,,ib ,union ,cal5d> ,no4 #gcf #aai?     
,,congress  #b;d ,session  ,h4 ,r4 #bbhc
 ,report ,no4 #aai-hci ,,9 ,,! ,,h\se   
,,( ,,repres5tatives  ,m>* #bd1         
#bjbe,mr4 ,bo/ introduc$ ! foll[+ bill2 
:i* 0 ref]r$ to ! ,committee on         
,vet]ans' ,affairs  ,octob] #e1         
#bjbf;,additional sponsors3 ,mrs4       
,radewag51 ,mr4 ,b]gman1 ,mr4 ,c>t] (   
,georgia1 ,mr4 ,ciscomani1 & ,mr4       
,bilirakis  ,octob] #e1 #bjbf,report$ ) 
an am5dm5t1 committ$ to ! ,committee ( !
 ,:ole ,h\se on ! ,/ate ( ! ,union1 &   
ord]$ to be printed,strike out all aft] 
! enact+ clause & ins]t ! "p pr9t$ 9    
italic,for text ( introduc$ bill1 see   
copy ( bill z introduc$ on ,m>* #bd1    
#bjbe  ,a ,,bill  ,to direct ! ,secret>y
 ( ,vet]ans ,affairs to c>ry out a pilot
 program to provide grants to outpati5t 
m5tal heal? facilities = ! provision (  
culturally compet5t1 evid5ce-bas$ m5tal 
heal? c>e = vet]ans1 & = o!r purposes4  
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,recogniz+ ,community ,organizations =

 ,vet]an ,engagem5t & ,recov]y ,act ( ! 
,,recov] ,act 4  #b4 ,dep>tm5t (        
,vet]ans ,affairs pilot program to      
provide grants to m5tal heal? c>e       
provid]s = ! provision ( m5tal heal? c>e
 = vet]ans  7a7 ,e/abli%m5t ,! ,secret>y
 ( ,vet]ans ,affairs %all c>ry out a    
?ree-ye> pilot program "u :i* !         
,secret>y %all make grants to eligible  
m5tal heal? c>e provid]s = ! provision (
 m5tal heal? c>e to vet]ans1 includ+    
evid5ce-bas$ m5tal heal? c>e deliv]$ 9  
p]son or via teleheal?1 by provid]s :o  
h-- 7#a7 docum5t$ exp]i5ce s]v+ vet]ans 
& _! families2 &  7#b7 tra9+ 9          
behavioral heal? conditions relat$ to   
milit>y s]vice4  7b7 ,eligibility ,to be
 eligible to receive a grant "u ! pilot 
program1 a m5tal heal? c>e provid]      
%all-- 7#a7 h op]at$ at lea/ "o         
outpati5t m5tal heal? facility 9 !      
,unit$ ,/ates = a cont9u\s p]iod ( at   
lea/ ?ree ye>s2  7#b7 be lic5s$ or      
c]tifi$ "u applicable /ate law to       
provide outpati5t m5tal heal? s]vices2  

7#c7 be accr$it$ by-- 7,a7 ! ,jo9t      
,commission on ,accr$itation ( ,heal?c>e
 ,organizations2  7,b7 ! ,commission on 
,accr$itation ( ,rehabilitation         
,facilities2 or  7,c7 any o!r nationally
 recogniz$ accr$it+ body ! ,secret>y    
det]m9es appropriate2 &  7#d7 submit to 
! ,secret>y an application t includes   
su* in=mation & assurances z ! ,secret>y
 may require1 includ+-- 7,a7 an         
id5tification ( ! outpati5t facility or 
facilities :]e ! m5tal heal? c>e s]vices
 w be provid$2  7,b7 a plan "u :i* at   
lea/ "o cl9ician at ea* facility t      
receives grant funds has complet$ tra9+ 
or cont9u+ education 9 ! diagnosis &    
treatm5t ( m5tal heal? conditions       
specific to vet]ans1 includ+ ! effect ( 
milit>y s]vice on behavioral heal?2 &   
7,c7 an id5tification ( ! p]c5tage ( !  
op]at+ budget = ea* su* facility t 0    
provid$ ?r\gh ,f$]al grants dur+ !      
fiscal ye> prec$+ ! ye> dur+ :i* !      
application is submitt$4  7c7 ,use (    
funds  7#a7 ,9 g5]al ,! recipi5t ( a    

