,,ii  #aah? ,,congress  #a/ ,session    
,s4 #bfdi  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,july #bg1 #bjbc ,mr4  
,te/] introduc$ ! foll[+ bill2 :i* 0    
read twice & ref]r$ to ! ,committee on  
,vet]ans' ,affairs  ,a ,,bill  ,to      
improve community c>e provid$ by !      
,dep>tm5t ( ,vet]ans ,affairs1 & = o!r  
purposes4  #a4 ,%ort title2 table (     
cont5ts  7a7 ,%ort title ,?is ,act may  
be cit$ z ! ,mak+ ,community ,c>e ,"w = 
,vet]ans ,act ( #bjbc4  7b7 ,table (    
cont5ts ,! table ( cont5ts = ?is ,act is
 z foll[s3  ,sec4 #a4 ,%ort title2 table
 ( cont5ts4 ,,title ,i--,improvem5ts to 
,community ,c>e ,sec4 #aja4 ,requirem5t 
t appo9tm5ts = c>e or s]vices "u        
,community ,c>e ,program ( ,dep>tm5t (  
,vet]ans ,affairs are timely s*$ul$4    
,sec4 #ajb4 ,modifications to access    
/&>ds = c>e furni%$ ?r\gh ,community    
,c>e ,program ( ,dep>tm5t ( ,vet]ans    
,affairs4 ,sec4 #ajc4 ,consid]ation (   
teleheal? 9 det]m9+ :e!r an appo9tm5t c 
be s*$ul$ )9 ! access /&>ds ( !         

,dep>tm5t ( ,vet]ans ,affairs4 ,sec4    
#ajd4 ,f9ality ( decision by vet]an &   
vet]an's ref]r+ cl9ician4 ,sec4 #aje4   
,b5efits = p]sons disabl$ by treatm5t "u
 ,community ,c>e ,program ( ,dep>tm5t ( 
,vet]ans ,affairs4 ,sec4 #ajf4 ,ext5sion
 ( p]iod = submittal ( claims by heal?  
c>e entities & provid]s4 ,sec4 #ajg4    
,program on self-ref]ral ( vet]ans =    
c]ta9 s]vices "u ,vet]ans ,community    
,c>e ,program4 ,sec4 #ajh4 ,report on   
ref]rals = non-,dep>tm5t ( ,vet]ans     
,affairs heal? c>e4 ,sec4 #aji4         
,requirem5t t heal? c>e provid]s "u     
,community ,c>e ,program ( ,dep>tm5t (  
,vet]ans ,affairs provide c]ta9 data4   
,sec4 #aaj4 ,high-compliance rat+       
program = provid]s "u ,vet]ans          
,community ,c>e ,program ( ,dep>tm5t (  
,vet]ans ,affairs4 ,sec4 #aaa4 ,adoption
 ( national int]op]ability /&>ds betwe5 
,dep>tm5t ( ,vet]ans ,affairs &         
community c>e provid]s4 ,sec4 #aab4     
,analysis ( feasibility & advisability (
 e/abli%+ a community c>e network = !   

provision ( c>e to vet]ans 9 ! ,republic
 ( ! ,philipp9es4 ,sec4 #aac4 ,pilot    
program on consolidat+ ! community c>e  
d5tal treatm5t plan approval process (  
,dep>tm5t ( ,vet]ans ,affairs4 ,sec4    
#aad4 ,reviews ( paym5t rate waiv]s "u  
,vet]ans ,community ,c>e ,program4 ,sec4
 #aae4 ,comptroll] ,g5]al report on     
d5ti/ry "u ,vet]ans ,community ,c>e     
,program4 ,,title ,,ii--,heal? c>e      
employees ,sec4 #bja4 ,e/abli%m5t ( ,/>t
 & ,/ay at ,,va program4 ,sec4 #bjb4    
,expansion ( p]iod ( paym5t "u ,employee
 ,inc5tive ,s*ol>%ip ,program4 ,sec4    
#bjc4 ,m5tor%ip program = executive     
lead]%ip teams at m$ical c5t]s ( !      
,dep>tm5t ( ,vet]ans ,affairs4 ,,title  
,,iii--,o!r heal? c>e matt]s ,sec4 #cja4
 ,tim+ = s*$ul+ ( appo9tm5ts at         
facilities ( ,dep>tm5t ( ,vet]ans       
,affairs4 ,sec4 #cjb4 ,modification (   
requirem5ts = /&>ds = quality ( c>e f   
,dep>tm5t ( ,vet]ans ,affairs4 ,sec4    
#cjc4 ,m5tal ,heal? ,resid5tial         
,rehabilitation ,treatm5t ,program ( !  

,dep>tm5t ( ,vet]ans ,affairs4 ,sec4    
#cjd4 ,electronic docum5t submission    
option = ! ,,*ampva program4 ,sec4 #cje4
 ,review ( workfl[s associat$ ) process+
 ref]rals betwe5 facilities ( ! ,vet]ans
 ,heal? ,adm9i/ration4  ,i ,improvem5ts 
to ,community ,c>e  #aja4 ,requirem5t t 
appo9tm5ts = c>e or s]vices "u          
,community ,c>e ,program ( ,dep>tm5t (  
,vet]ans ,affairs are timely s*$ul$  7a7
 ,9 g5]al ,section #agjc ( title #ch1   
,unit$ ,/ates ,code1 is am5d$-- 7#a7 by 
r$esignat+ subsections 7m71 7n71 & 7o7 z
 subsections 7n71 7o71 & 7p71           
respectively2 &  7#b7 by ins]t+ aft]    
subsection 7l7 ! foll[+ new subsection  
7m73  7m7 ,s*$ul+ ( appo9tm5ts  7#a7 ,! 
,secret>y %all ensure t an appo9tm5t = a
 cov]$ vet]an = c>e or s]vices "u ?is   
section--  7,a7 9 ! case ( a non-urg5t  
appo9tm5t1 is s*$ul$ 7b may occur at a  
lat] date7 n lat] ?an sev5 days aft] !  
e>li] ( ! date on :i*-- 7i7 a cl9ician (
 ! ,dep>tm5t det]m9es t ! vet]an        
requires c>e2 or  7ii7 ! vet]an pres5ts 

to ! ,dep>tm5t reque/+ c>e2 &  7,b7 9 ! 
case ( an appo9tm5t = urg5t c>e1 is     
complet$ n lat] ?an #dh h\rs aft] !     
e>li] ( ! date on :i*--  7i7 a cl9ician 
( ! ,dep>tm5t det]m9es t ! vet]an       
requires c>e2 or  7ii7 ! vet]an pres5ts 
to ! ,dep>tm5t reque/+ c>e4  7#b7 ,n    
less frequ5tly ?an qu>t]ly1 ! ,secret>y 
%all submit to ! ,committee on ,vet]ans'
 ,affairs ( ! ,s5ate & ! ,committee on  
,vet]ans' ,affairs ( ! ,h\se (          
,repres5tatives a report on ! av]age "t 
x takes ea* m$ical facility ( !         
,dep>tm5t to s*$ule appo9tm5ts = c>e or 
s]vices "u ?is section1 brok5 out by    
prim>y c>e1 m5tal heal? c>e1 & ea* type 
( specialty c>e4  7#c7 7,a7 ,ea* m$ical 
facility ( ! ,dep>tm5t = :i* any av]age 
"t report$ "u p>agraph 7#b7 is m ?an    
sev5 days %all submit to ! ,"u ,secret>y
 = ,heal?1 n lat] ?an #cj days aft] !   
date ( ! report--  7i7 an explanation = 
:y su* av]age "t is m ?an sev5 days1 :i*
 may include /aff+ %ortages1 insuffici5t
 network1 surge ( appo9tm5ts1 & any o!r 

factor increas+ su* av]age "t2  7ii7 a  
rem$iation plan to br+ su* av]age "t to 
n m ?an sev5 days2 &  7iii7 an          
explanation = h[ ea* issue specifi$ 9   
clause 7i7 is be+ mitigat$4  7,b7 ,)    
respect to any explanation "u           
subp>agraph 7,a77i7 t specifies         
insuffici5t network1 ! ,"u ,secret>y =  
,heal? %all--  7i7 consult ) any ?ird   
p>ty adm9i/rator responsible = adm9i/]+ 
su* network on h[ network insuffici5cy c
 be ov]come2 &  7ii7 exam9e :e!r ! ?ird 
p>ty adm9i/rator is meet+ contractual   
obligations4  4  7b7 ,effective date ,! 
,secret>y ( ,vet]ans ,affairs %all      
comply ) ! requirem5ts "u section       
#agjc7m77#a7 ( title #ch1 ,unit$ ,/ates 
,code1 z add$ by subsection 7a77#b71 by 
n lat] ?an #ahj days aft] ! date ( !    
enactm5t ( ?is ,act4  #ajb4             
,modifications to access /&>ds = c>e    
furni%$ ?r\gh ,community ,c>e ,program (
 ,dep>tm5t ( ,vet]ans ,affairs  7a7 ,9  
g5]al ,section #agjc;,b ( title #ch1    
,unit$ ,/ates ,code1 is am5d$--  7#a7 by

 /rik+ subsections 7a7 ?r\gh 7d7 &      
ins]t+ ! foll[+3  7a7 ,?re%old          
eligibility /&>ds = access to community 
c>e ,a cov]$ vet]an %all be eligible to 
elect to receive1 pursuant to subsection
 7d77#c7 ( section #agjc ( ?is title1   
non-,dep>tm5t hospital c>e1 m$ical      
s]vices1 or ext5d$ c>e s]vices "u su*   
section pursuant to subsection          
7d77#a77;,d7 ( su* section us+ ! foll[+ 
eligibility /&>ds = access to community 
c>e3  7#a7 ,) respect to prim>y c>e1    
m5tal heal? c>e1 or non-in/itutional    
ext5d$ c>e s]vices1 if ! ,secret>y _c   
s*$ule an appo9tm5t = ! cov]$ vet]an ) a
 heal? c>e provid] ( ! ,dep>tm5t-- 7,a7 
n m ?an #cj m9utes av]age driv+ "t f !  
resid5ce ( ! vet]an2 &  7,b7 n lat] ?an 
#bj days f ! date ( reque/ = su* an     
appo9tm5t1 unless a lat] date has be5   
agre$ to by ! vet]an 9 consultation ) ! 
heal? c>e provid]1 to ! fir/ next       
available appo9tm5t date relevant to !  
reque/$ m$ical s]vice4  7#b7 ,) respect 
to specialty c>e or specialty s]vices1  

if ! ,secret>y _c s*$ule an appo9tm5t = 
! cov]$ vet]an ) a heal? c>e provid] ( !
 ,dep>tm5t--  7,a7 n m ?an #fj m9utes   
av]age driv+ "t f ! resid5ce ( ! vet]an2
 &  7,b7 n lat] ?an #bh days f ! date ( 
reque/ = su* an appo9tm5t1 unless a lat]
 date has be5 agre$ to by ! vet]an 9    
consultation ) ! heal? c>e provid]1 to !
 fir/ next available appo9tm5t date     
relevant to ! reque/$ m$ical s]vice4  2 
7#b7 by r$esignat+ subsections 7e71 7f71
 7g71 7h71 & 7i7 z subsections 7b71 7c71
 7d71 7e71 & 7f71 respectively2  7#c7 9 
subsection 7b71 z r$esignat$ by p>agraph
 7#b7--  7,a7 9 ! matt] prec$+ p>agraph 
7#a71 by /rik+ ,n lat] ?an #c ye>s aft] 
! date on :i* ! ,secret>y e/abli%es     
access /&>ds "u subsection 7a7 & n less 
frequ5tly ?an once e #c ye>s !reaft] &  
ins]t+ ,review & report4--,n less       
frequ5tly ?an once e ?ree ye>s2  7,b7 9 
p>agraph 7#a71 by /rik+ su* /&>ds &     
ins]t+ ! eligibility /&>ds = access to  
community c>e "u subsection 7a72 &  7,c7
 9 p>agraph 7#b71 by /rik+ & any        

modification to ! access /&>ds ) respect
 to ! review conduct$ "u p>agraph 7#a7 &
 ins]t+ ( su* review & su*              
recomm5dations z ! ,secret>y may h )    
respect to su* eligibility /&>ds2  7#d7 
9 subsection 7c71 z s r$esignat$--  7,a7
 9 p>agraph 7#a7-- 7i7 by /rik+ 7#a7    
,subject to p>agraph 7#c7 & ins]t+      
,requirem5t ,to meet /&>ds4--7#a7       
,subject to p>agraphs 7#c7 & 7#d72 &    
7ii7 by ins]t+ & heal? c>e provid]s     
specifi$ "u section #agjc7;c7 ( ?is     
title be=e ! p]iod at ! end2  7,b7 9    
p>agraph 7#b71 by /rik+ ,! ,secret>y &  
ins]t+ ,subject to p>agraphs 7#c7 &     
7#d71 ! ,secret>y2 &  7,c7 by add+ at ! 
end ! foll[+ new p>agraph3  7#d7 7,a7 ,a
 heal? c>e provid] specifi$ "u section  
#agjc7;c7 ( ?is title t is furni%+ c>e  
pursuant to a contract1 agreem5t1 or o!r
 arrangem5t betwe5 su* provid] & !      
,secret>y may reque/ a waiv] to !       
requirem5t "u ?is subsection to meet !  
access /&>ds e/abli%$ "u subsection 7a74
  7,b7 ,any waiv] reque/$ by a heal? c>e

 provid] "u subp>agraph 7,a7 mu/ be     
reque/$ 9 writ+ & submitt$ to !         
,secret>y = approval4  7,c7 ,9 evaluat+ 
a waiv] reque/ by a heal? c>e provid] "u
 subp>agraph 7,a71 ! ,secret>y %all     
consid] ! factors specifi$ "u p>agraph  
7#c77;,d7 t are relevant to ! heal? c>e 
provid]4  2  7#e7 9 subsection 7d77#a71 
z s r$esignat$1 by /rik+ 7#a7 ,!        
,secret>y & ins]t+ ,publication4--7#a7  
,! ,secret>y2  7#f7 9 subsection        
7e77#a71 z s r$esignat$1 by /rik+ 7#a7  
,consi/5t ) & ins]t+ ,det]m9ation reg>d+
 eligibility4--7#a7 ,consi/5t )2 &  7#g7
 9 subsection 7f71 z s r$esignat$1 by   
/rik+ ,9 ?is section & ins]t+           
,def9itions4--,9 ?is section4  7b7      
,con=m+ am5dm5ts ,section #agjc7;d7 (   
su* title is am5d$--  7#a7 9 p>agraph   
7#a77;,d71 by /rik+ develop$ by !       
,secret>y2 &  7#b7 9 p>agraph 7#c71 by  
/rik+ develop$ by ! ,secret>y4  #ajc4   
,consid]ation ( teleheal? 9 det]m9+ :e!r
 an appo9tm5t c be s*$ul$ )9 ! access   
/&>ds ( ! ,dep>tm5t ( ,vet]ans ,affairs 

