,,ii  #aae? ,,congress  #a/ ,session    
,s4 #aebf  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,july #aa1 #bjag ,mr4  
,te/] 7= himself1 ,mr4 ,k+1 ,mr4 ,s&]s1 
,mrs4 ,murray1 ,mr4 ,blum5?al1 ,mr4     
,br[n1 ,ms4 ,baldw91 & ,ms4 ,hirono7    
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,vet]ans' ,affairs  ,a ,,bill  ,to      
appropriate am\nts to ! ,dep>tm5t (     
,vet]ans ,affairs to improve ! provision
 ( heal? c>e to vet]ans1 & = o!r        
purposes4  #a4 ,%ort title2 table (     
cont5ts  7a7 ,%ort title  ,?is ,act may 
be cit$ z ! ,vet]ans ,access to ,c>e    
,act ( #bjag4  7b7 ,table ( cont5ts ,!  
table ( cont5ts = ?is ,act is z foll[s3 
,sec4 #a4 ,%ort title2 table ( cont5ts4 
,,title ,i--,appropriation ( am\nts =   
heal? c>e = vet]ans ,sec4 #aja4         
,appropriation ( am\nts = ,vet]ans      
,*oice ,program4 ,sec4 #ajb4            
,appropriation ( am\nts = heal? c>e f   
,dep>tm5t ( ,vet]ans ,affairs4 ,,title  
,,ii--,improvem5t ( heal? c>e f         

,dep>tm5t ( ,vet]ans ,affairs ,sec4     
#bja4 ,program to increase numb] (      
graduate m$ical education resid5cy      
positions ( ,dep>tm5t ( ,vet]ans        
,affairs4 ,sec4 #bjb4 ,expansion (      
eligibility = p>ticipation 9 & s]vices  
provid$ "u family c>egiv] program (     
,dep>tm5t ( ,vet]ans ,affairs4 ,sec4    
#bjc4 ,au?orization ( c]ta9 major m$ical
 facility leases ( ! ,dep>tm5t (        
,vet]ans ,affairs4 ,,title              
,,iii--,adm9i/ration ( heal? c>e f      
non-,dep>tm5t ( ,vet]ans ,affairs       
provid]s ,sec4 #cja4 ,modification (    
process ?r\gh :i* ,dep>tm5t ( ,vet]ans  
,affairs records obligations =          
non-,dep>tm5t c>e4 ,sec4 #cjb4          
,modification ( report on am\nts        
available "u ,vet]ans ,*oice ,program4  
,,title ,,iv--,o!r matt]s ,sec4 #dja4   
,em]g5cy designations4  ,i              
,appropriation ( am\nts = heal? c>e =   
vet]ans  #aja4 ,appropriation ( am\nts =
 ,vet]ans ,*oice ,program  7a7 ,9 g5]al 
,!re is au?oriz$ to be appropriat$1 & is

 appropriat$1 to ! ,secret>y ( ,vet]ans 
,affairs1 out ( any funds 9 ! ,treasury 
n o!rwise appropriat$1 #d1cjj1jjj1jjj to
 be deposit$ 9 ! ,vet]ans ,*oice ,fund  
"u section #hjb ( ! ,vet]ans ,access1   
,*oice1 & ,acc\ntability ,act ( #bjad   
7,public ,law #aac-adf2 #ch ,u4,s4,c4   
#agja note74  7b7 ,availability ( am\nts
 ,! am\nt appropriat$ "u subsection 7a7 
%all be available = obligation or       
exp5diture )\t fiscal ye> limitation4   
#ajb4 ,appropriation ( am\nts = heal?   
c>e f ,dep>tm5t ( ,vet]ans ,affairs  7a7
 ,9 g5]al ,!re is au?oriz$ to be        
appropriat$1 & is appropriat$1 to !     
,secret>y ( ,vet]ans ,affairs1 out ( any
 funds 9 ! ,treasury n o!rwise          
appropriat$1 #d1cjj1jjj1jjj to c>ry out 
subsection 7c74  7b7 ,availability (    
am\nts ,! am\nt appropriat$ "u          
subsection 7a7 %all be available =      
obligation or exp5diture )\t fiscal ye> 
limitation4  7c7 ,use ( am\nts ,! am\nt 
appropriat$ "u subsection 7a7 %all be   
us$ by ! ,secret>y z foll[s3 7#a7 ,to   

