,i #aai? ,,congress #b;d ,session ,h4 ,r4 #ibcg ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,june #aj1 #bjbf,mr4 ,bo/ 7= himself1 ,mr4 ,bilirakis1 ,mr4 ,hudson1 ,mr4 ,lawl]1 ,mr4 ,van ,ord51 ,mrs4 ,mill]-,meeks1 ,mr4 ,murphy1 ,mr4 ,mc,guire1 ,mr4 ,b>rett1 ,mr4 ,b]gman1 ,mr4 ,baird1 ,mr4 ,meus]1 ,ms4 ,k+-,h9ds1 ,mrs4 ,kiggans ( ,virg9ia1 ,mr4 ,hamadeh ( ,arizona1 ,mr4 ,hill ( ,arkansas1 ,mr4 ,ob]nolte1 ,mr4 ,edw>ds1 ,mr4 ,mool5a>1 ,mr4 ,taylor1 & ,mr4 ,kelly ( ,p5nsylvania7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,vet]ans' ,affairs1 & 9 addition to ! ,committee on ,arm$ ,s]vices1 = a p]iod to be subsequ5tly det]m9$ by ! ,speak]1 9 ea* case = consid]ation ( su* provisions z fall )9 ! jurisdiction ( ! committee conc]n$ ,a ,,bill ,to am5d titles #aj & #ch1 ,unit$ ,/ates ,code1 & o!r ,f$]al laws1 to improve b5efits = vet]ans & ! adm9i/ration ( ! ,dep>tm5t ( ,vet]ans ,affairs4 #a4 ,%ort title2 table ( cont5ts 7a7 ,%ort title ,?is ,act may be cit$ z ! ,take ,c>e ( ,am]ica's ,vet]ans ,act4 7b7 ,table ( cont5ts ,! table ( cont5ts = ?is ,act is z foll[s3 ,sec4 #a4 ,%ort title2 table ( cont5ts4 ,title ,i--,comp5sation ,sec4 #aja4 ,major ,ri*>d ,/> ,act4 ,sec4 #ajb4 ,love ,lives ,on ,act4 ,sec4 #ajc4 ,ext5sion ( increas$ dep5d5cy & indemnity comp5sation to surviv+ sp\ses ( vet]ans :o die f amyotrophic lat]al scl]osis4 ,sec4 #ajd4 ,%>ri ,briley & ,eric ,edmundson ,vet]ans ,b5efits ,expansion ,act ( #bjbf4 ,sec4 #aje4 ,claims3 prohibition on d5ial solely = c]ta9 reason2 improv$ effici5cy ( adjudications & appeals4 ,sec4 #ajf4 ,annual report on causes ( dea? among vet]ans4 ,sec4 #ajg4 ,plan = use ( automation tools to process claims "u laws adm9i/]$ by ! ,secret>y ( ,vet]ans ,affairs4 ,sec4 #ajh4 ,re=ms relat+ to ,dep>tm5t ( ,vet]ans ,affairs disability rat+s4 ,sec4 #aji4 ,improvem5ts to tempor>y lic5sure requirem5ts = contract heal? c>e pr(essionals :o p]=m m$ical disability exam9ations = ! ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4 #aaj4 ,disability exam9ations3 /udy on access 9 rural areas2 review ( tra9+2 review ( inadequate or unnecess>y exam9ations4 ,sec4 #aaa4 ,improvem5ts to process+ & outrea* reg>d+ claims involv+ milit>y sexual trauma4 ,sec4 #aab4 ,indep5d5t assessm5t ( notices t ! ,secret>y ( ,vet]ans ,affairs s5ds to claimants4 ,sec4 #aac4 ,indep5d5t assessm5t ( =ms t ! ,secret>y ( ,vet]ans ,affairs s5ds to claimants4 ,title ,,ii--,education & ,economic ,opportunity ,sec4 #bja4 ,vets ,opportunity ,act4 ,sec4 #bjb4 ,improvem5ts to process = mak+ paym5ts to automobile sell]s = automobiles pur*as$ = c]ta9 disabl$ vet]ans4 ,sec4 #bjc4 ,mon?ly h\s+ /ip5d "u ! ,po/-#i_/aa ,educational ,assi/ance ,program = individuals :o pursue summ] programs ( education solely ?r\gh di/ance le>n+4 ,sec4 #bjd4 ,cl>ification reg>d+ inclusion ( m$ically necess>y automobile adaptations 9 ,dep>tm5t ( ,vet]ans ,affairs def9ition ( m$ical s]vices4 ,sec4 #bje4 ,digital communications3 ,solid ,/>t program2 educational assi/ance4 ,sec4 #bjf4 ,improvem5ts to ,transition ,assi/ance ,program & ,skillbridge4 ,sec4 #bjg4 ,transition ,assi/ance ,program3 pres5tation 9 presep>ation c\nsel+ to promote b5efits available to vet]ans4 ,sec4 #bjh4 ,elim9ation ( requirem5t t on-campus educational & vocational c\nsel+ is provid$ by c]ta9 ,dep>tm5t ( ,vet]ans ,affairs employees4 ,sec4 #bji4 ,expansion ( entitlem5t = paym5t = lic5s+ or c]tification te/s = vet]ans entitl$ to educational assi/ance4 ,sec4 #baj4 ,increase ( am\nt ( educational assi/ance paid by ! ,secret>y ( ,vet]ans ,affairs = fir/ ye> ( a full-"t program ( appr5tice%ip or o!r on-job tra9+4 ,sec4 #baa4 ,improv+ em]g+ te*nology opportunities = vet]ans4 ,title ,,iii--,heal? ,c>e ,sec4 #cja4 ,ext5sion & modification ( transportation grant program ( ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4 #cjb4 ,vet]an ,c>egiv] ,re$ucation1 ,reemploym5t1 & ,retirem5t ,act4 ,sec4 #cjc4 ,vet]ans ,,tbi ,break?r\gh ,exploration ( ,adaptive ,c>e ,opportunities ,nationwide ,act4 ,sec4 #cjd4 ,dep>tm5t ( ,vet]ans ,affairs assignm5t ( travel+ physicians to s]ve t]ritories & possessions4 ,sec4 #cje4 ,inclusion ( adaptive pro/heses & t]m9al devices = sports & o!r recreational activities 9 m$ical s]vices furni%$ to eligible vet]ans by ! ,secret>y ( ,vet]ans ,affairs4 ,sec4 #cjf4 ,modifications to & reau?orization ( ,/aff ,s]geant ,p>k] ,gordon ,fox ,suicide ,prev5tion ,grant ,program ( ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4 #cjg4 ,reports on ! use ( hyp]b>ic oxyg5 !rapy4 ,sec4 #cjh4 ,dep>tm5t ( ,vet]ans ,affairs pilot program to provide grants to m5tal heal? c>e provid]s = ! provision ( m5tal heal? c>e = vet]ans4 ,sec4 #cji4 ,furni%+ ( c]ta9 heal? s]vices to vet]ans 9 ! ,freely ,associat$ ,/ates4 ,sec4 #caj4 ,modification ( ,precision ,m$ic9e = ,vet]ans ,initiative2 report+ on suicide by vet]ans & memb]s ( ! ,arm$ ,=ces4 ,sec4 #caa4 ,e/abli%m5t ( ! ,bla/ ,ov]pressure ,task ,=ce ( ! ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4 #cab4 ,ext5sion ( %>+ ( ,dep>tm5t ( ,vet]ans ,affairs & ,dep>tm5t ( ,def5se ,heal? ,c>e ,res\rces2 res\rce %>+ ov]sight & implem5tation plan4 ,sec4 #cac4 ,timely report+ ( ! dea? ( a vet]an4 ,sec4 #cad4 ,expansion ( access by vet]ans to critical access hospitals & affiliat$ cl9ics "u ! ,vet]ans ,community ,c>e ,program4 ,sec4 #cae4 ,pilot plat=m = s]vices = vet]ans2 collection f vet]ans ( in=mation relat$ to social det]m9ants ( heal?4 ,sec4 #caf4 ,improvem5ts to ,dep>tm5t ( ,vet]ans ,affairs pro/hetic & rehabilitative items & s]vice4 ,sec4 #cag4 ,improvem5t ( submission ( m$ical docum5tation to ! ,secret>y ( ,vet]ans ,affairs by community c>e provid]s4 ,sec4 #cah4 ,implem5tation ( & report on ef=ts ( ,dep>tm5t ( ,vet]ans ,affairs to improve heal? c>e appo9tm5t s*$ul+4 ,sec4 #cai4 ,pilot program on coord9ation ( c>e betwe5 ,dep>tm5t ( ,vet]ans ,affairs & ,m$ic>e program4 ,sec4 #cbj4 ,fi%] ,h\se availability4 ,sec4 #cba4 ,agreem5ts betwe5 m$ical facilities ( ,dep>tm5t ( ,vet]ans ,affairs & rural m$ical facilities4 ,sec4 #cbb4 ,/udy on quality ( c>e diff]5ce betwe5 m5tal heal? & addiction !rapy c>e provid$ by heal? c>e provid]s ( ,dep>tm5t ( ,vet]ans ,affairs comp>$ to non-,dep>tm5t provid]s4 ,sec4 #cbc4 ,lactation spaces 9 m$ical c5t]s ( ! ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4 #cbd4 ,rese>* relat$ to m5opause1 p]im5opause1 & mid-life wom5's heal?3 report2 plan4 ,sec4 #cbe4 ,pilot program on provision ( opioid rescue m$ications to vet]ans4 ,sec4 #cbf4 ,e/abli%m5t ( ,vet]ans ,heal? ,adm9i/ration ,policy ,advisory ,commission4 ,sec4 #cbg4 ,access to heal? c>e4 ,sec4 #cbh4 ,rese>* on heal? conditions ( desc5dants ( toxic-expos$ vet]ans4 ,sec4 #cbi4 ,vet]ans ,sp9al ,trauma ,access to ,new ,devices ,act4 ,sec4 #ccj4 ,dep>tm5t ( ,vet]ans ,affairs pilot program to aw>d grants = ! provision ( s]vice dogs to vet]ans4 ,sec4 #cca4 ,au?orization ( major m$ical facility project ( ,dep>tm5t ( ,vet]ans ,affairs = fiscal ye> #bjbg 9 ,man*e/]1 ,new ,hamp%ire4 ,sec4 #ccb4 ,b[el & bladd] c>e program ( ,dep>tm5t ( ,vet]ans ,affairs4 ,title ,,iv--,organization ,sec4 #dja4 ,au?orization ( appropriations to ! ,(fice ( ,in=mation & ,te*nology ( ! ,dep>tm5t ( ,vet]ans ,affairs = c]ta9 purposes4 ,sec4 #djb4 ,e/abli%m5t ( ,"u ,secret>y = ,managem5t & ,*ief ,f9ancial ,(fic]4 ,sec4 #djc4 ,dep>tm5t ( ,vet]ans ,affairs acquisition re=m & co/ assessm5t4 ,sec4 #djd4 ,improvem5t ( telephone communication by ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4 #dje4 ,advanc+ ,dep>tm5t ( ,vet]ans ,affairs em]g5cy response to crisis4 ,sec4 #djf4 ,memb]%ip ( ,dep>tm5t ( ,vet]ans ,affairs ,g]iatrics & ,g]ontology ,advisory ,committee4 ,sec4 #djg4 ,s*$ul+ ( appo9tm5ts "u ! ,vet]ans ,community ,c>e ,program4 ,title ,v--,memorial ,affairs ,sec4 #eja4 ,expansion ( eligibility = ,dep>tm5t ( ,vet]ans ,affairs memorial head/one or m>k] = c]ta9 individuals4 ,sec4 #ejb4 ,dep>tm5t ( ,vet]ans ,affairs provision ( additional burial b5efits :5 an urn or commemorative plaque is furni%$4 ,sec4 #ejc4 ,fall5 ,s]vicememb]s ,religi\s ,h]itage ,re/oration ,program4 ,title ,,vi--,vet]ans' ,assur+ ,critical ,c>e ,expansions to ,support ,s]vicememb]s ,subtitle ,a--,improvem5t ( ,vet]ans ,community ,c>e ,program ,sec4 #fja4 ,codification ( requirem5ts = eligibility /&>ds = access to community c>e f ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4 #fjb4 ,requirem5t t ,secret>y notify vet]ans ( eligibility = c>e or d5ial ( reque/ = c>e "u ,vet]ans ,community ,c>e ,program4 ,sec4 #fjc4 ,consid]ation "u ,vet]ans ,community ,c>e ,program ( cont9uity ( c>e & ne$ = c>egiv] or att5dant4 ,sec4 #fjd4 ,discussion ( teleheal? options "u ,vet]ans ,community ,c>e ,program4 ,sec4 #fje4 ,ext5sion ( deadl9e = submittal ( claims by heal? c>e entities & provid]s "u prompt paym5t /&>d4 ,sec4 #fjf4 ,audit ( repres5tative sample ( vet]ans receiv+ c>e & s]vices "u ,vet]ans ,community ,c>e ,program4 ,sec4 #fjg4 ,in=mation on wait "t & drive "t options = receipt ( c>e by vet]ans4 ,sec4 #fjh4 ,e/abli%m5t ( p]iod dur+ :i* a ref]ral "u ,vet]ans ,community ,c>e ,program rema9s valid4 ,sec4 #fji4 ,updates to contract+ requirem5ts "u ,vet]ans ,community ,c>e ,program4 ,sec4 #faj4 ,publication ( community c>e network suffici5cy & paym5t waiv] reque/s & approvals4 ,sec4 #faa4 ,requirem5ts relat+ to quality ( community c>e provid]s4 ,sec4 #fab4 ,provid] tra9+4 ,sec4 #fac4 ,ov]sight au?ority ov] community c>e4 ,subtitle ,b--,m5tal ,heal? ,treatm5t ,programs ,sec4 #fba4 ,vet]an p>ticipation 9 c]ta9 m5tal heal? programs4 ,sec4 #fbb4 ,access to m5tal heal? resid5tial rehabilitation treatm5t programs = vet]ans ) sp9al cord injury or disord]4 ,subtitle ,c--,/aff+ ,matt]s ,sec4 #fca4 ,treatm5t ( psy*ologi/s4 ,sec4 #fcb4 ,m5tor%ip program = executive lead]%ip teams at m$ical c5t]s ( ! ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4 #fcc4 ,requirem5t = equival5t role po/+s = vacant positions at ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4 #fcd4 ,improvem5ts to ,dep>tm5t ( ,vet]ans ,affairs hir+ processes4 ,sec4 #fce4 ,dep>tm5t ( ,vet]ans ,affairs telework policy4 ,sec4 #fcf4 ,expansion ( reimbursem5t ( cont9u+ pr(essional education exp5ses4 ,sec4 #fcg4 ,dep>tm5t ( ,vet]ans ,affairs p]sonnel transp>5cy4 ,sec4 #fch4 ,modification ( au?ority ( lic5sure ( heal? c>e pr(essionals provid+ treatm5t via telem$ic9e4 ,sec4 #fci4 ,provision ( data on educational assi/ance programs ( ,vet]ans ,heal? ,adm9i/ration4 ,subtitle ,d--,optimization ( ,work=ce ,sec4 #fda4 ,dep>tm5t ( ,vet]ans ,affairs /rategic human capital plan4 ,sec4 #fdb4 ,dep>tm5t ( ,vet]ans ,affairs r$uction 9 =ce notice requirem5t4 ,sec4 #fdc4 ,detail$ plans & ju/ifications = reorganization ( (fices4 ,sec4 #fdd4 ,rule ( con/ruction4 ,subtitle ,e--,vet]ans ,infra/ructure & ,trans=mation ,sec4 #fea4 ,%ort title4 ,sec4 #feb4 ,modification ( au?ority = %>+ ( heal?-c>e res\rces ( ,dep>tm5t ( ,vet]ans ,affairs to include flexible space utilization & /reaml9$ s]vice agreem5ts4 ,sec4 #fec4 ,use ( comm]cial con/ruction & facilities code & /&>ds4 ,sec4 #fed4 ,feasibility /udy = full-s]vice hospital ( ,dep>tm5t ( ,vet]ans ,affairs 9 c]ta9 ,/ates4 ,sec4 #fee4 ,report on /rategic plan = infra/ructure & capital assets ( ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4 #fef4 ,p]man5t ext5sion ( pilot program on acceptance by ! ,dep>tm5t ( ,vet]ans affairs ( donat$ facilities & relat$ improvem5ts4 ,sec4 #feg4 ,au?ority to accept donations ( con/ruction s]vices1 m9or con/ruction or nonrecurr+ ma9t5ance projects1 & t>get$ contributions4 ,sec4 #feh4 ,report on use ( additional au?orities relat+ to recruitm5t & ret5tion ( p]sonnel4 ,sec4 #fei4 ,reports on key capital asset inve/m5ts1 activities1 & p]=mance ( ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4 #ffj4 ,developm5t ( /reaml9$ procurem5t model2 report4 ,sec4 #ffa4 ,submission & notification ( co/ e/imates = m$ical facility leases4 ,sec4 #ffb4 ,report on capital asset & in=mation te*nology ne$s ( ! rese>* & developm5t program ( ,dep>tm5t ( ,vet]ans ,affairs4 ,sec4 #ffc4 ,improv+ prev5tion1 detection1 & report+ ( wa/e1 fraud1 & abuse 9 ,dep>tm5t ( ,vet]ans ,affairs capital asset projects & activities4 ,sec4 #ffd4 ,report on long-t]m c>e physical infra/ructure ne$s ( ,dep>tm5t ( ,vet]ans ,affairs4 ,subtitle ,f--,o!r ,heal? ,c>e ,matt]s ,sec4 #fga4 ,prescription1 deliv]y1 di/ribution1 & disp5sation ( controll$ sub/ance m$ications by cov]$ heal? c>e pr(essionals ( ,dep>tm5t ( ,vet]ans ,affairs via telem$ic9e4 ,sec4 #fgb4 ,copaym5ts = limit$ supplies ( m$ications4 ,sec4 #fgc4 ,plan on e/abli%m5t ( int]active1 onl9e self-s]vice module = c>e4 ,sec4 #fgd4 ,modification ( requirem5ts = ,c5t] = ,innovation = ,c>e & ,paym5t ( ! ,dep>tm5t ( ,vet]ans ,affairs & transf] ( au?ority4 ,sec4 #fge4 ,report on improvem5ts to cl9ical appeals process4 ,sec4 #fgf4 ,plan on increas+ accessibility ( c>e = vet]ans ) sp9al cord injury or disord]4 ,i ,comp5sation #aja4 ,major ,ri*>d ,/> ,act 7a7 ,concurr5t receipt g5]ally ,section #adad7;b7 ( title #aj1 ,unit$ ,/ates ,code1 is am5d$ by /rik+ p>agraph 7#b7 & ins]t+ ! foll[+ new p>agraphs3 7#b7 ,combat-relat$ disability retirees 7,a7 ,9 g5]al ,a memb] retir$ "u *apt] #fa ( ?is title ) a combat-relat$ disability :o is entitl$ = any mon? to retir$ pay "u *apt] #fa ( ?is title & is also entitl$ = t mon? to vet]ans' disability comp5sation "u title #ch1 is entitl$ to be paid bo? )\t reg>d to sections #ecjd & #ecje ( title #ch1 z provid$ by subp>agraphs 7,b7 & 7,c74 7,b7 ,c>e] retirees ,9 ! case ( a memb] retir$ "u *apt] #fa ( ?is title :o has a combat-relat$ disability t is n a qualify+ s]vice-connect$ disability 7z def9$ 9 subsection 7a77#b77 & :o1 at ! "t ( ! memb]'s retirem5t1 _h #bj ye>s or m ( s]vice o!rwise cr$itable "u section #adje ( ?is title or at lea/ #bj ye>s ( s]vice comput$ "u section #abgcb ( ?is title1 ! memb] may receive1 )\t reg>d to sections #ecjd & #ecje ( title #ch1 bo?-- 7i7 ! am\nt ( retir$ pay to :i* ! memb] w\ld h be5 entitl$ "u any o!r provision ( law bas$ on ! memb]'s s]vice 9 ! uni=m$ s]vices if ! memb] _h n be5 retir$ "u *apt] #fa ( ?is title2 & 7ii7 vet]ans' disability comp5sation "u title #ch4 7,c7 ,disability retirees ) less ?an #bj ye>s ( s]vice ,9 ! case ( a memb] retir$ "u *apt] #fa ( ?is title ) a combat-relat$ disability & :o1 at ! "t ( ! memb]'s retirem5t1 _h less ?an #bj ye>s ( s]vice o!rwise cr$itable "u section #adje ( ?is title or less ?an #bj ye>s ( s]vice comput$ "u section #abgcb ( ?is title1 ! memb] may receive1 )\t reg>d to sections #ecjd & #ecje ( title #ch1 ! less] (-- 7i7 bo?-- 7,i7 ! retir$ pay = :i* ! memb] is eligible "u *apt] #fa ( ?is title2 & 7,,ii7 vet]ans' disability comp5sation "u title #ch2 or 7ii7 bo?-- 7,i7 an am\nt equal to ! product ( ! retir$ pay base comput$ "u section #adjf7;b7 or #adjg ( ?is title & ! retir$ pay multipli] det]m9$ "u section #adji ( ?is title1 z su* base pay & multipli] w\ld be comput$ if ! memb] _h #bj ye>s ( s]vice cr$itable "u section #adje ( ?is title2 & 7,,ii7 vet]ans' disability comp5sation "u title #ch4 7,d7 ,combat-relat$ disability def9$ ,9 ?is p>agraph1 ! t]m combat-relat$ disability has ! mean+ giv5 t t]m 9 subsection 7e7 ( section #adac;a ( ?is title & z det]m9$ "u ! crit]ia & proc$ures us$ = purposes ( su* section4 7#c7 ,exclusion ( o!r retirees ,subsection 7a7 does n apply to a memb] retir$ "u *apt] #fa ( ?is title if ! memb] is n cov]$ by p>agraph 7#a7 or 7#b74 4 7b7 ,te*nical & con=m+ am5dm5ts 7#a7 ,coord9ation ) combat-relat$ special comp5sation program ,section #adad7;d7 ( title #aj1 ,unit$ ,/ates ,code1 is am5d$ by /rik+ qualifi$ retiree "u ?is section & ins]t+ qualifi$ retiree "u subsection 7a7 or is entitl$ to a paym5t "u subsection 7b77#b74 7#b7 ,am5dm5ts reflect+ end ( concurr5t receipt phase-9 p]iod ,section #adad ( title #aj1 ,unit$ ,/ates ,code1 is fur!r am5d$-- 7,a7 9 subsection 7a77#a7-- 7i7 by /rik+ ! second s5t5ce2 & 7ii7 by /rik+ subp>agraphs 7,a7 & 7,b72 7,b7 by /rik+ subsection 7c7 & r$esignat+ subsections 7d7 & 7e7 z subsections 7c7 & 7d71 respectively2 & 7,c7 9 subsection 7d71 z r$esignat$1 by /rik+ p>agraphs 7#c7 & 7#d74 7#c7 ,section head+ ,! head+ ( section #adad ( su* title is am5d$ to read z foll[s3 #adad4 ,memb]s eligible = retir$ pay :o are also eligible = vet]ans' disability comp5sation3 concurr5t receipt 4 7#d7 ,con=m+ am5dm5t ,section #adac;a7f7 ( su* title is am5d$ by /rik+ ,subsection 7d7 & ins]t+ ,subsection 7c74 7c7 ,effective date ,! am5dm5ts made by ?is section %all take effect on ,janu>y #a1 #bjbg1 & %all apply to paym5ts = mon?s beg9n+ on or aft] t date4 #ajb4 ,love ,lives ,on ,act 7a7 ,modification ( entitlem5t to vet]ans dep5d5cy & indemnity comp5sation = surviv+ sp\ses :o rem>ry ,section #ajc7;d7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 9 p>agraph 7#b77;,b7-- 7,a7 by ins]t+ 7i7 be=e ,! rem>riage2 7,b7 9 clause 7i71 z designat$ by subp>agraph 7,a71 by /rik+ ,not)/&+ ! previ\s s5t5ce & ins]t+ ! foll[+3 7ii7 ,not)/&+ clause 7i7 2 & 7,c7 by add+ at ! end ! foll[+ new clause3 7iii7 ,not)/&+ clause 7ii71 ! rem>riage ( a surviv+ sp\se %all n b> ! furni%+ ( b5efits "u section #acaa or #aefb ( ?is title to ! surviv+ sp\se ( a vet]an4 2 & 7#b7 9 p>agraph 7#e7-- 7,a7 by /rik+ subp>agraph 7,a72 & 7,b7 by r5umb]+ subp>agraphs 7,b7 ?r\gh 7,e7 z subp>agraphs 7,a7 ?r\gh 7,d71 respectively4 7b7 ,cont9u$ eligibility = survivor b5efit plan = c]ta9 surviv+ sp\ses :o rem>ry ,section #adej7;b77#b7 ( title #aj1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 by /rik+ ,an annuity & ins]t+ ! foll[+3 7,a7 ,9 g5]al 7,a7 ,subject to subp>agraph 7,b71 an annuity 2 & 7#b7 by add+ at ! end ! foll[+ new subp>agraph3 7,b7 ,treatm5t ( survivors ( memb]s :o die on active duty ,! ,secret>y may n t]m9ate paym5t ( an annuity = a surviv+ sp\se describ$ 9 subp>agraph 7,a7 or 7,b7 ( section #addh7;d77#a7 solely because t surviv+ sp\se rem>ries4 ,9 ! case ( a surviv+ sp\se :o rem>ri$ be=e rea*+ age #ee & be=e ! date ( ! enactm5t ( ,take ,c>e ( ,am]ica's ,vet]ans ,act1 ! ,secret>y %all resume paym5t ( ! annuity to t surviv+ sp\se-- 7i7 except z provid$ by clause 7ii71 = ea* mon? t beg9s on or aft] ! date t is "o ye> aft] su* date ( enactm5t2 or 7ii7 on ! fir/ day ( ! fir/ mon? beg9n+ aft] su* date ( enactm5t1 9 ! case ( a surviv+ sp\se :o elect$ to transf] paym5t ( t annuity to a surviv+ *ild or *ildr5 "u ! provisions ( section #addh7;d77#b77;,b7 ( title #aj1 ,unit$ ,/ates ,code1 z 9 effect on ,decemb] #ca1 #bjai4 4 7c7 ,expansion ( def9ition ( dep5d5t "u ,,tric>e program to include a rem>ri$ wid[ or wid[] ^: subsequ5t m>riage has end$ ,section #ajgb7b7 ( title #aj1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 9 subp>agraph 7,h71 by /rik+ 2 & & ins]t+ a semicolon2 7#b7 9 subp>agraph 7,i77v71 by /rik+ ! p]iod at ! end & ins]t+ 2 &2 & 7#c7 by add+ at ! end ! foll[+ new subp>agraph3 7,j7 a rem>ri$ wid[ or wid[] ^: subsequ5t m>riage has end$ due to dea?1 divorce1 or annulm5t4 4 #ajc4 ,ext5sion ( increas$ dep5d5cy & indemnity comp5sation to surviv+ sp\ses ( vet]ans :o die f amyotrophic lat]al scl]osis 7a7 ,ext5sion ,section #acaa7;a77#b7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 by ins]t+ 7,a7 be=e ,! rate2 & 7#b7 by add+ at ! end ! foll[+ new subp>agraph3 7,b7 ,a vet]an :om ! ,secret>y det]m9es di$ f amyotrophic lat]al scl]osis %all be treat$ z a vet]an describ$ 9 subp>agraph 7,a7 )\t reg>d = h[ long ! vet]an _h su* disease prior to dea?4 4 7b7 ,applicability ,subp>agraph 7,b7 ( section #acaa7;a77#b7 ( title #ch1 ,unit$ ,/ates ,code1 z add$ by subsection 7a71 %all apply to a vet]an :o dies f amyotrophic lat]al scl]osis on or aft] ,octob] #a1 #bjbb4 #ajd4 ,%>ri ,briley & ,eric ,edmundson ,vet]ans ,b5efits ,expansion ,act ( #bjbf 7a7 ,increase 9 rates ( c]ta9 disability comp5sation & dep5d5cy & indemnity comp5sation "u laws adm9i/]$ by ,secret>y ( ,vet]ans ,affairs 7#a7 ,increase to rates ( w>time disability comp5sation 7,a7 ,9 g5]al ,section #aaad ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new subsection3 7u7 ,9 ! case ( a vet]an eligible = a mon?ly aid & att5dance all[ance "u subsection 7r7 or subsection 7t7 ( ?is section1 ! ,secret>y %all1 9 addition to ! total am\nt ( comp5sation = :i* ! vet]an is eligible "u ?is section1 pay ! vet]an a supplem5tal mon?ly all[ance at ! rate ( #hcc4cc4 4 7,b7 ,effective date2 applicability ,subsection 7u7 ( su* section 7z add$ by subp>agraph 7,a77 %all take effect on ,decemb] #a1 #bjbf1 & %all apply to mon?s beg9n+ on or aft] su* date4 7#b7 ,increase to rates ( dep5d5cy & indemnity comp5sation ,section #ecab ( su* title is am5d$ by add+ at ! end ! foll[+ new subsection3 7d7 7#a7 ,:5ev] !re is an increase 9 b5efit am\nts payable "u title ,,ii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #dja et seq47 z a result ( a det]m9ation made "u section #bae7;i7 ( su* ,act 7#db ,u4,s4,c4 #dae7;i771 ! ,secret>y %all1 except z provid$ 9 p>agraph 7#b71 effective on ! date ( su* increase 9 b5efit am\nts1 increase ! doll> am\nts 9 effect = ! paym5t ( dep5d5cy & indemnity comp5sation by ! ,secret>y "u p>agraph 7#a7 & p>agraph 7#c7 ( section #acaa7;a7 ( ?is title1 z su* am\nts 7 9 effect imm$iately be=e ! date ( su* increase 9 b5efit am\nts payable "u title ,,ii ( ! ,social ,security ,act1 by a p]c5tage equal to ! sum (-- 7,a7 ! p]c5tage by :i* su* b5efit am\nts are increas$2 & 7,b7 "o p]c5t4 7#b7 ,:5ev] !re is an increase "u p>agraph 7#a7 9 am\nts 9 effect = ! paym5t ( dep5d5cy & indemnity comp5sation1 ! ,secret>y %all publi% su* am\nts1 z increas$ pursuant to su* p>agraph1 9 ! ,f$]al ,regi/] at ! same "t z ! mat]ial requir$ by section #bae7;i77#b77;,d7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #dae7;i77#b77;,d77 is publi%$ by reason ( a det]m9ation "u section #bae7;i7 ( su* ,act 7#db ,u4,s4,c4 #dae7;i774 7#c7 ,! requirem5t to increase1 pursuant to p>agraph 7#a71 ! am\nts 9 effect = ! paym5t ( dep5d5cy & indemnity comp5sation "u p>agraph 7#a7 & p>agraph 7#c7 ( section #acaa 7a7 ( ?is title by ! ,secret>y %all-- 7,a7 take effect on ,decemb] #a1 #bjbf1 & %all apply ) respect to mon?s beg9n+ on or aft] su* date2 & 7,b7 t]m9ate aft] ! date on :i* ! ?ird increase to su* am\nts pursuant to su* p>agraph occurs4 4 7b7 ,modification ( waiv]s ( fees collect$ = h\s+ loans gu>ante$1 insur$1 or made by ! ,secret>y ( ,vet]ans ,affairs ,section #cgbi7;b77#b7 ( su* title is am5d$1 9 ! loan fee table-- 7#a7 9 subp>agraph 7,e71 by /rik+ #j4ej bo? places x appe>s & ins]t+ #a4db2 & 7#b7 9 subp>agraph 7,i71 by /rik+ #j4ej ea* place x appe>s & ins]t+ #a4j4 7c7 ,home af=dability = ,gu>d & ,res]ve 7#a7 ,eligibility ( c]ta9 memb]s ( ! res]ve compon5ts & ! ,national ,gu>d = gu>ante$ h\s+ loans 7,a7 ,exp&$ def9ition ( active duty = purposes ( h\s+ loans ,section #cgja7;b7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#i7 ,! t]m active duty has ! mean+s z foll[s3 7,a7 ,9 ! case ( memb]s ( ! regul> compon5ts ( ! ,arm$ ,=ces1 ! mean+ giv5 su* t]m 9 section #aja7ba77;,a74 7,b7 ,9 ! case ( memb]s ( ! res]ve compon5ts ( ! ,arm$ ,=ces-- 7i7 s]vice on active duty 7z def9$ 9 section #aja7;d7 ( title #aj71 inactive-duty tra9+ 7z def9$ 9 section #aja7;d7 ( title #aj71 or annual tra9+ duty2 or 7ii7 s]vice on active duty "u a call or ord] to active duty "u section #fhh1 #abcja7;a71 #abcja7;d71 #abcja7;g71 #abcja7;h71 #abcjb1 #abcjd1 #abcjd;a1 or #abcjd;b ( title #aj or section #gac ( title #ad1 b n includ+ inactive duty tra9+ 7z def9$ 9 section #aja7;d7 ( title #aj7 or annual tra9+ duty4 7,c7 ,9 ! case ( a memb] ( ! ,army ,national ,gu>d ( ! ,unit$ ,/ates or ,air ,national ,gu>d ( ! ,unit$ ,/ates1 9 addition to s]vice describ$ 9 subp>agraph 7,b71 full-"t s]vice-- 7i7 9 ! ,national ,gu>d ( a ,/ate = ! purpose ( organiz+1 adm9i/]+1 recruit+1 in/ruct+1 or tra9+ ! ,national ,gu>d2 7ii7 9 ! ,national ,gu>d :5 p]=m+ full-"t ,national ,gu>d duty 7z def9$ 9 section #aja ( title #cb72 or 7iii7 9 ! ,national ,gu>d :5 p]=m+ active duty 7z def9$ 9 section #aja ( title #cb74 4 7,b7 ,retroactive applicability to s]vice p]=m$ ,! am5dm5ts made by ?is subsection %all apply ) respect to any s]vice p]=m$ on or aft] ,septemb] #aa1 #bjja4 7#b7 ,expansion ( eligibility = gu>ante$ h\s+ loans to c]ta9 additional p]sonnel ^u paym5t ( additional loan fee 7,a7 ,expansion to individuals ) at lea/ #ad days ( s]vice ,section #cgja7;b7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by ins]t+ aft] p>agraph 7#g7 ! foll[+ new p>agraph3 7#h7 ,! t]m vet]an also includes1 = purposes ( home loans 7subject to ! additional loan fee 9 section #cgbi7;b77#d77;,j7 ( ?is title71 an individual :o-- 7,a7 is n o!rwise eligible = ! b5efits ( ?is *apt]2 7,b7 has complet$ a total s]vice ( at lea/ #ad days on active duty "u p>agraph 7,b7 or 7,c7 ( p>agraph 7#i72 & 7,c7 foll[+ completion ( su* s]vice1 cont9u$ to s]ve until ! completion ( entry level & skill tra9+ 7z def9$ 9 section #ccja7c7 ( ?is title74 4 7,b7 ,basic entitlem5t ,section #cgjb7;a77#b7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+3 7,h7 ,ea* individual describ$ 9 section #cgja7;b77#h7 ( ?is title4 4 7,c7 ,additional loan fee = su* individuals ,section #cgbi7;b77#d7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new subp>agraph3 7,j7 ,9 ! case ( a h\s+ loan 9 :i* ! vet]an has eligibility "u section #cgja7;b77#h7 ( ?is title & does n o!rwise h eligibility1 ! loan fee table 9 p>agraph 7#b7 %all be appli$ to ! vet]an or o!r obligor 7z applicable7 by add+ #a4jj to ! p]c5tage 9 ! table4 4 7,d7 ,notification to p]sonnel ,! ,secret>y ( ,vet]ans ,affairs %all provide in=mation ab\t ?is b5efit to ! ,secret>y ( ,def5se to ensure t ea* memb] ( a res]ve compon5t or a memb] ( ! ,army ,national ,gu>d ( ! ,unit$ ,/ates or ,air ,national ,gu>d ( ! ,unit$ ,/ates :o completes entry level & skill tra9+ 7z def9$ 9 section #ccja7c7 ( title #ch1 ,unit$ ,/ates ,code7 aft] ! date ( ! enactm5t ( ?is ,act is notifi$ ( _! eligibility = h\s+ loan b5efits "u *apt] #cg ( su* title1 includ+ eligibility 7subject to ! additional loan fee7 "u section #cgja7;b77#h7 ( su* title4 #aje4 ,claims3 prohibition on d5ial solely = c]ta9 reason2 improv$ effici5cy ( adjudications & appeals 7a7 ,prohibition on d5ial ( claims = b5efits "u laws adm9i/]$ by ,secret>y ( ,vet]ans ,affairs on sole basis t vet]an fail$ to appe> = c]ta9 m$ical exam9ation ,subsection 7d7 ( section #eajc;,a ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 9 ! head+1 by /rik+ comp5sation claims & ins]t+ claims = b5efits2 7#b7 9 p>agraph 7#b71 by /rik+ treat an exam9ation or op9ion z be+ necess>y to make a decision on a claim = purposes ( & ins]t+ provide = a m$ical exam9ation or obta9 a m$ical op9ion "u2 & 7#c7 by add+ at ! end ! foll[+ new p>agraph3 7#c7 ,if a vet]an fails to appe> = a m$ical exam9ation provid$ by ! ,secret>y 9 conjunction ) a claim = a b5efit "u a law adm9i/]$ by ! ,secret>y1 ! ,secret>y may n d5y su* claim on ! sole basis t su* vet]an fail$ to appe> = su* m$ical exam9ation4 4 7b7 ,improvem5ts to effici5cy ( adjudications & appeals ( claims = b5efits "u laws adm9i/]$ by ,secret>y ( ,vet]ans ,affairs 7#a7 ,annual report on l5g? ( adjudications 7,a7 ,9 g5]al ,section #eaji;,b ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7i7 by /rik+ ,! ,secret>y & ins]t+ 7a7 ,9 g5]al4--,! ,secret>y2 & 7ii7 by add+ at ! end ! foll[+ new subsection3 7b7 ,annual report ,! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate an annual report t includes1 ) respect to ! p]iod cov]$ by ! report-- 7#a7 ! av]age l5g? ( "t a claim 7or an issue )9 a claim7 t 0 rem&$ by ! ,bo>d ( ,vet]ans' ,appeals 0 or has be5 p5d+ be=e ! ,secret>y aft] su* rem&2 7#b7 ! numb] ( cases t advanc$ on ! docket by reason ( a motion t 0 fil$ "u section #gajg7;b7 ( ?is title & on :i* ! ,bo>d rul$1 disaggregat$ by-- 7,a7 :e!r a motion 0 grant$ or d5i$2 & 7,b7 ! reason provid$ = ! motion2 & 7#c7 ! numb] ( appeals dismiss$ by ! ,bo>d1 disaggregat$ by-- 7,a7 :e!r or n ! dismissal 0 by reason ( ! dea? ( ! appellant2 & 7,b7 9 ! case ( a dismissal by reason ( ! dea? ( ! appellant1 :e!r or n su* dea? 0 a result ( suicide4 4 7,b7 ,deadl9e ,! ,secret>y ( ,vet]ans ,affairs %all submit ! fir/ report requir$ by subsection 7b7 ( section #eaji;,b ( su* title 7z add$ by subp>agraph 7,a77 by n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act4 7#b7 ,guidel9es = advancem5t ( cases on docket ( ,bo>d ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs1 9 consultation ) ! ,bo>d ( ,vet]ans' ,appeals & ! ,g5]al ,c\nsel ( ! ,dep>tm5t ( ,vet]ans ,affairs1 %all prescribe guidel9es = ! advancem5t ( a case on ! docket ( ! ,bo>d on a motion = e>li] consid]ation & det]m9ation "u section #gajg7;b77#c7 ( title #ch1 ,unit$ ,/ates ,code4 ,su* guidel9es %all include ! type ( evid5ce t may be submitt$ ) ! motion = ! advancem5t ( ! case to %[ gr\nds = su* a motion4 7#c7 ,requirem5t ,to track c]ta9 claims = b5efits 7,a7 ,9 g5]al ,*apt] #ea ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by ins]t+ aft] section #eaji;,b ! foll[+ new section3 #eaji;,c4 ,requirem5t to track & ma9ta9 in=mation on c]ta9 claims = b5efits2 notice ( c]ta9 assignm5ts 7a7 ,9 g5]al ,! ,secret>y %all use te*nology to track & ma9ta9 in=mation 7includ+ in=mation ) respect to timel9ess7 on-- 7#a7 claims = b5efits "u ! laws adm9i/]$ by ! ,secret>y 7includ+ issues )9 su* claims7 t are-- 7,a7 cont9u\sly pursu$ 9 accordance )-- 7i7 sections #eajd;,c7a7 & #eaaj7;a77#b7 ( ?is title2 or 7ii7 any o!r policy e/abli%$ by ! ,secret>y2 7,b7 fil$ 9 ! ,national ,"w ,queue 7or any successor sy/em7 b h n be5 assign$ to an (fice ( ! ,vet]ans ,b5efits ,adm9i/ration = adjudication2 7,c7 af=d$ exp$iti\s treatm5t by ! ,vet]ans ,b5efits ,adm9i/ration pursuant to section #eaji;,b ( ?is title or any o!r policy e/abli%$ by ! ,secret>y2 7,d7 rem&$ by ! ,bo>d ( ,vet]ans' ,appeals to ! ,secret>y pursuant to section #gajd ( ?is title2 or 7,e7 p5d+ a he>+ by ! ,bo>d ( ,vet]ans' ,appeals "u section #gajg ( ?is title2 7#b7 in/ances 9 :i* an adjudicator ( ! ,vet]ans ,b5efits ,adm9i/ration does n comply ) a relevant decision ( ! ,bo>d ( ,vet]ans' ,appeals to rem& a claim = b5efits "u ! laws adm9i/]$ by ! ,secret>y 7or an issue )9 su* a claim71 includ+ any su* in/ance 9 :i* ! relevant decision conc]n$ a failure on ! "p ( ! ag5cy ( orig9al jurisdiction to satisfy ! duty ( ! ,secret>y to assi/ "u section #eajc;,a ( ?is title2 7#c7 supplem5tal claims "u section #eajh ( ?is title t are fil$-- 7,a7 9 accordance ) section #eajd;,c7a7 & section #eaaj7;a77#b7 ( ?is title2 & 7,b7 aft] ! date ( ! applicable f9al decision ( ! ,secret>y ) respect to a claim = b5efits "u ! laws adm9i/]$ by ! ,secret>y 7or an issue )9 su* a claim72 & 7#d7 fir/ notices submitt$ to ! ,secret>y ( ! dea? ( individuals 9 receipt ( b5efits "u ! laws adm9i/]$ by ! ,secret>y1 disaggregat$ by su* individuals :o 7-- 7,a7 assign$ a fiduci>y2 & 7,b7 n assign$ a fiduci>y4 7b7 ,annual report 7#a7 ,! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate an annual report t includes all in=mation ma9ta9$ & track$ pursuant to subsection 7a74 7#b7 ,! fir/ report requir$ by p>agraph 7#a7 %all be submitt$ by n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act4 4 7,b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( su* *apt] is am5d$ by ins]t+ aft] ! item relat+ to section #eaji;,b ! foll[+ new item3 #eaji;,c4 ,requirem5t to track & ma9ta9 in=mation on c]ta9 claims = b5efits2 notice ( c]ta9 assignm5ts4 4 7#d7 ,improvem5ts to ,bo>d ( ,vet]ans' ,appeals 7,a7 ,au?ority to aggregate c]ta9 claims 7i7 ,9 g5]al ,section #gajd7;a7 ( su* title is am5d$ by ins]t+ aft] ! second s5t5ce ! foll[+ new s5t5ce3 ,if ! ,*airman ( ! ,bo>d det]m9es t m ?an "o appeal involves common que/ions ( law or fact1 ! ,*airman may aggregate su* appeals to decide su* que/ions ( law or fact44 7ii7 ,effective date ,! am5dm5t made by clause 7i7 %all take effect on ! date ( ! enactm5t ( ?is ,act & apply beg9n+ on ! date #ij days aft] ! date on :i* ! ,secret>y ( ,vet]ans ,affairs submits to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ,h\se ( ,repres5tatives a copy ( ! policies & proc$ures requir$ "u p>agraph 7#g77;,d77i77,,ii74 7iii7 ,sunset ,! au?ority to aggregate appeals pursuant to clause 7i7 %all expire on ! date t is ?ree ye>s aft] ! date on :i* ! ,secret>y ( ,vet]ans ,affairs completes ! developm5t ( ! policies & proc$ures requir$ "u p>agraph 7#g77;,d77i77,,ii74 7,b7 ,requirem5t to ensure sub/antial compliance ) c]ta9 decisions ,su* section is fur!r am5d$-- 7i7 by r$esignat+ subsection 7f7 z subsection 7g72 & 7ii7 by ins]t+ aft] subsection 7e7 ! foll[+ new subsection 7f73 7f7 7#a7 ,! ,secret>y1 act+ ?r\gh a memb] ( ! ,bo>d1 %all ensure sub/antial compliance ) any decision ( ! ,bo>d to rem& a claim4 7#b7 ,! ag5cy ( orig9al adjudication may waive ! requirem5t "u p>agraph 7#a7 ) respect to a decision ( ! ,bo>d to rem& a claim to ! ,secret>y1 if a memb] ( ! ,bo>d det]m9es-- 7,a7 evid5ce add$ to ! evid5ti>y record aft] ! date ( su* decision is suffici5t to resolve ! issues und]ly+ su* decision2 or 7,b7 su* decision 0 unnecess>y4 7#c7 ,if ! ,secret>y waives su* requirem5t1 ! applicable memb] ( ! ,bo>d %all include1 pursuant to subsection 7d71 a det]m9ation ( su* waiv] 9 ! decision ( ! ,bo>d4 4 7,c7 ,def9ition ( aggregate2 report ,su* section is fur!r am5d$ by add+ at ! end ! foll[+ new subsections3 7h7 ,n lat] ?an ?ree ye>s aft] ! date on :i* ! ,secret>y ( ,vet]ans ,affairs completes ! developm5t ( ! policies & proc$ures requir$ "u p>agraph 7#g77;,d77i77,,ii71 & e five ye>s !reaft]1 ! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ,h\se ( ,repres5tatives a report on ! aggregation ( claims by ! ,bo>d "u subsection 7a74 ,ea* su* report %all include-- 7#a7 an id5tification ( ea* in/ance 9 :i* ! ,bo>d aggregat$ appeals dur+ ! p]iod cov]$ by ! report1 includ+1 = ea* su* in/ance1 ! numb] ( appeals t 7 aggregat$2 7#b7 an assessm5t ( :e!r ! aggregation ( appeals has contribut$ to improv$ effici5cy at ! ,bo>d ) issu+ decisions on appeals2 & 7#c7 su* o!r matt]s z ! ,secret>y det]m9es appropriate4 7i7 ,9 ?is section1 ! t]m aggregate-- 7#a7 means any practice or proc$ure to collect common issues1 claims1 or appeals by multiple p>ties = ! purposes ( resolv+ su* issues1 claims1 or appeals2 & 7#b7 includes ! use ( jo9d]1 consolidation1 int]v5tion1 class actions1 & any o!r multip>ty proce$+s4 4 7#e7 ,expansion ( jurisdiction ( ,c\rt ( ,appeals = ,vet]ans ,claims ,section #gbeb ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7,a7 by r$esignat+ subsections 7b7 & 7c7 z subsections 7d7 & 7e71 respectively2 & 7,b7 by ins]t+ aft] subsection 7a7 ! foll[+ new subsections3 7b7 7#a7 ,9 an appeal ov] :i* ! ,c\rt has jurisdiction pursuant to section #gbff ( ?is title1 if ! appellant files a reque/ = class c]tification pursuant to ! rules prescrib$ by ! ,c\rt pursuant to section #gbfd ( ?is title1 ! ,c\rt %all h supplem5tal jurisdiction ov] any claim = b5efits "u ! laws adm9i/]$ by ! ,secret>y-- 7,a7 fil$ by a claimant :o satisfies ! def9ition ( ! class conta9$ 9 su* reque/ 7includ+ a claimant :o has fil$ a claim = b5efits "u su* laws t are specifi$ 9 su* reque/72 & 7,b7 reg>d+ :i*-- 7i7 ! ag5cy ( orig9al jurisdiction has issu$ a nonf9al decision2 & 7ii7 ! claimant has fil$ a notice ( disagreem5t "u section #eajd;,c7a7 or section #gaje ( ?is title1 includ+ any case 9 :i* a claimant has fil$ a supplem5tal claim )9 "o ye> ( a ,bo>d decision "u section #eaaj7;a77#b77;,d7 & #eajh ( ?is title foll[+ a notice ( disagreem5t & decision ( ! ,bo>d4 7#b7 ,a claimant may submit a reque/ = adm9i/rative review ( su* a claim "u section #eajd;,c7a7 ( ?is title dur+ ! p]iod beg9n+ on ! date on :i* ! nam$ claimant ( ! motion = class action review submits to ! ,c\rt a motion = class action review & end+ on ! date t is #fj days aft] ! lat] ( ! foll[+ dates3 7,a7 ,! date on :i* ! ,c\rt issues a f9al decision ) respect to su* claim4 7,b7 ,! date on :i* ! ,c\rt issues a f9al decision ) respect to su* motion = class action review4 7#c7 ,9 ! case ( a claimant ^: claim is decid$ by ! ,bo>d dur+ ! p]iod :5 ! ,c\rt is review+ ! motion = class action review ! deadl9e = su* claimant to file an appeal to ! ,c\rt ) respect to ! decision ( ! ,bo>d %all be toll$ if ! ,c\rt d5ies ! motion = class action review4 7c7 7#a7 ,9 ! case ( a claim = b5efits "u ! laws adm9i/]$ by ! ,secret>y1 ! ,c\rt may rem& a matt] to ! ,bo>d ( ,vet]ans' ,appeals = ! limit$ purpose ( ord]+ ! ,bo>d to address a "q ( law or fact if ! ,c\rt det]m9es ! ,bo>d fail$ to-- 7,a7 address1 9 ! relevant decision ( ! ,bo>d1 an issue t-- 7i7 ! claimant or ! repres5tative ( ! claimant rais$2 or 7ii7 0 reasonably rais$ by ! evid5ti>y record ( ! claim2 or 7,b7 provide adequate reasons or bases = ! decision ( ! ,bo>d ) respect to su* "q4 7#b7 ,! ,c\rt %all issue ,rules t provide = ea* ( ! foll[+3 7,a7 ,:5 & h[ a p>ty to an appeal 7ei!r ! appellant or ! ,secret>y7 may reque/ t ! ,c\rt issue a limit$ rem&4 7,b7 ,! p]iod ( "t )9 :i* ! ,bo>d is requir$ to issue a decision on ! relevant "q id5tifi$ 9 a limit$ rem&4 7,c7 ,guidel9es = :5 ! ,c\rt may grant a reque/ = a limit$ rem&4 7,d7 ,guidel9es = :5 ! ,c\rt may decide sua sponte to issue a limit$ rem& )\t a reque/ f any p>ty4 7,e7 ,a requirem5t t ! p>ties to an appeal = :i* a limit$ rem& is issu$ provide notice to ! ,c\rt :5 ! ,bo>d issues its decision on ! relevant "q id5tifi$ 9 ! limit$ rem&4 7#c7 ,) respect to any matt] rem&$ to ! ,bo>d pursuant to p>agraph 7#a71 ! ,c\rt %all-- 7,a7 reta9 jurisdiction ov] su* matt]2 & 7,b7 /ay ! proce$+s ( ! ,c\rt on su* matt] until ! date on :i* ! ,bo>d issues ! decision requir$ by su* rem&4 4 7#f7 ,/udy & report on common que/ions ( law or fact be=e ,bo>d ( ,vet]ans' ,appeals 7,a7 ,/udy ,! ,*airman ( ! ,bo>d ( ,vet]ans' ,appeals %all c>ry out a /udy to id5tify que/ions ( law or fact ! ,bo>d commonly consid]s :5 review+ appeals pursuant to section #gajd ( title #ch1 ,unit$ ,/ates ,code1 = :i* prec$5tial guidance w\ld assi/ ! ,bo>d 9 issu+ f9al decisions on su* appeals4 ,! ,*airman may use artificial intellig5ce & o!r te*nology 9 c>ry+ out su* /udy4 7,b7 ,report ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,*airman ( ! ,bo>d ( ,vet]ans ,appeals %all submit to ! ,committees on ,vet]ans ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a report t includes ! f9d+s ( ! /udy requir$ by subp>agraph 7,a74 7#g7 ,indep5d5t assessm5t ( pot5tial modifications to au?ority ( ,bo>d ( ,vet]ans' ,appeals 7,a7 ,agreem5t ,n lat] ?an #cj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all seek to ent] into an agreem5t ) an ,,ffrdc "u :i* ! ,,ffrdc %all conduct an assessm5t ( ! feasibility ( modify+ ! au?ority ( ! ,bo>d ( ,vet]ans' ,appeals e/abli%$ "u *apt] #ga ( title #ch1 ,unit$ ,/ates ,code1 to p]mit ! ,bo>d to issue prec$5tial decisions ) respect to que/ions ( law or fact aris+ 9 matt]s be=e ! ,bo>d4 7,b7 ,report2 brief+s ,if ! ,secret>y fails to f9alize an agreem5t ) an ,,ffrdc "u subp>agraph 7,a7 be=e ! date t is #ahj days aft] ! date on :i* ! ,secret>y ent]s negotiations ) respect to su* agreem5t1 ! ,secret>y %all-- 7i7 submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a report t includes-- 7,i7 an explanation ( ! reasons ! ,secret>y fail$ to satisfy su* requirem5t2 & 7,,ii7 an e/imate ( ! date on :i* ! ,secret>y w f9alize ! agreem5t "u subp>agraph 7,a72 & 7ii7 n less frequ5tly ?an once e #fj days aft] ! date on :i* ! ,secret>y fail$ to satisfy su* requirem5t1 provide to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a brief+ on ! progress ( ! ,secret>y t[>d f9aliz+ su* agreem5t4 7,c7 ,assessm5t ,an ,,ffrdc t ent]s into an agreem5t "u subp>agraph 7,a7 %all1 9 consultation ) vet]ans s]vice organizations1 vet]ans' & survivors' advocate gr\ps1 relevant legal exp]ts1 & ! ,*air ( ! ,adm9i/rative ,conf]5ce ( ! ,unit$ ,/ates 7or ! designee or designees ( su* ,*air7 submit to ! ,secret>y a writt5 assessm5t t includes ! foll[+3 7i7 ,! det]m9ation ( ! ,,ffrdc ( :e!r modify+ ! au?ority ( ! ,bo>d to p]mit ! ,bo>d to issue prec$5tial decisions ) respect to que/ions ( law or fact aris+ 9 matt]s be=e ! ,bo>d is feasible4 7ii7 ,an assessm5t ( ! au?ority ( ! ,bo>d ( ,vet]ans' ,appeals to aggregate1 = review1 m ?an "o appeal "u *apt] #ga ( su* title t involves common que/ions ( law or fact pursuant to section #gajd ( su* title1 z am5d$ by p>agraph 7#d77;,a74 7iii7 7,i7 ,! recomm5dations ( ! ,,ffrdc ) respect to rules or pr9ciples to :i* ! ,bo>d %\ld adh]e :5 aggregat+ appeals = review pursuant to section #gajd7;a7 ( title #ch1 ,unit$ ,/ates ,code1 z s am5d$1 includ+-- 7aa7 :e!r ! use ( an opt-out sy/em is appropriate 9 a class c]tification describ$ 9 section #gajd7;a7 ( title #ch1 ,unit$ ,/ates ,code1 z am5d$2 7bb7 :e!r aggregation describ$ 9 clause 7ii7 is bett] c>ri$ out by "o memb]1 or a panel ( memb]s1 ( ! ,bo>d2 7cc7 :e!r su* aggregation may be accompli%$ 9 accordance ) section #gajg ( title #ch1 ,unit$ ,/ates ,code2 & 7dd7 h[ an accr$it$ repres5tative1 attorney1 or au?oriz$ ag5t may be select$ to repres5t a class be=e ! ,bo>d4 7,,ii7 ,! recomm5dations %all include1 b n be limit$ to1 ! foll[+3 7aa7 ,h[ ! ,bo>d %\ld provide notice to claimants ( ! ,bo>d's int5t to aggregate _! claim4 7bb7 ,?is %all include /&>ds = ensur+ t in=mation provid$ to claimants reg>d+ aggregation is writt5 9 pla9 language & cle>ly expla9s ! pot5tial effects ( aggregation on adjudication timel9es1 appeal rights1 & p>ticipation options4 7cc7 ,! options ! ,bo>d %\ld provide to claimants to opt out ( p>ticipation 9 aggregation ( _! claim4 7dd7 ,! rights ( ! claimants to appeal decisions t arise out ( aggregation ( claims1 & :e!r or n su* rights may be limit$ by exi/+ /atute1 regulation1 or judicial decisions4 7ee7 ,safegu>ds to ensure t aggregation ( appeals does n dim9i% ! requirem5t t ea* appeal be decid$ bas$ on ! individual facts1 evid5ce1 & circum/ances specific to ! claimant4 7ff7 ,recomm5dations reg>d+ quality review proc$ures & ov]sight me*anisms to monitor ! impact ( aggregation on claim accuracy1 consi/5cy1 timel9ess1 & claimant outcomes4 7,d7 ,report2 implem5tation 7i7 ,9 g5]al ,n lat] ?an #ij days aft] ! ,secret>y receives ! assessm5t "u subp>agraph 7,c71 ! ,secret>y %all-- 7,i7 submit to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ,h\se ( ,repres5tatives a copy ( su* assessm5t2 & 7,,ii7 beg9 develop+ policies & proc$ures to implem5t ! recomm5dations 9 ! assessm5t ) respect to ! au?ority ( ! ,bo>d ( ,vet]ans' ,appeals ref]r$ to 9 subp>agraph 7,c74 7ii7 ,deadl9e ,! ,secret>y %all complete ! developm5t ( ! policies & proc$ures requir$ "u clause 7i77,,ii7 & submit to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ,h\se ( ,repres5tatives a copy ( su* policies & proc$ures n lat] ?an six mon?s aft] ! date on :i* ! ,secret>y beg9s develop+ su* policies & proc$ures4 7,e7 ,def9itions ,9 ?is p>agraph3 7i7 ,! t]m ,,ffrdc means a f$]ally fund$ rese>* & developm5t c5t]4 7ii7 ,! t]m vet]ans s]vice organization means an organization recogniz$ by ! ,secret>y = ! repres5tation ( vet]ans "u section #eijb ( title #ch1 ,unit$ ,/ates ,code4 7c7 ,improvem5ts to sy/em = adjudication ( claims = b5efits "u laws adm9i/]$ by ,secret>y ( ,vet]ans ,affairs 7#a7 ,program = quality assurance 9 decisions ( ,bo>d ( ,vet]ans' ,appeals2 p]=mance reviews 7,a7 ,9 g5]al ,section #gaja ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new subsection3 7f7 7#a7 ,! ,*airman %all c>ry out a program to ensure quality 9 ! decisions ( ! ,bo>d4 ,"u su* program1 ! ,*airman %all-- 7,a7 develop policies & proc$ures =-- 7i7 measur+ quality 9 su* decisions2 7ii7 ma9ta9+ data & id5tify+ tr5ds ) respect to-- 7,i7 errors 9 su* decisions2 7,,ii7 errors 9 decisions rem&$ or return$ to ! ,bo>d by ! ,c\rt ( ,appeals = ,vet]ans ,claims2 & 7,,iii7 specific memb]s ( ! ,bo>d t issu$ decisions t 7 subsequ5tly vacat$ by ! ,c\rt ( ,appeals = ,vet]ans ,claims2 & 7iii7 ensur+ any su* decision ( ! ,bo>d to rem& a claim = a b5efit "u a law adm9i/]$ by ! ,secret>y is necess>y "u any applicable law or regulation2 7,b7 ) respect to a claim = su* a b5efit t is rem&$ to ! ,bo>d by ! ,c\rt ( ,appeals = ,vet]ans ,claims-- 7i7 in=m any employee ( ! ,bo>d responsible = draft+ ! decision ( ! ,bo>d ) respect to su* claim t su* decision 0 rem&$2 7ii7 provide any su* employee ) a copy ( ! relevant ord] ( ! ,c\rt ( ,appeals = ,vet]ans ,claims 7includ+ a copy ( any accompany+ jo9t motion = rem&72 & 7iii7 provide inc5tives to su* employees to review su* relevant ord]s & jo9t motions = rem&2 & 7,c7 ensure1 to ! maximum ext5t practicable1 t any error id5tifi$ by ! ,bo>d "u su* program is correct$ be=e ! date on :i* ! ,bo>d issues ! f9al decision associat$ ) su* error4 7#b7 ,9 develop+ policies & proc$ures to measure quality 9 decisions ( ! ,bo>d pursuant to clause 7i7 ( subp>agraph 7,a7 ( p>agraph 7#a71 ! ,*airman %all consid] ! data & tr5ds ma9ta9$ & id5tifi$ pursuant to clause 7ii7 ( su* subp>agraph4 7#c7 ,! ,*airman may use te*nology1 includ+ artificial intellig5ce1 to ma9ta9 su* data & id5tify su* tr5ds4 7#d7 ,! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate an annual report on ! program requir$ by ?is subsection t includes1 ) respect to ! p]iod cov]$ by ! report1 an id5tification (-- 7,a7 elem5ts1 if any ( ! process ( ! ,bo>d = review+ an appeal "u ?is *apt] t lead to errors 9 decisions ( ! ,bo>d2 & 7,b7 ! mo/ common reasons t a claim = a b5efit "u a law adm9i/]$ by ! ,secret>y 0 rem&$ to su* ,bo>d by ! ,c\rt ( ,appeals = ,vet]ans ,claims4 4 7,b7 ,deadl9e ,! ,secret>y %all submit ! fir/ report requir$ by p>agraph 7#b7 ( su* section 7z add$ by subp>agraph 7,a77 by n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act4 7#b7 ,tra9+ program = c]ta9 employees ( ,bo>d ( ,vet]ans' ,appeals2 p]=mance reviews 7,a7 ,tra9+ program 7i7 ,9 g5]al ,*apt] #ga ( su* title 7z am5d$ by p>agraph 7#a77 is fur!r am5d$ by ins]t+ aft] section #gaja;,a ! foll[+ new section3 #gaja;,b4 ,tra9+ program = memb]s ( ,bo>d on timely & correct adjudication ( appeals 7a7 ,9 g5]al ,! ,secret>y1 9 conjunction ) ! ,*airman ( ! ,bo>d ( ,vet]ans' ,appeals1 %all develop & c>ry out a program to provide ,memb]s ( ! ,bo>d tra9+ on timely & correct adjudication ( appeals "u ?is *apt]4 7b7 ,requir$ consid]ations ,9 c>ry+ out ! program requir$ by subsection 7a71 ! ,secret>y %all consid] ! foll[+3 7#a7 ,fe$back1 if any1 f memb]s ( ! ,bo>d & cov]$ employees ) respect to su* program4 7#b7 ,data on errors 9 decisions ( ! ,bo>d ma9ta9$ pursuant to ! program = quality assurance requir$ by subsection 7f7 ( section #gaja ( ?is title4 7#c7 ,any decision ( ! ,c\rt ( ,appeals = ,vet]ans ,claims to rem& a claim = b5efits "u ! laws adm9i/]$ by ! ,secret>y to ! ,bo>d = fur!r action1 includ+ a jo9t motion to rem& su* claim4 7c7 ,assessm5ts ( effectiv5ess ,! ,secret>y1 9 conjunction ) ! ,*airman ( ! ,bo>d ( ,vet]ans' ,appeals1 %all develop a me?od to assess1 on an annual basis1 ! effectiv5ess ( ! tra9+ program "u ?is section4 ,9 develop+ su* me?od1 ! ,secret>y %all consid] be/ practices = assess+ ! effectiv5ess ( tra9+ programs1 includ+ ! ,kirkpatrick evaluation model4 7d7 ,report ,! