,,ii  #aae? ,,congress  #b;d ,session   
,s4 #bcef  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,janu>y #cj1 #bjah ,mr4
 ,te/] 7= himself1 ,mrs4 ,murray1 ,mr4  
,s&]s1 & ,mr4 ,man*97 introduc$ ! foll[+
 bill2 :i* 0 read twice & ref]r$ to !   
,committee on ,vet]ans' ,affairs  ,a    
,,bill  ,to require ! ,secret>y (       
,vet]ans ,affairs to address /aff+ & o!r
 issues at facilities1 includ+ und]s]v$ 
facilities1 ( ! ,dep>tm5t ( ,vet]ans    
,affairs1 & = o!r purposes4  #a4 ,%ort  
title  ,?is ,act may be cit$ z ! ,/rong]
 ,m$ical ,work=ce = ,vet]ans ,act4  #b4 
,developm5t ( crit]ia = designation (   
c]ta9 m$ical facilities ( ! ,dep>tm5t ( 
,vet]ans ,affairs z und]s]v$ facilities 
& plan to address problem ( und]s]v$    
facilities  7a7 ,9 g5]al ,n lat] ?an    
#ahj days aft] ! date ( ! enactm5t ( ?is
 ,act1 ! ,secret>y ( ,vet]ans ,affairs  
%all develop crit]ia to designate m$ical
 c5t]s1 ambulatory c>e facilities1 &    
community bas$ outpati5t cl9ics ( !     
,dep>tm5t ( ,vet]ans ,affairs z und]s]v$

 facilities4  7b7 ,consid]ation ,crit]ia
 develop$ "u subsection 7a7 %all include
 consid]ation ( ! foll[+ ) respect to a 
facility3  7#a7 ,! ratio ( vet]ans to   
heal? c>e provid]s ( ! ,dep>tm5t (      
,vet]ans ,affairs = a /&>diz$ geographic
 area surr\nd+ ! facility1 includ+ a    
sep>ate ratio = g5]al practition]s &    
speciali/s4  7#b7 ,! range ( cl9ical    
specialties cov]$ by su* provid]s 9 su* 
area4  7#c7 ,:e!r ! local community is  
m$ically und]s]v$4  7#d7 ,! type1 numb]1
 & age ( op5 consults4  7#e7 ,:e!r !    
facility is meet+ ! wait-"t goals ( !   
,dep>tm5t4  7#f7 ,su* o!r crit]ia z !   
,secret>y consid]s important 9 det]m9+  
:i* facilities are n adequately s]v+    
area vet]ans4  7c7 ,analysis (          
facilities ,n less frequ5tly ?an        
annually1 directors ( ,vet]ans          
,integrat$ ,s]vice ,networks ( !        
,dep>tm5t %all p]=m an analysis to      
det]m9e :i* facilities )9 t ,vet]ans    
,integrat$ ,s]vice ,network qualify z   
und]s]v$ facilities pursuant to crit]ia 

develop$ "u subsection 7a74  7d7 ,annual
 plan ,to address und]s]v$ facilities   
7#a7 ,plan requir$ ,n lat] ?an "o ye>   
aft] ! date ( ! enactm5t ( ?is ,act1 & n
 less frequ5tly ?an once ea* ye>        
!reaft]1 ! ,secret>y %all submit to     
,congress a plan to address ! problem ( 
und]s]v$ facilities ( ! ,dep>tm5t1 z    
designat$ pursuant to crit]ia develop$  
"u subsection 7a74  7#b7 ,cont5ts ,ea*  
plan submitt$ "u p>agraph 7#a7 %all     
address ! foll[+3 7,a7 ,increas+        
p]sonnel or tempor>y p]sonnel assi/ance1
 includ+ mobile deploym5t teams4  7,b7  
,provid+ special hir+ inc5tives1 includ+
 "u ! ,education ,debt ,r$uction        
,program "u sub*apt] ,,vii ( *apt] #gf (
 title #ch1 ,unit$ ,/ates ,code1 &      
recruitm5t1 relocation1 & ret5tion      
inc5tives4  7,c7 ,us+ direct hir+       
au?ority4  7,d7 ,improv+ tra9+          
opportunities = /aff4  7,e7 ,su* o!r    
actions z ! ,secret>y consid]s          
appropriate4  #c4 ,pilot program on     
tuition reimbursem5t & loan repaym5t =  