increase ! access ( vet]ans to c>e z    
foll[s3  7,a7 ,to hire prim>y c>e &     
specialty c>e physicians = employm5t 9 !
 ,dep>tm5t ( ,vet]ans ,affairs4  7,b7   
,to hire o!r m$ical /aff1 includ+ !     
foll[+3 7i7 ,physicians4  7ii7          
,gynecologi/s4  7iii7 ,nurses4  7iv7    
,social work]s4  7v7 ,m5tal heal?       
pr(essionals4  7vi7 ,physician          
assi/ants4  7vii7 ,o!r heal? c>e        
pr(essionals z ! ,secret>y consid]s     
appropriate4  7,c7 ,to c>ry out !       
foll[+3 7i7 ,section #gdab ( title #ch1 
,unit$ ,/ates ,code4  7ii7 ,section     
#gcjb7;e7 ( su* title4  7iii7 ,sub*apt]s
 ,,ii & ,,vii ( *apt] #gf ( su* title4  
7iv7 ,section #cja7;b77#b7 ( ! ,vet]ans 
,access1 ,*oice1 & ,acc\ntability ,act (
 #bjad 7,public ,law #aac-adf2 #ch      
,u4,s4,c4 #gcjb note74  7,d7 ,to pay =  
exp5ses1 equipm5t1 & o!r co/s associat$ 
) ! hir+ ( prim>y c>e1 specialty c>e    
physicians1 & o!r m$ical /aff "u        
subp>agraphs 7,a71 7,b71 & 7,c74  7#b7  
,to improve ! physical infra/ructure ( !

 ,dep>tm5t z foll[s3 7,a7 ,to ma9ta9 &  
op]ate hospitals1 nurs+ homes1          
domicili>y facilities1 & o!r facilities 
( ! ,vet]ans ,heal? ,adm9i/ration4  7,b7
 ,to ent] into contracts or hire        
tempor>y employees to repair1 alt]1 or  
improve facilities "u ! jurisdiction ( !
 ,dep>tm5t t are n o!rwise provid$ = "u 
?is p>agraph4  7,c7 ,to c>ry out leases 
= facilities ( ! ,dep>tm5t4  7,d7 ,to   
c>ry out m9or con/ruction projects ( !  
,dep>tm5t4  7#c7 ,to c>ry out ! program 
to increase ! numb] ( graduate m$ical   
education resid5cy positions ( !        
,dep>tm5t "u section #bja4  7#d7 ,to    
c>ry out ! major m$ical facility leases 
au?oriz$ "u section #bjc4  7d7 ,report  
7#a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! 
date ( ! enactm5t ( ?is ,act1 !         
,secret>y ( ,vet]ans ,affairs %all      
submit to ! appropriate committees (    
,congress a report on h[ ! ,secret>y has
 obligat$ ! am\nt appropriat$ "u        
subsection 7a7 z ( ! date ( ! submittal 
( ! report4  7#b7 ,appropriate          

committees ( ,congress def9$ ,9 ?is     
subsection1 ! t]m appropriate committees
 ( ,congress means-- 7,a7 ! ,committee  
on ,vet]ans' ,affairs & ! ,committee on 
,appropriations ( ! ,s5ate2 &  7,b7 !   
,committee on ,vet]ans' ,affairs & !    
,committee on ,appropriations ( ! ,h\se 
( ,repres5tatives4  7e7 ,fund+ plan ,!  
,secret>y %all submit to ,congress a    
fund+ plan describ+ h[ ! ,secret>y      
int5ds to use ! am\nt appropriat$ "u    
subsection 7a74  ,,ii ,improvem5t (     
heal? c>e f ,dep>tm5t ( ,vet]ans        
,affairs  #bja4 ,program to increase    
numb] ( graduate m$ical education       
resid5cy positions ( ,dep>tm5t (        
,vet]ans ,affairs  7a7 ,9 g5]al ,!      
,secret>y ( ,vet]ans ,affairs %all      
conduct a program to increase ! numb] ( 
graduate m$ical education resid5cy      
positions at cov]$ facilities by n m ?an
 #a1ejj positions ?r\gh ! paym5t (      
educational assi/ance to p>ticipants 9 !
 program4  7b7 ,application ,to         
p>ticipate 9 ! program "u ?is section1  