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate an annual report on ! program requir$ by subsection 7a7 t includes1 ) respect to ! p]iod cov]$ by ! report-- 7#a7 a /atem5t ( ! topics ( ! tra9+ provid$ pursuant to ?is section1 disaggregat$ by-- 7,a7 m&atory tra9+2 & 7,b7 non-m&atory tra9+2 & 7#b7 ! results ( ! assessm5t ( ! effectiv5ess ( su* program requir$ "u subsection 7c74 7e7 ,cov]$ employee def9$ ,9 ?is section1 ! t]m cov]$ employee means an employee ( ! ,bo>d :o is-- 7#a7 n a memb] ( ! ,bo>d2 & 7#b7 responsible = draft+ decisions ( ! ,bo>d4 4 7ii7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( su* *apt] is am5d$ by ins]t+ aft] ! item relat+ to section #gaja;,a ! foll[+ new item3 #gaja;,b4 ,tra9+ program = ,memb]s ( ,bo>d on timely & correct adjudication ( appeals4 4 7,b7 ,p]=mance reviews ( memb]s ( ! ,bo>d ,section #gaja;,a ( su* title is am5d$-- 7i7 9 subp>agraph 7,b7 ( subsection 7c77#a7 by /rik+ n less (t5 ?an once e ?ree ye>s & ins]t+ n less (t5 ?an annually2 & 7ii7 by add+ at ! end ! foll[+ new subsection3 7h7 7#a7 ,) respect to any p]=mance review ( a cov]$ employee1 ! ,secret>y may n consid] ! timel9ess or quality ( "w ( any ,memb] ( ! ,bo>d4 7#b7 ,9 ?is subsection1 ! t]m cov]$ employee has ! mean+ giv5 su* t]m 9 section #gaja;,b ( ?is title4 4 7#c7 ,decisions ( ,bo>d to rem& 7,a7 ,in=mation relat+ to decisions to rem& ,section #gajd ( su* title is am5d$ 9 subsection 7d7-- 7i7 by r$esignat+ p>agraphs 7#a7 ?r\gh 7#c7 z p>agraphs 7#b7 ?r\gh 7#d71 respectively2 & 7ii7 by ins]t+ be=e p>agraph 7#b7 7z s r$esignat$71 ! foll[+ new p>agraph3 7#a7 ) respect to a claim t ! ,bo>d rem&s = fur!r action1 a /atem5t ( ! specific reasons su* claim 0 rem&$1 includ+ any failure on ! "p ( ! ,secret>y to comply )-- 7,a7 ! ,secret>y's duty to assi/ "u section #eajc;,a ( ?is title2 & 7,b7 ! ,secret>y's duty to notify "u section #eajc ( ?is title2 4 7,b7 ,notice ( rem&$ decision = c]ta9 employees ,su* section is fur!r am5d$ 9-- 7i7 subsection 7e7-- 7,i7 by r$esignat+ p>agraphs 7#a7 ?r\gh 7#c7 z subp>agraphs 7,a7 ?r\gh 7,c71 respectively2 7,,ii7 by /rik+ ,aft] & ins]t+ 7#a7 ,aft]2 & 7,,iii7 by add+ at ! end ! foll[+ new p>agraph3 7#b7 ,if1 pursuant to a decision on an appeal1 ! ,bo>d rem&s a claim = a b5efit "u a law adm9i/]$ by ! ,secret>y = fur!r action1 ! ,secret>y %all1 to ! maximum ext5t practicable1 issue a copy ( su* decision to ea* employee ( ! ,vet]ans ,b5efits ,adm9i/ration :o committ$ ! error result+ 9 ! decision ( ! ,bo>d to rem&1 :5 applicable4 2 & 7ii7 9 subsection 7g71 z r$esignat$ by section #c7;d77#b77;,a71 by /rik+ "u subsection 7e7 & ins]t+ "u p>agraph 7#a7 ( subsection 7e74 7#d7 ,annual reports = ,bo>d ( ,vet]ans' ,appeals 7,a7 ,9 g5]al ,*apt] #ga ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by ins]t+ aft] section #gaad ! foll[+ new section3 #gaae4 ,annual report on ,bo>d ( ,vet]ans' ,appeals ,! ,*airman ( ! ,bo>d %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate an annual report t includes1 = ea* decision ( ! ,bo>d to rem& a claim = a b5efit "u a law adm9i/]$ by ! ,secret>y to ! ,secret>y = fur!r adjudication dur+ ! p]iod cov]$ by ! report1 a /atem5t ( ! reasons = su* decision ( ! ,bo>d1 disaggregat$ by decisions on-- 7#a7 claims ) a rat+ decision dat$ on or aft] ,febru>y #ai1 #bjai2 & 7#b7 claims ) a rat+ decision dat$ be=e su* date4 4 7,b7 ,deadl9es ,! ,secret>y %all submit ! fir/ reports requir$ by subsections 7a7 & 7b7 ( section #gaae ( su* title 7z add$ by p>agraph 7#a77 by n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act4 7,c7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( su* *apt] is am5d$ by ins]t+ aft] ! item relat+ to section #gaad ! foll[+ new item3 #gaae4 ,annual report on ,bo>d ( ,vet]ans' ,appeals 4 7#e7 ,plan = improvem5ts to quality 9 decisions ( ,bo>d 7,a7 ,9 g5]al ,n lat] ?an six mon?s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs1 9 consultation ) ! ,*airman ( ! ,bo>d ( ,vet]ans' ,appeals & ! head ( ! ,(fice ( ,adm9i/rative ,review ( ! ,vet]ans ,b5efits ,adm9i/ration1 %all develop a plan to-- 7i7 improve ! quality ( decisions ( ! ,bo>d to rem&1 pursuant to section #gajd ( title #ch1 ,unit$ ,/ates ,code1 claims = a b5efit "u a law adm9i/]$ by ! ,secret>y to ! ,secret>y = fur!r action2 & 7ii7 mitigate ! numb] ( su* decisions t are unnecess>y "u any applicable law or regulation4 7,b7 ,report ,! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a report on su* plan by n lat] ?an six mon?s aft] ! date ( ! enactm5t ( ?is ,act4 7d7 ,notice ( avoidable def]rals ( claims = b5efits "u laws adm9i/]$ by ! ,secret>y ( ,vet]ans ,affairs2 /udy & report on c]ta9 op9ions ( ,dep>tm5t ( ,vet]ans ,affairs ,(fice ( ,g5]al ,c\nsel 7#a7 ,notice ( avoidable def]rals ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all develop policies1 proc$ures1 & te*nological capabilities to ensure t ea* employee ( ! ,vet]ans ,b5efits ,adm9i/ration t commits an avoidable def]ral ) respect to a claim = b5efits "u ! laws adm9i/]$ by ! ,secret>y ( ,vet]ans ,affairs 9 ! ,national ,"w ,queue is notifi$ ( any avoidable def]rals t su* employee commits ) respect to ! same claim4 7#b7 ,/udy & report on c]ta9 ,,ogc op9ions 7,a7 ,/udy ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs1 9 consultation ) ! ,(fice ( ! ,g5]al ,c\nsel ( ! ,dep>tm5t ( ,vet]ans ,affairs & ! ,*airman ( ! ,bo>d ( ,vet]ans' ,appeals1 %all complete a /udy to id5tify-- 7i7 issues ab\t :i* an op9ion f ! ,(fice ( ! ,g5]al ,c\nsel ( ! ,dep>tm5t w\ld fo/] consi/5cy 9 ! decisions ( ! ,secret>y ) respect to claims = b5efits "u ! laws adm9i/]$ by ! ,secret>y2 & 7ii7 issues rais$ 9 appeals ( su* decisions to ! ,unit$ ,/ates ,c\rt ( ,appeals = ,vet]ans ,claims be=e ! date ( ! enactm5t ( ?is ,act ab\t :i* ! ,(fice ( ! ,g5]al ,c\nsel has _h inconsi/5t op9ions 9 matt]s involv+ sub/antially simil> que/ions ( law or fact4 7,b7 ,report ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ,h\se ( ,repres5tatives a report t includes-- 7i7 ! f9d+s ( ! /udy requir$ by subp>agraph 7,a72 7ii7 a /atem5t ( :i* issues id5tifi$ pursuant to su* /udy ab\t :i* ! ,(fice ( ! ,g5]al ,c\nsel ( ! ,dep>tm5t int5ds to publi% an op9ion2 & 7iii7 a timel9e = ! publication ( any su* op9ion4 #ajf4 ,annual report on causes ( dea? among vet]ans 7a7 ,9 g5]al ,sub*apt] ,,ii ( *apt] #e ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new section3 #ecd4 ,annual report on causes ( dea? among vet]ans 7a7 ,9 g5]al ,! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate an annual report t conta9s data & in=mation on causes ( dea? among vet]ans4 7b7 ,elem5ts ,su* report %all include-- 7#a7 = ea* vet]an t di$ dur+ ! p]iod cov]$ by ! report an id5tification (-- 7,a7 :e!r su* vet]an _h a s]vice-connect$ disability rat$ z total2 7,b7 ! prim>y cause ( dea?2 7,c7 ! second>y cause ( dea?1 if applicable2 & 7,d7 ! mann] ( dea?2 7#b7 = ea* prim>y cause ( dea? id5tifi$ pursuant to p>agraph 7#a71 a /atem5t ( ! total numb] ( vet]ans t di$ f su* prim>y cause ( dea? dur+ ! p]iod cov]$ by ! report2 & 7#c7 = ea* mann] ( dea? id5tifi$ pursuant to p>agraph 7#a71 a /atem5t ( ! total numb] ( vet]ans t di$ 9 su* mann] dur+ ! p]iod cov]$ by ! report4 7c7 ,sunset ,?is section %all t]m9ate on ! date t is five ye>s aft] ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act4 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( *apt] #e ( su* title is am5d$ by ins]t+ aft] ! item relat+ to section #ecc ! foll[+ new item3 #ecd4 ,annual report on causes ( dea? among vet]ans 4 #ajg4 ,plan = use ( automation tools to process claims "u laws adm9i/]$ by ! ,secret>y ( ,vet]ans ,affairs 7a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ,h\se ( ,repres5tatives ! plan ( ! ,secret>y to make available1 to ! maximum ext5t practicable1 an automation tool describ$ 9 subsection 7b7 to elem5ts ( ! ,dep>tm5t ( ,vet]ans ,affairs = ! purpose ( process+ claims "u laws adm9i/]$ by ! ,secret>y4 7b7 ,automation tool describ$ ,an automation tool describ$ 9 ?is subsection is a te*nology develop$ = ! ,comp5sation ,s]vice ( ! ,vet]ans ,b5efits ,adm9i/ration t-- 7#a7 automates ! retrieval ( ! s]vice record or heal? records ( a vet]an2 7#b7 compiles evid5ce relevant to ! det]m9ation ( a claim = b5efits "u laws adm9i/]$ by ! ,secret>y2 7#c7 provides automat$ decision support relevant to su* a det]m9ation2 7#d7 automates in=mation %>+ betwe5 ,f$]al ag5cies2 & 7#e7 assi/s 9 g5]at+ correspond5ce reg>d+ su* a claim4 7c7 ,analysis ,9 develop+ ! plan requir$ "u subsection 7a71 ! ,secret>y %all conduct an analysis ( ea* ( ! foll[+3 7#a7 ,! feasibility & b5efits ( ! use ( an automation tool describ$ 9 subsection 7b7 by elem5ts ( ! ,dep>tm5t = ! purpose ( process+ claims "u laws adm9i/]$ by ! ,secret>y4 7#b7 ,any modification to an exi/+ automation tool t c\ld r5d] su* tool usable = su* purpose by su* an elem5t4 7#c7 ,any requirem5t ( any su* elem5t p]ta9+ to su* purpose t _c be address$ by us+ an automation tool4 7#d7 ,! ext5t to :i* ! te*nology (fices ( su* elem5ts may ne$ to collaborate ) ! te*nology (fice responsible = develop+ an automation tool 9 ! c\rse ( ! developm5t & use ( ! tool by ! elem5t = su* purpose4 7#e7 ,a timel9e = modify+ & implem5t+ any automation tool = use by su* elem5ts = su* purpose4 7d7 ,priority ,9 provid+ or exp&+ an automation tool describ$ 9 subsection 7b7 to elem5ts ( ! ,dep>tm5t pursuant to ! plan requir$ "u subsection 7a71 ! ,secret>y %all give priority to ! foll[+ elem5ts3 7#a7 ,! ,comp5sation ,s]vice4 7#b7 ,! ,p5sion & ,fiduci>y ,s]vice ( ! ,vet]ans ,b5efits ,adm9i/ration4 7#c7 ,! ,education ,s]vice ( ! ,vet]ans ,b5efits ,adm9i/ration4 7#d7 ,program (fices ( ! ,vet]ans ,b5efits ,adm9i/ration1 z det]m9$ by ! ,secret>y4 7#e7 ,! ,debt ,managem5t ,c5t]4 7#f7 ,! ,bo>d ( ,vet]ans' ,appeals4 7e7 ,o!r requirem5ts relat+ to te*nology at ,dep>tm5t ( ,vet]ans ,affairs 7#a7 ,automatic notices reg>d+ b5efits = c]ta9 *ildr5 ( vet]ans 7,a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all implem5t policies1 processes1 & te*nological capabilities1 includ+ 9 ! ,national ,"w ,queue 7or successor sy/em71 to ensure t1 9 ! case ( any cov]$ situation1 a claims processors is made aw>e (1 & assign$ to address1 su* cov]$ situation4 7,b7 ,def9itions ,9 ?is subsection3 7i7 ,! t]m cov]$ situation means-- 7,i7 any increase 9 ! am\nt ( dep5d5cy comp5sation paid to a b5efici>y = a *ild "u ! laws adm9i/]$ by ! ,secret>y2 & 7,,ii7 any educational assi/ance paid to ! *ild ( a vet]an "u ! laws adm9i/]$ by ! ,secret>y4 7ii7 ,! t]m *ild has ! mean+ giv5 su* t]m 9 section #aja7d77;,a77iii7 ( title #ch1 ,unit$ ,/ates ,code4 7#b7 ,correct label+ ( docum5ts ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ,h\se ( ,repres5tatives a plan to ensure t docum5ts 9 ! ,vet]ans ,b5efits ,managem5t ,sy/em 7or any successor sy/em7 are correctly label$ :5 su* docum5ts are upload$1 includ+ :5 su* docum5ts are label$ us+ automation tools4 #ajh4 ,re=ms relat+ to ,dep>tm5t ( ,vet]ans ,affairs disability rat+s 7a7 ,rat+s = sleep apnea 7#a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all revise ! s*$ule = rat+ disabilities adopt$ & appli$ "u section #aaee ( title #ch1 ,unit$ ,/ates ,code1 z foll[s3 7,a7 ,a grade ( disability ( #j p]c5t %all be assign$ = sleep apnea syndrome :5 ! syndrome is asymptomatic1 ) or )\t treatm5t4 7,b7 ,a grade ( disability ( #aj p]c5t %all be assign$ = sleep apnea syndrome :5 treatm5t yields incomplete relief4 7,c7 ,a grade ( disability ( #ej p]c5t %all be assign$ = sleep apnea syndrome only if-- 7i7 treatm5t is ei!r ineffective or ! vet]an is unable to use ! prescrib$ treatm5t due to comorbid conditions2 & 7ii7 !re is no end-organ damage4 7,d7 ,a grade ( disability ( #ajj p]c5t %all be assign$ = sleep apnea syndrome only if !re is also end-organ damage4 7#b7 ,qualify+ comorbid conditions ,= purposes ( p>agraph 7#a77;,c77i71 a comorbid condition is a condition t1 9 ! op9ion ( a qualifi$ m$ical provid]1 directly imp$es or prev5ts ! use (1 or implem5tation (1 a recogniz$ =m ( treatm5t int]v5tion normally %[n to be effective4 7b7 ,rat+s = t9nitus ,! ,secret>y ( ,vet]ans ,affairs %all revise ! s*$ule = rat+ disabilities adopt$ & appli$ "u section #aaee ( title #ch1 ,unit$ ,/ates ,code1 z foll[s3 7#a7 ,except z provid$ 9 p>agraph 7#b71 t9nitus may n be assign$ a sep>ate comp5sable disability rat+4 7#b7 ,a grade ( disability ( #aj p]c5t %all be assign$ = t9nitus only :5 t9nitus is diagnos$ z associat$ ) s]vice-connect$ 7z def9$ 9 section #aja7af7 ( title #ch1 ,unit$ ,/ates ,code7 he>+ loss t is o!rwise noncomp5sable "u ! laws adm9i/]$ by ! ,secret>y4 7c7 ,applicability 7#a7 ,9 g5]al ,! revisions to ! s*$ule = rat+ disabilities adopt$ & appli$ "u section #aaee ( title #ch1 ,unit$ ,/ates ,code1 made pursuant to ?is section %all apply ) respect to claims fil$ aft] ! date ( ! enactm5t ( ?is ,act4 7#b7 ,protection ( exi/+ rat+s ,! revisions to ! s*$ule = rat+ disabilities made pursuant to ?is section may n s]ve z ! basis = r$uc+1 discont9u+1 or o!rwise adv]sely affect+ comp5sation t 0 9 effect on ! day be=e ! date ( ! enactm5t ( ?is ,act4 #aji4 ,improvem5ts to tempor>y lic5sure requirem5ts = contract heal? c>e pr(essionals :o p]=m m$ical disability exam9ations = ! ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,expansion ,section #ejd ( ! ,vet]ans' ,b5efits ,improvem5ts ,act ( #aiif 7,public ,law #ajd-bge2 #ch ,u4,s4,c4 #eaja note71 z am5d$ by p>agraph 7#a7 ( subsection 7a7 ( section #bjjb ( ! ,johnny ,isakson & ,david ,p4 ,roe1 ,m4,d4 ,vet]ans ,heal? ,c>e & ,b5efits ,improvem5t ,act ( #bjbj 7,public ,law #aaf-cae2 #ch ,u4,s4,c4 #eaja note71 is fur!r am5d$1 subject to ! sunset 9 p>agraph 7#d7 ( su* subsection1 by /rik+ p>agraph 7#b7 ( subsection 7c7 & ins]t+ ! foll[+3 7#b7 ,heal? c>e pr(essional describ$ ,a heal? c>e pr(essional describ$ 9 ?is p>agraph is a p]son :o is eligible = appo9tm5t to a position 9 ! ,vet]ans ,heal? ,adm9i/ration cov]$ by section #gdjb7;b7 ( title #ch1 ,unit$ ,/ates ,code1 :o-- 7,a7 has a curr5t & unre/rict$ lic5se to practice ! heal? c>e pr(ession = :i* !y are lic5s$2 7,b7 is n b>r$ f practic+ su* heal? c>e pr(ession 9 any ,/ate1 ! ,di/rict ( ,columbia1 or a ,commonweal?1 t]ritory1 or possession ( ! ,unit$ ,/ates2 & 7,c7 is p]=m+ au?oriz$ duties = ! ,dep>tm5t pursuant to a contract ent]$ into "u subsection 7a74 7#c7 ,s\rce ( funds ,exp5ses ( c>ry+ out ?is section1 includ+ paym5ts = exam9ation travel & incid5tal exp5ses "u ! t]ms & conditions set =? by section #aaa ( ?is title1 %all be reimburs$ to ! acc\nts available = ! g5]al op]at+ exp5ses ( ! ,vet]ans ,b5efits ,adm9i/ration & in=mation te*nology sy/ems f am\nts available to ! ,secret>y = paym5t ( comp5sation & p5sions4 7#d7 ,me*anism = transmittal ( evid5ce introduc$ by applicants dur+ exam9ations ,! ,secret>y %all e/abli% a me*anism :]eby a heal? c>e pr(essional :o conducts m$ical exam9ations or op9ions "u section #eajc;,a7d7 ( ?is title may transmit to a vet]an's claims file1 evid5ce introduc$ by ! applicant dur+ a m$ical exam9ation or 9 conjunction ) a m$ical op9ion t exam9] us$ to in=m su* m$ical exam9ation or op9ion4 4 7b7 ,delay$ sunset ( am5dm5t ,p>agraph 7#d7 ( subsection 7a7 ( section #bjjb ( ! ,johnny ,isakson & ,david ,p4 ,roe1 ,m4,d4 ,vet]ans ,heal? ,c>e & ,b5efits ,improvem5t ,act ( #bjbj 7,public ,law #aaf-cae2 #ch ,u4,s4,c4 #eaja note7 is am5d$ by /rik+ ,on ! date t is five ye>s aft] ! date ( ! enactm5t ( ?is ,act & ins]t+ ,on ,septemb] #cj1 #bjcc4 7c7 ,con=m+ am5dm5t ,p>agraph 7#b7 ( su* subsection is am5d$ by /rik+ physicians assi/ants1 nurse practition]s1 audiologi/s1 & psy*ologi/s & ins]t+ heal? c>e pr(essionals4 7d7 ,report ,n lat] ?an #ae mon?s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ,h\se ( ,repres5tatives a report reg>d+ ! use ( ! au?ority "u section #ejd ( ! ,vet]ans' ,b5efits ,improvem5ts ,act ( #aiif 7,public ,law #ajd-bge2 #ch ,u4,s4,c4 #eaja note71 z tempor>ily am5d$ by section #bjjb7;a77#a7 ( ! ,johnny ,isakson & ,david ,p4 ,roe1 ,m4,d4 ,vet]ans ,heal? ,c>e & ,b5efits ,improvem5t ,act ( #bjbj 7,public ,law #aaf-cae2 #ch ,u4,s4,c4 #eaja note7 & ?is section4 ,su* report %all include1 ) respect to ! "o-ye> p]iod aft] ! date ( ! enactm5t ( ?is ,act1 ! foll[+ elem5ts3 7#a7 ,! numb] ( exam9ations conduct$ pursuant to a contract "u su* au?ority4 7#b7 ,! co/1 timel9ess1 & legal adequacy ( su* exam9ations1 disaggregat$ by-- 7,a7 heal? c>e pr(essional2 & 7,b7 contract4 7#c7 ,! numb] ( su* exam9ations conduct$ 9 ea* ,/ate1 ! ,di/rict ( ,columbia1 or a ,commonweal?1 t]ritory1 or possession ( ! ,unit$ ,/ates4 7#d7 ,! numb]s ( ea* k9d ( heal? c>e pr(essionals :o conduct$ su* exam9ations4 7#e7 ,! numb] ( exam9ations t 7 errone\sly conduct$ by a heal? c>e pr(essional-- 7,a7 )\t su* a contract2 or 7,b7 unau?oriz$ to ent] into su* a contract4 7#f7 ,! plan ( ! ,secret>y to correct errors 9 ! use ( su* au?ority4 #aaj4 ,disability exam9ations3 /udy on access 9 rural areas2 review ( tra9+2 review ( inadequate or unnecess>y exam9ations 7a7 ,/udy on improvem5ts to ,dep>tm5t ( ,vet]ans ,affairs cov]$ m$ical disability exam9ations 9 rural areas 7#a7 ,/udy requir$ ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all complete a /udy on access by vet]ans :o reside 9 rural & highly rural areas to cov]$ m$ical disability exam9ations4 7#b7 ,elem5ts 7,a7 ,9 g5]al ,! /udy conduct$ "u p>agraph 7#a7 %all include ! foll[+3 7i7 ,a comp>ison ( ! av]age numb] ( days to complete cov]$ m$ical disability exam9ations1 disaggregat$ by type ( exam9ation1 = vet]ans :o reside 9 rural & highly rural areas comp>$ to an av]age "t = vet]ans :o reside 9 o!r areas to complete a cov]$ m$ical disability exam9ation1 by ei!r contractors or employees ( ! ,dep>tm5t4 7ii7 ,a root cause analysis ( diff]5ces id5tifi$ pursuant to clause 7i74 7iii7 ,! plan ( ! ,secret>y = ! foll[+ ye> to improve access describ$ 9 p>agraph 7#a71 :i* %all include a plan = ! pursuit ( a comm]cial or indu/ry-/&>d solution or te*nology t c\ld enable h\seb\nd vet]ans or vet]ans :o live 9 rural areas to receive exam9ations )\t travel+ long di/ances4 7,b7 ,numb] ( days to complete def9$ ,= purposes ( subp>agraph 7,a77i71 ! t]m numb] ( days to complete means ! numb] ( days 9 ! p]iod-- 7i7 beg9n+ on ! date on :i* a contractor or employee ( ! ,dep>tm5t receiv$ a reque/ f ! ,secret>y to conduct a cov]$ m$ical disability exam9ation2 & 7ii7 end+ on ! date on :i* ! exam9ation 0 complet$4 7#c7 ,report on /udy ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! f9d+s ( ! ,secret>y ) respect to ! /udy complet$ "u p>agraph 7#a74 7#d7 ,def9itions ,9 ?is subsection3 7,a7 ,! t]m cov]$ m$ical disability exam9ation means a m$ical nexus exam9ation or m$ical op9ion = ! purposes ( adjudicat+ a claim = a b5efit "u *apt] #aa or #ae ( title #ch1 ,unit$ ,/ates ,code1 reg>dless ( :e!r conduct$ by an employee or a contractor ( ! ,dep>tm5t4 7,b7 ,! t]ms rural & highly rural h ! mean+s giv5 ^? t]ms "u ! rural-urban commut+ areas cod+ sy/em ( ! ,dep>tm5t ( ,agriculture4 7b7 ,review ( tra9+ = vet]ans s]vice repres5tatives & rat+ vet]ans s]vice repres5tatives 7#a7 ,review requir$ ,! ,secret>y ( ,vet]ans ,affairs %all conduct a compreh5sive review ( ! tra9+ provid$ to ,vet]ans ,s]vice ,repres5tatives 7,v,s,rs7 & ,rat+ ,vet]ans ,s]vice ,repres5tatives 7,r,v,s,rs7 reg>d+ cov]$ m$ical disability exam9ations = ! purpose ( claims adjudication4 7#b7 ,scope ( review ,! review %all include1 at m9imum1 an evaluation ( tra9+ & policies relat+ to-- 7,a7 assess+ ! adequacy ( cov]$ m$ical disability exam9ations = claims adjudication2 7,b7 det]m9+ ! necessity ( m$ical disability exam9ations :]e claims c be adjudicat$ bas$ on exi/+ evid5ce )\t ord]+ additional exam9ations2 7,c7 relevant /atutes1 judicial decisions1 regulations1 & ,dep>tm5t policies1 includ+-- 7i7 ! duty to assi/ claimants2 7ii7 evid5ti>y /&>ds reg>d+ causation2 7iii7 requir$ elem5ts & /&>ds = cov]$ m$ical disability exam9ations1 includ+ ! ne$ = reason$ m$ical op9ions2 & 7iv7 ! abs5ce ( /atutory or regulatory presumptions ( s]vice connection 9 cov]$ m$ical disability exam9ations2 & 7,d7 input f impact$ ,dep>tm5t employees1 includ+ duly appo9t$ labor repres5tatives4 7#c7 ,second-level review = new employees ,! ,secret>y %all evaluate ! effectiv5ess ( curr5t policies requir+ a second level ( review ( claims decisions made by new ,vet]ans ,s]vice ,repres5tatives & ,rat+ ,vet]ans ,s]vice ,repres5tatives be=e su* employees are au?oriz$ to ord] cov]$ m$ical disability exam9ations1 includ+ any applicable accuracy ?re%olds4 7#d7 ,report to ,congress ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report detail+ ! f9d+s ( ! ,secret>y ) respect to ! review conduct$ "u p>agraph 7#a71 ! data us$ by ! ,secret>y to support su* f9d+s1 & su* recomm5dations z ! ,secret>y may h = improvem5ts to tra9+ or policies4 7#e7 ,comptroll] ,g5]al ( ! ,unit$ ,/ates review ( f9d+s ,n lat] ?an #ahj days aft] ! date on :i* ! ,secret>y submits ! report "u p>agraph 7#d71 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all conduct a review ( ! f9d+s & recomm5dations conta9$ 9 ! report4 7#f7 ,modification ( reports by ! ,bo>d ( ,vet]ans' ,appeals & ,unit$ ,/ates ,c\rt ( ,appeals = ,vet]ans ,claims 7,a7 ,bo>d ( ,vet]ans' ,appeals ,section #gaja7;d77#b7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7i7 9 subp>agraph 7,f71 by /rik+ 2 & & ins]t+ a semicolon2 7ii7 9 subp>agraph 7,g71 by /rik+ ! p]iod at ! end & ins]t+ 2 &2 & 7iii7 by add+ at ! end ! foll[+ new subp>agraph3 7,h7 a summ>y ( recurr+ issues t result 9 ! ,bo>d rem&+ appeals back to ! ag5cy ( orig9al jurisdiction4 4 7,b7 ,unit$ ,/ates ,c\rt ( ,appeals = ,vet]ans ,claims ,section #gbhh7;b7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#af7 ,a summ>y ( recurr+ issues t result 9 rem&s4 4 7#g7 ,def9ition ( cov]$ m$ical disability exam9ation ,9 ?is subsection1 ! t]m cov]$ m$ical disability exam9ation means a m$ical exam9ation or m$ical op9ion t ! ,secret>y det]m9es necess>y = ! purposes ( adjudicat+ a claim = a b5efit "u *apt] #aa or #ae ( title #ch1 ,unit$ ,/ates ,code1 reg>dless ( :e!r conduct$ by an employee or a contractor ( ! ,dep>tm5t4 7c7 ,review & priority process+ ( claims ) inadequate or unnecess>y exam9ations 7#a7 ,review ,n lat] ?an #a ye> aft] ! date ( ! enactm5t ( ?is ,act & n less frequ5tly ?an once e ?ree mon?s !reaft]1 ! ,secret>y ( ,vet]ans ,affairs %all review a r&om & repres5tative sample ( all cov]$ m$ical disability exam9ations complet$ dur+ ! previ\s ?ree-mon? p]iod4 7#b7 ,fur!r sample requirem5ts ,"u ea* review requir$ by p>agraph 7#a71 ! ,secret>y %all ensure ! review includes-- 7,a7 a /ati/ically significant sample ( cov]$ m$ical disability exam9ations complet$ by employees ( ! ,dep>tm5t ( ,vet]ans ,affairs2 & 7,b7 a /ati/ically significant sample ( cov]$ m$ical disability exam9ations complet$ by ea* contractor t provides su* exam9ations = ! ,dep>tm5t4 7#c7 ,analysis ,"u ea* review requir$ by p>agraph 7#a71 ! ,secret>y %all-- 7,a7 analyze ! samples specifi$ 9 p>agraph 7#b72 & 7,b7 pursuant to su* analysis1 id5tify-- 7i7 ! p]c5tage ( exam9ations t 7 adequate = purposes ( adjudicat+ ! p>ticul> claim = a b5efit "u *apt] #aa or #ae ( title #ch1 ,unit$ ,/ates ,code1 = :i* ! exam9ation 0 ord]$ by ! ,dep>tm5t2 & 7ii7 ! p]c5tage ( exam9ations consid]$ ov]develop$ = purposes ( adjudicat+ claims = a b5efit "u *apt] #aa or #ae ( title #ch1 ,unit$ ,/ates ,code1 = :i* ! exam9ation 0 ord]$ by ! ,dep>tm5t4 7#d7 ,priority process+ 7,a7 ,9 g5]al ,except z provid$ = 9 subp>agraph 7,b71 if dur+ a review "u p>agraph 7#a7 ! ,secret>y f9ds any cov]$ m$ical disability exam9ation to be n adequate = adjudicat+ a claim1 ! ,secret>y %all ensure ! claimant exam9$ by t exam9ation-- 7i7 receives ano!r exam9ation1 if necess>y1 on a priority basis2 & 7ii7 receives priority process+ = ! entirety ( impact$ claim4 7,b7 ,exception ,! ,secret>y is n requir$ to furni% an additional exam9ation "u subp>agraph 7,a7 if ! ,secret>y det]m9es su* an exam9ation to be unnecess>y = purposes ( adjudicat+ ! claim4 7#e7 ,comptroll] ,g5]al ( ! ,unit$ ,/ates /udy ,! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all conduct a review ( ! me?odology & effectiv5ess ( ! ,dep>tm5ts review requir$ 9 p>agraph 7#a74 7#f7 ,cov]$ m$ical disability exam9ation def9$ ,9 ?is subsection1 ! t]m cov]$ m$ical disability exam9ation means a m$ical exam9ation or op9ion = ! purposes ( adjudicat+ a claim = a b5efit "u *apt] #aa or #ae ( title #ch1 ,unit$ ,/ates ,code1 reg>dless ( :e!r conduct$ by an employee or a contractor ( ! ,dep>tm5t4 7d7 ,review & plan reg>d+ dep>tm5t ( vet]ans affairs s*$ul+ ( m$ical exam9ations 7#a7 ,review requir$ ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all complete a review ( s*$ul+ reque/ tools1 contracts1 & sy/ems us$ by employees & contractors ( ! ,dep>tm5t ( ,vet]ans ,affairs to ord] & conduct m$ical disability exam9ations4 7#b7 ,plan requir$ ,n lat] ?an "o ye> 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 plan to ensure ! foll[+3 7,a7 ,sy/ems & processes us$ by ! ,dep>tm5t enable seamless & cle> communication ( requirem5ts betwe5 ! claims processors :o reque/ m$ical disability exam9ations & ! p]sons :o conduct su* exam9ations1 includ+ ?r\gh a contract4 7,b7 ,m$ical disability exam9]s1 includ+ ?r\gh a contract1 h access to ! m$ical records & claims in=mation !y ne$ to conduct exams t are adequate = purposes ( rat+ claims = b5efits "u laws adm9i/]$ by ! ,secret>y4 7,c7 ,claimants or appellants = :om a m$ical disability exam9ation is reque/$ ( ! ,dep>tm5t h ag5cy 9 det]m9+ :5 & :]e ! exam9ation is conduct$4 7,d7 ,claimants or appellants = :om a m$ical disability exam9ation is reque/$ ( ! ,dep>tm5t h a seamless exp]i5ce :5 s*$ul+ _! exam9ations )\t reg>d to :o conducts ! exam9ations4 7,e7 ,! ,dep>tm5t conducts cu/om] satisfaction & exp]i5ce surveys ( claimants or appellants :o att5d m$ical disability exam9ations provid$ "u laws adm9i/]$ by ! ,secret>y4 #aaa4 ,improvem5ts to process+ & outrea* reg>d+ claims involv+ milit>y sexual trauma 7a7 ,evaluation ( claims involv+ milit>y sexual trauma 7#a7 ,9 g5]al ,sub*apt] ,,vi ( *apt] #aa ( su* title is am5d$ by ins]t+ aft] section #aaff ! foll[+ new section3 #aaff;,a4 ,evaluation ( claims involv+ milit>y sexual trauma 7a7 ,notice & opportunity to supply evid5ce ,! ,secret>y may n d5y a claim ( a vet]an = comp5sation "u ?is *apt] = milit>y sexual trauma )\t fir/-- 7#a7 advis+ ! vet]an ( ! evid5ce t w\ld con/itute cr$ible corroborat+ evid5ce ( ! milit>y sexual trauma2 & 7#b7 all[+ ! vet]an an opportunity to furni% su* corroborat+ evid5ce4 7b7 ,po9t ( contact ,! ,secret>y %all ensure t ea* docum5t provid$ to a vet]an relat+ to a claim = comp5sation "u ?is *apt] = a milit>y sexual trauma includes contact in=mation = an appropriate po9t ( contact ) ! ,dep>tm5t4 7c7 ,specializ$ teams ,! ,secret>y %all ensure t all claims = comp5sation "u ?is *apt] = a milit>y sexual trauma are review$ & process$ by a specializ$ team e/abli%$ "u section #aaff ( ?is title4 7#a7 ,! ,secret>y %all ensure t n less ?an annually1 ! policies & proc$ures employ$ by ! specializ$ team e/abli%$ "u section #aaff ( ?is title are review$ by m$ical or m5tal heal? pr(essionals z ! ,secret>y consid]s appropriate to det]m9e :e!r ! curr5t /&>d ( evid5ti>y review = acceptable docum5tation adequately evaluates ! likelihood a milit>y sexual trauma occurr$4 7#b7 ,! ,secret>y %all also conduct p]iodic quality reviews ( claims process$ by ! specializ$ teams e/abli%$ "u section #aaff to id5tify inconsi/5cies1 tra9+ defici5cies1 or proc$ural %ortcom+s & implem5t corrective actions z appropriate4 4 7#b7 ,outrea* 7,a7 ,9 g5]al ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all implem5t1 ) input f ! vet]an community1 an in=mative outrea* program = vet]ans reg>d+ ! /&>d ( pro( = evaluation ( claims relat+ to milit>y sexual trauma1 includ+ requirem5ts = a m$ical exam9ation & op9ion4 7,b7 ,t>get$ outrea* ,9 implem5t+ ! program "u subp>agraph 7,a71 ! ,secret>y %all1 to ! ext5t practicable1 t>get outrea* to vet]ans :o submitt$ a claim relat+ to milit>y sexual trauma t 0 d5i$4 7#c7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( *apt] #aa ( su* title is am5d$ by ins]t+ aft] ! item relat+ to section #aaff ! foll[+ new item3 #aaff;,a4 ,evaluation ( claims involv+ milit>y sexual trauma4 4 7b7 ,communications f ! ,dep>tm5t ( ,vet]ans ,affairs to individuals :o h exp]i5c$ milit>y sexual trauma 7#a7 ,review work+ gr\p 7,a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all e/abli% a work+ gr\p to review correspond5ce relat+ to milit>y sexual trauma4 7,b7 ,memb]%ip ,! work+ gr\p e/abli%$ "u subp>agraph 7,a7 %all be compos$ ( memb]s :o %all be appo9t$ by ! ,secret>y f among employees ( ! ,dep>tm5t ( ,vet]ans ,affairs :o are exp]ts 9 milit>y sexual trauma & m5tal heal?1 ( :om-- 7i7 "o or m %all be appo9t$ f among m5tal heal? provid]s ( ! ,vet]ans ,heal? ,adm9i/ration2 7ii7 "o or m %all be appo9t$ f among exp]ts on sexual assault & sexual h>assm5t ( ! ,vet]ans ,b5efits ,adm9i/ration2 & 7iii7 "o or m %all be appo9t$ f among exp]ts on sexual assault & sexual h>assm5t ( ! ,bo>d ( ,vet]ans' ,appeals4 7,c7 ,duties ,! work+ gr\p e/abli%$ "u subp>agraph 7,a7 %all-- 7i7 review /&>d correspond5ce1 :i* may include templates = notices "u sections #eajc1 #eajd1 #eajd;,b1 & #gajd ( title #ch1 ,unit$ ,/ates ,code1 f ! ,dep>tm5t to individuals :o h exp]i5c$ milit>y sexual trauma = s5sitivity2 & 7ii7 ensure t ! correspond5ce-- 7,i7 treats su* individuals ) dignity & respect2 & 7,,ii7 does n re-traumatize su* individuals4 7,d7 ,individual :o has exp]i5c$ milit>y sexual trauma def9$ ,9 ?is subsection1 ! t]m individual :o has exp]i5c$ milit>y sexual trauma means-- 7i7 an individual :o has fil$ a claim = comp5sation "u *apt] ( title #ch1 ,unit$ ,/ates ,code1 relat+ to milit>y sexual trauma2 7ii7 a vet]an :o has be5 aw>d$ comp5sation "u su* *apt] relat+ to milit>y sexual trauma2 or 7iii7 a memb] ( ! ,arm$ ,=ces 7includ+ a memb] ( ! ,national ,gu>d or ,res]ves71 a =m] memb] ( ! ,arm$ ,=ces1 or a vet]an :o is receiv+ c>e f ! ,dep>tm5t relat+ to milit>y sexual trauma4 7#b7 ,cont5ts ( c]ta9 writt5 communications to individuals :o h exp]i5c$ milit>y sexual trauma 7,a7 ,notice to claimants ( requir$ in=mation & evid5ce ,section #eajc ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new subsection3 7c7 ,writt5 communications to individuals :o h exp]i5c$ milit>y sexual trauma 7#a7 ,! ,secret>y %all ensure t any writt5 communication "u ?is section f ! ,dep>tm5t to an individual :o has exp]i5c$ milit>y sexual trauma includes ea* ( ! foll[+3 7,a7 ,contact in=mation = ea* ( ! foll[+3 7i7 ,! milit>y sexual trauma coord9ator ( ! ,vet]ans ,b5efits ,adm9i/ration4 7ii7 ,! milit>y sexual trauma coord9ator ( ! ,vet]ans ,heal? ,adm9i/ration4 7iii7 ,! ,vet]ans ,crisis ,l9e4 7iv7 ,! facility ( ! ,vet]ans ,heal? ,adm9i/ration close/ to :]e ! individual resides4 7v7 ,! ,readju/m5t ,c\nsel+ ,s]vice location close/ to :]e ! individual resides4 7,b7 ,in=mation on ! eligibility ( ! individual = s]vices provid$ ?r\gh ! ,readju/m5t ,c\nsel+ ,s]vice location describ$ 9 subp>agraph 7,a77v74 7#b7 ,9 ?is subsection3 7,a7 ,! t]m individual :o has exp]i5c$ milit>y sexual trauma means-- 7i7 an individual :o has fil$ a claim = comp5sation "u *apt] #aa ( ?is title relat+ to milit>y sexual trauma2 7ii7 a vet]an :o has be5 aw>d$ comp5sation "u su* *apt] relat+ to milit>y sexual trauma2 or 7iii7 a memb] ( ! ,arm$ ,=ces 7includ+ a memb] ( ! ,national ,gu>d or ,res]ves71 a =m] memb] ( ! ,arm$ ,=ces1 or a vet]an :o is receiv+ c>e f ! ,dep>tm5t relat+ to milit>y sexual trauma4 7,b7 ,! t]m milit>y sexual trauma has ! mean+ giv5 t t]m 9 section #aaff7;d77#b7 ( ?is title4 7,c7 ,! t]m ,vet]ans ,crisis ,l9e means ! toll-free hotl9e = vet]ans e/abli%$ "u section #agbj;,f7h7 ( ?is title4 4 7,b7 ,decisions & notices ( decisions ,section #eajd ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new subsection3 7e7 7#a7 ,! ,secret>y %all ensure t any writt5 communication "u ?is section f ! ,dep>tm5t to an individual :o has exp]i5c$ milit>y sexual trauma includes ea* ( ! foll[+3 7,a7 ,contact in=mation = ea* ( ! foll[+3 7i7 ,! milit>y sexual trauma coord9ator ( ! ,vet]ans ,heal? ,adm9i/ration4 7ii7 ,! ,vet]ans ,crisis ,l9e4 7iii7 ,! facility ( ! ,vet]ans ,heal? ,adm9i/ration close/ to :]e ! individual resides4 7iv7 ,! ,readju/m5t ,c\nsel+ ,s]vice location close/ to :]e ! individual resides4 7,b7 ,in=mation on ! eligibility ( ! individual = s]vices provid$ ?r\gh ! ,readju/m5t ,c\nsel+ ,s]vice location describ$ 9 subp>agraph 7,a77iv74 7#b7 ,! ,secret>y %all ensure t any writt5 communication "u ?is section f ! ,dep>tm5t to an individual :o has exp]i5c$ milit>y sexual trauma t includes notification ( an aw>d ( comp5sation "u *apt] #aa ( ?is title relat+ to milit>y sexual trauma includes-- 7,a7 ! contact in=mation describ$ 9 p>agraph 7#a72 & 7,b7 ! contact in=mation = ! milit>y sexual trauma coord9ator ( ! ,vet]ans ,b5efits ,adm9i/ration4 7#c7 ,9 ?is subsection3 7,a7 ,! t]m individual :o has exp]i5c$ milit>y sexual trauma means-- 7i7 an individual :o has fil$ a claim = comp5sation "u *apt] #aa ( ?is title relat+ to milit>y sexual trauma2 7ii7 a vet]an :o has be5 aw>d$ comp5sation "u su* *apt] relat+ to milit>y sexual trauma2 or 7iii7 a memb] ( ! ,arm$ ,=ces 7includ+ a memb] ( ! ,national ,gu>d or ,res]ves71 a =m] memb] ( ! ,arm$ ,=ces1 or a vet]an :o is receiv+ c>e f ! ,dep>tm5t relat+ to milit>y sexual trauma4 7,b7 ,! t]m milit>y sexual trauma has ! mean+ giv5 t t]m 9 section #aaff7;d77#b7 ( ?is title4 7,c7 ,! t]m ,vet]ans ,crisis ,l9e means ! toll-free hotl9e = vet]ans e/abli%$ "u section #agbj;,f7h7 ( ?is title4 4 7,c7 ,high]-level review by ! ag5cy ( orig9al jurisdiction ,section #eajd;,b ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new subsection3 7f7 ,writt5 communications to individuals :o h exp]i5c$ milit>y sexual trauma 7#a7 ,! ,secret>y %all ensure t any writt5 communication "u ?is section f ! ,dep>tm5t to an individual :o has exp]i5c$ milit>y sexual trauma includes ea* ( ! foll[+3 7,a7 ,contact in=mation = ea* ( ! foll[+3 7i7 ,! milit>y sexual trauma coord9ator ( ! ,vet]ans ,heal? ,adm9i/ration4 7ii7 ,! ,vet]ans ,crisis ,l9e4 7iii7 ,! facility ( ! ,vet]ans ,heal? ,adm9i/ration close/ to :]e ! individual resides4 7iv7 ,! ,readju/m5t ,c\nsel+ ,s]vice location close/ to :]e ! individual resides4 7,b7 ,in=mation on ! eligibility ( ! individual = s]vices provid$ ?r\gh ! ,readju/m5t ,c\nsel+ ,s]vice location describ$ 9 subp>agraph 7,a77iv74 7#b7 ,! ,secret>y %all ensure t any writt5 communication "u ?is section f ! ,dep>tm5t to an individual :o has exp]i5c$ milit>y sexual trauma t includes notification ( an aw>d ( comp5sation "u *apt] #aa ( ?is title relat+ to milit>y sexual trauma includes-- 7,a7 ! contact in=mation describ$ 9 p>agraph 7#a72 & 7,b7 ! contact in=mation = ! milit>y sexual trauma coord9ator ( ! ,vet]ans ,b5efits ,adm9i/ration4 7#c7 ,9 ?is subsection3 7,a7 ,! t]m individual :o has exp]i5c$ milit>y sexual trauma means-- 7i7 an individual :o has fil$ a claim = comp5sation "u *apt] #aa ( ?is title relat+ to milit>y sexual trauma2 7ii7 a vet]an :o has be5 aw>d$ comp5sation "u su* *apt] relat+ to milit>y sexual trauma2 or 7iii7 a memb] ( ! ,arm$ ,=ces 7includ+ a memb] ( ! ,national ,gu>d or ,res]ves71 a =m] memb] ( ! ,arm$ ,=ces1 or a vet]an :o is receiv+ c>e f ! ,dep>tm5t relat+ to milit>y sexual trauma4 7,b7 ,! t]m milit>y sexual trauma has ! mean+ giv5 t t]m 9 section #aaff7;d77#b7 ( ?is title4 7,c7 ,! t]m ,vet]ans ,crisis ,l9e means ! toll-free hotl9e = vet]ans e/abli%$ "u section #agbj;,f7h7 ( ?is title4 4 7,d7 ,bo>d ( ,vet]ans' ,appeals ,section #gajd ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new subsection3 7g7 7#a7 ,! ,secret>y %all ensure t any writt5 communication "u ?is section f ! ,dep>tm5t to an individual :o has exp]i5c$ milit>y sexual trauma include ea* ( ! foll[+3 7,a7 ,contact in=mation = ea* ( ! foll[+3 7i7 ,! milit>y sexual trauma coord9ator ( ! ,vet]ans ,heal? ,adm9i/ration4 7ii7 ,! ,vet]ans ,crisis ,l9e4 7iii7 ,! facility ( ! ,vet]ans ,heal? ,adm9i/ration close/ to :]e ! individual resides4 7iv7 ,! ,readju/m5t ,c\nsel+ ,s]vice location close/ to :]e ! individual resides4 7,b7 ,in=mation on ! eligibility ( ! individual = s]vices provid$ ?r\gh ! ,readju/m5t ,c\nsel+ ,s]vice location describ$ 9 subp>agraph 7,a77iv74 7#b7 ,! ,secret>y %all ensure t any writt5 communication "u ?is section f ! ,dep>tm5t to an individual :o has exp]i5c$ milit>y sexual trauma t includes notification ( an aw>d ( comp5sation "u *apt] #aa ( ?is title relat+ to milit>y sexual trauma includes-- 7,a7 ! contact in=mation describ$ 9 p>agraph 7#a72 & 7,b7 ! contact in=mation = ! milit>y sexual trauma coord9ator ( ! ,vet]ans ,b5efits ,adm9i/ration4 7#c7 ,9 ?is subsection3 7,a7 ,! t]m individual :o has exp]i5c$ milit>y sexual trauma means-- 7i7 an individual :o has fil$ a claim = comp5sation "u *apt] #aa ( ?is title relat+ to milit>y sexual trauma2 7ii7 a vet]an :o has be5 aw>d$ comp5sation "u su* *apt] relat+ to milit>y sexual trauma2 or 7iii7 a memb] ( ! ,arm$ ,=ces 7includ+ a memb] ( ! ,national ,gu>d or ,res]ves71 a =m] memb] ( ! ,arm$ ,=ces1 or a vet]an :o is receiv+ c>e f ! ,dep>tm5t relat+ to milit>y sexual trauma4 7,b7 ,! t]m milit>y sexual trauma has ! mean+ giv5 t t]m 9 section #aaff7;d77#b7 ( ?is title4 7,c7 ,! t]m ,vet]ans ,crisis ,l9e means ! toll-free hotl9e = vet]ans e/abli%$ "u section #agbj;,f7h7 ( ?is title4 4 7c7 ,/udy on tra9+ & process+ relat+ to claims = disability comp5sation relat+ to milit>y sexual trauma 7#a7 ,/udy requir$ ,! ,secret>y ( ,vet]ans ,affairs %all conduct a /udy on-- 7,a7 ! quality ( tra9+ provid$ to p]sonnel ( ! ,dep>tm5t ( ,vet]ans ,affairs :o review claims = disability comp5sation "u *apt] #aa ( title #ch1 ,unit$ ,/ates ,code1 = disabilities relat+ to milit>y sexual trauma2 & 7,b7 ! quality ( ! proc$ures ( ! ,dep>tm5t = review+ ! accuracy ( ! process+ ( su* claims4 7#b7 ,elem5ts ,! /udy requir$ by subsection 7a7 %all include ! foll[+3 7,a7 ,) respect to ! quality ( tra9+ describ$ 9 p>agraph 7#a7 ( su* subsection3 7i7 ,:e!r ! ,dep>tm5t ensures p]sonnel complete su* tra9+ on "t4 7ii7 ,:e!r ! tra9+ has result$ 9 improvem5ts to ! process+ ( claims describ$ 9 su* subsection & issue-bas$ accuracy4 7iii7 ,su* recomm5dations z ! ,secret>y may h = improv+ ! tra9+4 7,b7 ,) respect to ! quality ( proc$ures describ$ 9 p>agraph 7#b7 ( su* subsection3 7i7 ,:e!r ! proc$ures ( ! ,dep>tm5t = review+ ! accuracy ( ! process+ ( claims describ$ 9 su* subsection comport ) g5]ally accept$ /ati/ical me?odologies to ensure reasonable accuracy ( su* reviews4 7ii7 ,:e!r su* proc$ures adequately include me*anisms to correct errors f\nd 9 su* reviews4 7iii7 ,a summ>y ( quality assurance reviews & reports conduct$ z "p ( su* proc$ures4 7iv7 ,su* recomm5dations z ! ,secret>y may h = improv+ su* proc$ures4 7#c7 ,report requir$ ,n lat] ?an "o ye> 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 detail+ ! f9d+s ( ! ,secret>y ) respect to ! /udy conduct$ "u p>agraph 7#a74 7d7 ,annual special focus review ( claims = disability comp5sation = disabilities relat+ to milit>y sexual trauma 7#a7 ,annual special focus review 7,a7 ,9 g5]al ,ea* ye>1 ! ,"u ,secret>y = ,b5efits ( ! ,dep>tm5t ( ,vet]ans ,affairs %all conduct a special focus review on ! accuracy ( ! process+ ( claims = disability comp5sation "u *apt] #aa ( title #ch1 ,unit$ ,/ates ,code1 = disabilities relat+ to milit>y sexual trauma4 7,b7 ,elem5ts ,ea* review conduct$ "u subp>agraph 7,a7 %all include a review ( ! foll[+3 7i7 ,a /ati/ically significant1 nationally repres5tative sample ( all claims = b5efits "u ! laws adm9i/]$ by ! ,secret>y ( ,vet]ans ,affairs relat+ to milit>y sexual trauma fil$ dur+ ! fiscal ye> prec$+ ! fiscal ye> 9 :i* ! report is submitt$4 7ii7 ,! accuracy ( ea* decision made ) respect to ea* claim describ$ 9 clause 7i74 7iii7 ,! types ( b5efit entitlem5t errors f\nd1 disaggregat$ by category4 7iv7 ,tr5ds f ye> to ye>4 7v7 ,tra9+ completion rates = p]sonnel ( ! ,dep>tm5t :o process claims describ$ 9 subp>agraph 7,a74 7#b7 ,reprocess+ ( claims ,if ! ,"u ,secret>y f9ds1 pursuant to a special focus review conduct$ "u p>agraph 7#a77;,a71 t an error 0 made ) respect to ! entitlem5t ( a vet]an to a b5efit "u ! laws adm9i/]$ by ! ,secret>y1 ! ,secret>y %all return ! relevant claim ( ! vet]an to ! appropriate (fice ( ! ,dep>tm5t = reprocess+ to ensure t ! vet]an receives an accurate decision ) respect to ! claim4 7#c7 ,report ,section #eeja7;b7 ( ! ,johnny ,isakson & ,david ,p4 ,roe1 ,m4,d4 ,vet]ans ,heal? ,c>e & ,b5efits ,improvem5t ,act ( #bjbj 7,public ,law #aaf-cae2 #acd ,/at4 #ejdh7 is am5d$-- 7,a7 9 p>agraph 7#a71 by /rik+ ?r\gh #bjbg & ins]t+ until ! date describ$ 9 section #aji7;d77#d7 ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act2 & 7,b7 9 p>agraph 7#b71 by add+ at ! end ! foll[+ new subp>agraph3 7,i7 ,! f9d+s ( ! mo/ rec5t special focus review conduct$ "u subsection 7d77#a77;,a7 ( section #aji ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act1 includ+-- 7i7 ! elem5ts "u subsection 7d77#a77;,b7 ( su* section2 7ii7 ! numb] ( claims return$ = reprocess+ "u subsection 7d77#b7 ( su* section2 & 7iii7 ! numb] ( claims describ$ 9 clause 7ii7 = :i* ! decision relat+ to s]vice-connection or entitlem5t to comp5sation *ang$ z a result ( reprocess+ ! claim4 4 7#d7 ,sunset ,on ! date t is #e ye>s aft] ! enactm5t ( ?is ,act1 p>agraph 7#a77;,a7 %all cease to be 9 effect4 7e7 ,work+ gr\p on m$ical exam9ations = claims = disability comp5sation = disabilities relat+ to milit>y sexual trauma 7#a7 ,9 g5]al ,n lat] ?an #ij days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all e/abli% a work+ gr\p on m$ical exam9ations = claims = disability comp5sation "u *apt] #aa ( title #ch1 ,unit$ ,/ates ,code1 = disabilities relat+ to milit>y sexual trauma 79 ?is section ref]r$ to z ! work+ gr\p74 7#b7 ,memb]%ip ,! work+ gr\p %all be compos$ ( ! foll[+3 7,a7 ,/aff ( ! op]ations c5t] = milit>y sexual trauma ( ! ,dep>tm5t ( ,vet]ans ,affairs :o h exp]i5ce review+ ! quality ( m$ical exam9ations 9 support ( claims = disability comp5sation "u *apt] #aa ( title #ch1 ,unit$ ,/ates ,code4 7,b7 ,/aff ( ! ,m$ical ,disability ,exam9ation ,(fice ( ! ,dep>tm5t4 7,c7 ,vet]ans s]vice (fic]s :o h exp]i5ce ) claims describ$ 9 p>agraph 7#a74 7,d7 ,m$ical exam9]s :o h exp]i5ce ) su* claims4 7,e7 ,/aff ( ! ,vet]ans ,exp]i5ce ,(fice ( ! ,dep>tm5t4 7,f7 ,su* o!r individuals z ! ,secret>y consid]s appropriate4 7#c7 ,duties ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! work+ gr\p %all-- 7,a7 review ! quality ( m$ical exam9ations describ$ 9 p>agraph 7#a72 7,b7 review ! feasibility ( m9imiz+ re-exam9ations = conditions relat+ to milit>y sexual trauma2 & 7,c7 submit to ! ,"u ,secret>y = ,b5efits ( ! ,dep>tm5t & ! ,secret>y recomm5dations on h[ to-- 7i7 elim9ate re-traumatization ( individuals :o file claims describ$ 9 p>agraph 7#a72 & 7ii7 r$uce ! ov]developm5t ( su* claims4 7#d7 ,report ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all submit to ,congress a report t includes ! foll[+3 7,a7 ,! views ( ! work+ gr\p on ef=ts by ! ,dep>tm5t to elim9ate re-traumatization ( individuals :o file claims describ$ 9 subsection 7a74 7,b7 ,legislative proposals to improve ! exp]i5ce ( su* individuals 9 pursu+ su* claims4 7,c7 ,! recomm5dations submitt$ "u p>agraph 7#c77;,c74 7,d7 ,! plan ( ! ,"u ,secret>y = ,b5efits ( ! ,dep>tm5t & ! ,secret>y to implem5t su* recomm5dations4 7#e7 ,review & implem5tation ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,"u ,secret>y = ,b5efits ( ! ,dep>tm5t & ! ,secret>y %all-- 7,a7 review ! recomm5dations submitt$ "u p>agraph 7#c77;,c72 & 7,b7 implem5t ! recomm5dations t1 z det]m9$ by ! ,"u ,secret>y & ! ,secret>y1 w\ld improve ! claims process = individuals :o file claims describ$ 9 p>agraph 7#a74 7f7 ,milit>y sexual trauma claims p]=mance da%bo>d 7#a7 ,e/abli%m5t ,! ,secret>y ( ,vet]ans ,affairs %all e/abli% an int]active p]=mance da%bo>d display+ in=mation ab\t claims relat+ to milit>y sexual trauma submitt$ to ! ,secret>y = b5efits "u laws adm9i/]$ by ! ,secret>y4 7#b7 ,elem5ts ,! da%bo>d e/abli%$ pursuant to p>agraph 7#a7 %all cov] ! foll[+3 7,a7 ,claims relat+ to milit>y sexual trauma submitt$ to ! ,secret>y = b5efits "u laws adm9i/]$ by ! ,secret>y t h be5 submitt$1 complet$1 or appeal$1 includ+ appeals p5d+ at ! ag5cy ( jurisdiction & at ! ,bo>d ( ,vet]ans' ,appeals4 7,b7 ,= comp>ison purposes ) subp>agraph 7,a71 claims n relat+ to milit>y sexual trauma submitt$ to ! ,secret>y = b5efits "u laws adm9i/]$ by ! ,secret>y t h be5 submitt$1 complet$1 or appeal$4 7,c7 ,ov]all1 cumulative in=mation relat+ to claims relat+ to milit>y sexual trauma submitt$ to ! ,secret>y = b5efits "u laws adm9i/]$ by ! ,secret>y1 includ+ ! foll[+3 7i7 ,av]age numb] ( days a claim is p5d+ review4 7ii7 ,av]age numb] ( days = complet$ adjudication4 7iii7 ,total numb] ( p5d+ claims1 disaggregat$ by :e!r ! claims h be5 p>tially adjudicat$ or n adjudicat$ at all4 7iv7 ,total numb] ( claims completely adjudicat$4 7v7 ,( ! numb] specifi$ 9 clause 7iv71 ! p]c5tage t 7 approv$1 d5i$1 or appeal$4 7,d7 ,! total numb] ( claims relat+ to milit>y sexual trauma submitt$ to ! ,secret>y = b5efits "u laws adm9i/]$ by ! ,secret>y4 7,e7 ,! me?ods us$ = submittal ( claims relat+ to milit>y sexual trauma to ! ,secret>y = b5efits "u laws adm9i/]$ by ! ,secret>y4 7,f7 ,! mo/ frequ5t reasons ! ,secret>y d5ies a claim relat+ to milit>y sexual trauma submitt$ to ! ,secret>y = a b5efit "u a law adm9i/]$ by ! ,secret>y4 7,g7 ,! mo/ frequ5t conditions or disabilities = :i* a claim relat+ to milit>y sexual trauma is d5i$4 7,h7 ,! mo/ frequ5t conditions or disabilities = :i* a claim relat+ to milit>y sexual trauma is submitt$ to ! ,secret>y = disability comp5sation "u *apt] #aa ( title #ch1 ,unit$ ,/ates ,code1 includ+ ! grant rate = su* cont5tions4 7#c7 ,additional res\rce in=mation ,! ,secret>y %all make available via ! p]=mance da%bo>d e/abli%$ pursuant to subsection 7a7 ! foll[+ in=mation3 7,a7 ,vet]ans ,crisis ,l9e contact in=mation4 7,b7 ,in=mation reg>d+ ! availability ( s]vices f milit>y sexual trauma coord9ators ( ! ,vet]ans ,heal? ,adm9i/ration4 7,c7 ,in=mation reg>d+ ! availability ( s]vices f milit>y sexual trauma coord9ators ( ! ,vet]ans ,b5efits ,adm9i/ration4 7,d7 ,in=mation on availability ( specializ$ c>e1 s]vices1 & b5efits f ! ,dep>tm5t = individuals :o h exp]i5c$ milit>y sexual trauma4 7,e7 ,su* additional in=mation z ! ,secret>y consid]s appropriate4 7#d7 ,availability ,! ,secret>y %all ensure t ! da%bo>d e/abli%$ pursuant to p>agraph 7#a7 is available to ! public f ! website ( ! ,dep>tm5t ( ,vet]ans ,affairs & is updat$ n less frequ5tly ?an once e #cj days4 7#e7 ,report+ requirem5ts 7,a7 ,n lat] ?an #b 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 detail+-- 7i7 ! annual co/ to implem5t ! da%bo>d requir$ by p>agraph 7#b72 7ii7 areas = improvem5t ( ! da%bo>d2 & 7iii7 su* additional in=mation z ! ,secret>y consid]s appropriate4 7,b7 ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all comm5ce provid+1 on a qu>t]ly basis1 to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a qu>t]ly brief+ on ! ,dep>tm5t's process+ ( milit>y sexual trauma-relat$ claims4 7#f7 ,def9ition ,9 ?is section1 ! t]m milit>y sexual trauma has ! mean+ giv5 su* t]m 9 section #aaff7;d77#b7 ( title #ch1 ,unit$ ,/ates ,code4 #aab4 ,indep5d5t assessm5t ( notices t ! ,secret>y ( ,vet]ans ,affairs s5ds to claimants 7a7 ,agreem5t ,n lat] ?an #cj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all seek to ent] into an agreem5t ) an ,,ffrdc = an assessm5t ( notices t ! ,secret>y s5ds to claimants4 7b7 ,assessm5t ,an ,,ffrdc t ent]s into an agreem5t "u subsection 7a7 %all submit to ! ,secret>y a writt5 assessm5t ( su* notices4 ,! assessm5t %all include ! foll[+3 7#a7 ,! det]m9ation ( ! ,,ffrdc1 made 9 consultation ) cov]$ entities1 :e!r ea* su* notice may be feasibly alt]$ to r$uce pap] consumption by1 & co/s to1 ! ,f$]al ,gov]nm5t4 7#b7 ,! recomm5dations ( ! ,,ffrdc reg>d+ h[ ! ,secret>y may make su* notices cle>] to claimants1 bett] organiz$1 & m concise4 7c7 ,report2 implem5tation ,n lat] ?an #ij days aft] ! ,secret>y receives ! assessm5t "u subsection 7b71 ! ,secret>y %all-- 7#a7 submit to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ,h\se ( ,repres5tatives a copy ( su* assessm5t2 & 7#b7 implem5t ! recomm5dations 9 ! assessm5t t are 9 compliance ) ! laws adm9i/]$ by ! ,secret>y4 7d7 ,deadl9e = implem5tation ,! ,secret>y %all complete ! implem5tation ( su* recomm5dations pursuant to subsection 7c77#b7 by n lat] ?an "o ye> aft] ! date on :i* ! ,secret>y comm5ces su* implem5tation4 7e7 ,def9itions ,9 ?is section3 7#a7 ,! t]m ,,ffrdc means a f$]ally fund$ rese>* & developm5t c5t]4 7#b7 ,! t]m cov]$ entities includes-- 7,a7 ! ,secret>y ( ,vet]ans ,affairs2 7,b7 an exp]t 9 laws adm9i/]$ by ! ,secret>y ( ,vet]ans ,affairs2 7,c7 a vet]ans s]vice organization recogniz$ "u section #eijb ( title #ch1 ,unit$ ,/ates ,code2 7,d7 an entity t advocates = vet]ans2 & 7,e7 an entity t advocates = ! survivors ( vet]ans4 7#c7 ,! t]ms claimant & notice h ! mean+s giv5 su* t]ms 9 section #eajj ( title #ch1 ,unit$ ,/ates ,code4 #aac4 ,indep5d5t assessm5t ( =ms t ! ,secret>y ( ,vet]ans ,affairs s5ds to claimants 7a7 ,agreem5t ,n lat] ?an #cj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all seek to ent] into an agreem5t ) an ,,ffrdc = an assessm5t ( =ms t ! ,secret>y s5ds to claimants4 7b7 ,assessm5t ,an ,,ffrdc t ent]s into an agreem5t "u subsection 7a7 %all submit to ! ,secret>y a writt5 assessm5t1 made 9 consultation ) cov]$ entities1 ( su* =ms4 ,! assessm5t %all include ! recomm5dations ( ! ,,ffrdc reg>d+ h[ ! ,secret>y may make su* =ms cle>] to claimants & bett] organiz$4 7c7 ,report2 implem5tation ,n lat] ?an #ij days aft] ! ,secret>y receives ! assessm5t "u subsection 7b71 ! ,secret>y %all-- 7#a7 submit to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ,h\se ( ,repres5tatives a copy ( su* assessm5t2 & 7#b7 implem5t ! recomm5dations 9 ! assessm5t t are 9 compliance ) ! laws adm9i/]$ by ! ,secret>y4 7d7 ,deadl9e = implem5tation ,! ,secret>y %all complete ! implem5tation ( su* recomm5dations pursuant to subsection 7c77#b7 by n lat] ?an two ye>s aft] ! date on :i* ! ,secret>y comm5ces su* implem5tation4 7e7 ,def9itions ,9 ?is section3 7#a7 ,! t]m ,,ffrdc means a f$]ally fund$ rese>* & developm5t c5t]4 7#b7 ,! t]m cov]$ entities includes-- 7,a7 ! ,secret>y ( ,vet]ans ,affairs2 7,b7 an exp]t 9 laws adm9i/]$ by ! ,secret>y ( ,vet]ans ,affairs2 7,c7 a vet]ans s]vice organization recogniz$ "u section #eijb ( title #ch1 ,unit$ ,/ates ,code2 7,d7 an entity t advocates = vet]ans2 & 7,e7 an entity t advocates = survivors ( vet]ans4 7#c7 ,! t]m claimant has ! mean+ giv5 su* t]m 9 section #eajj ( title #ch1 ,unit$ ,/ates ,code4 ,,ii ,education & ,economic ,opportunity #bja4 ,vets ,opportunity ,act 7a7 ,repaym5t ( memb]s ( ! ,arm$ ,=ces = contributions t[>ds ,po/-#i_/aa ,educational ,assi/ance3 tim+2 me*anism = individuals n eligible = a mon?ly h\s+ /ip5d 7#a7 ,9 g5]al ,subsection 7f7 ( section #ccbg ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7,a7 9 p>agraph 7#c71 by /rik+ toge!r & all t foll[s ?r\gh be=e & ins]t+ n lat] ?an #fj days aft]2 & 7,b7 by add+ at ! end ! foll[+ new p>agraph3 7#d7 ,additional assi/ance = an individual n eligible = a mon?ly h\s+ /ip5d ,9 ! case ( an individual mak+ an election "u subsection 7a7 :o is describ$ by subp>agraph 7,a71 7,c71 or 7,e7 ( p>agraph 7#a7 ( t subsection1 & :o is n eligible = a mon?ly /ip5d payable "u section #ccac7;c7 ( ?is title1 ! educational assi/ance payable to ! individual "u ?is *apt] %all be paid-- 7,a7 9 a lump sum calculat$ by multiply+-- 7i7 ! total am\nt ( contributions describ$ 9 p>agraph 7#a77;,a7 ) reg>ds to su* individual2 & 7ii7 ! sum ( ! numb] ( mon?s describ$ 9 subclauses 7,i7 & 7,,ii7 ( p>agraph 7#a77;,b77i7 ) reg>ds to su* individual2 & 7,b7 to ! individual n lat] ?an #fj days aft] ! exhau/ion ( ! individual's entitlem5t to educational assi/ance "u ?is *apt]4 4 7#b7 ,te*nical corrections & con=m+ am5dm5t ,su* subsection is fur!r am5d$-- 7,a7 by /rik+ p>agraphs 7#b7 ?r\gh 7#g7 & ins]t+ p>agraphs 7#b7 ?r\gh 7#f72 & 7,b7 9 p>agraph 7#a71 9 ! head+1 by ins]t+ = an individual eligible = a mon?ly h\s+ /ip5d aft] ,additional assi/ance4 7#c7 ,effective date ,! am5dm5ts made by ?is section %all take effect on ,augu/ #a1 #bjbg4 7b7 ,treatm5t ( c]ta9 indep5d5t /udy programs "u educational assi/ance programs ( ,dep>tm5t ( ,vet]ans ,affairs 7#a7 ,9 g5]al ,section #cfhj;,a7a77#d77;,a77ii77,,iii7 ( su* title is am5d$-- 7,a7 by ins]t+ t requires regul> & sub/antive int]action betwe5 /ud5ts & in/ructors aft] c\rse ( /udy2 7,b7 9 item 7aa71 by /rik+ 2 or & ins]t+ a semicolon2 7,c7 9 item 7bb71 by /rik+ 2 & & ins]t+ 2 or2 & 7,d7 by add+ at ! end by foll[+ new item3 7cc7 an in/itution ( high] education1 z su* t]m is def9$ 9 section #ajb ( ! ,high] ,education ,act ( #aife 7#bj ,u4,s4,c4 #ajjb71 t is approv$ to p>ticipate or is p>ticipat+ 9 ! /ud5t f9ancial assi/ance programs au?oriz$ by title ,,iv ( t ,act2 & 4 7#b7 ,applicability ,! am5dm5t made by p>agraph 7#a7 %all apply ) respect to a qu>t]1 seme/]1 or t]m1 z applicable1 t beg9s on or aft] ,augu/ #a1 #bjbg4 7#c7 ,ov]sight ,dur+ ! fir/ six ye>s beg9n+ on ! date ( enactm5t ( ?is ,act1 ! ,secret>y1 9 coord9ation ) ,/ate approv+ ag5cies1 %all1 e two ye>s1 conduct risk-bas$ surveys or reviews ( in/itutions approv$ pursuant to section #cfhj;,a7a77#d77;,a77ii77,,iii77cc7 ( title #ch1 ,unit$ ,/ates ,code1 z add$ by p>agraph 7#a74 7#d7 ,,gao report ,n lat] ?an #c ye>s aft] ! date ( enactm5t ( ?is ,act1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ,h\se ( ,repres5tatives a report on ! ov]sight & implem5tation ( ! am5dm5ts made by p>agraph 7#a71 includ+-- 7,a7 ! effectiv5ess ( ov]sight activities conduct$ by ! ,dep>tm5t ( ,vet]ans ,affairs & ,/ate approv+ ag5cies2 7,b7 in/itutional compliance ) applicable requirem5ts "u *apt] #cf ( title #ch1 ,unit$ ,/ates ,code2 7,c7 p>ticipation & outcomes ( vet]ans enroll$ 9 programs approv$ pursuant to section #cfhj;,a7a77#d77;,a77ii77,,iii77cc7 ( su* title1 z add$ by p>agraph 7#a72 & 7,d7 any recomm5dations to improve ov]sight1 program integrity1 or educational outcomes = vet]ans4 7#e7 ,applicability ,to ! ext5t practicable = any program requir+ practical1 laboratory1 cl9ical1 %op1 or h&s on compet5cies1 ! onl9e portion ( in/ruction may n sub/itute = ! sup]vis$ 9 p]son tra9+ necess>y to demon/rate su* compet5cies4 7c7 ,abs5ce f c]ta9 education due to c]ta9 s]vice 7#a7 ,options ,section #cfia;,a ( su* title is am5d$ by /rik+ p>agraph 7#a7 ( subsection 7a7 & ins]t+ ! foll[+3 7#a7 ,a cov]$ memb] may1 aft] receiv+ ord]s to ent] a p]iod ( cov]$ s]vice-- 7,a7 )draw f cov]$ education2 7,b7 take a leave ( abs5ce f cov]$ education2 or 7,c7 subject to subsection 7d71 ent] into an agreem5t ) ! in/itution conc]n$ to complete a c\rse ( cov]$ education to ! satisfaction ( su* in/itution conc]n$4 4 7#b7 ,con=m+ am5dm5t ,su* subsection is fur!r am5d$1 9 p>agraph 7#b77;,a71 by /rik+ or takes a leave ( abs5ce & ins]t+ 1 takes a leave ( abs5ce1 or ent]s into an agreem5t4 7#c7 ,agreem5t ,su* section is fur!r am5d$-- 7,a7 by r$esignat+ subsection 7d7 z subsection 7e72 & 7,b7 by ins]t+1 aft] subsection 7c71 ! foll[+ new subsection 7d73 7d7 ,agreem5t ) in/itution conc]n$ ,a cov]$ memb] may ent] into an agreem5t "u subsection 7a7 only if ! cov]$ memb] has complet$ at lea/ half ( a c\rse ( cov]$ education4 4 7#d7 ,section head+ ,su* section is fur!r am5d$ by /rik+ ! head+ & ins]t+ ,abs5ce f c]ta9 education due to c]ta9 s]vice4 7#e7 ,table ( sections ,! table ( sections at ! beg9n+ ( *apt] #cf ( su* title is am5d$ by /rik+ ! item relat+ to section #cfia;,a & ins]t+ ! foll[+ new item3 #cfia;,a4 ,abs5ce f c]ta9 education due to c]ta9 s]vice4 4 7d7 ,dep>tm5t ( ,vet]ans ,affairs compliance surveys ,section #cfic ( su* title is am5d$-- 7#a7 9 subsection 7c7-- 7,a7 by /rik+ n m ?an #aj bus9ess days ( notice2 7,b7 by /rik+ ?is section4 & ins]t+ ?is section--2 & 7,c7 by add+ at ! end ! foll[+ new p>agraphs3 7#a7 9 ! case ( an educational in/itution or tra9+ e/abli%m5t ) a "t /amp database collection feature1 n few] ?an #aj1 & n m ?an #ae1 bus9ess days ( notice2 & 7#b7 9 ! case ( any o!r educational in/itution or tra9+ e/abli%m5t1 n m ?an #aj bus9ess days ( notice4 2 & 7#b7 by /rik+ subsection 7d7 & ins]t+ ! foll[+ new subsection 7d73 7d7 ,def9itions ,9 ?is section3 7#a7 ,! t]ms educational in/itution & tra9+ e/abli%m5t h ! mean+s giv5 su* t]ms 9 section #cdeb ( ?is title4 7#b7 ,! t]m s*ool c]tify+ (ficial means an employee ( an educational in/itution ) prim>y responsibility = c]tify+ vet]an enrollm5t at ! educational in/itution4 4 7e7 ,notification ( s*ool c]tify+ (ficials ( h&book updates 7#a7 ,9 g5]al ,n lat] ?an #ad bus9ess days aft] updat+ ! s*ool c]tify+ (ficial h&book ( ! ,dep>tm5t ( ,vet]ans ,affairs1 ! ,secret>y ( ,vet]ans ,affairs %all provide notice to all s*ool c]tify+ (ficials ( su* update4 7#b7 ,s*ool c]tify+ (ficial def9$ ,! t]m s*ool c]tify+ (ficial means an employee ( an educational in/itution ) prim>y responsibility = c]tify+ vet]an enrollm5t at ! educational in/itution4 #bjb4 ,improvem5ts to process = mak+ paym5ts to automobile sell]s = automobiles pur*as$ = c]ta9 disabl$ vet]ans 7a7 ,timel9ess ( paym5ts ,section #cijb ( title #ch1 ,unit$ ,/ates ,code1 is am5d$1 9 subsection 7a7-- 7#a7 by ins]t+ 7#a7 be=e ,! ,secret>y2 & 7#b7 by add+ at ! end ! foll[+ new p>agraph3 7#b7 ,! ,secret>y %all-- 7,a7 make paym5ts "u ?is section 9 compliance ) regulations prescrib$ "u section #cijc7;a7 ( title #ca1 except t no int]e/ p5alties %all be requir$ to be paid "u ?is section2 & 7,b7 9 ! case ( any paym5t "u ?is section t is n process$ dur+ ! p]iod ( #cj days foll[+ receipt by ! ,secret>y ( ! f9al invoice = su* paym5t1 ! ,secret>y %all publi% 9 ! ,f$]al ,regi/] ! numb] ( days requir$ to process ! paym5t4 4 7b7 ,c5tralization ( process = mak+ paym5ts ,su* section is am5d$ by add+ at ! end ! foll[+ new subsection3 7f7 7#a7 ,! ,secret>y %all process paym5ts "u ?is section ?r\gh "o (fice ( ! ,dep>tm5t t ! ,secret>y det]m9es has ! capacity & exp]tise to make su* paym5ts 9 compliance ) regulations describ$ 9 subsection 7a77#b74 7#b7 ,! ,secret>y %all accurately track & resolve paym5ts due to sell]s "u ?is section t are m ?an #ij days ov]due4 4 7c7 ,report+ ,! ,secret>y ( ,vet]ans ,affairs %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ,h\se ( ,repres5tatives1 & publi% on a publicly accessible website ( ! ,dep>tm5t ( ,vet]ans ,affairs1 f\r semiannual reports aft] ! date ( ! enactm5t ( ?is ,act1 reg>d+ ! adm9i/ration ( section #cijb ( title #ch1 ,unit$ ,/ates ,code1 z am5d$ by ?is section4 ,ea* su* report %all include1 ) respect to ! p]iod ( six mon?s prec$+ ! date ( ! report1 ! foll[+ elem5ts3 7#a7 ,! av]age & m$ian numb] ( days betwe5 receipt ( a invoice = paym5t "u su* section by ! ,claims ,intake ,c5t] ( ! ,dep>tm5t & ! day :5 ! ,secret>y makes su* paym5t1 disaggregat$ by :e!r ! claim 0 "u review or be+ process$ by-- 7,a7 ! ,vet]ans ,heal? ,adm9i/ration2 7,b7 ! ,vet]ans ,b5efits ,adm9i/ration2 or 7,c7 ! sell]4 7#b7 ,improvem5ts to in=mation te*nology ( ! ,dep>tm5t t ! ,secret>y det]m9es w\ld r$uce ! "t requir$ = su* review or process+4 7d7 ,,gao report2 brief+ 7#a7 ,report ,n lat] ?an #ahj days aft] ! day ! ,secret>y completes c5tralization "u subsection 7f7 ( section #cijb ( title #ch1 ,unit$ ,/ates ,code1 z add$ by ?is section1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all review su* c5tralization & publi% a report conta9+ ! results ( su* review4 ,su* report %all include ! det]m9ations ( ! ,comptroll] ,g5]al reg>d+ ! foll[+3 7,a7 ,! capacity ( ! (fice det]m9$ by ! ,secret>y "u su* subsection1 to c>ry out process+ describ$ 9 su* subsection1 includ+-- 7i7 a compreh5sive assessm5t ( employees ( ! ,dep>tm5t :o c>ry out *apt] #ci ( su* title2 7ii7 a compreh5sive skills assessm5t indicat+ :at res\rces ! ,secret>y requires to o!rwise improve su* c5tralization1 includ+ additional funds1 employees1 or contractors2 & 7iii7 a review ( sy/ems ( in=mation te*nology1 includ+ sy/ems 9 use or to be acquir$1 to c>ry out su* c5tralization4 7,b7 ,recomm5dations to improve su* process+4 7,c7 ,e/imat$ co/s to ! ,unit$ ,/ates to implem5t su* recomm5dations4 7#b7 ,brief+ ,n lat] ?an #cj days aft] publi%+ ! report "u p>agraph 7#a71 ! ,comptroll] ,g5]al %all provide to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ,s5ate a brief+ on su* report4 ,su* brief+ %all include any response f ! ,secret>y to ! ,comptroll] ,g5]al reg>d+ ! recomm5dations 9 ! report4 #bjc4 ,mon?ly h\s+ /ip5d "u ! ,po/-#i_/aa ,educational ,assi/ance ,program = individuals :o pursue summ] programs ( education solely ?r\gh di/ance le>n+ 7a7 ,9 g5]al ,section #ccac7;c77#a77;,b7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 9 clause 7i71 by /rik+ & 7iii7 & ins]t+ 1 7iii71 & 7iv72 7#b7 by r$esignat+ clause 7iv7 z clause 7v72 & 7#c7 by ins]t+ aft] clause 7iii7 ! foll[+ new clause 7iv73 7iv7 ,9 ! case ( an individual pursu+1 solely ?r\gh di/ance le>n+1 a program ( education t is %ort] ?an #ab weeks dur+ ! summ]1 = ea* mon? ! individual pursues ! program ( education1 a mon?ly h\s+ /ip5d equal to ! product (-- 7,i7 ! national av]age ( ! mon?ly am\nt ( ! basic all[ance = h\s+ payable "u section #djc ( title #cg = a memb] ) dep5d5ts 9 pay grade ,e-#e1 multipli$ by 7,,ii7 ! less] (-- 7aa7 #a4j & 7bb7 ! numb] ( c\rse h\rs borne by ! individual 9 pursuit ( ! program ( education1 divid$ by ! m9imum numb] ( c\rse h\rs requir$ = full-"t pursuit ( ! program ( education1 r\nd$ to ! ne>e/ multiple ( #aj4 4 7b7 ,effective date ,! am5dm5ts made by subsection 7a7 %all apply to a program ( education beg9n+ on or aft] ,augu/ #a1 #bjbg4 #bjd4 ,cl>ification reg>d+ inclusion ( m$ically necess>y automobile adaptations 9 ,dep>tm5t ( ,vet]ans ,affairs def9ition ( m$ical s]vices ,section #agja7f77;,i7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ to read z foll[s3 7,i7 ,! provision ( any m$ically necess>y automobile adaptations = driv] or pass5g] use1 includ+-- 7i7 ramp & kneel+ sy/ems2 7ii7 rais$ doors or l[]$ floors2 7iii7 rais$ ro(s2 7iv7 air condition+2 7v7 occupi$ & unoccupi$ mobility lifts2 7vi7 +ress or egress accessibility modifications2 7vii7 :eel*air ti$[ns2 & 7viii7 adapt$ seat+4 4 #bje4 ,digital communications3 ,solid ,/>t program2 educational assi/ance 7a7 ,improvem5t to c]ta9 outrea* "u ,solid ,/>t program ( ,dep>tm5t ( ,vet]ans ,affairs ,section #fcbj7;b7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 9 p>agraph 7#a77;,b7-- 7,a7 by /rik+ call+ & ins]t+ communicat+ )2 & 7,b7 by ins]t+ ?r\gh ! use ( tailor$ l9es ( communication1 includ+ mail+s1 text messag+1 virtual *att+1 & o!r electronic =ms ( messag+ aft] ,arm$ ,=ces2 & 7#b7 9 p>agraph 7#b71 by /rik+ tailor$ mail+s & ins]t+ tailor$ l9es ( communication1 includ+ mail+s1 text messag+1 virtual *att+1 & o!r electronic =ms ( messag+14 7b7 ,dep>tm5t ( ,vet]ans ,affairs use ( tailor$ l9es ( communication = correspond5ce relat+ to educational assi/ance b5efits ,section #cfhj ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new subsection3 7i7 7#a7 ,! ,secret>y %all provide a me*anism by :i* an eligible vet]an or eligible p]son may use tailor$ l9es ( communication to s5d & receive correspond5ce ) ! ,dep>tm5t ( ,vet]ans relat$ to entitlem5t to & use ( educational assi/ance b5efits "u ! laws adm9i/]$ by ! ,secret>y4 ,! ,secret>y %all ensure t an eligible vet]an or eligible p]son is provid$ ) an opportunity to opt into s5d+ & receiv+ su* correspond5ce us+ su* l9es ( communication r ?an by mail4 7#b7 ,! ,secret>y %all provide to eligible vet]ans & eligible p]sons :o are enroll$ 9 a c\rse or program ( education or tra9+ notice ( ! opportunity to opt 9 to s5d+ & receiv+ correspond5ce us+ tailor$ l9es ( communication pursuant to p>agraph 7#a74 7#c7 ,9 ?is subsection1 ! t]m tailor$ l9es ( communication includes mail+s1 text messag+1 virtual *att+1 & o!r electronic =ms ( messag+4 4 #bjf4 ,improvem5ts to ,transition ,assi/ance ,program & ,skillbridge 7a7 ,transition ,assi/ance ,program3 am5dm5ts2 pilot program2 reports 7#a7 ,special op]ations =ces ,subsection 7a7 ( section #aadb ( title #aj1 ,unit$ ,/ates ,code1 is am5d$1 9 p>agraph 7#a71 by ins]t+ 7includ+ ea* memb] ( ! special op]ations =ces7 aft] arm$ =ces4 7#b7 ,requirem5t ( presep>ation c\nsel+3 numb] ( days ,su* subsection is fur!r am5d$1 9 p>agraph 7#a7-- 7,a7 by ins]t+ 7,a7 be=e ,)92 & 7,b7 by add+ at ! end ! foll[+ new subp>agraph3 7,b7 ,! ,secret>y conc]n$ %all ensure t a memb] describ$ 9 subp>agraph 7,a7 receives presep>ation c\nsel+ 9 ! foll[+ am\nts3 7i7 ,9 ! case ( a memb] :o has accept$ an (f] ( full-"t employm5t1 or has enroll$ 9 a program ( education or vocational tra9+1 t %all comm5ce aft] ! memb] sep>ates1 retires1 or is dis*>g$1 n few] ?an ?ree days4 7ii7 ,9 ! case ( a memb] o!r ?an a memb] describ$ 9 clause 7i71 n few] ?an five days4 4 7#c7 ,repeat att5dance ,su* subsection is fur!r am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#f7 ,a memb] :o receiv$ presep>ation c\nsel+ "u ?is section may1 be=e sep>ation1 retirem5t1 or dis*>ge1 reque/ to receive1 on a space-available basis1 su* presep>ation c\nsel+ a second "t4 4 7#d7 ,pa?ways3 /&>dization2 e/abli%m5t ( pa?way = memb]s ( ! res]ve compon5ts ,su* section is fur!r am5d$1 9 p>agraph 7#a7 ( subsection 7c71 9 ! matt] prec$+ subp>agraph 7,a77#a7-- 7,a7 by /rik+ ,ea* ,secret>y conc]n$ & ins]t+ ,! ,secret>ies ( ,def5se & ,homel& ,security2 & 7,b7 by /rik+ pa?ways = memb]s ( ! milit>y dep>tm5t conc]n$ & ins]t+ pa?ways1 /&>diz$ across ! arm$ =ces4 7#e7 ,pa?ways3 record ( pa?way assignm5t ,su* subsection is fur!r am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#d7 ,! ,secret>y conc]n$ %all ensure t ! pa?way 9 :i* a memb] is plac$1 & ! reasons = su* placem5t1 are not$ 9 ! s]vice record ( su* memb]4 4 7#f7 ,coord9ation betwe5 ,dep>tm5ts ( ,def5se1 ,vet]ans ,affairs1 & ,labor ,su* section is fur!r am5d$1 9 subsection 7d7-- 7,a7 by /rik+ ! head+ & ins]t+ ,transmission ( ,c]ta9 ,in=mation to ,o!r ,dep>tm5ts2 7,b7 by ins]t+ 7#a7 be=e ,9 ! case2 & 7,c7 by add+ at ! end ! foll[+ new p>agraphs3 7#b7 ,be=e a memb] describ$ 9 subsection 7a7 sep>ates1 retires1 or is dis*>g$1 ! ,secret>y conc]n$ %all transmit to ! ,secret>y ( ,vet]ans ,affairs ! ,dep>tm5t ( ,def5se ,=m ,,dd-#bfdh reg>d+ su* memb]4 7#c7 7,a7 ,9 ! case ( a memb] describ$ 9 subsection 7a7 :om ! ,secret>y det]m9$ z ti] #c /atus ! ,secret>y conc]n$ %all1 be=e ! memb] sep>ates1 retires1 or is dis*>g$1 provide su* memb] ) ! contact in=mation ( an employee ( ! ,dep>tm5t ( ,vet]ans ,affairs & an employee ( ! ,dep>tm5t ( ,labor2 & 7,b7 ,ea* employee describ$ 9 subp>agraph 7,a7 %all contact ! memb] describ$ 9 su* subp>agraph n lat] ?an #fj days aft] su* memb] sep>ates1 retires1 or is dis*>g$4 7,c7 ,! ,secret>y ( ,vet]ans ,affairs & ! ,secret>y ( ,labor %all ea* submit to ! ,committees on ,arm$ ,s]vices & on ,vet]ans' ,affairs ( ! ,s5ate & ,h\se ( ,repres5tatives an annual report t id5tifies ! numb] ( times1 & reasons :y1 an employee ( ! dep>tm5t "u ! jurisdiction ( su* ,secret>y fail$ to c>ry out subp>agraph 7,b7 9 ! ye> prec$+ ! date ( ! report4 7,d7 ,! ,secret>y ( ,def5se & ,secret>y ( ,homel& ,security %all prescribe regulations to ensure t1 = purposes ( ?is p>agraph1 ea* ,secret>y conc]n$ uses ! same def9ition ( ! t]m at risk = a difficult transition to civilian life4 4 7#g7 ,report ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ?is ,act & annually !reaft] = f\r ye>s1 ! ,secret>y ( ,def5se %all submit to ! ,committees on ,arm$ ,s]vices1 & ! ,committees on ,vet]ans' ,affairs1 ( ! ,s5ate & ,h\se ( ,repres5tatives1 a report on data record$ ) su* track+ sy/em dur+ ! ye> prec$+ ! date ( su* report4 ,su* a report %all include a li/ ( ! sev5 milit>y in/allations locat$ inside ! cont95tal ,unit$ ,/ates1 & ?ree milit>y in/allations locat$ outside ! cont95tal ,unit$ ,/ates1 :]e memb]s are lea/ likely to receive presep>ation c\nsel+ 9 accordance ) su* "t p]iods4 7,a7 ,! numb] ( memb]s :o1 9 ! c\rse ( su* presep>ation c\nsel+1 7 ref]r$ to ano!r ,f$]al ag5cy or dep>tm5t4 7,b7 ,! ,f$]al ag5cies or dep>tm5ts to :i* memb]s 7 s ref]r$4 7,c7 ,! numb] ( memb]s :o %\ld h be51 b 7 n1 s ref]r$1 & reasons :y su* ref]rals did n occur4 7,d7 ,! numb] ( memb]s :o receive su* presep>ation c\nsel+ & apply = unemploym5t comp5sation "u sub*apt] ,,ii ( *apt] #he ( title #e1 ,unit$ ,/ates ,code4 7,e7 ,! total am\nt ( su* unemploym5t comp5sation paid to memb]s sep>at+ f ! ,arm$ ,=ces4 7,f7 ,! frequ5cy ) :i* ! comm&] ( ! milit>y in/allation receiv$ a brief+ reg>d+ att5dance ( memb]s 9 accordance ) /atutory requirem5ts ( ! ,transition ,assi/ance ,program4 7#h7 ,contract+3 /&>dization ,su* section is fur!r am5d$ by add+ at ! end ! foll[+ new subsection3 7f7 ,contract+ ,a ,secret>y conc]n$ may ent] into an agreem5t ) an entity "u :i* su* entity %all provide presep>ation c\nsel+ "u ?is section4 ,if m ?an "o ,secret>y seeks to ent] into su* an agreem5t1 su* ,secret>ies conc]n$ %all1 to ! ext5t practicable1 seek to ent] into su* agreem5ts ) ! same entity4 4 7#i7 ,annual report on ,,tap p>ticipation ,! frequ5cy ) :i* ! comm&] ( ! milit>y in/allation receiv$ a brief+ reg>d+ att5dance ( memb]s 9 accordance ) /atutory requirem5ts ( ! ,transition ,assi/ance ,program4 7b7 ,skillbridge3 ,,gao /udy 7#a7 ,/udy requir$ ,! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all conduct a /udy ( ! ,skillbridge programs "u section #aadc7;e7 ( title #aj1 ,unit$ ,/ates ,code4 7#b7 ,report ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,comptroll] ,g5]al %all submit to ! ,committees on ,arm$ ,s]vices1 & ! ,committees on ,vet]ans' ,affairs1 ( ! ,s5ate & ,h\se ( ,repres5tatives1 a report reg>d+ su* /udy4 ,su* report %all include obs]vations & recomm5dations ( ! ,comptroll] reg>d+1 ) respect to memb]s & employ]s :o p>ticipate 9 ,skillbridge-- 7,a7 diff]5ces 9 crit]ia = p>ticipation betwe5 ! ,arm$ ,=ces2 7,b7 o!r diff]5ces 9 ,skillbridge programs betwe5 ! ,arm$ ,=ces2 7,c7 be/ practices 9 ,skillbridge programs across ! ,arm$ ,=ces1 includ+-- 7i7 ! selection ( employ]s2 & 7ii7 ! developm5t ( contracts2 & 7,d7 ! feasibility ( mak+ ,skillbridge programs uni=m across ! ,arm$ ,=ces4 #bjg4 ,transition ,assi/ance ,program3 pres5tation 9 presep>ation c\nsel+ to promote b5efits available to vet]ans 7a7 ,9 g5]al ,section #aadb7;b7 ( title #aj1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#bj7 ,a pres5tation t promotes ! b5efits available to vet]ans "u ! laws adm9i/]$ by ! ,secret>y ( ,vet]ans ,affairs4 ,su* pres5tation-- 7,a7 %all be /&>diz$2 7,b7 %all1 be=e implem5tation1 be review$ & approv$ by ! ,secret>y ( ,vet]ans ,affairs & ,secret>y ( ,def5se 9 collaboration ) vet]ans s]vice organizations t provide claims assi/ance "u ! b5efits deliv]y at dis*>ge program ( ! ,dep>tm5t ( ,vet]ans ,affairs2 7,c7 %all be submitt$ by ! ,secret>y ( ,vet]ans ,affairs to ! ,committees on ,vet]ans' ,affairs & ,arm$ ,s]vices ( ! ,s5ate & ! ,h\se ( ,repres5tatives = review at lea/ #ij days be=e implem5tation2 7,d7 :]e available1 %all be pres5t$ ) ! p>ticipation (-- 7i7 an employee or repres5tative ( ! ,dep>tm5t ( ,vet]ans ,affairs assi/$ by a repres5tative ( a vet]ans s]vice organization recogniz$ "u section #eijb ( title #ch2 or 7ii7 an employee or repres5tative ( ! ,dep>tm5t ( ,vet]ans ,affairs assi/$ by an individual recogniz$ "u section #eijc ( su* title & au?oriz$ by ! ,secret>y conc]n$ to s p>ticipate2 7,e7 %all include in=mation on h[ a vet]ans s]vice organization may assi/ ! memb] 9 fil+ a claim describ$ 9 p>agraph 7#ai72 7,f7 may n enc\rage ! memb] to jo9 a p>ticul> vet]ans s]vice organization2 & 7,g7 may n be long] ?an "o h\r4 4 7b7 ,annual report ,n less frequ5tly ?an once ea* ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all submit1 to ! ,committees on ,arm$ ,s]vices ( ! ,s5ate & ,h\se ( ,repres5tatives1 & to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ,h\se ( ,repres5tatives1 a report t-- 7#a7 id5tifies ea* vet]ans s]vice organization t p>ticipat$ 9 a pres5tation "u p>agraph 7#bj7 ( section #aadb7;b7 ( title #aj1 ,unit$ ,/ates ,code1 z add$ by subsection 7a72 7#b7 conta9s ! numb] ( memb]s ( ! ,arm$ ,=ces :o att5d$ su* pres5tations2 & 7#c7 includes any recomm5dations ( ! ,secret>y reg>d+ *anges to su* pres5tation or to su* p>agraph4 #bjh4 ,elim9ation ( requirem5t t on-campus educational & vocational c\nsel+ is provid$ by c]ta9 ,dep>tm5t ( ,vet]ans ,affairs employees 7a7 ,9 g5]al ,section #cfig;,b7a7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 by /rik+ ! second s5t5ce2 7#b7 by ins]t+ 7#a7 be=e ,! ,secret>y2 & 7#c7 by add+ at ! end ! foll[+ new p>agraph3 7#b7 ,any individual provid+ s]vices "u p>agraph 7#a7 on behalf ( ! ,dep>tm5t :o is n an employee ( ! ,dep>tm5t %all be subject to ! same ov]sight1 tra9+1 & acc\ntability /&>ds applicable to ,dep>tm5t employees provid+ su* s]vices4 4 7b7 ,expansion ( ,vet,success on ,campus program to at lea/ "o location 9 ea* ,/ate 7#a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all ensure t ! ,vet,success on ,campus program ( ! ,dep>tm5t ( ,vet]ans ,affairs is locat$ 9 e ,/ate4 7#b7 ,c\nselors ,9 c>ry+ out p>agraph 7#a71 ! ,secret>y %all ensure t at lea/ "o c\nselor ( ! ,vet,success on ,campus program is locat$ 9 ea* ,/ate1 not)/&+ ! numb] ( individuals 9 a ,/ate or at an educational in/itution :o may qualify to p>ticipate 9 ! program4 7#c7 ,pref]5ce ,9 c>ry+ out ?is section1 ! ,secret>y %all give pref]5ce to educational in/itutions t h ! l>ge/ populations ( /ud5ts :o are pursu+ programs ( education at su* in/itutions ) educational assi/ance provid$ "u laws adm9i/]$ by ! ,secret>y4 7#d7 ,/ate def9$ ,9 ?is section1 ! t]m ,/ate has ! mean+ giv5 su* t]m 9 section #aja ( title #ch1 ,unit$ ,/ates ,code4 #bji4 ,expansion ( entitlem5t = paym5t = lic5s+ or c]tification te/s = vet]ans entitl$ to educational assi/ance ,section #ccae ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 9 subsection 7a71 by /rik+ educational assi/ance "u ?is *apt] & ins]t+ cov]$ assi/ance2 7#b7 9 subsection 7b77#c71 by /rik+ "u ?is *apt] & ins]t+ ) respect to cov]$ assi/ance2 7#c7 9 subsection 7c71 9 ! matt] prec$+ p>agraph 7#a71 by /rik+ "u ?is *apt] & ins]t+ ) respect to cov]$ assi/ance2 & 7#d7 by add+ at ! end ! foll[+ new subsection3 7d7 ,w>n+s ,be=e provid+ any paym5t to or on behalf ( an individual describ$ 9 subsection 7a71 ! ,secret>y %all provide notice to ! individual a w>n+ t use ( entitlem5t "u ?is section = a lic5s+ or c]tification te/ may n lead to a lic5se or c]tification4 7e7 ,cov]$ assi/ance def9$ ,9 ?is section1 ! t]m cov]$ assi/ance means educational assi/ance available "u-- 7#a7 ?is *apt]1 *apt] #cj ( ?is title1 *apt] #ce ( ?is title1 or *apt] #afjf ( title #aj2 or 7#b7 any o!r provision ( law provid+ educational assi/ance to a vet]an1 or to ano!r individual 9 connection ) ! s]vice ( a vet]an 9 ! ,arm$ ,=ces4 4 #baj4 ,increase ( am\nt ( educational assi/ance paid by ! ,secret>y ( ,vet]ans ,affairs = fir/ ye> ( a full-"t program ( appr5tice%ip or o!r on-job tra9+ ,section #ccac7;g77#c77;,b7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 9 ! matt] prec$+ clause 7i71 by ins]t+ us+ educational assi/ance "u ?is *apt]2 & 7#b7 9 clause 7i77,,ii71 by /rik+ #hj p]c5t & ins]t+ #ajj p]c5t4 #baa4 ,improv+ em]g+ te*nology opportunities = vet]ans 7a7 ,inclusion ( em]g+ te*nologies 9 high te*nology program 7#a7 ,9 g5]al ,section #cfii;,c ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7,a7 9 ! section head+ by /rik+ ,high te*nology & ins]t+ ,high te*nology & em]g+ te*nology2 7,b7 by /rik+ high te*nology & ins]t+ high te*nology or em]g+ te*nology ea* place su* t]m appe>s2 & 7,c7 9 subsection 7c77#d7 by add+ at ! end ! foll[+ new subp>agraph3 7,e7 ,su* crit]ia %all also id5tify :i* te*nologies ( critical importance1 su* z artificial intellig5ce & semiconductor manufactur+1 %all be treat$ z em]g+ te*nologies = purposes ( ?is section4 4 7#b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( *apt] #cf ( su* title is am5d$ by /rik+ ! item relat+ to section #cfii;,c & ins]t+ ! foll[+ new item3 #cfii;,c4 ,high te*nology & em]g+ te*nology program4 4 7#c7 ,con=m+ am5dm5ts ,section #cfhj;,a ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ 9 subsections 7a77#d77;,b7 & 7d77#h7 by /rik+ high te*nology ea* place su* t]m appe>s & ins]t+ high te*nology or em]g+ te*nology4 7b7 ,employm5t rate calculation = ,,vet-,,tec high te*nology & em]g+ te*nology program ,section #cfii;,c ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 9 subsection 7f7-- 7,a7 9 ! matt] prec$+ p>agraph 7#a7 by ins]t+ aft] ,h\se ( ,repres5tatives ! foll[+3 1 & make available to ! public12 & 7,b7 9 p>agraph 7#c7 by add+ at ! end ! foll[+3 ,su* rate %all be calculat$ z a fraction1 ! d5om9ator ( :i* is ! numb] ( cov]$ individuals :o complet$ su* a program dur+ su* ye> & ! num]ator ( :i* is ! numb] ( individuals c\nt$ 9 ! d5om9ator :o are employ$ on ! date t is #ahj days aft] ! date on :i* ! individual complet$ ! program1 & express$ z a p]c5tage4 ,not)/&+ ! previ\s s5t5ce1 ! num]ator %all n c\nt a case 9 :i* ! individual is employ$ by ! same organization t 0 ! provid] ( ! individual's program ( education or a case 9 :i* ! individual is employ$1 by a p>5t or affiliate ( su* organization1 z an in/ructor = a sub/antially simil> program ( education4 ,to ! maximum ext5t practicable1 ! ,secret>y %all also report ! rates ( full-"t employm5t1 "p-"t employm5t1 & self-employm5t42 & 7#b7 9 subsection 7g7 by add+ at ! end ! foll[+ new p>agraph3 7#c7 ,! ,secret>y on an ongo+ basis %all solicit1 collect1 & analyze fe$back ab\t ! program f cov]$ individuals :o p>ticipate 9 ! program & f ! ,,gi ,bill ,s*ool ,fe$back ,tool4 ,! ,secret>y %all use su* fe$back to evaluate & improve ! implem5tation ( ! program4 4 ,,iii ,heal? ,c>e #cja4 ,ext5sion & modification ( transportation grant program ( ,dep>tm5t ( ,vet]ans ,affairs ,section #cjg ( ! ,c>egiv]s & ,vet]ans ,omnibus ,heal? ,s]vices ,act ( #bjaj 7,public ,law #aaa-afc2 #ch ,u4,s4,c4 #agaj note7 is am5d$-- 7#a7 9 subsection 7a7-- 7,a7 9 p>agraph 7#b71 by add+ at ! end ! foll[+ new subp>agraphs3 7,c7 ,indian tribes4 7,d7 ,tribal organizations4 7,e7 ,native ,hawaiian organizations4 7,f7 ,c\nty vet]ans s]vice organizations4 2 7,b7 9 p>agraph 7#c71 9 ! matt] prec$+ subp>agraph 7,a71 by /rik+ ,/ate vet]ans s]vice ag5cy or vet]ans s]vice organization aw>d$ & ins]t+ recipi5t (2 & 7,c7 by am5d+ p>agraph 7#d7 to read z foll[s3 7#d7 ,maximum am\nt 7,a7 ,9 g5]al ,except z provid$ 9 subp>agraphs 7,b7 & 7,c71 ! am\nt ( a grant "u ?is section may n exce$ #ej1jjj4 7,b7 ,(f-road communities ,9 ! case ( a c\nty t has m ?an five communities t are (f ! road sy/em1 ! am\nt ( a grant aw>d$ ) respect to t c\nty "u ?is section may be increas$ by an am\nt n to exce$ #ej p]c5t ( ! am\nt specifi$ 9 subp>agraph 7,a74 7,c7 ,pur*as+ a vehicle 7i7 ,am\nt ,! am\nt ( a grant aw>d$ "u ?is section to a recipi5t may be increas$ by n m ?an #hj1jjj if ! recipi5t is pur*as+ a vehicle to comply ) requirem5ts "u ! ,am]icans ) ,disabilities ,act ( #aiij 7#db ,u4,s4,c4 #abaja et seq47 9 c>ry+ out ?is section4 7ii7 ,limitations ,! ,secret>y may prescribe limitations on ! numb] ( vehicles pur*as$ by ea* recipi5t "u ?is section4 2 7#b7 by /rik+ subsection 7d72 7#c7 by r$esignat+ subsections 7b7 & 7c7 z subsections 7d7 & 7e71 respectively2 7#d7 by ins]t+ aft] subsection 7a7 ! foll[+ new subsections3 7b7 ,additional s]vices 7#a7 ,ne>by rural areas ,9 addition to provid+ innovative transportation options to vet]ans 9 highly rural areas1 a recipi5t ( a grant "u ?is section may use am\nts provid$ "u ! grant to provide innovative transportation options to vet]ans 9 ne>by rural areas4 7#b7 ,priority ,a recipi5t ( a grant "u ?is section %all prioritize ! provision ( innovative transportation options to vet]ans 9 highly rural areas1 & %all demon/rate to ! ,secret>y su* priority1 & may only provide s]vices "u p>agraph 7#a7 to vet]ans 9 ne>by rural areas if-- 7,a7 x does n imp$e ! s]vices provid$ to vet]ans 9 highly rural areas2 & 7,b7 ! grantee has excess capacity & res\rces available to provide su* s]vices to vet]ans 9 ne>by rural areas4 7c7 ,eligibility ( previ\s areas ,areas eligible = assi/ance "u ! grant program "u ?is section on ! day be=e ! date ( ! enactm5t ( ! ,support+ ,rural ,vet]ans ,access to ,heal?c>e ,s]vices ,act %all rema9 eligible = su* assi/ance on & aft] su* date ( enactm5t4 2 & 7#e7 9 subsection 7e71 z r$esignat$ by p>agraph 7#b7-- 7,a7 by r$esignat+ p>agraph 7#b7 z p>agraph 7#e72 & 7,b7 by /rik+ p>agraph 7#a7 & ins]t+ ! foll[+3 7#a7 ,indian tribe2 ,tribal organization ,! t]ms ,indian tribe & ,tribal organization h ! mean+s giv5 ^? t]ms 9 section #d ( ! ,indian ,self-,det]m9ation & ,education ,assi/ance ,act 7#be ,u4,s4,c4 #ecjd74 7#b7 ,native ,hawaiian organization ,! t]m ,native ,hawaiian organization has ! mean+ giv5 t t]m 9 section #fbjg ( ! ,elem5t>y & ,second>y ,education ,act ( #aife 7#bj ,u4,s4,c4 #geag74 7#c7 ,ne>by ,! t]m ne>by1 ) respect to a rural area1 includes rural areas adjac5t to a highly rural area & rural areas geographically betwe5 ! highly rural area & ! ne>e/ ,dep>tm5t ( ,vet]ans ,affairs m$ical c5t]4 7#d7 ,rural2 highly rural ,! t]ms rural & highly rural h ! mean+s giv5 ^? t]ms "u ! ,rural-,urban ,commut+ ,areas 7,,ruca7 cod+ sy/em ( ! ,dep>tm5t ( ,agriculture4 4 #cjb4 ,vet]an ,c>egiv] ,re$ucation1 ,reemploym5t1 & ,retirem5t ,act 7a7 ,ext5sion ( p]iod ( m$ical c>e cov]age = c>egiv]s designat$ z prim>y provid]s ( p]sonal c>e s]vices = vet]ans ,section #agha7;a77#d7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by ins]t+ be=e ! comma at ! end ! foll[+3 1 includ+ dur+ ! #ahj-;day p]iod foll[+ dis*>ge f ! program "u section #agbj;,g7a7 ( ?is title unless ! designation ( ! individual 0 revok$ due to fraud1 abuse1 mi/reatm5t1 or o!r misconduct4 7b7 ,employm5t & o!r b5efits = c>egiv]s designat$ z prim>y provid]s ( p]sonal c>e s]vices = vet]ans 7#a7 ,employm5t assi/ance ,section #agbj;,g ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new subsection3 7e7 ,employm5t assi/ance 7#a7 ,! ,secret>y %all1 subject to p>agraph 7#b71 provide to an individual designat$ z a prim>y provid] ( p]sonal c>e s]vices "u subsection 7a77#g77;,a7 employm5t assi/ance z foll[s3 7,a7 ,reimbursem5t ( fees associat$ ) c]tifications or relic5sure necess>y = su* employm5t4 7,b7 ,= purposes ( ga9+ cr$it = cont9u+ pr(essional education requirem5ts1 access to tra9+ modules ( ! ,dep>tm5t at no co/4 7,c7 ,9 consultation ) ! ,secret>y ( ,def5se & ! ,secret>y ( ,labor1 access to exi/+ employm5t assi/ance res\rces & programs z consid]$ appropriate4 7#b7 ,an individual describ$ 9 p>agraph 7#a7 %all h access to assi/ance describ$ 9 su* p>agraph-- 7,a7 :ile p>ticipat+ 9 ! program e/abli%$ "u subsection 7a77#a72 & 7,b7 dur+ ! #ahj-;day p]iod foll[+ ! date on :i* ! individual is no long] p>ticipat+ 9 su* program unless ! designation ( su* individual "u subsection 7a77#g77;,a7 0 revok$ = fraud1 abuse1 mi/reatm5t1 or o!r misconduct4 7#c7 ,! maximum lifetime am\nt t may be reimburs$ = an individual "u p>agraph 7#a77;,a7 is #a1jjj4 4 7#b7 ,expansion ( available s]vices ,subsection 7a77#c77;,a77ii7 ( su* section is am5d$-- 7,a7 9 subclause 7,v71 by /rik+ 2 & & ins]t+ a semicolon2 7,b7 9 subclause 7,,vi7-- 7i7 9 ! matt] prec$+ item 7aa71 by ins]t+ or agreem5ts aft] contracts2 7ii7 9 item 7aa71 by ins]t+ 1 includ+ retirem5t plann+ s]vices1 aft] s]vices2 & 7iii7 9 item 7bb71 by /rik+ ! p]iod at ! end & ins]t+ 2 &2 & 7,c7 by add+ at ! end ! foll[+ new subclause3 7,,vii7 su* in/ruction1 prep>ation1 tra9+1 & support z ! ,secret>y consid]s appropriate to assi/ 9 transition+ away f c>egiv+ dur+ ! #ahj-;day p]iod foll[+ ! date on :i* ! family c>egiv] is no long] p>ticipat+ 9 ! program requir$ by p>agraph 7#a71 unless su* designation 0 revok$ = fraud1 abuse1 or mi/reatm5t1 or o!r misconduct4 4 7#c7 ,assi/ance return+ to work=ce ,subclause 7,,vi7 ( su* subsection is fur!r am5d$-- 7,a7 9 item 7aa71 by /rik+ 2 & & ins]t+ a semicolon2 & 7,b7 by add+ at ! end ! foll[+ new item3 7cc7 assi/ance return+ to ! work=ce ^u dis*>ge or dismissal f ! program requir$ by p>agraph 7#a7 unless su* designation 0 revok$ = fraud1 abuse1 mi/reatm5t1 or o!r misconduct2 & 4 7#d7 ,b]eavem5t c\nsel+ & support ,subsection 7a77#c77;,a77i77,,iii7 ( su* section is am5d$ by ins]t+ be=e ! semicolon ! foll[+3 1 includ+ b]eavem5t c\nsel+ & support foll[+ ! dea? ( ! eligible vet]an4 7#e7 ,/udy on provision ( return%ip program 7,a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs1 9 p>tn]%ip ) ! ,secret>y ( ,labor1 %all complete a /udy on ! feasibility & advisability ( conduct+ a return%ip program to assi/ individuals :o are designat$ z a prim>y provid] ( p]sonal c>e s]vices "u section #agbj;,g7a77#g77;,a7 ( title #ch1 ,unit$ ,/ates ,code1 or :o 7 dis*>g$ f su* program1 9 return+ to ! work=ce4 7,b7 ,report ,n lat] ?an #ahj days aft] completion ( ! /udy "u subp>agraph 7,a71 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! /udy4 7#f7 ,/udy on incorporat+ =m] c>egiv]s into work=ce ( ,dep>tm5t ( ,vet]ans ,affairs 7,a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all complete a /udy on b>ri]s & inc5tives to hir+ individuals :o 7 designat$ z a prim>y provid] ( p]sonal c>e s]vices "u section #agbj;,g7a77#g77;,a7 ( title #ch1 ,unit$ ,/ates ,code1 at facilities ( ! ,dep>tm5t ( ,vet]ans ,affairs to address /aff+ ne$s4 7,b7 ,report ,n lat] ?an #ahj days aft] completion ( ! /udy "u subp>agraph 7,a71 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! /udy1 :i* %all include-- 7i7 a plan = increas+ employm5t opportunities at facilities ( ! ,dep>tm5t = individuals :o 7 designat$ z a prim>y provid] ( p]sonal c>e s]vices "u section #agbj;,g7a77#g77;,a7 ( title #ch1 ,unit$ ,/ates ,code2 & 7ii7 su* recomm5dations = legislative or adm9i/rative action z ! ,secret>y consid]s appropriate4 7c7 ,comptroll] ,g5]al report on ef=ts ( ,dep>tm5t ( ,vet]ans ,affairs 9 support+ family c>egiv]s transition+ away f c>egiv+ ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all submit to ,congress a report assess+ ! ef=ts ( ! ,secret>y ( ,vet]ans ,affairs to support individuals s]v+ z family c>egiv]s "u section #agbj;,g7a7 ( title #ch1 ,unit$ ,/ates ,code1 9 transition+ away f c>egiv+1 ei!r by assi/+ ^? individuals ) retirem5t plann+ or return+ to "w4 7d7 ,report on feasibility & advisability ( e/abli%+ a retirem5t plan or retirem5t sav+s = family c>egiv]s ( c]ta9 vet]ans ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs1 9 consultation ) ! ,secret>y ( ! ,treasury & ! heads ( su* o!r relevant entities z ! ,secret>y ( ,vet]ans ,affairs det]m9es necess>y1 %all submit to ,congress a report on ! feasibility & advisability (1 = individuals s]v+ z family c>egiv]s "u section #agbj;,g7a7 ( title #ch1 ,unit$ ,/ates ,code-- 7#a7 e/abli%+ an individual retirem5t plan 7z def9$ 9 section #ggja7;a77#cg7 ( ! ,int]nal ,rev5ue ,code ( #aihf 7#bf ,u4,s4,c4 #ggja7;a77#cg777 or simil> retirem5t plan2 or 7#b7 p]mitt+ su* individuals to jo9 an already e/abli%$ pa?way to retirem5t sav+s4 #cjc4 ,vet]ans ,,tbi ,break?r\gh ,exploration ( ,adaptive ,c>e ,opportunities ,nationwide ,act 7a7 ,dep>tm5t ( ,vet]ans ,affairs grant program = supplem5tal neurorehabilitation approa*es to *ronic mild ,,tbi treatm5t 7#a7 ,grant program 7,a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all c>ry out a ?ree-ye> program 7to be kn[n z ! ,,tbi ,innovation ,grant ,program7 "u :i* ! ,secret>y %all aw>d grants to eligible entities describ$ 9 p>agraph 7#b7 = ! developm5t1 implem5tation1 & evaluation ( approa*es & me?odologies = prospective r&omiz$ control trials = neurorehabilitation treatm5ts = ! treatm5t ( *ronic mild traumatic bra9 injury 79 ?is ,act ref]r$ to z m,t,b,i7 9 vet]ans4 7,b7 ,relation%ip to o!r ,dep>tm5t activities ,! grant program requir$ "u subp>agraph 7,a7 %all be c>ri$ out 9 a mann] t-- 7i7 supplem5ts1 & does n supplant1 o!r cl9ical c>e & rese>* ( ! ,dep>tm5t ( ,vet]ans ,affairs relat+ to m,t,b,i2 & 7ii7 facilitates1 z practicable1 coord9ation ) ,vet]ans ,heal? ,adm9i/ration facilities = ref]ral1 cont9uity ( c>e1 & dissem9ation ( f9d+s4 7#b7 ,eligible entities describ$ ,an eligible entity describ$ 9 ?is p>agraph is any ( ! foll[+3 7,a7 ,a nonpr(it organization ) demon/rat$ capability to conduct cl9ical trials & to deliv] or rese>* effective neurorehabilitation treatm5ts = m,t,b,i1 includ+ ?r\gh pati5t c>e deliv]y4 7,b7 ,an academic in/itution t conducts significant rese>* on m,t,b,i & has demon/rat$ capability to conduct cl9ical trials relat+ to neurorehabilitation treatm5ts4 7,c7 ,a non-,dep>tm5t heal? c>e provid] ) exp]tise 9 neurorehabilitative !rapies & demon/rat$ capability to conduct cl9ical trials & to evaluate m,t,b,i treatm5ts ?r\gh pati5t c>e deliv]y4 7,d7 ,a p>tn]%ip or consortium ( two or m entities describ$ 9 subp>agraphs 7,a7 ?r\gh 7,c74 7#c7 ,use ( funds ,an eligible entity 9 receipt ( a grant "u ?is subsection %all use su* grant to support activities t include-- 7,a7 design+ & te/+ novel or integrative treatm5ts = m,t,b,i t prioritize pati5t-c5t]$ c>e1 includ+ non-ph>macological !rapies2 7,b7 conduct+ cl9ical /udies & assessm5ts to measure ! effectiv5ess ( fund$ approa*es to-- 7i7 improve m5tal heal? outcomes among vet]ans2 7ii7 r$uce suicidality1 & common risk factors = complet+ suicide1 includ+ depression & sub/ance use disord]s among vet]ans2 & 7iii7 mitigate long-t]m effects ( m,t,b,i &1 to ! ext5t outcomes are collect$ "u ! applicable cl9ical protocol1 measure durability ( outcomes at approximately six mon?s foll[+ completion ( treatm5t2 7,c7 provid+ tra9+ = cl9icians & outrea* to vet]ans & _! families to improve aw>5ess & accessibility ( innovative m,t,b,i treatm5ts1 includ+ in=mation on available ,dep>tm5t res\rces & pa?ways to access su* res\rces2 & 7,d7 e/abli%+ p>tn]%ips ) community organizations1 academic in/itutions1 & heal? c>e facilities1 includ+1 z practicable1 coord9ation ) ,vet]ans ,heal? ,adm9i/ration facilities to facilitate ref]ral ( eligible vet]ans1 cont9uity ( c>e1 & dissem9ation ( aggregate f9d+s4 7#d7 ,limitation on grant am\nt ,! ,secret>y may n aw>d an eligible entity a grant "u ?is section 9 an am\nt t exce$s #e1jjj1jjj = any fiscal ye>4 7#e7 ,program adm9i/ration 7,a7 ,applications ,an eligible entity desir+ a grant "u ?is subsection %all submit to ! ,secret>y an application 9 su* =m1 at su* "t1 & conta9+ su* in=mation & assurances z ! ,secret>y det]m9es appropriate1 includ+ a detail$ description (-- 7i7 activities propos$ to be conduct$ us+ ! grant2 7ii7 expect$ outcomes ( su* activities2 7iii7 plans = evaluat+ ! effectiv5ess ( su* activities2 7iv7 h[ ! eligible entity w coord9ate1 z practicable1 ) ,vet]ans ,heal? ,adm9i/ration facilities = ref]ral & cont9uity ( c>e = vet]ans :o p>ticipate 9 activities c>ri$ out us+ grant funds1 & = dissem9ation ( aggregate f9d+s2 7v7 ! budget ( ! entity = ! use ( ! grant1 includ+ a n>rative ju/ification & an id5tification ( ! e/imat$ am\nt ( grant funds to be us$ = adm9i/rative or ov]head co/s2 & 7vi7 assurances ( compliance ) applicable ,f$]al laws & regulations relat+ to human subjects protections & pati5t safety4 7,b7 ,priority ,9 aw>d+ grants "u ?is subsection1 ! ,secret>y %all give priority to eligible entities t h demon/rat$ ! capacity to coord9ate ) ! ,dep>tm5t to facilitate ref]ral & cont9uity ( c>e = vet]ans :o p>ticipate 9 activities c>ri$ out us+ grant funds4 7,c7 ,p]iodic reports ,z a condition ( receiv+ a grant "u ?is section1 an eligible entity %all1 n less frequ5tly ?an annually dur+ ! grant p]iod & n lat] ?an #ahj days aft] ! end ( ! grant p]iod1 submit to ! ,secret>y a report t includes1 ) respect to ! p]iod cov]$ by ! report-- 7i7 a description ( h[ ! eligible entity us$ su* grant2 7ii7 a summ>y ( ! progress ( activities fund$ ) am\nts f su* grant2 7iii7 measur$ outcomes relat+ to su* activities2 7iv7 a detail$ acc\nt+ ( exp5ditures ( grant funds1 includ+ adm9i/rative or ov]head co/s2 7v7 to ! ext5t collect$ "u ! applicable cl9ical protocol or 9 ! ord9>y c\rse ( c>e1 a description ( any adv]se ev5ts & s]i\s adv]se ev5ts1 includ+ self-h>m or suicide-relat$ ev5ts2 & 7vi7 a description ( actions tak5 pursuant to ! coord9ation plan describ$ 9 subp>agraph 7,a77iv74 7,d7 ,ov]sight2 annual evaluations ,! ,secret>y %all-- 7i7 ensure rigor\s ov]sight ( ! grant program "u ?is section1 includ+ by monitor+ f9ancial compliance & timely receipt ( ! reports requir$ "u subp>agraph 7,b72 & 7ii7 on an annual basis until ! t]m9ation date specifi$ 9 p>agraph 7#i77;,a71 evaluate ! efficacy ( activities c>ri$ out us+ grant funds bas$ on ! reports submitt$ "u subp>agraph 7,b7 & o!r appropriate in=mation4 7,e7 ,rule ( con/ruction ,no?+ 9 ?is section %all be con/ru$ to au?orize ! ,secret>y to require prior approval (1 or *anges to1 any cl9ical protocol1 /udy design1 outcome measures1 or foll[-up s*$ule ( an eligible entity t receives a grant "u ?is section1 except z necess>y to ensure compliance ) applicable ,f$]al laws & regulations relat+ to human subjects protections & pati5t safety4 7,f7 ,en=cem5t au?ority ,! ,secret>y may susp5d1 modify1 or t]m9ate a grant aw>d$ "u ?is section1 if ! ,secret>y det]m9es t ! recipi5t ( su* grant has fail$ to comply ) report+ requirem5ts "u subp>agraph 7,b7 or o!r applicable t]ms & conditions ( ! grant4 7#f7 ,available am\nts2 au?orization ( appropriations 7,a7 ,available am\nts ,! ,secret>y may c>ry out ! program "u ?is section us+ am\nts available to ! ,secret>y = g5]al m5tal heal? c>e programs1 if ! use ( su* am\nts supplem5ts1 & does n supplant1 am\nts o!rwise available = ,dep>tm5t m5tal heal? & traumatic bra9 injury programs4 7,b7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$ to ! ,secret>y #aj1jjj1jjj = ea* ( fiscal ye>s #bjbf ?r\gh #bjbh to c>ry out ?is section4 7#g7 ,duration2 annual review 7,a7 ,duration ,! au?ority ( ! ,secret>y to c>ry out ! grant program "u ?is section %all t]m9ate on ! date t is ?ree ye>s aft] ! date ( ! enactm5t ( ?is ,act1 except t ! ,secret>y may cont9ue to use am\nts made available to c>ry out ?is section aft] su* date solely = ! purpose ( adm9i/]+ activities & obligations incurr$ be=e su* t]m9ation date4 7,b7 ,annual review ,dur+ su* ?ree-ye> p]iod1 ! ,secret>y %all1 on an annual basis1 review ! effectiv5ess ( ! grant program to det]m9e ! pot5tial ( su* grant program = cont9uation or expansion4 7b7 ,dep>tm5t ( ,vet]ans ,affairs grant program = indep5d5t ?ird-p>ty rese>* /udies & treatm5t ) respect to supplem5tal neurorehabilitation treatm5ts = m,t,b,i 7#a7 ,e/abli%m5t ,! ,secret>y ( ,vet]ans ,affairs %all e/abli% & c>ry out a rese>* grant program to aw>d grants to eligible entities describ$ 9 p>agraph 7#b7 to be us$ to c>ry out /udies & appli$ programs on approa*es & me?odologies = ! treatm5t ( m,t,b,i 9 vet]ans4 7#b7 ,eligible entities describ$ ,an eligible entity describ$ 9 ?is p>agraph is any ( ! foll[+3 7,a7 ,a nonpr(it organization t has demon/rat$ ! capability to conduct cl9ical trials & to evaluate traumatic bra9 injury treatm5ts ?r\gh pati5t c>e deliv]y4 7,b7 ,an academic in/itution t conducts significant rese>* on traumatic bra9 injury & has demon/rat$ ! capability to conduct cl9ical trials relat+ to neurorehabilitation treatm5ts4 7,c7 ,a p>tn]%ip or consortium ( two or m entities describ$ 9 subp>agraphs 7,a7 & 7,b74 7#c7 ,applications ,an eligible entity desir+ a grant "u ?is section %all submit to ! ,secret>y an application 9 su* =m1 at su* "t1 & conta9+ su* in=mation & assurances z ! ,secret>y det]m9es appropriate1 includ+ a summ>y (-- 7,a7 ! rese>* & treatm5t activities propos$ to be c>ri$ out us+ grant funds2 7,b7 ! me?odology to be us$ = su* activities2 7,c7 ! expect$ outcomes ( su* activities2 7,d7 h[ ! eligible entity w coord9ate1 z practicable1 ) ,vet]ans ,heal? ,adm9i/ration facilities = ref]ral & cont9uity ( c>e = vet]ans :o p>ticipate 9 activities c>ri$ out us+ grant funds1 & = dissem9ation ( aggregate f9d+s2 7,e7 ! budget ( ! entity = ! use ( ! grant1 includ+ a n>rative ju/ification & an id5tification ( ! e/imat$ am\nt ( grant funds to be us$ = adm9i/rative or ov]head co/s2 & 7,f7 assurances ( compliance ) applicable ,f$]al laws & regulations relat+ to human subjects protections & pati5t safety4 7#d7 ,adm9i/ration 7,a7 ,grant categories ,9 c>ry+ out ! grant program "u ?is subsection1 ea* fiscal ye> ! ,secret>y %all-- 7i7 subject to ! requirem5t "u subp>agraph 7,b71 aw>d f\r grants = exploratory or pilot rese>* & treatm5t projects1 ea* ( :i* %all be 9 an am\nt ( n m ?an #fbe1jjj2 & 7ii7 aw>d five grants = collaborative or multidiscipl9>y rese>* & treatm5t initiatives1 ea* ( :i* %all be 9 an am\nt ( n m ?an #a1ejj1jjj4 7,b7 ,priority ,( ! grants aw>d$ "u subp>agraph 7,a77i71 ! ,secret>y %all aw>d n few] ?an ?ree to nonpr(it organizations4 7,c7 ,en=cem5t au?ority ,! ,secret>y may susp5d1 modify1 or t]m9ate a grant aw>d$ "u ?is subsection1 if ! ,secret>y det]m9es t ! recipi5t ( su* grant has fail$ to comply ) ! applicable t]ms & conditions ( ! grant4 7#e7 ,agreem5t ) indep5d5t organization 7,a7 ,9 g5]al ,! ,secret>y %all seek to ent] into an agreem5t ) an indep5d5t organization t is n a compon5t ( ! ,dep>tm5t & t has demon/rat$ exp]tise 9 r&omiz$ controll$ trials1 neurorehabilitation outcomes evaluation1 & rese>* integrity1 "u :i* ! organization agrees to-- 7i7 adm9i/] ! rese>* grant program "u ?is subsection2 7ii7 c>ry out /udies & implem5t ef=ts t include-- 7,i7 analyz+ data f m,t,b,i treatm5t me?odologies develop$ pursuant to ! rese>* grant program to assess ! effect1 among vet]ans1 ( su* me?odologies on enhanc$ bra9 heal? outcomes1 m5tal heal?1 & long-t]m recov]y1 includ+1 to ! ext5t outcomes are collect$ "u ! applicable cl9ical protocol1 durability ( outcomes at approximately six mon?s foll[+ completion ( treatm5t2 7,,ii7 id5tify+ data-driv5 be/ practices & provid+ recomm5dations = fur!r rese>* or cl9ical application1 includ+ recomm5dations = dissem9ation to ,vet]ans ,heal? ,adm9i/ration cl9icians & facilities 7z appropriate72 & 7,,iii7 r&omiz$1 controll$ cl9ical trials to-- 7aa7 validate & deliv] treatm5ts2 7bb7 e/abli% a /&>d ( c>e2 & 7cc7 improve access to su* treatm5ts = vet]ans2 7iii7 submit to ! ,secret>y n less frequ5tly ?an annually a report describ+ activities c>ri$ out "u ?is section1 includ+ outcome data & me?odology2 & 7iv7 make available to ! ,secret>y all data & f9d+s f ! grants made "u ?is section1 consi/5t ) applicable ,f$]al law1 regulation1 & ,dep>tm5t policies relat+ to pati5t protections1 data security1 & privacy4 7,b7 ,rule ( con/ruction ,no?