,section #agjc7;d7 ( title #ch1 ,unit$  
,/ates ,code1 is am5d$ by add+ at ! end 
! foll[+ new p>agraph3  7#d7 ,9 det]m9+ 
"u p>agraph 7#a77;,d7 :e!r ! ,dep>tm5t  
is able to furni% c>e or s]vices 9 a    
mann] t complies ) ! access /&>ds       
e/abli%$ "u section #agjc;,b7a7 ( ?is   
title1 = purposes ( det]m9+ !           
availability ( an appo9tm5t1 a teleheal?
 appo9tm5t w only be consid]$ z an      
available appo9tm5t if ! vet]an accepts 
! use ( teleheal? by ! ,dep>tm5t4  4    
#ajd4 ,f9ality ( decision by vet]an &   
vet]an's ref]r+ cl9ician ,section       
#agjc7;d7 ( title #ch1 ,unit$ ,/ates    
,code1 z am5d$ by section #ajc1 is fur!r
 am5d$ by add+ at ! end ! foll[+ new    
p>agraph3  7#e7 7,a7 ,subject to        
subp>agraph 7,b71 an agreem5t by a cov]$
 vet]an & ! cov]$ vet]an's ref]r+       
cl9ician "u p>agraph 7#a77;,e7 reg>d+ ! 
be/ m$ical int]e/ ( ! cov]$ vet]an is   
f9al & is n subject to review or        
approval by ! ,dep>tm5t4  7,b7 ,a cov]$ 
vet]an & ! cov]$ vet]an's ref]r+        

cl9ician may correct any errors made )  
respect to an agreem5t describ$ 9       
subp>agraph 7,a74  4  #aje4 ,b5efits =  
p]sons disabl$ by treatm5t "u ,community
 ,c>e ,program ( ,dep>tm5t ( ,vet]ans   
,affairs  7a7 ,9 g5]al ,subsection 7a7 (
 section #aaea ( title #ch1 ,unit$      
,/ates ,code1 is am5d$--  7#a7 by       
r$esignat+ p>agraph 7#b7 z p>agraph     
7#c72  7#b7 9 p>agraph 7#a77;,b71 by    
/rik+ or at ! end2 &  7#c7 by ins]t+    
aft] p>agraph 7#a7 ! foll[+ new p>agraph
 7#b73  7#b7 ! disability or dea? 0     
caus$ by hospital c>e1 a m$ical s]vice1 
or an ext5d$ c>e s]vice furni%$ ! vet]an
 by a non-,dep>tm5t provid] "u section  
#agjc ( ?is title & ! proximate cause ( 
! disability or dea? 0--  7,a7          
c>elessness1 neglig5ce1 lack ( prop]    
skill1 error 9 judgm5t1 or simil>       
in/ance ( fault on ! "p ( ! provid] 9   
furni%+ ! hospital c>e1 m$ical s]vice1  
or ext5d$ c>e s]vice2 or  7,b7 an ev5t n
 reasonably =eseeable2 or  4  7b7 ,(fset
 ( aw>ds ,su* section is am5d$ by add+  

at ! end ! foll[+ new subsection3  7d7  
,! am\nt ( any judgm5t aw>d$ to an      
individual 9 a civil action br\ght by ! 
individual aga9/ a non-,dep>tm5t provid]
 9 a c\rt ( compet5t jurisdiction = a   
disability or dea? caus$ by hospital    
c>e1 a m$ical s]vice1 or an ext5d$ c>e  
s]vice furni%$ by a non-,dep>tm5t       
provid] z describ$ 9 subsection 7a77#b7 
%all be (fset by ! am\nt ( any          
comp5sation aw>d$ to ! individual "u su*
 subsection = su* disability or dea?4  4
  #ajf4 ,ext5sion ( p]iod = submittal ( 
claims by heal? c>e entities & provid]s 
,section #agjc;,d7b7 ( title #ch1 ,unit$
 ,/ates ,code1 is am5d$ by /rik+ #ahj   
days & ins]t+ "o ye>4  #ajg4 ,program on
 self-ref]ral ( vet]ans = c]ta9 s]vices 
"u ,vet]ans ,community ,c>e ,program    
7a7 ,9 g5]al ,! ,secret>y ( ,vet]ans    
,affairs %all c>ry out a program 79 ?is 
section ref]r$ to z ! ,program7 "u :i* !
 ,secret>y may furni% outpati5t s]vices 
specifi$ 9 subsection 7b7 ?r\gh a heal? 
c>e provid] specifi$ 9 section #agjc7;c7

 ( title #ch1 ,unit$ ,/ates ,code1 to a 
cov]$ vet]an :o--  7#a7 is eligible =   
su* s]vices "u crit]ia to be e/abli%$ by
 ! ,secret>y2 &  7#b7 *ooses to         
self-ref] = su* s]vices4  7b7 ,outpati5t
 s]vices specifi$ ,! outpati5t s]vices  
specifi$ 9 ?is subsection are ! foll[+3 
7#a7 ,vacc9ations4  7#b7 ,vision & he>+ 
s]vices4  7c7 ,conditions "u :i* s]vices
 are provid$ ,! ,secret>y %all provide  
s]vices "u ! ,program "u ! same         
conditions z su* s]vices w\ld be requir$
 to be provid$ "u section #agjc7;d7 (   
title #ch1 ,unit$ ,/ates ,code4  7d7    
,report on program  7#a7 ,9 g5]al ,n    
lat] ?an two ye>s aft] ! date ( !       
enactm5t ( ?is ,act1 & annually !reaft]1
 ! ,secret>y %all submit to ,congress a 
report on ! ,program4  7#b7 ,elem5ts    
,ea* report requir$ "u p>agraph 7#a7    
%all include1 = ! "o-ye> p]iod prec$+ ! 
date ( ! report--  7,a7 ! numb] (       
self-ref]rals made "u ! ,program1       
disaggregat$ by type ( s]vices s\ght2   
7,b7 an assessm5t ( ! timel9ess (       

appo9tm5ts made "u ! ,program z comp>$ )
 ! timel9ess ( o!r appo9tm5ts made = !  
same s]vice2  7,c7 an assessm5t (       
satisfaction ( vet]ans ) ! ,program2    
7,d7 an assessm5t ( ! impact ( !        
,program on ! heal? ( pati5ts receiv+   
s]vices "u ! ,program2 &  7,e7 su*      
recomm5dations z ! ,secret>y may h =    
s]vices to be add$ or remov$ f !        
,program4  7e7 ,effective date ,?is     
section %all take effect on ! date t is 
"o ye> aft] ! date ( ! enactm5t ( ?is   
,act4  7f7 ,cov]$ vet]an def9$ ,9 ?is   
section1 ! t]m cov]$ vet]an means a     
vet]an describ$ 9 section #agjc7;b7 (   
title #ch1 ,unit$ ,/ates ,code4  #ajh4  
,report on ref]rals = non-,dep>tm5t (   
,vet]ans ,affairs heal? c>e ,n lat] ?an 
#ahj days aft] ! date ( ! enactm5t ( ?is
 ,act1 & n less frequ5tly ?an mon?ly    
!reaft]1 ! ,secret>y ( ,vet]ans ,affairs
 %all submit to ! ,committee on         
,vet]ans' ,affairs ( ! ,s5ate & !       
,committee on ,vet]ans' ,affairs ( !    
,h\se ( ,repres5tatives a report        

conta9+1 ) respect to ref]rals =        
non-,dep>tm5t ( ,vet]ans ,affairs heal? 
c>e orig9at+ f m$ical facilities ( !    
,dep>tm5t dur+ ! "o-mon? p]iod prec$+ ! 
date ( ! report1 a measurem5t (1 = ea*  
su* facility ( ! ,dep>tm5t--  7#a7 !    
p]iod ( "t betwe5-- 7,a7 ! date t a     
cl9ician ( ! ,dep>tm5t det]m9es t a     
vet]an requires c>e1 or a vet]an pres5ts
 to ! ,dep>tm5t reque/+ c>e1 & ! date t 
! ref]ral = c>e is s5t to a             
non-,dep>tm5t heal? c>e provid]2  7,b7 !
 date t ! ref]ral = c>e is s5t to a     
non-,dep>tm5t heal? c>e provid] & ! date
 t a non-,dep>tm5t heal? c>e provid]    
accepts ! ref]ral2  7,c7 ! date t a     
non-,dep>tm5t heal? c>e provid] accepts 
! ref]ral & ! date t ! ref]ral to a     
non-,dep>tm5t heal? c>e provid] is      
complet$2  7,d7 ! date t ! ref]ral to a 
non-,dep>tm5t heal? c>e provid] is      
complet$ & ! date t an appo9tm5t ) a    
non-,dep>tm5t heal? c>e provid] is made2
 &  7,e7 ! date t an appo9tm5t ) a      
non-,dep>tm5t heal? c>e provid] is made 

& ! date t an appo9tm5t ) a             
non-,dep>tm5t heal? c>e provid] occurs2 
&  7#b7 any o!r p]iod ( "t t ! ,secret>y
 det]m9es necess>y to measure4  #aji4   
,requirem5t t heal? c>e provid]s "u     
,community ,c>e ,program ( ,dep>tm5t (  
,vet]ans ,affairs provide c]ta9 data    
7a7 ,9 g5]al ,beg9n+ n lat] ?an "o ye>  
aft] ! date ( ! enactm5t ( ?is ,act1 !  
,secret>y ( ,vet]ans ,affairs %all      
require t cov]$ provid]s submit to !    
,secret>y1 at su* "t & 9 su* mann] z !  
,secret>y may require1 data requir$ to  
be collect$ & consid]$ by ! ,secret>y "u
 section #agjc;,c7a77#c7 ( title #ch1   
,unit$ ,/ates ,code4  7b7 ,exclusion (  
cov]$ provid]s ,! ,secret>y may n p]mit 
a cov]$ provid] to p>ticipate 9 !       
,vet]ans ,community ,c>e ,program "u    
section #agjc ( title #ch1 ,unit$ ,/ates
 ,code1 if ! provid] has n provid$ to ! 
,secret>y data requir$ "u subsection    
7a74  7c7 ,o!r provid]s ,! ,secret>y    
%all enc\rage heal? c>e provid]s        
specifi$ 9 section #agjc7;c7 ( title    

#ch1 ,unit$ ,/ates ,code1 t are n cov]$ 
provid]s to submit to ! ,secret>y1 on a 
volunt>y basis1 data describ$ 9         
subsection 7a74  7d7 ,type ( data       
requir$ & waiv]  7#a7 ,type ( data ,!   
,secret>y %all det]m9e ! data requir$ to
 be submitt$ by ea* type ( cov]$ provid]
 "u subsection 7a74  7#b7 ,waiv] ,!     
,secret>y may waive ! requirem5t to     
submit data "u subsection 7a7 = a       
p>ticul> type ( cov]$ provid] if !      
,secret>y det]m9es t ! submittal by t   
type ( provid] ( su* data w\ld--  7,a7 n
 be appropriate or relevant2 or  7,b7   
con/itute too heavy ( a burd5 on !      
provid]4  7e7 ,li/ ( high-,p]=m+        
provid]s ,! ,secret>y %all publi% &     
ma9ta9 on a website ( ! ,dep>tm5t (     
,vet]ans ,affairs t is available to !   
public an up-to-date li/ ( all heal? c>e
 provid]s t-- 7#a7 h provid$ data       
describ$ 9 subsection 7a72 &  7#b7 are  
high-p]=m+ provid]s1 z det]m9$ by !     
,secret>y4  7f7 ,cov]$ provid] def9$ ,9 
?is section1 ! t]m cov]$ provid] means a

 heal? c>e provid] specifi$ 9 section   
#agjc7;c7 ( title #ch1 ,unit$ ,/ates    
,code1 t ! ,secret>y det]m9es has       
suffici5t res\rces to submit ! data     
requir$ "u subsection 7a7 at ! "t & 9 ! 
mann] requir$ by ! ,secret>y "u su*     
subsection4  #aaj4 ,high-compliance rat+
 program = provid]s "u ,vet]ans         
,community ,c>e ,program ( ,dep>tm5t (  
,vet]ans ,affairs  7a7 ,program ,!      
,secret>y ( ,vet]ans ,affairs %all      
e/abli% a program "u :i* ! ,secret>y    
provides a rat+ ( ,high ,compliance =   
community c>e provid]s t comply ) !     
qualifications "u subsection 7b74  7b7  
,provid] qualifications ,! ,secret>y    
%all provide a community c>e provid] ) a
 rat+ ( ,high ,compliance pursuant to ! 
program e/abli%$ "u subsection 7a7 if ! 
provid]--  7#a7 completes c]ta9 cont9u+ 
m$ical education c\rses provid$ by !    
,,vha ,,tra9 program or relat$ to !     
,opioid ,safety ,initiative1 z det]m9$  
by ! ,secret>y2  7#b7 s5ds to ! specific
 au?oriz+ (fice or designat$ ,community 

