,i  #aai? ,,congress  #a/ ,session  ,h4 
,r4 #fgcc  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,decemb] #af1         
#bjbe,mr4 ,bo/ introduc$ ! foll[+ bill2 
:i* 0 ref]r$ to ! ,committee on         
,vet]ans' ,affairs  ,a ,,bill  ,to am5d 
title #ch1 ,unit$ ,/ates ,code1 to make 
c]ta9 improvem5ts to ! adm9i/ration (   
,vet]ans ,integrat$ ,s]vice ,networks "u
 laws adm9i/]$ by ! ,secret>y ( ,vet]ans
 ,affairs1 & = o!r purposes4  #a4 ,%ort 
title ,?is ,act may be cit$ z ! ,,visn  
,re=m ,act ( #bjbe4  #b4 ,adm9i/ration (
 ,vet]ans ,integrat$ ,s]vice ,networks  
7a7 ,vet]ans integrat$ s]vice networks  
,sub*apt] ,i ( *apt] #gc ( title #ch1   
,unit$ ,/ates ,code1 is am5d$ by ins]t+ 
aft] section #gcje foll[+ new section3  
#gcje;,a4 ,vet]ans ,integrat$ ,s]vice   
,networks  7a7 ,organization ,!         
,secret>y %all organize ! ,vet]ans      
,heal? ,adm9i/ration 9 eight            
geographically def9$ ,vet]ans ,integrat$
 ,s]vice ,networks 7h]e9aft] ref]r$ to z
 ,v,i,s,ns74  7b7 ,alignm5t ) mission ( 

dep>tm5t ,! ,secret>y %all ensure t !   
employees1 s]vices1 & programs ( ea*    
,,visn are align$ ) ! mission ( !       
,dep>tm5t & ! specific heal? c>e        
requirem5ts ( ea* population ( vet]ans 9
 ea* ,network4  7c7 ,integrat$ heal? c>e
 sy/em ,! ,secret>y %all ma9ta9 a       
regional integrat$ heal? c>e sy/em )9 ! 
geographic area s]v$ by ea* ,,visn by-- 
7#a7 ent]+ into agreem5ts ) su* o!r     
gov]nm5tal1 public1 & private heal? c>e 
organizations & practition]s z !        
,secret>y consid]s appropriate to meet !
 ne$s ( vet]ans :o reside 9 ! geographic
 area s]v$ by ! ,,visn2  7#b7 provid+   
ov]sight & managem5t (1 & tak+          
responsibility =1 a regional budget = ! 
activities ( ea* ,,visn t-- 7,a7 is     
align$ ) ! budget guidel9es ( !         
,dep>tm5t & ! ,vet]ans ,heal?           
,adm9i/ration2 &  7,b7 is balanc$ at !  
end ( ea* fiscal ye>2 &  7#c7 us+       
national metrics to develop sy/ems to   
provide effective1 effici5t1 & safe     
deliv]y ( heal? c>e t is rat$ z highly  

satisfactory by pati5ts & families (    
pati5ts4  7d7 ,r$uction 9 duplicate     
functions ,! ,secret>y %all id5tify     
functions t are duplicat$ across !      
cl9ical1 adm9i/rative1 & op]ational     
processes & practices ( ! ,vet]ans      
,heal? ,adm9i/ration & op]ate ! sy/em ( 
,v,i,s,ns 9 a mann] design$ to r$uce !  
duplication ( su* functions4  7e7       
,collaboration & coop]ation  7#a7 ,!    
,secret>y %all op]ate ! ,,visn sy/em by 
work+ to a*ieve maximum effectiv5ess )  
respect to ! provision hospital c>e1    
m$ical s]vices1 & nurs+ home c>e1       
graduate m$ical education1 & rese>*2 &  
7#b7 ,! ,secret>y %all assess1 on an    
ongo+ basis1 ! consolidation or         
realignm5t ( in/itutional functions1    
includ+ capital asset1 safety1 &        
op]ational support functions1 9         
collaboration & coop]ation ) o!r        
,v,i,s,ns & ! foll[+ (fices or entities 
)9 ! geographic area s]v$ by ! ,,visn3  
7,a7 ,! (fices ( ! ,vet]ans ,b5efits    
,adm9i/ration & ! ,national ,cemet]y    