heal? c>e provid]s ( ! ,dep>tm5t (      
,vet]ans ,affairs at und]s]v$ facilities
  7a7 ,9 g5]al ,n lat] ?an #ij days aft]
 ! date ( ! enactm5t ( ?is ,act1 !      
,secret>y ( ,vet]ans ,affairs %all      
comm5ce a pilot program to assess !     
feasibility & advisability ( provid+    
inc5tives to individuals to "w at       
und]s]v$ facilities ( ! ,vet]ans ,heal? 
,adm9i/ration by provid+ tuition        
reimbursem5t & loan repaym5t to m$ical  
/ud5ts & heal? c>e provid]s :o commit to
 s]v+ 9 und]s]v$ facilities select$ "u  
subsection 7c74  7b7 ,duration ,!       
,secret>y %all c>ry out ! pilot program 
dur+ ! six-ye> p]iod beg9n+ on ! date ( 
! comm5cem5t ( ! pilot program4  7c7    
,selection ( locations  7#a7 ,9 g5]al ,!
 ,secret>y %all select n few] ?an ?ree  
m$ical c5t]s & sev5 ambulatory c>e      
facilities or community bas$ outpati5t  
cl9ics ( ! ,dep>tm5t to p>ticipate 9 !  
pilot program4  7#b7 ,rural & highly    
rural areas ,n few] ?an two ( ! m$ical  
c5t]s & five ( ! ambulatory c>e         

facilities or community bas$ outpati5t  
cl9ics select$ "u p>agraph 7#a7 %all be 
9 ,/ates or ,unit$ ,/ates t]ritories t  
are among ! t5 ,/ates or ,unit$ ,/ates  
t]ritories )--  7,a7 ! highe/ p]c5tage (
 l& designat$ z highly rural pursuant to
 ! rural-urban commut+ area codes set =?
 by ! ,dep>tm5t ( ,agriculture2 or  7,b7
 ! highe/ p]c5tage ( enroll$ vet]ans    
liv+ 9 rural1 highly rural1 or insul>   
isl& areas4  7#c7 ,/ates ,facilities    
select$ "u p>agraph 7#a7 %all be locat$ 
9 n few] ?an eight diff]5t ,/ates4  7d7 
,use ( am\nts ,( ! am\nts us$ to provide
 tuition reimbursem5t or loan repaym5t  
"u ! pilot program-- 7#a7 "o-half %all  
be us$ to provide tuition reimbursem5t  
or loan repaym5t = individuals practic+ 
9 a g5]al practice position2 &  7#b7    
"o-half %all be us$ to provide tuition  
reimbursem5t or loan repaym5t =         
individuals practic+--  7,a7 9 a        
speciali/ position2 or  7,b7 9 an       
occupation1 o!r ?an a position describ$ 
9 p>agraph 7#a71 includ$ 9 ! mo/ rec5t  

/aff+ %ortage det]m9ation ( ! ,dep>tm5t 
"u section #gdab ( title #ch1 ,unit$    
,/ates ,code4  7e7 ,tuition reimbursem5t
 ,"u ! pilot program1 ! ,secret>y may   
provide to an individual att5d+ m$ical  
s*ool & seek+ a degree z a ,doctor (    
,m$ic9e or a ,doctor ( ,o/eopa?ic       
,m$ic9e full tuition reimbursem5t 9     
ex*ange = a five-ye> commitm5t to s]ve  
at an und]s]v$ facility select$ "u      
subsection 7c74  7f7 ,/ud5t loan        
repaym5t ,"u ! pilot program1 9 ex*ange 
= a ?ree-ye> commitm5t to s]ve at an    
und]s]v$ facility select$ "u subsection 
7c71 ! ,secret>y may provide--  7#a7 to 
an individual curr5tly s]v+ z a heal?   
c>e provid] at an und]s]v$ facility1 an 
am\nt n to exce$ #cj1jjj to apply to any
 rema9+ /ud5t loan debt ( ! individual2 
&  7#b7 to an individual o!r ?an an     
individual describ$ 9 p>agraph 7#a71 an 
am\nt n to exce$ #ej1jjj to apply to any
 rema9+ /ud5t loan debt ( ! individual4 
7g7 ,brea* ,an individual :o p>ticipates
 9 ! pilot program & fails to satisfy a 