,c>e ,program (fice ( ! ,vet]ans ,heal? 
,adm9i/ration ! complete m$ical records 
& all requir$ treatm5t docum5tation1 z  
id5tifi$ by ! ,secret>y1 ( n less ?an   
#ie p]c5t ( ! vet]ans treat$ by !       
provid] "u ! ,vet]ans ,community ,c>e   
,program "u section #agjc ( title #ch1  
,unit$ ,/ates ,code1 n lat] ?an #ae days
 aft] ! completion ( treatm5t ( su*     
vet]ans2 &  7#c7 complies ) su* o!r     
crit]ia z ! ,secret>y may det]m9e       
appropriate4  7c7 ,f9ancial inc5tive ,! 
,secret>y may provide a f9ancial        
inc5tive = community c>e provid]s ) a   
,high ,compliance rat+4  7d7 ,program   
promotion ,! ,secret>y %all e/abli% a   
plan to promote ! program e/abli%$ "u   
subsection 7a7 & enc\rage ! p>ticipation
 ( community c>e provid]s 9 su* program4
  7e7 ,publication ( li/  7#a7 ,initial 
publication ,! ,secret>y %all publi% on 
a publicly available website ( !        
,vet]ans ,heal? ,adm9i/ration a li/ (   
community c>e provid]s t e>n a ,high    
,compliance rat+ pursuant to ! program  

e/abli%$ "u subsection 7a74  7#b7       
,update ,! ,secret>y %all update ! li/  
requir$ "u p>agraph 7#a7 n less         
frequ5tly ?an weekly4  7f7 ,report ,n   
lat] ?an "o ye> aft] ! e/abli%m5t ( !   
program "u subsection 7a71 & annually   
!reaft]1 ! ,secret>y %all submit to !   
,committee on ,vet]ans' ,affairs ( !    
,s5ate & ! ,committee on ,vet]ans'      
,affairs ( ! ,h\se ( ,repres5tatives a  
report on ! program1 includ+--  7#a7 !  
c\rses "u ! ,,vha ,,tra9 program or !   
,opioid ,safety ,initiative det]m9$ by !
 ,secret>y = purposes ( subsection      
7b77#a72 &  7#b7 ! /atus ( ! plans ( !  
,secret>y = promotion "u subsection 7c7 
( ! program e/abli%$ "u subsection 7a74 
7g7 ,def9itions ,9 ?is section3 7#a7    
,community c>e provid] ,! t]m community 
c>e provid] means a heal? c>e provid]   
specifi$ 9 subsection 7c7 ( section     
#agjc ( title #ch1 ,unit$ ,/ates ,code1 
t is p>ticipat+ 9 ! ,vet]ans ,community 
,c>e ,program "u su* section4  7#b7     
,opioid ,safety ,initiative ,! t]m      

,opioid ,safety ,initiative means       
programs1 processes1 & guidel9es ( !    
,vet]ans ,heal? ,adm9i/ration relat$ to 
! managem5t ( opioid !rapy & *ronic pa94
  7#c7 ,,vha ,,tra9 program ,! t]m ,,vha
 ,,tra9 program means ! free program ( !
 ,vet]ans ,heal? ,adm9i/ration t (f]s   
vet]an-specific cont9u+ m$ical education
 c\rses1 or successor simil> program4   
#aaa4 ,adoption ( national              
int]op]ability /&>ds betwe5 ,dep>tm5t ( 
,vet]ans ,affairs & community c>e       
provid]s  7a7 ,9 g5]al ,! ,secret>y (   
,vet]ans ,affairs1 9 consultation ) !   
,secret>y ( ,heal? & ,human ,s]vices1 ! 
,adm9i/rator ( ! ,c5t]s = ,m$ic>e       
,m$icaid ,s]vices1 & ! ,national        
,coord9ator = ,heal? ,in=mation         
,te*nology1 %all create & implem5t a    
plan = ! ,dep>tm5t ( ,vet]ans ,affairs  
to adopt national int]op]ability /&>ds =
 ! electronic coord9ation ( c>e &       
transf] ( heal? in=mation 7includ+      
in=mation relat+ to d5tal heal?7 betwe5 
! ,dep>tm5t & community c>e provid]s = !

 purposes ( heal? c>e s*$ul+1           
provision+1 coord9ation1 & quality      
assessm5t4  7b7 ,exceptions &           
accommodations = provid]s ) few] pati5ts
 ,! plan requir$ to be creat$ &         
implem5t$ "u subsection 7a7 %all include
 appropriate exceptions & accommodations
 = community c>e provid]s1 especially   
provid]s 9 rural areas & small]         
provid]s1 :o see few] pati5ts "u ! laws 
adm9i/]$ by ! ,secret>y ( ,vet]ans      
,affairs & :o h n adopt$ electronic     
heal? records to ensure ^? provid]s h ! 
option to %>e heal? in=mation ) !       
,dep>tm5t ( ,vet]ans ,affairs via       
non-electronic me?ods4  7c7 ,reports    
7#a7 ,report on plan ,n lat] ?an "o ye> 
aft] ! date ( ! enactm5t ( ?is ,act1 !  
,secret>y ( ,vet]ans ,affairs %all      
submit to ,congress a report on ! plan  
requir$ "u subsection 7a71 :i* %all     
include-- 7,a7 a gap analysis betwe5    
curr5t int]op]ability /&>ds 9 use betwe5
 ! ,dep>tm5t ( ,vet]ans ,affairs &      
community c>e provid]s & opportunities &

 advancem5ts 9 c>e deliv]y & coord9ation
 & relat$ matt]s us+ available curr5t   
/&>ds & /&>ds "u developm5t )9 ! ,f$]al 
& non-,f$]al heal? c>e sector1 includ+  
an analysis ( p>ticipation by !         
,dep>tm5t & community c>e provid]s 9 !  
,tru/$ ,ex*ange ,framework & ,common    
,agreem5t2  7,b7 recomm5dations = fur!r 
developm5t ( int]op]ability /&>ds2  7,c7
 a propos$ timel9e = adopt+             
int]op]ability /&>ds "u su* plan by bo? 
! ,dep>tm5t & community c>e provid]s2 & 
7,d7 an indication ( any res\rces or    
legislative au?orities ! ,secret>y may  
reque/ f ,congress to develop & implem5t
 adoption ( int]op]ability /&>ds "u su* 
plan4  7#b7 ,report on implem5tation ,n 
lat] ?an #ah mon?s aft] ! date ( !      
enactm5t ( ?is ,act1 & e #ahj days      
!reaft] until ! date t is f\r ye>s aft] 
! date ( ! enactm5t ( ?is ,act1 !       
,secret>y %all submit to ,congress a    
report on ! implem5tation & revision ( !
 plan requir$ "u subsection 7a71 :i*    
%all include--  7,a7 updates on curr5t  

gaps 9 int]op]ability /&>ds 9 use betwe5
 ! ,dep>tm5t & community c>e provid]s & 
recomm5dations = fur!r developm5t ( su* 
/&>ds2 &  7,b7 updates on implem5tation 
( ! plan & adoption ( ! plan by         
community c>e provid]s & ! ,dep>tm5t4   
7d7 ,community c>e provid] def9$ ,9 ?is 
section1 ! t]m community c>e provid]    
means a non-,dep>tm5t heal? c>e provid] 
provid+ c>e 7includ+ d5tal c>e7-- 7#a7  
"u section #agjc ( title #ch1 ,unit$    
,/ates ,code2  7#b7 pursuant to a       
,vet]ans ,c>e ,agreem5t "u section      
#agjc;,a ( su* title2 or  7#c7 "u any   
o!r law adm9i/]$ by ! ,secret>y4  #aab4 
,analysis ( feasibility & advisability (
 e/abli%+ a community c>e network = !   
provision ( c>e to vet]ans 9 ! ,republic
 ( ! ,philipp9es  7a7 ,9 g5]al ,n lat]  
?an "o ye> aft] ! date ( ! enactm5t (   
?is ,act1 ! ,secret>y ( ,vet]ans        
,affairs %all complete an analysis ( !  
feasibility & advisability ( e/abli%+ a 
community c>e network = ! provision (   
c>e to vet]ans 9 ! ,republic ( !        

,philipp9es4  7b7 ,report ,n lat] ?an   
#ahj days aft] ! completion ( ! analysis
 conduct$ "u subsection 7a71 ! ,secret>y
 %all submit to ! ,committee on         
,vet]ans' ,affairs ( ! ,s5ate & !       
,committee on ,vet]ans' ,affairs ( !    
,h\se ( ,repres5tatives a report t      
includes ! foll[+3  7#a7 ,! results (   
su* analysis4  7#b7 ,an assessm5t ( !   
numb] ( vet]ans resid+ 9 ! ,republic ( !
 ,philipp9es :o are eligible = ! ,=eign 
,m$ical ,program4  7#c7 ,an assessm5t ( 
! /aff+ ne$s & associat$ co/s ( e/abli%+
 a community c>e network 9 ! ,republic (
 ! ,philipp9es4  7#d7 ,an assessm5t ( ! 
infra/ructure ne$s & associat$ co/s (   
e/abli%+ a community c>e network 9 !    
,republic ( ! ,philipp9es4  7#e7 ,an    
assessm5t ( ! *all5ges ( e/abli%+ a     
community c>e network 9 ! ,republic ( ! 
,philipp9es4  7#f7 ,an assessm5t ( h[ ! 
,secret>y w\ld det]m9e paym5t rates =   
provid]s p>ticipat+ 9 a community c>e   
network 9 ! ,republic ( ! ,philipp9es to
 acc\nt = v>iances 9 m$ical co/s 9 !    

,republic ( ! ,philipp9es4  7#g7 ,an    
assessm5t ( ! impact ( a community c>e  
network 9 ! ,republic ( ! ,philipp9es on
 ! timel9ess ( reimbursem5t ( provid]s  
"u ! ,=eign ,m$ical ,program4  7#h7 ,su*
 o!r elem5ts z ! ,secret>y consid]s     
appropriate4  7c7 ,=eign ,m$ical        
,program def9$ ,9 ?is section1 ! t]m    
,=eign ,m$ical ,program means ! program 
"u :i* ! ,secret>y ( ,vet]ans ,affairs  
provides hospital c>e & m$ical s]vices  
"u section #agbd ( title #ch1 ,unit$    
,/ates ,code4  #aac4 ,pilot program on  
consolidat+ ! community c>e d5tal       
treatm5t plan approval process (        
,dep>tm5t ( ,vet]ans ,affairs  7a7 ,9   
g5]al ,comm5c+ n lat] ?an #ahj days aft]
 ! date ( ! enactm5t ( ?is ,act1 !      
,secret>y ( ,vet]ans ,affairs %all c>ry 
out a two-ye> pilot program 79 ?is      
section ref]r$ to z ! pilot program7 to 
te/ ! efficacy (--  7#a7 hir+ g5]al     
d5ti/s at ! facility level to manage    
approval by ! ,dep>tm5t ( ,vet]ans      
,affairs ( treatm5t plans reque/$ by    

d5tal provid]s 9 provid+ community c>e2 
&  7#b7 hir+ d5tal speciali/s at !      
,vet]ans ,integrat$ ,s]vice ,network    
level to aid 9 approv+ treatm5t plans = 
specialty d5tal c>e reque/$ by d5tal    
provid]s 9 provid+ community c>e4  7b7  
,locations ,! ,secret>y %all select n   
few] ?an two ,vet]ans ,integrat$ ,s]vice
 ,networks ( ! ,dep>tm5t at :i* to c>ry 
out ! pilot program4  7c7 ,reports  7#a7
 ,initial report ,n lat] ?an "o ye> aft]
 ! comm5cem5t ( ! pilot program1 !      
,secret>y %all submit to ! ,committee on
 ,vet]ans' ,affairs ( ! ,s5ate & !      
,committee on ,vet]ans' ,affairs ( !    
,h\se ( ,repres5tatives a report on !   
pilot program1 includ+--  7,a7 an       
id5tification ( ! ,vet]ans ,integrat$   
,s]vice ,networks p>ticipat+ 9 ! pilot  
program2  7,b7 a description ( !        
implem5tation ( ! pilot program2  7,c7  
an id5tification ( any b>ri]s or        
*all5ges to implem5t+ ! pilot program2  
7,d7 aggregat$ fe$back ) respect to !   
pilot program f d5ti/s ( ! ,dep>tm5t 9  

,vet]ans ,integrat$ ,s]vice ,networks   
p>ticipat+ 9 ! pilot program2 &  7,e7   
aggregat$ fe$back f d5tal provid]s      
provid+ community c>e )9 ,vet]ans       
,integrat$ ,s]vice ,networks p>ticipat+ 
9 ! pilot program reg>d+ any *anges 9 ! 
timel9ess ( treatm5t plan approvals by !
 ,dep>tm5t4  7#b7 ,f9al report ,n lat]  
?an #ij days be=e ! completion ( ! pilot
 program1 ! ,secret>y %all submit to !  
,committee on ,vet]ans' ,affairs ( !    
,s5ate & ! ,committee on ,vet]ans'      
,affairs ( ! ,h\se ( ,repres5tatives a  
report on ! pilot program t--  7,a7     
includes ! matt]s requir$ "u p>agraph   
7#a72  7,b7 includes recomm5dations on  
:e!r ! pilot program %\ld be cont9u$ or 
adopt$ ?r\gh\t ! ,dep>tm5t2 &  7,c7     
indicates :e!r ! ,secret>y reque/s      
action by ,congress to make ! pilot     
program p]man5t4  7d7 ,community c>e    
def9$ ,9 ?is section1 ! t]m community   
c>e means d5tal c>e provid$--  7#a7 "u  
section #agjc ( title #ch1 ,unit$ ,/ates
 ,code2 or  7#b7 pursuant to a ,vet]ans 