,adm9i/ration4  7,b7 ,(fices ( ,/ate &  
local ag5cies t h a mission to provide  
assi/ance to vet]ans4  7,c7 ,m$ical     
s*ools & o!r affiliates4  7,d7 ,f$]al1  
,/ate1 & local em]g5cy prep>$ness       
organizations4  7,e7 ,su* o!r (fices ( !
 ,f$]al ,gov]nm5t z ! ,secret>y consid]s
 appropriate4  7#c7 ,! ,director ( ea*  
,,visn %all be responsible = ov]sight & 
= ! en=cem5t ( ,dep>tm5t policies       
au?orities applicable to m$ical         
facilities ( ! ,dep>tm5t ) respect to   
su* m$ical facilities locat$ 9 !        
geographic area s]v$ by su* ,,visn4  7f7
 ,headqu>t]s  7#a7 ,!re %all be only "o 
headqu>t]s (fice = ea* ,,visn4 ,!       
,secret>y %all *oose ! location ( ea*   
su* (fice & %all ensure ea* su* (fice is
 colocat$ ) a m$ical c5t] ( ! ,dep>tm5t4
  7#b7  7,a7 ,ea* headqu>t]s (fice      
e/abli%$ "u p>agraph 7#a7 %all h n m ?an
 #ej full-"t employees4 ,( su* #ej      
full-"t employees1 n m ?an #aj %all be  
contractor employees4  7,b7 7i7 ,!      
,secret>y may waive ! limitation "u     

subp>agraph 7,a7 ) respect to a ,,visn  
headqu>t]s if ! ,secret>y--  7,i7       
det]m9es ! waiv] is necess>y to ma9ta9  
ess5tial op]ations ( ! ,,visn headqu>t]s
 dur+ ! implem5tation ( ! plan requir$  
"u p>agraph 7#c72 &  7,,ii7 be=e ! date 
on :i* ! waiv] becomes effective1       
submits to ! ,committees on ,vet]ans'   
,affairs ( ! ,s5ate & ! ,h\se (         
,repres5tatives a writt5 c]tification ( 
su* det]m9ation4  7ii7 ,! t]m ( any     
wavi] issu$ pursuant to clause 7i7 may n
 exce$ "o ye>4  7,c7 ,n less frequ5tly  
?an once ea* fiscal ye>1 ! ,secret>y    
%all submit to ! ,committees on         
,vet]ans' ,affairs ( ! ,s5ate & ! ,h\se 
( ,repres5tatives a report on employm5t 
at ! ,,visn headqu>t]s (fices dur+ !    
prec$+ fiscal ye>4 ,ea* su* report %all 
include ! foll[+ = ! ye> cov]$ by !     
report3  7i7 ,! numb] ( individuals     
employ$ at ea* ,,visn headqu>t]s (fice4 
7ii7 ,! numb] ( individuals employ$ by !
 ,vet]ans ,heal? ,adm9i/ration 9 ea*    
,,visn :o are n employ$ at ! same       

