,i  #aafth ,,congress  #ast ,session    
,h4 ,r4 #biaf  ,,in ,,the ,,house ,,of  
,,representatives  ,may #bb1 #bjai,ms4  
,gabbard 7for herself1 ,mrs4 ,radewagen1
 ,mr4 ,case1 ,mr4 ,san ,nicolas1 and    
,mr4 ,young7 introduced the following   
bill2 which was referred to the         
,committee on ,veterans' ,affairs  ,a   
,,bill  ,to require the ,secretary of   
,veterans ,affairs to carry out a pilot 
program to provide hospital care and    
medical services to veterans in the     
,freely ,associated ,states of the      
,republic of ,palau1 the ,republic of   
the ,marshall ,islands1 and the         
,federated ,states of ,micronesia1 and  
to conduct a study on the feasibility   
and advisability of establishing        
regional offices1 suboffices1 contact   
units1 or other subordinate offices of  
the ,department of ,veterans ,affairs in
 the ,freely ,associated ,states to     
provide such care and services1 and for 
other purposes4  #a4 ,short title ,this 
,act may be cited as the ,compact of    

,free ,association ,veterans ,review    
,act of #bjai or the ,,cofa ,veterans   
,review ,act of #bjai4  #b4 ,definitions
 ,in this ,act3  7#a7 ,appropriate      
committees of ,congress ,the term       
appropriate committees of ,congress     
means-- 7,a7 the ,committee on          
,veterans' ,affairs and the ,committee  
on ,appropriations of the ,senate2 and  
7,b7 the ,committee on ,veterans'       
,affairs and the ,committee on          
,appropriations of the ,house of        
,representatives4  7#b7 ,department ,the
 term ,department means the ,department 
of ,veterans ,affairs4  7#c7 ,freely    
,associated ,states ,the term ,freely   
,associated ,states means the ,republic 
of ,palau1 the ,republic of the         
,marshall ,islands1 and the ,federated  
,states of ,micronesia1 which have each 
entered into a ,compact of ,free        
,association with the ,united ,states4  
7#d7 ,hospital care2 medical services   
,the terms hospital care and medical    
services have the meanings given those  

terms in section #agja of title #ch1    
,united ,states ,code4  7#e7 ,patient   
aligned care team ,the term patient     
aligned care team means a team of health
 care professionals of the ,department  
that provides comprehensive primary care
 in partnership with the patient and    
manages and coordinates comprehensive   
health care services consistent with    
agreed-upon goals of care4  7#f7        
,project ,,echo education and training  
,the term ,project ,,echo education and 
training means education and training   
provided under the ,project ,extension  
for ,community ,health ,outcomes4  7#g7 
,secretary ,the term ,secretary means   
the ,secretary of ,veterans ,affairs4   
7#h7 ,service-connected2                
non-service-connected ,the terms        
service-connected and                   
non-service-connected have the meanings 
given those terms in section #aja of    
title #ch1 ,united ,states ,code4  7#i7 
,veterans service organization ,the term
 veterans service organization means any

 organization recognized by the         
,secretary for the representation of    
veterans under section #eijb of title   
#ch1 ,united ,states ,code4  #c4 ,pilot 
program on providing hospital care and  
medical services to veterans residing in
 the ,freely ,associated ,states  7a7   
,pilot program required ,commencing not 
later than ,january #a1 #bjbj1 the      
,secretary shall carry out a pilot      
program to provide hospital care1       
medical services1 and other related     
services to veterans residing in the    
,freely ,associated ,states4  7b7       
,duration ,the ,secretary shall carry   
out the pilot program required by       
subsection 7a7 during the three-year    
period beginning on the date of the     
commencement of the pilot program4  7c7 
,services provided ,in carrying out the 
pilot program required by subsection    
7a71 the ,secretary shall ensure that   
the pilot program--  7#a7 emphasizes the
 use of telehealth2  7#b7 provides      
,project ,,echo education and training  

to employees of the ,department         
responsible for carrying out the pilot  
program2  7#c7 includes the use of      
primary and specialty care provided by  
patient aligned care teams and specialty
 care providers2 and  7#d7 includes the 
provision of compensation and pension   
medical examinations4  7d7 ,outreach    
program ,as part of the pilot program   
required by subsection 7a71 the         
,secretary shall conduct a program of   
outreach to inform veterans in the      
,freely ,associated ,states about the   
pilot program and the services available
 under the pilot program4  7e7          
,authorization of appropriations ,there 
are authorized to be appropriated to the
 ,secretary such funds as may be        
necessary to carry out the pilot        
program4  #d4 ,study on providing       
hospital care and medical services to   
veterans residing in the ,freely        
,associated ,states  7a7 ,study required
  7#a7 ,in general ,the ,secretary shall
 conduct a study on the feasibility and 