p]iod ( obligat$ s]vice "u subsection   
7e7 or 7f7 %all be liable to ! ,unit$   
,/ates1 9 lieu ( su* obligat$ s]vice1 = 
! am\nt t has be5 paid or is payable to 
or on behalf ( ! individual "u ! pilot  
program1 r$uc$ by ! proportion t ! numb]
 ( days s]v$ = completion ( ! p]iod (   
obligat$ s]vice be>s to ! total numb] ( 
days 9 ! p]iod ( obligat$ s]vice ( su*  
individual4  7h7 ,exp$it$ hir+ ,!       
,secret>y %all ensure t ! hir+ (        
individuals to s]ve 9 ! ,dep>tm5t "u !  
pilot program is conduct$ 9 an exp$it$  
mann]4  7i7 ,cont9uation 9 pilot program
 ,an individual p>ticipat+ 9 ! pilot    
program 9 an occupation includ$ 9 a     
/aff+ %ortage det]m9ation ( ! ,dep>tm5t 
"u section #gdab ( title #ch1 ,unit$    
,/ates ,code1 may cont9ue p>ticipat+ 9 !
 pilot program not)/&+ t ! occupation is
 no long] includ$ 9 su* det]m9ation "u  
su* section4  7j7 ,annual report  7#a7  
,9 g5]al ,n lat] ?an "o ye> aft] ! date 
( ! enactm5t ( ?is ,act1 & n less       
frequ5tly ?an once ea* ye> !reaft]1 !   

,secret>y %all submit to ,congress a    
report on ! pilot program4  7#b7        
,cont5ts ,ea* report submitt$ "u        
p>agraph 7#a7 %all include ! foll[+3    
7,a7 ,! numb] ( p>ticipants1 includ+ !  
numb] receiv+ tuition reimbursem5t &    
/ud5t loan repaym5t4  7,b7 ,! numb] (   
facilities :]e p>ticipants are locat$4  
7,c7 ,! numb] ( individuals :o h appli$ 
to p>ticipate 9 ! pilot program4  7,d7  
,a li/ ( ! five mo/ common occupations (
 ! p>ticipants 9 ! pilot program1 o!r   
?an g5]al practice4  7k7 ,def9itions ,9 
?is section3 7#a7 ,enroll$ vet]an ,! t]m
 enroll$ vet]an means a vet]an :o is    
enroll$ 9 ! sy/em ( annual pati5t       
enrollm5t e/abli%$ & op]at$ "u section  
#agje7;a7 ( title #ch1 ,unit$ ,/ates    
,code4  7#b7 ,und]s]v$ facility ,! t]m  
und]s]v$ facility means a m$ical c5t]1  
ambulatory c>e facility1 or community   
bas$ outpati5t cl9ic ( ! ,dep>tm5t (    
,vet]ans ,affairs designat$ by !        
,secret>y ( ,vet]ans ,affairs pursuant  
to crit]ia develop$ "u section #b4  #d4 

,report on work=ce vacancies )9 !       
,vet]ans ,heal? ,adm9i/ration  7a7 ,9   
g5]al ,n lat] ?an #abj days 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 vacancies )9 ! ,vet]ans ,heal?
 ,adm9i/ration4  7b7 ,elem5ts ,! report 
requir$ by subsection 7a7 %all include !
 foll[+3 7#a7 ,) respect to vacancies ( 
p]sonnel appo9t$ "u section #gdja (     
title #ch1 ,unit$ ,/ates ,code--  7,a7 !
 total numb] ( su* vacancies2  7,b7 !   
numb] ( su* vacancies disaggregat$ by   
occupation1 ,/ate1 ,vet]ans ,integrat$  
,s]vice ,network1 m$ical facility1 & !  
c5tral (fice ( ! ,dep>tm5t ( ,vet]ans   
,affairs2 &  7,c7 a description ( !     
plans ( ! ,secret>y to fill su*         
vacancies1 includ+ a timel9e = fill+ su*
 vacancies1 & an assessm5t ( :e!r !     
,secret>y requires additional hir+      
au?orities to exp$ite ! hir+ process4   