an individual %all submit to ! ,secret>y
 an application = su* p>ticipation      
toge!r ) an agreem5t describ$ 9         
subsection 7d7 "u :i* ! individual      
agrees to s]ve a p]iod ( obligat$ s]vice
 9 ! ,vet]ans ,heal? ,adm9i/ration z    
provid$ 9 ! agreem5t 9 return = paym5t (
 educational assi/ance z provid$ 9 !    
agreem5t4  7c7 ,approval by ,secret>y   
7#a7 ,9 g5]al ,an individual becomes a  
p>ticipant 9 ! program "u ?is section ^u
 ! approval by ! ,secret>y ( !          
application ( ! individual & !          
acceptance by ! ,secret>y ( an agreem5t 
describ$ 9 subsection 7d7 ) respect to !
 individual4  7#b7 ,notification ,^u !  
approval by ! ,secret>y "u p>agraph 7#a7
 ( ! p>ticipation ( an individual 9 !   
program & ! acceptance ( an agreem5t    
describ$ 9 subsection 7d71 ! ,secret>y  
%all promptly notify ! individual 9     
writ+ ( t approval & acceptance4  7d7   
,agreem5t ,an agreem5t betwe5 !         
,secret>y & a p>ticipant 9 ! program "u 
?is section %all be 9 writ+ & %all be   

sign$ by ! p>ticipant conta9+ su* t]ms z
 ! ,secret>y may specify4  7e7          
,conditions = m$ical resid5cy ,!        
,secret>y may prescribe ! conditions (  
employm5t ( individuals p>ticipat+ 9 a  
m$ical resid5cy "u ! program "u ?is     
section1 includ+ necess>y tra9+1 & !    
cu/om>y am\nt & t]ms ( pay = su*        
individuals dur+ ! p]iod ( su* employm5t
 & tra9+ z a m$ical resid5t4  7f7       
,obligat$ s]vice  7#a7 ,9 g5]al ,ea*    
p>ticipant 9 ! program "u ?is section   
%all s]ve z a full-"t employee ( !      
,dep>tm5t ( ,vet]ans ,affairs = a p]iod 
( obligat$ s]vice provid$ 9 ! agreem5t  
ent]$ into by ! p>ticipant "u subsection
 7d74  7#b7 ,practice area ,s]vice by a 
p>ticipant "u p>agraph 7#a7 %all be 9 ! 
full-"t cl9ical practice ( ! pr(ession (
 ! p>ticipant or 9 ano!r heal? c>e      
position 9 an assignm5t or location     
det]m9$ by ! ,secret>y4  7#c7           
,notification ,n lat] ?an #fj days be=e 
! date ( ! beg9n+ ( ! p]iod ( obligat$  
s]vice ( a p>ticipant1 ! ,secret>y %all 

notify ! p>ticipant ( t date4  7g7      
,brea* ( agreem5t2 liability  7#a7      
,liquidat$ damages = failure to accept  
paym5t  7,a7 ,9 g5]al ,a p>ticipant 9 ! 
program "u ?is section 7o!r ?an a       
p>ticipant describ$ 9 p>agraph 7#b77 :o 
fails to accept paym5t1 or in/ructs !   
cov]$ facility at :i* ! p>ticipant is a 
m$ical resid5t n to accept paym5t1 9    
:ole or 9 "p1 ( educational assi/ance "u
 ! agreem5t ent]$ into "u subsection 7d7
 %all be liable to ! ,unit$ ,/ates =    
liquidat$ damages 9 ! am\nt ( #a1ejj4   
7,b7 ,treatm5t ( o!r obligations        
,liability = liquidat$ damages "u       
subp>agraph 7,a7 is 9 addition to any   
p]iod ( obligat$ s]vice or o!r          
obligation or liability "u ! agreem5t   
ent]$ into "u subsection 7d74  7#b7     
,liability = c]ta9 brea*es  7,a7 ,9     
g5]al ,a p>ticipant 9 ! program "u ?is  
section %all be liable to ! ,unit$      
,/ates = ! am\nt t has be5 paid to or on
 behalf ( ! p>ticipant "u ! agreem5t if 
any ( ! foll[+ occurs3  7i7 ,!          

