,i  #aafth ,,congress  #ast ,session    
,h4 ,r4 #aifc  ,,in ,,the ,,house ,,of  
,,representatives  ,march #bh1 #bjai,ms4
 ,brownley of ,california introduced the
 following bill2 which was referred to  
the ,committee on ,veterans' ,affairs   
,a ,,bill  ,to expand the research and  
education on and delivery of            
complementary and integrative medicine  
to veterans1 and for other purposes4    
#a4 ,short title ,this ,act may be cited
 as the ,expanding ,care for ,veterans  
,act4  #b4 ,expansion of research and   
education on and delivery of            
complementary and integrative medicine  
to veterans  7a7 ,development of plan   
,to expand research1 education1 and     
delivery ,not later than six months     
after the effective date specified in   
subsection 7f71 the ,secretary of       
,veterans ,affairs shall develop a plan 
to expand materially and substantially  
the scope of research and education on1 
and delivery and integration of1        
complementary and integrative medicine  

services into the health care services  
provided to veterans4  7b7 ,elements    
,the plan required by subsection 7a7    
shall provide for the following3 7#a7   
,research on the following3  7,a7 ,the  
comparative effectiveness of various    
complementary and integrative medicine  
therapies4  7,b7 ,approaches to         
integrating complementary and           
integrative medicine services into other
 health care services provided by the   
,department4  7#b7 ,education and       
training for health care professionals  
of the ,department on the following3    
7,a7 ,complementary and integrative     
medicine services selected by the       
,secretary for purposes of the plan4    
7,b7 ,appropriate uses of such services4
  7,c7 ,integration of such services    
into the delivery of health care to     
veterans4  7#c7 ,research1 education1   
and clinical activities on complementary
 and integrative medicine at centers of 
innovation at ,department medical       
centers4  7#d7 ,identification or       

development of metrics and outcome      
measures to evaluate the provision and  
integration of complementary and        
integrative medicine services into the  
delivery of health care to veterans4    
7#e7 ,integration and delivery of       
complementary and integrative medicine  
services with other health care services
 provided by the ,department4  7c7      
,consultation  7#a7 ,in general ,in     
carrying out subsection 7a71 the        
,secretary shall consult with the       
following3 7,a7 ,the ,director of the   
,national ,center on ,complementary and 
,integrative ,health of the ,national   
,institutes of ,health4  7,b7 ,the      
,commissioner of ,food and ,drugs4  7,c7
 ,institutions of higher education1     
private research institutes1 and        
individual researchers with extensive   
experience in complementary and         
integrative medicine and the integration
 of complementary and integrative       
medicine practices into the delivery of 
health care4  7,d7 ,nationally          

recognized providers of complementary   
and integrative medicine4  7,e7 ,such   
other officials1 entities1 and          
individuals with expertise on           
complementary and integrative medicine  
as the ,secretary considers appropriate4
  7#b7 ,scope of consultation ,the      
,secretary shall undertake consultation 
under paragraph 7#a7 in carrying out    
subsection 7a7 with respect to the      
following3  7,a7 ,to develop the plan4  
7,b7 ,to identify specific complementary
 and integrative medicine practices     
that1 on the basis of research findings 
or promising clinical interventions1 are
 appropriate to include as services to  
veterans4  7,c7 ,to identify barriers to
 the effective provision and integration
 of complementary and integrative       
medicine services into the delivery of  
health care to veterans1 and to identify
 mechanisms for overcoming such         
barriers4  7d7 ,funding ,there is       
authorized to be appropriated to the    
,secretary such sums as may be necessary

 to carry out this section4  7e7        
,complementary and integrative medicine 
defined ,in this section1 the term      
complementary and integrative medicine  
shall have the meaning given that term  
in regulations the ,secretary shall     
prescribe for purposes of this section1 
which shall1 to the degree practicable1 
be consistent with the meaning given    
such term by the ,secretary of ,health  
and ,human ,services4  7f7 ,effective   
date ,this section shall take effect on 
the date that is one year after the date
 of the enactment of this ,act4  #c4    
,program on integration of complementary
 and integrative medicine within        
,department of ,veterans ,affairs       
medical centers  7a7 ,program required  
,the ,secretary of ,veterans ,affairs   
shall-- 7#a7 carry out1 through the     
,office of ,patient ,centered ,care and 
,cultural ,transformation of the        
,department of ,veterans ,affairs1 a    
program to assess the feasibility and   
advisability of integrating the delivery

