,,ii  #aae? ,,congress  #b;d ,session   
,s4 #bceg  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,janu>y #cj1 #bjah ,mr4
 ,te/] 7= himself1 ,mrs4 ,murray1 ,mr4  
,blum5?al1 & ,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 review ! processes 
& requirem5ts ( ! ,dep>tm5t ( ,vet]ans  
,affairs = s*$ul+ appo9tm5ts = heal? c>e
 & conduct+ consultations "u ! laws     
adm9i/]$ by ! ,secret>y1 & = o!r        
purposes4  #a4 ,%ort title  ,?is ,act   
may be cit$ z ! ,acc\ntability 9        
,dep>tm5t ( ,vet]ans ,affairs ,s*$ul+ & 
,consult ,managem5t ,act4  #b4          
,processes & requirem5ts = s*$ul+       
appo9tm5ts = heal? c>e f ,dep>tm5t (    
,vet]ans ,affairs  7a7 ,processes &     
requirem5ts ,n lat] ?an #fj 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 description ( !       
processes & requirem5ts = s*$ul+        
appo9tm5ts = heal? c>e f ! ,dep>tm5t (  
,vet]ans ,affairs at ! m$ical facility  
level to be us$ by ! ,dep>tm5t4  7b7    
,tra9+ on processes & requirem5ts  7#a7 
,c]tification ,n lat] ?an "o ye> aft] ! 
date ( ! enactm5t ( ?is ,act1 !         
,secret>y %all require individuals      
involv$ 9 ! s*$ul+ ( appo9tm5ts = heal? 
c>e f ! ,dep>tm5t to c]tify to !        
,secret>y t ! individual und]/&s !      
processes & requirem5ts describ$ 9      
subsection 7a74  7#b7 ,new employees ,! 
,secret>y %all require all employees    
hir$ by ! ,dep>tm5t aft] ! date ( !     
enactm5t ( ?is ,act :o are to be involv$
 9 ! s*$ul+ ( appo9tm5ts = heal? c>e f !
 ,dep>tm5t to und]go tra9+ on !         
processes & requirem5ts describ$ 9      
subsection 7a7 z "p ( ! onbo>d+ process4
  7c7 ,me?od ,to monitor compliance     
7#a7 ,9 g5]al ,n lat] ?an #ahj days aft]
 ! date ( ! enactm5t ( ?is ,act1 !      

,secret>y %all e/abli% or ma9ta9 a me?od
 or tool to monitor & ensure t ea*      
m$ical facility ( ! ,dep>tm5t complies )
 ! processes & requirem5ts describ$ 9   
subsection 7a74  7#b7 ,use ?r\gh\t      
,dep>tm5t  7,a7 ,9 g5]al ,! ,secret>y   
%all require ea* m$ical facility ( !    
,dep>tm5t to use ! me?od or tool        
describ$ 9 p>agraph 7#a74  7,b7         
,c]tification ,n lat] ?an "o ye> aft] ! 
date ( ! enactm5t ( ?is ,act1 !         
,secret>y %all require ! director ( ea* 
m$ical facility ( ! ,dep>tm5t to c]tify 
to ! ,secret>y t ! director is us+ !    
me?od or tool describ$ 9 p>agraph 7#a74 
7#c7 ,audits  7,a7 ,9 g5]al ,n less     
frequ5tly ?an twice ea* ye>1 ! ,secret>y
 %all provide = ! conduct (             
facility-level audits ( ! s*$ul+ (      
appo9tm5ts1 :i* %all include            
recomm5dations = corrective action1     
includ+ additional tra9+1 increas$      
p]sonnel1 & su* o!r res\rces z !        
,secret>y consid]s necess>y4  7,b7      
,transmittal to ,,vha ,any audits       