,c>e ,agreem5t "u section #agjc;,a ( su*
 title4  #aad4 ,reviews ( paym5t rate   
waiv]s "u ,vet]ans ,community ,c>e      
,program  7a7 ,9 g5]al ,n lat] ?an #ahj 
days aft] ! date ( ! enactm5t ( ?is     
,act1 & annually !reaft]1 ! ,secret>y ( 
,vet]ans ,affairs %all-- 7#a7 conduct a 
review ( paym5t rate waiv]s = ?ird p>ty 
adm9i/rators "u ! ,vet]ans ,community   
,c>e ,program "u section #agjc ( title  
#ch1 ,unit$ ,/ates ,code1 to id5tify    
:e!r ^? waiv]s are help+ to alleviate   
community-specific *all5ges1 includ+    
sc>city ( m$ical s]vices associat$ )    
access to c>e2 &  7#b7 submit to        
,congress a report on ! results ( !     
review4  7b7 ,inclusion 9 rate review   
,ea* review requir$ "u subsection 7a7   
%all include--  7#a7 a review ( ! total 
numb] ( paym5t rate waiv]s reque/$ = ea*
 region1 includ+ ! numb] grant$1 d5i$1  
or )drawn2  7#b7 ! process = review (   
paym5t rate waiv]s2  7#c7 ! av]age "t to
 process paym5t rate waiv]s 9 ea*       
region2  7#d7 ! impact ( paym5t rate    

waiv]s grant$ 9 a region on access to   
c>e 9 t region2 &  7#e7 tr5ds id5tifi$  
by ! ,secret>y ) respect to paym5t rate 
waiv]s4  #aae4 ,comptroll] ,g5]al report
 on d5ti/ry "u ,vet]ans ,community ,c>e 
,program ,n lat] ?an "o ye> 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 d5tal c>e furni%$ by !        
,secret>y ( ,vet]ans ,affairs "u !      
,vet]ans ,community ,c>e ,program "u    
section #agjc ( title #ch1 ,unit$ ,/ates
 ,code1 to include a review (--  7#a7 ! 
impact curr5t reimbursem5t rates provid$
 by ! ,dep>tm5t ( ,vet]ans ,affairs to  
d5tal provid]s "u su* program h on--    
7,a7 ! availability ( d5tal c>e =       
vet]ans2 &  7,b7 ! ability ( ?ird p>ty  
adm9i/rators ( provid] networks "u su*  
program to meet _! contractual          
obligations = network adequacy2  7#b7 ! 
satisfaction ( d5tal provid]s provid+   

d5tal c>e "u su* program ) ! processes (
 ! ,dep>tm5t = approv+ d5tal c>e "u su* 
program2 &  7#c7 ! curr5t processes ( ! 
,dep>tm5t = approv+ em]g5t d5tal c>e "u 
su* program4  ,,ii ,heal? c>e employees 
#bja4 ,e/abli%m5t ( ,/>t & ,/ay at ,,va 
program  7a7 ,9 g5]al ,*apt] #gf ( title
 #ch1 ,unit$ ,/ates ,code1 is am5d$ by  
add+ at ! end ! foll[+ new sub*apt]3  ,x
 ,/>t & ,/ay at ,,va ,program  #gfii;,c4
 ,/>t & ,/ay at ,,va ,program  7a7 ,9   
g5]al ,z "p ( ! ,educational ,assi/ance 
,program1 ! ,secret>y %all c>ry out a   
program "u ?is sub*apt] to provide--    
7#a7 s*ol>%ips "u section #gfii;,c-#a ( 
?is title2 &  7#b7 lump sum education   
debt r$uction "u section #gfii;,c-#b (  
?is title4  7b7 ,"n ( program ,! program
 "u ?is sub*apt] %all be kn[n z ! ,/>t &
 ,/ay at ,,va ,program 79 ?is sub*apt]  
ref]r$ to z ! ,program74  #gfii;,c-#a4  
,s*ol>%ips  7a7 ,cov]$ co/s ,a s*ol>%ip 
provid$ to an individual "u ! ,program  
%all consi/ ( paym5t ( reasonable       
education exp5ses ( ! individual = a    

c\rse ( education or tra9+ describ$ 9   
subsection 7b77#c71 includ+ tuition1    
fees1 books1 & laboratory exp5ses4  7b7 
,eligibility ,an individual is eligible 
to receive a s*ol>%ip "u ! ,program if !
 individual--  7#a7 is an employee ( !  
,dep>tm5t s]v+ z a m$ical support       
assi/ant1 advanc$ m$ical support        
assi/ant1 lead m$ical support assi/ant1 
or sup]visory m$ical support assi/ant2  
7#b7 z ( ! date on :i* ! individual     
submits an application = p>ticipation 9 
! ,program1 has be5 cont9u\sly employ$  
by ! ,dep>tm5t 9 "o or m ( ! positions  
specifi$ 9 p>agraph 7#a7 = a p]iod ( n  
less ?an two ye>s2  7#c7 has be5 accept$
 = enrollm5t or is enroll$ z a /ud5t 9 a
 c\rse ( education or tra9+-- 7,a7 li/$ 
z a requirem5t = any %ortage occupation 
position1 z det]m9$ by ! ,secret>y2     
7,b7 relat$ to bus9ess1 heal? c>e       
adm9i/ration1 or human res\rces2 or     
7,c7 completion ( :i* results 9 any o!r 
degree or c]tification t ! ,secret>y    
consid]s appropriate = purposes ( !     

,program2 &  7#d7 has a record (        
employm5t ) ! ,dep>tm5t t1 9 ! judgm5t (
 ! ,secret>y1 demon/rates a high        
likelihood t ! individual w be          
successful 9 complet+ su* c\rse (       
education or tra9+ & 9 ga9+ employm5t 9 
a field relat$ to su* c\rse ( education 
or tra9+4  7c7 ,p]iod ( obligat$ s]vice 
7#a7 ,agreem5t  7,a7 ,9 g5]al ,an       
agreem5t betwe5 ! ,secret>y & a         
p>ticipant "u ! ,program :o seeks a     
s*ol>%ip "u ?is section1 9 addition to !
 requirem5ts set =? 9 section #gfjd (   
?is title1 %all include ! foll[+3  7i7  
,! agreem5t ( ! ,secret>y to provide !  
p>ticipant ) a s*ol>%ip "u ! ,program = 
a specifi$ numb] ( s*ool ye>s1 :i* may n
 exce$ ! cr$it equival5t ( f\r full     
s*ool ye>s1 dur+ :i* ! p>ticipant       
pursues a c\rse ( education or tra9+    
describ$ 9 subsection 7b77#c7 t meets ! 
requirem5ts set =? 9 section #gfjb7;a7 (
 ?is title4  7ii7 ,subject to           
subp>agraph 7,b71 ! agreem5t ( !        
p>ticipant to s]ve z a full-"t employee 

9 ! ,dep>tm5t 9 a position describ$ 9   
subsection 7b77#c77;,a7 = a p]iod ( "t1 
n less ?an "o ye>1 t is equal to ! p]iod
 ( ! c\rse ( education or tra9+ = :i* a 
s*ol>%ip is provid$ "u ?is section 79   
?is section ref]r$ to z ! p]iod (       
obligat$ s]vice ( ! p>ticipant74  7,b7  
,"p-"t /ud5ts ,9 ! case ( a p>ticipant  
:o is a "p-"t /ud5t dur+ a s*ool ye> )  
respect to :i* a s*ol>%ip is provid$ to 
! p>ticipant "u ?is section1 ! p]iod (  
obligat$ s]vice ( ! p>ticipant incurr$  
dur+ t s*ool ye> %all be r$uc$ 9        
accordance ) ! proportion t ! numb] (   
cr$it h\rs c>ri$ by ! p>ticipant 9 t    
s*ool ye> be>s to ! numb] ( cr$it h\rs  
requir$ to be c>ri$ by a full-"t /ud5t 9
 ! c\rse ( education or tra9+ pursu$ by 
! p>ticipant dur+ t s*ool ye>1 b 9 no   
ev5t may ! total p]iod ( obligat$ s]vice
 ( ! p>ticipant be r$uc$ to less ?an "o 
ye>4  7#b7 ,s]vice comm5cem5t date  7,a7
 ,9 g5]al ,except z provid$ 9           
subp>agraph 7,f7 ( 7,g71 n lat] ?an #fj 
days be=e ! s]vice comm5cem5t date ( a  

p>ticipant "u ?is section1 ! ,secret>y  
%all notify ! p>ticipant ( t s]vice     
comm5cem5t date4 ,t date is ! beg9n+ ( !
 p]iod ( obligat$ s]vice ( ! p>ticipant4
  7,b7 ,doctors & simil> heal? c>e      
pr(essionals ,9 ! case ( a p>ticipant   
receiv+ a degree f a s*ool ( m$ic9e1    
o/eopa?y1 d5ti/ry1 optometry1 or        
podiatry1 ! s]vice comm5cem5t date ( !  
p>ticipant is ! date ! p>ticipant       
becomes lic5s$ to practice m$ic9e1      
o/eopa?y1 d5ti/ry1 optometry1 or        
podiatry1 z ! case may be1 9 a ,/ate4   
7,c7 ,nurses ,9 ! case ( a p>ticipant   
receiv+ a degree f a s*ool ( nurs+1 !   
s]vice comm5cem5t date ( ! p>ticipant is
 ! lat] (--  7i7 ! c\rse completion date
 ( ! p>ticipant2 or  7ii7 ! date !      
p>ticipant becomes lic5s$ z a regi/]$   
nurse 9 a ,/ate4  7,d7 ,o!r heal? c>e   
pr(essionals ,9 ! case ( a p>ticipant n 
cov]$ by subp>agraph 7,b7 or 7,c71 !    
s]vice comm5cem5t date ( ! p>ticipant is
 ! lat] (-- 7i7 ! c\rse completion date 
( ! p>ticipant2 or  7ii7 ! date !       

p>ticipant meets any applicable lic5sure
 or c]tification requirem5ts4  7,e7     
,treatm5t ( "p-"t /ud5ts ,! ,secret>y   
%all specify ! s]vice comm5cem5t date = 
p>ticipants :o 7 "p-"t /ud5ts1 :i* %all 
include t]ms z simil> z practicable to !
 t]ms set =? 9 subp>agraphs 7,b7 ?r\gh  
7,d74  7,f7 ,s]vice dur+ c\rse (        
education or tra9+ ,a p>ticipant may    
s]ve ! p]iod ( obligat$ s]vice ( !      
p>ticipant1 or any portion ( su* p]iod (
 obligat$ s]vice1 dur+ ! p]iod 9 :i* !  
p>ticipant is enroll$ z a /ud5t 9 a     
c\rse ( education or tra9+ "u subsection
 7b77#c7 if ! p>ticipant is employ$ 9 a 
position describ$ 9 subp>agraph 7,a7 (  
su* subsection4  7,g7 ,s]vice foll[+    
lic5sure or ongo+ tra9+ ,) respect to a 
p>ticipant :o is lic5s$ b may ent] a    
resid5cy or simil> tra9+ program1 !     
,secret>y may adju/ ! beg9n+ ( ! p]iod (
 obligat$ s]vice ( ! p>ticipant to beg9 
foll[+ completion ( ! resid5cy or simil>
 tra9+ program4  7,h7 ,c\rse completion 
date def9$ ,9 ?is section1 ! t]m c\rse  

completion date means ! date on :i* a   
p>ticipant "u ?is section completes !   
c\rse ( education or tra9+ ( !          
p>ticipant "u ?is section4  7d7         
,liability = brea* ( agreem5t  7#a7     
,liability dur+ c\rse ( education or    
tra9+  7,a7 ,9 g5]al ,except z provid$ 9
 p>agraph 7#c71 a p>ticipant "u ?is     
section %all be liable to ! ,unit$      
,/ates = ! am\nt t has be5 paid to or on
 behalf ( ! p>ticipant "u ! agreem5t "u 
subsection 7c77#a7 if any ( ! foll[+    
occurs3  7i7 ,! p>ticipant fails to     
ma9ta9 an acceptable level ( academic   
/&+ 9 ! educational in/itution 9 :i* !  
p>ticipant is enroll$ 7z det]m9$ by !   
educational in/itution pursuant to      
direction by ! ,secret>y74  7ii7 ,!     
p>ticipant is dismiss$ f su* educational
 in/itution = discipl9>y reasons4  7iii7
 ,! p>ticipant volunt>ily t]m9ates !    
c\rse ( education or tra9+ 9 su*        
educational in/itution be=e ! completion
 ( su* c\rse ( education or tra9+4  7iv7
 ,! p>ticipant1 z applicable1 dur+ a    

p]iod ( "t det]m9$ by ! ,secret>y--     
7,i7 fails to become lic5s$ to practice 
m$ic9e1 o/eopa?y1 d5ti/ry1 podiatry1 or 
optometry 9 a ,/ate2  7,,ii7 fails to   
become lic5s$ z a regi/]$ nurse 9 a     
,/ate2 or  7,,iii7 9 ! case ( any o!r   
heal?-c>e p]sonnel :o is n cov]$ "u     
subclause 7,i7 or 7,,ii71 fails to meet 
any applicable lic5sure or c]tification 
requirem5t4  7,b7 ,9 lieu ( s]vice      
obligation ,liability "u ?is p>agraph is
 9 lieu ( any p]iod ( obligat$ s]vice   
aris+ "u ! agreem5t ( ! p>ticipant "u   
subsection 7c77#a74  7#b7 ,liability    
dur+ p]iod ( obligat$ s]vice ,except z  
provid$ 9 p>agraph 7#c71 if a p>ticipant
 "u ?is section brea*es ! agreem5t "u   
subsection 7c77#a7 by fail+ = any reason
 to complete ! p]iod ( obligat$ s]vice (
 ! p>ticipant1 ! ,unit$ ,/ates %all be  
entitl$ to recov] f ! p>ticipant an     
am\nt equal to-- 7,a7 ! total am\nt paid
 "u ?is section to ! p>ticipant2        
multipli$ by  7,b7 a fraction-- 7i7 !   
num]ator ( :i* is--  7,i7 ! total numb] 