 of complementary and integrative       
medicine services selected by the       
,secretary with other health care       
services provided by the ,department for
 veterans with mental health conditions1
 chronic pain conditions1 other chronic 
conditions1 and such other conditions as
 the ,secretary determines appropriate2 
and  7#b7 in developing the program1    
identify and resolve barriers to the    
provision of complementary and          
integrative medicine services selected  
by the ,secretary and the integration of
 those services with other health care  
services provided by the ,department4   
7b7 ,duration of program ,the program   
shall be carried out during the         
three-year period beginning on the      
effective date specified in subsection  
7j74  7c7 ,locations  7#a7 ,in general  
,the ,secretary shall carry out the     
program at not fewer than #ae separate  
,department medical centers4  7#b7      
,polytrauma centers ,not less than two  
of the medical centers designated under 

paragraph 7#a7 shall be located at      
polytrauma rehabilitation centers of the
 ,department4  7#c7 ,selection of       
locations ,in carrying out the program1 
the ,secretary shall select locations   
that include the following areas3 7,a7  
,rural areas4  7,b7 ,areas that are not 
in close proximity to an active duty    
military installation4  7,c7 ,areas     
representing different geographic       
locations1 such as census tracts        
established by the ,bureau of the       
,census4  7d7 ,provision of services    
,under the program1 the ,secretary shall
 provide covered services to covered    
veterans by integrating complementary   
and integrative medicine services with  
other services provided by the          
,department at the medical centers      
designated under subsection 7c77#a74    
7e7 ,covered veterans ,for purposes of  
the program1 a covered veteran is any   
veteran who-- 7#a7 has a mental health  
condition diagnosed by a clinician of   
the ,department2  7#b7 experiences      

chronic pain2 or  7#c7 has a chronic    
condition being treated by a clinician  
of the ,department4  7f7 ,covered       
services  7#a7 ,in general ,for purposes
 of the program1 covered services are   
services consisting of complementary and
 integrative medicine as selected by the
 ,secretary4  7#b7 ,administration of   
services ,covered services shall be     
administered under the program as       
follows3 7,a7 ,covered services shall be
 administered by clinicians employed by 
the ,secretary for purposes of this     
section who1 to the extent practicable1 
shall provide services consisting of    
complementary and integrative medicine1 
including those clinicians who solely   
provide such services4  7,b7 ,covered   
services shall be included as part of   
the ,patient ,aligned ,care ,teams      
initiative of the ,office of ,patient   
,care ,services1 ,primary ,care ,program
 ,office1 in coordination with the      
,office of ,patient ,centered ,care and 
,cultural ,transformation4  7,c7        

,covered services shall be made         
available to both-- 7i7 covered veterans
 with mental health conditions1 pain    
conditions1 or chronic conditions       
described in subsection 7e7 who have    
received conventional treatments from   
the ,department for such conditions2 and
  7ii7 covered veterans with mental     
health conditions1 pain conditions1 or  
chronic conditions described in         
subsection 7e7 who have not received    
conventional treatments from the        
,department for such conditions4  7g7   
,voluntary participation ,the           
participation of a veteran in the       
program shall be at the election of the 
veteran and in consultation with a      
clinician of the ,department4  7h7      
,reports to ,congress  7#a7 ,quarterly  
reports ,not later than #ij days after  
the date of the commencement of the     
program and not less frequently than    
once every #ij days thereafter for the  
duration of the program1 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 efforts of the ,secretary to    
carry out the program1 including a      
description of the outreach conducted by
 the ,secretary to veterans and         
community organizations to inform such  
organizations about the program4  7#b7  
,final report  7,a7 ,in general ,not    
later than #ahj days after the          
completion of the program1 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        
program4  7,b7 ,contents ,the report    
submitted under subparagraph 7,a7 shall 
include the following3 7i7 ,the findings
 and conclusions of the ,secretary with 
respect to the program1 including with  
respect to--  7,i7 the utilization and  
efficacy of the complementary and       
integrative medicine services           

established under the program2  7,,ii7  
an assessment of the benefit of the     
program to covered veterans in mental   
health diagnoses1 pain management1 and  
treatment of chronic illness2 and       
7,,iii7 the comparative effectiveness of
 various complementary and integrative  
medicine therapies4  7ii7 ,barriers     
identified under subsection 7a77#b7 that
 were not resolved4  7iii7 ,such        
recommendations for the continuation or 
expansion of the program as the         
,secretary considers appropriate4  7i7  
,complementary and integrative medicine 
defined ,in this section1 the term      
complementary and integrative medicine  
shall have the meaning given that term  
in section #b7;e7 of this ,act4  7j7    
,effective date ,this section shall take
 effect on the date that is one year    
after the date of the enactment of this 
,act4  #d4 ,studies of barriers         
encountered by veterans in receiving1   
and administrators and clinicians in    
providing1 complementary and integrative

 medicine services furnished by the     
,department of ,veterans ,affairs  7a7  
,studies required  7#a7 ,in general ,the
 ,secretary of ,veterans ,affairs shall 
conduct comprehensive studies of the    
barriers encountered by veterans in     
receiving1 and administrators and       
clinicians in providing1 complementary  
and integrative medicine services       
furnished by the ,department of         
,veterans ,affairs4  7#b7 ,studies      
conducted  7,a7 ,veterans ,in conducting
 the study of veterans1 the ,secretary  
shall-- 7i7 survey veterans who seek or 
receive hospital care or medical        
services furnished by the ,department1  
as well as veterans who do not seek or  
receive such care or services2  7ii7    
administer the survey to a              
representative sample of veterans from  
each ,veterans ,integrated ,service     
,network2 and  7iii7 ensure that the    
sample of veterans surveyed is of       
sufficient size for the study results to
 be statistically significant4  7,b7    