+ 9 ?is section %all be con/ru$ to au?orize ! ,secret>y1 or an indep5d5t organization t ent]s into an agreem5t ) ! ,secret>y "u subp>agraph 7,a71 to require prior approval (1 or *anges to1 any cl9ical protocol1 /udy design1 outcome measures1 or foll[-up s*$ule e/abli%$ by an eligible entity t receives a grant "u ?is section1 except z necess>y to ensure compliance ) applicable ,f$]al laws & regulations relat+ to human subjects protections & pati5t safety4 7,c7 ,report ,an agreem5t "u subp>agraph 7,a7 %all include a requirem5t t ! indep5d5t organization submits to ,congress & ! ,secret>y a compreh5sive report t includes-- 7i7 ! f9d+s ( ! /udies requir$ "u su* agreem5t2 7ii7 recomm5dations ) respect to ! expansion ( successful ,,tbi treatm5t me?odologies & /&>d ( c>e recomm5dations1 if any1 develop$ pursuant to ! rese>* grant program2 & 7iii7 to ! ext5t available f ! reports & /udy mat]ials ( grant recipi5ts1 a summ>y (-- 7,i7 ! durability ( outcomes at approximately six mon?s foll[+ completion ( treatm5t1 if collect$ "u ! applicable cl9ical protocol2 7,,ii7 adv]se ev5ts & s]i\s adv]se ev5ts1 includ+ self-h>m or suicide-relat$ ev5ts1 if collect$ "u ! applicable cl9ical protocol or 9 ! ord9>y c\rse ( c>e2 & 7,,iii7 aggregate exp5ditures ( grant funds1 includ+ adm9i/rative or ov]head co/s4 7,d7 ,surveys ,! ,secret>y may conduct surveys ( any indep5d5t organization t ent]s into an agreem5t ) ! ,secret>y "u subp>agraph 7,a7 9 ord] to assess ! effectiv5ess ( su* organization 9 adm9i/]+ ! rese>* grant program "u ?is subsection4 7#f7 ,available am\nts2 au?orization ( appropriations 7,a7 ,available am\nts ,! ,secret>y may use am\nts available to ! ,secret>y = ! op]at+ budget ( ! ,national ,c5t] = ,po/traumatic ,/ress ,disord] to c>ry out ! rese>* grant program "u ?is subsection1 if ! use ( su* am\nts supplem5ts1 & does n supplant1 am\nts o!rwise available = ,dep>tm5t programs & s]vices4 7,b7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$ to ! ,secret>y #aj1jjj1jjj = ea* ( fiscal ye>s #bjbf ?r\gh #bjbh to c>ry out ?is subsection4 7#g7 ,t]m9ation date ,! au?ority ( ! ,secret>y to c>ry out ! rese>* grant program "u ?is section %all t]m9ate on ! date t is ?ree ye>s aft] ! date ( ! enactm5t ( ?is ,act4 7c7 ,reports to ,congress ,n lat] ?an two ye>s aft] ! date on :i* ! ,secret>y comm5ces ! rese>* grant program "u subsection 7a71 & on an annual basis !reaft] until ! t]m9ation date specifi$ 9 p>agraph 7#h7 ( su* subsection1 ! ,secret>y %all submit to ,congress a report on ! grant programs "u subsections 7a7 & 7b74 ,ea* su* report %all include-- 7#a7 ! f9d+s ( ! /udies "u subsection 7a77#f77;,b72 7#b7 a description ( any agreem5t ent]$ into by ! ,secret>y "u subsection 7b77#e77;,a72 7#c7 recomm5dations ( ! ,secret>y ) respect to policy & programmatic improvem5ts to s]vices ( ! ,dep>tm5t to treat m,t,b,i among vet]ans2 7#d7 any f9d+s d]iv$ f surveys conduct$ "u subsection 7b77#e77;,d71 includ+ any recomm5dations ( ! ,secret>y = improvem5ts to ! /ructure1 ov]sight1 adm9i/ration1 or p]=mance ( ! indep5d5t organization t ent]s into an agreem5t ) ! ,secret>y "u subsection 7b77#e77;,a72 & 7#e7 su* o!r matt]s z ! ,secret>y det]m9es appropriate4 7d7 ,def9itions ,9 ?is section3 7#a7 ,! t]ms *ronic mild traumatic bra9 injury & m,t,b,i mean a mild traumatic bra9 injury ) symptoms t p]si/ = n few] ?an six mon?s aft] ! incit+ injury1 z det]m9$ us+ validat$ cl9ical crit]ia4 7#b7 ,! t]m nonpr(it organization-- 7,a7 means an organization describ$ 9 section #eja7;c77#c7 ( ! ,int]nal ,rev5ue ,code ( #aihf & exempt f taxation "u section #eja7;a7 ( su* ,code2 & 7,b7 includes su* an organization t is a hospital1 nonpr(it heal? sy/em1 academic m$ical c5t]1 or cl9ic t deliv]s neurorehabilitation c>e or conducts cl9ical rese>* relat+ to m,t,b,i4 7#c7 ,! t]m vet]an has ! mean+ giv5 su* t]m 9 section #aja ( title #ch1 ,unit$ ,/ates ,code4 #cjd4 ,dep>tm5t ( ,vet]ans ,affairs assignm5t ( travel+ physicians to s]ve t]ritories & possessions 7a7 ,9 g5]al ,sub*apt] ,i ( *apt] #gd ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new section3 #gdae4 ,travel+ physicians 7a7 ,9 g5]al 7#a7 ,! ,secret>y may assign a physician appo9t$ "u section #gdja or section #gdca ( ?is title to s]ve z a travel+ physician = a p]iod ( n m ?an "o ye> at a "t4 ,a physician assign$ to s]ve z a travel+ physician "u ?is section may be assign$ to provide heal? c>e to vet]ans resid+ 9 ,am]ican ,samoa1 ,guam1 ! ,commonweal? ( ! ,nor!rn ,m>iana ,isl&s1 ! ,commonweal? ( ,pu]to ,rico1 ! ,virg9 ,isl&s ( ! ,unit$ ,/ates1 or any o!r t]ritory or possession ( ! ,unit$ ,/ates at ,dep>tm5t facilities or o!r approv$ facilities locat$ 9 su* t]ritory or possession4 7#b7 ,! ,secret>y may assign multiple physicians to s]ve z travel+ physicians "u ?is section & may assign ea* su* physician to s]ve 9 a specific t]ritory or possession4 7b7 ,coord9ation ( c>e ,9 provid+ c>e "u ?is section1 travel+ physicians %all coord9ate ) non-,dep>tm5t m$ical provid]s to ! ext5t practicable & necess>y to ensure high quality & coord9at$ c>e = vet]ans receiv+ hospital c>e & m$ical s]vices4 7c7 ,pay ,9 addition to pay "u section #gdca ( ?is title1 ! ,secret>y %all provide a relocation or ret5tion bonus to travel+ physicians "u ?is section4 ,su* relocation or ret5tion bonus %all be sub/antially simil> to a relocation or ret5tion bonus (f]$ "u section #gdaj7;a7 ( ?is title1 z ! ,secret>y consid]s appropriate4 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( su* *apt] is am5d$ by ins]t+ aft] ! item relat+ to section #gdad ! foll[+ new item3 #gdae4 ,travel+ physicians4 4 7c7 ,te*nical & con=m+ am5dm5ts ,title #ch1 ,unit$ ,/ates ,code1 is fur!r am5d$ z foll[s3 7#a7 ,9 section #gdaj7;a77#a71 by-- 7,a7 by /rik+ ret5tion all[ances & ins]t+ ret5tion bonuses2 & 7,b7 by /rik+ ! second comma aft] section #gdja7a7 ( ?is title2 & 7#b7 ,9 section #gdca7;e77#e77;,b71 by /rik+ ret5tion all[ances & ins]t+ ret5tion bonuses4 #cje4 ,inclusion ( adaptive pro/heses & t]m9al devices = sports & o!r recreational activities 9 m$ical s]vices furni%$ to eligible vet]ans by ! ,secret>y ( ,vet]ans ,affairs ,section #agja ( title #ch1 ,unit$ ,/ates ,code1 is am5d$1 9 p>agraph 7#f77;,f77i71 by ins]t+ 7includ+ adaptive pro/heses & t]m9al devices = sports & o!r recreational activities t are det]m9$ to be cl9ically appropriate by ! ,secret>y7 aft] artificial limbs4 #cjf4 ,modifications to & reau?orization ( ,/aff ,s]geant ,p>k] ,gordon ,fox ,suicide ,prev5tion ,grant ,program ( ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,coord9ation by ,secret>y ,subsection 7b7 ( section #bja ( ! ,comm&] ,john ,scott ,hannon ,vet]ans ,m5tal ,heal? ,c>e ,improvem5t ,act ( #bjai 7,public ,law #aaf-aga2 #ch ,u4,s4,c4 #agbj;,f note7 is am5d$ by /rik+ ! second s5t5ce4 7b7 ,use ( grant funds ,subsection 7c7 ( su* section is am5d$-- 7#a7 9 ! subsection head+1 by ins]t+ 2 ,use ( ,grant ,funds aft] ,grants2 & 7#b7 by add+ at ! end ! foll[+ new p>agraphs3 7#c7 ,r5ewal ( grant am\nts 7,a7 ,9 g5]al ,9 det]m9+ :e!r to r5ew a grant aw>d$ "u ?is section to an eligible entity1 ! ,secret>y %all consid]1 among su* o!r factors z ! ,secret>y may consid] appropriate-- 7i7 ! compliance by ! eligible entity 9 adm9i/]+ pre- & po/-int]v5tion assessm5ts requir$ "u subsection 7e77#f72 & 7ii7 any demon/rat$ improvem5ts 9 p>ticipant outcomes4 7,b7 ,additional am\nts ,bas$ on a consid]ation ( ! factors describ$ 9 subp>agraph 7,a71 ! ,secret>y may aw>d am\nts1 n to exce$ #bej1jjj p] grantee p] fiscal ye>1 to a grantee 9 addition to ! maximum am\nt "u p>agraph 7#b77;,a7 bas$ on a p]=mance-bas$ metric e/abli%$ by ! ,secret>y4 4 7c7 ,priority = new recipi5ts ,subsection 7d7 ( su* section is am5d$-- 7#a7 9 ! subsection head+1 by /rik+ & ,pref]5ce & ins]t+ 1 ,pref]5ce1 & ,priority2 7#b7 9 p>agraph 7#a77;,a7-- 7,a7 9 clause 7iv71 by /rik+ ! semi-colon at ! end & ins]t+ 2 &2 7,b7 by /rik+ clause 7v72 & 7,c7 by r$esignat+ clause 7vi7 z clause 7v72 & 7#c7 by add+ at ! end ! foll[+ new p>agraph3 7#c7 ,priority = new recipi5ts ,to ! maximum ext5t practicable1 ! ,secret>y %all prioritize grants = eligible entities t h satisfi$ ! requirem5ts provid$ "u subsection 7f7 & are locat$ 9 ,/ates 9 :i* a grant has n be5 aw>d$ "u ?is section4 4 7d7 ,requirem5ts = receipt ( grants ,subsection 7e7 ( su* section is am5d$-- 7#a7 9 p>agraph 7#c7-- 7,a7 by r$esignat+ subp>agraphs 7,b7 & 7,c7 z subp>agraphs 7,c7 & 7,d71 respectively2 & 7,b7 by ins]t+ aft] subp>agraph 7,a7 ! foll[+ new subp>agraph 7,b73 7,b7 coord9ate ) ! ,secret>y to develop a plan = communication betwe5 ! entity & local m5tal heal? provid]s ( ! ,dep>tm5t reg>d+ :e!r vet]ans receiv+ assi/ance "u ?is section f ! entity are att5d+ appo9tm5ts to ensure cont9uity ( c>e2 2 & 7#b7 by add+ at ! end ! foll[+ new p>agraph3 7#f7 ,assessm5ts ,an eligible entity receiv+ a grant "u ?is section %all conduct a pre- & po/-int]v5tion assessm5t ) respect to ea* eligible individual :o receives suicide prev5tion s]vices pursuant to su* grant across all relevant metrics1 z det]m9$ by ! ,secret>y4 7#g7 ,metrics & outcomes ,an eligible entity receiv+ a grant "u ?is section %all collect & submit to ! ,secret>y su* metrics & outcome data z ! ,secret>y may require1 includ+-- 7,a7 ?r\ghput measures1 includ+ ! numb] ( vet]ans scre5$1 ref]r$1 connect$ to c>e1 & reta9$ 9 s]vices "u ! grant program2 7,b7 r$uctions 9 sev]ity scale measurem5ts1 includ+ r$uctions 9 suicidality id5tifi$ ?r\gh applicable inv5tories or assessm5ts2 & 7,c7 su* o!r quantifiable metrics z ! ,secret>y det]m9es appropriate4 4 7e7 ,tra9+ & te*nical assi/ance ,subsection 7g7 ( su* section is am5d$-- 7#a7 9 p>agraph 7#a7-- 7,a7 9 ! matt] prec$+ subp>agraph 7,a71 by ins]t+ 1 or int]e/$ 9 receiv+ su* grants1 aft] ?is section2 & 7,b7 9 subp>agraph 7,a71 by ins]t+ 1 includ+ tra9+ on h[ to prop]ly use ! ,columbia ,protocol 7also kn[n z ! ,columbia-,suicide ,sev]ity ,rat+ ,scale 7,c-,,ssrs77 & o!r scre5+ tools select$ by ! ,secret>y aft] managem5t2 & 7#b7 by add+ at ! end ! foll[+ new p>agraphs3 7#c7 ,tra9+ = dep>tm5t employees ,! ,secret>y %all provide tra9+ to employees ( ! ,dep>tm5t z ! ,secret>y consid]s appropriate on ! grant program "u ?is section4 4 7f7 ,brief+ = local ,,vamcs ,subsection 7h7 ( su* section is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#e7 ,brief+ = local ,,vamcs ,n less frequ5tly ?an once p] ye>1 unless ! ,secret>y det]m9es t su* frequ5cy is n advisable1 ! ,secret>y %all provide1 to ! appropriate p]sonnel ( ea* m$ical c5t] ( ! ,dep>tm5t id5tifi$ on ! grantee's application "u ?is section1 a brief+ ab\t ! grant program "u ?is section 9 ord] to improve coord9ation betwe5 su* recipi5t & p]sonnel4 4 7g7 ,duration ,subsection 7j7 ( su* section is am5d$ by /rik+ ,septemb] #cj1 #bjbf & ins]t+ ,septemb] #cj1 #bjbi4 7h7 ,reports ,subsection 7k77#b7 is am5d$-- 7#a7 9 ! p>agraph head+1 by /rik+ ,f9al report & ins]t+ ,annual reports2 & 7#b7 9 subp>agraph 7,b7-- 7,a7 by r$esignat+ clauses 7iii7 & 7iv7 z 7v7 & 7vi71 respectively2 & 7,b7 by add+ ! foll[+ new clauses 7iii7 & 7iv73 7iii7 ,a description ( ! ,secret>y's compliance ) ! requirem5t to tra9 employees ( ! ,dep>tm5t "u subsection 7g77#c74 7iv7 ,an optional description & inclusion ( subjective or n>rative /ories ( community or individual impact to all[ grant recipi5ts to %>e mean+ful accompli%m5ts4 4 7i7 ,ref]ral = c>e ,subsection 7m7 ( su* section is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#d7 ,requir$ response or action 7,a7 ,if ! ,secret>y receives a ref]ral "u p>agraph 7#a7 = additional c>e1 ! ,secret>y %all review su* ref]ral & contact ! vet]an n lat] ?an #gb-;h\rs foll[+ ! ref]ral4 7,b7 ,if ! ,secret>y receives a ref]ral "u p>agraph 7#b7 = em]g5t suicide c>e1 ! ,secret>y %all review su* ref]ral & contact ! vet]an n lat] ?an #bd h\rs foll[+ ! ref]ral by su* entity "u subsection 7m77#a74 4 7j7 ,reau?orization ,subsection 7p7 ( su* section is am5d$-- 7#a7 by /rik+ section a total & ins]t+ section-- 7#a7 a total 2 7#b7 by /rik+ ! p]iod at ! end & ins]t+ 2 &2 & 7#c7 by add+ at ! end ! foll[+ new p>agraph3 7#b7 a total ( #bjj1jjj1jjj = fiscal ye>s #bjbg ?r\gh #bjbi4 4 7k7 ,te*nical correction to def9itions ,subsection 7q77#e7 ( su* section is am5d$1 9 ! fir/ s5t5ce-- 7#a7 by /rik+ ,m$ical s]vices & ins]t+ ,! t]m em]g5cy treatm5t means m$ical s]vices2 & 7#b7 by /rik+ 0 r5d]$ & ins]t+ r5d]$4 7l7 ,id5tification ( dem& = o!r s]vices & support ,subsection 7e7 ( su* section1 z am5d$1 is fur!r am5d$-- 7#a7 by r$esignat+ p>agraphs 7#e7 & 7#f7 z 7#f7 & 7#g71 respectively2 & 7#b7 by add+ aft] p>agraph 7#d7 ! foll[+ new p>agraph3 7#e7 ,dem& = o!r s]vices & support ,an entity receiv+ a grant "u ?is section %all submit to ! ,secret>y in=mation conc]n+-- 7,a7 ! numb] ( individuals seek+ s]vices f ! entity :o are n eligible individuals & ! mo/ common reason su* individuals are n eligible individuals2 7,b7 a description ( ! types ( s]vices t eligible individuals or individuals describ$ 9 subp>agraph 7,a7 require bas$ on any scre5+ conduct$ by ! entity2 & 7,c7 any actions tak5 by ! entity to provide ! s]vices describ$ 9 subp>agraph 7,b7 or to ref] ! individual or eligible individual to ano!r entity = ! receipt ( su* s]vices4 4 7m7 ,suicide prev5tion s]vices 7#a7 ,requir$ use ( c]ta9 scre5+ protocol ,subsection 7q77#aa77;,a77ii7 ( su* section is am5d$ by add+ at ! end ! foll[+ new s5t5ce3 ,9 ! case ( a recipi5t ( a grant aw>d$ "u ?is section on or aft] ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act1 su* scre5+ %all be ,columbia ,protocol 7also kn[n z ! ,columbia-,suicide ,sev]ity ,rat+ ,scale 7,c-,,ssrs77 or ! ,pati5t ,heal? ,que/ionnaire-#i 7,,phq#i71 or a successor scre5+ tool select$ by ! ,secret>y42 7#b7 ,transportation ,subsection 7q77#aa77;,a7 ( su* section is am5d$-- 7,a7 by r$esignat+ clause 7xi7 z clause 7xii72 & 7,b7 by ins]t+ aft] clause 7x7 ! foll[+ new clause3 7xi7 ,transportation & ride%>e s]vices = eligible individuals to use = appo9tm5ts4 4 7n7 ,eligible individuals ,subsection 7q77#d77;,c7 ( su* section is am5d$ by /rik+ clauses 7i7 ?r\gh 7iv7 & ins]t+ clauses 7i7 ?r\gh 7vi74 7o7 ,effective date ,! am5dm5ts made by ?is section %all take effect on-- 7#a7 ! effective date ( aw>d foll[+ ! date ! ,secret>y publi%es a notice ( fund+ opportunity = ! program requir$ by section #bja7;a7 ( ! ,comm&] ,john ,scott ,hannon ,vet]ans ,m5tal ,heal? ,c>e ,improvem5t ,act ( #bjai 7,public ,law #aaf-aga2 7#ch ,u4,s4,c4 #agbj;,f771 if ! ,secret>y det]m9es su* am5dm5ts d n require rulemak+2 or 7#b7 ! effective date ( aw>d foll[+ ! date ! ,secret>y publi%es a notice ( fund+ opportunity foll[+ ! effective date ( subsequ5t rulemak+1 if ! ,secret>y det]m9es su* am5dm5ts d require rulemak+4 #cjg4 ,reports on ! use ( hyp]b>ic oxyg5 !rapy 7a7 ,,gao report on ! use ( hyp]b>ic oxyg5 !rapy to treat traumatic bra9 injury & po/-traumatic /ress disord] ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ,h\se ( ,repres5tatives an update to ! report titl$ ,rese>* on ,hyp]b>ic ,oxyg5 ,!rapy to ,treat ,traumatic ,bra9 ,injury & ,po/-,traumatic ,/ress ,disord] 7,,gao-#af-aed74 ,su* report %all include ! assessm5t ( ! ,comptroll] ,g5]al ( cl9ical trials conduct$1 s9ce ! publication ( su* report-- 7#a7 reg>d+ ! use ( hyp]b>ic oxyg5 !rapy to treat traumatic bra9 injury & po/-traumatic /ress disord]2 & 7#b7 by-- 7,a7 ! ,secret>y ( ,vet]ans ,affairs2 7,b7 ! ,secret>y ( ,def5se2 & 7,c7 private entities4 7b7 ,foll[-up /udy 7#a7 ,9 g5]al ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all conduct a sy/ematic review ( publi%$ rese>* lit]ature on ! (f-label use ( hyp]b>ic oxyg5 !rapy to treat po/-traumatic /ress disord] & traumatic bra9 injury among vet]ans & nonvet]ans4 7#b7 ,elem5ts ,! review conduct$ "u p>agraph 7#a7 %all include ! foll[+3 7,a7 ,an analysis ( available rese>* lit]ature publi%$ aft] ! review complet$ pursuant to section #gjb ( ! ,comm&] ,john ,scott ,hannon ,vet]ans ,m5tal ,heal? ,c>e ,improvem5t ,act 7,public ,law #aaf-aga72 7,b7 ,an assessm5t ( ! curr5t p>amet]s = rese>* on ! use by ! ,dep>tm5t ( ,vet]ans ,affairs ( hyp]b>ic oxyg5 !rapy1 includ+-- 7i7 te/s & que/ionnaires us$ to det]m9e ! efficacy ( su* !rapy2 & 7ii7 metrics = det]m9+ ! success ( su* !rapy4 7,c7 ,a comp>ative analysis ( te/s & que/ionnaires us$ to /udy po/-traumatic /ress disord] & traumatic bra9 injury 9 o!r rese>* conduct$ by ! ,dep>tm5t ( ,vet]ans ,affairs1 o!r ,f$]al ag5cies1 & entities outside ! ,f$]al ,gov]nm5t4 7,d7 ,a m>ket assessm5t ( available hyp]b>ic oxyg5 !rapy facilities or units )9 facilities to assess ! mo/ effective locations & practices1 includ+-- 7i7 an analysis ( :e!r multi-p]son *amb]s c\ld r$uce p]-vet]an co/s2 7ii7 an analysis ( areas ) l[] prices comp>$ to a national av]age2 & 7iii7 an id5tification ( n few] ?an two ,v,i,s,ns 9 :i* ! provision or furni%+ ( hyp]b>ic oxyg5 !rapy w\ld b5efit ! mo/ numb] ( vet]ans at ! l[e/ co/ to ! ,dep>tm5t4 #cjh4 ,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>e1 includ+ evid5ce-bas$ m5tal heal? c>e deliv]$ 9 p]son or via teleheal?4 7b7 ,eligibility ,to be eligible to receive a grant "u ! pilot program1 a m5tal heal? c>e provid] %all-- 7#a7 be a non-pr(it organization2 7#b7 h op]at$ at lea/ "o outpati5t m5tal heal? facility 9 ! ,unit$ ,/ates = a cont9u\s p]iod ( at lea/ ?ree ye>s2 7#c7 be lic5s$ or c]tifi$ "u applicable /ate law to provide outpati5t m5tal heal? s]vices2 7#d7 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#e7 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$2 7,b7 a plan = provid+ cl9icians at ea* facility 9 receipt ( grant funds ) units ( cont9u+ education ) respect to vet]ans issues2 & 7,c7 an id5tification ( ! p]c5tage ( ! op]at+ budget = ea* su* facility t 0 provid$ ?r\gh ,f$]al grants dur+ ! fiscal ye> prec$+ ! ye> dur+ :i* ! application is submitt$4 7c7 ,use ( funds 7#a7 ,9 g5]al ,! recipi5t ( a grant "u ! pilot program %all use ! grant-- 7,a7 to deliv] evid5ce-bas$ m5tal heal? c>e = vet]ans 9 p]son or via teleheal?4 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 ( suicide4 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 #cji4 ,furni%+ ( c]ta9 heal? s]vices to vet]ans 9 ! ,freely ,associat$ ,/ates 7a7 ,requirem5t to furni% c]ta9 heal? s]vices to vet]ans 9 ! ,freely ,associat$ ,/ates 7#a7 ,agreem5ts requir$ ,consi/5t ) section #agbd7;f7 ( title #ch1 ,unit$ ,/ates ,code1 & section #bji7;a77#d77;,a7 ( ! ,compact ( ,free ,association ,am5dm5ts ,act ( #bjbd 7#dh ,u4,s4,c4 #aihh7;a77#d77;,a771 ! ,secret>y ( ,vet]ans ,affairs %all "w exp$iti\sly ) ! gov]nm5ts ( ! ,freely ,associat$ ,/ates to ent] into ! agreem5ts describ$ 9 su* sections4 7#b7 ,inclusion ( teleheal? & mail ord] ph>macy s]vices requir$ ,consi/5t ) su* sections & ) ! agreem5ts requir$ by p>agraph 7#a71 ! ,secret>y %all furni% to vet]ans 9 ! ,freely ,associat$ ,/ates s]vices t include1 at a m9imum-- 7,a7 m$ical s]vices au?oriz$ to be provid$ "u *apt] #ag ( title #ch1 ,unit$ ,/ates ,code1 :i* c be adm9i/]$ ?r\gh teleheal?2 & 7,b7 ph>maceutical products au?oriz$ to be provid$ "u su* *apt]1 deliv]$ by mail4 7#c7 ,implem5tation dates ,9 c>ry+ out p>agraphs 7#a7 & 7#b71 ! ,secret>y %all-- 7,a7 initiate outrea* to ea* su* gov]nm5t n lat] ?an #cj days aft] ! date ( ! enactm5t ( ?is ,act2 7,b7 ent] into ea* agreem5t requir$ by p>agraph 7#a7 n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act2 & 7,c7 beg9 furni%+ ! s]vices requir$ by subp>agraphs 7,a7 & 7,b7 ( p>agraph 7#b7 n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act4 7#d7 ,b5efici>y travel ,section #aaa7;h77#a7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by /rik+ ! ,secret>y may make paym5ts & ins]t+ beg9n+ n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act1 ! ,secret>y %all make paym5ts4 7#e7 ,reports ,n less frequ5tly ?an qu>t]ly1 ! ,secret>y %all submit to ! appropriate committees ( ,congress a report on ! implem5tation ( ?is section & ! co/ ( su* implem5tation4 ,until ! ,secret>y has ent]$ into ! agreem5ts requir$ by p>agraph 7#a7 & begun furni%+ ! s]vices requir$ by subp>agraphs 7,a7 & 7,b7 ( p>agraph 7#b71 ! report %all also describe ! te*nical & logi/ical factors t h prev5t$ or imp$$ ! ,secret>y f do+ s4 7#f7 ,def9itions ,9 ?is subsection3 7,a7 ,appropriate committees ( ,congress ,! t]m appropriate committees ( ,congress means-- 7i7 ! ,committee on ,vet]ans' ,affairs & ! ,committee on ,appropriations ( ! ,s5ate2 & 7ii7 ! ,committee on ,vet]ans' ,affairs & ! ,committee on ,appropriations ( ! ,h\se ( ,repres5tatives4 7,b7 ,freely ,associat$ ,/ates ,! t]m ,freely ,associat$ ,/ates has ! mean+ giv5 su* t]m 9 section #agbd7;f7 ( title #ch1 ,unit$ ,/ates ,code4 7b7 ,assignm5t ( travel+ physicians to s]ve vet]ans 9 ,freely ,associat$ ,/ates 7#a7 ,9 g5]al ,sub*apt] ,i ( *apt] #gd ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new section3 #gdae4 ,travel+ physicians = vet]ans 9 ,freely ,associat$ ,/ates ,! ,secret>y may assign a physician appo9t$ "u section #gdja ( ?is title to s]ve z a travel+ physician = a p]iod ( n m ?an "o ye>4 ,a travel+ physician %all provide heal? c>e to vet]ans resid+ 9 ! ,freely ,associat$ ,/ates 7z def9$ 9 section #agbd7;f7 ( ?is title74 4 7#b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( su* *apt] is am5d$ by ins]t+ aft] ! item relat+ to section #gdad ! foll[+ new item3 #gdae4 ,travel+ physicians = vet]ans 9 ,freely ,associat$ ,/ates4 4 #caj4 ,modification ( ,precision ,m$ic9e = ,vet]ans ,initiative2 report+ on suicide by vet]ans & memb]s ( ! ,arm$ ,=ces 7a7 ,modification ( ,precision ,m$ic9e = ,vet]ans ,initiative ,section #cje ( ! ,comm&] ,john ,scott ,hannon ,vet]ans ,m5tal ,heal? ,c>e ,improvem5t ,act ( #bjai 7,public ,law #aaf-aga2 #ch ,u4,s4,c4 #agab;,a note7 is am5d$-- 7#a7 9 subsection 7a71 by /rik+ & su* o!r m5tal heal? conditions & ins]t+ repetitive l[-level bla/ exposure1 dem5tia1 & su* o!r bra9 & m5tal heal? conditions2 7#b7 9 subsection 7d77#d71 by add+ at ! end ! foll[+ new subp>agraph3 7,e7 ,data-%>+ p>tn]%ip 7i7 ,9 g5]al ,! ,secret>y %all "w ) ! ,secret>y ( ,def5se to e/abli% a data-%>+ p>tn]%ip betwe5 ! ,dep>tm5t ( ,vet]ans ,affairs & ! ,dep>tm5t ( ,def5se4 7ii7 ,/orage ,! p>tn]%ip e/abli%$ "u clause 7i7 %all be /or$ 9 ! op5 plat=m made available "u ?is p>agraph4 7iii7 ,data ,! data suppli$ by ! ,secret>y ( ,def5se "u ! p>tn]%ip e/abli%$ "u clause 7i7 %all include relevant data ?r\gh\t ! ,dep>tm5t ( ,def5se relat+ to l[-level repetitive bla/ exposure & traumatic bra9 injury collect$ by ! ,arm$ ,=ces & o!r appropriate entities1 z det]m9$ jo9tly by ! ,secret>y ( ,def5se & ! ,secret>y ( ,vet]ans ,affairs4 2 & 7#c7 by add+ at ! end ! foll[+ new subsections3 7f7 ,repetitive l[-level bla/ exposure rese>* ,9 c>ry+ out ! initiative "u subsection 7a71 ! ,secret>y %all prioritize rese>*-- 7#a7 to id5tify & validate biom>k]s associat$ ) repetitive l[-level bla/ exposure & traumatic bra9 injury2 7#b7 to evaluate cl9ical & non-cl9ical int]v5tions t improve cognitive function1 quality ( life1 & m5tal heal? outcomes among vet]ans ) symptoms associat$ ) repetitive l[-level bla/ exposure2 7#c7 to improve ! diagnosis1 treatm5t1 & c>e coord9ation = vet]ans ) a hi/ory ( l[-level repetitive bla/ exposure or traumatic bra9 injury1 includ+ vet]ans :o p]=m$ duties or tasks associat$ ) increas$ risk ( l[-level repetitive bla/ exposure2 & 7#d7 to develop evid5ce-bas$ /rategies to r$uce suicide risk among vet]ans ) a hi/ory ( l[-level repetitive bla/ exposure or traumatic bra9 injury4 7g7 ,assi/ance & report by national academies ( sci5ces1 eng9e]+1 & m$ic9e ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act1 ! ,secret>y ( ,vet]ans ,affairs %all seek to ent] into a contract ) ! ,national ,academies ( ,sci5ces1 ,eng9e]+1 & ,m$ic9e "u :i* ! ,national ,academies %all-- 7#a7 "w 9 t&em ) ! initiative "u subsection 7a7 on validation ( bra9 & m5tal heal? biom>k]s among vet]ans2 & 7#b7 n less frequ5tly ?an once e two ye>s1 submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! "w complet$ "u p>agraph 7#a74 7h7 ,assessm5t 7#a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all conduct an assessm5t ( all translational rese>* /udies 9 progress & plann$ "u ! initiative "u subsection 7a71 includ+ rese>* "u subsection 7f74 7#b7 ,report ,n lat] ?an #fj days aft] completion ( ! assessm5t conduct$ "u p>agraph 7#a71 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! assessm5t4 7i7 ,reports 7#a7 ,9 g5]al ,n less frequ5tly ?an once e two ye>s1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! initiative "u subsection 7a74 7#b7 ,recomm5dations ,ea* report requir$ by p>agraph 7#a7 may include recomm5dations = imm$iate adm9i/rative & legislative action to improve ! initiative "u subsection 7a74 7j7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$ to ! ,secret>y ( ,vet]ans ,affairs #e1jjj1jjj to c>ry out ! initiative "u subsection 7a7 = ea* ( fiscal ye>s #bjbg ?r\gh #bjcb4 4 7b7 ,inclusion ( in=mation 9 reports on suicide prev5tion among vet]ans & memb]s ( ! ,arm$ ,=ces 7#a7 ,inclusion ( in=mation 9 national vet]an suicide prev5tion annual report ,section #adi7;a77#d77;,b7 ( ! ,s5ator ,elizabe? ,dole #ba/ ,c5tury ,vet]ans ,heal?c>e & ,b5efits ,improvem5t ,act 7,public ,law #aah-baj2 #ch ,u4,s4,c4 #agji;,b note7 is am5d$ by add+ at ! end ! foll[+3 7iv7 ,milit>y occupation data ( vet]ans :o attempt or commit suicide4 4 7#b7 ,inclusion ( in=mation 9 ,dep>tm5t ( ,def5se annual report ,! ,secret>y ( ,def5se %all include 9 ! annual report ( ! ,def5se ,suicide ,prev5tion ,(fice1 or successor (fice1 in=mation on-- 7,a7 occupational data ( memb]s ( ! ,arm$ ,=ces :o attempt suicide2 & 7,b7 outcomes ( suicide prev5tion int]v5tions among memb]s ( ! ,arm$ ,=ces4 #caa4 ,e/abli%m5t ( ! ,bla/ ,ov]pressure ,task ,=ce ( ! ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,e/abli%m5t ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all appo9t1 ?r\gh ! ,dep>tm5t ( ,vet]ans ,affairs-,dep>tm5t ( ,def5se ,jo9t ,executive ,committee "u section #cbj ( title #ch1 ,unit$ ,/ates ,code1 ! ,bla/ ,ov]pressure ,task ,=ce ( ! ,dep>tm5t ( ,vet]ans ,affairs 79 ?is section ref]r$ to z ! ,task ,=ce74 7b7 ,memb]%ip ,ea* memb] ( ! ,task ,=ce appo9t$ "u subsection 7a7 %all be a memb] ( ! ,heal? ,executive ,committee "u subsection 7b77#b7 ( su* section :o1 at ! "t ( appo9tm5t1 is involv$ 9 rese>* reg>d+ ! mitigation & treatm5t ( bla/ ov]pressure or bla/ exposure4 7c7 ,duties ,! duties ( ! ,task ,=ce are ! foll[+3 7#a7 ,to improve h[ ! ,secret>y ( ,vet]ans ,affairs1 9 consultation ) ! ,secret>y ( ,def5se1 provides heal? c>e & o!r b5efits to vet]ans or memb]s ( ! ,arm$ ,=ces diagnos$ ) traumatic bra9 injury1 po/-traumatic /ress disord]1 or o!r symptoms1 f bla/ ov]pressure or bla/ exposure4 7#b7 ,to align rese>* ag5das & acquisition /rategies ( ! ,dep>tm5t reg>d+ su* heal? c>e4 7#c7 ,to e/abli% physiological & cognitive p]=mance basel9es = su* vet]ans & memb]s4 7#d7 ,to prioritize translational rese>* reg>d+ su* vet]ans & memb]s1 includ+ rese>* reg>d+-- 7,a7 sleep !rapy2 7,b7 bla/-relat$ gut heal?2 7,c7 mobile diagno/ics2 7,d7 ve/ibul> dysfunction & balance impairm5t2 7,e7 autonomic n]v\s sy/em dysregulation2 7,f7 cumulative mild traumatic bra9 injury2 7,g7 neuro9flammation & glial activation2 & 7,h7 any o!r issue det]m9$ appropriate by ! ,secret>y4 7#e7 ,to monitor s5sory decl9e 7includ+ ) reg>ds to vision1 he>+1 & ve/ibul> function7 & /ress-relat$ impairm5ts among su* vet]ans & memb]s4 7#f7 ,to support cont9uity ( su* c>e by integrat+ mobile & longitud9al diagno/ic tools4 7d7 ,reports ,! ,task ,=ce %all issue annual reports to ! ,committees on ,vet]ans' ,affairs & on ,arm$ ,s]vices ( ! ,s5ate & ,h\se ( ,repres5tatives4 ,ea* su* report %all include ! foll[+ elem5ts3 7#a7 ,details ( rese>* initiatives1 coord9ation outcomes1 & cl9ical advancem5ts ( ! ,task ,=ce4 7#b7 ,recomm5dations ( ! ,task ,=ce reg>d+-- 7,a7 h[ claims processors ( ! ,dep>tm5t ( ,vet]ans ,affairs %\ld evaluate evid5ce t l9ks su* conditions to active milit>y1 naval1 air1 or space s]vice2 & 7,b7 be/ practices reg>d+ ! evaluation ( neurological injuries 9 exam9ations = b5efits "u *apt]s #aa or #ae ( title #ch1 ,unit$ ,/ates ,code4 7e7 ,sunset ,! ,task ,=ce %all t]m9ate on ,septemb] #cj1 #bjbi4 #cab4 ,ext5sion ( %>+ ( ,dep>tm5t ( ,vet]ans ,affairs & ,dep>tm5t ( ,def5se ,heal? ,c>e ,res\rces2 res\rce %>+ ov]sight & implem5tation plan 7a7 ,ext5sion ,section #haaa7;d77#c7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by /rik+ ,septemb] #cj1 #bjbf & ins]t+ ,septemb] #cj1 #bjbg4 7b7 ,ov]sight 7#a7 ,ju/ification ,su* section is fur!r am5d$ 9 subsection 7a7-- 7,a7 by ins]t+ 7#a7 be=e ,to ! maximum ext5t practicable1 ! ,secret>y2 & 7,b7 by add+ at ! end ! foll[+ new p>agraph3 7#b7 ,if ! ,secret>y ( ,vet]ans ,affairs elects n to ent] into su* an agreem5t or contract1 not)/&+ p>agraph 7#a71 ! ,secret>y & ! ,dep>tm5t ( ,vet]ans ,affairs-,dep>tm5t ( ,def5se ,jo9t ,executive ,committee %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a writt5 ju/ification = su* election4 4 7#b7 ,=m ( in=mation ,if ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives or ! ,s5ate reque/s in=mation f ! ,secret>y ( ,vet]ans ,affairs reg>d+ section #haaa ( title #ch1 ,unit$ ,/ates ,code1 ! ,secret>y %all provide su* in=mation 9 ! =m reque/$ by su* committee1 includ+ und]ly+ records1 datasets1 me?odologies1 contracts1 & communications1 & may n be limit$ to summ>ies or brief+ mat]ials 9 lieu ( orig9al s\rce docum5ts unless au?oriz$ by ! reque/+ committee4 7#c7 ,int]f]5ce ) transmission ( in=mation ,9 response to su* a reque/1 no (ficial or employee ( ! ,dep>tm5t ( ,vet]ans ,affairs %all-- 7,a7 )hold1 scre51 or alt] responsive in=mation2 7,b7 delay or condition production on initial cle>ance or political review2 7,c7 require a nondisclosure agreem5t unless requir$ by law2 7,d7 sub/itute summ>ies = reque/$ #b records2 or 7,e7 o!rwise imp$e or int]f]e ) direct transmission ( in=mation to ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives or ! ,s5ate4 7#d7 ,classifi$ in=mation ,if ! ,secret>y ( ,vet]ans' ,affairs det]m9es t any in=mation reg>d+ su* section reque/$ by ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives or ! ,s5ate is classifi$1 ! ,secret>y %all make arrangem5ts to pres5t su* in=mation to ! ,*air & ,rank+ ,memb] ( ! su* committee us+ appropriate security measures4 7c7 ,implem5tation plan & report 7#a7 ,jo9t res\rce %>+ implem5tation plan ,n lat] ?an #ij days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs1 9 coord9ation ) ! ,secret>y ( ,def5se1 %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a ,jo9t ,res\rce ,%>+ ,implem5tation ,plan4 ,su* plan %all include-- 7,a7 a compreh5sive inv5tory ( all agreem5ts "u section #haaa ( title #ch1 ,unit$ ,/ates ,code2 7,b7 a /&>diz$ reimbursem5t me?odology2 7,c7 capacity assessm5ts ( ,dep>tm5t ( ,vet]ans ,affairs & ,dep>tm5t ( ,def5se facilities2 & 7,d7 id5tification ( priority regions = expansion4 7#b7 ,report ,n lat] ?an #b ye>s aft] date ( ! enactm5t ( ?is ,act1 ! ,comptroll] ,g5]al %all submit a report to ,congress on ! implem5tation ( section #haaa ( title #ch1 ,unit$ ,/ates ,code4 ,su* report %all include-- 7,a7 a description ( use & effectiv5ess ( agreem5ts "u su* section2 7,b7 a description ( ! role & output ( ! ,jo9t ,executive ,committee "u su* section2 7,c7 an evaluation ( ! effectiv5ess ( coord9ation ( c>e & %>+ ( res\rces by ! ,dep>tm5t ( ,vet]ans ,affairs & ! ,dep>tm5t ( ,def5se "u su* section2 & 7,d7 a description ( any /atutory1 op]ational1 or cultural b>ri]s to ! implem5tation ( su* section4 #cac4 ,timely report+ ( ! dea? ( a vet]an 7a7 ,f9d+s ,congress f9ds ! foll[+3 7#a7 ,/ates & c\nties h report$ significant delays 9 ! sign+ ( dea? c]tificates = vet]ans :o pass away f natural causes4 7#b7 ,su* delays1 caus$ by ! refusal (1 or po/ponem5t by1 physicians ( ! ,dep>tm5t ( ,vet]ans ,affairs h1 9 "s cases1 la/$ z long z eight weeks4 7#c7 ,su* delays prev5t ! timely burial ( deceas$ vet]ans & access to survivor b5efits4 7b7 ,timely c]tification ( ! dea? ( a vet]an 7#a7 ,9 g5]al 7,a7 ,,va physician1 nurse practition]1 or physician assi/ant ,subject to subp>agraph 7,b71 a physician1 nurse practition]1 or physician assi/ant employ$ by ! ,secret>y ( ,vet]ans ,affairs :o is ! prim>y c>e provid] ( a vet]an :o dies ( natural causes %all c]tify ! dea? ( su* vet]an n lat] ?an two bus9ess days aft] su* physician1 nurse practition]1 or physician assi/ant le>ns ( su* dea?4 7,b7 ,coron] or m$ical exam9] ,if a physician1 nurse practition]1 or physician assi/ant describ$ 9 subp>agraph 7,a7 _c comply ) su* p>agraph ) respect to a dea? describ$ 9 su* p>agraph1 a coron] or m$ical exam9] 9 ! jurisdiction :]e su* dea? occurr$ may c]tify su* dea?4 7#b7 ,report 7,a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 & annually !reaft] = ! foll[+ five ye>s1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report reg>d+ compliance ) p>agraph 7#a74 7,b7 ,elem5ts ,ea* report requir$ "u subp>agraph 7,a7 %all include1 ) respect to ! ye> prec$+ ! date ( ! report1 ! foll[+ elem5ts3 7i7 ,! p]c5tage ( cases 9 :i* a physician1 nurse practition]1 or physician assi/ant employ$ by ! ,secret>y compli$ ) p>agraph 7#a77;,a74 7ii7 ,! numb] ( cases 9 :i* su* a physician1 nurse practition]1 or physician assi/ant c\ld n s comply4 7iii7 ,an id5tification ( ! mo/ common reasons :y su* a physician1 nurse practition]1 or physician assi/ant c\ld n s comply4 7#c7 ,rule ( con/ruction ,no?+ 9 ?is section %all be con/ru$ to au?orize a physician assi/ant or nurse practition] to c]tify a dea? 9 any ,/ate 9 :i* su* au?ority is n p]mitt$ "u ,/ate or local law4 #cad4 ,expansion ( access by vet]ans to critical access hospitals & affiliat$ cl9ics "u ! ,vet]ans ,community ,c>e ,program 7a7 ,pilot program to improve c>e coord9ation = vet]ans f critical access hospitals & affiliat$ cl9ics 7#a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all comm5ce a five-ye> pilot program to improve c>e coord9ation = eligible vet]ans :o receive c>e f a critical access hospital or a provid]-bas$ rural heal? cl9ic affiliat$ ) su* hospital 79 ?is section ref]r$ to z ! pilot program74 7#b7 ,contracts1 agreem5ts1 or o!r arrangem5ts 7,a7 ,9 g5]al ,9 c>ry+ out ! pilot program1 ! ,secret>y %all ent] into contracts1 agreem5ts1 or o!r arrangem5ts ) facilities p>ticipat+ 9 ! pilot program to reimburse critical access hospitals & affiliat$ cl9ics = outpati5t heal? c>e & m$ical s]vices provid$ to eligible vet]ans4 7,b7 ,elem5ts ,! ,secret>y1 9 coord9ation ) p>ticipat+ critical access hospitals1 %all ensure t any contract1 agreem5t1 or o!r arrangem5t ent]$ into "u subp>agraph 7,a7 e/abli%es crit]ia1 z ! ,secret>y consid]s appropriate1 to ensure-- 7i7 ! provision ( timely1 safe1 & high-quality heal? c>e s]vices to p>ticipants 9 ! pilot program1 includ+ ?r\gh timely %>+ ( p]t95t m$ical record & o!r in=mation betwe5 m$ical facilities p>ticipat+ 9 ! pilot program & m$ical facilities ( ! ,dep>tm5t ( ,vet]ans ,affairs2 7ii7 ! provision ( heal? c>e s]vices ?r\gh ! pilot program is 9 accordance ) ! m$ical b5efits package ( ! ,dep>tm5t2 7iii7 no additional *>ges are impos$ on vet]ans p>ticipat+ 9 ! pilot program or ! heal? c>e insur] ( su* vet]ans = any m$ical s]vice = :i* paym5t is made by ! ,secret>y2 7iv7 appropriate reimbursem5t rates1 includ+ ?r\gh ! consid]ation ( co/-bas$ reimbursem5ts2 & 7v7 su* o!r consid]ations z ! ,secret>y consid]s appropriate4 7#c7 ,locations ,! ,secret>y %all ensure p>ticipation 9 ! pilot program is op5 to all qualifi$ facilities locat$ 9 ,/ates t are designat$ by ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices z fronti] ,/ates4 7#d7 ,au?orization = c>e ,! ,secret>y %all provide eligible vet]ans opt+ to p>ticipate 9 ! pilot program a "o-ye> au?orization f ! ,dep>tm5t to receive outpati5t s]vices at facilities p>ticipat+ 9 ! pilot program4 7#e7 ,outrea* 7,a7 ,eligible vet]ans ,n less frequ5tly ?an annually dur+ ea* ye> 9 :i* ! pilot program is c>ri$ out1 ! ,secret>y %all conduct direct outrea* to eligible vet]ans 9 areas 9 :i* ! pilot program is c>ri$ out to notify su* vet]ans ( _! ability to p>ticipate 9 ! pilot program4 7,b7 ,hospitals ,! ,secret>y %all conduct direct outrea* to critical access hospitals 9 areas 9 :i* ! pilot program is c>ri$ out to notify ^? hospitals ( _! ability to p>ticipate 9 ! pilot program4 7#f7 ,/aff ,! ,secret>y %all ensure t ea* m$ical facility ( ! ,dep>tm5t )9 ! cat*m5t area ( a location 9 :i* ! pilot program is c>ri$ out has suffici5t d$icat$ /aff to h&le-- 7,a7 adm9i/rative & te*nical *all5ges t arise f ! pilot program2 7,b7 c>e coord9ation & foll[ up ) ! vet]an & ! facility p>ticipat+ 9 ! pilot program aft] an episode ( c>e2 & 7,c7 timely records return foll[+ an episode ( c>e4 7#g7 ,limitation ,! ,secret>y may n ext5d ! pilot program beyond ! five-ye> p]iod specifi$ "u subsection 7a7 or exp& ! pilot program to additional ,/ates or conv]t ! pilot program into a p]man5t au?ority unless expressly au?oriz$ by a subsequ5t ,act ( ,congress4 7#h7 ,report 7,a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 & annually !reaft] = ! duration ( ! 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 program4 7,b7 ,elem5ts 7i7 ,9 g5]al ,ea* report requir$ "u subp>agraph 7,a7 %all conta9 ! recomm5dation ( ! ,secret>y = ! expansion or cont9uation ( ! pilot program4 7ii7 ,initial report ,! initial report requir$ "u clause 7i7 %all conta9-- 7,i7 a description ( ! outrea* conduct$ to critical access hospitals conc]n+ ! pilot program2 7,,ii7 a li/ ( facilities t h opt$ to p>ticipate 9 ! pilot program2 7,,iii7 in=mation1 by facility1 reg>d+ total obligations & exp5ditures1 utilization av]age "t f au?orization to c>e1 timel9ess reg>d+ m$ical records return & claim paym5t1 em]g5cy dep>tm5t utilization1 vet]an satisfaction1 & any effect on c>e furni%$ by ,dep>tm5t facilities2 & 7,,iv7 a li/ ( ! b>ri]s1 if any1 cit$ by facilities t opt$ n to p>ticipate 9 ! pilot program4 7iii7 ,subsequ5t reports ,ea* report requir$ "u clause 7i7 aft] ! initial report %all conta9-- 7,i7 an updat$ li/ ( facilities p>ticipat+ 9 ! pilot program2 7,,ii7 ! numb] ( vet]ans p>ticipat+ 9 ! pilot program1 disaggregat$ by facility2 7,,iii7 an ov]view ( ! types ( c>e receiv$ ?r\gh ! pilot program2 7,,iv7 fe$back f ! facilities p>ticipat+ 9 ! pilot program1 ) id5tify+ in=mation remov$1 reg>d+ ! /atus ( ! pilot program1 *all5ges 9 p>ticipat+ 9 ! pilot program1 & ! int]e/ ( ! facility 9 cont9u$ p>ticipation 9 su* a program2 & 7,v7 any additional in=mation t ! ,secret>y det]m9es relevant or necess>y4 7#i7 ,def9itions ,9 ?is subsection3 7,a7 ,critical access hospital ,! t]m critical access hospital has ! mean+ giv5 t t]m 9 section #ahfa7mm7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciex7mm774 7,b7 ,eligible vet]an ,! t]m eligible vet]an means a vet]an-- 7i7 enroll$ 9 ! pati5t enrollm5t sy/em ( ! ,dep>tm5t ( ,vet]ans ,affairs e/abli%$ & op]at$ "u section #agje7;a7 ( title #ch1 ,unit$ ,/ates ,code2 7ii7 :o has receiv$ c>e at a facility ( ! ,dep>tm5t or 9-network provid] "u ! ,vet]ans ,community ,c>e ,program "u section #agjc ( su* title dur+ ! previ\s two-ye> p]iod2 7iii7 :o lives )9 #ce miles ( a critical access hospital2 & 7iv7 :o w\ld be eligible = c>e or s]vices "u ! ,vet]ans ,community ,c>e ,program4 7b7 ,action plan to address b>ri]s to c>e = vet]ans liv+ 9 rural areas 7#a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all develop & submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a compreh5sive action plan to id5tify1 address1 & elim9ate b>ri]s to access+ c>e = vet]ans resid+ 9 rural1 highly rural1 & fronti] areas4 7#b7 ,elem5ts ,9 develop+ ! action plan requir$ "u p>agraph 7#a71 ! ,secret>y %all-- 7,a7 consult ) heal? c>e provid]s t provide c>e 9 ! community "u ! laws adm9i/]$ by ! ,secret>y1 ,/ate ,(fices ( ,rural ,heal?1 ,tribal heal? au?orities1 & o!r relevant /akehold]s 9 rural1 highly rural1 & fronti] areas z ! ,secret>y det]m9es appropriate2 7,b7 assess b>ri]s to c>e 9 ! community = vet]ans resid+ 9 rural & highly rural areas1 includ+ *all5ges ) respect to-- 7i7 network adequacy2 7ii7 provid] p>ticipation2 7iii7 geographic di/ance2 7iv7 transportation2 7v7 in=mation te*nology2 7vi7 physical infra/ructure2 7vii7 outrea* & und]/&+ ( eligibility = su* c>e2 7viii7 timel9ess ( ref]rals1 au?orization1 & m$ical docum5tation ex*ange2 & 7ix7 any o!r matt] ! ,secret>y det]m9es appropriate2 7,c7 li/ specific & measurable /rategies & actions to address ! b>ri]s & *all5ges assess$ "u subp>agraph 7,b71 to include ! consid]ation (-- 7i7 exp&+ p>ticipation 9 ! ,vet]ans ,community ,c>e ,program "u section #agjc ( title #ch1 ,unit$ ,/ates ,code1 among provid]s 9 rural1 highly rural1 & fronti] areas2 7ii7 physically locat+ heal? c>e facilities ( ! ,dep>tm5t ( ,vet]ans ,affairs )9 ! same build+ or on ! campuses ( o!r heal? c>e facilities locat$ 9 rural1 highly rural1 or fronti] areas2 7iii7 enhanc+ transportation assi/ance2 7iv7 increas+ reimbursem5t rates1 includ+ ?r\gh co/-bas$ reimbursem5ts2 & 7v7 improv+ coord9ation ) ,/ate1 ,tribal1 & local p>tn]s2 & 7,d7 assess legislative & regulatory b>ri]s1 if any1 to address+ ! b>ri]s assess$ "u subp>agraph 7,b74 7#c7 ,implem5tation ,n lat] ?an #ij days aft] submitt+ ! action plan "u p>agraph 7#a71 ! ,secret>y %all beg9 implem5tation ( ! plan & %all ensure full implem5tation n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ?is ,act4 7c7 ,outrea* 7#a7 ,outrea* to vet]ans ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 & annually !reaft]1 ! ,secret>y ( ,vet]ans ,affairs1 ?r\gh ! ,(fice ( ,rural ,heal? 7or successor (fice7 & ! ,(fice ( ,integrat$ ,vet]an ,c>e 7or successor (fice71 %all conduct outrea* to vet]ans resid+ 9 rural1 highly rural1 & fronti] areas reg>d+-- 7,a7 opportunities to seek c>e ?r\gh facilities & programs ( ! ,dep>tm5t ( ,vet]ans ,affairs1 includ+ via teleheal?1 exi/+ programs provid$ ?r\gh grantees or contractors ( ! ,dep>tm5t1 ,vet ,c5t]s 7z def9$ 9 section #agab;,a ( title #ch1 ,unit$ ,/ates ,code71 & volunte] programs & s]vices = transportation2 7,b7 opportunities to seek c>e ?