p>ticipant is dismiss$ f s]v+ z a m$ical
 resid5t at a cov]$ facility =          
discipl9>y reasons4  7ii7 ,! p>ticipant 
volunt>ily t]m9ates s]vice z a m$ical   
resid5t at a cov]$ facility be=e        
completion ( su* s]vice4  7iii7 ,!      
p>ticipant loses 8 or h] lic5se1        
regi/ration1 or c]tification to practice
 8 or h] heal? c>e pr(ession 9 a ,/ate4 
7,b7 ,treatm5t ( p]iod ( obligat$ s]vice
 ,liability "u subp>agraph 7,a7 is 9    
lieu ( any p]iod ( obligat$ s]vice "u ! 
agreem5t ent]$ into "u subsection 7d74  
7#c7 ,liability = fail+ to complete     
p]iod ( s]vice  7,a7 ,9 g5]al ,if a     
p>ticipant 9 ! program "u ?is section   
brea*es ! agreem5t "u subsection 7d7 by 
fail+ 7= any reason7 to complete ! p]iod
 ( obligat$ s]vice ( ! p>ticipant1 !    
,unit$ ,/ates %all be entitl$ to recov] 
f ! p>ticipant an am\nt det]m9$ 9       
accordance ) ! foll[+ =mula3 ,a  #c7t   
s_/t74  7,b7 ,=mula v>iables ,9 ! =mula 
specifi$ 9 subp>agraph 7,a73 7i7 ,a is !
 am\nt ! ,unit$ ,/ates is entitl$ to    

recov] f ! p>ticipant4  7ii7  is ! sum  
(-- 7,i7 ! am\nts paid "u ?is section to
 or on behalf ( ! p>ticipant2 &  7,,ii7 
! int]e/ on su* am\nts :i* w\ld be      
payable if at ! "t ! am\nts 7 paid !y 7 
loans be>+ int]e/ at ! maximum legal    
prevail+ rate1 z det]m9$ by ! ,treasur] 
( ! ,unit$ ,/ates4  7iii7 t is ! total  
numb] ( mon?s 9 ! p]iod ( obligat$      
s]vice ( ! p>ticipant4  7iv7 s is !     
numb] ( mon?s ( su* p]iod s]v$ by !     
p>ticipant4  7#d7 ,paym5t deadl9e ,any  
am\nt ( damages t ! ,unit$ ,/ates is    
entitl$ to recov] "u ?is subsection %all
 be paid to ! ,unit$ ,/ates )9 ! "o-ye> 
p]iod beg9n+ on ! date ( ! brea* ( !    
agreem5t "u subsection 7d74  7h7 ,cov]$ 
facilities def9$ ,9 ?is section1 ! t]m  
cov]$ facilities means any ( ! foll[+3  
7#a7 ,a ,dep>tm5t facility4  7#b7 ,a    
facility op]at$ by an ,indian tribe or a
 tribal organization1 z ^? t]ms are     
def9$ 9 section #d ( ! ,indian          
,self-,det]m9ation & ,education         
,assi/ance ,act 7#be ,u4,s4,c4 #ecjd74  