,administrators and clinicians ,in      
conducting the study of clinicians and  
administrators1 the ,secretary shall--  
7i7 survey administrators of the        
,department who are involved in the     
provision of health care services2  7ii7
 survey clinicians that have provided   
complementary and integrative medicine  
services through the program established
 under section #c of this ,act1 after   
those clinicians have provided those    
services through such program for at    
least #ij days2 and  7iii7 administer   
the survey to administrators under      
clause 7i7-- 7,i7 before the            
introduction of complementary and       
integrative medicine services through   
such program2 and  7,,ii7 not earlier   
than #ij days after the introduction of 
complementary and integrative medicine  
services through such program4  7b7     
,elements of studies  7#a7 ,veterans ,in
 conducting the study of veterans       
required by subsection 7a71 the         
,secretary shall study the following3   

7,a7 ,the perceived barriers associated 
with obtaining complementary and        
integrative medicine services from the  
,department4  7,b7 ,the satisfaction of 
veterans with complementary and         
integrative medicine services in primary
 care4  7,c7 ,the degree to which       
veterans are aware of eligibility       
requirements for1 and the scope of      
services available under1 complementary 
and integrative medicine services       
furnished by the ,department4  7,d7 ,the
 effectiveness of outreach to veterans  
on the availability of complementary and
 integrative medicine for veterans4     
7,e7 ,such other barriers as the        
,secretary considers appropriate4  7#b7 
,administrators and clinicians ,in      
conducting the study of administrators  
and clinicians required by subsection   
7a71 the ,secretary shall study the     
following3  7,a7 ,the extent of the     
integration of complementary and        
integrative medicine services within the
 services provided by the ,department4  

7,b7 ,the perception by administrators  
and clinicians of the structural and    
attitudinal barriers to the delivery of 
high quality complementary and          
integrative medicine services by the    
,department4  7,c7 ,strategies that have
 been used to reduce or eliminate such  
barriers and the results of such        
strategies4  7,d7 ,the satisfaction of  
administrators and clinicians regarding 
the integration of complementary and    
integrative medicine services within the
 services provided by the ,department4  
7,e7 ,the perception by administrators  
and clinicians of the value of specific 
complementary and integrative medicine  
services for inpatient and outpatient   
veteran populations4  7c7 ,discharge by 
contract ,the ,secretary shall enter    
into a contract with a qualified        
independent entity or organization to   
carry out the studies required by this  
section4  7d7 ,mandatory review of data 
by the ,national ,research ,advisory    
,council  7#a7 ,in general ,the         

,secretary shall ensure that the head of
 the ,national ,research ,advisory      
,council reviews the results of the     
studies conducted under this section4   
7#b7 ,submittal of findings ,the head of
 the ,national ,research ,advisory      
,council shall submit findings with     
respect to the studies to the ,under    
,secretary for ,health and to other     
pertinent program offices within the    
,department with responsibilities       
relating to health care services for    
veterans4  7e7 ,reports  7#a7 ,report on
 implementation ,not later than one year
 after the date of the enactment of this
 ,act1 the ,secretary shall submit to   
,congress a report on the status of the 
implementation of this section4  7#b7   
,report on study  7,a7 ,in general ,not 
later than #de days after the date of   
the completion of the study1 the        
,secretary shall submit to ,congress a  
report on the study required by         
subsection 7a74  7,b7 ,contents ,the    
report required by subparagraph 7,a7    

shall include the following3 7i7        
,recommendations for such administrative
 and legislative proposals and actions  
as the ,secretary considers appropriate4
  7ii7 ,the findings of the head of the 
,national ,research ,advisory ,council  
and of the ,under ,secretary for        
,health4  7f7 ,authorization of         
appropriations ,there is authorized to  
be appropriated for fiscal year #bjai   
for the ,department of ,veterans        
,affairs1 #b1jjj1jjj to carry out this  
section4  7g7 ,complementary and        
integrative medicine defined ,in this   
section1 the term complementary and     
integrative medicine shall have the     
meaning given that term in section      
#b7;e7 of this ,act4  #e4 ,program on   
use of wellness programs as             
complementary approach to mental health 
care for veterans and family members of 
veterans  7a7 ,program required  7#a7   
,in general ,the ,secretary of ,veterans
 ,affairs shall carry out a program     
through the award of grants to public or