\gh ! ,vet]ans ,community ,c>e ,program "u section #agjc ( title #ch1 ,unit$ ,/ates ,code2 7,c7 opportunities to seek c>e at critical access hospitals ) contracts1 p>tn]%ips1 or agreem5ts ) ! ,dep>tm5t ( ,vet]ans ,affairs2 & 7,d7 any o!r matt]s ! ,secret>y consid]s appropriate4 7#b7 ,outrea* to provid]s ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 & annually !reaft]1 ! ,secret>y ( ,vet]ans ,affairs1 ?r\gh ! ,(fice ( ,rural ,heal? 7or successor (fice7 & ! ,(fice ( ,integrat$ ,vet]an ,c>e 7or successor (fice71 %all-- 7,a7 conduct outrea* to heal? c>e facilities & critical access hospitals 9 rural areas reg>d+-- 7i7 ! ,vet]ans ,community ,c>e program "u section #agjc ( title #ch1 ,unit$ ,/ates ,code1 & ! pilot program "u subsection 7a7 ( ?is section2 & 7ii7 any o!r matt]s ! ,secret>y consid]s appropriate2 & 7,b7 seek to ent] into contracts1 p>tn]%ips1 agreem5ts1 or o!r arrangem5ts ) heal? c>e facilities & critical access hospitals 9 rural areas4 7#c7 ,critical access hospital def9$ ,9 ?is section1 ! t]m critical access hospital has ! mean+ giv5 t t]m 9 section #ahfa7mm7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciex7mm774 #cae4 ,pilot plat=m = s]vices = vet]ans2 collection f vet]ans ( in=mation relat$ to social det]m9ants ( heal? 7a7 ,pilot program on e/abli%m5t or enhancem5t ( community integration plat=m = vet]ans 7#a7 ,9 g5]al ,comm5c+ n lat] ?an #ah mon?s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y1 act+ ?r\gh ! ,c5t] = ,innovation = ,c>e & ,paym5t ( ! ,dep>tm5t ( ,vet]ans ,affairs1 %all c>ry out a pilot program "u :i* ! ,secret>y %all e/abli% a new1 or enhance an exi/+1 int]op]able community integration plat=m to coord9ate local support s]vices = vet]ans ?r\gh o!r gov]nm5tal & nongov]nm5tal organizations 79 ?is section ref]r$ to z ! pilot program74 7#b7 ,elem5ts ( pilot program ,9 c>ry+ out ! pilot program1 ! ,secret>y %all ensure t ! community integration plat=m e/abli%$ or enhanc$ "u ! pilot program-- 7,a7 p]mits vet]ans to id5tify & connect ) cov]$ entities t furni% cov]$ s]vices2 7,b7 p]mits cov]$ entities to id5tify & connect ) vet]ans 9 ne$ ( cov]$ s]vices2 7,c7 utilizes1 to ! ext5t practicable1 exi/+ int]op]able te*nology networks2 7,d7 prioritizes connectivity ) appropriate exi/+ te*nology networks develop$ by public or private organizations t comply )1 z applicable1 /&>ds adopt$ by ! ,secret>y ( ,heal? & ,human ,s]vices "u section #cjjd ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;jj-#ad71 = ! provision ( cov]$ s]vices2 7,e7 ensures t-- 7i7 reasonable measures are tak5 to promote connectivity & int]op]able ex*ange among cov]$ entities & betwe5 cov]$ entities & vet]ans2 & 7ii7 appropriate privacy & security protections are 9 place1 9 accordance ) applicable ,f$]al & ,/ate privacy law2 7,f7 is accessible by employees ( ! ,dep>tm5t1 cov]$ entities1 & vet]ans2 7,g7 connects cov]$ entities & vet]ans = purposes ( communication1 s]vice coord9ation1 & consum] assi/ance1 ref]ral & capacity managem5t1 outcome track+ & report+1 & relat$ s]vices2 & 7,h7 is accessible via a web-bas$ plat=m = all vet]ans & via a non-web-bas$ alt]native plat=m or process = vet]ans :o are unable to easily & reliably access ! web-bas$ plat=m4 7#c7 ,locations 7,a7 ,initial locations ,! ,secret>y %all c>ry out ! pilot program at n few] ?an five m$ical facilities ( ! ,dep>tm5t ( ,vet]ans ,affairs select$ by ! ,secret>y = purposes ( ! pilot program4 7,b7 ,expansion ,! ,secret>y may exp& beyond initial sites = ! pilot program select$ "u p>agraph 7#a7 n be=e two ye>s aft] ! date ( enactm5t1 n be=e ?irty days aft] brief+ ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ! ,h\se ( ! expansion plan1 & aft] demon/rat$ success4 7,c7 ,v>iety ( facilities ,9 select+ facilities "u subp>agraph 7,a71 ! ,secret>y %all ensure ! selection ( a v>iety ( diff]5t types ( facilities1 includ+-- 7i7 fronti] facilities2 7ii7 "u-res\rc$ facilities2 7iii7 facilities at :i* !re are exi/+ ef=ts to coord9ate ) community res\rces2 & 7iv7 facilities locat$ 9 communities ) an e/abli%$ community-bas$ vet]an s]vice coord9ation network capable ( integration ) ! pilot program4 7#d7 ,procurem5t ( te*nology ,9 c>ry+ out ! pilot program1 ! ,secret>y %all ensure full & op5 competition 9 ! procurem5t ( any s]vices or te*nology & %all n ent] into an exclusive national contract = ! op]ation ( ! community integration plat=m "u ! pilot program4 ,9 procur+ te*nology "u ?is section1 ! ,secret>y may prioritize1 to ! maximum ext5t practicable1 te*nologies1 plat=ms1 or capabilities t are already deploy$1 validat$1 int]op]able1 or o!rwise 9 op]ational use )9 m$ical c5t]s or o!r compon5ts ( ! ,dep>tm5t1 unless ! ,secret>y det]m9es & docum5ts t an alt]native solution w\ld bett] a*ieve ! purposes ( ?is section4 7#e7 ,application process 7,a7 ,9 g5]al ,! ,secret>y may require cov]$ entities t seek to p>ticipate 9 ! pilot program to submit to ! ,secret>y an application !re=e 9 su* =m1 9 su* mann]1 & conta9+ su* commitm5ts & in=mation z ! ,secret>y consid]s necess>y to c>ry out ?is section4 7,b7 ,review 7i7 ,9 g5]al ,! ,secret>y %all review ! applications ( cov]$ entities submitt$ "u subp>agraph 7,a7 to ensure t ! p>ticipation ( su* entities w\ld be safe & appropriate = vet]ans p>ticipat+ 9 ! pilot program4 7ii7 ,due dilig5ce ,9 review+ applications "u clause 7i71 ! ,secret>y %all conduct due dilig5ce consi/5t ) h[ ! ,secret>y conducts due dilig5ce = public-private p>tn]%ips "u o!r laws adm9i/]$ by ! ,secret>y4 7#f7 ,scre5+ & track+ ( p>ticipants 7,a7 ,9 g5]al ,! ,secret>y %all require vet]ans p>ticipat+ 9 ! community integration plat=m "u ! pilot program to provide in=mation reg>d+ social det]m9ants ( heal? us+ ! ,,icd-#aj diagno/ic codes ,z#ee ?r\gh ,z#fc & ,z#ge 7z 9 effect on ! date ( ! enactm5t ( ?is ,act7 9 a /&>diz$ risk assessm5t or scre5+ tool & su* o!r in=mation z ! ,secret>y consid]s necess>y to adm9i/] ! pilot program4 7,b7 ,in=m$ cons5t ,in=mation collect$ "u ! pilot program ) respect to a vet]an %all be obta9$ ) ! in=m$ cons5t ( ! vet]an & us$ solely = purposes ( c>e coord9ation1 s]vice deliv]y1 or program evaluation "u ! pilot program4 7,c7 ,track+ ( in=mation 7i7 ,9 g5]al ,! ,secret>y %all track-- 7,i7 ! numb] ( ref]rals ( vet]ans to cov]$ entities ?r\gh ! community integration plat=m "u ! pilot program2 7,,ii7 ! response "t ( cov]$ entities to :i* su* vet]ans are ref]r$2 & 7,,iii7 ! outcome ( ! initial meet+ by a vet]an & a cov]$ entity to :i* ! vet]an is ref]r$1 includ+ a description ( ! s]vices t are provid$ to ! vet]an by su* entity4 7ii7 ,track+ by entities ,! ,secret>y may require cov]$ entities p>ticipat+ 9 ! pilot program to track ! in=mation requir$ "u clause 7i7 9 a m$ium det]m9$ appropriate by ! ,secret>y4 7#g7 ,coord9ation & integration ( programs 7,a7 ,coord9ation ) exi/+ networks ,9 c>ry+ out ! pilot program1 ! ,secret>y %all coord9ate ) exi/+ community networks4 7,b7 ,coord9ation & integration ) ,/ate m$icaid programs ,! ,secret>y may consult & coord9ate ) ! ,secret>y ( ,heal? & ,human ,s]vices & ) ,/ates reg>d+ exi/+ ,f$]al & ,/ate programs1 b no?+ 9 ?is section %all be con/ru$ to au?orize ! ,secret>y ( ,vet]ans ,affairs to adm9i/]1 direct1 or modify a ,/ate ,m$icaid program or waiv]4 7#h7 ,p]=mance b5*m>ks ,! ,secret>y %all e/abli% p]=mance b5*m>ks = ! pilot program1 includ+ measures ( ref]ral completion1 timel9ess ( s]vice connection1 & vet]an-report$ satisfaction4 7#i7 ,report & brief+s 7,a7 ,report ,n lat] ?an ?ree ye>s aft] ! comm5cem5t ( ! pilot program1 ! ,secret>y %all submit to ! appropriate committees ( ,congress a report analyz+ ! ne$s ( vet]ans = cov]$ s]vices reflect$ by ! use ( su* s]vices "u ! community integration plat=m "u ! pilot program1 includ+ an assessm5t (-- 7i7 ! ne$ = su* s]vices t is be+ met ?r\gh su* plat=m2 & 7ii7 ! ne$ = su* s]vices t is n be+ met ?r\gh su* plat=m4 7,b7 ,brief+ on entities n select$ ,n lat] ?an #ahj days aft] ! comm5cem5t ( ! pilot program1 & n less frequ5tly ?an once e #ahj days !reaft] until ! conclusion ( ! pilot program1 ! ,secret>y %all brief ! appropriate committees ( ,congress on ! cov]$ entities t submitt$ an application to p>ticipate 9 ! pilot program b 7 n select$ = p>ticipation & ! reason ^? entities 7 n select$4 7#aj7 ,comptroll] ,g5]al evaluation1 report1 & recomm5dations 7,a7 ,evaluation ,! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all conduct an evaluation t measures ! ov]all impact ( ! community integration plat=m e/abli%$ or enhanc$ "u ! pilot program ) respect to-- 7i7 *anges 9 individual & population heal? outcomes among vet]ans2 7ii7 *anges 9 access to heal? c>e or social s]vices among vet]ans2 & 7iii7 su* o!r factors z ! ,comptroll] ,g5]al consid]s appropriate4 7,b7 ,report & recomm5dations 7i7 ,9 g5]al ,n lat] ?an f\r ye>s aft] ! comm5cem5t ( ! pilot program1 ! ,comptroll] ,g5]al %all-- 7,i7 submit to ,congress a report on ! evaluation conduct$ "u subp>agraph 7,a72 7,,ii7 make su* report publicly available2 & 7,,iii7 bas$ on su* evaluation1 make recomm5dations to ! ,secret>y on h[ to improve & su/a9 ! community integration plat=m e/abli%$ or enhanc$ "u ! pilot program4 7ii7 ,elem5ts ( report ,! report "u clause 7i77,i7 %all include data on-- 7,i7 :at cov]$ s\rces "u ! pilot program are be+ utiliz$ ! mo/2 7,,ii7 :at reque/s = s]vices "u ! pilot program _c be met2 & 7,,iii7 ! impact ( ! provision ( s]vices "u ! pilot program on heal? outcomes ( vet]ans4 7#aa7 ,limitations 7,a7 ,! ,secret>y may n use ! pilot program e/abli%$ "u subsection 7a7 to supplant s]vices o!rwise requir$ to be furni%$ by ! ,dep>tm5t "u title #ch1 ,unit$ ,/ates ,code4 7,b7 ,no cov]$ entity p>ticipat+ 9 ! pilot program e/abli%$ "u subsection 7a7 may receive access to p]sonally id5tifiable in=mation1 protect$ heal? in=mation1 or social det]m9ants in=mation ( a vet]an )\t ! vet]an's in=m$ writt5 cons5t1 & su* in=mation may be us$ only = ! specific ref]ral or s]vice au?oriz$ by ! vet]an4 7#ab7 ,def9itions ,9 ?is subsection3 7,a7 ,appropriate committees ( ,congress ,! t]m appropriate committees ( ,congress means ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives4 7,b7 ,community integration plat=m ,! t]m community integration plat=m means an int]op]able plat=m or network ( int]op]able sy/ems us$ to enable ! coord9ation1 alignm5t1 & connection ( cov]$ entities & vet]ans at ! local level = purposes ( communication1 s]vice coord9ation1 & ref]ral managem5t ( cov]$ s]vices4 7,c7 ,cov]$ entity ,! t]m cov]$ entity means any ( ! foll[+ entities or provid]s t h ent]$ into an agreem5t ) ! ,secret>y to p>ticipate 9 ! pilot program3 7i7 ,a community-bas$ organization t-- 7,i7 accepts ref]rals f heal? c>e organizations2 & 7,,ii7 provides cov]$ s]vices4 7ii7 ,a public or private heal? c>e provid] organization4 7iii7 ,a public or private fund$ payor ( heal? c>e s]vices1 includ+ home- or community-bas$ s]vices4 7iv7 ,a ,/ate1 local1 t]ritorial1 or ,tribal heal? or social s]vices ag5cy4 7v7 ,a ,/ate public h\s+ au?ority or h\s+ f9ance ag5cy4 7vi7 ,a public heal? in=mation ex*ange or public heal? in=mation network1 z def9$ by ! ,secret>y4 7vii7 ,a fai?-bas$ s]vice provid]4 7viii7 ,any o!r simil> entity1 z det]m9$ by ! ,secret>y4 7,d7 ,cov]$ s]vices ,! t]m cov]$ s]vices means any ( ! foll[+3 7i7 ,nutritional assi/ance4 7ii7 ,h\s+4 7iii7 ,heal? c>e1 includ+ prev5tive heal? int]v5tion1 *ronic disease managem5t1 & behavioral heal? c>e4 7iv7 ,transportation4 7v7 ,job tra9+ & employm5t4 7vi7 ,*ild developm5t or c>e4 7vii7 ,c>egiv+ & respite c>e4 7viii7 ,disability assi/ance4 7ix7 ,suicide prev5tion4 7x7 ,sexual assault s]vices4 7xi7 ,legal aid4 7xii7 ,transition assi/ance = vet]ans newly sep>at$ or dis*>g$ f active milit>y1 naval1 air1 or space s]vice 7z def9$ 9 section #aja7bd7 ( title #ch1 ,unit$ ,/ates ,code74 7xiii7 ,assi/ance ) utilities necess>y = safe habitation4 7xiv7 ,o!r s]vices directly relat$ to heal? c>e access1 suicide prev5tion1 homelessness prev5tion1 food insecurity1 transportation to heal? c>e1 or assi/ance sep>at+ f milit>y s]vice & re5t]+ civilian life1 z expressly au?oriz$ "u laws adm9i/]$ by ! ,secret>y4 7,e7 ,secret>y ,! t]m ,secret>y means ! ,secret>y ( ,vet]ans ,affairs4 7,f7 ,/ate ,! t]m ,/ate has ! mean+ giv5 t t]m 9 section #aja ( title #ch1 ,unit$ ,/ates ,code4 7b7 ,collection ( in=mation f vet]ans relat$ to social det]m9ants ( heal? 7#a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all collect f vet]ans enroll$ 9 ! sy/em ( annual pati5t enrollm5t ( ! ,dep>tm5t ( ,vet]ans ,affairs e/abli%$ & op]at$ "u section #agje7;a7 ( title #ch1 ,unit$ ,/ates ,code1 z "p ( r\t9e scre5+s ( su* vet]ans "u ! laws adm9i/]$ by ! ,secret>y1 in=mation relat$ to social det]m9ants t may factor into ! heal? ( su* vet]ans4 7#b7 ,social det]m9ants ( heal? 7,a7 ,9 g5]al ,! in=mation collect$ "u subsection 7a7 %all include /&>diz$ def9itions = id5tify+ social det]m9ants ( heal? ne$s id5tifi$ 9 ! ,,icd-#aj diagno/ic codes ,z#ee ?r\gh ,z#fc & ,z#ge 7z 9 effect on ! date ( enactm5t ( ?is ,act74 7,b7 ,incorporation ( measures ,def9itions includ$ "u subp>agraph 7,a7 ) respect to id5tify+ social det]m9ants ( heal? ne$s %all incorporate measures = quantify+ ! relative sev]ity ( any su* social det]m9ant ( heal? ne$ id5tifi$ 9 an individual4 #caf4 ,improvem5ts to ,dep>tm5t ( ,vet]ans ,affairs pro/hetic & rehabilitative items & s]vice 7a7 ,pro/hetic & ,rehabilitative ,items & ,s]vices ,=mul>y 7#a7 ,9 g5]al ,*apt] #ag ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by ins]t+ aft] section #agji;,c ! foll[+ new section3 #agji;,d4 ,pro/hetic & ,rehabilitative ,items & ,s]vices ,=mul>y 7a7 ,9 g5]al ,! ,secret>y %all e/abli% a li/ ( pro/hetic & rehabilitative items & s]vices1 :i* may be ref]r$ to z ! ,pro/hetic & ,rehabilitative ,items & ,s]vices ,=mul>y or ! ,=mul>y1 = purposes ( furni%+ m$ical s]vices "u section #agja7f77;,f7 ( ?is title pursuant to section #agaj ( ?is title4 7b7 ,requirem5ts 7#a7 ,input ,9 develop+ ! ,=mul>y1 ! ,secret>y %all solicit input f vet]ans & ! public4 7#b7 ,availability ( items ,! ,secret>y %all ensure t all items & s]vices includ$ 9 ! ,=mul>y are available at or ?r\gh all facilities ( ! ,dep>tm5t4 7#c7 ,items ,to be includ$ ,9 develop+ ! ,=mul>y1 ! ,secret>y %all rely on ! be/ available evid5ce to id5tify :i* items & s]vices %\ld be includ$ on ! ,=mul>y4 7c7 ,publication & communication 7#a7 ,publication & update ,! ,secret>y %all publi% ! ,=mul>y on a website ( ! ,dep>tm5t & %all update ! ,=mul>y p]iodically4 7#b7 ,communication ,! ,secret>y %all communicate to vet]ans ! cont5ts ( ! ,=mul>y & in=mation ab\t h[ to appeal decisions reg>d+ ! provision ( items & s]vices on ! ,=mul>y4 7d7 ,contracts ,! ,secret>y %all ent] into su* contracts z ! ,secret>y consid]s necess>y to support ! availability ( items & s]vices includ$ 9 ! ,=mul>y4 7e7 ,tra9+ ,! ,secret>y %all ensure ! availability ( tra9+ on ! ,=mul>y = cl9icians & o!r /aff ( ! ,dep>tm5t4 7f7 ,exceptions 7#a7 ,9 g5]al ,! ,secret>y %all e/abli% a process = cl9icians ( ! ,dep>tm5t to reque/1 prescribe1 & furni% pro/hetic & rehabilitative items & s]vices t are n includ$ on ! ,=mul>y :5 m$ically necess>y4 7#b7 ,monitor+ ( non-,=mul>y items & s]vices ,! ,secret>y %all monitor reque/s & prescriptions = & ! furni%+ ( pro/hetic & rehabilitative items & s]vices "u p>agraph 7#a7-- 7,a7 to ensure t su* items & s]vices are be+ consi/5tly & appropriately prescrib$ at all facilities ( ! ,dep>tm5t2 & 7,b7 to det]m9e :e!r su* items or s]vices %\ld be add$ to ! ,=mul>y4 7#c7 ,prior au?orization = non-=mul>y procurem5t ,! ,secret>y %all e/abli% a prior au?orization process = ! procurem5t ( pro/hetic & rehabilitative items t are n includ$ on ! ,=mul>y or available ?r\gh a national contract4 7#d7 ,op5 m>ket procurem5t ,! ,secret>y %all ensure t procurem5t ( items t are n includ$ on ! ,=mul>y or available ?r\gh a national contract is p]mitt$ only if a cl9ician det]m9es ! item is m$ically necess>y4 7g7 ,consid]ation ,9 develop+ ! ,=mul>y1 ! ,secret>y %all consid] h[ ! approa* ( ! ,ph>macy ,b5efits ,managem5t ,s]vices ( ! ,dep>tm5t = =mul>y managem5t & m$ication safety c be adapt$ to support ! effici5t & effective adm9i/ration ( ! ,=mul>y4 7h7 ,ent]prise procurem5t & ord]+ sy/em 7#a7 ,9 g5]al ,! ,secret>y %all implem5t an ent]prise electronic ord]+ sy/em = pro/hetic & rehabilitative items & s]vices furni%$ "u ?is section4 7#b7 ,sy/ems elem5ts ,! sy/em requir$ "u p>agraph 7#a7 %all-- 7,a7 enable ! automat$ ord]+ ( items includ$ on ! ,=mul>y2 7,b7 provide visibility ( contract pric+ & availability across all facilities ( ! ,dep>tm5t2 7,c7 all[ ent]prise load+ ( nationally contract$ products2 7,d7 provide procurem5t analytics to monitor compliance ) national contracts & r$uce op5 m>ket pur*as+2 & 7,e7 conta9 all data elem5ts requir$ = ! ,f$]al ,electronic ,heal?c>e ,record 9 a se>*able =mat4 7#c7 ,implem5tation ,! ,secret>y %all ensure t ! sy/em requir$ "u p>agraph 7#a7 is implem5t$ across all m$ical c5t]s ( ! ,dep>tm5t by n lat] ?an ?ree ye>s aft] ! date ( ! enactm5t ( ?is section4 7i7 ,program managem5t 7#a7 ,9 g5]al ,! ,secret>y %all ensure t ! ,pro/hetic & ,s5sory ,aids ,s]vice ( ! ,dep>tm5t ma9ta9s adequate /aff+ to adm9i/] ! ,=mul>y & associat$ procurem5t programs4 7#b7 ,/aff+ includ$ ,/aff+ requir$ "u p>agraph 7#a7 %all include-- 7,a7 d$icat$ program manag]s = major pro/hetic product categories2 & 7,b7 full-"t cl9ical /aff responsible = cl9ical evaluations & practice recomm5dations4 7j7 ,report to ,congress ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ?is section1 & annually !reaft]1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report describ+-- 7#a7 rates ( compliance by ! ,dep>tm5t ) national pro/hetic contracts2 7#b7 op5 m>ket pur*as+ tr5ds ( ! ,dep>tm5t2 7#c7 utilization ( ! ,=mul>y across facilities ( ! ,dep>tm5t2 & 7#d7 /eps tak5 by ! ,dep>tm5t to improve ent]prise procurem5t effici5cy4 4 7#b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( su* *apt] is am5d$ by ins]t+ aft] ! item relat+ to section #agji;,c ! foll[+ new item3 #agji;,d4 ,pro/hetic & rehabilitative items & s]vices =mul>y4 7b7 ,report 7#a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report conta9+ a compreh5sive op]ational & te*nology assessm5t ( ! ,pro/hetic & ,rehabilitative ,items & ,s]vices ,=mul>y e/abli%$ "u section #agji;,d ( title #ch1 ,unit$ ,/ates ,code1 z add$ by subsection 7a74 7#b7 ,elem5ts ,! report requir$ by p>agraph 7#a7 %all id5tify pot5tial impacts ( ! ,pro/hetic & ,rehabilitative ,items & ,s]vices ,=mul>y on-- 7,a7 access by vet]ans to pro/hetic & rehabilitative items & s]vices2 7,b7 cl9ician workload2 7,c7 procurem5t timel9es2 & 7,d7 innovation adoption4 #cag4 ,improvem5t ( submission ( m$ical docum5tation to ! ,secret>y ( ,vet]ans ,affairs by community c>e provid]s 7a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all ensure t ea* contract1 agreem5t1 or o!r arrangem5t ?r\gh :i* ! ,secret>y furni%es hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices to eligible vet]ans ?r\gh non-,dep>tm5t ( ,vet]ans ,affairs entities or provid]s includes cle> requirem5ts1 includ+ requirem5ts reg>d+ timel9ess1 reg>d+ ! submission ( m$ical docum5tation to ! ,secret>y aft] a vet]an receives su* c>e or s]vices f ! non-,dep>tm5t entity or provid]4 7b7 ,int]nal ,measures ,! ,secret>y %all e/abli% su* goals & relat$ p]=mance measures = m$ical c5t]s ( ! ,dep>tm5t z ! ,secret>y det]m9es appropriate 9 obta9+ m$ical docum5tation f non-,dep>tm5t entities or provid]s "u subsection 7a74 7c7 ,tra9+ ,! ,secret>y may e/abli% goals & relat$ p]=mance measures = ! completion by non-,dep>tm5t entities or provid]s ( core tra9+ relat$ to ! submission to ! ,secret>y ( m$ical docum5tation "u subsection 7a7 & may monitor ! completion ( su* tra9+4 7d7 ,outrea* ,! ,secret>y %all ensure t communications by ! ,secret>y ) non-,dep>tm5t entities or provid]s conta9 cle> & accurate in=mation reg>d+ requirem5ts = submitt+ m$ical docum5tation "u subsection 7a7 & complet+ ! core tra9+ describ$ 9 subsection 7c74 7e7 ,submission ( goals1 measures1 & mat]ials ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 & n less frequ5tly ?an annually !reaft] = ! foll[+ five ye>s1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives copies ( any goals1 p]=mance measures1 tra9+ mat]ials1 or outrea* mat]ials p]ta9+ to ! submission ( m$ical docum5tation "u ?is section4 #cah4 ,implem5tation ( & report on ef=ts ( ,dep>tm5t ( ,vet]ans ,affairs to improve heal? c>e appo9tm5t s*$ul+ 7a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! appropriate committees ( ,congress a plan to improve ! process = s*$ul+ appo9tm5ts = heal? c>e f ! ,dep>tm5t ( ,vet]ans ,affairs1 includ+ improvem5ts = bo? pati5ts & employees ( ! ,dep>tm5t responsible = s*$ul+ su* appo9tm5ts4 7b7 ,elem5ts ( plan 7#a7 ,9 g5]al ,! plan requir$ by subsection 7a7 %all include-- 7,a7 su* actions1 res\rces1 te*nology1 & process improvem5ts z ! ,secret>y det]m9es necess>y to ensure ! ,dep>tm5t a*ieves1 9 a timely mann]1 improv$ deliv]y ( heal? c>e1 access to heal? c>e1 cu/om] exp]i5ce & s]vice relat+ to ! receipt ( heal? c>e1 & effici5cy ) respect to ! deliv]y ( heal? c>e2 & 7,b7 a propos$ s*$ule & timel9e to c>ry out su* plan4 7#b7 ,objectives 7,a7 ,9 g5]al ,! ,secret>y %all ensure t ! plan requir$ by subsection 7a7 addresses ! foll[+ objectives3 7i7 ,to develop or cont9ue ! developm5t ( a s*$ul+ sy/em t enables bo? p]sonnel & pati5ts ( ! ,dep>tm5t to view available appo9tm5ts = c>e furni%$ by ! ,dep>tm5t1 includ+ prim>y c>e1 m5tal heal? c>e1 & all =ms ( specialty c>e4 7ii7 ,to develop or cont9ue ! developm5t ( a self-s]vice s*$ul+ plat=m1 available = use by all pati5ts ( ! ,dep>tm5t1 :i* %all-- 7,i7 enable su* pati5ts to view available appo9tm5ts &1 subject to ! process describ$ 9 clause 7iii71 fully s*$ule appo9tm5ts = all c>e furni%$ by ! ,dep>tm5t2 7,,ii7 if a ref]ral is requir$ = an appo9tm5t1 provide a me?od = ! pati5t to reque/ a ref]ral & subsequ5tly book an appo9tm5t if ! ref]ral is approv$2 & 7,,iii7 provide su* pati5ts ) ! ability to cancel or res*$ule appo9tm5ts4 7iii7 ,to create a process ?r\gh :i* all pati5ts ( ! ,dep>tm5t c telephonically speak ) a s*$ul] :o c assi/ ! pati5t to det]m9e appo9tm5t availability & c fully s*$ule appo9tm5ts on behalf ( ! pati5t = all c>e furni%$ by ! ,dep>tm5t4 7iv7 ,to c>ry out su* o!r functions1 ov]sight1 metric developm5t & track+1 *ange managem5t1 cross-,dep>tm5t coord9ation1 & o!r relat$ matt]s1 includ+ improvem5ts to employee-fac+ in=mation te*nology1 tra9+1 & processes1 z ! ,secret>y det]m9es appropriate z x relates to s*$ul+ tools1 functions1 & op]ations ) respect to heal? c>e appo9tm5ts furni%$ by ! ,dep>tm5t4 7,b7 ,explanation ( inability to implem5t c]ta9 objectives1 features1 or s]vices ,if ! ,secret>y det]m9es t an objective "u subp>agraph 7,a71 or any feature or s]vice 9 connection ) t objective1 _c be implem5t$ or o!rwise incorporat$ into a f9al product pursuant to ! plan requir$ by subsection 7a71 ! ,secret>y %all include ) ! plan submitt$ "u su* subsection a report conta9+-- 7i7 an explanation z to :y t objective1 feature1 or s]vice _c be implem5t$ or incorporat$1 z ! case may be2 & 7ii7 a plan = implem5t+ ! plan requir$ by subsection 7a7 )\t t objective1 feature1 or s]vice4 7c7 ,implem5tation ,n lat] ?an two ye>s aft] submitt+ to ! appropriate committees ( ,congress ! plan requir$ by subsection 7a71 ! ,secret>y %all fully implem5t ! plan4 7d7 ,coord9ation ) ,electronic ,heal? ,record ,mod]nization ,program ,9 develop+ ! plan requir$ by subsection 7a71 ! ,secret>y %all ensure t ! elem5ts & objectives ( su* plan set =? "u subsection 7b7 are develop$ 9 consid]ation ( ! deploym5t s*$ule & capabilities ( ! ,electronic ,heal? ,record ,mod]nization ,program ( ! ,dep>tm5t to ensure a smoo? transition to us+ ! tools & features "u su* plan z relevant & appropriate4 7e7 ,implem5tation reports ,n lat] ?an ea* ( "o ye> & two ye>s aft] ! date on :i* ! ,secret>y submits ! plan requir$ by subsection 7a71 ! ,secret>y %all submit to ! appropriate committees ( ,congress a report on ! progress ( ! ,secret>y 9 implem5t+ su* plan1 includ+-- 7#a7 ! co/s incurr$ to implem5t ! plan z ( ! date ( ! report2 7#b7 ! expect$ co/s to complete implem5tation ( ! plan 7includ+ co/s = managem5t & te*nology72 7#c7 ! s*$ule = deploym5t ( any capabilities develop$ pursuant to ! plan2 & 7#d7 ! goals & metrics a*iev$1 *all5ges1 & lessons le>n$ 9 implem5t+ ! plan4 7f7 ,rule ( con/ruction ,no?+ 9 ?is section %all be con/ru$ to require ! ,secret>y to include 9 ! plan requir$ by subsection 7a7 any te*nology or process t w\ld preclude or imp$e ! ability ( a vet]an to contact or s*$ule an appo9tm5t directly ) a facility or provid] ?r\gh a non-onl9e s*$ul+ process1 %\ld ! vet]an *oose to d s4 7g7 ,def9itions ,9 ?is section3 7#a7 ,appropriate committees ( ,congress ,! t]m appropriate committees ( ,congress means ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives4 7#b7 ,fully s*$ule ,! t]m fully s*$ule1 ) respect to an appo9tm5t = heal? c>e1 means t ! appo9tm5t book+ is complet$1 r ?an simply reque/$4 #cai4 ,pilot program on coord9ation ( c>e betwe5 ,dep>tm5t ( ,vet]ans ,affairs & ,m$ic>e program 7a7 ,9 g5]al ,! ,secret>y1 9 consultation ) ! ,secret>y ( ,heal? & ,human ,s]vices1 %all c>ry out a pilot program 79 ?is section ref]r$ to z ! pilot program7 to coord9ate1 navigate1 & manage c>e & b5efits = cov]$ vet]ans4 7b7 ,purposes ( pilot program ,! purposes ( ! pilot program are z foll[s3 7#a7 ,to improve access to heal? c>e s]vices = cov]$ vet]ans f ! ,dep>tm5t ( ,vet]ans ,affairs & "u ! ,m$ic>e program "u title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq474 7#b7 ,to improve satisfaction ) c>e receiv$ by cov]$ vet]ans4 7#c7 ,to improve quality ( c>e receiv$ by cov]$ vet]ans4 7#d7 ,to l[] co/s to ! ,f$]al ,gov]nm5t = c>e receiv$ by cov]$ vet]ans4 7#e7 ,to r$uce gaps 9 c>e & duplication ( s]vices & exp5ses = cov]$ vet]ans4 7#f7 ,to improve c>e coord9ation = cov]$ vet]ans1 includ+ coord9ation ( pati5t in=mation & m$ical records betwe5 provid]s & betwe5 ! ,dep>tm5t & ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices4 7c7 ,locations ,! ,secret>y %all c>ry out ! pilot program 9 n few] ?an ?ree b n m ?an five ,vet]ans ,integrat$ ,s]vice ,networks ) a significant numb] ( cov]$ vet]ans & geographic div]sity1 includ+-- 7#a7 locations t are 9 rural or highly rural areas1 z det]m9$ ?r\gh ! use ( ! ,rural-,urban ,cont9uum codes ( ! ,dep>tm5t ( ,agriculture2 & 7#b7 locations t are 9 m$ically und]s]v$ communities 7z def9$ 9 section #gii;,b ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #biep774 7d7 ,case manag] ,9 c>ry+ out ! pilot program1 ! ,secret>y %all assign ea* cov]$ vet]an p>ticipat+ 9 ! pilot program a case manag] responsible =-- 7#a7 coord9at+ ) ! vet]an1 ! prim>y c>e team ( ! vet]an1 & any relevant c>e coord9ators already assi/+ ! vet]an to develop an individualiz$ ne$s assessm5t = ! vet]an &1 bas$ on su* assessm5t1 a c>e coord9ation plan ) def9$ treatm5t goals2 & 7#b7 navigat+ ! sy/ems ( c>e "u ! laws adm9i/]$ by ! ,secret>y & "u ! ,m$ic>e program "u title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq474 7e7 ,use ( exi/+ models ,9 design+ ! pilot program1 ! ,secret>y may use exi/+ models us$ by comm]cial heal? c>e programs to improve access1 heal? outcomes1 quality1 & cu/om] exp]i5ce & l[] p] capita co/s4 7f7 ,contract+ ) private sector entities 7#a7 ,9 g5]al ,! ,secret>y1 to ! ext5t practicable1 %all consid] ent]+ into contracts or agreem5ts ) private sector entities c>ry+ out comm]cial heal? c>e programs = assi/ance 9 design+1 implem5t+1 & manag+ c>e & b5efits "u ! pilot program1 to include provid+ c>e coord9ation4 7#b7 ,notification ,if ! ,secret>y det]m9es t ent]+ into contracts or agreem5ts ) private sector entities "u p>agraph 7#a7 is n necess>y or practicable1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives-- 7,a7 a notification ( t det]m9ation2 7,b7 a description ( ! /eps1 if any1 ! ,secret>y has tak5 to attempt to ent] into a contract or an agreem5t ) a private sector entity2 7,c7 a ju/ification = :y ! ,secret>y has det]m9$ t su* contract or agreem5t is n necess>y or practicable2 & 7,d7 a plan = h[ ! ,secret>y w c>ry out ! pilot program )\t ent]+ into a contract or an agreem5t ) a private sector entity1 includ+ ?r\gh ! use ( employees ( ! ,dep>tm5t ( ,vet]ans ,affairs or o!r gov]nm5t ag5cies1 nonpr(it organizations1 or o!r entities4 7g7 ,metrics 7#a7 ,9 g5]al ,! ,secret>y %all track metrics "u ! pilot program1 includ+ ! foll[+3 7,a7 ,! numb] ( vet]ans p>ticipat+ 9 ! pilot program1 disaggregat$ by ,vet]ans ,integrat$ ,s]vice ,network4 7,b7 ,reliance on heal? c>e s]vices adm9i/]$ by ! ,secret>y4 7,c7 ,reliance on heal? c>e s]vices adm9i/]$ "u ! ,m$ic>e program "u title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq474 7,d7 ,quality ( c>e1 includ+ pati5t outcomes4 7,e7 ,co/ ( c>e4 7,f7 ,access to c>e1 includ+ "u ! designat$ access /&>ds develop$ by ! ,secret>y "u section #agjc;,b ( title #ch1 ,unit$ ,/ates ,code4 7,g7 ,pati5t satisfaction4 7,h7 ,provid] satisfaction4 7,i7 ,c>e coord9ation1 includ+ timely in=mation %>+ & m$ical docum5tation return4 7#b7 ,elem5ts ,9 track+ metrics "u p>agraph 7#a71 ! ,secret>y %all track in=mation relat+ to-- 7,a7 :e!r c>e receiv$ by a cov]$ vet]an is relat$ to a s]vice-connect$ disability 7z def9$ 9 section #aja ( title #ch1 ,unit$ ,/ates ,code72 7,b7 ! priority gr\p "u section #agje7;a7 ( title #ch1 ,unit$ ,/ates ,code1 ?r\gh :i* ea* cov]$ vet]an 0 enroll$ 9 ! sy/em ( annual pati5t enrollm5t ( ! ,dep>tm5t ( ,vet]ans ,affairs "u su* section2 7,c7 ! type ( c>e & s]vices provid$ to cov]$ vet]ans2 & 7,d7 ! demographics ( cov]$ vet]ans p>ticipat+ 9 ! pilot program1 includ+ age4 7h7 ,supplem5t n supplant ,! s]vices provid$ "u ! pilot program %all supplem5t1 n supplant1 ! s]vices provid$ "u ! education program "u section #aba ( ! ,,va ,,mission ,act ( #bjah 7,public ,law #aae-ahb2 #ch ,u4,s4,c4 #agja note74 7i7 ,duration ,! ,secret>y %all c>ry out ! pilot program = a ?ree-ye> p]iod beg9n+ on ! comm5cem5t ( ! pilot program4 7j7 ,reports 7#a7 ,developm5t1 implem5tation1 results1 & design ( pilot program 7,a7 ,9 g5]al ,n less frequ5tly ?an biannually dur+ ! two-ye> p]iod beg9n+ on ! 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 ! developm5t1 implem5tation1 results1 & design ( ! pilot program1 includ+ in=mation on ! metrics track$ "u subsection 7g74 7,b7 ,f9al design ,"o ( ! reports requir$ "u subp>agraph 7,a7 %all conta9 a description ( ! f9al design ( ! pilot program4 7#b7 ,results ( pilot program 7,a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! submission ( ! f9al report "u p>agraph 7#a71 & n less frequ5tly ?an annually !reaft] dur+ ! duration ( ! pilot program1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! results ( ! pilot program4 7,b7 ,f9al report ,9 ! f9al report submitt$ "u subp>agraph 7,a71 ! ,secret>y %all include ! recomm5dation ( ! ,secret>y = :e!r ! pilot program %\ld be ext5d$ or made p]man5t4 7k7 ,def9itions ,9 ?is section3 7#a7 ,cov]$ vet]an ,! t]m cov]$ vet]an means a vet]an :o is enroll$ 9 bo? ! ,m$ic>e program "u title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq47 & ! sy/em ( annual pati5t enrollm5t ( ! ,dep>tm5t ( ,vet]ans ,affairs "u section #agje7;a7 ( title #ch1 ,unit$ ,/ates ,code4 7#b7 ,secret>y ,! t]m ,secret>y means ! ,secret>y ( ,vet]ans ,affairs4 #cbj4 ,fi%] ,h\se availability ,section #agjh ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 9 subsection 7a71 by /rik+ 9 connection ) & all t foll[s ?r\gh ! p]iod at ! end & ins]t+ 9 accordance ) ?is section42 7#b7 9 subsection 7b7-- 7,a7 9 p>agraph 7#b7-- 7i7 by ins]t+ describ$ 9 p>agraph 7#a7 aft] family ( a vet]an2 & 7ii7 by ins]t+ su* aft] accompany2 & 7,b7 by add+ at ! end ! foll[+ new p>agraphs3 7#c7 ,on a space-available basis1 a cov]$ b5efici>y :o mu/ travel a significant di/ance to receive c>e or s]vices at a ,dep>tm5t or non-,dep>tm5t facility4 7#d7 ,on a space-available basis1 a memb] ( ! family ( a cov]$ b5efici>y describ$ 9 p>agraph 7#c7 & o!rs :o accompany su* a cov]$ b5efici>y :o is receiv+ c>e or s]vices & provide ! equival5t ( familial support = su* b5efici>y :5 ! cov]$ b5efici>y or ! family memb] is travel+ to receive c>e or s]vices at a ,dep>tm5t or non-,dep>tm5t facility4 7#e7 ,on a space-available basis1 a vet]an & a memb] ( ! family ( a vet]an & o!rs :o mu/ travel a significant di/ance = a memb] ( ! vet]an's family to receive c>e or s]vices at a ,dep>tm5t or non-,dep>tm5t facility4 7#f7 ,on a space available basis1 a cov]$ b5efici>y & a memb] ( ! family ( a cov]$ b5efici>y & o!rs :o mu/ travel a significant di/ance = a memb] ( ! cov]$ b5efici>y's family to receive c>e or s]vices at a ,dep>tm5t or non-,dep>tm5t facility4 2 7#c7 by /rik+ subsection 7c7 & r$esignat+ subsections 7d7 & 7e7 z subsections 7c7 & 7d71 respectively2 7#d7 9 subsection 7d71 z s r$esignat$-- 7,a7 9 p>agraph 7#b71 by /rik+ subsection 7d7 & ins]t+ subsection 7c72 7,b7 9 p>agraph 7#c71 by /rik+ "u subsection 7b77#b7 & ins]t+ or a cov]$ b5efici>y "u subsection 7b72 7,c7 9 p>agraph 7#d71 by /rik+ & aft] ! semicolon2 7,d7 by r$esignat+ p>agraph 7#e7 z p>agraph 7#f72 & 7,e7 by ins]t+ aft] p>agraph 7#d7 ! foll[+ new p>agraph 7#e73 7#e7 e/abli%+ crit]ia = provid+ access to tempor>y lodg+ facilities on a space-available basis "u p>agraphs 7#c7 ?r\gh 7#f7 ( subsection 7b72 & 2 & 7#e7 by add+ at ! end ! foll[+ new subsection3 7e7 ,9 ?is section3 7#a7 ,! t]m cov]$ b5efici>y means a memb] ( ! uni=m$ s]vices1 includ+ memb]s ( ! arm$ s]vices reg>dless ( duty /atus4 7#b7 ,! t]m ,fi%] h\se means a h\s+ facility t-- 7,a7 is locat$ at1 or 9 proximity to1 a ,dep>tm5t m$ical facility2 7,b7 is available = resid5tial use on a tempor>y basis by pati5ts ( t facility & o!rs describ$ 9 subsection 7b72 & 7,c7 is con/ruct$ by1 & donat$ to ! ,secret>y by1 ! ,za*>y & ,elizabe? ,m4 ,fi%] ,arm$ ,s]vices ,f\ndation or ! ,fi%] ,h\se ,f\ndation1 ,inc4 4 #cba4 ,agreem5ts betwe5 m$ical facilities ( ,dep>tm5t ( ,vet]ans ,affairs & rural m$ical facilities 7a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all comm5ce a #e-ye> pilot program to provide great] access to c>e = eligible vet]ans 9 rural areas & r$uce ! initial or long-t]m co/s to ! ,dep>tm5t or ! eligible entity ( provid+ su* c>e = eligible vet]ans4 7b7 ,pilot program ,9 c>ry+ out ! pilot program1 ! ,secret>y %all ensure t ea* m$ical c5t] ( ! ,dep>tm5t p>ticipat+ 9 ! pilot ent]s into or provides mat]ial support to an agreem5t ) an eligible entity relat$ to "o or m ( ! foll[+3 7#a7 ,co-location ( ,dep>tm5t & non- ,dep>tm5t heal? c>e res\rces4 7#b7 ,! provision ( teleheal? to eligible vet]ans by heal? c>e provid]s ( ! ,dep>tm5t4 7#c7 ,leas+ ( space or equipm5t by or f ! ,dep>tm5t4 7#d7 ,tra9+ by heal? c>e provid]s ( ! ,dep>tm5t ( non-,dep>tm5t heal? c>e provid]s1 subject to p>agraph 7#d74 7#e7 ,c>e coord9ation = au?oriz$ c>e furni%$ by ! eligible entity = eligible vet]ans4 7#f7 ,c>e coord9ation1 includ+ transportation coord9ation1 = em]g5cy treatm5t 7z def9$ 9 section #agbe7;h7 ( title #ch1 ,unit$ ,/ates ,code4 7#g7 ,! provision by ! eligible entity ( hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices "u section #agjc ( ?is title4 7#h7 ,su* o!r conditions or s]vices directly relat$ to heal? c>e z expressly au?oriz$ "u laws adm9i/]$ by ! ,secret>y4 7c7 ,types ( arrangem5ts ,an agreem5t "u subsection 7b7 may include a lease or co-location agreem5t1 a memor&um ( und]/&+1 a p>tn]%ip agreem5t1 a contract or agreem5t = ! mutual use or ex*ange ( use ( heal?-c>e res\rces1 or any o!r simil> agreem5t or arrangem5t4 7d7 ,report ,= ea* ye> ( ! pilot1 ! ,secret>y %all submit to ! appropriate committees ( ,congress a report on ! op]ation & p]=mance ( agreem5ts ent]$ into "u subsection 7a7 includ+-- 7#a7 new agreem5ts ent]$ into1 9 ! case ( ! initial report1 s9ce ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act1 &1 9 ! case ( any subsequ5t report1 dur+ ! p]iod foll[+ ! previ\s report2 7#b7 an assessm5t ( ! success ( all agreem5ts ent]$ into pursuant to ?is ,act 9 deliv]+ s]vices to eligible vet]ans1 includ+-- 7,a7 ! numb] ( eligible vet]ans1 by region1 :o receiv$ s]vices "u an agreem5t comp>$ to ! previ\s five-ye> p]iod2 7,b7 an evaluation ( accessibility to s]vices = eligible vet]ans z comp>$ to ! accessibility ( s]vices = ^? vet]ans prior to ! implem5tation ( su* agreem5ts2 7,c7 an ov]view ( be/ practices1 includ+ new be/ practices1 develop$ = su* agreem5ts & ! ,dep>tm5t m broadly2 7,d7 ! numb] ( vet]ans receiv+ comp5sation f ! ,dep>tm5t = a s]vice-connect$ disability1 disaggregat$ by region1 comp>$ to ! previ\s #e-ye> p]iod2 & 7,e7 su* o!r factors consid]$ appropriate by ! ,secret>y ( ,vet]ans ,affairs4 7e7 ,def9itions ,9 ?is section3 7#a7 ,appropriate committees ( congress ,! 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 7#b7 ,eligible entity ,! t]m eligible entity means a non-,dep>tm5t entity or provid] furni%+ heal? c>e or heal? c>e s]vices 9 a rural area4 7#c7 ,eligible vet]an ,! t]m eligible vet]an means a cov]$ vet]an "u section #agjc7;b7#af ( ?is title4 7#d7 ,mat]ial support ,! t]m mat]ial support means support provid$ by a heal? c>e provid] or o!r /aff ( ! ,dep>tm5t to fur!r ! purpose or purposes ( an agreem5t "u subsection 7a77#a7 & may include-- 7,a7 ! use ( "t or res\rces ( heal? c>e provid]s ( ! ,dep>tm5t2 7,b7 ! obligation or receipt ( funds2 & 7,c7 su* o!r support z ! ,secret>y det]m9es appropriate4 7#e7 ,rural ,! t]m rural1 ) respect to an area1 means ! area has a code o!r ?an #a or #a4a 9 ! ,rural-,urban ,commut+ ,areas 7,,ruca7 cod+ sy/em ( ! ,dep>tm5t ( ,agriculture4 #cbb4 ,/udy on quality ( c>e diff]5ce betwe5 m5tal heal? & addiction !rapy c>e provid$ by heal? c>e provid]s ( ,dep>tm5t ( ,vet]ans ,affairs comp>$ to non-,dep>tm5t provid]s 7a7 ,9 g5]al ,n lat] ?an #ij days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all seek to ent] into an agreem5t ) an indep5d5t & objective organization outside ! ,dep>tm5t ( ,vet]ans ,affairs "u :i* t organization %all-- 7#a7 conduct a /udy on ! quality ( c>e diff]5ce betwe5 m5tal heal? & addiction !rapy c>e "u ! laws adm9i/]$ by ! ,secret>y provid$ by heal? c>e provid]s ( ! ,dep>tm5t comp>$ to non-,dep>tm5t provid]s across v>i\s modalities1 su* z teleheal?1 9-pati5t1 int5sive out-pati5t1 out-pati5t1 & resid5tial treatm5t2 & 7#b7 submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & publi% on a publicly available website a report conta9+ ! f9al results ( su* /udy4 7b7 ,tim+ ,! ,secret>y %all ensure t ! organization ) :i* ! ,secret>y ent]s into an agreem5t pursuant to subsection 7a7 is able to complete ! requirem5ts "u su* subsection by n lat] ?an #ah mon?s aft] ! date on :i* ! agreem5t is ent]$ into4 7c7 ,elem5ts ,! report submitt$ pursuant to subsection 7a77#b7 %all include an assessm5t ( ! foll[+3 7#a7 ,! am\nt ( improvem5t 9 heal? outcomes f />t ( treatm5t to completion1 includ+ symptom scores & suicide risk us+ evid5ce-bas$ scales1 includ+ ! ,columbia-,suicide ,sev]ity ,rat+ ,scale4 7#b7 ,:e!r provid]s ( ! ,dep>tm5t & non-,dep>tm5t provid]s are us+ evid5ce-bas$ practices 9 ! treatm5t ( m5tal heal? & addiction !rapy c>e1 includ+ crit]ia set =? by ! ,am]ican ,society ( ,addiction ,m$ic9e4 7#c7 ,pot5tial gaps 9 coord9ation betwe5 provid]s ( ! ,dep>tm5t & non-,dep>tm5t provid]s 9 respond+ to individuals seek+ m5tal heal? or addiction !rapy c>e1 includ+ ! %>+ ( pati5t heal? records4 7#d7 ,implem5tation ( vet]an-c5tric c>e1 includ+ ! level ( satisfaction ( pati5ts ) c>e & ! compet5cy ( provid]s ) ! unique exp]i5ces & ne$s ( ! milit>y & vet]an population4 7#e7 ,:e!r vet]ans ) co-occurr+ conditions receive integrat$ c>e to holi/ically address _! ne$s4 7#f7 ,:e!r provid]s monitor heal? outcomes cont9ually ?r\gh\t treatm5t & at regul> int]vals = up to ?ree ye>s aft] treatm5t4 7#g7 ,! av]age l5g? ( "t to initiate s]vices1 :i* %all include a comp>ison ( ! av]age l5g? ( "t betwe5 ! initial po9t ( contact aft] pati5t outrea* to ! po9t ( initial s]vice1 z measur$ or det]m9$ by ! ,secret>y4 #cbc4 ,lactation spaces 9 m$ical c5t]s ( ! ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,9 g5]al ,sub*apt] ,,ii ( *apt] #ag ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new section3 #agbj,m4 ,lactation spaces 9 m$ical c5t]s ( ! ,dep>tm5t 7a7 ,lactation space requir$ ,! ,secret>y %all ensure t ea* m$ical c5t] ( ! ,dep>tm5t conta9s a lactation space4 7b7 ,no unau?oriz$ entry ,no?+ 9 ?is section %all be con/ru$ to au?orize an individual to ent] a m$ical c5t] ( ! ,dep>tm5t or portion !re( t ! individual is n o!rwise au?oriz$ to ent]4 7c7 ,lactation space def9$ ,9 ?is section1 ! t]m lactation space means a hygi5ic place1 o!r ?an a ba?room1 t-- 7#a7 is %ield$ f view2 7#b7 is free f intrusion2 7#c7 is accessible to disabl$ individuals 7includ+ su* individuals :o use :eel*airs72 7#d7 conta9s a *air & a work+ surface2 7#e7 is easy to locate2 7#f7 is cle>ly id5tifi$ ) signage2 & 7#g7 is available = use by wom5 vet]ans & memb]s ( ! public to express brea/ milk4 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( su* *apt] is am5d$ by ins]t+ aft] ! item relat$ to section #agbj,l ! foll[+ new item3 #agbj,m4 ,lactation spaces 9 m$ical c5t]s ( ! ,dep>tm5t4 4 7c7 ,implem5tation ,! ,secret>y ( ,vet]ans ,affairs %all ensure t-- 7#a7 n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ?is ,act1 n few] ?an #hj p]c5t ( m$ical c5t]s ( ! ,dep>tm5t ( ,vet]ans ,affairs are 9 compliance ) section #agbj,m ( title #ch1 ,unit$ ,/ates ,code1 z add$ by subsection 7a72 & 7#b7 n lat] ?an ?ree ye>s aft] su* date ( enactm5t1 all m$ical c5t]s ( ! ,dep>tm5t are 9 compliance ) su* section4 7d7 ,report 7#a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 & annually !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 on ! progress ( ! ,secret>y 9 meet+ ! requirem5ts "u section #agbj,m ( title #ch1 ,unit$ ,/ates ,code1 z add$ by subsection 7a71 includ+-- 7,a7 a li/ ( :i* m$ical c5t]s ( ! ,dep>tm5t ( ,vet]ans ,affairs curr5tly h a lactation space2 7,b7 a li/ ( :i* m$ical c5t]s ( ! ,dep>tm5t d n h a lactation space2 & 7,c7 = ea* m$ical c5t] li/$ "u subp>agraph 7,b71 a description ( actions ! ,dep>tm5t has tak5 to design & plan a lactation space & a timel9e = su* lactation space to be fully functional & op5 = use )9 ! "t p]iods specifi$ "u subsection 7c74 7#b7 ,t]m9ation ,! ,secret>y is n requir$ to submit a report "u p>agraph 7#a7 on or aft] ! date on :i* ! ,secret>y confirms 9 a report submitt$ "u su* p>agraph t ea* m$ical c5t] ( ! ,dep>tm5t conta9s a lactation space4 #cbd4 ,rese>* relat$ to m5opause1 p]im5opause1 & mid-life wom5's heal?3 report2 plan 7a7 ,def9itions ,9 ?is section3 7#a7 ,cov]$ provid] ,! t]m cov]$ provid] means a heal? c>e provid] employ$ by ! ,dep>tm5t ( ,vet]ans ,affairs4 7#b7 ,m5opause ,! t]m m5opause means ! /age ( a woman's life-- 7,a7 :5 m5/rual p]iods /op p]man5tly & %e c no long] get pregnant2 & 7,b7 t is n a disease /ate1 b a normal "p ( ag+ = wom54 7#c7 ,mid-life ,! t]m mid-life means a life /age t-- 7,a7 co9cides ) ! m5opausal transition 9 wom51 :i* may be physical or emotional2 7,b7 encompasses ! late reproductive age1 :i* c beg9 at approximately #ce ye>s ( age1 to ! late po/m5opausal /ages ( reproductive ag+1 :i* c ext5d to approximately #fe ye>s ( age2 & 7,c7 (t5 m>ks ! onset ( _m *ronic diseases4 7#d7 ,p]im5opause ,! t]m p]im5opause means ! "t dur+ a woman's life :5 levels ( ! hormone e/rog5 fall unev5ly 9 a woman's body & is also call$ ! m5opausal transition4 7#e7 ,po/m5opausal ,! t]m po/m5opausal means ! /age ( a woman's life aft] a woman has be5 )\t a m5/rual p]iod = #ab mon?s t la/s = ! re/ ( a woman's life & reflects a "t :5 wom5 are at increas$ risk = o/eoporosis & he>t disease4 7b7 ,evaluation ( c]ta9 rese>* relat$ to m5opause1 p]im5opause1 or mid-life wom5's heal? 7#a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs1 %all evaluate-- 7,a7 ! results ( complet$ rese>* relat$ to m5opause1 p]im5opause1 or mid-life wom5's heal? among wom5 :o are memb]s ( ! uni=m$ s]vices or vet]ans2 7,b7 ! /atus ( su* rese>* t is ongo+2 7,c7 any gaps 9 k & rese>* on-- 7i7 treatm5ts = m5opause-relat$ symptoms1 includ+ hormone & non-hormone treatm5ts2 7ii7 ! safety & effectiv5ess ( treatm5ts = m5opause-relat$ symptoms2 7iii7 ! impact ( p]im5opause & m5opause on ! m5tal heal? ( wom5 :o are memb]s ( ! uni=m$ s]vices or vet]ans2 7,d7 ! availability ( & uptake ( pr(essional tra9+ res\rces = cov]$ provid]s relat+ to mid-life wom5's heal? ) respect to ! c>e1 treatm5t1 & managem5t ( p]im5opause & m5opausal symptoms1 & relat$ support s]vices2 & 7,e7 ! availability ( & uptake ( treatm5ts = wom5 :o are memb]s ( ! uni=m$ s]vices or vet]ans :o are exp]i5c+ p]im5opause or m5opause4 7#b7 ,report2 /rategic plan ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ,congress a report conta9+-- 7,a7 ! f9d+s ( ! evaluation conduct$ "u p>agraph 7#a72 7,b7 recomm5dations = improv+ pr(essional tra9+ res\rces describ$ 9 p>agraph 7#a77;,d7 = cov]$ provid]s2 & 7,c7 a /rategic plan t-- 7i7 resolves ! gaps 9 k & rese>* id5tifi$ 9 ! report2 & 7ii7 id5tifies topics 9 ne$ ( fur!r rese>* relat+ to pot5tial treatm5ts = m5opause-relat$ symptoms ( wom5 :o are memb]s ( ! uni=m$ s]vices or vet]ans4 7#c7 ,nonduplication & supplem5tation ( ef=ts ,9 c>ry+ out activities "u ?is section1 ! ,secret>y ( ,vet]ans ,affairs %all ensure t su* activities m9imize duplication & supplem5t1 n supplant1 exi/+ in=mation-%>+ ef=ts ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices4 7c7 ,s5se ( ,congress on additional rese>* relat$ to m5opause1 p]im5opause1 or mid-life wom5's heal? ,x is ! s5se ( ,congress t ! ,secret>y ( ,def5se & ! ,secret>y ( ,vet]ans ,affairs %\ld ea* conduct rese>* relat$ to m5opause1 p]im5opause1 or mid-life heal? reg>d+ wom5 :o are memb]s ( ! uni=m$ s]vices or vet]ans4 #cbe4 ,pilot program on provision ( opioid rescue m$ications to vet]ans 7a7 ,9 g5]al ,comm5c+ n lat] ?an #abj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all c>ry out a "o-ye> pilot program "u :i* ! ,secret>y %all make cov]$ m$ications available to any vet]an at no *>ge 79 ?is section ref]r$ to z ! pilot program74 7b7 ,provision ( m$ication prior to confirmation ( /atus ,! ,secret>y may provide cov]$ m$ication to an individual "u ! pilot program prior to confirm+ ! /atus ( ! individual z a vet]an if ! individual provides contact in=mation = ! individual & a writt5 self-atte/ation ( vet]an /atus4 7c7 ,site selection ,! ,secret>y %all prioritize c>ry+ out ! pilot program 9 geographical areas :]e data indicates a disproportionately high risk ( ov]dose among ! vet]an population4 7d7 ,limitation on use ( in=mation 7#a7 ,9 g5]al ,9 c>ry+ out ?is section1 ! ,secret>y may only collect ! p]sonally id5tifiable in=mation ne$$ = prescrib+ cov]$ m$ication "u ! pilot program1 & any p]sonally id5tifiable in=mation collect$ "u ?is section may be us$ solely = ! purpose ( deliv]+1 evaluat+1 & enhanc+ ! quality ( heal? c>e4 7#b7 ,exclusion ,! ,secret>y may n use any p]sonally id5tifiable in=mation collect$ "u ?is section-- 7,a7 = ! purpose ( prev5t+ a vet]an f employm5t2 7,b7 z evid5ce ( a hi/ory ( drug use2 or 7,c7 z evid5ce t an individual is an unlawful us] ( or addict$ to any controll$ sub/ance4 7e7 ,provision ( in=mation ,! ,secret>y %all ensure t any individual :o receives cov]$ m$ication "u ! pilot program also receives-- 7#a7 in=mation ab\t addiction s]vices1 suicide prev5tion s]vices1 m5tal heal? s]vices1 & o!r relat$ s]vices provid$ by ! ,dep>tm5t ( ,vet]ans ,affairs2 & 7#b7 in=mation on ! use & application ( cov]$ m$ications4 7f7 ,report 7#a7 ,9 g5]al ,n lat] ?an #cj days be=e ! completion ( ! pilot program "u ?is section1 ! ,secret>y %all submit to ,congress a report on ! pilot program4 7#b7 ,elem5ts ,! report requir$ by p>agraph 7#a7 %all include ! foll[+3 7,a7 ,! numb] ( vet]ans :o receiv$ a cov]$ m$ication "u ! pilot program1 disaggregat$ by ^? enroll$ 9 ! sy/em ( annual pati5t enrollm5t ( ! ,dep>tm5t ( ,vet]ans ,affairs "u section #agje7;a7 ( title #ch1 ,unit$ ,/ates ,code1 & ^? n enroll$ 9 su* sy/em4 7,b7 ,an assessm5t ( ! feasibility ( exp&+ ! pilot program to provide cov]$ m$ications to imm$iate family memb]s ( vet]ans4 7,c7 ,any consid]ations associat$ ) cont9u+1 exp&+1 or mak+ p]man5t ! pilot program4 7,d7 ,any o!r recomm5dations ( ! ,secret>y ) respect to modify+ or cont9u+ ! pilot program4 7g7 ,def9itions ,9 ?is section3 7#a7 ,cov]$ m$ication ,! t]m cov]$ m$ication means any opioid ov]dose rescue m$ication1 su* z naloxone4 7#b7 ,vet]an ,! t]m vet]an has ! mean+ giv5 t t]m 9 section #aja ( title #ch1 ,unit$ ,/ates ,code4 #cbf4 ,e/abli%m5t ( ,vet]ans ,heal? ,adm9i/ration ,policy ,advisory ,commission 7a7 ,9 g5]al ,*apt] #a ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new section3 #abj4 ,vet]ans ,heal? ,adm9i/ration ,policy ,advisory ,commission 7a7 ,e/abli%m5t ,!re is e/abli%$ ! ,vet]ans ,heal? ,adm9i/ration ,policy ,advisory ,commission 79 ?is section ref]r$ to z ! ,commission74 7b7 ,memb]%ip 7#a7 ,composition ,! ,commission %all be compos$ ( #ag memb]s appo9t$ by ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates1 ( :i* n few] ?an #b %all be vet]ans4 7#b7 ,qualifications 7,a7 ,9 g5]al ,an individual is eligible = appo9tm5t to ! ,commission "u p>agraph 7#a7 if ! individual has significant exp]tise 9 op]at+ or advis+ l>ge m$ical sy/ems1 includ+ exp]tise 9 quality ( c>e1 /aff+ issues1 heal? in=mation te*nology1 artificial intellig5ce 9 heal? c>e1 m$ical rese>*1 & manag$ c>e plans & networks4 7,b7 ,exp]i5ce ( memb]s ,9 appo9t+ memb]s "u p>agraph 7#a71 ! ,comptroll] ,g5]al %all select individuals f backgr\nds t reflect ! broad div]sity ( heal? c>e receiv$ by vet]ans1 includ+ nonpr(it heal? sy/ems1 public & private heal? sy/ems1 c>e furni%$ by ! ,vet]ans ,heal? ,adm9i/ration1 & c>e furni%$ by ! ,dep>tm5t ( ,def5se4 7#c7 ,e?ical disclosure ,a memb] ( ! ,commission %all be consid]$ an employee ( ,congress ^: comp5sation is disburs$ by ! ,secret>y ( ! ,s5ate = purposes ( apply+ sub*apt] ,i ( *apt] #aca ( title #e1 ,unit$ ,/ates ,code1 except t a memb] ( ! ,commission is requir$ to file public f9ancial disclosure reports )\t reg>d to _! numb] ( days ( s]vice or rate ( pay4 7c7 ,p]iod ( appo9tm5t2 vacancies 7#a7 ,vacancies 7,a7 ,9 g5]al ,a vacancy on ! ,commission %all be fill$ 9 ! mann] 9 :i* ! orig9al appo9tm5t 0 made & %all be subject to any conditions t appli$ ) respect to ! orig9al appo9tm5t4 7,b7 ,fill+ unexpir$ t]m ,an individual *os5 to fill a vacancy %all be appo9t$ = ! unexpir$ t]m ( ! memb] replac$4 7#b7 ,expiration ( t]ms ,! t]m ( any memb] %all n expire be=e ! date on :i* ! memb]'s successor takes (fice4 7d7 ,meet+s 7#a7 ,frequ5cy ,! ,commission %all meet at ! call ( ! ,*airman1 b n less frequ5tly ?an once p] ye>4 7#b7 ,quorum ,a majority ( ! memb]s ( ! ,commission %all con/itute a quorum1 b a less] numb] ( memb]s may hold meet+s4 7e7 ,*airman & ,vice ,*airman ,! ,comptroll] ,g5]al %all designate "o memb] ( ! ,commission z ,*airman & "o memb] ( ! ,commission z ,vice ,*airman1 at ! "t ( appo9tm5t ( su* memb] & = ! t]m ( appo9tm5t ( su* memb]1 except t 9 ! case ( vacancy ( ! ,*airman%ip or ,vice ,*airman%ip1 ! ,comptroll] ,g5]al may designate ano!r memb] = ! rema9d] ( t memb]'s t]m4 7f7 ,duties ( ! ,commission 7#a7 ,review ,! ,commission %all-- 7,a7 review op]ations at ! ,vet]ans ,heal? ,adm9i/ration2 & 7,b7 prep>e reports = ,congress bas$ on su* review1 includ+ recomm5dations to ,congress4 7#b7 ,topics to be review$ ,9 conduct+ a review "u p>agraph 7#a77;,a71 ! ,commission %all include p]iodic reviews ( ! foll[+1 tak+ into consid]ation o!r indep5d5t assessm5ts 9 select+ topics to limit duplicative ef=ts3 7,a7 ,in=mation te*nology infra/ructure at m$ical facilities ( ! ,dep>tm5t1 includ+ ) respect to electronic heal? record sy/ems4 7,b7 ,ref]rals to c>e at facilities ( ! ,dep>tm5t & "u ! ,vet]ans ,community ,c>e ,program "u section #agjc ( ?is title1 & factors impact+ ^? ref]rals4 7,c7 ,access & wait times at m$ical facilities ( ! ,dep>tm5t & "u ! ,vet]ans ,community ,c>e ,program1 includ+ bo? prim>y & specialty c>e1 & factors impact+ ^? wait times4 7,d7 ,! quality ( heal? c>e furni%$ by ! ,dep>tm5t & ?r\gh ! ,vet]ans ,community ,c>e ,program4 7,e7 ,work=ce issues1 includ+ work=ce p]=mance1 recruitm5t1 & ret5tion factors4 7,f7 ,pati5t satisfaction & cu/om] s]vice at m$ical facilities ( ! ,dep>tm5t & ?r\gh ! ,vet]ans ,community ,c>e ,program4 7,g7 ,! tra9+ ( heal? c>e provid]s & ! /&>ds ( c>e at facilities ( ! ,dep>tm5t & 9 ! ,vet]ans ,community ,c>e ,program4 7,h7 ,! long-t]m budget>y outlook ( ! ,vet]ans ,heal? ,adm9i/ration1 z well z key compon5ts driv+ budget>y *anges ov] "t4 7,i7 ,! rese>* program ( ! ,dep>tm5t1 includ+ bo? int]nal & ext]nal rese>*4 7,j7 ,! int]action ( c>e "u ! ,m$ic>e program "u title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq471 ! ,m$icaid program "u title ,,xix ( su* ,act 7#db ,u4,s4,c4 #acif et seq471 ! ,,tric>e program "u *apt] #ee ( title #aj1 & comm]cial heal? c>e plans ) c>e furni%$ by ! ,vet]ans ,heal? ,adm9i/ration4 7#c7 ,use ( exi/+ data ,9 c>ry+ out ! requirem5ts ( ?is subsection1 ! ,commission1 to ! ext5t practicable1 %all use exi/+ data t has be5 compil$ by ! ,dep>tm5t1 compil$ = ! ,dep>tm5t1 or pur*as$ by ! ,dep>tm5t1 includ+-- 7,a7 data describ$ 9 subsection 7c77#a7 ( section #agjd;,a ( ?is title2 & 7,b7 ! results ( ! indep5d5t assessm5ts conduct$ "u su* section4 7#d7 ,issues reg>d+ vet]an heal? c>e deliv]y g5]ally ,9 c>ry+ out ! requirem5ts ( ?is subsection1 ! ,commission %all review ! effect ( policies "u ?is title on ! deliv]y ( heal? c>e s]vices to vet]ans & assess ! implications ( *anges 9 heal? c>e deliv]y = vet]ans "u ! laws adm9i/]$ by ! ,secret>y4 7#e7 ,transmittal ( c]ta9 reports ,if ! ,secret>y or ! ,inspector ,g5]al ( ! ,dep>tm5t ( ,vet]ans ,affairs submits to ,congress 7or a committee ( ,congress7 a report t is requir$ by law & t relates to policies = heal? c>e furni%$ "u ! laws adm9i/]$ by ! ,secret>y1 ! ,secret>y %all transmit a copy ( t report to ! ,commission4 7#f7 ,consultation & additional reviews & /udies 7,a7 ,consultation ,9 c>ry+ out ! requirem5ts ( ?is subsection1 ! ,commission %all consult p]iodically ) ! *airm5 & rank+ memb]s ( ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives reg>d+ ! ag5da ( ! ,commission & progress t[>ds a*iev+ t ag5da4 7,b7 ,additional reviews & reports ,! ,commission may conduct additional reviews1 & may submit additional reports to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives1 f "t to "t on su* topics relat+ to ! activities ( ! ,commission z may be reque/$ by ! ,*airman & memb]s & z ! ,commission det]m9es appropriate4 7,c7 ,special /udies ,! ,commission may conduct special /udies reque/$ by ! *airman or rank+ memb] ( ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate or ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & z ! ,commission det]m9es appropriate4 7#g7 ,coord9ation ,9 c>ry+ out reviews1 prep>+ reports1 & conduct+ /udies "u ?is section1 ! ,commission %all1 to ! ext5t practicable1 coord9ate ) ! ,inspector ,g5]al ( ! ,dep>tm5t to ensure ! "w ( ! ,commission does n int]f]e ) inve/igations or rem$iations und]way by ! ,inspector ,g5]al4 7#h7 ,budget>y consid]ations ,be=e mak+ any recomm5dations to ,congress1 ! ,commission %all exam9e ! budget consequ5ces ( su* recomm5dations1 directly or ?r\gh consultation ) appropriate exp]t entities4 7#i7 ,report 7,a7 ,9 g5]al ,by n lat] ?an ,m>* #ae ( ea* ye>1 ! ,commission %all submit to ,congress a report conta9+ ! results & recomm5dations f ! review conduct$ "u p>agraph 7#a74 7,b7 ,inclusion ( recomm5dations ,a recomm5dation may be includ$ 9 a report "u subp>agraph 7,a7 if a simple majority ( ! memb]s ( ! ,commission vote to include ! recomm5dation 9 ! report4 7#aj7 ,limitation ,no?