location z ! headqu>t]s (fice ( t       
,,visn4  7iii7 ,! title = ea* position (
 employm5t at a headqu>t]s (fice4  7iv7 
,! title = ea* position ( employm5t ) ! 
,vet]ans ,heal? ,adm9i/ration 9 ea*     
,,visn ^: duty /ation is n at ! same    
location z ! headqu>t]s (fice ( t       
,,visn4  7v7 ,an assessm5t ( ! effect ( 
! employm5t ( individuals at ,,visn     
headqu>t]s (fices on ! budget ( !       
,dep>tm5t4  7#c7 7,a7 ,n lat] ?an #ahj  
days aft] ! date ( ! enactm5t ( ?is     
section1 ! ,secret>y %all develop &     
submit to ! ,committees on ,vet]ans'    
,affairs ( ! ,s5ate & ! ,h\se (         
,repres5tatives a compreh5sive plan = ! 
reorganization & "r-siz+ ( ! work=ce (  
ea* ,,visn headqu>t]s to a*ieve         
compliance ) ! limitation "u p>agraph   
7#b77;,a74  7,b7 ,! plan "u subp>agraph 
7,a7 %all include1 = ea* ,,visn         
headqu>t]s-- 7i7 an id5tification ( all 
positions curr5tly assign$ to !         
headqu>t]s1 includ+ duty location1      
occupational s]vices1 pay grade1 &      

prim>y function2  7ii7 a det]m9ation (  
:i* positions-- 7,i7 are ess5tial to    
execute ! mission ( ! ,,visn2 &  7,,ii7 
are duplicative or adm9i/rative 9       
nature2  7iii7 a phas$ implem5tation    
s*$ule = su* plan2  7iv7 a description (
 any work=ce realignm5ts1 reassignm5ts1 
or sep>ations requir$ to comply ) !     
limitation "u p>agraph 7#b77;,a71       
includ+ volunt>y sep>ation inc5tive     
paym5ts or retra9+ opportunities "u     
title #e2 &  7v7 a c]tification t !     
implem5tation ( su* plan w n result 9 a 
r$uction 9 access to c>e or s]vices     
furni%$ to vet]ans "u ! laws adm9i/]$ by
 ! ,secret>y4  7,c7 ,9 develop+ &       
implem5t+ ! plan requir$ "u ?is         
subsection1 ! ,secret>y %all-- 7i7      
ensure t ea* ,,visn headqu>t]s is 9     
compliance ) ! limitation "u p>agraph   
7#b77;,a7 n lat] ?an ! date t is ?ree   
ye>s aft] ! date ( ! enactm5t ( ?is     
section2 &  7ii7 to ! maximum ext5t     
practicable1 (f] ea* employee ( a ,,visn
 headqu>t]s :o is a lic5s$ physician1   

nurse1 psy*ologi/1 or o!r heal?c>e      
pr(essional su* ! opportunity to        
transf]1 )\t loss ( pay or b5efits1 to a
 position appo9t$ "u *apt] #gd ( ?is    
title to furni% direct pati5t c>e or    
cl9ical support at a ,dep>tm5t m$ical   
facility4  7g7 ,p]sonnel  7#a7 ,! head (
 ea* ,,visn %all be ! ,director1 :o %all
 be appo9t$ by ! ,presid5t1 by & ) !    
advice & cons5t ( ! ,s5ate4 ,! position 
( ,director ( a ,,visn %all be a nonc>e]
 appo9tee position4 ,! ,director ( a    
,,visn %all--  7,a7 be responsible = !  
functions ( ! ,,visn2 &  7,b7 h !       
au?ority & responsibility to en=ce !    
policies & /&>ds ( ! ,dep>tm5t ) respect
 to all ,dep>tm5t p]sonnel employ$ )9 ! 
,,visn4  7#b7 ,ea* employee employ$ at a
 facility ( ! ,vet]ans ,heal?           
,adm9i/ration locat$ 9 ! geographic area
 s]v$ by a ,,visn %all-- 7,a7 report    
directly to ! ,director ( ! ,,visn2     
7,b7 9 ! case ( an employee :o is lic5s$
 to practice 9 a hospital1 "w at lea/ "o
 day ea* week 9 a ,dep>tm5t m$ical c5t] 