grant "u ! pilot program %all use !     
grant-- 7,a7 to deliv] m5tal heal? c>e  
describ$ 9 subsection 7a72  7,b7 to     
op]ate or exp& an exi/+ outpati5t m5tal 
heal? facility or e/abli% a new         
outpati5t m5tal heal? facility = !      
purpose ( provid+ su* c>e2  7,c7 to     
enc\rage vet]ans :o are eligible =      
enrollm5t 9 ! pati5t enrollm5t sy/em "u 
section #agje ( title #ch1 ,unit$ ,/ates
 ,code1 to enroll 9 su* sy/em & to      
receive m$ical s]vices furni%$ by !     
,dep>tm5t ( ,vet]ans ,affairs2  7,d7 to 
support activities necess>y to deliv] or
 su/a9 c>e1 includ+-- 7i7 outrea*2  7ii7
 c>e coord9ation2  7iii7 vet]an         
engagem5t2  7iv7 cl9ician tra9+2  7v7   
implem5tation support2 &  7vi7 program  
evaluation2 &  7,e7 to support cont9u\s 
quality improvem5t & outcomes measurem5t
 activities1 includ+ ! collection &     
report+ ( cl9ical outcomes & op]ational 
metrics2  7,f7 to support activities ( !
 program t are n billable1 reimbursable1
 or o!rwise au?oriz$ by law1 includ+--  

7i7 outrea*2  7ii7 c>e coord9ation2     
7iii7 engagem5t2  7iv7 implem5tation    
support2 &  7v7 program evaluation2 &   
7,g7 to provide s]vices to individuals =
 :i* reimbursem5t is n o!rwise          
available1 includ+ su* individuals :o   
are-- 7i7 un9sur$2  7ii7 ineligible =   
heal? c>e furni%$ by ! ,dep>tm5t (      
,vet]ans ,affairs2 or  7iii7 9 receipt (
 heal? c>e t is n reimbursable z ( !    
date ( ! enactm5t ( ?is ,act4  7#b7     
,limitations on use ( grant funds ,!    
recipi5t ( a grant "u ! pilot program   
may n-- 7,a7 *>ge an eligible vet]an a  
fee associat$ ) ! receipt ( m5tal heal? 
c>e fund$ by su* grant2  7,b7 refuse to 
provide m5tal heal? c>e to an eligible  
vet]an on ! basis t ! vet]an is n       
eligible = reimbursem5t = su* c>e "u    
ano!r pay] s\rce2 or  7,c7 use grant    
funds to-- 7i7 duplicate paym5ts made "u
 any contract or agreem5t to :i* !      
,dep>tm5t is a p>ty z ( ! date ( !      
enactm5t ( ?is ,act2 or  7ii7 pay = !   
same cl9ical s]vices or s]vice units t  

are o!rwise billable to a ,f$]al pay]1  
includ+ ! ,vet]ans ,community ,c>e      
,program "u section #agjc ( title #ch1  
,unit$ ,/ates ,code1 or any o!r public  
or private heal? plan4  7#c7 ,rules (   
con/ruction ,no?+ 9 ?is subsection may  
be con/ru$ to-- 7,a7 prohibit a grant   
recipi5t f seek+ reimbursem5t f         
non-,dep>tm5t pay]s = m5tal heal?       
s]vices provid$ by ! grant recipi5t1    
except t grant funds %all n be us$ to   
supplant or duplicate a reimbursem5t    
o!rwise available "u ,f$]al law2 or     
7,b7 au?orize d\ble bill+ or duplicate  
paym5ts = ! same cl9ical s]vice or unit 
( s]vice4  7#d7 ,sp\se & dep5d5t c>e ,a 
recipi5t may use grant funds to provide 
c>e to sp\ses & dep5d5t *ildr5 ( a      
vet]an :5 su* s]vices are integral to   
a*iev+ a successful cl9ical outcome4    
,p]missible s]vices include-- 7,a7      
family !rapy2  7,b7 c\ples !rapy2  7,c7 
gr\p !rapy2  7,d7 family psy*o$ucation2 
&  7,e7 o!r c\nsel+ s]vices ! ,secret>y 
det]m9es are cl9ically necess>y4  7d7   

,selection ( facilities ,9 aw>d+ grants 
"u ! pilot program1 ! ,secret>y-- 7#a7  
%all ensure t grants are di/ribut$      
geographically ev5ly among rural & urban
 areas2  7#b7 may consid] ! proportion (
 vet]ans hi/orically s]v$ by ! grant    
recipi5t2  7#c7 may prioritize outpati5t
 m5tal heal? facilities locat$ 9 areas t
 ! ,secret>y det]m9es-- 7,a7 are        
m$ically und]s]v$2  7,b7 h l>ge vet]an  
populations2  7,c7 are locat$ ne>       
milit>y in/allations2 or  7,d7 h l>ge   
numb]s ( vet]ans at high risk ( suicide2
 &  7#d7 %all prioritize a provid] t--  
7,a7 demon/rates a prim>y mission ( s]v+
 vet]ans or milit>y-connect$            
populations2 or  7,b7 demon/rates t     
grant funds w be us$ to exp& vet]ans'   
access to c>e & to improve pati5t       
outcomes4  7e7 ,am\nt ( grant  7#a7 ,9  
g5]al  7,a7 ,9 g5]al ,except z provid$ 9
 subp>agraph 7,b71 no grant "u ! pilot  
program = a facility = any fiscal ye>   
may exce$ #a1ejj1jjj4  7,b7 ,limitation 
,9 ! case ( an outpati5t m5tal heal?    

