,,ii  #aaf? ,,congress  #a/ ,session    
,s4 #fbi  ,,9 ,,! ,,s5ate ,,( ,,!       
,,unit$ ,,/ates  ,febru>y #bh1 #bjai,mr4
 ,te/] 7= himself1 ,mrs4 ,murray1 ,mr4  
,blum5?al1 & ,mr4 ,br[n7 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  7#a7 ,9 g5]al
 ,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 
( ! ,dep>tm5t ( ,vet]ans ,affairs =     
s*$ul+ appo9tm5ts = heal? c>e f !       
,dep>tm5t at ! m$ical facility level4   
7#b7 ,p]iodic revision  7,a7 ,9 g5]al ,!
 ,secret>y may revise ! processes &     
requirem5ts requir$ "u p>agraph 7#a7 z !
 ,secret>y consid]s necess>y4  7,b7     
,submittal to ,congress ,n lat] ?an #cj 
days be=e revis+ ! processes &          
requirem5ts "u subp>agraph 7,a71 !      
,secret>y %all submit to ! ,committee on
 ,vet]ans' ,affairs ( ! ,s5ate & !      
,committee on ,vet]ans' ,affairs ( !    
,h\se ( ,repres5tative a description (  
^? revis$ processes & requirem5ts1      
includ+ a description ( any             
modifications to ! c]tification & tra9+ 
"u subsection 7b74  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 7a71 includ+ ! maximum numb] 
( days all[$ to complete ea* /ep ( !    
s*$ul+ process4  7#b7 ,new employees ,! 
,secret>y %all require all employees    
hir$ 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 enable real-"t monitor+ ( & 
ensure t ea* m$ical facility ( !        
,dep>tm5t complies ) ! s*$ul+ processes 
& requirem5ts describ$ 9 subsection 7a71
 includ+ compliance ) policies ( !      
,dep>tm5t relat+ to ! maximum numb] (   
days all[$ to complete ea* /ep ( !      
s*$ul+ process4  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 
7d7 ,comptroll] ,g5]al report ,n lat]   
?an two ye>s aft] ! date ( ! enactm5t ( 
?is ,act1 ! ,comptroll] ,g5]al ( !      
,unit$ ,/ates %all submit to !          
,committee on ,vet]ans' ,affairs ( !    
,s5ate & ! ,committee on ,vet]ans'      
,affairs ( ! ,h\se ( ,repres5tatives a  
report on ! compliance ( ! ,secret>y ) !
 requirem5ts ( ?is section4  #c4 ,audits
 reg>d+ s*$ul+ ( appo9tm5ts & managem5t 
( consultations = heal? c>e f ,dep>tm5t 
( ,vet]ans ,affairs  7a7 ,9 g5]al ,n    
lat] ?an "o ye> aft] ! date ( ! enactm5t
 ( ?is ,act1 & n less frequ5tly ?an     
annually !reaft]1 ! ,secret>y ( ,vet]ans

 ,affairs %all provide = ! conduct (    
facility-level audits ( ! s*$ul+ (      
appo9tm5ts & ! managem5t ( consultations
 = heal? c>e "u ! laws adm9i/]$ by !    
,secret>y4  7b7 ,elem5ts ,ea* audit     
conduct$ "u subsection 7a7 %all include 
! foll[+3 7#a7 ,) respect to ea* m$ical 
c5t] ( ! ,dep>tm5t ( ,vet]ans ,affairs1 
an assessm5t ( any s*$ul+ or            
consultation managem5t issues at t      
m$ical c5t]1 includ+ ! foll[+3  7,a7 ,an
 assessm5t ( non-compliance ) policies (
 ! ,vet]ans ,heal? ,adm9i/ration relat+ 
to s*$ul+ appo9tm5ts & manag+           
consultations4  7,b7 ,an assessm5t ( !  
ext5t to :i* appo9tm5ts or consultations
 are n timely process$4  7,c7 ,a        
description ( any backlogs 9 appo9tm5ts 
or consultations t are await+ action4   
7,d7 ,an assessm5t ( :e!r consultations 
are appropriately process$4  7,e7 ,data 
) respect to consultations z foll[s3    
7i7 ,consultations t 7 s*$ul$ )9 !      
reque/ w9d[4  7ii7 ,duplicate           
consultation reque/s4  7iii7            