7#c7 ,a facility op]at$ by ! ,indian    
,heal? ,s]vice4  7#d7 ,a                
,f$]ally-qualifi$ heal? c5t]1 z def9$ 9 
section #aije7l77#b77;,b7 ( ! ,social   
,security ,act 7#db ,u4,s4,c4           
#acif;d7l77#b77;,b774  7#e7 ,a community
 heal? c5t]4  7#f7 ,a facility op]at$ by
 ! ,dep>tm5t ( ,def5se4  7#g7 ,any o!r  
heal? c>e facility designat$ by !       
,secret>y ( ,vet]ans ,affairs4  #bjb4   
,expansion ( eligibility = p>ticipation 
9 & s]vices provid$ "u family c>egiv]   
program ( ,dep>tm5t ( ,vet]ans ,affairs 
7a7 ,family c>egiv] program  7#a7       
,expansion ( eligibility ,subsection    
7a77#b77;,b7 ( section #agbj;,g ( title 
#ch1 ,unit$ ,/ates ,code1 is am5d$ by   
/rik+ on or aft] ,septemb] #aa1 #bjja4  
7#b7 ,cl>ification ( eligibility =      
illness ,su* subsection is fur!r am5d$  
by ins]t+ or illness aft] s]i\s injury4 
7#c7 ,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$2 or  
4  7#d7 ,expansion ( s]vices provid$    
,subsection 7a77#c77;,a77ii7 ( su*      
section is am5d$-- 7,a7 9 subclause     
7,,iv71 by /rik+ 2 & & ins]t+ a         
semicolon2  7,b7 9 subclause 7,v71 by   
/rik+ ! p]iod at ! end & ins]t+ a       
semicolon2 &  7,c7 by add+ at ! end !   
foll[+ new subclauses3  7,,vi7 *ild c>e 
s]vices or a mon?ly /ip5d = su* s]vices 
if su* s]vices are n readily available f
 ! ,dep>tm5t2  7,,vii7 f9ancial plann+  
s]vices relat+ to ! ne$s ( injur$ & ill 
vet]ans & _! c>egiv]s2 &  7,,viii7 legal
 s]vices1 includ+ legal advice &        
consultation1 relat+ to ! ne$s ( injur$ 
& ill vet]ans & _! c>egiv]s4  4  7#e7   
,expansion ( respite c>e provid$        
,subsection 7a77#c77;,b7 ( su* section  

is am5d$ by /rik+ %all be & all t foll[s
 ?r\gh ! p]iod at ! end & ins]t+ %all-- 
7i7 be m$ically & age-appropriate2  7ii7
 include 9-home c>e2 &  7iii7 include   
pe]-ori5t$ gr\p activities4  4  7#f7    
,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> or ext5sive     
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#g7        
,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#h7 ,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#i7       

,eligibility ( & assi/ance = family     
c>egiv]s ,subsection 7a7 ( su* section  
is am5d$ by add+ at ! end ! foll[+ new  
p>agraphs3  7#aa7 ,not)/&+ any o!r      
provision ( ?is subsection1 a family    
c>egiv] ( an eligible vet]an :o is      
eligible "u p>agraph 7#b7 solely because
 ( a s]i\s injury or illness 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 #bjja1 is eligible =     
assi/ance "u ?is subsection z foll[s3   
7,a7 ,n e>li] ?an ,octob] #a1 #bjah1 if 
! family c>egiv] w\ld m]it a mon?ly     
p]sonal c>egiv] /ip5d "u p>agraph       
7#c77;,a77ii77,v7 9 an am\nt t is 9 !   
highe/ ti] specifi$ 9 ! s*$ule e/abli%$ 
by ! ,secret>y "u p>agraph 7#c77;,c77i74
  7,b7 ,n e>li] ?an ,octob] #a1 #bjbj1  
if ! family c>egiv] w\ld m]it su* a     
/ip5d 9 an am\nt t is 9 ! middle ti]    
specifi$ 9 su* s*$ule4  7,c7 ,n e>li]   
?an ,octob] #a1 #bjbb1 if ! family      