locat$ 9 su* geographic area2 &  7,c7   
visit r\t9ely ) s]vice l9e *iefs at     
,dep>tm5t m$ical c5t]s1 z direct$ by !  
,secret>y4  7h7 ,tri5nial /ructure      
review1 reassessm5t & report  7#a7 ,n   
lat] ?an ?ree ye>s aft] ! date ( !      
enactm5t ( ?is section1 & n less        
frequ5tly ?an once e ?ree ye>s !reaft]1 
! ,secret>y %all conduct a review &     
assessm5t ( ! /ructure & op]ations ( !  
,v,i,s,ns4  7#b7 ,n lat] ?an #ahj days  
aft] conduct+ a review & assessm5t "u   
p>agraph 7#a71 ! ,secret>y %all submit  
to ! ,committees on ,vet]ans' ,affairs (
 ! ,s5ate & ! ,h\se ( ,repres5tatives a 
report on su* review & assessm5t1 :i*   
%all include su* recomm5dations =       
legislative or regulatory action z !    
,secret>y consid]s appropriate to       
improve ! ,v,i,s,ns4  4  7b7 ,cl]ical   
am5dm5t ,! table ( sections at ! beg9n+ 
( *apt] #gc ( su* title is am5d$ by     
ins]t+ aft] ! item relat+ to section    
#gcje ! foll[+ new item3  #gcje;,a4     
,vet]ans ,integrat$ ,s]vice ,networks  4

  #c4 ,consolidation ( ,vet]ans         
,integrat$ ,s]vice ,networks ,9 ord] to 
comply ) section #gcje;,a ( title #ch1  
,unit$ ,/ates ,code1 z add$ by section  
#b1 n lat] ?an "o ye> aft] ! date ( !   
enactm5t ( ?is ,act1 ! ,secret>y (      
,vet]ans ,affairs %all geographically   
realign & comb9e ! ,vet]ans ,integrat$  
,s]vice ,networks 9 effect on ! day be=e
 ! date ( enactm5t ( ?is ,act into      
geographically def9$ ,vet]ans ,integrat$
 ,s]vice ,networks z foll[s3  7#a7      
,vet]ans ,integrat$ ,s]vice ,network #a1
 ,vet]ans ,integrat$ ,s]vice ,network   
#b1 & ,vet]ans ,integrat$ ,s]vice       
,network #d %all be ,comb9$ into a s+le 
,vet]ans ,integrat$ ,s]vice ,network4   
7#b7 ,vet]ans ,integrat$ ,s]vice        
,network #e1 ,vet]ans ,integrat$ ,s]vice
 ,network #f1 & ,vet]ans ,integrat$     
,s]vice ,network #i %all be comb9$ into 
a s+le ,vet]ans ,integrat$ ,s]vice      
,network4  7#c7 ,vet]ans ,integrat$     
,s]vice ,network #aj1 ,vet]ans          
,integrat$ ,s]vice ,network #ab1 &      

,vet]an ,integrat$ ,s]vice ,network #bc 
%all be comb9$ into a s+le ,vet]ans     
,integrat$ ,s]vice ,network4  7#d7      
,vet]ans ,integrat$ ,s]vice ,network #g1
 ,vet]ans ,integrat$ ,s]vice ,network   
#h1 & ,vet]an ,integrat$ ,s]vice        
,network #af %all be comb9$ into a s+le 
,vet]ans ,integrat$ ,s]vice ,network4   
7#e7 ,vet]ans ,integrat$ ,s]vice        
,network #ae & ,vet]an ,integrat$       
,s]vice ,network #ai %all be comb9$ into
 a s+le ,vet]ans ,integrat$ ,s]vice     
,network4  7#f7 ,vet]ans ,integrat$     
,s]vice ,network #ag & ,vet]an          
,integrat$ ,s]vice ,network #bb %all be 
comb9$ into a s+le ,vet]ans ,integrat$  
,s]vice ,network4  7#g7 ,vet]ans        
,integrat$ ,s]vice ,network #bj %all    
rema9 a s+le ,vet]ans ,integrat$ ,s]vice
 ,network4  7#h7 ,vet]ans ,integrat$    
,s]vice ,network #ba %all rema9 a s+le  
,vet]ans ,integrat$ ,s]vice ,network4