,consultations t 7 discont9u$4  7iv7    
,delays 9 consultations4  7v7           
,consultations t 7 n prop]ly clos$ or   
discont9u$1 includ+ a description (     
rem$iation attempts4  7,f7 ,a review =  
accuracy ) respect to consultation      
managem5t z foll[s3 7i7 ,a review ( !   
accuracy ( ! type ( s]vice1 ei!r        
adm9i/rative or cl9ical1 t is inputt$ 9 
! electronic heal? record4  7ii7 ,a     
review ( ! accuracy ( ! type (          
consultation sett+1 ei!r impati5t or    
outpati5t1 t is inputt$ 9 ! electronic  
heal? record4  7iii7 ,a review ( !      
appropriat5ess ( ! level ( urg5cy ( !   
consultation t is inputt$ 9 ! electronic
 heal? record4  7iv7 ,a review ( any    
delay$ or unresolv$ consultations4  7#b7
 ,an id5tification ( su* recomm5dations 
= corrective action z ! ,secret>y       
consid]s necess>y1 includ+ additional   
tra9+1 increas$ p]sonnel1 & o!r         
res\rces4  7#c7 ,a c]tification t !     
director ( ea* m$ical c5t] ( ! ,dep>tm5t
 is 9 compliance ) ! processes &        

requirem5ts describ$ 9 section #b7;a7 & 
su* o!r requirem5ts relat+ to ! s*$ul+ (
 appo9tm5ts & managem5t ( consultations 
z ! ,secret>y consid]s appropriate4     
7#d7 ,) respect to ref]rals = heal? c>e 
betwe5 heal? c>e provid]s or facilities 
( ! ,dep>tm5t1 a measurem5t (1 = ea*    
m$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  7c7 ,conduct (    
audit by ?ird p>ty ,ea* audit conduct$  
"u subsection 7a7 ) respect to a m$ical 
facility ( ! ,dep>tm5t %all be conduct$ 

by an individual or entity t is n       
affiliat$ ) ! facility4  7d7            
,transmittal to ,,vha ,ea* audit        
conduct$ "u subsection 7a7 %all be      
transmitt$ to ! ,"u ,secret>y = ,heal? (
 ! ,dep>tm5t s t ! ,"u ,secret>y c--    
7#a7 /r5g!n ov]sight ( ! s*$ul+ (       
appo9tm5ts & managem5t ( consultations  
?r\gh\t ! ,dep>tm5t2  7#b7 monitor      
national policy on su* s*$ul+ &         
managem5t2  7#c7 det]m9e if a mobile    
deploym5t team furni%$ "u ! pilot       
program e/abli%$ "u section #djb ( !    
,,va ,,mission ,act ( #bjah 7,public    
,law #aae-ahb7 is w>rant$2 &  7#d7      
develop a rem$iation plan to address    
issues uncov]$ by ^? audits4  7e7       
,annual report  7#a7 ,9 g5]al ,n lat]   
?an ,decemb] #ca ( ea* ye>1 ! ,secret>y 
%all submit to ! ,committee on ,vet]ans'
 ,affairs ( ! ,s5ate & ! ,committee on  
,vet]ans' ,affairs ( ! ,h\se (          
,repres5tatives a report on ! audits    
conduct$ "u subsection 7a7 dur+ ! ye>   
end+ on t date4  7#b7 ,elem5ts ,!       