+ 9 ?is section %all be con/ru$ to au?orize ! ,commission to direct1 control1 approve1 susp5d1 delay1 or adm9i/] any program1 policy1 contract1 p]sonnel action1 budget>y decision1 cl9ical decision1 or op]ational activity ( ! ,dep>tm5t4 ,! ,commission %all s]ve solely 9 an advisory capacity to ,congress & to ! ,dep>tm5t on matt]s expressly au?oriz$ "u laws adm9i/]$ by ! ,secret>y4 7g7 ,p[]s ( ,commission 7#a7 ,9 g5]al ,! ,commission may-- 7,a7 employ & fix ! comp5sation3 7i7 ( an ,executive ,director 7at a rate ( pay n great] ?an t provid$ = level ,,iii ( ! ,executive ,s*$ule "u section #ecad ( title #e7 :o is confirm$ by two ?irds vote by memb]s ( ! ,commission2 & 7ii7 o!r su* p]sonnel z may be necess>y to c>ry out ! duties ( ! ,commission1 )\t reg>d to ! provisions ( title #e gov]n+ appo9tm5ts 9 ! competitive s]vice2 7,b7 seek su* assi/ance & support z may be requir$ 9 ! p]=mance ( its duties f appropriate dep>tm5ts & ag5cies ( ! ,unit$ ,/ates or dep>tm5ts or ag5cies ( a ,/ate2 7,c7 ent] into a contract or conduct orig9al rese>* only ^u a writt5 det]m9ation by ! ,*air & ,vice ,*air t comp>able in=mation is unavailable1 insuffici5t1 or outdat$2 7,d7 make advance1 progress1 & o!r paym5ts t relate to ! "w ( ! ,commission2 7,e7 provide transportation & subsi/5ce = individuals s]v+ ! ,commission )\t comp5sation2 & 7,f7 prescribe su* rules & regulations z ! ,commission det]m9es necess>y ) respect to ! int]nal organization & op]ation ( ! ,commission4 7#b7 ,data collection ,9 ord] to c>ry out its functions1 ! ,commission %all-- 7,a7 utilize exi/+ in=mation1 bo? publi%$ & unpubli%$1 if possible1 collect$ & assess$ ei!r by its own /aff or "u o!r arrangem5ts made 9 accordance ) ?is section2 7,b7 to ! maximum ext5t practicable1 rely on exi/+ data1 reports1 audits1 evaluations1 & assessm5ts prep>$ by ! ,dep>tm5t1 ! ,inspector ,g5]al ( ! ,dep>tm5t1 ! ,gov]nm5t ,acc\ntability ,(fice1 ! ,congressional ,rese>* ,s]vice1 ! ,congressional ,budget ,(fice1 & o!r relevant ,f$]al entities be=e ent]+ into any contract or conduct+ orig9al rese>*2 & 7,c7 adopt proc$ures all[+ any int]e/$ p>ty to submit in=mation = use by ! ,commission 9 mak+ reports & recomm5dations4 7#c7 ,in=mation f ,f$]al ag5cies 7,a7 ,9 g5]al ,! ,commission may secure directly f any relevant dep>tm5t or ag5cy ( ! ,unit$ ,/ates heal? c>e in=mation ! ,*airman det]m9es w\ld be helpful to enable ! ,commission to c>ry out ?is section4 7,b7 ,tim+ ,^u reque/ ( ! ,*airman1 ! head ( a dep>tm5t or ag5cy ( ! ,unit$ ,/ates %all furni% in=mation reque/$ "u subp>agraph 7,a7 to ! ,commission on an agre$ ^u s*$ule or n lat] ?an #ahj days aft] ! date ( ! reque/4 7h7 ,comp5sation 7#a7 ,memb]s 7,a7 ,9 g5]al ,:ile conduct+ ! bus9ess ( ! ,commission 7includ+ travel "t71 a memb] ( ! ,commission %all be entitl$ to comp5sation at ! p] diem equival5t ( ! rate provid$ = level ,,iv ( ! ,executive ,s*$ule "u section #ecae ( title #e4 7,b7 ,travel exp5ses ,:ile conduct+ ! bus9ess ( ! ,commission away f home & ! regul> place ( bus9ess ( ! memb]1 a memb] may be all[$ travel exp5ses1 z au?oriz$ by ! ,*airman4 7#b7 ,physician comp>ability all[ance = p]sonnel ,! ,commission may provide a physician comp>ability all[ance to physicians s]v+ z p]sonnel ( ! ,commission 9 ! same mann] z physicians ( ! ,f$]al ,gov]nm5t may be provid$ su* an all[ance by an ag5cy "u section #eidh ( title #e1 & = su* purpose1 subsection 7i7 ( su* section %all apply to ! ,commission 9 ! same mann] z x applies to ! ,t5nessee ,valley ,au?ority4 7#c7 ,treatm5t ( p]sonnel ,= purposes ( pay 7o!r ?an pay ( memb]s ( ! ,commission7 & employm5t b5efits1 rights1 & privileges1 all p]sonnel ( ! ,commission %all be treat$ z if !y 7 employees ( ! ,unit$ ,/ates ,s5ate4 7i7 ,detail ( ,f$]al employees ,an employee ( ! ,f$]al ,gov]nm5t may be detail$ to ! ,commission )\t reimbursem5t & )\t int]ruption or loss ( civil s]vice /atus or privileges4 7j7 ,access ( congressional support ag5cies to in=mation ,! ,commission %all provide to ! ,comptroll] ,g5]al1 ! ,congressional ,rese>* ,s]vice1 & ! ,congressional ,budget ,(fice unre/rict$ access to all delib]ations1 records1 & nonpropriet>y data ( ! ,commission n lat] ?an #cj days aft] su* access is reque/$4 7k7 ,au?orization ( appropriations ,! ,commission %all submit reque/s = appropriations 9 ! same mann] z ! ,comptroll] ,g5]al submits reque/s = appropriations1 b am\nts appropriat$ = ! ,commission %all be sep>ate f am\nts appropriat$ = ! ,comptroll] ,g5]al4 7l7 ,t]m9ation 7#a7 ,! ,commission %all t]m9ate on ,septemb] #cj1 #bjcb4 7#b7 ,n lat] ?an #a ye> be=e ! date ( t]m9ation "u p>agraph 7#a71 ! ,commission %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a f9al assessm5t on :e!r ! ,commission %\ld be cont9u$1 modifi$1 or all[$ to t]m9ate4 7#c7 ,a memb] ( ! ,commission %all be appo9t$ "u subsection 7b77#a7 = a t]m ( #e ye>s1 except t ! ,comptroll] ,g5]al %all designate /agg]$ t]ms = ! memb]s fir/ appo9t$4 7#d7 ,no funds may be obligat$ by ! ,commission aft] ! date ( t]m9ation "u p>agraph 7#a71 except = activities necess>y to close out ! op]ations ( ! ,commission4 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( su* *apt] is am5d$ by ins]t+ aft] ! item relat+ to section #aai ! foll[+ new item3 #abj4 ,vet]ans ,heal? ,adm9i/ration ,policy ,advisory ,commission4 4 7c7 ,initial appo9tm5t ,n lat] ?an #bhj days aft] ! date on :i* am\nts are fir/ appropriat$ to ! ,vet]ans ,heal? ,adm9i/ration ,policy ,advisory ,commission e/abli%$ "u section #abj ( title #ch1 ,unit$ ,/ates ,code1 z add$ by subsection 7a71 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all make initial appo9tm5ts ( memb]s to ! ,commission "u subsection 7b77#a7 ( su* section4 #cbg4 ,access to heal? c>e 7a7 ,connection to ,vet]ans ,heal? ,adm9i/ration :5 a disability claim relat$ to milit>y sexual trauma is submitt$ to ,vet]ans ,b5efits ,adm9i/ration ,section #b ( ! ,,m/ ,claims ,coord9ation ,act 7,public ,law #aag-cjc2 #ch ,u4,s4,c4 #aaff note7 is am5d$-- 7#a7 9 subsection 7a77#a7-- 7,a7 9 subp>agraph 7,c71 by /rik+ 2 & & ins]t+ a semicolon2 & 7,b7 by /rik+ subp>agraph 7,d7 & ins]t+ ! foll[+3 7,d7 ! contact in=mation = ! ne>e/ milit>y sexual trauma coord9ator = ! vet]an at ! ,vet]ans ,b5efits ,adm9i/ration & a description ( ! assi/ance su* coord9ator c provide2 7,e7 ! contact in=mation = ! ne>e/ milit>y sexual trauma coord9ator = ! vet]an at ! ,vet]ans ,heal? ,adm9i/ration & a description ( ! assi/ance su* coord9ator c provide2 7,f7 ! types ( s]vices t individuals :o h exp]i5c$ milit>y sexual trauma are eligible to receive f ! ,dep>tm5t ( ,vet]ans ,affairs1 su* z m5tal heal? c\nsel+ f provid]s tra9$ 9 milit>y sexual trauma issues & pe] support s]vices1 includ+ ! ne>e/ locations :]e su* s]vices are furni%$1 includ+ ! ne>e/ ,readju/m5t ,c\nsel+ ,s]vice location1 & ! contact in=mation = ! provid]s ( su* s]vices2 & 7,g7 su* o!r in=mation on s]vices1 c>e1 or res\rces = milit>y sexual trauma z ! ,secret>y det]m9es appropriate4 2 & 7#b7 9 subsection 7d7-- 7,a7 9 p>agraph 7#c7-- 7i7 9 subp>agraph 7,b71 by /rik+ 2 & & ins]t+ a semicolon2 7ii7 9 subp>agraph 7,c71 by /rik+ ! p]iod & ins]t+ 2 &2 & 7iii7 by add+ at ! end ! foll[+3 7,d7 submitt+ a claim = disability comp5sation to ! ,vet]ans ,b5efits ,adm9i/ration = a disability relat+ to milit>y sexual trauma4 2 & 7,b7 by am5d+ p>agraph 7#e7 to read z foll[s3 7#e7 ,! t]m milit>y sexual trauma ) respect to eligibility = heal? c>e1 has ! mean+ giv5 su* t]m 9 section #aaff7;d77#b7 ( title #ch1 ,unit$ ,/ates ,code4 4 7b7 ,c>e relat+ to milit>y sexual trauma = individuals :o )draw f or o!rwise d n complete s]vice at s]vice academies 7#a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs1 9 coord9ation ) ! ,secret>y ( ,def5se1 ! ,secret>y ( ,homel& ,security1 & ! ,secret>y ( ,transportation1 %all ensure t ea* individual :o )draws f1 or o!rwise does n complete s]vice at1 a s]vice academy is provid$-- 7,a7 in=mation on ! pot5tial eligibility ( su* individual = c>e & c\nsel+ relat+ to milit>y sexual trauma provid$ ?r\gh ! ,dep>tm5t ( ,vet]ans ,affairs2 & 7,b7 ! option to receive copies (-- 7i7 ! individual's s]vice treatm5t records or milit>y p]sonnel records t docum5t milit>y sexual trauma2 7ii7 report+ =ms ( ! ,dep>tm5t ( ,def5se1 ! ,dep>tm5t ( ,homel& ,security1 or ! ,dep>tm5t ( ,transportation on sexual assault or sexual h>assm5t = :i* ! individual 0 ! victim2 & 7iii7 any inve/igative reports into milit>y sexual trauma t occurr$ dur+ ! individual's s]vice 9 ! ,arm$ ,=ces & = :i* ! individual 0 ! victim1 :i* are 9 ! possession ( ! ,dep>tm5t ( ,def5se1 ! ,dep>tm5t ( ,homel& ,security1 or ! ,dep>tm5t ( ,transportation4 7#b7 ,def9itions ,9 ?is subsection3 7,a7 ,milit>y sexual trauma ,! t]m milit>y sexual trauma has ! mean+ giv5 su* t]m 9 section #aaff7;d77#b7 ( title #ch1 ,unit$ ,/ates ,code4-- 7,b7 ,s]vice academy ,! t]m s]vice academy means any ( ! foll[+3 7i7 ,! ,unit$ ,/ates ,milit>y ,academy4 7ii7 ,! ,unit$ ,/ates ,naval ,academy4 7iii7 ,! ,unit$ ,/ates ,air ,=ce ,academy4 7iv7 ,! ,unit$ ,/ates ,coa/ ,gu>d ,academy4 7v7 ,! ,unit$ ,/ates ,m]*ant ,m>9e ,academy4 #cbh4 ,rese>* on heal? conditions ( desc5dants ( toxic-expos$ vet]ans 7a7 ,rese>* on diagnosis & treatm5t ( heal? conditions ( desc5dants ( individuals expos$ to toxic sub/ances :ile s]v+ 9 ,arm$ ,=ces 7#a7 ,contract or agreem5t ,! ,secret>y ( ,vet]ans ,affairs %all ent] into a contract or int]ag5cy agreem5t ) ! ,ag5cy = ,toxic ,sub/ances & ,disease ,regi/ry 79 ?is section ref]r$ to z ! ,ag5cy7 to p]=m ! s]vices cov]$ by ?is section4 7#b7 ,s]vices ,"u a contract or agreem5t betwe5 ! ,secret>y & ! ,ag5cy "u ?is section1 ! ,ag5cy %all-- 7,a7 conduct a lit]ature review on ! heal? effects on desc5dants ( toxic-expos$ vet]ans & toxic-expos$ memb]s ( ! ,arm$ ,=ces f _! toxic exposure & id5tify any gaps 9 k or rese>* on su* topic2 7,b7 n lat] ?an #ahj days aft] complet+ ! lit]ature review "u subp>agraph 7,a7 e/abli% & ma9ta9 a publicly available report ) in=mation on-- 7i7 ! f9d+s ( ! ,ag5cy ) respect to su* lit]ature review2 & 7ii7 ! ongo+ rese>* & activities direct$ by ! ,ag5cy1 includ+ a review ( all relevant data to det]m9e ! /r5g? ( evid5ce = a positive association betwe5 a heal? condition rese>*$ & a toxic exposure bas$ on ! categories set =? "u section #aagc7;c77#b7 ( title #ch1 ,unit$ ,/ates ,code2 & 7,c7 n lat] ?an #cj days aft] ! date on :i* ! fir/ review is publi%$ "u subp>agraph 7,b7 & n less frequ5tly ?an once e ye> !reaft]1 publi% a new report conta9+ ! in=mation made available "u clause 7ii7 ( su* subp>agraph4 7#c7 ,sunset ,on ! date t is #g ye>s aft] ! date ( enactm5t ( ?is ,act4 7#d7 ,lit]ature review 7,a7 ,9 g5]al ,9 c>ry+ out ! lit]ature review "u p>agraph 7#b77;,a71 ! ,ag5cy %all review available lit]ature to det]m9e ! association betwe5 milit>y toxic exposures & ! incid5ce or preval5ce ( bir? defects among ! desc5dants ( toxic-expos$ vet]ans & toxic-expos$ memb]s ( ! ,arm$ ,=ces4 7,b7 ,report ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,ag5cy %all submit to ! ,secret>y1 ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate1 & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report conta9+ ! f9d+s ( ! ,ag5cy ) respect to ! activities ( ! ,ag5cy "u p>agraph 7#b77;,a74 7,c7 ,plan 7i7 ,9 g5]al ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,ag5cy %all submit to ! ,secret>y & to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a plan describ+ ! ,ag5cy's propos$ approa* to c>ry+ out ! lit]ature review "u p>agraph 7#b77;,a74 7ii7 ,cont5ts ,! plan submitt$ pursuant to clause 7i7 %all include-- 7,i7 ! scope & key rese>* que/ions to be address$2 & 7,,ii7 ! me?odology to be us$ 9 id5tify+1 evaluat+1 & syn!siz+ relevant sci5tific & m$ical lit]ature4 7#e7 ,consultation ,! ,ag5cy %all c>ry out ! s]vices cov]$ by ?is subsection 9 consultation ) su* ,f$]al1 ,/ate1 & rese>* p>tn]s z ! ,ag5cy & ! ,secret>y jo9tly consid] appropriate4 7#f7 ,prohibition on expansion ( s]vices ,no?+ 9 ?is section %all be con/ru$ to au?orize ! expansion ( comp5sation or heal?c>e b5efits furni%$ by ! ,dep>tm5t to ! desc5dants ( memb]s ( ! ,arm$ ,=ces4 7b7 ,program = monitor+ heal? ( desc5dants ( vet]ans & memb]s ( ! ,arm$ ,=ces subject$ to toxic exposure 9 ! ,arm$ ,=ces 7#a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all use ! results ( ! lit]ature review conduct$ "u subsection 7a77#b77;,a7 to e/abli% a heal? monitor+ or scre5+ program = desc5dants ( toxic-expos$ vet]ans & toxic-expos$ memb]s ( ! ,arm$ ,=ces1 to assi/ 9 id5tify+ pot5tial patt]ns or signals1 support+ public heal? surveillance1 & facilitat+ epidemiologic & cl9ical rese>* relat$ to bir? defects4 7#b7 ,requirem5ts ,9 c>ry+ out ! program requir$ by p>agraph 7#a71 ! ,secret>y %all-- 7,a7 lev]age ,gov]nm5t data sets to improve ! program2 7,b7 recruit additional desc5dants2 7,c7 consult ) relevant /akehold]s to develop a /rategy to coord9ate collection ( in=mation "u ! program2 & 7,d7 ensure data f ! program is us$ to in=m basic rese>*1 translational rese>*1 & epidemiological /udies to help address data & k gaps id5tifi$ 9 ! lit]ature review conduct$ "u subsection 7a77#b77;,a74 7#c7 ,me*anisms = adm9i/ration ,! ,secret>y may adm9i/] ! program requir$ by p>agraph 7#a7 ei!r directly or ?r\gh su* me*anisms z ! ,secret>y consid]s appropriate1 su* z ?r\gh ! aw>d ( a grant or coop]ative agreem5t4 7#d7 ,collection ( in=mation ,9 adm9i/]+ ! heal? monitor+ program requir$ by p>agraph 7#a71 ! ,secret>y may collect1 process1 ma9ta91 & consolidate in=mation on bir? defects among desc5dants ( toxic-expos$ vet]ans & toxic-expos$ memb]s ( ! ,arm$ ,=ces1 includ+ biological samples1 environm5tal factors1 & p]sonal & social factors4 7#e7 ,consultation ,! ,secret>y %all c>ry out ! s]vices cov]$ by ?is section 9 consultation ) su* ,f$]al1 ,/ate1 & rese>* p>tn]s z ! ,dep>tm5t consid]s appropriate4 7#f7 ,sunset ,on ! date t is #g ye>s aft] ! date ( enactm5t ( ?is ,act4 7#g7 ,prohibition on expansion ( s]vices ,no in=mation collect$ by ?is program %all be us$ to in=m ! expansion ( comp5sation or heal?c>e b5efits furni%$ by ! ,dep>tm5t to ! desc5dants ( memb]s ( ! ,arm$ ,=ces1 unless o!rwise au?oriz$ by ano!r ,act ( ,congress on a date aft] ! passage ( ?is legislation4 7c7 ,def9itions ,9 ?is subsection3 7#a7 ,active milit>y1 naval1 air1 or space s]vice ,! t]m active milit>y1 naval1 air1 or space s]vice has ! mean+ giv5 su* t]m 9 section #aja ( title #ch1 ,unit$ ,/ates ,code4 7#b7 ,relevant /akehold]s ,! t]m relevant /akehold]s means-- 7,a7 public heal? exp]ts ) exp]i5ce 9 develop+ & ma9ta9+ regi/ries2 7,b7 epidemiologi/s ) exp]i5ce 9 /udy+ heal? effects ( toxic exposure on ! desc5dants ( toxic-expos$ vet]ans2 7,c7 desc5dants ( toxic-expos$ vet]ans2 & 7,d7 vet]ans s]vice organizations4 7#c7 ,toxic-expos$ memb] ( ! ,arm$ ,=ces ,! t]m toxic-expos$ memb] ( ! ,arm$ ,=ces means a memb] ( ! ,arm$ ,=ces :o 0 subject to a toxic exposure 9 l9e ( duty 9 ! active milit>y1 naval1 air1 or space s]vice4 7#d7 ,toxic-expos$ vet]an ,! t]m toxic-expos$ vet]an means a vet]an :o 0 subject to a toxic exposure 9 l9e ( duty 9 ! active milit>y1 naval1 air1 or space s]vice4 7#e7 ,toxic exposure ,! t]ms toxic exposure & toxic-expos$ vet]an h ! mean+s giv5 su* t]ms 9 section #aja ( title #ch1 ,unit$ ,/ates ,code4 #cbi4 ,vet]ans ,sp9al ,trauma ,access to ,new ,devices ,act ,section #agjf ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new subsection3 7d7 7#a7 ,9 manag+ ! provision ( hospital c>e & m$ical s]vices "u section #agaj7;a7 ( ?is title1 ! ,secret>y %all furni% 7?r\gh direct provision ( s]vice1 ref]ral1 or a teleheal? program op]at$ by ! ,dep>tm5t7 a prev5tative heal? evaluation annually to any vet]an ) a sp9al cord injury or disord] :o elects to und]go ! evaluation4 7#b7 ,! evaluation describ$ 9 p>agraph 7#a7 %all include ! foll[+3 7,a7 ,an assessm5t ( any circum/ance or condition ! vet]an is exp]i5c+ t indicates a risk = any heal? complication relat$ to ! sp9al cord injury or disord]1 includ+ a risk ( comorbidities4 7,b7 ,an assessm5t reg>d+ *ronic pa9 &1 if applicable1 ! managem5t ( *ronic pa94 7,c7 ,an assessm5t reg>d+ diet>y managem5t & weight managem5t4 7,d7 ,an assessm5t reg>d+ pro/hetic equipm5t1 includ+ :i* pro/hetic equipm5t ! vet]an ne$s1 h[ well any exi/+ pro/hetic equipm5t is function+ consid]+ ! ne$s ( ! vet]an1 & any safety conc]ns reg>d+ ! pro/hetic equipm5t 9 use by or recomm5d$ to ! vet]an4 7,e7 ,an assessm5t ) respect to ! provision ( assi/ive te*nology1 includ+ sp9al cord neuromodulation te*nology 7su* z non-invasive transcutane\s sp9al /imulation71 t c\ld help maximize ! vet]an's volunt>y motor or autonomic function1 indep5d5ce1 or mobility1 includ+ suitability = home use & ne$ = tra9+1 programm+1 & remote foll[-up4 7#c7 7,a7 ,9 ma9ta9+1 prescrib+1 or am5d+ any guidance1 rules1 or regulations issu$ by ! ,dep>tm5t reg>d+ ! requirem5ts set out 9 ?is subsection1 ! ,secret>y %all consult )-- 7i7 ! sp9al cord injury & disord] program manag]s ( ! ,dep>tm5t2 7ii7 cl9icians employ$ by ! ,dep>tm5t z speciali/s 9 sp9al cord injuries & disord]s2 7iii7 cl9icians & te*nologi/s ) demon/rat$ exp]tise 9 sp9al cord neuromodulation !rapies1 includ+ non-invasive transcutane\s approa*es2 & 7iv7 repres5tatives ( organizations recognzi$ "u section #eijb ( ?is title4 7,b7 ,be=e issu+ any guidance1 rules1 or regulations reg>d+ ! requirem5ts set out 9 ?is subsection1 ! ,secret>y %all consult ) manufactur]s ( assi/ive te*nologies & o!r entities relevant to ! provision ( assi/ive te*nologies if ! guidance1 rules1 or regulations w\ld directly affect su* manufactur]s or entities4 7,c7 ,! ,secret>y %all ensure1 to ! ext5t possible1 t any vet]an kn[n by ! ,secret>y to h a sp9al cord injury or disord] receives in=mation annually ab\t ! evaluation available "u ?is subsection & ! b5efits to ! vet]an ( *oos+ to und]go ! evaluation4 7#d7 ,z ! ,secret>y det]m9es cl9ically appropriate1 ! ,secret>y may provide tra9+1 programm+1 remote monitor+1 & foll[-up = assi/ive te*nologies ?r\gh teleheal?4 7#e7 ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act1 & e two ye>s !reaft]1 ! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ! ,h\se ( ,repres5tatives a report t includes ! foll[+3 7,a7 ,= ! p]iod cov]$ by ! report-- 7i7 ! numb] ( vet]ans :o-- 7,i7 receiv$ m$ical c>e or hospital s]vices f ! ,dep>tm5t & us$ an assi/ive te*nology2 7,,ii7 receiv$ m$ical c>e or hospital s]vices f ! ,dep>tm5t & 7 assess$ = ! provision ( an assi/ive te*nology2 & 7,,iii7 receiv$ m$ical c>e or hospital s]vices f ! ,dep>tm5t & 7 prescrib$ an assi/ive te*nology4 7ii7 = any assi/ive te*nology prescrib$1 an id5tification ( ! category ( su* te*nology1 includ+ sp9al cord neuromodulation1 & a summ>y ( functional outcomes associat$ ) ! prescription ( su* te*nology1 if available4 7,b7 ,! ye>-to-ye> *ange 7= ! p]iod cov]$ by ! report1 includ+ ! two ye>s imm$iately prior to ye> ! report is submitt$7 9 ! p]c5t ( vet]ans ) a sp9al cord injury or disord] :o receiv$ an evaluation "u ?is subsection4 7#f7 ,9 review+ ! p]=mance metrics ( a ,vet]ans ,integrat$ ,s]vice ,network = any ye> beg9n+ aft] ! date t is "o ye> aft] ! date ( ! enactm5t ( ! ,vet]ans ,sp9al ,trauma ,access to ,new ,devices ,act1 ! ,secret>y %all consid] ! provision ( evaluations "u p>agraph 7#a74 7#g7 ,9 ?is subsection1 ! t]m assi/ive te*nology means a p[]$ m$ical device or electronic tool us$ to treat or alleviate symptoms or conditions caus$ by a sp9al cord injury or disord]1 includ+ ! foll[+3 7,a7 ,a p]sonal mobility device1 includ+ a p[]$ exoskeleton device4 7,b7 ,a spee* g5]at+ device4 7,c7 ,a sp9al cord neuromodulation te*nology1 includ+ non-invasive transcutane\s sp9al /imulation us+ s5sory 7aff]5t7 pa?ways1 int5d$ to improve volunt>y motor function1 autonomic function1 indep5d5ce1 or quality ( life4 7,d7 ,:]e cl9ically appropriate1 & consi/5t ) ! pro/hetic & s5sory aids policies ( ! ,dep>tm5t1 an implantable sp9al cord /imulation sy/em t is approv$ by ! ,food & ,drug ,adm9i/ration4 4 #ccj4 ,dep>tm5t ( ,vet]ans ,affairs pilot program to aw>d grants = ! provision ( s]vice dogs to vet]ans 7a7 ,9 g5]al 7#a7 ,pilot program requir$ ,n lat] ?an #bd mon?s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all e/abli% a pilot program "u :i* ! ,secret>y %all aw>d grants1 on a competitive basis bas$ on ! application elem5ts li/$ 9 subsection 7b77#b71 to nonpr(it entities to provide s]vice dogs to eligible vet]ans4 7#b7 ,duration ,! ,secret>y %all c>ry out ! pilot program dur+ ! ?ree-ye> p]iod beg9n+ on ! date on :i* ! fir/ grant is aw>d$ "u ?is section4 7b7 ,applications 7#a7 ,9 g5]al ,to be eligible to receive a grant "u ?is section1 a nonpr(it entity %all submit an application to ! ,secret>y at su* "t & 9 su* mann] z ! ,secret>y may require4 7#b7 ,elem5ts ,an application submitt$ by a nonpr(it entity "u p>agraph 7#a7 %all include ! foll[+3 7,a7 ,a proposal = ! provision ( s]vice dogs to eligible vet]ans1 includ+ h[ ! nonpr(it entity w communicate ) ! ,secret>y to ensure an increas+ numb] ( s]vice dogs are provid$ to vet]ans4 7,b7 ,a description ( ! foll[+ s]vices or commitm5ts to be provid$ by ! nonpr(it entity3 7i7 ,! tra9+ t w be provid$ to eligible vet]ans4 7ii7 ,! tra9+ ( dogs t w s]ve z s]vice dogs4 7iii7 ,any additional support or s]vices t w be provid$ = su* dogs & eligible vet]ans4 7iv7 ,! plan = publiciz+ ! availability ( su* s]vice dogs ?r\gh a m>ket+ campaign t t>gets eligible vet]ans4 7v7 ,! commitm5t to h humane /&>ds = animals4 7vi7 ,! demon/rat$ exp]i5ce ( ! nonpr(it entity 9 tra9+ s]vice dogs 9 compliance ) ! requirem5ts ( ! ,am]icans ) ,disabilities ,act ( #aiij 7#db ,u4,s4,c4 #abaja et seq474 7c7 ,aw>d ( grants 7#a7 ,9 g5]al ,! ,secret>y %all aw>d a grant to ea* nonpr(it entity = :i* ! ,secret>y has approv$ an application submitt$ "u subsection 7b77#a74 7#b7 ,agreem5t requir$ ,be=e ! provision ( any grant am\nts to a nonpr(it entity select$ to receive a grant "u ?is section1 ! ,secret>y %all ent] into an agreem5t1 conta9+ su* t]ms1 conditions1 & limitations z ! ,secret>y det]m9es appropriate1 ) su* entity4 7#c7 ,maximum grant am\nt ,except z provid$ 9 subp>agraph 7,b71 a grant aw>d$ to a nonpr(it entity "u ?is section may n exce$ #b1jjj1jjj 9 a fiscal ye>4 7#d7 ,paym5ts ,! ,secret>y %all e/abli% int]vals ( paym5t = ! adm9i/ration ( ea* grant aw>d$ "u ?is section4 7d7 ,use ( funds 7#a7 ,9 g5]al 7,a7 ,requirem5t ,a recipi5t ( a grant "u ?is section %all use ! grant am\nts to plan1 develop1 implem5t1 & manage "o or m cov]$ programs4 7,b7 ,cov]$ program def9$ ,9 ?is p>agraph1 ! t]m cov]$ program means a program "u :i*-- 7i7 s]vice dogs are provid$ to p>ticipants 9 ! program2 & 7ii7 only eligible vet]ans are all[$ to p>ticipate 9 ! program4 7#b7 ,adm9i/rative exp5ses ,! ,secret>y may e/abli% a maximum am\nt = ea* grant aw>d$ "u ?is section t may be us$ by ! recipi5t ( ! grant to cov] adm9i/rative exp5ses4 7#c7 ,o!r conditions & limitations ,! ,secret>y may e/abli% o!r conditions or limitations on ! use ( grant am\nts "u ?is section4 7e7 ,requirem5ts = grant recipi5ts 7#a7 ,notifications & in=mation ,a recipi5t ( a grant "u ?is section %all-- 7,a7 notify ea* vet]an :o receives a s]vice dog ?r\gh su* grant t ! s]vice dog is be+ paid =1 9 :ole or 9 "p1 by ! ,dep>tm5t ( ,vet]ans ,affairs2 & 7,b7 in=m ea* su* vet]an ( ! b5efits & s]vices available f ! ,secret>y = ! vet]an & ! s]vice dog4 7#b7 ,prohibition on c]ta9 fees ,a recipi5t ( a grant "u ?is section may n *>ge a fee to a vet]an receiv+ a s]vice dog ?r\gh su* grant4 7f7 ,vet]9>y insurance 7#a7 ,9 g5]al ,! ,secret>y %all provide to ea* vet]an :o receives a s]vice dog ?r\gh a grant "u ?is section a comm]cially available vet]9>y insurance policy = ! s]vice dog4 7#b7 ,cont9uation ,if ! ,secret>y provides a vet]9>y insurance policy to a vet]an "u p>agraph 7#a71 ! ,secret>y %all cont9ue to provide ! policy to ! vet]an )\t reg>d to ! cont9uation or t]m9ation ( ! pilot program4 7g7 ,tra9+ & te*nical assi/ance ,! ,secret>y may provide tra9+ & te*nical assi/ance reg>d+ grant application & adm9i/ration to recipi5ts ( grants "u ?is section4 7h7 ,ov]sight & monitor+ ,! ,secret>y-- 7#a7 may require ea* recipi5t ( a grant "u ?is section to provide1 9 su* =m z may be prescrib$ by ! ,secret>y1 su* reports or answ]s 9 writ+ to specific que/ions1 surveys1 or que/ionnaires z ! ,secret>y det]m9es necess>y to c>ry out ! pilot program2 7#b7 %all e/abli% su* ov]sight & monitor+ requirem5t z ! ,secret>y det]m9es appropriate to ensure t grant am\nts aw>d$ "u ?is section are us$ appropriately2 & 7#c7 may take su* actions z ! ,secret>y det]m9es necess>y & accord+ to ! t]ms ( ! grant agreem5t to address any issues id5tifi$ ?r\gh ! en=cem5t ( su* requirem5ts4 7i7 ,def9itions ,9 ?is section3 7#a7 ,eligible vet]an ,! t]m eligible vet]an means a vet]an 7z def9$ 9 section #aja ( title #ch1 ,unit$ ,/ates ,code7 :o-- 7,a7 z det]m9$ by a physician1 has "o or m disabilities1 conditions1 or diagnoses describ$ 9 p>agraph 7#b72 & 7,b7 is enroll$ 9 ! sy/em ( annual pati5t enrollm5t ( ! ,dep>tm5t ( ,vet]ans ,affairs e/abli%$ & op]at$ "u section #agje7;a7 ( title #ch1 ,unit$ ,/ates ,code1 or is o!rwise entitl$ to receive su* c>e & s]vices "u subsection 7c77#b7 ( su* section4 7#b7 ,disability1 condition1 diagnosis describ$ ,a disability1 condition1 or diagnosis describ$ 9 ?is subp>agraph is any ( ! foll[+3 7,a7 ,bl9dness or visual impairm5t4 7,b7 ,loss ( use ( a limb1 p>alysis1 or o!r significant mobility issue4 7,c7 ,loss ( he>+4 7,d7 ,po/-traumatic /ress disord]4 7,e7 ,traumatic bra9 injury4 7,f7 ,any o!r disability1 condition1 or diagnosis = :i* ! ,secret>y det]m9es1 bas$ on m$ical judgm5t1 t x is optimal = ! vet]an to manage ! disability1 condition1 or diagnosis & live indep5d5tly ?r\gh ! assi/ance ( a s]vice dog4 7#c7 ,pilot program ,! t]m pilot program means ! pilot program requir$ by subsection 7a77#a74 7#d7 ,s]vice dog ,! t]m s]vice dog means any dog t is individually tra9$ to d "w or p]=m tasks t are-- 7,a7 = ! b5efit ( a vet]an ) a disability1 condition1 or diagnosis describ$ 9 p>agraph 7#a77;,b72 & 7,b7 directly relat$ to ! disability1 condition1 or diagnosis ( ! vet]an4 7j7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$ to c>ry out ?is section #aj1jjj1jjj = ea* ( ! ?ree consecutive fiscal ye>s beg9n+ ! fiscal ye> 9 :i* ! pilot program is e/abli%$ "u subsection 7a74 7k7 ,t]m9ation 7#a7 ,! au?ority to c>ry out a pilot program "u ?is section %all t]m9ate on ,septemb] #cj1 #bjbi4 7#b7 ,no funds may be obligat$ by ! ,secret>y to c>ry out a pilot program "u ?is section aft] ! date ( t]m9ation 9 p>agraph 7#a71 except = activities necess>y to close op]ations ( su* pilot program4 #cca4 ,au?orization ( major m$ical facility project ( ,dep>tm5t ( ,vet]ans ,affairs = fiscal ye> #bjbg 9 ,man*e/]1 ,new ,hamp%ire 7a7 ,au?orization ( major m$ical facility project ( ,dep>tm5t ( ,vet]ans ,affairs = fiscal ye> #bjbg 9 ,man*e/]1 ,new ,hamp%ire 7#a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all c>ry out a major m$ical facility project = ! replacem5t ( a m$ical c5t]1 a new c5tral utility plant1 a community liv+ c5t]1 a resid5tial rehabilitation treatm5t facility1 associat$ p>k+1 & demolition ( exi/+ build+s 9 ,man*e/]1 ,new ,hamp%ire4 7#b7 ,non-,dep>tm5t ,f$]al entity waiv] ,9 ord] to r$uce co/ & exp$ite timel9es1 ! ,secret>y may waive ! requirem5ts "u section #hajc7;e7 ( title #ch1 ,unit$ ,/ates ,code1 & section #ajif ( ! ,national ,def5se ,au?orization ,act = ,fiscal ,ye> #bjaf 7,public ,law #aad-ib2 #ch ,u4,s4,c4 #hajc note7 = a non-,dep>tm5t ,f$]al entity to be engag$ 9 project managem5t & o!r activities = ! project "u p>agraph 7#a74 7#c7 ,notification ,n lat] ?an #fj days aft] mak+ a waiv]1 modification1 or sub/itution relat+ to ! project "u subsection 7a71 includ+ a waiv] "u p>agraph 7#b71 ! ,secret>y %all submit to ! appropriate committees ( ,congress a notification describ+ ! waiv]1 modification1 or sub/itution & ! reason = su* waiv]1 modification1 or sub/itution4 7#d7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$ to ! ,secret>y ( ,vet]ans ,affairs = ! ,con/ruction1 ,major ,projects acc\nt #a1ahj1jjj1jjj = ! project "u p>agraph 7#a71 to rema9 available until exp5d$4 7#e7 ,appropriate committees ( ,congress def9$ ,9 ?is section ! 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 7b7 ,access to in=mation = m$ical facility con/ruction projects & leases 7#a7 ,9 g5]al ,sub*apt] ,i ( *apt] #ha ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by ins]t+ aft] section #hajf ! foll[+3 #hajg4 ,access to in=mation = m$ical facility con/ruction projects & leases 7a7 ,9 g5]al ,= any major con/ruction project1 lease1 or enhanc$-use lease = a m$ical facility ( ! ,dep>tm5t1 ! ,secret>y %all ensure t ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives are provid$ timely access to all in=mation1 records1 docum5ts1 data1 analyses1 communications1 contracts1 agreem5ts1 project s*$ules1 co/ e/imates1 memor&a1 brief+s1 reports1 & o!r mat]ials relat+ to ! project or lease4 7b7 ,prohibition on )hold+ in=mation ,! ,secret>y may n )hold in=mation "u subsection 7a7 f ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives solely on ! basis t ! in=mation is pr$ecisional1 delib]ative1 advisory1 procurem5t-s5sitive1 or subject to an int]nal policy or directive ( ! ,dep>tm5t4 4 7#b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( su* *apt] is am5d$ by ins]t+ aft] ! item relat+ to section #hajf ! foll[+ new item3 #hajg4 ,access to in=mation = m$ical facility con/ruction projects & leases4 4 #ccb4 ,b[el & bladd] c>e program ( ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,f9d+s2 ,s5se ( ,congress 7#a7 ,f9d+s ,congress f9ds ! foll[+3 7,a7 ,b[el c>e & bladd] c>e are supportive & necess>y m$ical s]vices = vet]ans ) sp9al cord injuries & disord]s :5 !y are unable to manage _! b[el & bladd] functions indep5d5tly4 7,b7 ,inadequate c>e w lead to complications & problems su* z autonomic dysreflexia t c be pot5tially life-?reat5+ & result 9 illness & hospitalization4 7,c7 ,b[el c>e & bladd] c>e are ess5tial to support vet]ans ) sp9al cord injuries & disord]s 9 non-in/itutional sett+s1 improve quality ( life1 optimize heal?1 & prev5t complications f neurog5ic b[el & bladd]4 7,d7 ,family c>egiv]s & individually employ$ c>egiv]s provide life-su/a9+ c>e = ! b[el & bladd] c>e ne$s ( vet]ans t all[ !m to live 9 _! communities4 7#b7 ,s5se ( ,congress ,x is ! s5se ( ,congress t-- 7,a7 family c>egiv]s & individually employ$ c>egiv]s %\ld n be subject$ to self-employm5t taxes & treat$ z v5dors or contractors = ! vet]ans to :om !y provide c>e2 7,b7 vet]ans %\ld n be =c$ to f9i% _! b[el & bladd] c>e ne$s 9 a set p]iod ( "t t does n consid] _! individual ne$s2 & 7,c7 vet]ans %\ld n be subject$ to ongo+ cl9ical det]m9ations reg>d+ _! b[el & bladd] c>e ne$s abs5t a decision by _! m$ical c>e provid] t su* c>e is no long] ne$$4 7b7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all e/abli% a program to address ! b[el & bladd] c>e ne$s ( cov]$ vet]ans 79 ?is section ref]r$ to z ! program74 7c7 ,provision ( c>e 7#a7 ,cl9ical ne$ ,! ,secret>y %all provide b[el & bladd] c>e "u ! program to cov]$ vet]ans bas$ on cl9ical ne$1 :i* may include cov]$ vet]ans receiv+ aid & att5dance b5efits f ! ,dep>tm5t ( ,vet]ans ,affairs4 7#b7 ,c>egiv] or ag5cy ,a cov]$ vet]an may receive b[el & bladd] c>e "u ! program ?r\gh a qualifi$ family memb]1 an individually employ$ c>egiv]1 or a contract$ home heal? ag5cy4 7#c7 ,individualiz$ assessm5t ,! ,secret>y %all conduct an individualiz$ assessm5t ) respect to a cov]$ vet]an to det]m9e ! numb] ( h\rs ( b[el & bladd] c>e ne$$ by su* vet]an "u ! program4 7#d7 ,d5ial ( c>e ,be=e d5y+ b[el & bladd] c>e = any cov]$ vet]an "u ! program1 ! ,secret>y %all fir/ obta9 review ( & concurr5ce ) respect to su* d5ial f a designat$ ,sp9al ,cord ,injuries & ,disord]s ,c5t] ( ! ,dep>tm5t4 7d7 ,coord9ation ( c>e & b5efits ,! ,secret>y %all ensure ! program is coord9at$ ) o!r programs & b5efits ( ! ,dep>tm5t = :i* ! cov]$ vet]an is eligible to ensure t cov]$ vet]ans & c>egiv]s receive appropriate support )\t duplicat+ b5efits or s]vices4 7e7 ,supportive m$ical tra9+ & qualifications 7#a7 ,9 g5]al ,! ,secret>y %all provide to ea* family memb] or individually employ$ c>egiv] provid+ c>e to a cov]$ vet]an "u ! program necess>y supportive m$ical tra9+ to p>ticipate 9 & receive paym5t by ! ,secret>y = ! provision ( su* c>e4 7#b7 ,qualifications ,! ,secret>y %all e/abli% su* requirem5ts1 conditions1 & qualifications = provid]s ( c>e "u ! program z necess>y to provide cl9ically appropriate b[el & bladd] c>e to cov]$ vet]ans & to ensure ! f9ancial & adm9i/rative integrity ( ! program4 7f7 ,paym5t 7#a7 ,9 g5]al ,! ,secret>y %all provide a mon?ly /ip5d to family memb]s & individually employ$ c>egiv]s & paym5t to contract$ home heal? ag5cies = c>e provid$ to cov]$ vet]ans "u ! program4 7#b7 ,limitation 7,a7 ,family memb]s & individually employ$ c>egiv]s ,! /ip5d = a family memb] or individually employ$ c>egiv] = c>e provid$ to a cov]$ vet]an "u ! program-- 7i7 %all be det]m9$ by ! ,secret>y2 7ii7 %all be bas$ on ! am\nt & degree ( assi/ance provid$2 & 7iii7 may n exce$ ! fif? /ep ( ! applicable grade ( ! ,g5]al ,s*$ule h\rly rate paid to nurs+ assi/ants :o provide su* c>e at ! m$ical facility ( ! ,dep>tm5t t is ne>e/ to ! resid5ce ( su* vet]an4 7,b7 ,home heal? ag5cies ,paym5t to a home heal? ag5cy = c>e provid$ to a cov]$ vet]an "u ! program may n exce$ ! paym5t rates ( ! ,dep>tm5t "u section #ag4djce ( title #ch1 ,code ( ,f$]al ,regulations 7relat+ to paym5t rates & me?odologies71 or successor regulations4 7g7 ,submission ( docum5tation ,family memb]s & individually employ$ c>egiv]s provid+ c>e to cov]$ vet]ans "u ! program %all provide su* docum5tation & in=mation 9 su* =mat & "u su* t]ms z ! ,secret>y may require z a condition ( receiv+ paym5t "u ! program4 7h7 ,cont9u$ p>ticipation 9 program ,if a cov]$ vet]an has be5 m$ically det]m9$ to require c>e "u ! program = a cont9u\s p]iod ( ?ree ye>s or m1 ! vet]an is deem$ to require su* c>e = life or until su* "t z ! m$ical provid] = su* vet]an det]m9es ! s]vice is no long] ne$$4 7i7 ,n v5dors or contractors ,family memb]s & individually employ$ c>egiv]s provid+ c>e to cov]$ vet]ans "u ! program %all n be consid]$ v5dors or contractors = purposes ( ! program4 7j7 ,limitation ,c>e may n be provid$ "u ! program to a vet]an :o c p]=m ! b[el & bladd] functions ( ! vet]an )\t assi/ance4 7k7 ,cov]$ vet]an def9$ ,9 ?is section1 ! t]m cov]$ vet]an means a vet]an :o-- 7#a7 is enroll$ 9 ! sy/em ( annual pati5t enrollm5t ( ! ,dep>tm5t ( ,vet]ans ,affairs e/abli%$ & op]at$ "u section #agje7;a7 ( title #ch1 ,unit$ ,/ates ,code2 7#b7 has a sp9al cord injury or disord]2 & 7#c7 is dep5d5t ^u o!rs = b[el & bladd] c>e :ile resid+ 9 non-in/itutional sett+s4 ,,iv ,organization #dja4 ,au?orization ( appropriations to ! ,(fice ( ,in=mation & ,te*nology ( ! ,dep>tm5t ( ,vet]ans ,affairs = c]ta9 purposes 7a7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$1 & !re is appropriat$1 to ! ,secret>y ( ,vet]ans ,affairs #ejj1jjj1jjj = fiscal ye> #bjbf1 to rema9 available until ,septemb] #cj1 #bjca1 = deposit into ! acc\nts ( ! ,(fice ( ,in=mation & ,te*nology ( ! ,dep>tm5t ( ,vet]ans ,affairs = ! purposes describ$ 9 subsection 7b74 7b7 ,use ( funds ,funds %all be allocat$ & exp5d$ only z foll[s3 7#a7 #aej1jjj1jjj = ,ent]prise ,logi/ics & ,supply ,*a9 ,visibility -- ,to develop & deploy integrat$1 real-"t ent]prise-wide logi/ics sy/ems1 inv5tory visibility1 ph>maceutical track+1 & m$ical supply *a9 resili5cy capabilities4 ,^! sy/ems %all support bo? r\t9e vet]an c>e op]ations & #d? ,mission m$ical surge1 pati5t movem5t1 & em]g5cy di/ribution requirem5ts 9 consultation ) ,do,d1 ,,fema1 & o!r ag5cies4 7#b7 #bjj1jjj1jjj = ,cyb]security & ,op]ational ,resili5cy -- ,= z]o tru/ ar*itecture implem5tation1 ?reat detection1 secure cl\d h>d5+1 endpo9t protection1 cont9uity ( op]ations 7,,coop7 plat=ms1 & protection ( mission-ess5tial sy/ems aga9/ cyb] & physical disruptions4 ,funds %all prioritize high-risk legacy sy/ems & m$ical device security4 7#c7 #aej1jjj1jjj = ,resili5t ,communications & ,digital ,records ,mod]nization -- ,= int]op]able1 survivable communications infra/ructure & t>get$ digitization_/automation ( high-volume pap]-bas$ workfl[s 7claims1 correspond5ce1 adm9i/rative records7 to r$uce fraud risk & improve cont9uity dur+ degrad$ or em]g5cy environm5ts4 ,funds %all n be us$ = broad ,electronic ,heal? ,record ,mod]nization expansion4 7c7 ,ov]sight & protection ( s5sitive in=mation 7#a7 ,! ,secret>y may obligate & exp5d am\nts "u ?is section 9 classifi$1 controll$1 or protect$ environm5ts consi/5t ) applicable law4 7#b7 ,n lat] ?an #ij days aft] ! date ( enactm5t ( ?is ,act1 & annually !reaft] until ,septemb] #cj1 #bjca1 ! ,secret>y %all provide to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a brief+ & report on-- 7,a7 activities c>ri$ out us+ funds made available "u ?is section2 7,b7 progress on improv+ cyb]security1 resili5cy1 cont9uity1 logi/ics1 communications1 digitization1 & mission assurance capabilities2 & 7,c7 coord9ation ) o!r ,f$]al ag5cies1 z appropriate4 ,su* reports may include a classifi$ annex4 7#c7 ,detail$ implem5tation plan & qu>t]ly brief+s 7,a7 ,n lat] ?an #ij days aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y1 act+ ?r\gh ! ,(fice ( ,in=mation & ,te*nology1 %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a compreh5sive implem5tation plan4 ,! plan %all include-- 7i7 specific mile/ones1 deliv]ables1 & p]=mance metrics = ea* category ( activities 9 subsection 7b72 7ii7 a z]o tru/ ar*itecture /rategy ) timel9es & te*nical requirem5ts2 7iii7 a detail$ exp5diture plan by fiscal qu>t] & by activity category2 &7iv7 any propos$ int]ag5cy or private-sector p>tn]%ips4 7,b7 ,n lat] ?an #cj days aft] ! end ( ea* fiscal qu>t] ?r\gh ,septemb] #cj1 #bjca1 ! ,secret>y %all provide ! ,committees a brief+ & writt5 report on-- 7i7 obligations & exp5ditures to date1 by category2 7ii7 progress aga9/ ! implem5tation plan2 7iii7 any deviations f ! plan & corrective actions2 & 7iv7 updat$ projections = rema9+ funds4 ,! initial brief+ %all be 9 p]son2 subsequ5t brief+s may be virtual unless o!rwise reque/$ by ! ,committees4 ,reports may include a classifi$ annex4 7d7 ,limitation ,funds made available "u ?is section may n be us$ = any purpose unrelat$ to in=mation te*nology mod]nization1 cyb]security1 op]ational resili5ce1 logi/ics mod]nization1 communications mod]nization1 digitization1 or fraud prev5tion activities ( ! ,dep>tm5t4 7e7 ,supplem5t1 n supplant ,am\nts made available "u ?is section %all supplem5t & n supplant o!r am\nts o!rwise au?oriz$ to be appropriat$ = ! ,(fice ( ,in=mation & ,te*nology ( ! ,dep>tm5t ( ,vet]ans ,affairs4 7f7 ,rule ( con/ruction ,no?+ 9 ?is section %all be con/ru$ to require ! public disclosure ( classifi$ in=mation1 controll$ unclassifi$ in=mation1 op]ational details1 cyb]security ar*itecture1 cont+5cy plann+ in=mation1 mission-ess5tial sy/em design1 or in=mation o!rwise protect$ f disclosure "u ,f$]al law or ,executive ,ord]4 7g7 ,reau?orization & sunset 7#a7 ,reau?orization requir$ ,! au?ority provid$ "u ?is section to obligate or exp5d am\nts appropriat$ pursuant to subsection 7a7 %all t]m9ate on ,septemb] #cj1 #bjca1 unless subsequ5tly reau?oriz$ by law4 7#b7 ,limitation on new obligations aft] sunset ,beg9n+ on ,octob] #a1 #bjca1 ! ,secret>y may n initiate1 aw>d1 ent] into1 r5ew1 ext5d1 or o!rwise obligate funds = any new program1 project1 activity1 contract1 task ord]1 or op]ational capability c>ri$ out pursuant to ?is section unless expressly au?oriz$ by a subsequ5t ,act ( ,congress4 7#c7 ,cont9uation ( exi/+ activities ,no?