( mon?s 9 ! p]iod ( obligat$ s]vice ( ! 
p>ticipant2 m9us  7,,ii7 ! numb] ( mon?s
 s]v$ by ! p>ticipant2 &  7ii7 !        
d5om9ator ( :i* is ! total numb] ( mon?s
 9 ! p]iod ( obligat$ s]vice ( !        
p>ticipant4  7#c7 ,limitation on        
liability = r$uction 9 =ce ,liability   
%all n arise "u p>agraph 7#a7 or 7#b7 9 
! case ( a individual cov]$ by ei!r su* 
p>agraph if ! individual does n obta91  
or fails to ma9ta91 employm5t z an      
employee ( ! ,dep>tm5t due to /aff+     
*anges approv$ by ! ,secret>y4  7e7     
,paym5t ( am\nts & limitations  7#a7    
,total am\nt = a s*ool ye> ,! total     
am\nt ( a s*ol>%ip payable to a         
p>ticipant "u ?is section-- 7,a7 may n  
exce$ #bj1jjj = ! equival5t ( "o ye> (  
full-"t c\rsework 9 a c\rse ( education 
or tra9+2 or  7,b7 9 ! case ( a         
p>ticipant :o is a "p-"t /ud5t1 may n   
exce$ an am\nt t be>s ! same ratio to ! 
am\nt t w\ld be paid "u subp>agraph 7,a7
 if ! /ud5t 7 a full-"t /ud5t 9 ! c\rse 
( education or tra9+ be+ pursu$ by !    

p>ticipant z ! c\rsework c>ri$ by !     
p>ticipant comp>es to full-"t c\rsework 
9 t c\rse ( education or tra9+4  7#b7   
,maximum numb] ( s*ool ye>s  7,a7 ,total
 ye>s ,! numb] ( s*ool ye>s = :i* a     
s*ol>%ip may be paid to a p>ticipant "u 
?is section may n exce$ eight s*ool     
ye>s4  7,b7 ,full-"t equival5t ,a       
p>ticipant may n receive a s*ol>%ip "u  
?is section = m ?an ! equival5t ( f\r   
ye>s ( full-"t c\rsework4  7#c7 ,maximum
 total am\nt ,! total am\nt paid to or  
on behalf ( a p>ticipant ?r\gh a        
s*ol>%ip "u ?is section may n exce$     
#hj1jjj4  7#d7 ,paym5t ( educational    
exp5ses by educational in/itutions ,!   
,secret>y may arrange ) an educational  
in/itution 9 :i* a p>ticipant "u ?is    
section is enroll$ = ! paym5t (         
education exp5ses "u subsection 7a74    
,su* paym5ts may be made )\t reg>d to   
subsections 7a7 & 7b7 ( section #ccbd ( 
title #ca4  #gfii;,c-#b4 ,lump sum      
education debt r$uction  7a7 ,cov]$ co/s
 ,lump sum education debt r$uction      

provid$ by ! ,secret>y "u ?is section to
 an individual %all consi/ ( paym5t (   
pr9cipal & int]e/ "u a loan1 ! proce$s (
 :i* 7 us$ by or on behalf ( t          
individual to pay co/s relat+ to a c\rse
 ( education or tra9+1 includ+ tuition  
exp5ses & o!r reasonable educational    
exp5ses1 includ+ fees1 books1 laboratory
 exp5ses1 & reasonable liv+ exp5ses4    
7b7 ,eligibility ,an individual is      
eligible to receive lump sum education  
debt repaym5t "u ?is section if !       
individual-- 7#a7 owes any am\nt (      
pr9cipal & int]e/ "u a loan1 ! proce$s (
 :i* 7 us$ by or on behalf ( t          
individual to pay co/s relat+ to a c\rse
 ( education or tra9+2  7#b7 commits to 
a p]iod ( obligat$ s]vice "u subsection 
7d72 &  7#c7 has be5 (f]$ employm5t 9 ! 
,dep>tm5t 9 ! position ( a m$ical       
support assi/ant1 advanc$ m$ical support
 assi/ant1 lead m$ical support assi/ant1
 or sup]visory m$ical support assi/ant4 
7c7 ,paym5ts  7#a7 ,9 g5]al ,a lump sum 
education debt r$uction paym5t "u ?is   

section %all consi/ ( a paym5t to a     
p>ticipant "u ?is section ( an am\nt n  
to exce$ ! less] (-- 7,a7 ! pr9cipal &  
int]e/ on loans describ$ 9 subsection   
7a7 t is out/&+ = su* p>ticipant at ! "t
 ( ! paym5t2 or  7,b7 #dj1jjj4  7#b7    
,pro( ( use ( am\nts ,p>ticipants "u ?is
 section 9 receipt ( a lump sum         
education debt r$uction paym5t "u ?is   
section mu/ provide pro( ( paym5t v]ify+
 ! full lump sum paym5t receiv$ 0 paid  
to ! l5d] = ! loan held by su*          
p>ticipant n lat] ?an #de days aft]     
receiv+ ! lump sum paym5t4  7d7 ,p]iod (
 obligat$ s]vice  7#a7 ,9 g5]al ,9      
ex*ange = a "o-"t lump sum education    
debt paym5t "u ?is section1 a p>ticipant
 "u ?is section %all agree to be employ$
 = n less ?an ?ree ye>s at ! ,dep>tm5t  
79 ?is section ref]r$ to z ! p]iod (    
obligat$ s]vice74  7#b7 ,positions (    
employm5t  7,a7 ,m$ical support ,n few] 
?an two ( ! ye>s ( ! p]iod ( obligat$   
s]vice ( a p>ticipant "u ?is section    
%all be s]v$ 9 ! position ( m$ical      

support assi/ant1 advanc$ m$ical support
 assi/ant1 lead m$ical support assi/ant1
 or sup]visory m$ical support assi/ant (
 ! ,dep>tm5t4  7,b7 ,h>d-to-hire or     
h>d-to-recruit ,! rema9d] ( any p]iod ( 
obligat$ s]vice n cov]$ "u subp>agraph  
7,a7 %all be s]v$ 9 a h>d-to-hire or    
h>d-to-recruit position z det]m9$ by !  
,secret>y4  7e7 ,liability dur+ p]iod ( 
obligat$ s]vice  7#a7 ,9 g5]al ,except z
 provid$ 9 p>agraph 7#b71 if a          
p>ticipant "u ?is section fails to      
complete ! p]iod ( obligat$ s]vice ( !  
p>ticipant = any reason1 ! ,unit$ ,/ates
 %all be entitl$ to recov] f !          
p>ticipant an am\nt equal to--  7,a7 !  
total am\nt paid "u ?is section to !    
p>ticipant2 multipli$ by  7,b7 a        
fraction--  7i7 ! num]ator ( :i* is--   
7,i7 ! total numb] ( mon?s 9 ! p]iod (  
obligat$ s]vice ( ! p>ticipant2 m9us    
7,,ii7 ! numb] ( mon?s s]v$ by !        
p>ticipant2 &  7ii7 ! d5om9ator ( :i* is
 ! total numb] ( mon?s 9 ! p]iod (      
obligat$ s]vice ( ! p>ticipant4  7#b7   

,exception ,liability %all n arise "u   
p>agraph 7#a7 9 ! case ( an individual  
cov]$ by t p>agraph if ! individual does
 n obta91 or fails to ma9ta91 employm5t 
z an employee ( ! ,dep>tm5t due to /aff+
 *anges approv$ by ! ,secret>y4         
#gfii;,c-#c4 ,adm9i/ration  7a7 ,outrea*
  7#a7 ,9 g5]al ,! ,secret>y %all       
develop an outrea* program to ,tribal   
,colleges & ,univ]sities1 hi/orically   
,black colleges & univ]sities1 high     
s*ools 9 rural areas1 community         
colleges1 transition assi/ance programs 
= memb]s ( ! ,arm$ ,=ces transition+ to 
civilian life1 & sp\ses ( su* memb]s to 
provide in=mation ab\t ! ,program4  7#b7
 ,tribal ,college or ,univ]sity def9$ ,9
 ?is subsection1 ! t]m ,tribal ,college 
or ,univ]sity has ! mean+ giv5 t t]m "u 
section #caf ( ! ,high] ,education ,act 
( #aife 7#bj ,u4,s4,c4 #ajei;c74  7b7   
,m5tors ,! ,secret>y %all ensure t a    
m5tor or m5tors are available = ea*     
individual p>ticipat+ 9 ! ,program at ! 
facility at :i* ! individual is employ$4

  #gfii;,c-#d4 ,limitation ,no          
individual may receive bo? a s*ol>%ip "u
 section #gfii;,c-#a ( ?is title & a    
lump sum education debt r$uction "u     
section #gfii;,c-#b ( ?is title4        
#gfii;,c-#e4 ,t]m9ation ,! au?ority to  
c>ry out ! ,program %all t]m9ate on !   
date t is #aj ye>s aft] ! date ( !      
enactm5t ( ! ,mak+ ,community ,c>e ,"w =
 ,vet]ans ,act ( #bjbc4  4  7b7 ,cl]ical
 am5dm5t ,! table ( sections at ! beg9n+
 ( su* *apt] is am5d$ by add+ at ! end !
 foll[+3  ,,sub*apt] ,x--,/>t & ,/ay at 
,,va ,program ,sec4 #gfii;,c4 ,/>t &    
,/ay at ,,va ,program4 #gfii;,c-#a4     
,s*ol>%ips4 #gfii;,c-#b4 ,lump sum      
education debt r$uction4 #gfii;,c-#c4   
,adm9i/ration4 #gfii;,c-#d4 ,limitation4
 #gfii;,c-#e4 ,t]m9ation4  4  7c7       
,con=m+ am5dm5ts  7#a7 ,e/abli%m5t (    
program ,section #gfja7;a7 ( su* title  
is am5d$--  7,a7 9 p>agraph 7#f71 by    
/rik+ &2  7,b7 9 p>agraph 7#g71 by /rik+
 ! p]iod & ins]t+ 2 &2 &  7,c7 by add+  
at ! end ! foll[+ new p>agraph3  7#h7 ! 

program to provide s*ol>%ips & lump sum 
education debt r$uction provid$ = 9     
sub*apt] ,x ( ?is *apt]4  4  7#b7       
,eligibility ,section #gfjb ( su* title 
is am5d$-- 7,a7 9 subsection 7a77#a7--  
7i7 by /rik+ or ,,ix & ins]t+ ,,ix1 or  
,x2  7ii7 by /rik+ or = :i* a s*ol>%ip &
 ins]t+ = :i* a s*ol>%ip2 &  7iii7 by   
ins]t+ or = :i* a s*ol>%ip or lump sum  
education debt r$uction may be provid$  
"u sub*apt] ,x ( ?is *apt]1 be=e z !    
case may be2 &  7,b7 9 subsection 7b71  
by /rik+ or ,,ix & ins]t+ ,,ix1 or ,x4  
7#c7 ,application ,section #gfjc7;a77#a7
 ( su* title is am5d$ by /rik+ or ,,ix &
 ins]t+ ,,ix1 or ,x4  7#d7 ,t]ms (      
agreem5t ,section #gfjd ( su* title is  
am5d$ by /rik+ or ,,ix ea* place x      
appe>s & ins]t+ ,,ix1 or ,x4  7#e7      
,annual report ,section #gfcb ( su*     
title is am5d$-- 7,a7 9 p>agraph 7#a71  
by /rik+ & ! ,readju/m5t ,c\nsel+       
,s]vice ,s*ol>%ip ,program & ins]t+ !   
,readju/m5t ,c\nsel+ ,s]vice ,s*ol>%ip  
,program1 & ! ,/>t & ,/ay at ,,va       

,program2 &  7,b7 9 p>agraph 7#d71 by   
/rik+ & p] p>ticipant 9 ! ,readju/m5t   
,c\nsel+ ,s]vice ,s*ol>%ip ,program &   
ins]t+ p] p>ticipant 9 ! ,readju/m5t    
,c\nsel+ ,s]vice ,s*ol>%ip ,program1 &  
p] p>ticipant 9 ! ,/>t & ,/ay at ,,va   
,program4  #bjb4 ,expansion ( p]iod (   
paym5t "u ,employee ,inc5tive ,s*ol>%ip 
,program ,section #gfgc7;c7 ( title #ch1
 ,unit$ ,/ates ,code1 is am5d$--  7#a7 9
 p>agraph 7#a7 by /rik+ six & ins]t+    
eight2 &  7#b7 9 p>agraph 7#b7 by /rik+ 
?ree & ins]t+ f\r4  #bjc4 ,m5tor%ip     
program = executive lead]%ip teams at   
m$ical c5t]s ( ! ,dep>tm5t ( ,vet]ans   
,affairs  7a7 ,9 g5]al ,! ,secret>y (   
,vet]ans ,affairs may e/abli% a program 
to connect cov]$ individuals 79 ?is     
section ref]r$ to z m5tees7 ) pe] m5tors
 to facilitate %>+ ( be/ practices &    
lead]%ip exp]i5ces & to fo/]            
opportunities to develop k & skills     
requir$ to lead successfully at m$ical  
facilities ( ! ,dep>tm5t 79 ?is section 
ref]r$ to z ! m5tor%ip program74  7b7   