,secret>y %all include 9 ea* report     
requir$ by p>agraph 7#a7-- 7,a7 a       
description ( ! audits conduct$ "u      
subsection 7a7 ) respect to ea* facility
 ( ! ,dep>tm5t2  7,b7 an assessm5t ( h[ 
! ,dep>tm5t /r5g!n$ ov]sight ( ! s*$ul+ 
( appo9tm5ts & managem5t ( consultations
 at t facility z a result ( ^? audits2  
7,c7 an assessm5t ( h[ ^? audits in=m$ !
 national policy ( ! ,dep>tm5t ) respect
 to ! s*$ul+ ( appo9tm5ts & managem5t ( 
consultations2 &  7,d7 a description (  
any rem$iation plans to address issues  
rais$ by ^? audits t 7 complet$4  #d4   
,adm9i/ration ( non-,dep>tm5t ( ,vet]ans
 ,affairs heal? c>e  7a7 ,c]tification (
 prop] adm9i/ration  7#a7 ,review  7,a7 
,9 g5]al ,! ,secret>y ( ,vet]ans        
,affairs %all conduct a review ( !      
/aff+1 tra9+1 & o!r requirem5ts necess>y
 to adm9i/] section #aja ( ! ,vet]ans   
,access1 ,*oice1 & ,acc\ntability ,act (
 #bjad 7,public ,law #aac-adf2 #ch      
,u4,s4,c4 #agja note71 section #agjc (  
title #ch1 ,unit$ ,/ates ,code 7z 9     

effect on ! date specifi$ 9 section     
#aja7;b7 ( ! ,c>+ = ,our ,vet]ans ,act (
 #bjah 7title ,i ( ,public ,law         
#aae-ahb771 & 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$ical facility ( !    
,dep>tm5t--  7i7 an assessm5t ( ! type (
 positions requir$ to be /aff$ at !     
m$ical facility2  7ii7 ! numb] ( su*    
positions au?oriz$2  7iii7 ! numb] ( su*
 positions fill$2 &  7iv7 ! numb] (     
additional su* positions requir$ to be  
au?oriz$4  7#b7 ,c]tification ,n lat]   
?an #ahj days aft] ! date ( ! enactm5t (
 ?is ,act1 & e #ahj days !reaft]1 !     
,secret>y ( ,vet]ans ,affairs %all      
submit to ! ,committee on ,vet]ans'     
,affairs ( ! ,s5ate & ! ,committee on   
,vet]ans' ,affairs ( ! ,h\se (          
,repres5tatives ! results ( ! review    
conduct$ "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] 
set =? "u subp>agraphs 7,a7 ?r\gh 7,f7 (
 p>agraph 7#c74  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 t ! appo9tm5t ) !   
non-,dep>tm5t heal? c>e provid] occurs4 
7,e7 ,! date t ! ref]ral to !           
non-,dep>tm5t heal? c>e provid] is      
complet$4  7,f7 ,any o!r /ep t !        
,secret>y det]m9es necess>y to measure4 
7#d7 ,publication ( data  7,a7 ,9 g5]al 
,n lat] ?an "o ye> aft] ! date ( !      
enactm5t ( ?is ,act1 ! ,secret>y %all   
publi% ! data measur$ "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 ,review ,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 ( ! validity & reliability ( 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  #e4 ,reque/s = mobile deploym5t  
teams by directors ( m$ical c5t]s (     
,dep>tm5t ( ,vet]ans ,affairs  7a7 ,9   
g5]al ,a director ( a m$ical c5t] ( !   
,dep>tm5t ( ,vet]ans ,affairs %all      
reque/ f ! ,secret>y ( ,vet]ans ,affairs
 a mobile deploym5t team "u ! pilot     
program e/abli%$ "u section #djb ( !    
,,va ,,mission ,act ( #bjah 7,public    
,law #aae-ahb7 if requirem5ts ( !       
,dep>tm5t "u sections #b & #d h n be5   
met ) respect to a facility "u !        
jurisdiction ( ! director4  7b7 ,report 
,n less frequ5tly ?an once e #ahj days1 
! ,secret>y %all submit to ! appropriate
 committees ( ,congress a report sett+  
=? ea* reque/ "u subsection 7a7 dur+ !  
p]iod cov]$ by ! report1 includ+ an     
explanation ( :y a mobile deploym5t team

 0 or 0 n provid$1 z ! case may be4  7c7
 ,appropriate committees ( congress     
def9$ ,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  #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$4  7#b7 ,consultation ,9 conduct+ !
 exam9ation "u p>agraph 7#a71 !         
,secret>y %all consult ) heal? c>e /aff+
 exp]ts 9 ! ,f$]al ,gov]nm5t & ! private
 sector4  7#c7 ,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