+ 9 p>agraph 7#b7 %all be con/ru$ to prohibit ! ,secret>y f-- 7,a7 ma9ta9+1 su/a9+1 secur+1 op]at+1 complet+1 or support+ any program1 project1 activity1 contract1 sy/em1 plat=m1 infra/ructure capability1 or op]ational activity lawfully initiat$ us+ am\nts obligat$ be=e ,septemb] #cj1 #bjca2 or 7,b7 c>ry+ out simil> in=mation te*nology mod]nization1 cyb]security1 cont9uity ( op]ations1 logi/ics mod]nization1 communications mod]nization1 op]ational resili5cy1 or mission assurance activities us+ am\nts o!rwise au?oriz$ & appropriat$ "u any o!r provision ( law4 7h7 ,use ( exi/+ contract+ au?orities ,! ,secret>y %all c>ry out ! activities au?oriz$ "u ?is section1 to ! maximum ext5t practicable1 ?r\gh contracts1 task ord]s1 deliv]y ord]s1 int]ag5cy agreem5ts1 coop]ative agreem5ts1 or o!r agreem5ts ent]$ into "u exi/+ au?orities ( title #ch1 ,unit$ ,/ates ,code1 z applicable4 ,am\nts made available "u ?is section %all n be us$ to e/abli% a new full-"t equival5t position1 hire additional employees ( ! ,dep>tm5t1 or o!rwise increase ! numb] ( full-"t equival5t employees ( ! ,dep>tm5t1 except to ! ext5t ! ,secret>y det]m9es t su* p]sonnel are necess>y = ! ov]sight1 managem5t1 cyb]security sup]vision1 acquisition adm9i/ration1 or op]ational integration ( activities c>ri$ out "u ?is section4 #djb4 ,e/abli%m5t ( ,"u ,secret>y = ,managem5t & ,*ief ,f9ancial ,(fic] 7a7 ,*ief ,f9ancial ,(fic]2 ,(fice ( ,budget ,section #cji ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ to read z foll[s3 #cji4 ,"u ,secret>y = ,managem5t & ,*ief ,f9ancial ,(fic] 7a7 ,"u ,secret>y = ,managem5t & ,*ief ,f9ancial ,(fic] 7#a7 ,! ,"u ,secret>y = ,managem5t & ,*ief ,f9ancial ,(fic] %all be ! pr9cipal managem5t & f9ancial (fic] ( ! ,dep>tm5t4 7#b7 ,! ,"u ,secret>y %all report directly to ! ,secret>y4 7#c7 ,! ,"u ,secret>y %all s]ve z ! ,*ief ,f9ancial ,(fic] ( ! ,dep>tm5t = purposes ( *apt] #i ( title #ca4 7#d7 ,! ,"u ,secret>y %all ex]cise au?ority1 direction1 & control ov] ! ,(fice ( ,budget & su* o!r (fices z may be assign$ by law or by ! ,secret>y4 7b7 ,duties ,! duties ( ! ,"u ,secret>y include ! foll[+3 7#a7 ,to advise ! ,secret>y on f9ancial managem5t ( ! ,dep>tm5t4 7#b7 ,to =mulate1 ju/ify1 execute1 ov]see1 & c]tify ! budget ( ! ,dep>tm5t4 7#c7 ,to control1 acc\nt =1 audit1 & report on ! f9ances ( ! ,dep>tm5t4 7#d7 ,to coord9ate & assi/ ! ,*ief ,acquisition ,(fic] ) ! life cycle ( major acquisition programs ( ! ,dep>tm5t4 7#e7 ,to ex]cise ! au?ority & c>ry out ! functions specifi$ 9 section #ijb ( title #ca4 7#f7 ,to ensure compliance ) sections #acda1 #acdb1 #acdi1 #acej1 & #aeaa ?r\gh #aeai ( title #ca4 7#g7 ,to provide to ,congress1 or a congressional committee ^u reque/1 in=mation reg>d+ ! budget1 f9ances1 & fiscal condition ( ! ,dep>tm5t4 7#h7 ,to s]ve z ! head ( ! ,(fice ( ,budget ( ! ,dep>tm5t4 7#i7 ,to e/abli% & ov]see ,dep>tm5t-wide f9ancial managem5t policies1 acc\nt+ sy/ems1 int]nal controls1 ent]prise risk managem5t programs1 /rategic plann+ processes1 & capital plann+ activities4 7#aj7 ,to ov]see infra/ructure inve/m5t plann+1 f9ancial sy/ems mod]nization1 & bus9ess trans=mation initiatives ( ! ,dep>tm5t4 7c7 ,deputy ,assi/ant ,secret>y 7#a7 ,!re is 9 ! ,dep>tm5t a ,deputy ,assi/ant ,secret>y = ,infra/ructure & ,con/ruction4 7#b7 ,su* ,deputy ,assi/ant ,secret>y %all be a c>e] appo9tee 7z t t]m is def9$ 9 section #cacb7;a7 ( title #e7 )9 ! ,s5ior ,executive ,s]vice ( ! ,dep>tm5t4 7d7 ,(fice ( ,infra/ructure & ,con/ruction ,!re is an ,(fice ( ,infra/ructure & ,con/ruction 9 ! ,dep>tm5t4 7e7 ,budget & ,appropriations ,affairs ,(fice 7#a7 ,!re is )9 ! ,(fice ( ,managem5t a ,budget & ,appropriations ,affairs ,(fice 79 ?is subsection ref]r$ to z ! ,,baa (fice74 ,! ,und]secret>y %all appo9t a head ( ! ,,baa ,(fice :o %all report exclusively to ! ,und]secret>y4 7#b7 ,! sole function ( ! ,,baa ,(fice is to provide to ,congress 7or a congressional committee71 accurate1 timely1 & c]tifi$ in=mation reg>d+ ! f9ances & budget ( ! ,dep>tm5t4 7#c7 ,congress or a congressional committee may submit a reque/ = in=mation describ$ 9 p>agraph 7#b7 directly to ! ,,baa ,(fice4 7#d7 ,p>agraphs 7#b7 & 7#c7 not)/&+1 ! ,assi/ant ,secret>y = ,congressional & ,legislative ,affairs may facilitate & transmit responses to reque/s describ$ 9 p>agraph 7#c7 t are submitt$ to ! ,,baa ,(fice4 ,any response conta9+ in=mation describ$ 9 p>agraph 7#b7 %all be prep>$ & c]tifi$ by ! ,,baa ,(fice & may n be alt]$1 delay$1 )held1 edit$1 or modifi$ by any o!r (fic] or employee ( ! ,dep>tm5t prior to transmission to ,congress or a congressional committee4 7#e7 ,n m ?an six full-"t equival5t employees1 includ+ sup]visors1 may be assign$ to ! ,,baa ,(fice4 7f7 ,limitation on au?ority to appo9t ,! ,secret>y may n e/abli% an employee position-- 7#a7 t p]=ms a function sub/antially simil> to ! function ( ! ,budget & ,appropriations ,affairs ,(fice e/abli%$ "u section #cji7;e72 & 7#b7 t is n )9 ! ,(fice ( ,managem5t4 7g7 ,transf] ( functions 7#a7 ,all functions1 p[]s1 duties1 au?orities1 responsibilities1 p]sonnel1 prop]ty1 records1 contracts1 delegations1 directives1 regulations1 adm9i/rative actions1 & unobligat$ balances ( appropriations relat+ to ! ,*ief ,f9ancial ,(fic] ( ! ,dep>tm5t imm$iately be=e ! effective date ( ?is ,act are transf]r$ to ! ,"u ,secret>y = ,managem5t & ,*ief ,f9ancial ,(fic]4 7#b7 ,any delegation1 det]m9ation1 rule1 regulation1 ord]1 p]mit1 contract1 agreem5t1 c]tification1 or o!r adm9i/rative action 9 effect imm$iately be=e ! effective date ( ?is ,act %all cont9ue 9 effect accord+ to its t]ms until modifi$1 sup]s$$1 t]m9at$1 or revok$4 7g7 ,ref]5ces ,any ref]5ce 9 any law1 regulation1 rule1 directive1 delegation1 contract1 agreem5t1 det]m9ation1 record1 or o!r (ficial docum5t ( ! ,unit$ ,/ates to ! ,*ief ,f9ancial ,(fic] ( ! ,dep>tm5t %all be deem$ to ref] to ! ,"u ,secret>y = ,managem5t & ,*ief ,f9ancial ,(fic]4 4 7b7 ,te*nical & con=m+ am5dm5ts 7#a7 ,! table ( sections = *apt] #c ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ accord+ly4 7#b7 ,! ,secret>y %all make su* additional te*nical & con=m+ am5dm5ts to regulations1 directives1 delegations1 organizational *>t]s1 manuals1 & int]nal guidance z may be necess>y to c>ry out ?is ,act4 #djc4 ,dep>tm5t ( ,vet]ans ,affairs acquisition re=m & co/ assessm5t 7a7 ,dep>tm5t ( ,vet]ans ,affairs acquisition organization 7#a7 ,def9itions ,*apt] #ha ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by ins]t+ aft] sub*apt] ,,vi ! foll[+ new sub*apt]3 ,,vii ,acquisition ,organization1 ,co/ ,assessm5t1 & ,program ,evaluation #haha4 ,def9ition ( major acquisition program ,9 ?is sub*apt]1 ! t]m major acquisition program means a program ( ! ,dep>tm5t to acquire s]vices1 supplies1 te*nology1 sy/ems1 or a comb9ation !re(1 ) an e/imat$ total program co/1 e/imat$ by ! ,secret>y1 t exce$s-- 7#a7 #a1jjj1jjj1jjj 7adju/$ pursuant to section #aijh ( title #da7 = ! total life cycle co/ ( ! program2 or 7#b7 #bjj1jjj1jjj 7adju/$ pursuant to section #aijh ( title #da7 annually4 4 7#b7 ,assi/ant ,secret>y = ,acquisition ,section #cjh ( su* title is am5d$-- 7,a7 9 subsection 7a77#a71 by /rik+ sev5 & ins]t+ eight2 & 7,b7 9 subsection 7b77#aj71 by /rik+ ,procurem5t functions & ins]t+ ,acquisition functions4 7#c7 ,acquisition organization ,sub*apt] ,,vii ( *apt] #ha ( su* title1 z add$ by p>agraph 7#a71 is am5d$ by add+ at ! end ! foll[+ new section3 #hahb4 ,acquisition organization 7a7 ,assi/ant ,secret>y = ,acquisition2 ,*ief ,acquisition ,(fic] 7#a7 ,! ,secret>y %all designate "o ( ! ,assi/ant ,secret>ies specifi$ 9 subsection 7a77#a7 ( section #cjh ( ?is title z ! ,assi/ant ,secret>y ( ,vet]ans ,affairs = ,acquisition1 :o %all focus solely on ! adm9i/ration ( functions specifi$ 9 subsection 7b77#aj7 ( su* section4 7#b7 ,pursuant to section #agjb7;a7 ( title #da1 ! ,secret>y %all designate ! ,assi/ant ,secret>y ( ,vet]ans ,affairs = ,acquisition z ! ,*ief ,acquisition ,(fic] ( ! ,dep>tm5t4 7b7 ,(fice ( ,acquisition 7#a7 ,!re is 9 ! ,dep>tm5t an ,(fice ( ,acquisition4 7#b7 ,! head ( ! ,(fice ( ,acquisition %all be ! ,assi/ant ,secret>y ( ,vet]ans ,affairs = ,acquisition designat$ pursuant to subsection 7a74 7#c7 ,! ,secret>y %all take su* actions z may be necess>y to ensure t major acquisition program (fices ( ! ,dep>tm5t align "u ! ,(fice ( ,acquisition & report directly to ! ,assi/ant ,secret>y ( ,vet]ans ,affairs = ,acquisition4 7#d7 ,! budget ( ! ,(fice ( ,acquisition1 includ+ budgets = major acquisition programs1 %all be e/abli%$ 9 ! budget ju/ification mat]ials submitt$ to ,congress 9 support ( ! budget ( ! ,dep>tm5t 7z submitt$ ) ! budget ( ! ,presid5t "u section #aaje7;a7 ( title #ca74 7c7 ,deputy ,assi/ant ,secret>y = ,logi/ics 7#a7 ,pursuant to section #cjh7;d7 ( ?is title1 ! ,secret>y %all appo9t a ,deputy ,assi/ant ,secret>y ( ,vet]ans ,affairs = ,logi/ics1 :o %all report to ! ,assi/ant ,secret>y = ,acquisition4 7#b7 ,! ,deputy ,assi/ant ,secret>y ( ,vet]ans ,affairs = ,logi/ics %all be responsible = adm9i/ration ( logi/ics & supply *a9 op]ations ( ! ,dep>tm5t4 7d7 ,deputy ,assi/ant ,secret>y = ,procurem5t 7#a7 ,pursuant to section #cjh7;d7 ( ?is title1 ! ,secret>y %all appo9t a ,deputy ,assi/ant ,secret>y ( ,vet]ans ,affairs = ,procurem5t1 :o %all report to ! ,assi/ant ,secret>y = ,acquisition4 7#b7 ,! ,deputy ,assi/ant ,secret>y ( ,vet]ans ,affairs = ,procurem5t %all be responsible = all procurem5t & contract+ organizations ( ! ,dep>tm5t4 7e7 ,deputy ,assi/ant ,secret>y = ,acquisition1 ,program ,managem5t1 & ,p]=mance 7#a7 ,pursuant to section #cjh7;d7 ( ?is title1 ! ,secret>y %all appo9t a ,deputy ,assi/ant ,secret>y ( ,vet]ans ,affairs = ,acquisition1 ,program ,managem5t1 & ,p]=mance1 :o %all report to ! ,assi/ant ,secret>y = ,acquisition4 7#b7 ,! ,deputy ,assi/ant ,secret>y = ,acquisition1 ,program ,managem5t1 & ,p]=mance %all be responsible = ! foll[+3 7,a7 ,lifecycle managem5t4 7,b7 ,requirem5ts plann+4 7,c7 ,programm+ & budget+4 7,d7 ,policy4 7,e7 ,p]=mance /&>ds4 7,f7 ,gov]nance4 7,g7 ,enhanc+ ! capabilities ( ! acquisition work=ce4 7f7 ,program ,executive ,(fic]s 7#a7 ,! ,assi/ant ,secret>y = ,acquisition %all appo9t no few] ?an f\r ,program ,executive ,(fic]s1 ea* responsible = ov]see+ major acquisition programs 9 "o ( ! foll[+ areas3 7,a7 ,m$ical4 7,b7 ,in=mation te*nology4 7,c7 ,pr(essional s]vices4 7,d7 ,o!r areas n includ$ 9 subp>agraphs 7,a7 ?r\gh 7,c74 7#b7 ,ea* ,program ,executive ,(fic] %all report directly to ! ,assi/ant ,secret>y = ,acquisition & %all sup]vise ! manag]s ( major acquisition programs )9 _! respective area1 z appo9t$ "u section #hahc ( ?is title4 7#c7 ,ea* ,program ,executive ,(fic] %all be-- 7,a7 c]tifi$ 9 project managem5t at level ?ree by-- 7i7 ! ,dep>tm5t2 7ii7 ! ,f$]al ,acquisition ,in/itute pursuant to section #abja ( title #da2 or 7iii7 ! ,dep>tm5t ( ,def5se pursuant to section #agja;a ( title #aj2 or 7,b7 hold an equival5t c]tification by a private sector project managem5t c]tification organization1 z det]m9$ appropriate by ! ,secret>y4 4 7b7 ,dep>tm5t ( ,vet]ans ,affairs major acquisition program manag]s ,sub*apt] ,,vii ( *apt] #ha ( title #ch1 ,unit$ ,/ates ,code1 z add$ by subsection 7a71 is am5d$ by add+ at ! end ! foll[+ new section3 #hahc4 ,major acquisition program manag]s 7a7 ,appo9tm5ts ,n lat] ?an #cj days aft] any date on :i* ! ,secret>y approves a major acquisition program to comm5ce1 ! applicable ,program ,executive ,(fic] %all appo9t a manag] to be responsible = adm9i/]+ su* program4 7b7 ,qualifications ,ea* manag] appo9t$ pursuant to subsection 7a7 %all be-- 7#a7 c]tifi$ 9 project managem5t at level ?ree by-- 7,a7 ! ,dep>tm5t2 7,b7 ! ,f$]al ,acquisition ,in/itute pursuant to section #abja ( title #da2 or 7,c7 ! ,dep>tm5t ( ,def5se pursuant to section #agja;a ( title #aj2 or 7#b7 hold an equival5t c]tification by a private sector project managem5t c]tification organization1 z det]m9$ appropriate by ! ,secret>y4 7c7 ,duties ,ea* manag] appo9t$ pursuant to subsection 7a7 = a major acquisition program %all-- 7#a7 report to ! ,assi/ant ,secret>y = ,acquisition ?r\gh ! ,program ,executive ,(fic] responsible = ! major acquisition program2 & 7#b7 %all be responsible =1 ) respect to ! major acquisition program-- 7,a7 develop+1 9 coord9ation ) ! ,program ,executive ,(fic]1 a plan to adm9i/] major acquisition program1 :i* %all be kn[n z ! program basel9e = ! major acquisition program1 t includes-- 7i7 a description ( ea* acquisition phase ( ! major acquisition program2 7ii7 = ea* su* acquisition phase1 requirem5ts = advanc+ ! major acquisition program to a subsequ5t acquisition phase2 & 7iii7 e/imates ( ! co/1 s*$ule1 & p]=mance ( ! major acquisition program t acc\nt = ! entire life cycle ( ! major acquisition program2 7,b7 ensur+ ! major acquisition program is 9 compliance ) su* requirem5ts & provid+ all program docum5tation1 includ+ program basel9e docum5tation1 co/1 s*$ule1 p]=mance & risk assessm5ts1 & o!r relevant mat]ials1 to designat$ (ficials & relevant gov]nance bo>ds2 7,c7 develop+ res\rce reque/s & ju/ifications necess>y to satisfy su* requirem5ts2 & 7,d7 on a cont9u\s basis1 assess+ & manag+ risks to satisfy+ ! requirem5ts ( su* program basel9e relat+ to co/ & s*$ule4 7d7 ,program decision au?ority ,! ,secret>y %all ensure t-- 7#a7 program decision au?ority = ov]sight ( a major acquisition program is ! ,assi/ant ,secret>y = ,acquisition2 & 7#b7 program managem5t (fices = major acquisition programs are indep5d5t ( ! ,vet]ans ,b5efits ,adm9i/ration1 ! ,vet]ans ,heal? ,adm9i/ration1 ! ,national ,cemet]y ,adm9i/ration1 & /aff (fices ( ! ,dep>tm5t by report+ directly to ! ,assi/ant ,secret>y = ,acquisition4 7e7 ,program decision au?ority notification requir$ ,n lat] ?an #cj days aft] any date on :i* a major acquisition program concludes an acquisition phase1 ! manag] ( su* program appo9t$ pursuant to subsection 7a7 %all notify ! program decision au?ority "u subsection 7c74 4 7c7 ,dep>tm5t ( ,vet]ans ,affairs acquisition & procurem5t reorganization matt]s 7#a7 ,organizational consolidation ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all organizationally consolidate "u ! ,assi/ant ,secret>y ( ,vet]ans ,affairs = ,acquisition e activity ( ! ,dep>tm5t ( ,vet]ans ,affairs1 includ+ ! ,vet]ans ,b5efits ,adm9i/ration1 ! ,vet]ans ,heal? ,adm9i/ration1 & ! ,national ,cemet]y ,adm9i/ration1 t relates to-- 7,a7 acquisition2 7,b7 procurem5t & contract+2 or 7,c7 logi/ics & supply *a94 7#b7 ,relocation ,p>agraph 7#a7 %all n be con/ru$ to require ! physical relocation ( employees ( ! ,dep>tm5t4 7#c7 ,plan & brief+ 7,a7 ,9 g5]al ,n lat] ?an #ij days aft] comm5c+ organizational consolidation "u subsection 7a71 ! ,secret>y %all-- 7i7 submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a writt5 plan to c>ry out su* organizational consolidation2 & 7ii7 provide su* committees a brief+ on su* plan4 7,b7 ,cont5ts ,! plan submitt$ pursuant to subp>agraph 7,a77i7 %all include ! foll[+3 7i7 ,a timel9e4 7ii7 ,a plan = communication & tra9+ activities = relevant ,dep>tm5t p]sonnel4 7iii7 ,a plan = modification ( relevant ,dep>tm5t policy & guidance4 7iv7 ,su* o!r matt]s z ! ,secret>y consid]s relevant & appropriate4 7d7 ,indep5d5t v]ification & validation ( major acquisition programs ( ,dep>tm5t ( ,vet]ans ,affairs 7#a7 ,contract+ au?ority ,n lat] ?an #abj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all seek to ent] into "o or m contracts us+ competitive proc$ures ) "o or m entities to c>ry out ! functions describ$ 9 p>agraph 7#c74 7#b7 ,eligibility 7,a7 ,9 g5]al ,an entity is n eligible to be aw>d$ a contract "u ?is section unless ! ,*ief ,acquisition ,(fic] ( ! ,dep>tm5t ( ,vet]ans ,affairs det]m9es1 at ! "t ( evaluation ( (f]s submitt$ "u p>agraph 7#a71 t ! entity is curr5tly p]=m+ or has p]=m$1 dur+ ! prec$+ ?ree-ye> p]iod1 n few] ?an ?ree prime contracts f ei!r gov]nm5tal or comm]cial heal? c>e organizations =-- 7i7 ! indep5d5t v]ification & validation s]vices or equival5t s]vices1 includ+ sy/ems eng9e]+ & te*nical advisory 7,,seta7 support ( major acquisition programs2 or 7ii7 ! indep5d5t v]ification & validation or sy/ems eng9e]+ & te*nical advisory 7,,seta7 support ( ! developm5t or acquisition ( major acquisition programs or def5se sy/ems1 9 accordance ) guidance ( ! ,dep>tm5t ( ,def5se relat+ to su* acquisition programs or su* bus9ess sy/ems4 7,b7 ,pa/ p]=mance ,= any contract us$ to demon/rate eligibility "u subp>agraph 7,a71 an entity mu/ h p]=m$ ! "w at a satisfactory or bett] level z indicat$ by ! pa/ p]=mance in=mation 9 ! ,contractor ,p]=mance ,assessm5t ,report+ ,sy/em1 or successor sy/em4 7,c7 ,demon/ration ( lack ( conflict ( int]e/ ,! ,secret>y %all revoke ! eligibility ( an entity "u ?is subsection if an entity does n demon/rate cle> & unmitigable evid5ce t ! entity does n h a conflict ( int]e/ ) respect to ! effective p]=mance ( functions "u p>agraph 7#c74 7,d7 ,no mitigation plans acceptable ,! ,secret>y may n accept f an entity a plan to mitigate a conflict ( int]e/ 9 ord] to ameliorate any limitation or prohibition "u ?is subsection4 7#c7 ,functions ,! functions specifi$ 9 ?is subsection are ! foll[+3 7,a7 ,! indep5d5t v]ification & validation ( ea* major acquisition program project-- 7i7 :5 su* major acquisition program is initiat$1 ) respect to its design & ! developm5t ( its requirem5ts & acquisition2 7ii7 at ! conclusion ( su* program2 & 7iii7 at any o!r int]vals dur+ su* program select$ by ! ,*ief ,acquisition ,(fic] ( ! ,dep>tm5t4 7,b7 ,! indep5d5t v]ification & validation ( o!r programs or projects ( ! ,dep>tm5t select$ by ! ,*ief ,acquisition ,(fic] ( ! ,dep>tm5t1 at int]vals select$ by ! ,*ief ,acquisition ,(fic]4 7#d7 ,fund+ ,! ,*ief ,f9ancial ,(fic] ( ! ,dep>tm5t %all ensure t ea* organizational subdivision ( ! ,dep>tm5t t ent]s into a contract "u p>agraph 7#a7 proportionally contributes am\nts to fund ea* su* contract4 7#e7 ,def9itions ,9 ?is section3 7,a7 ,cov]$ contract ,! t]m cov]$ contract means any prime or subcontract ) ! ,dep>tm5t1 includ+-- 7i7 in=mation te*nology support or s(tw>e or sy/em design1 developm5t1 su/a9m5t1 or ma9t5ance s]vices2 7ii7 pr(essional or managem5t consult+ s]vices2 or 7iii7 advisory & assi/ance s]vices4 7,b7 ,indep5d5t v]ification validation ,! t]m indep5d5t v]ification & validation means a compreh5sive inspection1 a review1 analysis1 & te/+1 or an assessm5t ( sy/ems1 s(tw>e1 or h>dw>e1 z applicable1 p]=m$ by an entity aw>d$ a contract "u p>agraph 7#a7-- 7i7 to v]ify t ! requirem5ts ( a program1 project or sy/em1 or a developm5t phase ( su* a program or project1 are correctly def9$2 & 7ii7 to validate co/1 s*$ule1 & p]=mance basel9es ( curr5t programs & measure program effectiv5ess4 7e7 ,dep>tm5t ( ,vet]ans ,affairs co/ assessm5t & program evaluation 7#a7 ,9 g5]al ,sub*apt] ,,vii ( *apt] #ha ( title #ch1 ,unit$ ,/ates ,code1 z add$ by subsection 7a7 & am5d$ by subsection 7b71 is fur!r am5d$ by add+ at ! end ! foll[+ new section3 #hahd4 ,co/ assessm5t & program evaluation 7a7 ,director ( ,co/ ,assessm5t & ,program ,evaluation ,!re is 9 ! ,dep>tm5t a ,director ( ,co/ ,assessm5t & ,program ,evaluation1 :o %all report directly to ! ,secret>y4 7b7 ,responsibilities ,! responsibilities ( ! ,director are z foll[s3 7#a7 ,to develop policies & proc$ures = co/ e/imation & analysis ( major acquisition programs ( ! ,dep>tm5t4 7#b7 ,to conduct indep5d5t co/ e/imates & analyses = major acquisition programs to support acquisition decisions1 or any o!r acquisitions z direct$ by ! ,secret>y1 7#c7 ,to provide an indep5d5t co/ e/imate to ! ,assi/ant ,secret>y = ,acquisition 9 advance ( a decision to proce$ ) full-scale acquisition = a major acquisition program or any o!r program z direct$ by ! ,director4 7#d7 ,to evaluate ! effectiv5ess ( major acquisition programs 9 meet+ ,dep>tm5t objectives4 7#e7 ,n less frequ5tly ?an once ea* ye>1 to submit to ! ,secret>y & ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives an annual report on co/ e/imation & program evaluation activities1 includ+ recomm5dations to improve acquisition effici5cy4 ,su* report %all include a li/ ( all acquisitions :]e ! indep5d5t co/ e/imate = a major acquisition program exce$$ ! budget reque/ = ! program by m ?an #e p]c5t4 7c7 ,support & res\rces ,! ,*ief ,f9ancial ,(fic] ( ! ,dep>tm5t %all provide to ! ,secret>y su* support & res\rces z may be necess>y = ! ,secret>y to ensure ! effective e/abli%m5t & function+ ( ! ,director ( ,co/ ,assessm5t & ,program ,evaluation4 4 7#b7 ,report on monitor+ ( op]at+ & support co/s = major acquisition programs 7,a7 ,report to ,secret>y ( ,vet]ans ,affairs ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 & n less frequ5tly ?an once ea* ye> !reaft] until ,decemb] #ca1 #bjbh1 ! ,director ( ,co/ ,assessm5t & ,program ,evaluation ( ! ,dep>tm5t ( ,vet]ans ,affairs %all submit to ! ,secret>y ( ,vet]ans ,affairs a report on sy/ems & me?ods = track+ & assess+ op]at+ & support co/s ( major acquisition programs 7z def9$ 9 section #haha ( title #ch1 ,unit$ ,/ates ,code1 z add$ by subsection 7a771 includ+ recomm5dations = e/abli%+ co/ basel9es4 7,b7 ,transmittal to ,congress ,n lat] ?an #cj days aft] receiv+ a report pursuant to subp>agraph 7,a71 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives ! report receiv$ by ! ,secret>y4 7f7 ,improvem5ts to hir+ ( entry-level acquisition positions 9 ,dep>tm5t ( ,vet]ans ,affairs 7#a7 ,priority use ( int]n%ip programs = hir+ into entry-level positions 9 acquisitions ,! ,secret>y ( ,vet]ans ,affairs %all prioritize ! use ( acquisition int]n%ip programs to hire employees to entry-level positions relat+ to acquisition 9 ! ,dep>tm5t ( ,vet]ans ,affairs4 7#b7 ,annual numb] ( p>ticipants 9 acquisition int]n%ip programs 7,a7 ,9 g5]al ,n lat] ?an ,septemb] #cj ( ! fir/ fiscal ye> beg9n+ aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all take su* actions z may be necess>y to ensure t ! annual numb] ( p>ticipants 9 acquisition int]n%ip programs ( ! ,dep>tm5t is-- 7i7 n few] ?an twice ! numb] ( p>ticipants 9 su* programs dur+ fiscal ye> #bjbe2 & 7ii7 n m ?an #d times ! numb] ( p>ticipants 9 su* programs dur+ su* fiscal ye>4 7,b7 ,t]m9ation ,! requirem5ts ( subp>agraph 7,a7 %all t]m9ate on ! date on :i* ! ,secret>y c]tifies to ! appropriate committees ( ,congress t ! project$ numb] ( graduates ( acquisition int]n%ip programs is suffici5t to satisfy ! human capital ne$s ( ! ,dep>tm5t ) respect to acquisition1 tak+ into acc\nt ! rate ( attrition & project$ retirem5ts ( p]sonnel4 7,c7 ,appropriate committees ( ,congress def9$ ,9 ?is subsection1 ! t]m appropriate committees ( ,congress means ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives4 7g7 ,indep5d5t analysis ( acquisition process ( ,dep>tm5t ( ,vet]ans ,affairs 7#a7 ,sy/ems eng9e]+ analysis ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans' ,affairs %all ent] into a memor&um ( und]/&+ ) ! ,executive ,director ( ! ,acquisition ,rese>* ,c5t] ( ! ,dep>tm5t ( ,def5se to conduct a sy/ems eng9e]+ analysis ( ! acquisition process ( ! ,dep>tm5t ( ,vet]ans ,affairs4 7#b7 ,report ,n lat] ?an "o ye> aft] ! date 9 :i* ! ,secret>y ent]s into ! memor&um ( und]/&+ requir$ by p>agraph 7#a71 ! ,secret>y %all submit to ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! f9d+s ( ! ,executive ,director ) respect to ! analysis conduct$ "u su* subsection4 7h7 ,requirem5ts developm5t process 7#a7 ,9 g5]al ,sub*apt] ,,vii ( *apt] #ha ( title #ch1 ,unit$ ,/ates ,code1 z add$ by subsection 7a7 & am5d$ by subsections 7b7 & 7e71 is fur!r am5d$ by add+ at ! end ! foll[+ new section3 #hahe4 ,requirem5ts developm5t process 7a7 ,e/abli%m5t ( process 7#a7 ,! ,secret>y %all e/abli% a /&>diz$ requirem5ts developm5t process = major acquisition programs4 7#b7 ,! process e/abli%$ pursuant to p>agraph 7#a7 %all-- 7,a7 def9e & validate mission-driv5 requirem5ts = major acquisition programs exce$+ #bjj1jjj1jjj annually or #a1jjj1jjj1jjj 9 lifecycle co/s1 9 coord9ation ) ! ,assi/ant ,secret>y = ,acquisition2 7,b7 incorporate data-driv5 ne$s assessm5ts1 /akehold] input f relevant adm9i/rations1 /aff (fices1 & o!r elem5ts ( ! ,dep>tm5t1 & alignm5t ) /atutory m&ates1 su* z section #haba ( ?is title2 & 7,c7 ensure it]ative validation ( requirem5ts ?r\gh indep5d5t v]ification & validation1 z describ$ 9 section #hahe ( ?is title1 to confirm co/1 s*$ule1 & p]=mance basel9es4 7b7 ,limitation on p]sonnel ,! ,secret>y %all implem5t ! process e/abli%$ pursuant to subsection 7a7 us+ /aff )9 ! ,(fice ( ,acquisition & o!r relevant (fices ( ! ,dep>tm5t1 z e/abli%$ "u section #hahb ( ?is title1 )\t creat+ new positions1 unless a subsequ5t co/-b5efit analysis1 validat$ by ! ,director ( ,co/ ,assessm5t & ,program ,evaluation1 ju/ifies additional res\rces4 4 7#b7 ,report ,n lat] ?an #ahj days aft] ! enactm5t ( ?is ,act1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report detail+ ! requirem5ts process e/abli%$ pursuant to section #hahg ( su* title1 z add$ by p>agraph 7#a7 & a plan = implem5tation ( su* process1 includ+ timel9es = integration ) major acquisition program basel9es4 7i7 ,con=m+ am5dm5ts ,sub*apt] ,,vi ( *apt] #ha ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 9 section #haga1 by /rik+ p>agraphs 7#e7 & 7#f72 & 7#b7 by /rik+ section #hagb4 7j7 ,cl]ical am5dm5ts ,! table ( sections at ! beg9n+ ( *apt] #ha ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 by /rik+ ! item relat+ to section #hagb2 & 7#b7 by add+ at ! end ! foll[+3 ,,sub*apt] ,,vii--,acquisition ,review1 ,co/ ,assessm5t1 & ,program ,evaluation #haha4 ,def9ition ( major acquisition program4 #hahb4 ,acquisition reorganization4 #hahc4 ,major acquisition program manag]s4 #hahd4 ,co/ assessm5t & program evaluation4 #hahe4 ,requirem5ts developm5t process4 4 #djd4 ,improvem5t ( telephone communication by ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,9 g5]al ,*apt] #fc ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new section3 #fcba4 ,telephone communication 7a7 ,calls associat$ ) ,dep>tm5t ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act1 ! ,secret>y %all ensure1 to ! ext5t practicable & feasible1 t any call made to a vet]an1 b5efici>y1 claimant1 or o!r relevant individual by an employee or contractor ( ! ,dep>tm5t reg>d+ s]vices or b5efits furni%$ by ! ,dep>tm5t-- 7#a7 is made f a s+le1 well-kn[n telephone numb]2 & 7#b7 uses call] id5tification br&+ t indicates to ! individual t ! call is f or on behalf ( ! ,dep>tm5t4 7b7 ,call c5t]s = heal? c>e appo9tm5ts & ref]rals 7#a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act1 ! ,secret>y %all ensure t ! ,vet]ans ,heal? ,adm9i/ration has at lea/ "o call c5t] 9 ea* ( ! "t zones specifi$ 9 p>agraph 7#c7 to address conc]ns reg>d+ appo9tm5ts & ref]rals = heal? c>e "u ! laws adm9i/]$ by ! ,secret>y4 7#b7 ,exi/+ ef=ts & call c5t]s ,9 c>ry+ out p>agraph 7#a71 ! ,secret>y-- 7,a7 %all ensure coord9ation ) exi/+ ef=ts ( ! ,dep>tm5t to improve call c5t] op]ations2 & 7,b7 may use exi/+ call c5t]s to meet ! requirem5ts ( su* p>agraph4 7#c7 ,"t zones specifi$ ,! "t zones specifi$ 9 ?is p>agraph are ! foll[+3 7,a7 ,ea/]n "t4 7,b7 ,c5tral "t4 7,c7 ,m\nta9 "t4 7,d7 ,pacific "t4 7,e7 ,alaska "t4 7,f7 ,hawaii "t4 7#d7 ,cl>ification ,! ,secret>y is n requir$ to ensure t ! ,vet]ans ,heal? ,adm9i/ration has a call c5t] 9 any location g5]ally )9 a "t zone specifi$ 9 p>agraph 7#c7 t does n foll[ daylight sav+ "t4 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( *apt] #fc ( su* title is am5d$ by add+ at ! end ! foll[+ new item3 #fcba4 ,telephone communication4 4 7c7 ,report ,n lat] ?an #ahj days aft] enactm5t1 & annually = ?ree ye>s !reaft]1 ! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs a report on implem5tation1 includ+ call-answ] rates1 ab&on$-call rates1 av]age wait times1 vet]an compla9ts1 spo(+ or fraud-prev5tion measures1 & any exceptions grant$4 #dje4 ,advanc+ ,dep>tm5t ( ,vet]ans ,affairs em]g5cy response to crisis 7a7 ,report on em]g5cy managem5t roles = ,dep>tm5t ( ,vet]ans ,affairs 7#a7 ,9 g5]al ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report outl9+ ! roles & responsibilities ( all (fices ( ! ,dep>tm5t ( ,vet]ans ,affairs involv$ ) em]g5cy managem5t4 7#b7 ,consultation ,9 prep>+ ! report requir$ by p>agraph 7#a71 ! ,secret>y ( ,vet]ans ,affairs %all consult ) ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates1 ! ,inspector ,g5]al ( ! ,dep>tm5t ( ,vet]ans ,affairs1 ! ,secret>y ( ,homel& ,security1 ! ,secret>y ( ,def5se1 & su* o!r ,f$]al ag5cies z ! ,secret>y ( ,vet]ans ,affairs consid]s relevant1 to obta9 insights f _! exp]i5ce & tr5ds t !y h f\nd1 & su* recomm5dations z !y may h ) respect to ! managem5t by ! ,dep>tm5t ( ,vet]ans ,affairs ( em]g5cy managem5t functions4 7#c7 ,cont5ts ,! report submitt$ pursuant to p>agraph 7#a7 %all include ! foll[+3 7,a7 ,a description ( ! organizational /ructure ( ea* (fice1 bo? dur+ normal op]ations & dur+ em]g5cy or disa/] op]ations4 7,b7 ,! roles & responsibilities ( ea* (fice4 7,c7 ,a detail$ description ( roles & responsibilities t are %>$ by bo? ! ,(fice ( ,em]g5cy ,managem5t ( ! ,dep>tm5t & ! ,(fice ( ,op]ations1 ,security1 & ,prep>$ness ( ! ,dep>tm5t1 includ+ an analysis ( h[ ea* (fice plays a "p 9 em]g5cy managem5t functions4 7,d7 ,recomm5dations = improv+ ! /ructure & alignm5t ( relevant (fices to bett] prep>e ! ,dep>tm5t = em]g5cies1 remove r$undancies1 & improve acc\ntability4 7,e7 ,an analysis ( ! feasibility & advisability ( consolidat+ relevant (fices into "o c5traliz$ em]g5cy managem5t (fice to improve communication & /reaml9e em]g5cy prep>$ness & response ef=ts ( ! ,dep>tm5t4 7b7 ,plan to all[ fuel %>+ & increas$ coord9ation betwe5 ! ,f$]al ,em]g5cy ,managem5t ,ag5cy & ! ,dep>tm5t ( ,vet]ans ,affairs ,n lat] ?an #ij days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all1 aft] consult+ ) ! ,adm9i/rator ( ! ,f$]al ,em]g5cy ,managem5t ,ag5cy1 submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate1 ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives1 ! ,committee on ,homel& ,security & ,gov]nm5t ,affairs ( ! ,s5ate1 & ! ,committee on ,homel& ,security ( ! ,h\se ( ,repres5tatives a report reg>d+-- 7#a7 ! curr5t limitations prev5t+ ! ,f$]al ,em]g5cy ,managem5t ,ag5cy f provid+ fuel or o!r res\rces to ! ,dep>tm5t ( ,vet]ans ,affairs dur+ em]g5cies2 7#b7 :e!r ! ,dep>tm5t requires action by ,congress to all[ su* res\rce provision to occur2 7#c7 :e!r ! ,secret>y has be5 unable to coord9ate ) ! ,adm9i/rator dur+ prior em]g5cies or ,f\r? ,mission activations due to a lack ( au?ority = su* coord9ation2 7#d7 :e!r ! ,secret>y requires action by ,congress to address any ( ! issues m5tion$ "u p>agraph 7#c72 & 7#e7 :e!r ! ,secret>y requires action by ,congress to address ! issue ( ,dep>tm5t employees or respond]s be+ unable to use ,dep>tm5t-pur*as$ fuel4 #djf4 ,memb]%ip ( ,dep>tm5t ( ,vet]ans ,affairs ,g]iatrics & ,g]ontology ,advisory ,committee ,section #gcae ( title #ch1 ,unit$ ,/ates ,code1 is am5d$1 9 subsection 7a7-- 7#a7 9 ! second s5t5ce1 by /rik+ & at lea/ "o repres5tative ( a national vet]ans s]vice organization & ins]t+ 1 at lea/ "o individual :o repres5ts a national vet]ans s]vice organization1 at lea/ "o individual :o has s]v$ vet]ans or families ( vet]ans 9 a ,/ate home1 & at lea/ "o individual :o holds a pr(essional lic5se 9 nurs+ home adm9i/ration2 & 7#b7 by designat+ ! fir/1 second1 & ?ird s5t5ces z p>agraphs 7#a7 ?r\gh 7#c71 respectively 7& adju/+ ! m>g9s accord+ly74 #djg4 ,s*$ul+ ( appo9tm5ts "u ! ,vet]ans ,community ,c>e ,program 7a7 ,9 g5]al 7#a7 ,electronic process ,subsection 7d7 ( section #caja ( ! ,johnny ,isakson & ,david ,p4 ,roe1 ,m4,d4 ,vet]ans ,heal? ,c>e & ,b5efits ,improvem5t ,act ( #bjbj 7,public ,law #aaf-cae2 #ch ,u4,s4,c4 #agja note7 is am5d$ to read z foll[s3 7d7 ,electronic process 7#a7 ,! ,secret>y %all implem5t an electronic process ?r\gh :i* a s*$ul] ( ! ,dep>tm5t1 us+ an in=mation te*nology sy/em1 may s*$ule an appo9tm5t = heal? c>e furni%$ by ! ,dep>tm5t or ?r\gh ! ,vet]ans ,community ,c>e ,program1 "u section #agjc ( ?is title1 by a non-,dep>tm5t heal? c>e provid]4 7#b7 ,! electronic process "u ?is subsection %all all[ a s*$ul]1 ) reg>ds to appo9tm5ts describ$ 9-- 7,a7 ei!r clause ( subp>agraph 7,a7 ( subsection 7a77#a71 to view1 se>*1 & sort su* appo9tm5ts by type ( c>e1 location1 & date2 & 7,b7 clause 7ii7 ( su* subp>agraph-- 7i7 to s*$ule su* an appo9tm5t2 7ii7 to provide ref]ral & au?orization docum5ts directly to a non-,dep>tm5t provid]2 & 7iii7 to p]=m any o!r function ! ,secret>y det]m9es necess>y4 7#c7 ,! ,secret>y %all ensure t ! electronic process all[s a s*$ul] to s*$ule an appo9tm5t = heal? c>e furni%$ by ! ,secret>y ?r\gh a heal? c>e provid] ( ! ,dep>tm5t4 7#d7 ,! ,secret>y %all implem5t ! electronic process ?r\gh an exi/+ agreem5t if practicable4 7#e7 ,! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ,h\se ( ,repres5tatives ! foll[+ reg>d+ ! electronic process3 7,a7 ,n lat] ?an #ij days aft] ! ,secret>y makes a det]m9ation "u subp>agraph 7,b77iii7 ( p>agraph 7#b71 a brief+ reg>d+ ! functions ! ,secret>y has det]m9$ necess>y4 7,b7 ,n lat] ?an six mon?s aft] ! date ( ! enactm5t ( ,take ,c>e ( ,am]ica's ,vet]ans ,act1 & semiannually !reaft] dur+ ! foll[+ ?ree ye>s1 a report reg>d+ op]ation ( ! electronic process dur+ bo? ! semiannual p]iod prec$+ ! date ( ! report & ! cumulative p]iod s9ce ! date ( ! enactm5t ( su* ,act4 ,su* a report %all include ! foll[+ = ea* su* p]iod3 7i7 ,! numb] ( non-,dep>tm5t heal? c>e provid]s t p>ticipat$ 9 su* electronic process1 disaggregat$ by-- 7,i7 category ( hospital c>e or m$ical s]vices provid$2 & 7,,ii7 m$ical c5t] ( ! ,dep>tm5t2 7ii7 ,! numb] ( appo9tm5ts s*$ul$ pursuant to ! electronic process1 disaggregat$ by-- 7,i7 category ( hospital c>e or m$ical s]vices provid$2 7,,ii7 m$ical c5t] ( ! ,dep>tm5t2 & 7,,iii7 mon?4 7iii7 ,a comp>ison ( ! av]age wait "t = appo9tm5ts s*$ul$ ?r\gh ! electronic process & ?r\gh non-electronic me?ods1 disaggregat$ by m$ical c5t] ( ! ,dep>tm5t4 7iv7 ,! rates at :i* vet]ans cancell$ appo9tm5ts s*$ul$ ?r\gh ! electronic process4 7v7 ,! rates at :i* vet]ans did n appe> = appo9tm5ts s*$ul$ ?r\gh ! electronic process4 4 7#b7 ,implem5tation 7,a7 ,date ,! ,secret>y ( ,vet]ans ,affairs %all implem5t ! electronic process "u subsection 7d7 ( section #agjc;,h ( su* title1 z add$ by ?is section1 n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ?is ,act4 7,b7 ,guidel9es ,n lat] ?an #ij days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all e/abli% guidel9es4 ,su* guidel9es %all include ! foll[+3 7i7 ,proc$ures = s*$ul]s & o!r employees ( ! ,dep>tm5t involv$ 9 ! s*$ul+ ( appo9tm5ts describ$ 9 su* section4 7ii7 ,a directive t employees describ$ 9 clause 7i7 use ! electronic process to ! ext5t practicable4 7iii7 ,a directive t employees describ$ 9 clause 7i71 :5 s*$ul+ an appo9tm5t = a cov]$ vet]an 7z su* t]m is us$ 9 section #agjc ( su* title7 = heal? c>e furni%$ by ! ,secret>y1 in=m su* cov]$ vet]an ( available appo9tm5ts ?\gh provid]s ( ! ,dep>tm5t & ?r\gh provid]s "u ! ,vet]ans ,community ,c>e ,program :5 eligible4 7iv7 ,proc$ures = engag+ ) non-,dep>tm5t heal? c>e provid]s 9 specializ$ cases4 7v7 ,/&>ds reg>d+ timel9ess & accuracy4 7vi7 ,escalation protocols = s*$ul+ failures or delays4 7,c7 ,tra9+ ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all implem5t a m&atory tra9+ program = employees describ$ 9 subp>agraph 7,b7 reg>d+ ! guidel9es "u subp>agraph 7,b74 7,d7 ,evaluation ,n lat] ?an #fj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all prescribe p]=mance b5*m>ks & outcome-bas$ metrics = ! electronic process "u su* section1 includ+-- 7i7 "t betwe5 a ref]ral & a s*$ul$ appo9tm5t2 7ii7 pati5t satisfaction2 & 7iii7 ! p]c5tage ( appo9tm5ts s*$ul$ exclusively ?r\gh ! electronic process4 7,e7 ,outrea* ,n lat] ?an #ij days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all plan & c>ry out an outrea* /rategy to enc\rage non-,dep>tm5t ( ,vet]ans ,affairs heal? c>e provid]s t p>ticipate 9 ! ,vet]ans ,community ,c>e ,program to p>ticipate 9 ! electronic process "u su* subsection4 ,su* outrea* %all-- 7i7 include contact+ ea* su* provid] dur+ su* #ij days2 7ii7 include seek+ to ent] into an agreem5t ) ea* su* provid] "u :i* ! provid] %all p>ticipate 9 ! electronic process2 7iii7 include collaborat+ ) ,/ate hospital associations & rural heal? associations to promote su* p>ticipation2 7iv7 focus on provid]s 9 specialties or und]s]v$ areas1 z det]m9$ by ! ,secret>y2 & 7v7 include ! publication1 on a publicly accessible website ( ! ,dep>tm5t1 ( in=mation reg>d+-- 7,i7 details ( ! electronic process2 7,,ii7 h[ a provid] may elect to p>ticipate 9 ! electronic process2 & 7,,iii7 a po9t ( contact 9 ! ,dep>tm5t reg>d+ ! electronic process4 7,f7 ,ov]sight ,! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ,h\se ( ,repres5tatives1 ) reg>ds to ! electronic process "u su* subsection1 ! foll[+3 7i7 ,n lat] ?an #cj days aft] ! ,secret>y e/abli%es guidel9es "u subp>agraph 7,b7 ( ?is p>agraph1 a copy ( su* guidel9es4 7ii7 ,n lat] ?an #cj days aft] ! ,secret>y =mulates ! plan "u subp>agraph 7,e7 ( ?is p>agraph1 a brief+ on ! outrea* /rategy "u su* p>agraph4 7iii7 ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! b5*m>ks & metrics prescrib$ "u subp>agraph 7,d74 7#c7 ,expansion ,n lat] ?an #ij days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all submit to ! ,committees on ,vet]ans' ,affairs ( ! ,s5ate & ,h\se ( ,repres5tatives a plan to integrate ! s*$ul+ ( appo9tm5ts = heal? c>e furni%$ ?r\gh heal? c>e provid]s ( ! ,dep>tm5t ( ,vet]ans ,affairs into ! electronic process "u subsection 7d7 ( section #agjc;,h ( su* title4 ,su* plan %all include ! foll[+ elem5ts3 7,a7 ,a timel9e to implem5t su* plan4 7,b7 ,e/imat$ co/s to c>ry out su* plan4 7,c7 ,*anges to policies & proc$ures ( ! ,dep>tm5t ! ,secret>y det]m9es necess>y to implem5t su* plan4 7#d7 ,codification 7,a7 ,9 g5]al ,section #caja ( su* ,act1 z am5d$ by p>agraph 7#a71 is transf]r$ to sub*apt] ,i ( *apt] #ag ( title #ch1 ,unit$ ,/ates ,code1 ins]t$ aft] section #agjc;,g1 & r$esignat$ z section #agjc;,h4 7,b7 ,con=m+ am5dm5ts ,section #agjc;,h ( su* title1 z transf]r$ & r$esignat$ by ?is subsection1 is am5d$-- 7i7 by /rik+ any head+ t is n a section head+ or subsection head+ & con=m+ ! m>g9s accord+ly2 7ii7 by /rik+ ( title #ch1 ,unit$ ,/ates ,code bo? places x appe>s & ins]t+ ( ?is title2 7iii7 9 subsection 7b77#a71 by /rik+ ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y & ins]t+ ,! ,secret>y2 7iv7 9 subsection 7c7-- 7,i7 9 p>agraph 7#a71 9 ! matt] prec$+ subp>agraph 7,a71 by /rik+ ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y & ins]t+ ,! ,secret>y2 & 7,,ii7 9 p>agraph 7#b71 by /rik+ subp>agraphs 7,a7 & 7,b7 & ins]t+ ,! ,secret>y %all require ea* m$ical facility ( ! ,dep>tm5t to use ! me?od or tool describ$ 9 p>agraph 7#a742 7v7 9 ! section enum]ator1 by /rik+ ,sec4 & ins]t+ 2 & 7vi7 9 ! section head+-- 7,i7 by /rik+ ,process & requirem5ts = s*$ul+ appo9tm5ts = heal? c>e f ,dep>tm5t ( ,vet]ans ,affairs & non-,dep>tm5t heal? c>e4 & ins]t+ ,s*$ul+ ( appo9tm5ts2 & 7,,ii7 by con=m+ ! typeface & type/yle1 includ+ capitalization1 to ! typeface & type/yle us$ 9 ! section head+ ( section #agjc;,g ( su* title4 7,c7 ,table ( sections ,! table ( sections at ! beg9n+ ( su* *apt] is am5d$ by ins]t+1 aft] ! item relat+ to section #agjc;,g1 ! foll[+ new item3 #agjc;,h4 ,s*$ul+ ( appo9tm5ts4 4 ,v ,memorial ,affairs #eja4 ,expansion ( eligibility = ,dep>tm5t ( ,vet]ans ,affairs memorial head/one or m>k] = c]ta9 individuals ,section #bcjf7;b77#b7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ 9 subp>agraphs 7,b7 & 7,c7 by /rik+ :o dies on or aft] ,novemb] #aa1 #aiih1 ea* place x appe>s4 #ejb4 ,dep>tm5t ( ,vet]ans ,affairs provision ( additional burial b5efits :5 an urn or commemorative plaque is furni%$ 7a7 ,9 g5]al ,p>agraph 7#b7 ( section #bcjf7;h7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ to read z foll[s3 7#b7 ,if ! ,secret>y furni%es an urn or commemorative plaque = an individual "u p>agraph 7#a71 ! ,secret>y may n provide = su* individual a head/one or m>k] "u ?is section1 or any int]m5t b5efit "u section #bdjb ( ?is title1 unless-- 7,a7 9 ! case ( a reque/ = a head/one or m>k] "u ?is section-- 7i7 su* reque/ is made at ! same "t z a reque/ = placem5t ( a head/one or m>k] = ano!r individual :o is eligible to h su* a head/one or m>k] plac$ 9 a national cemet]y1 a vet]ans' cemet]y 9 receipt ( a grant made "u section #bdjh ( ?is title1 or a po/ cemet]y2 & 7ii7 ! ,secret>y furni%es "o head/one or m>k] inscrib$ = bo? individuals2 or 7,b7 9 ! case ( a reque/ = int]m5t1 ! individual is int]r$ at ! same "t & 9 ! same gravesite z ! int]m5t ( ano!r individual eligible = int]m5t 9 a national cemet]y "u section #bdjb7;a7 ( ?is title4 4 7b7 ,applicability ,! am5dm5t made by subsection 7a7 %all apply ) respect to an individual :o dies on or aft] ,janu>y #e1 #bjba4 #ejc4 ,fall5 ,s]vicememb]s ,religi\s ,h]itage ,re/oration ,program 7a7 ,f9d+s ,congress f9ds ! foll[+3 7#a7 ,an e/imat$ #ijj ,am]ican-,jewi% s]vicememb]s ( ! ,arm$ ,=ces1 kill$ 9 ,_w ,w> ,i & ,_w ,w> ,,ii & buri$ ov]seas 9 ,unit$ ,/ates milit>y cemet]ies 71 = v>i\s reasons1 mi/ak5ly buri$ "u ,lat9 ,crosses4 ,9 mo/ in/ances1 ^? mi/akes 7 made inadv]t5tly4 7#b7 ,9 #bjbb1 m ?an #b1jjj1jjj p visit$ ! ,unit$ ,/ates ,_w ,w> ,i & ,_w ,w> ,,ii cemet]ies 9 =eign c\ntries4 7#c7 ,am]ican-,jewi% s]vicememb]s play$ a vital role 9 ! ,alli$ victories 9 ,_w ,w> ,i & ,_w ,w> ,,ii4 7#d7 ,am]ican-,jewi% s]vicememb]s :o f\ght & di$ = ! ,unit$ ,/ates mu/ h _! h]itage prop]ly recogniz$ & honor$4 7#e7 ,! ,unit$ ,/ates ,gov]nm5t has a solemn responsibility to ensure t e ,am]ican s]vicememb] kill$ 9 action & buri$ ov]seas is prop]ly honor$4 7#f7 ,! "w ( prop]ly id5tify+ ,am]ican-,jewi% s]vicememb]s buri$ ov]seas is vital & integral to ! responsibility ( ! ,am]ican ,battle ,monum5ts ,commission to ensure t pa/ mi/akes 9 honor+ ^? s]vicememb]s :o di$ 9 ! l9e ( duty are correct$4 7b7 ,fall5 s]vicememb]s religi\s h]itage re/oration program 7#a7 ,e/abli%m5t ,! ,am]ican ,battle ,monum5ts ,commission %all e/abli% a program to id5tify cov]$ memb]s & to contact survivors & desc5dants ( su* cov]$ memb]s4 ,su* program %all be kn[n z ! ,fall5 ,s]vicememb]s ,religi\s ,h]itage ,re/oration ,program4 7#b7 ,duration ,! ,commission %all c>ry out ! ,fall5 ,s]vicememb]s ,religi\s ,h]itage ,re/oration ,program dur+ ! fir/ five fiscal ye>s t beg9 aft] ! date ( ! enactm5t ( ?is ,act4 7#c7 ,contracts 7,a7 ,au?ority ,dur+ ea* fiscal ye> describ$ 9 subsection 7b71 ! ,commission %all seek to ent] into a contract ) a nonpr(it organization "u :i* su* nonpr(it organization %all c>ry out ! purpose describ$ 9 subsection 7a74 7,b7 ,t]m2 am\nt ,ea* contract "u ?is subsection %all be = "o ye> & 9 ! am\nt ( #ejj1jjj to ! nonpr(it organization4 7,c7 ,priority ,9 aw>d+ a contract "u ?is subsection1 ! ,commission %all give priority to a nonpr(it organization t has demon/rat$ capability & exp]tise 9 c>ry+ out ! purpose describ$ 9 subsection 7a74 7#d7 ,def9itions ,9 ?is section3 7,a7 ,! t]m cov]$ memb] means a deceas$ memb] ( ! ,arm$ ,=ces :o 0 ,jewi% & buri$-- 7i7 9 a ,unit$ ,/ates milit>y cemet]y locat$ outside ! ,unit$ ,/ates2 & 7ii7 "u a m>k] t indicates su* memb] 0 n ,jewi%4 7,b7 ,! t]m nonpr(it organization means an organization describ$ 9 section #eja7;c77#c7 ( ! ,int]nal ,rev5ue ,code ( #aihf & exempt f taxation "u section #eja7;a7 ( su* ,code4 ,,vi ,vet]ans' ,assur+ ,critical ,c>e ,expansions to ,support ,s]vicememb]s ,a ,improvem5t ( ,vet]ans ,community ,c>e ,program #fja4 ,codification ( requirem5ts = eligibility /&>ds = access to community c>e f ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,eligibility access /&>ds ,section #agjc;,b ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 by /rik+ subsections 7a7 ?r\gh 7e7 & ins]t+ ! foll[+3 7a7 ,access /&>ds = community c>e 7#a7 ,= purposes ( section #agjc7;d77#a77;,d7 ( ?is title1 ! eligibility access /&>ds = hospital c>e1 m$ical s]vices1 or non-in/itutional ext5d$ c>e s]vices1 are z foll[s3 7,a7 ,) respect to prim>y c>e1 m5tal heal? c>e1 or non-in/itutional ext5d$ c>e s]vices1 ! ,secret>y mu/ s*$ule an appo9tm5t = ! cov]$ vet]an ) a heal? c>e provid] ( ! ,dep>tm5t :o c provide ! ne$$ s]vice-- 7i7 )9 #cj m9utes av]age driv+ "t f ! resid5ce ( ! vet]an unless a long] av]age driv+ "t has be5 agre$ to by ! vet]an 9 consultation ) a heal? c>e provid] ( ! vet]an2 & 7ii7 )9 #bj days ( ei!r ! date ( reque/ = su* an appo9tm5t or a lat] date agre$ to by ! vet]an 9 consultation ) a heal? c>e provid] ( ! vet]an4 7,b7 ,) respect to specialty c>e1 ! ,secret>y mu/ s*$ule an appo9tm5t = ! cov]$ vet]an ) a heal? c>e provid] ( ! ,dep>tm5t :o c provide ! ne$$ s]vice-- 7i7 )9 #fj m9utes av]age driv+ "t f ! resid5ce ( ! vet]an unless a long] av]age driv+ "t has be5 agre$ to by ! vet]an 9 consultation ) a heal? c>e provid] ( ! vet]an2 & 7ii7 )9 #bh days ( ei!r ! date ( reque/ = su* an appo9tm5t or a lat] date agre$ to by ! vet]an 9 consultation ) a heal? c>e provid] ( ! vet]an4 7,c7 ,) respect to a cov]$ treatm5t program1 ! ,secret>y mu/-- 7i7 provide to a cov]$ vet]an a scre5+ n lat] ?an #dh h\rs aft] ! date on :i* ! vet]an1 or a relevant heal? c>e provid]1 makes a docum5t$ reque/ = ! vet]an to be admitt$ to a cov]$ treatm5t program2 & 7ii7 if ! vet]an is det]m9$ eligible = priority admission to a cov]$ treatm5t program-- 7,i7 admit ! vet]an to a cov]$ treatm5t program n lat] ?an #dh h\rs aft] ! date ( su* det]m9ation or give ! vet]an ! option ( seek+ c>e at a non-,dep>tm5t facility pursuant to section #agib7;e7 ( ?is title2 or 7,,ii7 give ! vet]an ! option ( seek+ c>e at a non-,dep>tm5t facility pursuant to section #agib7;e7 ( ?is title4 7#b7 ,= ! purposes ( det]m9+ ! ability ( ! ,secret>y to s*$ule an appo9tm5t = a cov]$ vet]an ) a heal? c>e provid] ( ! ,dep>tm5t "u p>agraph 7#a71 ! ,secret>y %all n take into consid]ation ! availability ( teleheal? appo9tm5ts f ! ,dep>tm5t4 7#c7 ,9 ! case ( a cov]$ vet]an :o has _h an appo9tm5t ) a heal? c>e provid] ( ! ,dep>tm5t cancel$ by ! ,dep>tm5t = a reason o!r ?an ei!r ! reque/ ( ! vet]an or ! failure ( ! vet]an to appe> z s*$ul$1 9 calculat+ a wait "t = a subsequ5t appo9tm5t "u ! eligibility access /&>ds e/abli%$ "u p>agraph 7#a71 ! ,secret>y %all calculate su* wait "t f ! date ( ! reque/ = ! orig9al1 cancel$ appo9tm5t4 7#d7 ,if a vet]an agrees to a long] av]age drive "t or a lat] date "u p>agraph 7#a71 ! ,secret>y %all docum5t ! agreem5t to su* long] av]age drive "t or lat] date 9 ! electronic heal? record ( ! vet]an & provide ! vet]an a copy ( su* docum5tation4 ,su* copy may be provid$ electronically4 7#e7 ,p>agraph 7#a77;,c7 %all n be con/ru$ to affect a cov]$ vet]an 9 a cov]$ treatm5t program pursuant to a det]m9ation made on or be=e ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act4 7#f7 7,a7 ,subject to ! provisions ( ?is p>agraph1 subp>agraphs 7,a7 & 7,b7 ( p>agraph 7#a7 %all t]m9ate on ! date t is eight ye>s aft] ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act4 7,b7 ,n lat] ?an sev5 ye>s aft] ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report conta9+-- 7i7 an assessm5t ( ! effects ( ! codification ( eligibility access /&>ds = prim>y c>e1 m5tal heal? c>e1 non-in/itutional ext5d$ c>e s]vices1 & specialty c>e "u ?is subsection on ! managem5t & ov]sight ( ! ,vet]ans ,community ,c>e ,program "u section #agjc ( ?is title2 & 7ii7 ! recomm5dation ( ! ,secret>y = cont9u$ codification ( su* /&>ds along ) a ju/ification = su* recomm5dation4 7,c7 ,on & aft] ! date t is eight ye>s aft] ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act1 ! ,secret>y may n e/abli% access /&>ds = c>e & s]vices describ$ 9 subp>agraph 7,a7 or 7,b7 ( p>agraph 7#a7 t are diff]5t f ! /&>ds set =? 