,i  #aae? ,,congress  #b;d ,session  ,h4
 ,r4 #ejdg  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,febru>y #ae1         
#bjah,mr4 ,bilirakis 7= himself1 ,ms4   
,ku/] ( ,new ,hamp%ire1 ,mr4 ,arr+ton1  
,mr4 ,c(fman1 & ,mr4 ,pet]s7 introduc$ !
 foll[+ bill2 :i* 0 ref]r$ to !         
,committee on ,vet]ans' ,affairs  ,a    
,,bill  ,to direct ! ,secret>y (        
,vet]ans ,affairs to c>ry out a         
demon/ration program to provide exp&$   
access to m$ical s]vices ?r\gh p>tn]%ips
 betwe5 ,dep>tm5t ( ,vet]ans ,affairs   
m$ical c5t]s & ,f$]ally ,qualifi$ ,heal?
 ,c5t]s1 & = o!r purposes4  #a4 ,%ort   
title ,?is ,act may be cit$ z ! ,,va    
,community ,c>e ,enhancem5t ,act4  #b4  
,dep>tm5t ( ,vet]ans ,affairs           
demon/ration program on exp&$           
availability ( m$ical s]vices ?r\gh     
contracts ) ,f$]ally ,qualifi$ ,heal?   
,c5t]s  7a7 ,demon/ration program ,!    
,secret>y ( ,vet]ans ,affairs %all c>ry 
out a demon/ration program "u :i* !     
,secret>y %all furni% c]ta9 m$ical      

s]vices "u *apt] #ag ( title #ch1 ,unit$
 ,/ates ,code1 ?r\gh contracts betwe5   
,dep>tm5t ( ,vet]ans ,affairs m$ical    
c5t]s & ,f$]ally ,qualifi$ ,heal? ,c5t]s
 7h]e9aft] ref]r$ to z ,f,q,h,cs74  7b7 
,community-,c>e collaborative           
arrangem5ts ,"u ! demon/ration program1 
! ,secret>y %all ent] into contracts1 on
 behalf ( ,dep>tm5t m$ical c5t]s1 ) n   
less ?an five sep>ate ,f,q,h,cs t meet !
 selection crit]ia "u subsection 7c74   
,su* a contract %all provide t--  7#a7 a
 ,dep>tm5t m$ical provid] at ! m$ical   
c5t] may ref] pati5ts directly to !     
,,fqhc1 )\t any requirem5t to consult ) 
o!r ag5cies1 (fices1 or units )9 !      
,dep>tm5t or ) entities "u contract ) ! 
,dep>tm5t2  7#b7 all pati5t ref]rals to 
! ,,fqhc are at ! discretion ( !        
,dep>tm5t m$ical provid]1 & ! decision  
:e!r to accept su* a ref]ral w be at !  
discretion ( ! pati5t2  7#c7 if a pati5t
 accepts su* a ref]ral1 ! ,,fqhc agrees 
to accept ! pati5t2  7#d7 if ! ,,fqhc   
accepts ! pati5t1 ! ,,fqhc %all provide 

m$ical s]vices to ! pati5t only to !    
ext5t t su* s]vices are available f !   
,,fqhc pursuant to section #ccj ( !     
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bed;b72  7#e7 if a pati5t    
accept$ by ! ,,fqhc is a vet]an1 !      
,,fqhc %all accept ! family memb]s ( !  
vet]an & %all provide c>e & s]vices to  
su* family memb]s 9 accordance ) *apt]  
#ag ( title #ch1 ,unit$ ,/ates ,code1 if
 su* family memb]s are eligible = m$ical
 s]vices "u su* *apt]2  7#f7 if a pati5t
 ref]r$ "u ! demon/ration program is n  
eligible = a type ( c>e or s]vice ne$$  
by ! pati5t "u *apt] #ag ( title #ch1   
,unit$ ,/ates ,code1 ! ,,fqhc agrees to 
provide su* c>e or s]vice to ! pati5t1 &
 accept paym5t = su* c>e or s]vice1 9   
accordance ) section #ccj ( ! ,public   
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#bed;b72  7#g7 ! ,,fqhc agrees to       
provide to pati5ts ref]r$ "u !          
demon/ration program-- 7,a7 9           
consultation ) ! ,dep>tm5t m$ical c5t]1 
appropriate education on :at c>e &      