conduct$ "u subp>agraph 7,a7 %all be    
transmitt$ to ! ,"u ,secret>y = ,heal? (
 ! ,dep>tm5t s t ! ,"u ,secret>y c--    
7i7 /r5g!n ov]sight ( ^? audits2  7ii7  
monitor national policy on ! s*$ul+ (   
appo9tm5ts ?r\gh\t ! ,dep>tm5t2  7iii7  
det]m9e if a mobile deploym5t team is   
w>rant$2 &  7iv7 develop a rem$iation   
plan to address issues uncov]$ by ^?    
audits4  7#d7 ,report+ ( s*$ul+ issues  
,! ,secret>y %all require ea* director (
 a m$ical c5t] ( ! ,dep>tm5t-- 7,a7 to  
submit to ! ,"u ,secret>y = ,heal?1 n   
less frequ5tly ?an qu>t]ly1 a report    
conta9+ any s*$ul+ issues t are uncov]$ 
at t m$ical c5t]2  7,b7 to id5tify any  
corrective actions to be tak5 ) respect 
to su* issues1 includ+ increas$ tra9+ or
 hir+2 &  7,c7 to c]tify to ! ,secret>y 
t ! director is 9 compliance )          
requirem5ts ( subp>agraphs 7,a7 & 7,b74 
#c4 ,adm9i/ration ( non-,dep>tm5t (     
,vet]ans ,affairs heal? c>e  7a7        
,c]tification ( prop] adm9i/ration  7#a7
 ,review  7,a7 ,9 g5]al ,! ,secret>y (  

,vet]ans ,affairs %all conduct a review 
( ! /aff+1 tra9+1 & o!r requirem5ts     
necess>y to adm9i/] section #aja ( !    
,vet]ans ,access1 ,*oice1 &             
,acc\ntability ,act ( #bjad 7,public    
,law #aac-adf2 #ch ,u4,s4,c4 #agja note7
 & any o!r community c>e program ( !    
,dep>tm5t ( ,vet]ans ,affairs4  7,b7    
,elem5ts ,! review conduct$ "u p>agraph 
7#a7 %all include1 ) respect to ea*     
m$ical facility ( ! ,dep>tm5t1 an       
assessm5t ( ! type ( positions requir$  
to be /aff$1 ! numb] ( su* positions at 
! m$ical facility1 & ! numb] fill$ at ! 
m$ical facility4  7#b7 ,c]tification ,n 
lat] ?an #ahj days aft] ! date ( !      
enactm5t ( ?is ,act1 & e #ahj days      
!reaft]1 ! ,secret>y ( ,vet]ans ,affairs
 %all submit to ! ,committee on         
,vet]ans' ,affairs ( ! ,s5ate & !       
,committee on ,vet]ans' ,affairs ( !    
,h\se ( ,repres5tatives ! results ( !   
review conduct$ "u p>agraph 7#a71       
includ+ a c]tification t all /aff+1     
tra9+1 & o!r requirem5ts describ$ 9     

p>agraph 7#a77;,a7 are fulfill$4  7b7   
,s*$ul+ ( appo9tm5ts  7#a7 ,9 g5]al ,!  
,secret>y %all be responsible = ensur+ t
 appo9tm5ts = heal? c>e f non-,dep>tm5t 
heal? c>e provid]s "u ! laws adm9i/]$ by
 ! ,secret>y are s*$ul$4  7#b7          
,timel9ess goals ,n lat] ?an #cj days   
aft] ! date ( ! enactm5t ( ?is ,act1 !  
,secret>y %all e/abli% timel9ess goals =
 ea* /ep 9 s*$ul+ an appo9tm5t = heal?  
c>e f a non-,dep>tm5t heal? c>e provid]4
  7#c7 ,measurem5t ( timel9ess = ea*    
facility ,n lat] ?an #abj days aft] !   
date ( ! enactm5t ( ?is ,act1 !         
,secret>y %all measure1 = ea* m$ical    
facility ( ! ,dep>tm5t1 ! "t x takes f !
 date t a cl9ician ( ! ,dep>tm5t        
det]m9es t a vet]an requires c>e f a    
non-,dep>tm5t heal? c>e provid] to ea* (
 ! foll[+3  7,a7 ,! date t ! ref]ral =  
c>e is s5t to ! non-,dep>tm5t heal? c>e 
provid]4  7,b7 ,! date t ! non-,dep>tm5t
 heal? c>e provid] accepts ! ref]ral4   
7,c7 ,! date t ! appo9tm5t ) !          
non-,dep>tm5t heal? c>e provid] is made4

