic  
all[ance = h\s+ to b5efits "u laws      
adm9i/]$ by ,secret>y ( ,vet]ans        
,affairs  7a7 ,repeal ,subsection 7b7 ( 
section #fjd ( ! ,c>l ,lev9 & ,h[>d ,p4 
,buck ,mc,keon ,national ,def5se        
,au?orization ,act = ,fiscal ,ye> #bjae 
7,public ,law #aac-bia2 #cg ,u4,s4,c4   
#djc note7 is repeal$4  7b7 ,effective  
date ,! am5dm5t made by subsection 7a7  
%all take effect on ,janu>y #a1 #bjaf4  

#ejc4 ,dep>tm5t ( ,vet]ans ,affairs     
program ( int]nal audits  7a7 ,9 g5]al  
,sub*apt] ,,ii ( *apt] #e ( title #ch1  
,unit$ ,/ates ,code1 is am5d$ by ins]t+ 
aft] section #ebg ! foll[+ new section3 
#ebg;,a4 ,program ( int]nal audits  7a7 
,program requir$  7#a7 ,! ,secret>y %all
 c>ry out a program ( int]nal audits &  
self-analysis to improve ! furni%+ (    
b5efits & heal? c>e to vet]ans & _!     
families4  7#b7 ,! ,secret>y %all c>ry  
out ! program requir$ by p>agraph 7#a7  
?r\gh an (fice ! ,secret>y %all e/abli% 
= purposes ( ! program )9 ! (fice ( !   
,secret>y t is int]discipl9>y &         
indep5d5t (--  7,a7 ! o!r (fices )9 !   
(fice ( ! ,secret>y2 &  7,b7 ! cov]$    
adm9i/rations 7or functions ( su*       
adm9i/rations71 /aff organizations1 &   
/aff (fices id5tifi$ "u subsection      
7b77#a77;,a74  7b7 ,program requirem5ts 
7#a7 ,9 c>ry+ out ! program requir$ by  
subsection 7a71 ! ,secret>y %all-- 7,a7 
conduct p]iodic risk assessm5ts ( !     
,dep>tm5t to id5tify ^? cov]$           

adm9i/rations 7or functions ( su*       
adm9i/rations71 /aff organizations1 &   
/aff (fices ( ! ,dep>tm5t ! audit ( :i* 
w\ld lead t[>ds ! greate/ improvem5t 9 !
 furni%+ ( b5efits & heal? c>e to       
vet]ans & _! families2  7,b7 develop    
plans t are in=m$ by ! risk assessm5ts  
conduct$ "u p>agraph 7#a7 to conduct    
int]nal audits ( ! cov]$ adm9i/rations  
7or functions ( su* adm9i/rations71 /aff
 organizations1 & /aff (fices id5tifi$  
"u subp>agraph 7,a72 &  7,c7 conduct    
int]nal audits 9 accordance ) ! plans   
develop$ pursuant to subp>agraph 7,b74  
7#b7 ,! ,secret>y %all c>ry out "u !    
program requir$ by subsection 7a7 an    
audit ( n few] ?an five cov]$           
adm9i/rations 7or functions ( su*       
adm9i/rations71 /aff organizations1 or  
/aff (fices ( ! ,dep>tm5t ea* ye>4  7#c7
 ,9 id5tify+ cov]$ adm9i/rations 7or    
functions ( su* adm9i/rations71 /aff    
organizations1 & /aff (fices ( !        
,dep>tm5t "u p>agraph 7#a77;,a71 !      
,secret>y %all accord priority to !     

cov]$ adm9i/rations & functions ( su*   
adm9i/rations4  7#d7 7,a7 ,= purposes ( 
?is subsection1 ! cov]$ adm9i/rations ( 
! ,dep>tm5t are ! foll[+3 7i7 ,!        
,national ,cemet]y ,adm9i/ration4  7ii7 
,! ,vet]ans ,b5efits ,adm9i/ration4     
7iii7 ,! ,vet]ans ,heal? ,adm9i/ration4 
7,b7 ,= purposes ?is subsection1 ! cov]$
 /aff organizations ( ! ,dep>tm5t are ! 
foll[+3 7i7 ,! ,(fice ( ,acquisition1   
,logi/ics1 & ,con/ruction4  7ii7 ,!     
,advisory ,committee ,managem5t ,(fice4 
7iii7 ,! ,bo>d ( ,vet]ans' ,appeals4    
7iv7 ,! ,c5t] = ,fai?-,bas$ &           
,neighborhood ,p>tn]%ips4  7v7 ,! ,c5t] 
= ,m9ority ,vet]ans4  7vi7 ,! ,c5t] =   
,wom5 ,vet]ans4  7vii7 ,! ,(fice (      
,g5]al ,c\nsel4  7viii7 ,! ,(fice (     
,regulation ,policy & ,managem5t4  7ix7 
,! ,(fice ( ,employm5t ,discrim9ation   
,compla9t ,adjudication4  7x7 ,! ,(fice 
( ,int]ag5cy ,c>e & ,b5efits            
,coord9ation4  7xi7 ,! ,(fice ( ,small &
 ,disadvantag$ ,bus9ess ,utilization4   
7xii7 ,! ,(fice ( ,survivors ,assi/ance4