s]vices may be provid$ to ! pati5t "u   
*apt] #ag ( title #ch1 ,unit$ ,/ates    
,code1 & :at c>e & s]vices may n be     
provid$ "u su* title2 &  7,b7           
appropriate education on :at c>e &      
s]vices are provid$ "u section #ccj ( ! 
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bed;b7 & :at c>e & s]vices   
are n provid$ "u su* section2  7#h7 !   
,,fqhc agrees to provide m$ical s]vices 
to ! vet]an 9 a context t suffici5tly   
takes into acc\nt ! culture ( memb]s ( !
 uni=m$ s]vices1 vet]ans1 & family      
memb]s & c>egiv]s ( memb]s ( ! uni=m$   
s]vices & vet]ans1 includ+ ! exp]i5ce ( 
combat & ! exp]i5ce ( milit>y sexual    
trauma2  7#i7 ! m$ical c5t] & ! ,,fqhc  
agree to coop]ate to ensure t pati5ts   
ref]r$ "u ! demon/ration program are    
pati5ts ( bo? ! m$ical c5t] & ! ,,fqhc  
&1 = su* purposes1 to ensure            
int]op]ability1 to ! ext5t practicable1 
9 t]ms ( %>+ ! electronic heal? records 
( ! pati5ts2  7#aj7 ! ,,fqhc agrees to  
beg9 provid+ c>e & s]vices to a ref]r$  

pati5t promptly aft] receiv+ ! ref]ral1 
)\t reg>d to :e!r ! pati5t has complet$ 
! process ( enroll+ 9 ! pati5t enrollm5t
 sy/em "u section #agje ( title #ch1    
,unit$ ,/ates ,code2  7#aa7 ) respect to
 a pati5t :o is a vet]an :o has n       
complet$ su* enrollm5t process z ( ! "t 
! ref]ral is made1 ! ,,fqhc agrees to-- 
7,a7 9 coord9ation ) ! m$ical c5t]1 make
 available to ! vet]an assi/ance ) !    
enrollm5t process2 &  7,b7 accept t     
reimbursem5t f ! ,secret>y = provid+ c>e
 or s]vices to ! vet]an w be delay$     
until aft] ! enrollm5t process is       
complet$2  7#ab7 ! ,,fqhc agrees to     
accept ! f9ancial risk t a pati5t ref]r$
 "u ! demon/ration program may n qualify
 = c>e or s]vices furni%$ by ! ,secret>y
 "u title #ch1 ,unit$ ,/ates ,code2     
7#ac7 ! ,,fqhc agrees to make available 
to ref]r$ pati5ts1 at "o or m s]vices   
sites ( ! ,,fqhc & 9 accordance ) !     
limitations on ! scope ( s]vices        
applicable "u section #ccj ( ! ,public  
,heal? ,s]vice ,act 7#db ,u4,s4,c4      

#bde;b7--  7,a7 behavioral & m5tal heal?
 & sub/ance abuse s]vices2  7,b7 wom5's 
heal? s]vices1 includ+ ,,obgyn s]vices2 
7,c7 audiology2  7,d7 ,,hiv & hepatitis 
,c treatm5t2  7,e7 d5tal c>e2  7,f7     
optometry & oph?almology2  7,g7 pa9     
managem5t2  7,h7 int]nal m$ic9e2  7,i7  
canc] detection & scre5+2  7,j7         
podiatry2 &  7,k7 urg5t c>e2  7#ad7 !   
,,fqhc agrees to provide additional     
s]vices to ref]r$ pati5ts to enable su* 
pati5ts to access m$ical s]vices furni%$
 "u ! demon/ration program1 includ+     
outrea* & transportation s]vices2  7#ae7
 ! ,secret>y agrees to provide timely   
reimbursem5t to ! ,,fqhc = m$ical       
s]vices1 provid$ to ref]r$ pati5ts at ! 
applicable rate = ! ,/ate 9 :i* ! ,,fqhc
 is locat$ "u section #aijb7;bb7 ( !    
,social ,security ,act 7#db ,u4,s4,c4   
#acif;a72  7#af7 ! ,,fqhc agrees to     
und]go p]iodic audits 9 accordance )    
section #ccj ( ! ,public ,heal? ,s]vice 
,act 7#db ,u4,s4,c4 #bed;b7 & title     
,,xix ( ! ,social ,security ,act 7#db   