,cov]$ individual def9$ ,9 ?is section1 
! t]m cov]$ individual means--  7#a7 an 
individual 9 ! position ( ,facility     
,director1 ,*ief ( ,/aff1 ,associate    
,director ( ,pati5t ,c>e ,s]vices1      
,associate ,director1 ,assi/ant         
,director1 or ,deputy ,director at a    
m$ical c5t] ( ! ,dep>tm5t2 or  7#b7 any 
o!r employee ( ! ,dep>tm5t :o is det]m9$
 by ! ,secret>y to be an executive lead]
 at a m$ical c5t] ( ! ,dep>tm5t4  7c7   
,eligibility ,! foll[+ employees ( !    
,dep>tm5t are eligible = p>ticipation z 
m5tees 9 ! m5tor%ip program3 7#a7 ,an   
employee appo9t$ to a position z a cov]$
 individual on or aft] ! date ( !       
enactm5t ( ?is ,act4  7#b7 ,a cov]$     
individual employ$ at a m$ical c5t] ( ! 
,dep>tm5t 7reg>dless ( appo9tm5t        
comm5cem5t date7 t meets "o or m ( !    
foll[+ crit]ia3 7,a7 ,reports poor      
p]=mance1 z def9$ by ! ,secret>y1 on !  
,/rategic ,analytics = ,improvem5t &    
,le>n+ ,value ,model ( ! ,dep>tm5t1 or  
successor simil> model4  7,b7 ,reports  

data "u section #agjc;,c7a77#c7 ( title 
#ch1 ,unit$ ,/ates ,code1 z publi%$ on !
 ,access to ,c>e website ( ! ,dep>tm5t1 
or successor simil> website1 t-- 7i7    
does n consi/5tly meet ! level report$ 9
 ! community surr\nd+ su* m$ical c5t]1 z
 det]m9$ by ! ,secret>y2 or  7ii7 does n
 meet a ?re%old level det]m9$ by !      
,secret>y4  7,c7 ,has "o or m           
recomm5dations f a report by ! ,(fice ( 
,inspector ,g5]al ( ! ,dep>tm5t (       
,vet]ans ,affairs t is /ill op5 m ?an "o
 ye> aft] ! report 0 publi%$4  7#c7 ,a  
cov]$ individual employ$ at a m$ical    
c5t] ( ! ,dep>tm5t 7reg>dless (         
appo9tm5t comm5cem5t date7 :o is        
recomm5d$ by ! director ( ! ,vet]ans    
,integrat$ ,s]vice ,network ov]see+ su* 
m$ical c5t]4  7d7 ,crit]ia = pe] m5tors 
,ea* pe] m5tor to be pair$ ) a m5tee "u 
subsection 7a7 %all meet ea* ( ! foll[+ 
crit]ia3  7#a7 ,previ\s or curr5t       
employm5t 9 ! same position title z !   
m5tee4  7#b7 ,employm5t 9 t position = n
 less ?an two ye>s4  7#c7 ,employm5t at 

a m$ical c5t] ( ! ,dep>tm5t t reports-- 
7,a7 above av]age p]=mance1 z def9$ by !
 ,secret>y1 on ! ,/rategic ,analytics = 
,improvem5t & ,le>n+ ,value ,model ( !  
,dep>tm5t1 or successor simil> model2 & 
7,b7 data "u section #agjc;,c7a77#c7 (  
title #ch1 ,unit$ ,/ates ,code1 z       
publi%$ on ! ,access to ,c>e website ( !
 ,dep>tm5t1 or successor simil> website1
 t exce$s ! level report$ 9 ! community 
surr\nd+ su* m$ical c5t]1 z det]m9$ by !
 ,secret>y4  7e7 ,report ,n lat] ?an "o 
ye> aft] ! date ( ! enactm5t ( ?is ,act1
 & annually !reaft] = an additional ?ree
 ye>s1 ! ,secret>y %all submit to !     
,committee on ,vet]ans' ,affairs ( !    
,s5ate & ! ,committee on ,vet]ans'      
,affairs ( ! ,h\se ( ,repres5tatives a  
report on ! m5tor%ip program1 includ+-- 
7#a7 ! numb] ( m5tees & pe] m5tors      
p>ticipat+ 9 ! m5tor%ip program1        
disaggregat$ by m$ical c5t] ( !         
,dep>tm5t2  7#b7 ! numb] ( m5tor-m5tee  
pair+s initiat$ "u ea* ( ! eligibility  
crit]ia outl9$ 9 p>agraphs 7#a71 7#b71 &

 7#c7 ( subsection 7c71 includ+         
in=mation on any circum/ances 9 :i*     
multiple crit]ia "u su* p>agraphs 7 met2
  7#c7 a description ( ! actions tak5 by
 ! ,dep>tm5t to enc\rage communication  
betwe5 m5tees & pe] m5tors2  7#d7       
aggregat$ fe$back f p>ticipants 9 !     
m5tor%ip program2 &  7#e7 ! turnov] rate
 = cov]$ individuals4  ,,iii ,o!r heal? 
c>e matt]s  #cja4 ,tim+ = s*$ul+ (      
appo9tm5ts at facilities ( ,dep>tm5t (  
,vet]ans ,affairs  7a7 ,9 g5]al         
,sub*apt] ,i ( *apt] #ag ( title #ch1   
,unit$ ,/ates ,code1 is am5d$ by ins]t+ 
aft] section #agjf;,a ! foll[+ new      
section3  #agjf;,b4 ,requirem5ts = tim+ 
( s*$ul+ ( appo9tm5ts at ,dep>tm5t      
facilities ,! ,secret>y %all ensure t an
 appo9tm5t = a vet]an = c>e or s]vices  
"u ?is *apt] f a facility ( !           
,dep>tm5t-- 7#a7 9 ! case ( a non-urg5t 
appo9tm5t1 is s*$ul$ 7b may occur at a  
lat] date7 n lat] ?an sev5 days aft] !  
e>li] ( ! date on :i*--  7,a7 a cl9ician
 ( ! ,dep>tm5t det]m9es t ! vet]an      

requires c>e2 or  7,b7 ! vet]an pres5ts 
to ! ,dep>tm5t reque/+ c>e2 &  7#b7 9 ! 
case ( an appo9tm5t = urg5t c>e1 is     
complet$ n lat] ?an #dh h\rs aft] !     
e>li] ( ! date on :i*-- 7,a7 a cl9ician 
( ! ,dep>tm5t det]m9es t ! vet]an       
requires c>e2 or  7,b7 ! vet]an pres5ts 
to ! ,dep>tm5t reque/+ c>e4  4  7b7     
,cl]ical am5dm5t ,! table ( sections at 
! beg9n+ ( su* sub*apt] is am5d$ by     
ins]t+ aft] ! item relat+ to section    
#agjf;,a ! foll[+ new item3  #agjf;,b4  
,requirem5ts = tim+ ( s*$ul+ (          
appo9tm5ts at ,dep>tm5t facilities4  4  
7c7 ,effective date ,! ,secret>y (      
,vet]ans ,affairs %all comply ) !       
requirem5ts "u section #agjf;,b ( title 
#ch1 ,unit$ ,/ates ,code1 z add$ by     
subsection 7a71 by n lat] ?an #ahj days 
aft] ! date ( ! enactm5t ( ?is ,act4    
#cjb4 ,modification ( requirem5ts =     
/&>ds = quality ( c>e f ,dep>tm5t (     
,vet]ans ,affairs  7a7 ,9 g5]al         
,subsection 7a7 ( section #agjc;,c (    
title #ch1 ,unit$ ,/ates ,code1 is      

am5d$--  7#a7 9 p>agraph 7#b7-- 7,a7 by 
/rik+ ,9 e/abli%+ & ins]t+ 7,a7 ,9      
e/abli%+2 &  7,b7 by add+ at ! end !    
foll[+ new subp>agraph3  7,b7 ,!        
,secret>y %all ensure t ! /&>ds =       
quality e/abli%$ "u p>agraph 7#a7 are   
comp>able to indu/ry /&>ds to ensure !re
 is adequate data transf]5ce betwe5 c>e 
furni%$ by ! ,dep>tm5t & c>e furni%$ by 
a non-,dep>tm5t provid]4  2  7#b7 9     
p>agraph 7#c7-- 7,a7 9 subp>agraph 7,a71
 by /rik+ 2 & & ins]t+ a semicolon2     
7,b7 9 subp>agraph 7,b7-- 7i7 9 ! matt] 
prec$+ clause 7i71 by /rik+ to ! foll[+3
 & ins]t+ to--2  7ii7 9 clause 7i7--    
7,i7 by /rik+ ,timely & ins]t+ timely2 &
  7,,ii7 by /rik+ ! p]iod at ! end &    
ins]t+ a semicolon2  7iii7 9 clause     
7ii7--  7,i7 by /rik+ ,effective &      
ins]t+ effective2 &  7,,ii7 by /rik+ !  
p]iod at ! end & ins]t+ a semicolon2    
7iv7 9 clause 7iii7-- 7,i7 by /rik+     
,safety & ins]t+ safety2 &  7,,ii7 by   
/rik+ ! p]iod at ! end & ins]t+ a       
semicolon2  7v7 9 clause 7iv7--  7,i7 by

 /rik+ ,effici5cy & ins]t+ effici5cy2 & 
7,,ii7 by /rik+ ! p]iod at ! end &      
ins]t+ 2 &2 &  7vi7 by add+ at ! end !  
foll[+ new clause3  7v7 equitable c>e2 &
  2 &  7,c7 by add+ at ! end ! foll[+   
new subp>agraph3  7,c7 measurem5ts (    
/&>ds = quality t include measurem5ts   
(--  7i7 ! degree to :i* c>e is furni%$ 
uniquely to pati5t ne$s2  7ii7 work=ce  
safety2  7iii7 employee engagem5t2  7iv7
 safety culture2  7v7 outcomes on pati5t
 quality ( life2 &  7vi7 su* o!r matt]s 
z ! ,secret>y consid]s appropriate4  2  
7#c7 9 p>agraph 7#d71 by /rik+ & !      
,c5t]s = ,m$ic>e  ,m$icaid ,s]vices &   
ins]t+ ! ,c5t]s = ,m$ic>e  ,m$icaid     
,s]vices1 & ! ,indian ,heal? ,s]vice2 & 
7#d7 by /rik+ p>agraph 7#e7 & ins]t+ !  
foll[+ new p>agraphs3  7#e7 ,:5         
collect+1 consid]+1 & apply+ data relat$
 to pati5t c>e = purposes ( e/abli%+    
/&>ds = quality "u p>agraph 7#a71 !     
,secret>y %all ensure no metric is be+  
ov] or "u analyz$4  7#f7 ,9 e/abli%+    
/&>ds = quality "u p>agraph 7#a71 !     

,secret>y %all--  7,a7 utilize ! mo/    
curr5t practices 9 extract+ & analyz+   
relevant data2  7,b7 utilize all        
relevant data available to ! ,secret>y2 
7,c7 ensure ! mo/ effici5t use ( "t &   
res\rces relat$ to ! use ( data sci5ti/s
 employ$ by ! ,dep>tm5t2 &  7,d7        
collaborate1 z appropriate1 ) entities  
specifi$ 9 p>agraph 7#d74  7#g7  7,a7 ,n
 lat] ?an five ye>s aft] ! submittal ( !
 report requir$ by section              
#cjb7;d77#b77;,b7 ( ! ,mak+ ,community  
,c>e ,"w = ,vet]ans ,act ( #bjbc1 & n   
less frequ5tly ?an once e five ye>s     
!reaft]1 ! ,secret>y %all update ! /&>ds
 = quality e/abli%$ "u p>agraph 7#a7    
pursuant to ! requirem5ts = ! e/abli%m5t
 ( su* /&>ds "u ?is subsection4  7,b7 ,n
 lat] ?an #cj days aft] any update "u   
subp>agraph 7,a7 ( /&>ds = quality      
e/abli%$ "u p>agraph 7#a71 ! ,secret>y  
%all submit to ! appropriate committees 
( ,congress a report on su* updat$ /&>ds
 = quality4  4  7b7 ,publication &      
consid]ation ( public comm5ts           

,subsection 7b7 ( su* section is am5d$--
 7#a7 9 p>agraph 7#a7--  7,a7 by /rik+  
,n lat] ?an #a ye> aft] ! date on :i* ! 
,secret>y e/abli%es /&>ds = quality "u  
subsection 7a7 & ins]t+ ,n less         
frequ5tly ?an once e ?ree ye>s2 &  7,b7 
by ins]t+ pursuant to /&>ds = quality "u
 subsection 7a7 aft] m$ical facilities (
 ! ,dep>tm5t2 &  7#b7 9 p>agraph 7#b71  
by ins]t+ or updates aft] e/abli%es4    
7c7 ,report ,n lat] ?an "o ye> aft] !   
date ( ! enactm5t ( ?is ,act1 !         
,secret>y ( ,vet]ans ,affairs %all      
submit to ! appropriate committees (    
,congress a report on--  7#a7 h[ !      
,secret>y has consult$ ) entities       
specifi$ 9 p>agraph 7#d7 ( section      
#agjc;,c7a7 ( title #ch1 ,unit$ ,/ates  
,code1 be=e ! date ( ! enactm5t ( ?is   
,act 9 e/abli%+ /&>ds = quality "u su*  
section2  7#b7 h[ ! ,secret>y has       
cont9u$ to consult ) ^? entities on &   
aft] su* date ( enactm5t2 &  7#c7 h[ !  
,secret>y int5ds to lev]age data sci5ces
 to improve /&>ds = quality c>e furni%$ 

by ! ,dep>tm5t ( ,vet]ans ,affairs4  7d7
 ,initial update to quality c>e metrics 
7#a7 ,report ,n lat] ?an "o ye> aft] !  
date ( ! enactm5t ( ?is ,act1 !         
,secret>y ( ,vet]ans ,affairs %all      
submit to ! appropriate committees (    
,congress a report on h[ ! ,secret>y    
plans to implem5t ! am5dm5ts made by    
subsections 7a7 & 7b74  7#b7            
,implem5tation ,n lat] ?an two ye>s aft]
 ! date ( ! enactm5t ( ?is ,act1 !      
,secret>y %all-- 7,a7 implem5t !        
am5dm5ts made by subsections 7a7 & 7b71 
includ+ by updat+ ! /&>ds = quality     
e/abli%$ "u section #agjc;,c7a77#a7 (   
title #ch1 ,unit$ ,/ates ,code2 &  7,b7 
submit to ! appropriate committees (    
,congress a report detail+ ! /&>ds =    
quality updat$ pursuant to su* am5dm5ts4
  7e7 ,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  #cjc4 ,m5tal ,heal? 
,resid5tial ,rehabilitation ,treatm5t   
,program ( ! ,dep>tm5t ( ,vet]ans       
,affairs  7a7 ,g5]al requirem5ts  7#a7  
,deadl9e ,! ,secret>y ( ,vet]ans        
,affairs %all fulfill ea* requirem5t "u 
?is section by n lat] ?an "o ye> aft] ! 
date ( ! enactm5t ( ?is ,act1 unless    
o!rwise specifi$4  7#b7 ,guidance ,!    
,secret>y %all update ! guidance ( !    
,dep>tm5t ( ,vet]ans ,affairs on !      
op]ation ( ! ,m5tal ,heal? ,resid5tial  
,rehabilitation ,treatm5t ,program 79   
?is section ref]r$ to z ! ,program7 to  
reflect ea* ( ! requirem5ts "u          
subsections 7b7 ?r\gh 7h74  7b7 ,ref]ral
 & admission  7#a7 ,ref]ral  7,a7       
,/&>diz$ process ,! ,secret>y %all      
e/abli% a /&>diz$ consultation          
requirem5t or o!r process = ref]rals to 
! ,program4  7,b7 ,timel9ess /&>ds ,!   
,secret>y %all specify timel9ess /&>ds =
 respond+ to ref]rals & complet+ scre5+s