c>egiv] w\ld m]it su* a /ip5d 9 an am\nt
 t is 9 ! l[e/ ti] specifi$ 9 su*       
s*$ule4  7#ab7 7,a7 ,9 provid+ assi/ance
 "u ?is subsection to family c>egiv]s ( 
eligible vet]ans1 ! ,secret>y may ent]  
into contracts1 provid] agreem5ts1 &    
memor&a ( und]/&+ ) ,f$]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$]al      
ag5cies1 ,/ates1 & o!r entities t       
provide assi/ance "u ?is p>agraph4  4   
7b7 ,t]m9ation ( g5]al c>egiv] support  
program  7#a7 ,9 g5]al ,subsection 7b7 (
 su* section is am5d$ by add+ at ! end !
 foll[+ new p>agraph3  7#f7 ,! au?ority 
( ! ,secret>y to provide support s]vices
 = c>egiv]s ( cov]$ vet]ans "u ?is      

subsection %all t]m9ate on ,octob] #a1  
#bjbb4  4  7#b7 ,cont9uation ( c]ta9    
assi/ance ,! ,secret>y ( ,vet]ans       
,affairs %all ensure t any activities   
c>ri$ out "u subsection 7b7 ( su*       
section on ,septemb] #cj1 #bjbb1 are    
cont9u$ "u subsection 7a7 ( su* section 
on & aft] ,octob] #a1 #bjbb4  7c7       
,modification ( def9ition ( family memb]
 ,subp>agraph 7,b7 ( subsection 7d77#c7 
( su* section is am5d$ to read z foll[s3
  7,b7 is n a memb] ( ! family ( !      
vet]an & does n provide c>e to ! vet]an 
on a pr(essional basis4  4  7d7         
,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$4  4  7e7   
,annual evaluation report ,p>agraph 7#b7
 ( section #aja7;c7 ( ! ,c>egiv]s &     
,vet]ans ,omnibus ,heal? ,s]vices ,act (
 #bjaj 7,public ,law #aaa-afc2 #ch      
,u4,s4,c4 #agbj;,g note7 is am5d$ to    
read z foll[s3  7#b7 ,cont5ts ,ea*      
report requir$ by p>agraph 7#a7 aft] !  
date ( ! enactm5t ( ! ,vet]ans ,*oice   
,act ( #bjag %all include ! foll[+ )    
respect to ! program ( compreh5sive     
assi/ance = family c>egiv]s requir$ by  
subsection 7a77#a7 ( su* section        
#agbj;,g3  7,a7 ,! numb] ( family       
c>egiv]s t receiv$ assi/ance "u su*     
program4  7,b7 ,! co/ to ! ,dep>tm5t (  
provid+ assi/ance "u su* program4  7,c7 
,a description ( ! outcomes a*iev$ by1 &
 any measurable b5efits (1 c>ry+ out su*
 program4  7,d7 ,an assessm5t ( !       
effectiv5ess & ! effici5cy ( !          
implem5tation ( su* program1 includ+ a  
description ( any b>ri]s to access+ &   

receiv+ c>e & s]vices "u su* program4   
7,e7 ,a description ( ! outrea*         
activities c>ri$ out by ! ,secret>y "u  
su* program4  7,f7 ,an assessm5t ( !    
mann] 9 :i* res\rces are exp5d$ by !    
,secret>y "u su* program1 p>ticul>ly )  
respect to ! provision ( mon?ly p]sonal 
c>egiv] /ip5ds "u subsection            
7a77#c77;,a77ii77,v7 ( su* section      
#agbj;,g4  7,g7 ,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  7,h7 ,su*     
recomm5dations1 includ+ recomm5dations =
 legislative or adm9i/rative action1 z !
 ,secret>y consid]s appropriate 9 light 
( c>ry+ out su* program4  4  #bjc4      
,au?orization ( c]ta9 major m$ical      
facility leases ( ! ,dep>tm5t ( ,vet]ans
 ,affairs  ,! ,secret>y ( ,vet]ans      
,affairs may c>ry out ! foll[+ major    
m$ical facility leases at ! locations   
specifi$ & 9 an am\nt = ea* lease n to  
exce$ ! am\nt specifi$ = su* location 7n