  7xiii7 ,! ,vet]ans' ,s]vice           
,organizations ,liaison4  7,c7 ,=       
purposes ( ?is subsection1 ! cov]$ /aff 
(fices ( ! ,dep>tm5t are ! foll[+3 7i7  
,! (fice ( ! ,assi/ant ,secret>y =      
,congressional & ,legislative ,affairs4 
7ii7 ,! (fice ( ! ,assi/ant ,secret>y = 
,human ,res\rces & ,adm9i/ration4  7iii7
 ,! (fice ( ! ,assi/ant ,secret>y =     
,in=mation & ,te*nology4  7iv7 ,! ,(fice
 ( ,managem5t4  7v7 ,! (fice ( !        
,assi/ant ,secret>y = ,op]ations1       
,security1 & ,prep>$ness4  7vi7 ,! (fice
 ( ! ,assi/ant ,secret>y = ,policy &    
,plann+4  7vii7 ,! (fice ( ! ,assi/ant  
,secret>y = ,public & ,int]gov]nm5tal   
,affairs4  7c7 ,reports  7#a7 7,a7 ,n   
lat] ?an #ij days aft] complet+ an audit
 "u ! program requir$ by subsection 7a71
 ! ,secret>y %all submit to !           
appropriate committees ( ,congress a    
report on ! audit4  7,b7 ,ea* report    
submitt$ "u subp>agraph 7,a7 ) respect  
to an audit %all include ! foll[+3 7i7  
,a summ>y ( ! audit4  7ii7 ,! f9d+s ( ! 

,secret>y ) respect to ! audit4  7iii7  
,su* recomm5dations z ! ,secret>y may h 
= legislative or adm9i/rative action to 
improve ! furni%+ ( b5efits & heal? c>e 
to vet]ans & _! families4  7iv7 ,plans  
to c>ry out ! recomm5dations submitt$ "u
 clause 7iii71 includ+ timel9es =       
completion ( su* plans4  7#b7 7,a7 ,n   
lat] ?an ,septemb] #a ( ea* ye>1 !      
,secret>y %all submit to ! appropriate  
committees ( ,congress a report on !    
adm9i/ration ( ?is section4  7,b7 ,ea*  
report submitt$ "u subp>agraph 7,a7 %all
 include ! foll[+3 7i7 ,a detail$       
description ( ea* matt] = :i* a         
recomm5dation 0 submitt$ "u clause 7iii7
 ( p>agraph 7#a77;,b7 & ) respect to :i*
 plans t 7 submitt$ "u clause 7iv7 ( su*
 p>agraph h n be5 complet$4  7ii7 ,a    
plan = ! conduct ( audits "u ?is section
 dur+ ! fir/ fiscal ye> beg9n+ aft] !   
fiscal ye> 9 :i* ! report is submitt$1  
:i* %all include ! foll[+3  7,i7 ,a     
description ( any risk assessm5ts !     
,secret>y plans to conduct 9 su* fiscal 

ye>4  7,,ii7 ,a summ>y ( ea* audit !    
,secret>y plans to conduct 9 su* fiscal 
ye>1 includ+ a description ( ! subject  
matt] ( ! audit & id5tification ( !     
adm9i/ration1 (fice1 or function to be  
audit$4  7#c7 ,9 ?is subsection1 ! t]m  
appropriate committees ( ,congress      
includes-- 7,a7 ! ,committee on         
,vet]ans' ,affairs1 ! ,committee on     
,appropriations1 & ! ,committee on      
,homel& ,security & ,gov]nm5tal ,affairs
 ( ! ,s5ate2 &  7,b7 ! ,committee on    
,vet]ans' ,affairs1 ! ,committee on     
,appropriations1 & ! ,committee on      
,ov]sight & ,gov]nm5t ,re=m ( ! ,h\se ( 
,repres5tatives4  4  7b7 ,fir/ risk     
assessm5t ,! ,secret>y ( ,vet]ans       
,affairs %all complete ! fir/ risk      
assessm5t requir$ by section            
#ebg;,a7b77#a77;,a7 ( su* title1 z add$ 
by subsection 7a71 by n lat] ?an #ahj   
days aft] ! date ( ! enactm5t ( ?is     
,act4  7c7 ,cl]ical am5dm5t ,! table (  
sections at ! beg9n+ ( *apt] #e ( su*   
title is am5d$ by ins]t+ aft] ! item    

relat+ to section #ebg ! foll[+ new     
item3  #ebg;,a4 ,program ( int]nal      
audits4  4  #ejd4 ,improvem5t ( tra9+ = 
manag]s ,! ,secret>y ( ,vet]ans ,affairs
 %all provide to ea* employee ( !       
,dep>tm5t ( ,vet]ans ,affairs :o is     
employ$ by ! ,dep>tm5t 9 a manag]ial    
position p]iodic tra9+ on ! foll[+3     
7#a7 ,! rights ( :i/lebl[]s & h[ to     
address a report by an employee ( a     
ho/ile "w environm5t1 reprisal1 or      
h>assm5t4  7#b7 ,h[ to effectively      
motivate1 manage1 & rew>d ! employees :o
 report to ! manag]4  7#c7 ,h[ to       
effectively manage employees :o are     
p]=m+ at an unacceptable level & access 
assi/ance f ! human res\rces (fice ( !  
,dep>tm5t & ! ,(fice ( ! ,g5]al ,c\nsel 
( ! ,dep>tm5t ) respect to ^? employees4
  ,am5d ! title s z to read3 ,a bill to 
am5d title #ch1 ,unit$ ,/ates ,code1 to 
improve ! b5efits & heal? c>e provid$ by
 ! ,dep>tm5t ( ,vet]ans ,affairs1 & =   
o!r purposes44 ,decemb] #g1             
#bjaf,report$ ) an am5dm5t & an am5dm5t 

to ! title