 = ! ,program1 includ+ = :5 priority    
admission is reque/$1 f--  7i7 provid]s 
( ! ,dep>tm5t2  7ii7 non-,dep>tm5t      
provid]s2 &  7iii7 vet]an pati5ts       
7self-ref]rals74  7#b7 ,scre5+ (        
priority vet]ans  7,a7 ,9 g5]al ,= any  
vet]an :o meets priority admission /&>ds
 "u ! ,program dur+ a scre5+ = !        
,program1 ! ,secret>y %all admit !      
vet]an n lat] ?an #gb h\rs aft] ! "t at 
:i* ! vet]an 0 scre5$4  7,b7 ,o!r       
admission options ,) respect to a vet]an
 specifi$ 9 subp>agraph 7,a71 if !re are
 no available b$ spaces = admission "u !
 ,program at ! facility ( ! ,dep>tm5t or
 )9 ! ,vet]ans ,integrat$ ,s]vice       
,network ne>e/ to ! resid5ce ( ! vet]an 
)9 ! #gb-;h\r p]iod specifi$ 9 su*      
subp>agraph1 ! ,secret>y %all (f] !     
vet]an a *oice ( c>e-- 7i7 at ano!r     
facility ( ! ,dep>tm5t any:]e 9 ! ,unit$
 ,/ates t c admit ! vet]an )9 su* p]iod2
 or  7ii7 at a non-,dep>tm5t resid5tial 
c>e facility 9 ! community t c admit !  
vet]an )9 su* p]iod &-- 7,i7 has a      

contract or agreem5t ) ! ,dep>tm5t 9    
place2 or  7,,ii7 w ent] into su* a     
contract or agreem5t prior to furni%+   
su* c>e4  7#c7 ,admission ,! ,secret>y  
%all specify timel9ess /&>ds = !        
admission ( a vet]an into ! ,program1 or
 ! ref]ral ( a vet]an to a non-,dep>tm5t
 resid5tial c>e facility 9 ! community1 
^u mak+ an admission decision ) respect 
to ! vet]an4  7#d7 ,p]=mance metrics    
7,a7 ,9 g5]al ,! ,secret>y %all develop 
metrics to track1 & %all subsequ5tly    
track1 ! p]=mance ( ! ,dep>tm5t1 &      
contractors ( ! ,dep>tm5t t provide     
resid5tial c>e to vet]ans1 9 meet+-- 7i7
 ! requirem5ts = ref]ral to ! ,program  
"u p>agraph 7#a7 & any o!r provision (  
law2  7ii7 ! requirem5ts = scre5+ = !   
,program & o!r admission options "u     
p>agraph 7#b72 &  7iii7 ! requirem5ts = 
timely admission to ! ,program "u       
p>agraph 7#c74  7,b7 ,elem5ts ,! metrics
 develop$ "u subp>agraph 7,a7 %all      
include metrics = track+ p]=mance )     
respect to r\t9e & priority access "u ! 

,program4  7c7 ,placem5t2 transportation
  7#a7 ,locations2 />t dates ,if !      
,secret>y det]m9es t a vet]an is 9 ne$ (
 resid5tial c>e "u ! ,program1 !        
,secret>y %all provide ! vet]an ) a li/ 
( locations t meet--  7,a7 ! c>e ne$s ( 
! vet]an1 includ+ applicable treatm5t   
tracks2 &  7,b7 ! cl9ically indicat$ be/
 />t date = ! vet]an to receive c>e1    
tak+ into acc\nt ! pref]5ces ( ! vet]an4
  7#b7 ,wait times ,! ,secret>y %all    
make e ef=t to limit ! "t a vet]an waits
 = placem5t into ! ,program1 includ+ by 
(f]+ ! vet]an placem5t at "o or m       
locations outside ( ! area ( ! home     
facility ( ! vet]an or ! home ,vet]ans  
,integrat$ ,s]vice ,network ( ! vet]an1 
or at a non-,dep>tm5t resid5tial c>e    
facility1 if !re are no o!r options t   
meet ! c>e ne$s ( ! vet]an & are        
consi/5t ) ! policy ( ! ,dep>tm5t on    
wait times = access to c>e "u !         
,program4  7#c7 ,transportation cov]age 
,! ,secret>y %all provide transportation
 or pay = or reimburse ! co/s (         

transportation = any vet]an :o is       
admitt$ into ! ,program & ne$s          
transportation assi/ance--  7,a7 f !    
resid5ce ( ! vet]an or a facility ( !   
,dep>tm5t or au?oriz$ non-,dep>tm5t     
facility t does n provide su* c>e to    
ano!r su* facility t provides resid5tial
 c>e cov]$ "u ! ,program2 &  7,b7 back  
to ! resid5ce ( ! vet]an aft] !         
conclusion ( ! ,program1 if applicable4 
7d7 ,consid]ations ,9 mak+ scre5+1      
admission1 & placem5t decisions "u !    
,program1 ! ,secret>y %all consid] !    
input & pref]5ces ( ! vet]an & ! treat+ 
cl9icians ( ! vet]an1 includ+ ) respect 
to wait times1 ! program specialty1     
subtype1 or treatm5t track (f]$ to !    
vet]an1 & ! geographic placem5t ( !     
vet]an1 includ+ family- or              
occupation-relat$ pref]5ces or          
circum/ances4  7e7 ,appeals  7#a7 ,9    
g5]al ,! ,secret>y %all develop a       
national policy & associat$ proc$ures "u
 :i* a vet]an1 a repres5tative ( a      
vet]an1 or a provid] :o ref]s a vet]an  

to ! ,program1 includ+ a provid] ( !    
,dep>tm5t or a non-,dep>tm5t provid]1   
may file an appeal if ! vet]an is d5i$  
admission into ! ,program or is accept$ 
into ! ,program b is n (f]$ b$ placem5t 
9 a timely mann]4  7#b7 ,timel9ess /&>ds
 = review  7,a7 ,9 g5]al ,! national    
policy & proc$ures develop$ "u p>agraph 
7#a7 = appeals describ$ 9 su* p>agraph  
%all include timel9ess /&>ds = !        
,dep>tm5t to review & make a decision on
 su* an appeal4  7,b7 ,priority         
admission ,! ,secret>y %all review &    
respond to all appeals relat$ to        
priority admission to ! ,program n lat] 
?an #gb h\rs aft] receiv+ ! appeal4     
7,c7 ,r\t9e admission ,! ,secret>y %all 
review & respond to all appeals relat$  
to r\t9e admission to ! ,program n lat] 
?an five bus9ess days aft] receiv+ !    
appeal4  7#c7 ,public guidance ,!       
,secret>y %all develop1 & make available
 to ! public1 guidance on h[ a vet]an1 a
 repres5tative ( ! vet]an1 or a ref]r+  
provid] ( ! vet]an c file an appeal--   

7,a7 if ! vet]an is d5i$ admission into 
! ,program2  7,b7 if ! vet]an is admitt$
 into ! ,program & ! fir/ date on :i* ! 
vet]an may ent] ! ,program does n comply
 ) ! wait "t /&>ds e/abli%$ by !        
,dep>tm5t & "u ?is section = purposes ( 
priority or r\t9e admission into !      
,program2 or  7,c7 ) respect to su* o!r 
factors z ! ,secret>y may specify4  7f7 
,track+ ( availability & wait times     
7#a7 ,9 g5]al ,! ,secret>y %all create a
 me?od = track+ availability & wait     
times "u ! ,program across all          
facilities & ,vet]ans ,integrat$ ,s]vice
 ,networks ( ! ,dep>tm5t ?r\gh\t !      
,unit$ ,/ates4  7#b7 ,availability (    
in=mation ,! ,secret>y %all make !      
in=mation track$ "u p>agraph 7#a7       
available 9 real "t to-- 7,a7 ! m5tal   
heal? treatm5t coord9ators at ea*       
facility ( ! ,dep>tm5t2  7,b7 ! lead]%ip
 ( ea* m$ical c5t] ( ! ,dep>tm5t2  7,c7 
! lead]%ip ( ea* ,vet]ans ,integrat$    
,s]vice ,network2 &  7,d7 ! ,(fice ( !  
,"u ,secret>y = ,heal? ( ! ,dep>tm5t4   

7g7 ,tra9+ & ov]sight  7#a7 ,tra9+  7,a7
 ,9 g5]al ,! ,secret>y %all update &    
implem5t tra9+ = all /aff ( ! ,dep>tm5t 
involv$ 9 ! ,program reg>d+ ref]rals1   
scre5+1 admission1 placem5t decisions1 &
 appeals = ! ,program1 includ+ all      
*anges to processes & guidance "u !     
,program requir$ by ?is section4  7,b7  
,vet]ans await+ admission ,! tra9+ "u   
subp>agraph 7,a7 %all include proc$ures 
= ! c>e ( vet]ans await+ admission into 
! ,program & communication ) su* vet]ans
 & _! ref]r+ provid]s4  7,c7 ,tim+ (    
tra9+  7i7 ,9 g5]al ,! ,secret>y %all   
require ! tra9+ "u subp>agraph 7,a7 to  
be complet$ by /aff requir$ to complete 
su* tra9+--  7,i7 ^u be+ fir/ employ$ 9 
a position t includes "w involv+ !      
,program2 &  7,,ii7 n less frequ5tly ?an
 annually4  7ii7 ,track+ ,! ,secret>y   
%all track completion ( tra9+ requir$ "u
 clause 7i7 by /aff requir$ to complete 
su* tra9+ & ensure its completion z     
requir$ "u su* clause4  7#b7 ,ov]sight  
/&>ds ,! ,secret>y %all review & revise 

ov]sight /&>ds = ! lead]%ip ( ! ,vet]ans
 ,integrat$ ,s]vice ,networks to ensure 
t facilities & /aff ( ! ,dep>tm5t are   
adh]+ to ! policy ( ! ,program on access
 to c>e4  7h7 ,c>e coord9ation &        
foll[-,up c>e  7#a7 ,cont9uity ( c>e ,! 
,secret>y %all ensure ea* vet]an :o is  
scre5$ = admission to ! ,program is     
(f]$1 & provid$ if agre$ ^u1 c>e options
 dur+ ! p]iod betwe5 scre5+ ( ! vet]an &
 admission ( ! vet]an to ! ,program to  
ensure ! vet]an does n exp]i5ce any     
lapse 9 c>e4  7#b7 ,c>e coord9ation =   
sub/ance use disord] ,= a vet]an be+    
treat$ = sub/ance use disord]1 !        
,secret>y %all--  7,a7 ensure !re is a  
c>e plan 9 place dur+ ! p]iod betwe5 any
 detoxification s]vices or inpati5t c>e 
receiv$ by ! vet]an & admission ( !     
vet]an to ! ,program2 &  7,b7           
communicate t c>e plan to ! vet]an1 !   
prim>y c>e provid] ( ! vet]an1 & !      
facility ( ! ,program :]e ! vet]an is or
 w be resid+4  7#c7 ,c>e plann+ prior to
 dis*>ge  7,a7 ,9 g5]al ,! ,secret>y1 9 

consultation ) ! vet]an & ! treat+      
provid]s ( ! vet]an 9 ! ,program1 %all  
ensure ! completion ( a c>e plan prior  
to ! vet]an be+ dis*>g$ f ! ,program4   
7,b7 ,matt]s ,to be includ$ ,! c>e plan 
requir$ "u subp>agraph 7,a7 = a vet]an  
%all include details on ! c\rse (       
treatm5t = ! vet]an foll[+ completion ( 
treatm5t "u ! ,program1 includ+ any ne$$
 foll[-up c>e4  7,c7 ,%>+ ( c>e plan ,! 
c>e plan requir$ "u subp>agraph 7,a7    
%all be %>$ ) ! vet]an1 ! prim>y c>e    
provid] ( ! vet]an1 & any o!r provid]s )
 :i* ! vet]an cons5ts to %>+ ! plan4    
7,d7 ,dis*>ge f non-,dep>tm5t facility  
,^u dis*>ge ( a vet]an "u ! ,program f a
 non-,dep>tm5t facility1 ! facility %all
 %>e ) ! ,dep>tm5t all c>e records      
ma9ta9$ by ! facility ) respect to !    
vet]an & %all "w 9 consultation ) !     
,dep>tm5t on ! c>e plan ( ! vet]an      
requir$ "u subp>agraph 7,a74  7i7       
,reports to ,congress  7#a7 ,report on  
*anges made to ,program  7,a7 ,9 g5]al  
,n lat] ?an two ye>s 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 *anges made 
to ! guidance1 op]ation1 & ov]sight ( ! 
,program to fulfill ! requirem5ts ( ?is 
section4  7,b7 ,fund+ ,! report requir$ 
by subp>agraph 7,a7 %all--  7i7 exam9e  
h[ c>e provid$ to vet]ans "u ! ,program 
is fund$1 includ+ c>e provid$ ?r\gh--   
7,i7 facilities ( ! ,dep>tm5t2 &  7,,ii7
 non-,dep>tm5t facilities2  7ii7 assess 
:e!r co/s ( ! ,program1 includ+ =       
resid5tial c>e provid$ ?r\gh facilities 
( ! ,dep>tm5t & non-,dep>tm5t           
facilities1 s]ve z a dis9c5tive to      
placem5t 9 ! ,program2  7iii7 id5tify ! 
av]age co/ ( a /ay "u ! ,program1       
includ+ total /ay av]age & daily av]age1
 at-- 7,i7 a facility ( ! ,dep>tm5t2 &  
7,,ii7 a non-,dep>tm5t facility2 &  7iv7
 include su* recomm5dations z !         
,secret>y may h = legislative or        
adm9i/rative action to address any fund+