 includ+ any e/imat$ cancellation co/s73
  7#a7 ,= an outpati5t cl9ic1 ,ann      
,arbor1 ,mi*igan1 an am\nt n to exce$   
#d1bdg1jjj4  7#b7 ,= an outpati5t m5tal 
heal? cl9ic1 ,birm+ham1 ,alabama1 an    
am\nt n to exce$ #f1fdi1jjj4  7#c7 ,=   
rese>* space1 ,bo/on1 ,massa*usetts1 an 
am\nt n to exce$ #f1bbd1jjj4  7#d7 ,=   
rese>* space1 ,*>le/on1 ,s\? ,c>ol9a1 an
 am\nt n to exce$ #g1bgd1jjj4  7#e7 ,=  
an outpati5t cl9ic1 ,corpus ,*ri/i1     
,texas1 an am\nt n to exce$ #f1eef1jjj4 
7#f7 ,= an outpati5t cl9ic1 ,daytona    
,bea*1 ,florida1 an am\nt n to exce$    
#ab1aih1jjj4  7#g7 ,= ,*ief ,bus9ess    
,(fice ,pur*as$ ,c>e (fice space1 ,d5v]1
 ,colorado1 an am\nt n to exce$         
#ad1ghd1jjj4  7#h7 ,= an outpati5t      
cl9ic1 ,fr$]icksburg1 ,virg9ia1 an am\nt
 n to exce$ #de1jae1jjj4  7#i7 ,= an    
outpati5t cl9ic1 ,ga9esville1 ,florida1 
an am\nt n to exce$ #g1hia1jjj4  7#aj7  
,= an outpati5t m5tal heal? cl9ic1      
,ga9esville1 ,florida1 an am\nt n to    
exce$ #d1cbj1jjj4  7#aa7 ,= an outpati5t

 cl9ic1 ,hampton ,roads1 ,virg9ia1 an   
am\nt n to exce$ #ah1ada1jjj4  7#ab7 ,= 
a replacem5t outpati5t cl9ic1           
,indianapolis1 ,indiana1 an am\nt n to  
exce$ #g1hgf1jjj4  7#ac7 ,= a replacem5t
 outpati5t cl9ic1 ,jacksonville1        
,florida1 an am\nt n to exce$           
#ah1fbc1jjj4  7#ad7 ,= an outpati5t     
cl9ic1 ,miss\la1 ,montana1 an am\nt n to
 exce$ #f1idb1jjj4  7#ae7 ,= an         
outpati5t m5tal heal? cl9ic1 ,nor!rn    
,colorado1 ,colorado1 an am\nt n to     
exce$ #h1ijd1jjj4  7#af7 ,= an outpati5t
 cl9ic1 ,ocala1 ,florida1 an am\nt n to 
exce$ #e1jbf1jjj4  7#ag7 ,= an outpati5t
 cl9ic1 ,oxn>d1 ,cali=nia1 an am\nt n to
 exce$ #e1bgd1jjj4  7#ah7 ,= an         
outpati5t cl9ic1 ,pike ,c\nty1 ,georgia1
 an am\nt n to exce$ #e1efe1jjj4  7#ai7 
,= a replacem5t outpati5t cl9ic1        
,pittsburgh1 ,p5nsylvania1 an am\nt n to
 exce$ #f1bdg1jjj4  7#bj7 ,= an         
outpati5t cl9ic1 ,portl&1 ,ma9e1 an     
am\nt n to exce$ #f1hjh1jjj4  7#ba7 ,=  
an outpati5t cl9ic1 ,raleigh1 ,nor?     