  7,d7 ,! date ( ! appo9tm5t ) !        
non-,dep>tm5t heal? c>e provid]4  7,e7  
,any o!r /ep t ! ,secret>y det]m9es     
necess>y to measure4  7#d7 ,publication 
( data  7,a7 ,9 g5]al ,n lat] ?an "o ye>
 aft] ! date ( ! enactm5t ( ?is ,act1 ! 
,secret>y %all publi% ! data measur$ "u 
p>agraph 7#c71 disaggregat$ by m$ical   
facility1 on a publicly available       
,int]net website ( ! ,dep>tm5t4  7,b7   
,update ,n less frequ5tly ?an biweekly1 
! ,secret>y %all update ! data publi%$  
"u subp>agraph 7,a74  7c7 ,comptroll]   
,g5]al report  7#a7 ,9 g5]al ,beg9n+ n  
lat] ?an "o ye> aft] ! date ( ! enactm5t
 ( ?is ,act1 ! ,comptroll] ,g5]al ( !   
,unit$ ,/ates %all review compliance by 
! ,secret>y ) ! requirem5ts ( ?is       
section1 includ+ a review ( ! v]acity ( 
data publi%$ by ! ,secret>y "u          
subsection 7b77#d74  7#b7 ,completion ,n
 lat] ?an ?ree ye>s aft] ! date ( !     
enactm5t ( ?is ,act1 ! ,comptroll]      
,g5]al %all submit to ! ,committee on   
,vet]ans' ,affairs ( ! ,s5ate & !       

,committee on ,vet]ans' ,affairs ( !    
,h\se ( ,repres5tatives ! results ( !   
review conduct$ "u p>agraph 7#a74  #d4  
,adm9i/ration ( consultations = heal?   
c>e f ,dep>tm5t ( ,vet]ans ,affairs  7a7
 ,adm9i/ration ( outpati5t consultation 
reque/s  7#a7 ,national process ,n lat] 
?an #ahj days aft] ! date ( ! enactm5t (
 ?is ,act1 ! ,secret>y ( ,vet]ans       
,affairs %all e/abli% a national process
 to track & process outpati5t cl9ical   
consultation reque/s4  7#b7 ,tra9+ ,n   
lat] ?an "o ye> aft] ! date ( ! enactm5t
 ( ?is ,act1 ! ,secret>y %all ensure t  
all individuals involv$ 9 ! process (   
s*$ul+ outpati5t cl9ical consultations  
are prop]ly tra9$4  7#c7 ,c]tification  
7,a7 ,9 g5]al ,! ,secret>y %all ensure t
 directors ( m$ical c5t]s & ,vet]ans    
,integrat$ ,s]vice ,networks ( !        
,dep>tm5t ( ,vet]ans ,affairs c]tify    
compliance1 on a qu>t]ly basis1 ) !     
national process e/abli%$ "u p>agraph   
7#a74  7,b7 ,elem5ts ,! c]tification "u 
subp>agraph 7,a7 %all include ! foll[+3 