advisability of establishing one or more
 regional offices1 suboffices1 contact  
units1 or other subordinate offices of  
the ,department in the remote ,pacific  
islands1 including the ,freely          
,associated ,states1 to provide hospital
 care and medical services to veterans  
residing in the remote ,pacific islands1
 including the ,freely ,associated      
,states4  7#b7 ,considerations and      
analysis ,in conducting the study       
required by paragraph 7#a71 the         
,secretary shall consider and analyze   
the following3  7,a7 ,the results of the
 pilot program required by section      
#c7;a74  7,b7 ,the ability of the       
,department to provide hospital care and
 medical services to veterans residing  
or traveling outside the ,united        
,states1 including veterans residing in 
the ,freely ,associated ,states4  7,c7  
,the feasibility1 efficacy1 and         
advisability of building clinics or     
leasing space on embassy compounds or in
 consulate facilities of the ,united    

,states in the ,freely ,associated      
,states or insular areas for the        
purposes of providing hospital care and 
medical services to veterans residing or
 traveling outside the ,united ,states1 
including veterans residing in the      
,freely ,associated ,states4  7,d7 ,the 
feasibility and advisability of         
providing services1 such as telehealth1 
,project ,,echo education and training1 
primary and specialty care provided by  
patient aligned care teams and specialty
 care providers1 and compensation and   
pension medical examinations1 to        
veterans residing in the ,freely        
,associated ,states4  7,e7 ,updates to  
census data of the ,department on the   
number of veterans residing in the      
,freely ,associated ,states to determine
 whether such data supports the         
establishment of a permanent patient    
aligned care team of the ,department    
based in the ,freely ,associated        
,states4  7,f7 ,with respect to the     
,united ,states and the ,freely         

,associated ,states1 the data standards 
for-- 7i7 patient medical record        
information2 and  7ii7 the electronic   
interchange of such information4  7,g7  
,the feasibility and advisability of    
providing hospital care and medical     
services to veterans residing in the    
,freely ,associated ,states for         
non-service-connected disabilities4     
7,h7 ,the feasibility and advisability  
of providing continuity of care to      
veterans for service-connected          
disabilities that cannot be treated by  
the ,department within a regional       
office1 suboffice1 contact unit1 or     
other subordinate office of the         
,department in the remote ,pacific      
islands1 including the ,freely          
,associated ,states4  7,i7 ,such other  
matters as the ,secretary considers     
appropriate4  7#c7 ,cooperation and     
consultation ,the ,secretary shall      
conduct the study required by paragraph 
7#a7--  7,a7 in cooperation with-- 7i7  
the ,secretary of ,defense2  7ii7 the   

,secretary of ,health and ,human        
,services2  7iii7 the ,secretary of the 
,interior2  7iv7 the ,secretary of      
,state2 and  7v7 such other heads of    
,federal agencies as may be interested  
in the study2 and  7,b7 in consultation 
with-- 7i7 such representatives of      
,state and local governments as the     
,secretary determines may be interested 
in the study2  7ii7 each government of  
the ,freely ,associated ,states2  7iii7 
veterans service organizations2  7iv7   
such nongovernmental organizations as   
the ,secretary considers appropriate2   
and  7v7 the public4  7b7 ,report       
required  7#a7 ,in general ,not later   
than #bgj days after the date on which  
the pilot program required by section   
#c7;a7 terminates1 the ,secretary shall 
submit to the appropriate committees of 
,congress a report on the findings of   
the ,secretary with respect to the study
 required by subsection 7a77#a74  7#b7  
,contents ,the report submitted under   
paragraph 7#a7 shall include the        

following3 7,a7 ,a description of the   
processes required for the ,secretary to
 establish one or more regional offices1
 suboffices1 contact units1 or other    
subordinate offices in the ,freely      
,associated ,states4  7,b7 ,the number  
of veterans expected to receive hospital
 care and medical services provided     
under laws administered by the          
,secretary in the ,freely ,associated   
,states4  7,c7 ,a resource management   
plan for the ,department to provide     
hospital care and medical services in   
the ,freely ,associated ,states1        
including an assessment of the effect   
that such provision would have on the   
,department of ,veterans ,affairs       
,pacific ,islands ,health ,care ,system4
  7,d7 ,an explanation of the guidelines
 that the ,department will use to       
provide hospital care and medical       
services under laws administered by the 
,secretary in the ,freely ,associated   
,states1 including an explanation of    
benefits for service-connected and      

non-service-connected disabilities4     
7,e7 ,an explanation of how the         
,department expects to provide          
continuity of care to veterans for      
service-connected disabilities that     
cannot be treated within a regional     
office1 suboffice1 contact unit1 or     
other subordinate office in the ,freely 
,associated ,states1 including how the  
,department plans to communicate with   
such veterans regarding their continuity
 of care4  7,f7 ,an assessment of the   
budgetary resources required to         
establish and provide hospital care and 
medical services to veterans in the     
,freely ,associated ,states during the  
#aj-year period beginning on the date of
 the submittal of the report4