facility = :i* at lea/ #ej p]c5t ( !    
op]at+ budget ( ! facility = ! prec$+   
fiscal ye> 0 provid$ ?r\gh ,f$]al       
grants1 no grant "u ! pilot program = ! 
facility = any fiscal ye> may exce$ !   
less] (-- 7i7 #ej p]c5t ( ! op]at+      
budget ( ! facility2 or  7ii7           
#a1ejj1jjj4  7#b7 ,multiple grants ,!   
recipi5t ( a grant "u ! pilot program-- 
7,a7 may apply =1 & receive1 grants = m 
?an "o facility ( ! recipi5t = any      
fiscal ye>2 &  7,b7 may apply =1 &      
receive1 a grant = a facility t has     
already receiv$ a grant "u ! pilot      
program4  7f7 ,regulations2             
acc\ntability ,! ,secret>y %all         
prescribe regulations to c>ry out ?is   
section1 :i* %all include a requirem5t t
 ea* recipi5t ( a grant "u ! pilot      
program %all-- 7#a7 demon/rate !        
capacity to provide acc\ntability2  7#b7
 demon/rate cl9ical outcomes2  7#c7     
ju/ify ! effective use ( any private    
inve/m5t funds or ,f$]al grant funds    
?r\gh data collection & report+ metrics2

 &  7#d7 collect /&>diz$ outcome        
measures includ+ symptom improvem5t &   
program completion4  7g7 ,cont9uity (   
c>e ,a recipi5t ( a grant "u ! pilot    
program %all adh]e to ! cont9uity ( c>e 
model e/abli%$ by ! ,secret>y to !      
,vet]ans ,community ,c>e ,program4  7h7 
,report ,n lat] ?an #ahj days aft] !    
completion ( ! pilot program "u ?is     
section1 ! ,secret>y %all submit to     
,congress a report on ! pilot program t 
includes ! foll[+3 7#a7 ,! numb] (      
vet]ans :o receiv$ m5tal heal? c>e "u ! 
program4  7#b7 ,an id5tification ( !    
types ( m5tal heal? c>e provid$ & ! "t  
p]iod = :i* su* c>e 0 provid$4  7#c7 ,an
 id5tification & summ>y ( program       
outcomes4  7#d7 ,! numb] ( vet]ans :o   
receiv$ m5tal heal? c>e "u ! program &  
subsequ5tly enroll$ 9 ! pati5t enrollm5t
 sy/em "u section #agje ( title #ch1    
,unit$ ,/ates ,code4  7#e7 ,an          
id5tification ( any ob/acles fac$ by    
grant recipi5ts 9 provid+ m5tal heal?   
c>e "u ! program4  7#f7 ,a summ>y (     

cl9ical outcomes bas$ on pre- &         
po/-cli5t function+-- 7,a7 ! numb] (    
vet]ans :o improv$ cl9ically bas$ on    
relevant cl9ical evaluation metrics t ! 
,secret>y det]m9es appropriate2  7,b7 ! 
degree ( cl9ical improvem5t bas$ on su* 
relevant cl9ical evaluation metrics2    
7,c7 ! total numb] ( vet]ans p>ticipat+ 
9 ! program2 &  7,d7 any o!r outcome    
metrics z ! ,secret>y det]m9es          
appropriate4  7#g7 ,f9d+s ) respect to !
 su/a9ability ( ! program4  7i7         
,au?orization ( appropriations ,!re is  
au?oriz$ to be appropriat$ to !         
,secret>y to c>ry out ! pilot program "u
 ?is section #bj1jjj1jjj = ea* ( fiscal 
ye>s #bjbg ?r\gh #bjbi4  #c4            
,modification ( c]ta9 h\s+ loan fees ,! 
loan fee table 9 section #cgbi7;b77#b7 (
 title #ch1 ,unit$ ,/ates ,code1 is     
am5d$ by /rik+ ,june #i1 #bjcd ea* place
 x appe>s & ins]t+ ,july #bd1 #bjcd4    
,octob] #e1 #bjbf,report$ ) an am5dm5t1 
committ$ to ! ,committee ( ! ,:ole ,h\se
 on ! ,/ate ( ! ,union1 & ord]$ to be   

pr9t$