,,ii  #aaeth ,,congress  #ast ,session  
,s4 #bjig  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,november #h1  
#bjag ,mr4 ,tester 7for himself1 ,mr4   
,heller1 and ,ms4 ,baldwin7 introduced  
the following bill2 which was read twice
 and referred to the ,committee on      
,veterans' ,affairs  ,a ,,bill  ,to     
amend title #ch1 ,united ,states ,code1 
to improve the administration of ,state 
homes furnishing care to veterans under 
the laws administered by the ,secretary 
of ,veterans ,affairs1 and for other    
purposes4  #a4 ,short title  ,this ,act 
may be cited as the ,state ,veterans    
,home ,program ,improvement ,act of     
#bjag4  #b4 ,modification of            
requirements on use by ,states of ,state
 home funds received from the           
,department of ,veterans ,affairs  7a7  
,in general ,subchapter ,v of chapter   
#ag of title #ch1 ,united ,states ,code1
 is amended by adding at the end the    
following new section3  #agdf4          
,requirements on use of amounts  7a7    

,use of amounts ,amounts paid to a      
,state for the treatment of veterans at 
a ,state home under this subchapter may 
not be used for a purpose other than the
 operation of a ,state home in that     
,state4  7b7 ,prohibition on transfer to
 state treasury ,a ,state may not       
transfer amounts paid to the ,state     
under this subchapter to the general    
treasury of the ,state4  7c7            
,authorization of transfer of amounts ,a
 ,state may transfer amounts paid to the
 ,state under this subchapter to other  
,state homes located in that ,state4    
7d7 ,waiver ,the ,secretary may waive   
the requirements of subsections 7a7 and 
7b7 with respect to a ,state if the     
,state submits to the ,secretary a      
certification that--  7#a7 the ,state   
homes located in that ,state do not     
require additional maintenance1 capital 
improvements1 or staffing2 and  7#b7 the
 amounts paid to the ,state under this  
subchapter will be used to benefit      
veterans4  4  7b7 ,clerical amendment   

,the table of sections at the beginning 
of chapter #ag of such title is amended 
by inserting after the item relating to 
section #agde the following new item3   
#agdf4 ,requirements on use of amounts4 
4  #c4 ,modification of priority of     
,state home projects of the ,department 
of ,veterans ,affairs  7a7 ,projects    
from previous years  7#a7 ,in general   
,paragraph 7#d7 of section #hace7;c7 of 
title #ch1 ,united ,states ,code1 is    
amended-- 7,a7 by striking ,the         
,secretary and inserting 7,a7 ,the      
,secretary2 and  7,b7 by adding at the  
end the following new subparagraph3     
7,b7 ,with respect to a project that is 
approved in a fiscal year but for which 
a grant has not been awarded under this 
subchapter in that fiscal year1 the     
,secretary may not accord a lower       
priority on the list described in       
subparagraph 7,a7 to that project in any
 subsequent fiscal year 7as compared to 
the priority accorded that project in   
any previous fiscal year7 unless the    

reason for such lower priority is the   
inclusion in such list of a project     
described in subparagraph 7,a7 or 7,b7  
of paragraph 7#b74  4  7#b7 ,conforming 
amendment ,paragraph 7#b7 of such       
section is amended1 in the matter       
preceding subparagraph 7,a71 by striking
 paragraphs 7#c7 and 7#e77;,c7 and      
inserting paragraphs 7#c71 7#d77;,b71   
and 7#e77;,c74  7b7 ,consideration of   
access to private facilities ,such      
section is further amended by adding at 
the end the following new paragraph3    
7#h7 ,in determining under subparagraphs
 7,d71 7,f71 and 7,h7 of paragraph 7#b7 
whether a ,state has a great1           
significant1 or limited need for beds in
 connection with an application under   
subsection 7a71 the ,secretary shall--  
7,a7 consider the availability and      
accessibility to individuals in that    
,state of private facilities providing  
similar care to the care for which the  
application is submitted under such     
subsection2 and  7,b7 accord a lower    

priority in the list established under  
paragraph 7#d7 to applications by       
,states with a significant number of    
such private facilities1 as determined  
by the ,secretary4  4  #d4 ,pilot       
program to compensate ,states for ,state
 home services provided in facilities   
that are not intended exclusively for   
veterans  7a7 ,pilot program  7#a7 ,in  
general ,the ,secretary of ,veterans    
,affairs shall carry out a pilot program
 to compensate ,states for furnishing   
care described in paragraph 7#b7 to     
veterans at ,state-operated facilities  
that are not intended to be used        
exclusively by veterans4  7#b7 ,care    
described ,care described in this       
paragraph is care that is the same as   
care furnished in ,state homes under    
subchapter ,v of chapter #ag of title   
#ch1 ,united ,states ,code4  7b7        
,duration ,the ,secretary may not carry 
out the pilot program under this section
 after the date that is four years after
 the date of the enactment of this ,act4

  7c7 ,reports  7#a7 ,annual report ,not
 later than one year after the date of  
the enactment of this ,act1 and not less
 frequently than annually thereafter    
until the termination of the pilot      
program under this section1 the         
,secretary shall submit to the          
,committee on ,veterans' ,affairs of the
 ,senate and the ,committee on          
,veterans' ,affairs of the ,house of    
,representatives a report on the        
outcomes of the pilot program with      
respect to quality of care1 satisfaction
 of veterans with care1 and cost        
effectiveness of care furnished under   
the pilot program4  7#b7 ,comptroller   
,general report ,not later than #bgj    
days after the termination of the pilot 
program under this section1 the         
,comptroller ,general of the ,united    
,states shall submit to the ,committee  
on ,veterans' ,affairs of the ,senate   
and the ,committee on ,veterans'        
,affairs of the ,house of               
,representatives a report on the        

outcomes of the pilot program with      
respect to quality of care1 satisfaction
 of veterans with care1 and cost        
effectiveness of care furnished under   
the pilot program4