 private nonprofit entities to assess   
the feasibility and advisability of     
using wellness programs to complement   
the provision of mental health care to  
veterans and family members eligible for
 counseling under section               
#agab;,a7a77#a77;,c7 of title #ch1      
,united ,states ,code4  7#b7 ,matters to
 be addressed ,the program shall be     
carried out so as to assess the         
following3 7,a7 ,means of improving     
coordination between ,federal1 ,state1  
local1 and community providers of health
 care in the provision of mental health 
care to veterans and family members     
described in paragraph 7#a74  7,b7      
,means of enhancing outreach1 and       
coordination of outreach1 by and among  
providers of health care referred to in 
subparagraph 7,a7 on the mental health  
care services available to veterans and 
family members described in paragraph   
7#a74  7,c7 ,means of using wellness    
programs of providers of health care    
referred to in subparagraph 7,a7 as     

complements to the provision by the     
,department of ,veterans ,affairs of    
mental health care to veterans and      
family members described in paragraph   
7#a74  7,d7 ,whether wellness programs  
described in subparagraph 7,c7 are      
effective in enhancing the quality of   
life and well-being of veterans and     
family members described in paragraph   
7#a74  7,e7 ,whether wellness programs  
described in subparagraph 7,c7 are      
effective in increasing the adherence of
 veterans described in paragraph 7#a7 to
 the primary mental health services     
provided such veterans by the           
,department4  7,f7 ,whether wellness    
programs described in subparagraph 7,c7 
have an impact on the sense of          
well-being of veterans described in     
paragraph 7#a7 who receive primary      
mental health services from the         
,department4  7,g7 ,whether wellness    
programs described in subparagraph 7,c7 
are effective in encouraging veterans   
receiving health care from the          

,department to adopt a more healthy     
lifestyle4  7b7 ,duration ,the          
,secretary shall carry out the program  
for a period of three years beginning on
 the date that is one year after the    
date of the enactment of this ,act4  7c7
 ,locations ,the ,secretary shall carry 
out the program at facilities of the    
,department providing mental health care
 services to veterans and family members
 described in subsection 7a77#a74  7d7  
,grant proposals  7#a7 ,in general ,a   
public or private nonprofit entity      
seeking the award of a grant under this 
section shall submit an application     
therefor to the ,secretary in such form 
and in such manner as the ,secretary may
 require4  7#b7 ,application contents   
,each application submitted under       
paragraph 7#a7 shall include the        
following3 7,a7 ,a plan to coordinate   
activities under the program1 to the    
extent possible1 with the ,federal1     
,state1 and local providers of services 
for veterans to enhance the following3  

7i7 ,awareness by veterans of benefits  
and health care services provided by the
 ,department4  7ii7 ,outreach efforts to
 increase the use by veterans of        
services provided by the ,department4   
7iii7 ,educational efforts to inform    
veterans of the benefits of a healthy   
and active lifestyle4  7,b7 ,a statement
 of understanding from the entity       
submitting the application that1 if     
selected1 such entity will be required  
to report to the ,secretary periodically
 on standardized data and other         
performance data necessary to evaluate  
individual outcomes and to facilitate   
evaluations among entities participating
 in the program4  7,c7 ,other           
requirements that the ,secretary may    
prescribe4  7e7 ,grant uses  7#a7 ,in   
general ,a public or private nonprofit  
entity awarded a grant under this       
section shall use the award for purposes
 prescribed by the ,secretary4  7#b7    
,eligible veterans and family ,in       
carrying out the purposes prescribed by 

the ,secretary in paragraph 7#a71 a     
public or private nonprofit entity      
awarded a grant under this section shall
 use the award to furnish services only 
to individuals specified in section     
#agab;,a7a77#a77;,c7 of title #ch1      
,united ,states ,code4  7f7 ,reports    
7#a7 ,periodic reports  7,a7 ,in general
 ,not later than #ahj days after the    
date of the commencement of the program1
 and every #ahj days thereafter1 the    
,secretary shall submit to ,congress a  
report on the program4  7,b7 ,report    
elements ,each report required by       
subparagraph 7,a7 shall include the     
following3 7i7 ,the findings and        
conclusions of the ,secretary with      
respect to the program during the       
#ahj-;day period preceding the report4  
7ii7 ,an assessment of the benefits of  
the program to veterans and their family
 members during the #ahj-;day period    
preceding the report4  7#b7 ,final      
report ,not later than #ahj days after  
the end of the program1 the ,secretary  

shall submit to ,congress a report      
detailing the recommendations of the    
,secretary as to the advisability of    
continuing or expanding the program4    
7g7 ,wellness defined ,in this section1 
the term wellness has the meaning given 
that term in regulations prescribed by  
the ,secretary4