,u4,s4,c4 #acif et seq472 &  7#ag7 to ! 
ext5t practicable1 ! m$ical c5t] agrees 
to provide in=mation to pati5ts on !    
availability 9 su* area ( m$ical s]vices
 ?r\gh ! p>ticipation ( ! ,,fqhc 9 !    
demon/ration program1 includ+ in=mation 
on ! p>ticul> s]vices t are available f 
! ,,fqhc & on ! ext5t to :i* ! pati5t w 
be requir$ to make paym5ts = su* s]vice4
  7c7 ,selection crit]ia  7#a7 ,9 g5]al 
,9 ord] to select ,f,q,h,cs ) :i* to    
ent] into contracts "u subsection 7b71 !
 ,secret>y %all develop selection       
crit]ia4 ,su* selection crit]ia %all--  
7,a7 take into acc\nt geographic &      
demographic diff]5ces across cat*m5t    
areas1 z def9$ by ! ,vet]ans ,heal?     
,adm9i/ration2  7,b7 provide = !        
selection ( "o or m ,f,q,h,cs t h n few]
 ?an two s]vice sites1 includ+ "o s]vice
 site 9 a highly rural area2  7,c7      
provide = ! selection ( "o or m         
,f,q,h,cs t-- 7i7 h a l>ge numb] (      
s]vice sites2  7ii7 h a s]vice area--   
7,i7 9 :i* a significant numb] ( vet]ans

 reside2  7,,ii7 t includes bo? rural & 
urban areas1 & "o or m ,dep>tm5t m$ical 
c5t]s2 &  7,,iii7 t is locat$ )9 #ajj   
miles ( a milit>y base2  7iii7 is       
p>ticipat+ 9 a network t-- 7,i7 provides
 connectivity ) respect to electronic   
heal? records2 &  7,,ii7 includes "o or 
m ,dep>tm5t m$ical c5t]s z p>ticipants2 
&  7iv7 has engag$ 9 outrea* to "o or m 
,dep>tm5t m$ical c5t]s t[>d collaborat+ 
on ! provision ( s]vices to vet]ans2    
7,d7 require t a select$ ,,fqhc has !   
capability to assi/ vet]ans 9 navigat+ !
 b5efits available to !m "u ! laws      
adm9i/]$ by ! ,secret>y ( ,vet]ans      
,affairs2 &  7,e7 require a select$     
,,fqhc to commit to e/abli%+ a program  
to educate heal? pr(essionals employ$ by
 ! ,,fqhc on cultural compet5cy 9       
provid+ s]vices to vet]ans4  7#b7       
,approval ( c]ta9 ,f,q,h,cs ,ea*        
contract ent]$ into "u subsection 7b7   
%all specify ! date on :i* ! ,,fqhc     
agrees to beg9 provid+ m$ical s]vices to
 pati5ts ref]r$ by a m$ical provid] at a

 ,dep>tm5t ( ,vet]ans ,affairs m$ical   
c5t] "u ! contract4 ,su* date may n be  
lat] ?an #ahj days aft] ! date on :i* ! 
,secret>y & ! ,,fqhc ent] into !        
contract4  7d7 ,coord9ation ) ,dep>tm5t 
( ,heal? & ,human ,s]vices ,9 c>ry+ out 
! demon/ration program "u ?is section1 !
 ,secret>y ( ,vet]ans ,affairs %all     
consult ) ! ,secret>y ( ,heal? & ,human 
,s]vices 7act+ ?r\gh ! ,adm9i/rator ( ! 
,heal? ,res\rces & ,s]vices             
,adm9i/ration71 :o %all provide to !    
,secret>y ( ,vet]ans ,affairs in=mation 
on ! capacity ( ,f,q,h,cs to s]ve       
vet]ans4 ,) respect to ,f,q,h,cs t are  
p>ticipat+ 9 su* demon/ration program1 !
 ,secret>y ( ,heal? & ,human ,s]vices   
may1 subject to t availability (        
appropriations = su* purpose1 make      
paym5ts to su* ,f,q,h,cs to increase su*
 capacity4  7e7 ,pati5t enrollm5t  7#a7 
,non-enroll$ vet]ans ,not)/&+ subsection
 7c7 ( section #agje ( title #ch1 ,unit$
 ,/ates ,code1 ! ,secret>y %all develop 
a process to ref] vet]ans :o are n      