7i7 ,an assessm5t ( :e!r consultations 7
 appropriately process$4  7ii7 ,data )  
respect to consultations z foll[s3 7,i7 
,consultations t 7 s*$ul$ )9 ! reque/   
w9d[4  7,,ii7 ,duplicate consultation   
reque/s4  7,,iii7 ,consultations t 7    
discont9u$4  7,,iv7 ,delays 9           
consultations4  7,v7 ,consultations t 7 
n prop]ly clos$4  7iii7 ,= consultations
 t 7 improp]ly discont9u$1 a description
 ( rem$iation attempts4  7#d7 ,reque/s =
 mobile deploym5t teams  7,a7 ,9 g5]al  
,a director ( a m$ical c5t] ( !         
,dep>tm5t %all reque/ f ! ,secret>y a   
mobile deploym5t team "u ! program      
e/abli%$ "u section #f if ! requirem5ts 
( ! national process e/abli%$ "u        
p>agraph 7#a7 h n be5 met ) respect to a
 facility "u ! jurisdiction ( !         
director4  7,b7 ,report ,n less         
frequ5tly ?an once e #ahj days1 !       
,secret>y %all submit to ! appropriate  
committees ( ,congress a report sett+ =?
 ea* reque/ "u subp>agraph 7,a7 dur+ !  
p]iod cov]$ by ! report1 includ+ an     

explanation ( :y a mobile deploym5t team
 0 or 0 n provid$1 z ! case may be4  7b7
 ,initial review  7#a7 ,9 g5]al ,!      
,secret>y %all review ! processes &     
requirem5ts ( ! ,dep>tm5t ) respect to  
consultations = heal? c>e "u ! laws     
adm9i/]$ by ! ,secret>y4  7#b7 ,report  
,n lat] ?an #ahj days aft] ! date ( !   
enactm5t ( ?is ,act1 ! ,secret>y %all   
submit to ! appropriate committees (    
,congress a report on ! results ( !     
review conduct$ "u p>agraph 7#a74  7c7  
,biannual review ,n lat] ?an #ahj days  
aft] ! date ( ! enactm5t ( ?is ,act1 & e
 #ahj days !reaft]1 ! ,secret>y %all    
conduct a review ( consultations        
conduct$ at ea* m$ical facility ( !     
,dep>tm5t t includes ! foll[+3  7#a7 ,a 
review ( ! accuracy ( ! type ( s]vice1  
ei!r adm9i/rative or cl9ical1 t is      
inputt$ 9 ! electronic heal? record4    
7#b7 ,a review ( ! accuracy ( ! type (  
consultation sett+1 ei!r inpati5t or    
outpati5t1 t is inputt$ 9 ! electronic  
heal? record4  7#c7 ,a review ( !       

appropriat5ess ( ! level ( urg5cy ( !   
consultation t is inputt$ 9 ! electronic
 heal? record4  7#d7 ,a review ( any    
delay$ or unresolv$ consultations4  7#e7
 ,a det]m9ation ( ! timel9ess (         
consultations bas$ on guidance set =? by
 ! ,"u ,secret>y = ,heal? ( ! ,dep>tm5t4
  7d7 ,appropriate committees (         
,congress def9$ ,9 ?is section1 ! 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  #e4 ,measurem5t (   
timel9ess = ref]rals = heal? c>e among  
heal? c>e provid]s or facilities (      
,dep>tm5t ( ,vet]ans ,affairs  7a7 ,9   
g5]al ,) respect to ref]rals = heal? c>e
 betwe5 heal? c>e provid]s or facilities
 ( ! ,dep>tm5t ( ,vet]ans ,affairs1 n   
lat] ?an #abj days aft] ! date ( !      
enactm5t ( ?is ,act1 ! ,secret>y (      
,vet]ans ,affairs %all measure1 = ea*   