7#b7 ,) respect to vacancies ( human    
res\rce speciali/s ( ! ,vet]ans ,heal?  
,adm9i/ration-- 7,a7 ! total numb] ( su*
 vacancies2  7,b7 ! numb] ( su*         
vacancies disaggregat$ by ,/ate & m$ical
 facility2 &  7,c7 a description ( !    
plans ( ! ,secret>y to fill su*         
vacancies1 includ+ a timel9e = fill+ su*
 vacancies1 & an assessm5t ( :e!r !     
,secret>y requires additional hir+      
au?orities to exp$ite ! hir+ process4   
7#c7 ,a description ( any imp$im5ts to  
fill+ ! vacancies describ$ 9 p>agraphs  
7#a7 & 7#b7 & any actions ! ,secret>y   
int5ds to take to address su* imp$im5ts4
  7#d7 ,an update on ! implem5tation by 
! ,secret>y (-- 7,a7 ! ,vet]ans ,heal?  
,adm9i/ration ,work=ce & ,succession    
,/rategic ,plan = #bjaf2  7,b7 !        
recomm5dation by ! ,(fice ( ! ,inspector
 ,g5]al ( ! ,dep>tm5t t ! ,"u ,secret>y 
= ,heal? develop /aff+ models = critical
 ne$ occupations ( ! ,vet]ans ,heal?    
,adm9i/ration1 z det]m9$ by ! ,secret>y2
 &  7,c7 ! recomm5dation by ! ,(fice ( !

 ,inspector ,g5]al t ! ,"u ,secret>y =  
,heal? e/abli% mile/ones & timetables = 
fur!r developm5t1 pilot+1 &             
implem5tation ( /aff+ models = critical 
ne$ occupations ( ! ,vet]ans ,heal?     
,adm9i/ration1 z det]m9$ by ! ,secret>y4
  #e4 ,assignm5t to ,dep>tm5t ( ,vet]ans
 ,affairs ( commission$ (fic]s ( !      
,regul> ,corps ( ! ,public ,heal?       
,s]vice  7a7 ,assignm5t  7#a7 ,9 g5]al  
,n lat] ?an #ahj days aft] ! date ( !   
enactm5t ( ?is ,act1 ! ,secret>y (      
,vet]ans ,affairs & ! ,surgeon ,g5]al   
%all ent] into a memor&um ( und]/&+ = ! 
assignm5t ( n few] ?an #ejj commission$ 
(fic]s ( ! ,regul> ,corps ( ! ,public   
,heal? ,s]vice to ! ,dep>tm5t ( ,vet]ans
 ,affairs4  7#b7 ,mann] ( assignm5t     
,assignm5ts "u p>agraph 7#a7 %all be    
made 9 ! same mann] 9 :i* assignm5ts are
 made to o!r ,f$]al ag5cies4  7b7       
,reimbursem5t ,! ,secret>y %all         
reimburse ! ,surgeon ,g5]al = su*       
exp5ses z ! ,surgeon ,g5]al may incur 9 
assign+ commission$ (fic]s pursuant to a

 memor&um ( und]/&+ ent]$ into "u       
subsection 7a74  7c7 ,report  7#a7 ,9   
g5]al ,n lat] ?an "o ye> aft] ! date ( !
 enactm5t ( ?is ,act1 ! ,secret>y & !   
,surgeon ,g5]al %all ea* submit to !    
,committee on ,vet]ans' ,affairs ( !    
,s5ate & ! ,committee on ,vet]ans'      
,affairs ( ! ,h\se ( ,repres5tatives a  
report on ! memor&um ( und]/&+ ent]$    
into "u subsection 7a7 & ! commission$  
(fic]s assign$ pursuant to su* memor&um 
( und]/&+4  7#b7 ,cont5ts ,! report     
requir$ by p>agraph 7#a7 %all include ! 
foll[+3 7,a7 ,! numb]s1 grades1 &       
specialties ( commission$ (fic]s assign$
 pursuant to ! memor&um ( und]/&+ ent]$ 
into "u subsection 7a74  7,b7 ,a        
description ( any problems enc\nt]$ 9   
su* assignm5t4  #f4 ,inclusion ( ,vet   
,c5t] employees 9 education debt        
r$uction program ( ,dep>tm5t ( ,vet]ans 
,affairs  7a7 ,9 g5]al ,! ,secret>y (   
,vet]ans ,affairs %all ensure t cl9ical 
/aff work+ at ,vet ,c5t]s are eligible  
to p>ticipate 9 ! education debt        

r$uction program ( ! ,dep>tm5t (        
,vet]ans ,affairs "u sub*apt] ,,vii (   
*apt] #gf ( title #ch1 ,unit$ ,/ates    
,code4  7b7 ,report ,n lat] ?an "o ye>  
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 !   
numb] ( p>ticipants 9 ! education debt  
r$uction program ( ! ,dep>tm5t "u su*   
sub*apt] :o "w at ,vet ,c5t]s4  7c7 ,vet
 ,c5t] def9$ ,9 ?is section1 ! t]m ,vet 
,c5t] has ! mean+ giv5 t t]m 9 section  
#agab;,a7h7 ( title #ch1 ,unit$ ,/ates  
,code4