 con/ra9ts or dis9c5tives = use ( !     
,program4  7,c7 ,actions tak5 to address
 recomm5dations  7i7 ,9 g5]al ,!        
,secret>y %all include ) ! report       
requir$ by subp>agraph 7,a7 a           
description ( actions tak5 by !         
,dep>tm5t to address ! f9d+s &          
recomm5dations by ! ,secret>y conta9$ 9 
! report "u section #ejc7;c7 ( ! ,,/rong
 ,vet]ans ,act ( #bjbb 7division ,v (   
,public ,law #aag-cbh74  7ii7 ,actions  
,to be includ$ ,actions to be includ$ "u
 clause 7i7 %all include--  7,i7 any new
 locations ( ! ,program add$2  7,,ii7   
any b$s add$ at exi/+ facilities ( !    
,program2 &  7,,iii7 any additional     
treatm5t tracks or g5d]-specific        
programs creat$ or add$ at facilities ( 
! ,dep>tm5t4  7#b7 ,annual report on    
op]ation ( ,program  7,a7 ,9 g5]al ,n   
lat] ?an "o ye> aft] submitt+ ! report  
requir$ by p>agraph 7#a77;,a71 & n less 
frequ5tly ?an annually !reaft]1 !       
,secret>y %all submit to ! ,committee on
 ,vet]ans' ,affairs ( ! ,s5ate & !      

,committee on ,vet]ans' ,affairs ( !    
,h\se ( ,repres5tatives a report on !   
op]ation ( ! ,program4  7,b7 ,elem5ts   
,ea* report requir$ by subp>agraph 7,a7 
%all include ! foll[+3 7i7 ,! numb] (   
vet]ans s]v$ by ! ,program1 disaggregat$
 by--  7,i7 ,vet]ans ,integrat$ ,s]vice 
,network 9 :i* ! vet]an receives c>e2   
7,,ii7 facility1 includ+ facilities ( ! 
,dep>tm5t & non-,dep>tm5t facilities1 at
 :i* ! vet]an receives c>e2  7,,iii7    
type ( resid5tial rehabilitation        
treatm5t c>e receiv$ by ! vet]an "u !   
,program2  7,,iv7 g5d] ( ! vet]an2 &    
7,v7 race or e?nicity ( ! vet]an4  7ii7 
,wait times "u ! ,program = ! mo/ rec5t 
ye> data is available1 disaggregat$ by--
  7,i7 treatm5t track or specificity (  
resid5tial rehabilitation treatm5t c>e  
s\ght by ! vet]an2  7,,ii7 g5d] ( !     
vet]an2  7,,iii7 ,/ate or t]ritory 9 :i*
 ! vet]an is locat$2  7,,iv7 ,vet]ans   
,integrat$ ,s]vice ,network 9 :i* !     
vet]an is locat$2 &  7,v7 facility ( !  
,dep>tm5t at :i* ! vet]an seeks c>e4    

7iii7 ,a li/ ( all locations ( !        
,program & numb] ( b$ spaces at ea* su* 
location1 disaggregat$ by resid5tial    
rehabilitation treatm5t c>e or treatm5t 
track provid$ "u ! ,program at su*      
location4  7iv7 ,a li/ ( any new        
,program locations add$ or remov$ & any 
b$ spaces add$ or remov$ dur+ ! "o-ye>  
p]iod prec$+ ! date ( ! report4  7v7    
,av]age co/ ( a /ay "u ! ,program1      
includ+ total /ay av]age & daily av]age1
 at--  7,i7 a facility ( ! ,dep>tm5t2 & 
7,,ii7 a non-,dep>tm5t facility4  7vi7  
,a review ( /aff+ ne$s & gaps ) respect 
to ! ,program4  7vii7 ,any              
recomm5dations = *anges to ! op]ation ( 
! ,program1 includ+ any policy *anges1  
guidance *anges1 tra9+ *anges1 or o!r   
*anges4  7j7 ,gov]nm5t ,acc\ntability   
,(fice review on access to c>e "u !     
,program  7#a7 ,9 g5]al ,n lat] ?an two 
ye>s aft] ! date ( ! enactm5t ( ?is     
,act1 ! ,comptroll] ,g5]al ( ! ,unit$   
,/ates %all review access to c>e "u !   
,program = vet]ans 9 ne$ ( resid5tial   

m5tal heal? c>e & sub/ance use disord]  
c>e4  7#b7 ,elem5ts ,! review requir$ by
 p>agraph 7#a7 %all include ! foll[+3   
7,a7 ,a review ( wait times "u !        
,program1 disaggregat$ by-- 7i7 treatm5t
 track or specificity ( resid5tial      
rehabilitation treatm5t c>e ne$$2  7ii7 
g5d] ( ! vet]an2  7iii7 home ,/ate ( !  
vet]an2  7iv7 home ,vet]ans ,integrat$  
,s]vice ,network ( ! vet]an2 &  7v7 wait
 times =--  7,i7 facilities ( !         
,dep>tm5t2 &  7,,ii7 non-,dep>tm5t      
facilities4  7,b7 ,a review ( policy &  
tra9+ ( ! ,dep>tm5t on scre5+1          
admission1 & placem5t "u ! ,program4    
7,c7 ,a review ( ! rights ( vet]ans &   
ref]r+ provid]s to appeal admission     
decisions "u ! ,program & h[ ! ,dep>tm5t
 adjudicates appeals4  7,d7 ,a review ( 
h[ ! pref]5ces ( a vet]an admitt$ to !  
,program are tak5 into consid]ation :5  
det]m9+ ! facility at :i* ! vet]an w be 
plac$ 9 ! ,program4  7,e7 ,a review (   
/aff+ & /aff+ ne$s & gaps ( ! ,program1 
includ+ ) respect to--  7i7 m5tal heal? 

provid]s & coord9ators at ! facility    
level2  7ii7 /aff ( ,program facilities2
 &  7iii7 ov]all adm9i/ration ( !       
,program at ! national level4  7,f7     
,recomm5dations = improvem5t ( access by
 vet]ans to c>e "u ! ,program1 includ+ )
 respect to--  7i7 any new sites or     
types ( programs ne$$ or 9 developm5t2  
7ii7 *anges 9 tra9+ or policy2  7iii7   
*anges 9 communications ) vet]ans2 &    
7iv7 ov]sight ( ! ,program by !         
,dep>tm5t4  7k7 ,def9itions ,9 ?is      
section3 7#a7 ,m5tal ,heal? ,resid5tial 
,rehabilitation ,treatm5t ,program ,!   
t]m ,m5tal ,heal? ,resid5tial           
,rehabilitation ,treatm5t ,program--    
7,a7 means ! array ( programs & s]vices 
( ! ,dep>tm5t t comprise resid5tial c>e 
= m5tal heal? & sub/ance use disord]s2 &
  7,b7 includes ! programs designat$ z (
 ! date ( ! enactm5t ( ?is ,act z       
domicili>y resid5tial rehabilitation    
treatm5t programs4  7#b7 ,treatm5t track
 ,! t]m treatm5t track means a          
specializ$ treatm5t program t is provid$

 to a subset ( vet]ans 9 ! ,program :o  
receive ! same or simil> int5sive       
treatm5t & rehabilitative s]vices4  7#c7
 ,unit$ ,/ates ,! t]m ,unit$ ,/ates     
means ! #ej ,/ates1 ! ,di/rict (        
,columbia1 ! ,commonweal? ( ,pu]to      
,rico1 ,guam1 ! ,virg9 ,isl&s1 ,am]ican 
,samoa1 & any o!r commonweal?1 t]ritory1
 or possession ( ! ,unit$ ,/ates4  #cjd4
 ,electronic docum5t submission option =
 ! ,,*ampva program  7a7 ,onl9e portal  
,n lat] ?an #ah mon?s aft] ! date ( !   
enactm5t ( ?is ,act1 ! ,secret>y (      
,vet]ans ,affairs %all publi% an onl9e  
portal all[+-- 7#a7 individuals apply+ =
 m$ical c>e "u section #agha ( title    
#ch1 ,unit$ ,/ates ,code1 ! ability to--
  7,a7 submit application mat]ials      
electronically2  7,b7 view ! /atus ( _! 
application onl9e2 &  7,c7 select _!    
pref]r$ me?od ( communication reg>d+ _! 
application1 :i* ! ,dep>tm5t ( ,vet]ans 
,affairs %all use ^u _! fir/ attempt to 
contact ! individual if !re are any     
issues ) _! application2  7#b7          

individuals apply+ = or receiv+ m$ical  
c>e "u su* section ! ability to submit  
electronically--  7,a7 docum5tation     
reg>d+ o!r heal? insurance c]tification2
  7,b7 docum5tation reg>d+ s*ool        
enrollm5t c]tification2 &  7,c7 any o!r 
docum5tation requir$ to apply = or      
cont9ue cov]age "u su* section2 &  7#c7 
individuals receiv+ m$ical c>e "u su*   
section & provid]s ( m$ical c>e "u su*  
section ! ability to--  7,a7 submit     
m$ical claims docum5tation              
electronically2  7,b7 reque/ reprocess+ 
( a d5i$ claim electronically2 &  7,c7  
file a reconsid]ation or appeal ( a     
claim electronically4  7b7 ,contract ,! 
,secret>y may ent] into a contract ) a  
non-,dep>tm5t entity to c>ry out        
subsection 7a74  7c7 ,outrea* ,^u !     
implem5tation ( ! onl9e portal requir$  
"u subsection 7a71 ! ,secret>y %all     
conduct outrea* to ensure individuals   
eligible = c>e "u section #agha ( title 
#ch1 ,unit$ ,/ates ,code1 & provid]s (  
su* c>e are aw>e ( ! portal4  7d7 ,rule 

( con/ruction ,no?+ 9 ?is section %all  
be con/ru$ to limit ! ability ( !       
,secret>y to collect application        
mat]ials relat+ to m$ical c>e "u section
 #agha ( title #ch1 ,unit$ ,/ates ,code1
 by mail or by fax4  7e7 ,reports  7#a7 
,9 g5]al ,n lat] ?an #bgj days aft] !   
date ( ! enactm5t ( ?is ,act1 & e #ahj  
days !reaft] = ?ree ye>s1 ! ,secret>y   
%all submit to ! ,committee on ,vet]ans'
 ,affairs ( ! ,s5ate & ! ,committee on  
,vet]ans' ,affairs ( ! ,h\se (          
,repres5tatives a report on ! progress (
 implem5tation ( ! onl9e portal requir$ 
"u subsection 7a74  7#b7 ,elem5ts ,ea*  
report requir$ "u p>agraph 7#a7 %all    
include--  7,a7 :e!r a contract ) a     
non-,dep>tm5t entity 0 procur$ to c>ry  
out subsection 7a7 &1 if s1 in=mation on
 :i* entity or entities to :i* !        
contract 0 aw>d$2  7,b7 ! numb] (       
applications = m$ical c>e "u section    
#agha ( title #ch1 ,unit$ ,/ates ,code1 
t are curr5tly p5d+1 disaggregat$ by    
:e!r !y 7 receiv$--  7i7 by mail2  7ii7 

by fax2 or  7iii7 electronically2  7,c7 
a description ( ef=ts tak5 by !         
,dep>tm5t to conduct outrea* "u         
subsection 7c72 &  7,d7 an assessm5t (  
us] satisfaction ) ! new onl9e portal   
requir$ "u subsection 7a74  #cje4       
,review ( workfl[s associat$ ) process+ 
ref]rals betwe5 facilities ( ! ,vet]ans 
,heal? ,adm9i/ration  7a7 ,9 g5]al ,!   
,secret>y ( ,vet]ans ,affairs %all      
conduct a review ( ! workfl[s directly  
associat$ ) process+ ref]rals ( pati5ts 
betwe5 facilities ( ! ,vet]ans ,heal?   
,adm9i/ration to id5tify specific delays
 or bottl5ecks 9 su* ref]rals4  7b7     
,inclusion ( consult managem5t review ,!
 review requir$ "u subsection 7a7 %all  
include-- 7#a7 a review ( ! int]facility
 consult managem5t guidance ( ! ,vet]ans
 ,heal? ,adm9i/ration t assi/s          
facilities 9 sett+ up a workfl[ =       
consults betwe5 facilities2 &  7#b7 a   
review ( ! roles & responsibilities ( ! 
individuals involv$ 9 ! consult         
managem5t process 9 manag+ ^? consults1 

includ+ ! role ( ! ref]ral coord9ation  
team4  7c7 ,report ,n lat] ?an #ahj days
 aft] ! date ( ! enactm5t ( ?is ,act1 ! 
,secret>y %all submit to ,congress a    
report on ! results ( ! review conduct$ 
"u subsection 7a74