m$ical facility ( ! ,dep>tm5t1 ! "t x   
takes f ! date t a cl9ician ( !         
,dep>tm5t det]m9es t a vet]an requires  
c>e f ano!r heal? c>e provid] or        
facility to ea* ( ! foll[+3  7#a7 ,!    
date t ! ref]ral = c>e is s5t to ! o!r  
heal? c>e provid] or facility4  7#b7 ,! 
date t ! o!r heal? c>e provid] or       
facility accepts ! ref]ral4  7#c7 ,!    
date t ! appo9tm5t ) ! o!r heal? c>e    
provid] or at ! o!r facility is made4   
7#d7 ,! date ( ! appo9tm5t ) ! o!r heal?
 c>e provid] or at ! o!r facility4  7#e7
 ,any o!r /ep t ! ,secret>y det]m9es    
necess>y to measure4  7b7 ,publication (
 data ,n lat] ?an "o ye> aft] ! date ( !
 enactm5t ( ?is ,act1 ! ,secret>y %all  
publi% ! data measur$ "u subsection 7a71
 disaggregat$ by m$ical facility1 on a  
publicly available ,int]net website ( ! 
,dep>tm5t4  #f4 ,exam9ation ( heal? c>e 
consultation & s*$ul+ positions (       
,dep>tm5t ( ,vet]ans ,affairs  7a7      
,prop] grad+ ( consultation & s*$ul+    
positions  7#a7 ,9 g5]al ,! ,secret>y ( 

,vet]ans ,affairs %all conduct an       
exam9ation ( heal? c>e positions ( !    
,dep>tm5t ( ,vet]ans ,affairs to det]m9e
 :e!r heal? c>e positions involv$ 9 !   
consultation & s*$ul+ processes are     
appropriately grad$4  7#b7 ,submittal to
 ,congress ,n lat] ?an #abj days aft] ! 
date ( ! enactm5t ( ?is ,act1 !         
,secret>y %all submit to ! appropriate  
committees ( ,congress ! results ( !    
exam9ation conduct$ "u p>agraph 7#a74   
7b7 ,review ( onbo>d+ process ,n lat]   
?an #ahj days aft] ! date ( ! enactm5t (
 ?is ,act1 ! ,secret>y %all submit to ! 
appropriate committees ( ,congress--    
7#a7 a review ( ! onbo>d+ process (     
individuals 9 heal? c>e positions       
describ$ 9 subsection 7a71 includ+ h[   
long x takes to hire ^? individuals2 &  
7#b7 a description ( any *anges t !     
,secret>y has made or plans to make to  
improve t process4  7c7 ,appropriate    
committees ( ,congress def9$ ,9 ?is     
section1 ! 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  #g4 ,program to     
furni% mobile deploym5t teams to m$ical 
facilities t require assi/ance  7a7 ,9  
g5]al ,! ,secret>y ( ,vet]ans ,affairs  
%all e/abli% a program to furni% mobile 
deploym5t teams ( s*$ul+ & m$ical       
p]sonnel to m$ical facilities ( !       
,dep>tm5t t require assi/ance4  7b7     
,elem5ts ,9 furni%+ a mobile deploym5t  
team to a m$ical facility "u subsection 
7a71 includ+ ! p>ticul> p]sonnel to be  
includ$1 ! ,secret>y %all consid] !     
foll[+ elem5ts3  7#a7 ,! s*$ul+ ne$s ( !
 facility4  7#b7 ,! unfill$ m$ical      
positions at ! facility4  7#c7 ,! numb] 
( op5 consultations at ! facility4  7#d7
 ,! results ( s*$ul] audits conduct$ "u 
section #b7;d77#c74  7#e7 ,reque/s "u   
section #d7;a77#d7 = mobile deploym5t   
teams due to a failure ( ! facility to  
meet consultation requirem5ts4  7#f7    

,su* o!r elem5ts z ! ,secret>y consid]s 
necess>y = effective ov]sight ( !       
program e/abli%$ "u subsection 7a74  7c7
 ,completion ( duty ,9 c>ry+ out !      
program "u ?is section1 ! ,secret>y %all
 require ea* mobile deploym5t team      
furni%$ to a m$ical facility "u         
subsection 7a7 to develop a rem$iation  
plan t1 ^u completion1 t]m9ates !       
deploym5t ( ! team to t facility4