,c>ol9a1 an am\nt n to exce$            
#ba1hgj1jjj4  7#bb7 ,= a replacem5t     
outpati5t cl9ic1 phase ,,ii1 ,ro*e/]1   
,new ,york1 an am\nt n to exce$         
#c1fde1jjj4  7#bc7 ,= rese>* space1 ,san
 ,diego1 ,cali=nia1 an am\nt n to exce$ 
#d1heb1jjj4  7#bd7 ,= an outpati5t      
cl9ic1 ,santa ,rosa1 ,cali=nia1 an am\nt
 n to exce$ #f1ibb1jjj4  7#be7 ,= a     
replacem5t m5tal heal? cl9ic1 ,tampa1   
,florida1 an am\nt n to exce$           
#ac1chg1jjj4  7#bf7 ,= a replacem5t     
outpati5t cl9ic1 ,lakel&1 ,tampa1       
,florida1 an am\nt n to exce$           
#aj1gfj1jjj4  7#bg7 ,= a replacem5t     
outpati5t cl9ic1 ,t]re ,haute1 ,indiana1
 an am\nt n to exce$ #d1ajb1jjj4  ,,iii 
,adm9i/ration ( heal? c>e f             
non-,dep>tm5t ( ,vet]ans ,affairs       
provid]s  #cja4 ,modification ( process 
?r\gh :i* ,dep>tm5t ( ,vet]ans ,affairs 
records obligations = non-,dep>tm5t c>e 
7a7 ,9 g5]al ,sub*apt] ,,iii ( *apt] #ag
 ( title #ch1 ,unit$ ,/ates ,code1 is   
am5d$ by add+ at ! end ! foll[+ new     

section3  #agcj;,b4 ,record+ obligations
 = c>e at non-,dep>tm5t facilities      
,not)/&+ sections #acda7;a77#a7 & #aeja 
( title #ca1 ! ,secret>y may record z an
 obligation ( ! ,unit$ ,/ates ,gov]nm5t 
am\nts ow$ = hospital c>e or m$ical     
s]vices furni%$ "u ?is *apt] at         
non-,dep>tm5t facilities on ! date on   
:i* a claim by a heal? c>e provid] =    
paym5t is approv$ r ?an on ! date t !   
hospital c>e or m$ical s]vices are      
au?oriz$ by ! ,secret>y4  4  7b7        
,cl]ical am5dm5t ,! table ( sections at 
! beg9n+ ( *apt] #ag ( su* title is     
am5d$ by ins]t+ aft] ! item relat+ to   
section #agcj;,a ! foll[+ new item3     
#agcj;,b4 ,record+ obligations = c>e at 
non-,dep>tm5t facilities4  4  #cjb4     
,modification ( report on am\nts        
available "u ,vet]ans ,*oice ,program   
,section #aja7q77#b7 ( ! ,vet]ans       
,access1 ,*oice1 & ,acc\ntability ,act (
 #bjad 7,public ,law #aac-adf2 #ch      
,u4,s4,c4 #agja note7 is am5d$--  7#a7 9
 ! matt] prec$+ subp>agraph 7,a71 by    

/rik+ #cj days & ins]t+ #ad days2  7#b7 
by r$esignat+ subp>agraph 7,f7 z        
subp>agraph 7,h72 &  7#c7 by ins]t+ aft]
 subp>agraph 7,e7 ! foll[+ new          
subp>agraphs3  7,f7 ,an assessm5t ( !   
rate at :i* am\nts deposit$ 9 ! ,vet]ans
 ,*oice ,fund h be5 exhau/$ dur+ !      
#ij-;day p]iod prec$+ ! submittal ( !   
report1 includ+ an id5tification ( any  
major factors t are caus+ am\nts to be  
exhau/$ quickly or sl[ly4  7,g7 ,an     
e/imate ( :5 am\nts 9 ! ,vet]ans ,*oice 
,fund w be completely exhau/$4  4  ,,iv 
,o!r matt]s  #dja4 ,em]g5cy designations
  7a7 ,9 g5]al ,?is ,act is designat$ z 
an em]g5cy requirem5t pursuant to       
section #d7;g7 ( ! ,/atutory            
,pay-,z-,y-,g ,act ( #bjaj 7#b ,u4,s4,c4
 #icc7;g774  7b7 ,designation 9 ,s5ate  
,9 ! ,s5ate1 ?is ,act is designat$ z an 
em]g5cy requirem5t pursuant to section  
#djc7;a7 ( ,s4 ,con4 ,res4 #ac 7#aaa?   
,congress71 ! concurr5t resolution on ! 
budget = fiscal ye> #bjaj4