enroll$ 9 ! pati5t enrollm5t sy/em ( !  
,dep>tm5t ( ,vet]ans ,affairs "u su*    
section to an ,,fqhc = ! provision (    
m$ical s]vices to ! vet]an "u ! pilot   
program4  7#b7 ,facilitation ( enrollm5t
 ,! ,secret>y %all develop a process by 
:i* ,f,q,h,cs t h ent]$ into a contract 
) ! ,secret>y "u subsection 7b7 are able
 to facilitate ! enrollm5t ( vet]ans    
ref]r$ to ! ,,fqhc "u p>agraph 7#a7 9   
su* pati5t enrollm5t sy/em4  7f7        
,electronic heal? records ,! ,secret>y (
 ,vet]ans ,affairs %all provide notice  
to any vet]an accept+ a ref]ral to an   
,,fqhc "u ! demon/ration program t su*  
acceptance %all s]ve z cons5t = !       
,dep>tm5t m$ical c5t] & ! ,,fqhc to %>e 
electronic heal? records unless ! vet]an
 elects n to au?orize su* %>+ ( records 
us+ a =m provid$ by ! ,secret>y = su*   
purpose4  7g7 ,rule ( con/ruction ,no?+ 
9 ?is section %all be con/ru$ z         
affect+-- 7#a7 any au?ority or          
obligation ( ! ,secret>y ( ,vet]ans     
,affairs to furni% m$ical s]vices "u    

*apt] #ag ( title #ch1 ,unit$ ,/ates    
,code1 to a pati5t :o is ref]r$ to an   
,,fqhc "u ! demon/ration program2  7#b7 
! eligibility ( any individual to       
receive m$ical s]vices "u *apt] #ag (   
title #ch1 ,unit$ ,/ates ,code2 or  7#c7
 section #ccj ( ! ,public ,heal? ,s]vice
 ,act 7#db ,u4,s4,c4 #bed;b74  7h7      
,fund+ ,no additional am\nts are        
au?oriz$ to be appropriat$ to c>ry out  
?is section4 ,! ,secret>y %all c>ry out 
! demon/ration program us+ am\nts       
o!rwise available to ! ,secret>y =      
,m$ical ,community ,c>e = fiscal ye>s   
#bjah ?r\gh #bjbb4  7i7 ,duration2      
t]m9ation  7#a7 ,duration ,! ,secret>y (
 ,vet]ans ,affairs may ent] into        
contracts "u ! demon/ration program dur+
 ! ?ree-ye> p]iod beg9n+ on ! date ( !  
enactm5t ( ?is ,act4 ,su* p]iod may be  
ext5d$ or made p]man5t at ! discretion (
 ! ,secret>y4  7#b7 ,provision ( c>e ,if
 ! ,secret>y t]m9ates ! demon/ration    
program "u ?is section1 ! ,secret>y %all
 ensure t pati5ts receiv+ c>e or s]vices

 ?r\gh a ,,fqhc pursuant to a contract  
ent]$ into "u subsection 7b7 are able to
 receive m$ical s]vices provid$ by !    
,,fqhc "u su* contract until !          
conclusion ( ! relevant episode ( c>e4  
7j7 ,def9ition ( ,f$]ally ,qualifi$     
,heal? ,c5t] ,! t]m ,f$]ally ,qualifi$  
,heal? ,c5t] means an entity receiv+ a  
grant "u section #ccj ( ! ,public ,heal?
 ,s]vice ,act 7#db ,u4,s4,c4 #bed;b7 or 
any o!r entity describ$ 9 section       
#ahfa7;aa77#d7 ( ! ,social ,security    
,act4