9 ^? subp>agraphs unless1 n lat] ?an #ahj days be=e e/abli%+ su* diff]5t /&>ds-- 7i7 ! ,secret>y submits to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives notification ( ! int5t ( ! ,secret>y to e/abli% su* diff]5t /&>ds1 includ+ a description ( ! *anges ! ,secret>y int5ds to make & ! ju/ification = su* *anges2 & 7ii7 a jo9t resolution ( approval is enact$ t approves su* diff]5t /&>ds4 7,d7 ,= purposes ( ?is subsection1 ! t]m jo9t resolution ( approval means only a jo9t resolution ! matt] aft] ! resolv+ clause ( :i* is z foll[s3 ,t ,congress approves ! access /&>ds e/abli%$ by ! ,secret>y submitt$ on relat+ to 41 ) ! fir/ blank space fill$ by ! appropriate date & ! second blank space fill$ ) a description ( ! access /&>ds4 7,e7 ,a jo9t resolution ( approval %all be consid]$ "u ! exp$it$ proc$ures outl9$ 9 section #hjb ( title #e to ! same ext5t z a jo9t resolution describ$ 9 subsection 7a7 ( t section is consid]$4 7b7 ,application ,! ,secret>y %all ensure t ! eligibility access /&>ds e/abli%$ "u subsection 7a7 apply-- 7#a7 to all c>e & s]vices )9 ! m$ical b5efits package ( ! ,dep>tm5t to :i* a cov]$ vet]an is eligible "u section #agjc ( ?is title2 & 7#b7 to all cov]$ vet]ans1 reg>dless ( :e!r a vet]an is a new or e/abli%$ pati5t4 7c7 ,p]iodic review ( access /&>ds 7#a7 ,n lat] ?an ?ree ye>s aft] ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act1 & n less frequ5tly ?an once e ?ree ye>s !reaft]1 ! ,secret>y %all-- 7,a7 conduct a review ( ! eligibility access /&>ds "u subsection 7a7 9 consultation )-- 7i7 su* ,f$]al entities z ! ,secret>y consid]s appropriate1 includ+ ! ,dep>tm5t ( ,def5se1 ! ,dep>tm5t ( ,heal? & ,human ,s]vices1 & ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices2 7ii7 entities & individuals 9 ! private sector1 includ+-- 7,i7 vet]an pati5ts2 7,,ii7 repres5tatives ( vet]ans1 includ+ individual vet]ans & p>ticipants f vet]an /akehold] organizations select$ ?r\gh an op5 & transp>5t process2 & 7,,iii7 heal? c>e provid]s p>ticipat+ 9 ! ,vet]ans ,community ,c>e ,program "u section #agjc ( ?is title2 & 7iii7 o!r entities t are n "p ( ! ,f$]al ,gov]nm5t2 & 7,b7 submit to ! appropriate committees ( ,congress a report on-- 7i7 ! f9d+s ( ! ,secret>y ) respect to ! review conduct$ "u p>agraph 7#a72 & 7ii7 su* recomm5dations z ! ,secret>y may h ) respect to ! eligibility access /&>ds "u subsection 7a74 7#b7 ,*apt] #aj ( title #e %all n apply to ! consultation requir$ by p>agraph 7#a77;,a74 2 7#b7 by /rik+ subsection 7g72 7#c7 by r$esignat+ subsections 7f71 7h71 & 7i7 z subsections 7d71 7e71 & 7f71 respectively2 7#d7 9 subsection 7d71 z r$esignat$ by p>agraph 7#c7-- 7,a7 by /rik+ e/abli%$ ea* place x appe>s2 & 7,b7 9 p>agraph 7#a71 by /rik+ 7#a7 ,subject to & ins]t+ ,compliance by ,community ,c>e ,provid]s ,) ,access ,/&>ds4--7#a7 ,subject to2 7#e7 9 subsection 7e71 z s r$esignat$-- 7,a7 9 p>agraph 7#a7-- 7i7 by /rik+ 7#a7 ,consi/5t ) & ins]t+ ,det]m9ation ,reg>d+ ,eligibility4--7#a7 ,consi/5t )2 & 7ii7 by /rik+ designat$ access /&>ds e/abli%$ "u ?is section & ins]t+ eligibility access /&>ds "u subsection 7a72 & 7,b7 9 p>agraph 7#b77;,b71 by /rik+ designat$ access /&>ds e/abli%$ "u ?is section & ins]t+ eligibility access /&>ds "u subsection 7a72 & 7#f7 9 subsection 7f71 z r$esignat$ by p>agraph 7#b7-- 7,a7 9 ! matt] prec$+ p>agraph 7#a71 by /rik+ ,9 ?is section & ins]t+ ,def9itions4--,9 ?is section2 & 7,b7 9 p>agraph 7#b7-- 7i7 by /rik+ cov]$ vet]ans & ins]t+ cov]$ vet]an2 7ii7 by /rik+ vet]ans describ$ & ins]t+ a vet]an describ$2 7iii7 by r$esignat+ p>agraphs 7#c7 & 7#d7 z p>agraphs 7#d7 & 7#e71 respectively2 & 7iv7 by ins]t+ aft] p>agraph 7#b7 ! foll[+ new p>agraph 7#c73 7#c7 ,! t]m cov]$ treatm5t program has ! mean+ giv5 su* t]m 9 section #agia ( ?is title4 4 7b7 ,con=m+ am5dm5ts ,section #agjc7;d7 ( su* title is am5d$-- 7#a7 9 p>agraph 7#a77;,d71 by /rik+ designat$ access /&>ds develop$ by ! ,secret>y "u section #agjc;,b ( ?is title & ins]t+ eligibility access /&>ds "u section #agjc;,b7a7 ( ?is title2 7#b7 9 p>agraph 7#c71 by /rik+ designat$ access /&>ds develop$ by ! ,secret>y "u section #agjc;,b ( ?is title & ins]t+ eligibility access /&>ds "u section #agjc;,b7a7 ( ?is title2 & 7#c7 9 p>agraph 7#d71 by /rik+ designat$ access /&>ds develop$ by ! ,secret>y "u section #agjc;,b ( ?is title & ins]t+ eligibility access /&>ds "u section #agjc;,b7a7 ( ?is title4 #fjb4 ,requirem5t t ,secret>y notify vet]ans ( eligibility = c>e or d5ial ( reque/ = c>e "u ,vet]ans ,community ,c>e ,program 7a7 ,9 g5]al ,section #agjc7;a7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#e7 7,a7 7i7 ,except z provid$ 9 clause 7iii71 ! ,secret>y %all notify ea* cov]$ vet]an 9 writ+ ( ! eligibility ( su* vet]an = c>e or s]vices "u ?is section z soon z possible b n lat] ?an five days aft] ! date on :i* ! ,secret>y is aw>e t ! vet]an is seek+ c>e or s]vices & is eligible = su* c>e or s]vices "u ?is section4 7ii7 ,! ,secret>y is requir$ to notify a cov]$ vet]an "u clause 7i7 only at ! />t ( an episode ( c>e = su* vet]an4 7iii7 ,! ,secret>y %all all[ a cov]$ vet]an to opt out ( receiv+ notification "u clause 7i74 7,b7 ,) respect to ea* cov]$ vet]an eligible = c>e or s]vices "u subsection 7d71 & consi/5t ) subp>agraph 7,a71 ! ,secret>y %all provide su* vet]an p]iodic rem9d]s1 z applicable & z ! ,secret>y det]m9es appropriate1 ( _! ongo+ eligibility "u su* subsection4 7,c7 ,any notification or rem9d] "u ?is p>agraph may be provid$ electronically4 7#f7 7,a7 ,if a reque/ by a vet]an = ! ,secret>y to au?orize c>e or s]vices "u ?is section is d5i$1 except z provid$ 9 subp>agraph 7,c71 ! ,secret>y %all notify ! vet]an 9 writ+ z soon z possible b n lat] ?an five days aft] ! d5ial is made-- 7i7 ( ! reason = ! d5ial2 & 7ii7 ) in/ructions on h[ to appeal su* d5ial us+ ! cl9ical appeals process ( ! ,vet]ans ,heal? ,adm9i/ration4 7,b7 ,if a d5ial "u subp>agraph 7,a7 is due to ! ,secret>y meet+ ! eligibility access /&>ds "u section #agjc;,b7a7 ( ?is title1 notice "u su* subp>agraph %all include an explanation ( h[ ! ,secret>y met su* /&>ds4 7,c7 ,! ,secret>y %all all[ a cov]$ vet]an to opt out ( receiv+ notification "u subp>agraph 7,a74 7,d7 ,any notification "u ?is p>agraph may be provid$ electronically4 4 7b7 ,reports to ,congress ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 & n less frequ5tly ?an annually !reaft] = a p]iod ( five ye>s1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! implem5tation ( ! am5dm5ts made by subsection 7a71 includ+-- 7#a7 an assessm5t ( ! timel9ess ( ! notifications requir$ by ^? am5dm5ts2 7#b7 a description ( b>ri]s to increas+ ! timel9ess ( ^? notifications2 & 7#c7 ! numb] ( vet]ans :o opt out ( receiv+ ^? notifications4 #fjc4 ,consid]ation "u ,vet]ans ,community ,c>e ,program ( cont9uity ( c>e & ne$ = c>egiv] or att5dant ,section #agjc7;d7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 9 p>agraph 7#b71 by add+ at ! end ! foll[+ new subp>agraphs3 7,f7 ,! pot5tial = improv$ cont9uity ( c>e1 includ+ if a vet]an has an e/abli%$ relation%ip ) a non-,dep>tm5t provid] & ! likelihood ( ! cov]$ vet]an to seek & complete recomm5d$ c>e1 includ+ if ! vet]an w\ld ab/a9 f seek+ su* c>e if requir$ to seek su* c>e at a facility ( ! ,dep>tm5t4 7,g7 ,:e!r ! cov]$ vet]an ne$s an att5dant to provide requir$ aid or assi/ance to ! vet]an1 includ+ = ! vet]an to travel to a facility ( ! ,dep>tm5t4 2 & 7#b7 by add+ at ! end ! foll[+ new p>agraph3 7#e7 ,! ,secret>y %all ensure t consid]ation ( ! factors specifi$ 9 p>agraph 7#b7 includes consid]ation ( all relevant factors1 is driv5 by cl9ical ne$1 & t no s+le factor is requir$ to be det]m9ative :5 consid]+ ! be/ m$ical int]e/ ( a cov]$ vet]an4 4 #fjd4 ,discussion ( teleheal? options "u ,vet]ans ,community ,c>e ,program ,section #agjc ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 by r$esignat+ subsection 7q7 z subsection 7r72 & 7#b7 by ins]t+ aft] subsection 7p7 ! foll[+ new subsection 7q73 7q7 ,discussion ( options = teleheal? 7#a7 ,:5 discuss+ options = c>e or s]vices = a cov]$ vet]an "u ?is section1 ! ,secret>y %all ensure t ! vet]an is in=m$ ( ! ability ( ! vet]an to seek c>e or s]vices via teleheal?1 ei!r ?r\gh a m$ical facility ( ! ,dep>tm5t or ?r\gh a non-,dep>tm5t provid]1 if-- 7,a7 teleheal? is-- 7i7 available to ! vet]an2 7ii7 appropriate = ! type ( c>e or s]vices ! vet]an is seek+1 z det]m9$ by ! ,secret>y2 & 7iii7 is acceptable to ! vet]an2 or 7,b7 ! c>e or s]vices ! vet]an is seek+ is only or prim>ily available ?r\gh teleheal?4 7#b7 ,no?+ 9 p>agraph 7#a7 %all be con/ru$ to prohibit a heal? c>e provid] specifi$ 9 subsection 7c7 f furni%+ hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices "u ?is section via teleheal?4 4 #fje4 ,ext5sion ( deadl9e = submittal ( claims by heal? c>e entities & provid]s "u prompt paym5t /&>d ,section #agjc;,d ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 9 subsection 7a77#b71 by /rik+ ! reason = d5y+ ! claim & :at1 if any1 additional in=mation is requir$ to process ! claim & ins]t+ ! reason = d5y+ ! claim & reque/ additional miss+ in=mation1 if any1 t is requir$ to process ! claim2 7#b7 by am5d+ subsection 7b7 to read z foll[s3 7b7 ,submittal ( claims by heal? c>e entities & provid]s 7#a7 ,a heal? c>e entity or provid] t furni%es hospital c>e1 a m$ical s]vice1 or an ext5d$ c>e s]vices "u ?is *apt] pursuant to a contract1 agreem5t1 or o!r arrangem5t %all submit to ! ,secret>y a claim = paym5t = furni%+ ! hospital c>e1 m$ical s]vice1 or ext5d$ c>e s]vice n lat] ?an "o ye> aft] ! date on :i* ! entity or provid] furni%$ ! hospital c>e1 m$ical s]vice1 or ext5d$ c>e s]vice4 7#b7 ,no heal? c>e entity or provid] may seek paym5t f a pati5t if ! heal? c>e entity or provid] fail$ to comply ) ! timely fil+ requirem5t set =? 9 p>agraph 7#a74 2 & 7#c7 9 subsection 7c71 by add+ at ! end ! foll[+ new p>agraph3 7#c7 7,a7 ,if ! ,secret>y det]m9es1 bas$ on reliable evid5ce1 t a heal? c>e entity or provid] has submitt$ or caus$ to be submitt$ a fraudul5t claim = paym5t "u ?is *apt]1 ! ,secret>y may susp5d su* entity or provid] f furni%+ hospital c>e1 m$ical s]vices1 or ext5d$ c>e s]vices "u ?is *apt]4 7,b7 ,be=e impos+ a susp5sion "u subp>agraph 7,a7 ) respect to an entity or provid]1 ! ,secret>y %all-- 7i7 provide writt5 notice to ! entity or provid] id5tify+ ! basis = ! propos$ susp5sion2 7ii7 af=d ! entity or provid] an opportunity to respond )9 a p]iod ( #cj days2 & 7iii7 consid] any evid5ce or explanation submitt$ by ! entity or provid]4 7,c7 7i7 ,! ,secret>y %all take all necess>y actions to resolve a susp5sion "u subp>agraph 7,a7 z soon z possible b n long] ?an )9 "o ye> ( ! date ( ! beg9n+ ( ! susp5sion1 unless ! ,secret>y det]m9es & provides a writt5 det]m9ation t an ext5sion beyond "o ye> is /rictly necess>y to protect ! int]e/s ( vet]ans & taxpay]s & to pres]ve ! integrity ( ! heal? c>e deliv]y sy/em ( ! ,dep>tm5t4 7ii7 ,any ext5sion "u clause 7i7 ( a susp5sion %all-- 7,i7 be = an additional p]iod ( n long] ?an "o ye>2 & 7,,ii7 %all be report$ to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives4 7,d7 ,! ,secret>y %all e/abli% proc$ures = re9/atem5t ( an entity or provid] susp5d$ "u subp>agraph 7,a7 foll[+ ! resolution ( any fraud-relat$ inve/igation or proce$+4 7,e7 ,! ,secret>y %all coord9ate actions "u ?is p>agraph ) ! ,(fice ( ,inspector ,g5]al ( ! ,dep>tm5t4 7,f7 ,! ,secret>y %all prescribe regulations to c>ry out ?is p>agraph1 includ+ /&>ds ( evid5ce1 notice1 & appeal proc$ures4 7,g7 7i7 ,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 writt5 notification ( ! susp5sions ent]$ into1 if any1 dur+ ! prec$+ qu>t] t includes-- 7,i7 ! id5tity ( ! susp5d$ entity or provid]2 7,,ii7 ! /atutory or regulatory basis = ! susp5sion2 7,,iii7 a summ>y ( ! factual f9d+s or evid5ce support+ ! action2 & 7,,iv7 ! /atus ( any relat$ inve/igation ( or ref]ral to ! ,(fice ( ,inspector ,g5]al ( ! ,dep>tm5t or any o!r appropriate ,f$]al ag5cy4 7ii7 ,! ,secret>y %all provide to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives1 ^u reque/1 all records1 memor&a1 & communications relevant to any susp5sion or re9/atem5t action tak5 "u ?is p>agraph1 9 accordance ) applicable laws relat$ to privacy1 ongo+ inve/igations1 or s5sitive law en=cem5t in=mation4 7iii7 ,failure by ! ,secret>y to provide notice "u clause 7i7 %all be treat$ z a failure to comply ) a /atutory report+ requirem5t4 4 #fjf4 ,audit ( repres5tative sample ( vet]ans receiv+ c>e & s]vices "u ,vet]ans ,community ,c>e ,program ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 & n less frequ5tly ?an annually !reaft] = ! foll[+ five ye>s1 ! ,secret>y ( ,vet]ans ,affairs %all-- 7#a7 conduct an audit1 = ! "o-ye> p]iod prec$+ ! audit1 (-- 7,a7 ! numb] ( vet]ans eligible = c>e or s]vices "u section #agjc ( title #ch1 ,unit$ ,/ates ,code1 & ! reasons = su* eligibility1 includ+ multiple su* reasons = vet]ans eligible "u m ?an "o eligibility crit]ia2 7,b7 ( ^? vet]ans eligible = c>e or s]vices "u section #agjc ( title #ch1 ,unit$ ,/ates ,code1 ! numb] ( vet]ans :o are in=m$ ( su* eligibility2 7,c7 ! numb] ( vet]ans :o opt to seek c>e or s]vices "u su* section2 7,d7 ! numb] ( vet]ans :o d n opt to seek c>e or s]vices "u su* section2 7,e7 ! timel9ess ( ref]rals = c>e or s]vices "u su* section & ! timel9ess ( receipt ( su* c>e or s]vices1 includ+ :e!r c>e or s]vices receiv$ by ! vet]an ?r\gh a non-,dep>tm5t ( ,vet]ans ,affairs provid] _h a %ort] wait "t ?an ! av]age wait "t = su* c>e or s]vices at a facility ( ! ,dep>tm5t2 7,f7 ! numb] ( reque/s = an appeal ( a d5ial ( c>e or s]vices "u su* section us+ ! cl9ical appeals process ( ! ,vet]ans ,heal? ,adm9i/ration2 7,g7 ! timel9ess ( ea* su* appeal2 & 7,h7 ! outcome ( ea* su* appeal2 & 7#b7 submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! audit conduct$ "u p>agraph 7#a74 #fjg4 ,in=mation on wait "t & drive "t options = receipt ( c>e by vet]ans 7a7 ,9 g5]al ,to ! greate/ ext5t practicable1 ! ,secret>y ( ,vet]ans ,affairs %all ensure t vet]ans are in=m$ 9 writ+1 = ea* episode ( c>e provid$ "u ! laws adm9i/]$ by ! ,secret>y1 ( curr5t wait "t & av]age drive "t options = su* episode ( c>e disaggregat$ by c>e provid$-- 7#a7 9 p]son at a facility ( ! ,dep>tm5t ( ,vet]ans ,affairs2 7#b7 via teleheal? ?r\gh a provid] ( ! ,dep>tm5t4 7#c7 9 p]son ?r\gh ! ne>e/ suitable non-,dep>tm5t facility ) :i* ! ,dep>tm5t has a provid] agreem5t or o!r arrangem5t = non-,dep>tm5t c>e pursuant to section #agjc ( title #ch1 ,unit$ ,/ates ,code2 & 7#d7 via teleheal? ?r\gh a non-,dep>tm5t provid] ) :i* ! ,dep>tm5t has a provid] agreem5t or o!r arrangem5t = non-,dep>tm5t c>e pursuant to su* section ) ! %orte/ wait "t4 7b7 ,=m ( in=mation ,in=mation provid$ "u subsection 7a7-- 7#a7 may be provid$ electronically2 & 7#b7 %all be docum5t$ 9 ! heal? record ( ! vet]an4 7c7 ,opt out ,! ,secret>y %all p]mit a vet]an to opt out ( receiv+ in=mation "u subsection 7a74 #fjh4 ,e/abli%m5t ( p]iod dur+ :i* a ref]ral "u ,vet]ans ,community ,c>e ,program rema9s valid ,section #agjc7;a7 ( title #ch1 ,unit$ ,/ates ,code1 z am5d$ by section #fjb7;a71 is fur!r am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#g7 ,:5 au?oriz+ c>e or s]vices "u ?is section1 ! ,secret>y %all ensure t ! p]iod dur+ :i* su* c>e or s]vices may be p]=m$ by a heal? c>e provid] specifi$ 9 subsection 7c7 beg9s on ! date t ! cov]$ vet]an has ! fir/ appo9tm5t ) su* provid]4 4 #fji4 ,updates to contract+ requirem5ts "u ,vet]ans ,community ,c>e ,program ,section #agjc7;h7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 9 p>agraph 7#c7-- 7,a7 by am5d+ subp>agraph 7,a7 to read z foll[s3 7,a7 ,! ,secret>y may t]m9ate a contract ) an entity ent]$ into "u p>agraph 7#a7 at su* "t & ^u su* notice to ! entity z ! ,secret>y may specify = purposes ( ?is section1 if ! ,secret>y notifies ! appropriate committees ( ,congress t1 at a m9imum-- 7i7 ! entity fail$ to comply sub/antially ) ! provisions ( ! contract or ) ! provisions ( ?is section & ! regulations prescrib$ "u ?is section1 includ+ ) respect to access1 quality1 tra9+1 & m$ical docum5tation2 7ii7 x is reasonable to t]m9ate ! contract bas$ on ! heal? c>e ne$s ( vet]ans2 or 7iii7 x is reasonable to t]m9ate ! contract bas$ on cov]age provid$ by contracts or %>+ agreem5ts ent]$ into "u au?orities o!r ?an ?is section4 2 7,b7 by r$esignat+ subp>agraph 7,b7 z subp>agraph 7,d72 7,c7 by ins]t+ aft] subp>agraph 7,a7 ! foll[+ new subp>agraphs3 7,b7 7i7 ,! ,secret>y %all t]m9ate a contract ) an entity ent]$ into "u p>agraph 7#a7 at su* a "t & ^u su* notice to ! entity z ! ,secret>y may specify = ! purposes ( ?is section1 if ! entity-- 7,i7 is exclud$ f p>ticipation 9 a ,f$]al heal? c>e program 7z def9$ 9 section #aabh;,b7f7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g;b7f777 "u section #aabh or #aabh;,a ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g & #acbj;a-#g;a72 7,,ii7 has be5 convict$ ( a felony or o!r s]i\s (f5se "u ,f$]al or ,/ate law & ! cont9u$ p>ticipation ( ! entity w\ld be detrim5tal to ! be/ int]e/s ( vet]ans or ! ,dep>tm5t2 or 7,,iii7 is id5tifi$ z an exclud$ s\rce on ! li/ ma9ta9$ 9 ! ,sy/em = ,aw>d ,managem5t1 or any successor sy/em4 7ii7 ,! ,secret>y may issue a waiv] = entities subject to clause 7i7 = a "o-ye> p]iod1 & su* a waiv] %all be report$ to ,congress n lat] ?an #cj days aft] su* waiv] is issu$4 7,c7 ,any entities ineligible to ent] into contracts ) ! ,dep>tm5t due to "o or m reasons specifi$ 9 ?is p>agraph may be li/$ on a publicly available website ( ! ,dep>tm5t or appropriate ?ird p>ty adm9i/rator4 2 7,d7 9 subp>agraph 7,d71 z r$esignat$ by subp>agraph 7,b7 ( ?is p>agraph1 by /rik+ 9 subp>agraph 7,a7 & ins]t+ 9 ?is p>agraph2 & 7#b7 by add+ at ! end ! foll[+ new p>agraph3 7#g7 ,any contract or agreem5t betwe5 ! ,dep>tm5t & a ?ird p>ty adm9i/rator or betwe5 a ?ird p>ty adm9i/rator & a heal? c>e provid] specifi$ 9 subsection 7c7 t is made ) respect to c>e or s]vices provid$ "u ?is section %all include-- 7,a7 notice ( obligations to comply ) ,f$]al laws & ! consequ5ces = failure to comply ) ^? laws1 includ+ specific in=mation reg>d+ claims = paym5t & consequ5ces = any false claims1 /atem5ts1 or docum5ts1 or concealm5t ( a mat]ial fact2 7,b7 confirmation by ! heal? c>e provid] t !y are accr$it$ to provide any specializ$ s]vices subject to ! contract or agreem5t & t !y w only use qualifi$ /aff to provide ^? s]vices2 & 7,c7 confirmation t ! heal? c>e provid] w id5tify any individuals provid+ specializ$ s]vices or treatm5ts includ$ 9 ! contract or agreem5t & provide pro( ( ! lic5sure ( ^? individuals to ! ,dep>tm5t4 4 #faj4 ,publication ( community c>e network suffici5cy & paym5t waiv] reque/s & approvals ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 & n less frequ5tly ?an annually !reaft]1 ! ,secret>y ( ,vet]ans ,affairs %all publi% on a publicly available & us]-fri5dly website-- 7#a7 ! in=mation conta9$ 9 ! mo/ rec5t report requir$ by section #agjc7p7 ( title #ch1 ,unit$ ,/ates ,code2 & 7#b7 an ov]view1 disaggregat$ by region1 ( ! waiv]s reque/$1 approv$1 & d5i$ "u section #agjc;,b7f77#c7 ( su* title4 #faa4 ,requirem5ts relat+ to quality ( community c>e provid]s 7a7 ,mon?ly *ecks aga9/ li/ ( exclud$ individuals or entities ,! ,secret>y ( ,vet]ans ,affairs %all ensure t ?ird p>ty adm9i/rators "u ! ,vet]ans ,community ,c>e ,program p]=m automat$ mon?ly *ecks = all community c>e provid]s aga9/ ! li/ ( exclud$ individuals or entities set =? by ! ,(fice ( ,inspector ,g5]al ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices us+ national provid] id5tifi] records or o!r unique id5tifi]s4 7b7 ,revision ( provid] exclusion /&>d op]at+ proc$ures ,n lat] ?an #ij days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all ensure t ! ,(fice ( ,integrat$ ,vet]an ,c>e or successor (fice revises its provid] exclusion /&>d op]at+ proc$ures to require automat$ mat*+ ( community c>e provid]s 9 ! provid] pr(ile managem5t sy/em ( ! ,dep>tm5t ( ,vet]ans ,affairs to ! sy/em = aw>d managem5t exclusions ( ! ,g5]al ,s]vices ,adm9i/ration us+ bo? taxpay] id5tification numb] & national provid] id5tifi] z id5tifi]s4 7c7 ,process to id5tify dep>tm5t provid]s t]m9at$ or resign+ f employm5t ,n lat] ?an #ij days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all ensure t ! ,"u ,secret>y = ,heal? ( ! ,dep>tm5t ( ,vet]ans ,affairs develops a process to id5tify heal? c>e provid]s t are t]m9at$1 retire1 or resign f employm5t ) ! ,dep>tm5t = quality ( c>e conc]ns or :ile "u inve/igation = quality ( c>e conc]ns s ^? heal? c>e provid]s c be prev5t$ f p>ticipat+ 9 ! ,vet]ans ,community ,c>e ,program4 7d7 ,update ( in=mation on provid]s ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y1 ?r\gh ! ,(fice ( ,integrat$ ,vet]an ,c>e or successor (fice1 %all develop a process to ensure t ?ird p>ty adm9i/rators regul>ly1 n less frequ5tly ?an qu>t]ly-- 7#a7 update _! li/s ( community c>e provid]s to reflect accurate provid] contact in=mation2 7#b7 annotate provid]s t are n curr5tly accept+ pati5ts "u ! ,vet]ans ,community ,c>e ,program2 & 7#c7 remove provid]s f ! provid] pr(ile managem5t sy/em t-- 7,a7 are on ! li/ ( exclud$ individuals or entities set =? by ! ,(fice ( ,inspector ,g5]al ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices2 7,b7 are 9 ! sy/em = aw>d managem5t exclusions ( ! ,g5]al ,s]vices ,adm9i/ration2 or 7,c7 h be5 t]m9at$ f employm5t ) ! ,dep>tm5t ( ,vet]ans ,affairs due to quality ( c>e conc]ns or left su* employm5t volunt>ily1 ?r\gh resignation1 or ?r\gh retirem5t1 :ile "u inve/igation = quality ( c>e conc]ns4 7e7 ,def9itions ,9 ?is section3 7#a7 ,community c>e provid] ,! t]m community c>e provid] means a heal? c>e provid] specifi$ "u section #agjc7;c7 ( title #ch1 ,unit$ ,/ates ,code4 7#b7 ,vet]ans ,community ,c>e ,program ,! t]m ,vet]ans ,community ,c>e ,program means ! ,vet]ans ,community ,c>e ,program "u section #agjc ( title #ch1 ,unit$ ,/ates ,code4 #fab4 ,provid] tra9+ 7a7 ,developm5t ( plan ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all develop a compreh5sive plan to bett] align tra9+ & inc5tive requirem5ts applicable to community c>e provid]s p>ticipat+ 9 ! ,vet]ans ,community ,c>e ,program & heal? c>e provid]s1 resid5ts1 & tra9ees ( ! ,dep>tm5t ( ,vet]ans ,affairs4 7b7 ,elem5ts ,! plan requir$ "u subsection 7a7 %all-- 7#a7 id5tify exi/+ tra9+ requirem5ts or inc5tives applicable to heal? c>e provid]s ( ! ,dep>tm5t2 7#b7 id5tify exi/+ tra9+ requirem5ts or inc5tives applicable to heal? c>e tra9ees or resid5ts ( ! ,dep>tm5t2 7#c7 id5tify exi/+ tra9+ requirem5ts or inc5tives applicable to community c>e provid]s2 7#d7 assess gaps betwe5 tra9+ requirem5ts & inc5tives = heal? c>e provid]s ( ! ,dep>tm5t1 tra9ees or resid5ts ( ! ,dep>tm5t1 & community c>e provid]s2 7#e7 e/abli% /&>diz$ basel9e tra9+ requirem5ts to ensure consi/5cy 9 ! quality ( c>e furni%$ ?r\gh ! ,dep>tm5t f heal? c>e provid]s ( ! ,dep>tm5t1 tra9ees or resid5ts ( ! ,dep>tm5t1 & community c>e provid]s2 & 7#f7 provide a /rategy1 assessm5t ( b>ri]s1 & timel9e = implem5t+ su* basel9e tra9+ requirem5ts1 includ+-- 7,a7 ?r\gh onl9e modules & cont9u+ m$ical education programs2 & 7,b7 )9 su* /rategy-- 7i7 metrics to measure ! effectiv5ess ( basel9e tra9+ requirem5ts 9 improv+ cl9ical quality1 satisfaction ( vet]ans1 & heal? outcomes = vet]ans2 7ii7 a me*anism to acc\nt = non-,dep>tm5t tra9+ t is equival5t or sub/antially simil> to ! ,dep>tm5t tra9+ 9 l5g?1 scope1 & cont5t1 z det]m9$ by ! ,secret>y2 7iii7 a me*anism to regul>ly communicate1 includ+ ?r\gh direct outrea* & publication onl9e & 9 provid] h&books ( ?ird p>ty adm9i/rators "u ! ,vet]ans ,community ,c>e ,program1 requirem5ts & expectations ) respect to tra9+2 7iv7 a me*anism to track1 report1 & address non-compliance1 to include corrective actions1 :i* may include susp5d+ or b>r+ provid]s :o are r\t9ely non-compliant2 & 7v7 a me*anism to designate community c>e provid]s :o r\t9ely meet or exce$ basel9e tra9+ requirem5ts z pref]r$ provid]s or "p ( ! high p]=m+ provid] program ( ! ,dep>tm5t1 z ! ,secret>y consid]s appropriate4 7c7 ,implem5tation ,n lat] ?an "o ye> aft] submission ( ! report requir$ "u subsection 7d71 ! ,secret>y %all beg9 implem5t+ ! plan requir$ "u subsection 7a74 7d7 ,report to ,congress ,n lat] ?an #ahj days 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 conta9+-- 7#a7 ! plan requir$ "u subsection 7a72 7#b7 a description ( id5tifi$ gaps betwe5 tra9+ or inc5tives = provid]s ( ! ,dep>tm5t1 tra9ees or resid5ts ( ! ,dep>tm5t1 & community c>e provid]s2 7#c7 ! e/imat$ co/s associat$ ) implem5tation ( ! plan2 & 7#d7 a description ( any legislative or regulatory *anges necess>y to c>ry out ! plan4 7e7 ,annual updates ,n lat] ?an "o ye> aft] ! submission ( ! report requir$ by subsection 7d71 & annually !reaft] = ! foll[+ two ye>s1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives an update-- 7#a7 describ+ progress 9 implem5t+ ! plan requir$ "u subsection 7a72 7#b7 assess+ any measurable impacts ( su* implem5tation on quality ( c>e2 & 7#c7 assess+ any improvem5ts 9 rates ( compliance ) tra9+ requirem5ts among heal? c>e provid]s1 tra9ees1 & resid5ts ( ! ,dep>tm5t & community c>e provid]s4 7f7 ,def9itions ,9 ?is section3 7#a7 ,community c>e provid] ,! t]m community c>e provid] means a heal? c>e provid] specifi$ "u section #agjc7;c7 ( title #ch1 ,unit$ ,/ates ,code4 7#b7 ,tra9+ ,! t]m tra9+ includes tra9+ relat+ to-- 7,a7 vet]an-specific cultural compet5cy2 7,b7 heal? conditions relat$ to milit>y s]vice1 includ+ toxic exposures1 po/-traumatic /ress disord]1 traumatic bra9 injury1 & milit>y sexual trauma2 7,c7 suicide prev5tion2 7,d7 pa9 managem5t & opioid safety2 & 7,e7 any o!r matt] ! ,secret>y det]m9es appropriate4 7#c7 ,vet]ans ,community ,c>e ,program ,! t]m ,vet]ans ,community ,c>e ,program means ! ,vet]ans ,community ,c>e ,program "u section #agjc ( title #ch1 ,unit$ ,/ates ,code4 #fac4 ,ov]sight au?ority ov] community c>e 7a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all include 9 ea* contract or agreem5t us$ to provide c>e or s]vices ?r\gh ! ,vet]ans ,community ,c>e ,program provisions requir+ ! contractor & any subcontractor or p>ticipat+ provid] to provide gov]nm5t (ficials1 includ+ ! ,(fice ( ! ,inspector ,g5]al ( ! ,dep>tm5t ( ,vet]ans ,affairs1 access1 )9 a reasonable "t & mann]1 to records1 mat]ials1 docum5ts1 data1 & p]sonnel necess>y to conduct audits1 inspections1 evaluations1 or inve/igations relat$ to su* c>e or s]vices4 7b7 ,?ird p>ty adm9i/rators 7#a7 ,requirem5t ,! ,secret>y %all require ?ird p>ty adm9i/rators "u ! ,vet]ans ,community ,c>e ,program to include provisions 9 agreem5ts ) p>ticipat+ provid]s t are equival5t to ! provisions requir$ "u subsection 7a74 7#b7 ,notification ,notification ( ! requirem5ts "u ?is section & any o!r relat$ in=mation z ! ,secret>y det]m9es appropriate %all be includ$ 9 ! provid] h&books ( ?ird p>ty adm9i/rators "u ! ,vet]ans ,community ,c>e ,program4 7c7 ,/&>d contract language ,! ,secret>y %all e/abli% /&>d contract language "u ?is section 9 consultation ) ! ,inspector ,g5]al ( ! ,dep>tm5t ( ,vet]ans ,affairs4 7d7 ,vet]ans ,community ,c>e ,program def9$ ,9 ?is section1 ! t]m ,vet]ans ,community ,c>e ,program means ! ,vet]ans ,community ,c>e ,program "u section #agjc ( title #ch1 ,unit$ ,/ates ,code4 ,b ,m5tal ,heal? ,treatm5t ,programs #fba4 ,vet]an p>ticipation 9 c]ta9 m5tal heal? programs 7a7 ,e/abli%m5t ,*apt] #ag ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new sub*apt]3 ,,ix ,p>ticipation by ,vet]ans 9 ,c]ta9 ,m5tal ,heal? ,treatm5t ,programs #agia4 ,def9itions ,9 ?is sub*apt]3 7#a7 ,activities ( daily liv+ ,! t]m activities ( daily liv+ means specific p]sonal c>e activities t are requir$ = basic daily ma9t5ance & su/5ance1 to include eat+1 toilet+1 ba?+1 groom+1 dress+ & undress+1 & mobility4 7#b7 ,cov]$ treatm5t program 7,a7 ,9 g5]al ,! t]m cov]$ treatm5t program-- 7i7 means-- 7,i7 a m5tal heal? resid5tial rehabilitation treatm5t program ( ! ,dep>tm5t2 or 7,,ii7 a program ( ! ,dep>tm5t = resid5tial c>e = m5tal heal? & sub/ance use disord]s2 7ii7 includes-- 7,i7 ! programs designat$ z ( ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act z domicili>y resid5tial rehabilitation treatm5t programs2 & 7,,ii7 any programs designat$ z domicili>y resid5tial rehabilitation treatm5t programs on or aft] su* date ( enactm5t2 & 7iii7 does n include-- 7,i7 ,comp5sat$ ,"w ,!rapy ,transition ,resid5ce programs ( ! ,dep>tm5t2 or 7,,ii7 ,dep>tm5t or non-,dep>tm5t programs 9 :i* m ?an #bj p]c5t ( ! c>e provid$ is provid$ ?r\gh teleheal?4 7,b7 ,accr$itation ,a program describ$ 9 subp>agraph 7,a7 mu/ ma9ta9 accr$itation by ! ,commission on ,accr$itation ( ,rehabilitation ,facilities & ! ,jo9t ,commission4 7#c7 ,cov]$ vet]an ,! t]m cov]$ vet]an means a vet]an describ$ 9 section #agjc7;b7 ( ?is title4 7#d7 ,evid5ce-bas$ treatm5t ,! t]m evid5ce-bas$ treatm5t means treatm5t provid$ 9 accordance ) ! ,dep>tm5t ( ,vet]ans ,affairs_/,dep>tm5t ( ,def5se ,cl9ical ,practice ,guidel9es = ,m5tal ,heal? & ,sub/ance ,use ,disord]1 or any successor simil> guidel9es4 7#e7 ,social support sy/ems ,! t]m social support sy/ems1 ) respect to a cov]$ vet]an-- 7,a7 means-- 7i7 a memb] ( ! family ( ! cov]$ vet]an1 includ+ a p>5t1 sp\se1 *ild1 /ep-family memb]1 or ext5d$ family memb]2 or 7ii7 an individual :o lives ) ! vet]an b is n a memb] ( ! family ( ! vet]an2 & 7,b7 does n include a facility-organiz$ pe] support program4 #agib4 ,/&>diz$ process to det]m9e eligibility ( cov]$ vet]ans = p>ticipation 9 c]ta9 m5tal heal? treatm5t programs 7a7 ,/&>diz$ scre5+ process ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act1 ! ,secret>y %all e/abli% a /&>diz$ scre5+ process to det]m9e1 bas$ on cl9ical ne$1 :e!r a cov]$ vet]an satisfies crit]ia = priority or r\t9e admission to a cov]$ treatm5t program4 7b7 ,eligibility crit]ia = priority admission 7#a7 ,9 g5]al ,"u ! /&>diz$ scre5+ process requir$ by subsection 7a71 a cov]$ vet]an %all be eligible = priority admission to a cov]$ treatm5t program if ! cov]$ vet]an meets crit]ia e/abli%$ by ! ,secret>y t include any ( ! foll[+3 7,a7 ,a cl9ical assessm5t ( ! symptoms ( ! vet]an1 includ+ symptoms t-- 7i7 significantly affect activities ( daily life2 & 7ii7 increase ! risk ( adv]se outcomes1 su* z ov]dose1 suicide1 self-h>m1 or an unsafe liv+ situation4 7,b7 ,! lack ( availability & applicability ( o!r treatm5t options4 7,c7 ,:e!r ! vet]an has a rec5t suicide or ov]dose attempt4 7,d7 ,:e!r ! vet]an is det]m9$ to be a high risk = suicide or ov]dose4 7,e7 ,:e!r ! vet]an has a demon/rat$ hi/ory ( non-responsiv5ess1 relapse1 or inability to f9d recov]y f two o!r complet$ c\rses ( treatm5t1 su* z outpati5t or int5sive outpati5t treatm5t1 ?r\gh a program t-- 7i7 is lic5s$ by a ,/ate2 7ii7 is accr$it$ by ! ,commission on ,accr$itation ( ,rehabilitation ,facilities or ! ,jo9t ,commission2 & 7iii7 provides evid5ce-bas$ treatm5t4 7,f7 ,su* o!r crit]ia z ! ,secret>y det]m9es appropriate1 9 consultation ) ,congress4 7#b7 ,consid]ation ,9 mak+ a det]m9ation t a cov]$ vet]an meets crit]ia e/abli%$ by ! ,secret>y "u p>agraph 7#a7 = priority admission to a cov]$ treatm5t program1 ! ,secret>y %all-- 7,a7 consid] any ref]ral ( a heal? c>e provid] ( a cov]$ vet]an2 & 7,b7 ensure t consid]ation ( su* crit]ia includes consid]ation ( all relevant factors1 is driv5 by cl9ical ne$1 & t no s+le factor is requir$ to be det]m9ative :5 consid]+ ! be/ m$ical int]e/ ( a cov]$ vet]an4 7#c7 ,provision ( high]-level c>e ,! ,secret>y %all provide imm$iate & cl9ically necess>y c>e "u o!r au?orities available to ! ,secret>y to any cov]$ vet]an :o is n cl9ically recomm5d$ = admission to a cov]$ treatm5t program bas$ on ! ne$ = a high] level ( c>e1 su* z be+ at a high acute risk = suicide4 7c7 ,scre5+ = traumatic bra9 injury ,"u ! /&>diz$ scre5+ process requir$ by subsection 7a71 ! ,secret>y %all ensure a cov]$ vet]an is scre5$ at an appropriate "t = pot5tial mild1 mod]ate1 or sev]e traumatic bra9 injury4 7d7 ,consid]ations ,9 mak+ placem5t decisions 9 a cov]$ treatm5t program = vet]ans :o meet crit]ia = priority or r\t9e admission1 ! ,secret>y %all-- 7#a7 consid] ! input ( ! cov]$ vet]an ) respect to !-- 7,a7 program specialty1 subtype1 & treatm5t track (f]$ to ! cov]$ vet]an2 & 7,b7 geographic placem5t ( ! cov]$ vet]an1 includ+ proximity to ! curr5t resid5ce1 "t zone1 or geographic region ( ! cov]$ vet]an2 7#b7 maximize ! proximity ( ! cov]$ vet]an to social support sy/ems2 & 7#c7 to ! greate/ ext5t practicable1 place ! vet]an 9 a cov]$ treatm5t program locat$ )9 ! same "t zone & geographic region z ! resid5ce ( ! vet]an at ! "t ( admission4 7e7 ,conditions "u :i* c>e %all be furni%$ ?r\gh non-,dep>tm5t provid]s 7#a7 ,priority admission ,if ! ,secret>y det]m9es a cov]$ vet]an is eligible = priority admission to a cov]$ treatm5t program pursuant to ! /&>diz$ scre5+ process requir$ by subsection 7a7 & ! ,secret>y is unable to admit su* cov]$ vet]an to a cov]$ treatm5t program at a facility ( ! ,dep>tm5t 9 a mann] t complies ) ! requirem5ts "u subsection 7d7 & section #agjc;,b7a77#a77;,c7 ( ?is title1 ! ,secret>y %all (f] ! cov]$ vet]an ! option to receive c>e at a non-,dep>tm5t facility t-- 7,a7 c admit ! cov]$ vet]an )9 ! p]iod requir$ by section #agjc;,b7a77#a77;,c77ii77,i7 ( ?is title2 7,b7 is p>ty to a contract or agreem5t ) ! ,dep>tm5t or ent]s into su* a contract or agreem5t "u :i* ! ,dep>tm5t furni%es a program t is equival5t to a cov]$ treatm5t program to a vet]an ?r\gh su* non-,dep>tm5t facility2 7,c7 is lic5s$ by a ,/ate2 7,d7 is accr$it$ by ! ,commission on ,accr$itation ( ,rehabilitation ,facilities or ! ,jo9t ,commission2 & 7,e7 provides evid5ce-bas$ treatm5t4 7#b7 ,r\t9e admission ,if ! ,secret>y det]m9es a cov]$ vet]an is eligible = r\t9e admission to a cov]$ treatm5t program pursuant to ! /&>diz$ scre5+ process requir$ by subsection 7a7 & ! ,secret>y is unable to admit su* cov]$ vet]an to a cov]$ treatm5t program at a facility ( ! ,dep>tm5t 9 a mann] t complies ) ! requirem5ts "u section #agjc;,b7a77#a77;,c7 ( ?is title ) respect to r\t9e admission1 ! ,secret>y %all (f] ! cov]$ vet]an ! option to receive c>e at a non-,dep>tm5t facility t-- 7,a7 is p>ty to a contract or agreem5t ) ! ,dep>tm5t or ent]s into su* a contract or agreem5t "u :i* ! ,dep>tm5t furni%es a program t is equival5t to a cov]$ treatm5t program to a vet]an ?r\gh su* non-,dep>tm5t facility2 7,b7 is lic5s$ by a ,/ate2 7,c7 is accr$it$ by ! ,commission on ,accr$itation ( ,rehabilitation ,facilities or ! ,jo9t ,commission2 & 7,d7 provides evid5ce-bas$ treatm5t4 7#c7 ,rule ( con/ruction ,?is subsection %all n be con/ru$ to affect a cov]$ vet]an 9 a cov]$ treatm5t program pursuant to a det]m9ation made on or be=e ! date ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act4 #agic4 ,improvem5ts to ,dep>tm5t ( ,vet]ans ,affairs m5tal heal? resid5tial rehabilitation treatm5t program 7a7 ,p]=mance metrics 7#a7 ,9 g5]al ,! ,secret>y %all develop metrics to track1 & %all subsequ5tly track1 ! p]=mance ( m$ical facilities ( ! ,dep>tm5t1 ,vet]ans ,integrat$ ,s]vice ,networks1 & non-,dep>tm5t facilities 9 meet+ ! requirem5ts =-- 7,a7 scre5+1 "u section #agib ( ?is title1 = a cov]$ treatm5t program2 7,b7 timely admission1 "u section #agib ( ?is title1 to a cov]$ treatm5t program pursuant to su* scre5+2 & 7,c7 adh]5ce to evid5ce-bas$ treatm5t /&>ds develop$ by ! ,secret>y 9 consultation ) appropriate gov]nm5tal & non-gov]nm5tal pr(essional organizations ) a demon/rat$ hi/ory ( provid+ or accr$it+ programs t are sub/antially simil> to cov]$ treatm5t programs1 or made ( pr(essionals :o provide = su* programs1 includ+ by-- 7i7 us+ placem5t crit]ia e/abli%$ by ! ,am]ican ,society ( ,addiction ,m$ic9e2 & 7ii7 ma9ta9+ /&>ds to meet accr$itation by ! ,commission on ,accr$itation ( ,rehabilitation ,facilities or ! ,jo9t ,commission4 7#b7 ,elem5ts ,! metrics develop$ "u p>agraph 7#a7 %all include metrics = track+ ! p]=mance ( m$ical facilities ( ! ,dep>tm5t1 ,vet]ans ,integrat$ ,s]vice ,networks1 & non-,dep>tm5t facilities ) respect to r\t9e & priority admission "u a cov]$ treatm5t program z well z adh]5ce to evid5ce-bas$ treatm5t /&>ds4 7#c7 ,consultation ,9 develop+ metrics "u p>agraph 7#a71 ! ,secret>y %all consult ) m5tal heal? & sub/ance use disord] provid]s1 includ+ provid]s employ$ by ! ,dep>tm5t & ^? employ$ by non-,dep>tm5t entities1 & ensure adh]5ce to indu/ry /&>ds4 7#d7 ,report ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se a report describ+ ! consultation & p]=mance metrics requir$ "u ?is subsection4 7b7 ,ov]sight 7#a7 ,9 g5]al ,! ,secret>y %all develop a process = sy/ematically assess+ at ! facility1 network1 & regional level1 z ! ,secret>y consid]s appropriate1 ! quality ( c>e deliv]$ by facilities ( ! ,dep>tm5t & non-,dep>tm5t facilities treat+ cov]$ vet]ans "u ?is section z well z a process = rectify+ any id5tifi$ conc]ns4 7#b7 ,elem5ts ,! processes requir$ "u p>agraph 7#a7 %all include assessm5ts (-- 7,a7 ! ext5t to :i* provid]s at ! facility deliv] evid5ce-bas$ treatm5ts to cov]$ vet]ans2 7,b7 cl9ical outcomes = cov]$ vet]ans1 includ+ ^? outcomes assessm5t pursuant to a subsequ5t cl9ical scre5+ "u subsection 7g77#c77;,e72 7,c7 ! ratio ( lic5s$ indep5d5t practition]s p] resid5t2 7,d7 ! rate ( completion ( tra9+ "u section #agie ( ?is title by lic5s$ indep5d5t practition]s2 7,e7 :e!r non-,dep>tm5t facilities & provid]s g5]ally meet ! crit]ia outl9$ 9 section #agib7;e7 ( ?is title2 7,f7 ! timel9ess1 complet5ess1 & rate ( transmission1 if applicable1 ( m$ical records dur+ & foll[+ treatm5t ( cov]$ vet]ans2 & 7,g7 pot5tially wa/eful1 fraudul5t1 or inappropriate ref]ral or bill+ practices4 7#c7 ,consultation ,9 develop+ ! processes requir$ "u p>agraph 7#a71 ! ,secret>y %all consult ) relevant /akehold]s1 includ+ m5tal heal? & sub/ance use disord] provid]s employ$ by ! ,dep>tm5t & ^? employ$ by non-,dep>tm5t entities1 & ensure adh]5ce to indu/ry /&>ds4 7#d7 ,report ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se a report describ+ ! consultation & ov]sight processes requir$ by ?is subsection4 7c7 ,placem5t2 transportation 7#a7 ,locations ,if ! ,secret>y det]m9es t a cov]$ vet]an is 9 ne$ ( resid5tial c>e "u a cov]$ treatm5t program1 ! ,secret>y %all provide to ! cov]$ vet]an a li/ ( locations at :i* su* cov]$ vet]an c receive su* resid5tial c>e t meets-- 7,a7 ! /&>ds = scre5+ "u section #agib ( ?is title2 & 7,b7 ! c>e ne$s ( ! cov]$ vet]an1 includ+ applicable treatm5t tracks4 7#b7 ,transportation cov]age 7,a7 ,9 g5]al ,not)/&+ any o!r provision ( law reg>d+ ! transportation ( individuals "u ?is title1 or any o!r law adm9i/]$ by ! ,secret>y1 & except z provid$ 9 subp>agraph 7,b71 ! ,secret>y %all provide transportation1 pay =1 or reimburse ! co/s ( transportation = any cov]$ vet]an :o is admitt$ into a cov]$ treatm5t program & ne$s transportation assi/ance-- 7i7 f ! resid5ce ( ! cov]$ vet]an or a facility ( ! ,dep>tm5t or au?oriz$ non-,dep>tm5t facility t does n provide su* c>e to ano!r ,dep>tm5t or non-,dep>tm5t facility t provides resid5tial c>e cov]$ "u a cov]$ treatm5t program2 & 7ii7 back to ! resid5ce ( ! cov]$ vet]an or to a facility ( ! ,dep>tm5t or an au?oriz$ non-,dep>tm5t facility aft] ! conclusion ( a cov]$ treatm5t program1 if applicable4 7,b7 ,limitations 7i7 ,co/s incurr$ by vet]ans ,! ,secret>y %all provide reimbursem5t "u subp>agraph 7,a7 directly to a cov]$ vet]an only = co/s directly incurr$ by ! cov]$ vet]an & pre-approv$ by ! ,dep>tm5t4 7ii7 ,no cov]age ( transportation provid$ by cov]$ treatm5t program ,! ,secret>y %all n reimburse a cov]$ vet]an = transportation provid$ to ! cov]$ vet]an by a cov]$ treatm5t program1 unless = a purpose & am\nt approv$ by ! ,secret>y4 7d7 ,appeals 7#a7 ,9 g5]al ,! ,secret>y %all develop a national policy & associat$ proc$ures1 9 accordance ) ! exi/+ cl9ical appeals process ( ! ,vet]ans ,heal? ,adm9i/ration1 "u :i* a cov]$ vet]an1 a repres5tative ( a cov]$ vet]an1 or a provid] :o reque/s a cov]$ vet]an be admitt$ to a cov]$ treatm5t program1 includ+ a provid] ( ! ,dep>tm5t or a non-,dep>tm5t provid]1 may file a cl9ical appeal pursuant to ?is subsection if ! cov]$ vet]an is-- 7,a7 d5i$ admission into a cov]$ treatm5t program2 or 7,b7 accept$ into a cov]$ treatm5t 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 ,decision ,! ,secret>y %all review & respond to any appeal "u p>agraph 7#a7 n lat] ?an #gb h\rs aft] ! ,secret>y receives su* appeal4 7#c7 ,public guidance ,! ,secret>y %all develop1 & make available to ! public1 guidance on h[ a cov]$ vet]an1 a repres5tative ( ! cov]$ vet]an1 or a provid] ( ! cov]$ vet]an c file a cl9ical appeal pursuant to ?is subsection-- 7,a7 if ! cov]$ vet]an is d5i$ admission into a cov]$ treatm5t program2 7,b7 if ! fir/ date on :i* ! cov]$ vet]an may ent] a cov]$ treatm5t program does n comply ) ! eligibility access /&>ds "u section #agjc;,b7a7 ( ?is title = c>e at a cov]$ treatm5t program2 or 7,c7 ) respect to su* o!r factors z ! ,secret>y may specify4 7#d7 ,rule ( con/ruction ,no?+ 9 ?is subsection may be con/ru$ z grant+ a cov]$ vet]an1 a repres5tative ( a cov]$ vet]an1 or a provid] :o reque/s a cov]$ vet]an be admitt$ to a cov]$ treatm5t program1 includ+ a provid] ( ! ,dep>tm5t or a non-,dep>tm5t provid]1 ! "r to appeal a decision ( ! ,secret>y ) respect to admission to a cov]$ treatm5t program to ! ,bo>d ( ,vet]ans' ,appeals "u *apt] #ga ( ?is title4 7e7 ,track+ ( availability & wait times 7#a7 ,9 g5]al ,! ,secret>y1 to ! ext5t practicable1 %all create a me?od = track+ availability & wait times "u a cov]$ treatm5t program across all facilities ( ! ,dep>tm5t1 ,vet]ans ,integrat$ ,s]vice ,networks1 & non-,dep>tm5t provid]s ?r\gh\t ! ,unit$ ,/ates4 7#b7 ,availability ( in=mation ,! ,secret>y %all make ! in=mation track$ "u p>agraph 7#a7 available1 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 7#c7 ,publication ( in=mation ,n less frequ5tly ?an mon?ly1 ! ,secret>y %all publi% ! in=mation track$ "u p>agraph 7#a7 on a publicly accessible website ( ! ,dep>tm5t4 7f7 ,/aff+ matt]s 7#a7 ,tra9+ 7,a7 ,9 g5]al ,! ,secret>y %all update & implem5t tra9+ = /aff ( ! ,dep>tm5t directly involv$ 9 a cov]$ treatm5t program reg>d+ ref]rals1 scre5+1 admission1 placem5t decisions1 & appeals = su* program1 includ+ all *anges to processes & guidance "u su* program requir$ by ?is section & section #agib4 7,b7 ,cov]$ vet]ans await+ admission ,! tra9+ "u subp>agraph 7,a7 %all include proc$ures = ! c>e ( cov]$ vet]ans await+ admission into a cov]$ treatm5t program & communication ) su* cov]$ vet]ans & ! provid]s ( su* cov]$ vet]ans4 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 n lat] ?an #fj days aft] beg9n+ employm5t at ! ,dep>tm5t 9 a position t includes "w directly involv+ a cov]$ treatm5t 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+4 7#b7 ,ov]sight /&>ds ,! ,secret>y %all review & revise ov]sight /&>ds = ! lead]%ip ( ! ,vet]ans ,integrat$ ,s]vice ,networks & ! ,vet]ans ,heal? ,adm9i/ration to ensure t facilities & /aff ( ! ,dep>tm5t are adh]+ to ! policy on access to c>e ( ea* cov]$ treatm5t program4 7#c7 ,/aff cov]age ,! ,secret>y %all n require /aff ( a cov]$ treatm5t program to act z cov]age = any o!r team1 s]vice1 or project unrelat$ to ! cov]$ treatm5t program = a p]iod ( great] ?an ?ree days p] mon? unless su* cov]age is = purposes ( ! f\r? mission ( ! ,dep>tm5t or "u an em]g5cy decl>ation4 7g7 ,c>e coord9ation & foll[-up c>e 7#a7 ,cont9uity ( c>e ,! ,secret>y %all ensure ea* cov]$ vet]an :o is scre5$ = admission to a cov]$ treatm5t program is (f]$1 & provid$ if agre$ ^u1 c>e options dur+ ! p]iod betwe5 scre5+ ( ! cov]$ vet]an & admission ( ! cov]$ vet]an to su* program to ensure ! cov]$ vet]an does n exp]i5ce any lapse 9 c>e4 7#b7 ,c>e coord9ation = sub/ance use disord] ,= a cov]$ 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 ! cov]$ vet]an & admission ( ! cov]$ vet]an to a cov]$ treatm5t program2 & 7,b7 communicate t c>e plan to ! cov]$ vet]an1 ! prim>y c>e provid] ( ! cov]$ vet]an1 & ! facility :]e ! cov]$ vet]an is or w be resid+ "u su* program4 7#c7 ,c>e plann+ & cl9ical scre5+ 7,a7 ,9 g5]al ,a cov]$ treatm5t program1 9 consultation ) ! cov]$ vet]an & ! treat+ provid]s ( ! cov]$ vet]an 9 ! cov]$ treatm5t program1 %all ensure ! completion ( a c>e plan & a cl9ical scre5+ ^u admittance to ! cov]$ treatm5t program & prior to dis*>ge f ! cov]$ treatm5t program1 :i* %all include an assessm5t (1 ) respect to ! cov]$ vet]an-- 7i7 ov]all m5tal heal?2 7ii7 risk = suicide2 7iii7 risk = ov]dose2 7iv7 h\s+ insecurity2 7v7 food insecurity2 7vi7 employm5t2 7vii7 complex m$ical ne$s & diagnoses2 & 7viii7 any o!r factors ! ,secret>y det]m9es necess>y4 7,b7 ,matt]s to be includ$ ,! c>e plan requir$ "u subp>agraph 7,a7 = a cov]$ vet]an %all include details on ! c\rse ( treatm5t = ! cov]$ vet]an foll[+ completion ( treatm5t "u ! cov]$ treatm5t program1 includ+ recomm5d$ l5g? ( /ay & any necess>y foll[-up c>e & ! results ( any scre5+ conduct$ "u su* subp>agraph4 7,c7 ,l5g? ( /ay 7i7 ,9 g5]al ,cov]$ treatm5t programs at non-,dep>tm5t facilities %all submit ! c>e plan "u subp>agraph 7,a7 = a cov]$ vet]an1 includ+ ! reque/$ or recomm5d$ l5g? ( /ay = ! cov]$ vet]an1 to ! ,dep>tm5t n lat] ?an #gb h\rs aft] ! vet]an is admitt$ to ! cov]$ treatm5t program4 7ii7 ,approval requir$ ,any l5g? ( /ay ( a cov]$ vet]an at a cov]$ treatm5t program long] ?an #cj days or ext5sions ( l5g? ( /ay great] ?an a total ( #cj days %all require approval by ! ,secret>y4 ,! ,secret>y %all respond to any su* reque/s = approval )9 #gb h\rs4 ,any su* reque/s t h n receiv$ a response )9 #gb h\rs %all be automatically approv$ on a daily basis until ! ,secret>y responds4 7,d7 ,%>+ ( c>e plan ,! c>e plan requir$ "u subp>agraph 7,a7 %all be %>$ ) ! cov]$ vet]an1 ! prim>y c>e provid] ( ! cov]$ vet]an1 & any o!r provid]s ) :i* ! cov]$ vet]an cons5ts to %>+ ! plan4 7,e7 ,dis*>ge f non-,dep>tm5t facility ,^u dis*>ge ( a cov]$ vet]an "u a cov]$ treatm5t program f a non-,dep>tm5t facility1 & n lat] ?an #cj days aft] dis*>ge1 ! facility %all %>e ) ! ,dep>tm5t all c>e records ma9ta9$ by ! facility ) respect to ! cov]$ vet]an & %all "w 9 consultation ) ! ,dep>tm5t on ! c>e plan ( ! cov]$ vet]an requir$ "u subp>agraph 7,a74 7,f7 ,subsequ5t cl9ical scre5+ ,n lat] ?an #ahj days aft] ! end ( treatm5t ( a cov]$ vet]an 9 a cov]$ treatm5t program1 ! cov]$ treatm5t program or a ,dep>tm5t or non-,dep>tm5t provid] %all conduct a subsequ5t cl9ical scre5+1 :i* %all include an assessm5t ( ! factors specifi$ 9 clauses 7i7 ?r\gh 7viii7 ( subp>agraph 7,a7 & recomm5dations = foll[-up c>e z ! ,secret>y consid]s appropriate4 7,g7 ,complex m$ical ne$s ,be=e1 dur+1 & aft] treatm5t 9 a cov]$ treatm5t program1 ! ,secret>y %all provide great] engagem5t1 coord9ation1 & monitor+ ( c>e = cov]$ vet]ans )-- 7i7 complex m$ical diagnoses1 includ+ diagnoses ( dem5tia1 sp9al cord injury or disord]1 epilepsy1 ,p>k9son's1 anemia1 sev]e m5tal illness1 multiple scl]osis1 incont95ce ( ! bladd] or b[el1 mobility limitations1 or impair$ vision2 or 7ii7 complex m$ical ne$s1 includ+ *emo!rapy or o!r oncology c>e1 dialysis1 recurr+ blood transfusions1 or physical or occupational !rapy4 7h7 ,data collection ,! ,secret>y %all consult ) ! ,(fice ( ,rese>* & ,developm5t ( ! ,dep>tm5t1 or any successor (fice1 reg>d+ any data ! ,dep>tm5t %\ld consid] reque/+ or requir+ f non-,dep>tm5t facilities to assi/ ) rese>* /udies & projects 9 :i* ! ,dep>tm5t is p>ticipat+ relat+ to m5tal heal? resid5tial rehabilitation treatm5t programs4 7i7 ,reports to ,congress 7#a7 ,report on modifications to programs 7,a7 ,9 g5]al ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on modifications made to ! guidance1 op]ation1 & ov]sight ( cov]$ treatm5t programs to fulfill ! requirem5ts ( ?is section4 7,b7 ,elem5ts ,! report requir$ by subp>agraph 7,a7 %all include-- 7i7 an assessm5t ( :e!r co/s ( cov]$ treatm5t programs1 includ+ = resid5tial c>e provid$ ?r\gh facilities ( ! ,dep>tm5t & non-,dep>tm5t facilities1 s]ve z a dis9c5tive to placem5t 9 ! su* a program2 7ii7 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-cbh2 #acf ,/at4 #eeae71 includ+-- 7,i7 su* actions ) respect to-- 7aa7 any new locations add$ = cov]$ treatm5t programs2 7bb7 any b$s add$ at exi/+ facilities ( su* programs2 & 7cc7 any additional treatm5t tracks or sex-specific programs creat$ or add$ at facilities ( ! ,dep>tm5t2 & 7,,ii7 a breakd[n ( ! numb] & p]c5tage ( cov]$ vet]ans :o are det]m9$ eligible = priority placem5t into a cov]$ treatm5t program & ! numb] & p]c5tage ( cov]$ vet]ans :o are det]m9$ eligible = r\t9e placem5t into a cov]$ treatm5t program2 & 7iii7 su* recomm5dations z ! ,secret>y may h = legislative or adm9i/rative action to address any fund+ con/ra9ts or dis9c5tives = use ( a cov]$ treatm5t program4 7#b7 ,annual report on op]ation ( programs 7,a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! submission ( ! report "u p>agraph 7#a71 & n less frequ5tly ?an annually !reaft] = ! foll[+ five ye>s1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! op]ation ( cov]$ treatm5t programs4 7,b7 ,elem5ts ,subject to subp>agraph 7,c71 ea* report requir$ by subp>agraph 7,a7 %all include ! foll[+3 7i7 ,! numb] ( cov]$ vet]ans s]v$ by a cov]$ treatm5t program1 disaggregat$ by-- 7,i7 ,vet]ans ,integrat$ ,s]vice ,network 9 :i* ! cov]$ vet]an receives c>e2 7,,ii7 facility1 includ+ facilities ( ! ,dep>tm5t & non-,dep>tm5t facilities1 at :i* ! cov]$ vet]an receives c>e2 7,,iii7 type ( resid5tial rehabilitation treatm5t c>e receiv$ by ! cov]$ vet]an "u su* program2 7,,iv7 sex ( ! cov]$ vet]an2 & 7,v7 race or e?nicity ( ! cov]$ vet]an4 7ii7 ,wait times "u a cov]$ treatm5t program = ! mo/ rec5t ye> data is available1 disaggregat$ by-- 7,i7 treatm5t track or specificity ( resid5tial rehabilitation treatm5t c>e s\ght by ! cov]$ vet]an2 7,,ii7 sex ( ! cov]$ vet]an2 7,,iii7 ,/ate or t]ritory 9 :i* ! cov]$ vet]an is locat$2 7,,iv7 ,vet]ans ,integrat$ ,s]vice ,network 9 :i* ! cov]$ vet]an is locat$2 & 7,v7 facility ( ! ,dep>tm5t at :i* ! cov]$ vet]an seeks c>e4 7iii7 ,a li/ ( all locations ( a cov]$ treatm5t program & numb] ( b$ spaces at ea* su* location1 disaggregat$ by resid5tial rehabilitation treatm5t c>e or treatm5t track provid$ "u su* program at su* location4 7iv7 ,a li/ ( any new locations ( cov]$ treatm5t programs add$ or remov$ & any b$ spaces add$ or remov$ dur+ ! "o-ye> p]iod prec$+ ! date ( ! report4 7v7 ,av]age co/ ( a /ay "u a cov]$ treatm5t program1 includ+ total /ay av]age & daily av]age1 at facilities ( ! ,dep>tm5t comp>$ to non-,dep>tm5t facilities4 7vi7 ,a review ( /aff+ ne$s & gaps ) respect to cov]$ treatm5t programs t is data-driv5 & align$ ) indu/ry b5*m>ks & /&>ds1 includ+-- 7,i7 a li/ ( facilities t _h un/aff$ b$s or clos$ b$s due to lack ( /aff+ at any po9t 9 ! previ\s ye>2 7,,ii7 ! numb] ( additional /aff ne$$ to /aff ^? b$s2 7,,iii7 ! numb] ( b$s at ea* facility2 7,,iv7 ! av]age wait-times = ! cov]$ treatm5t program1 disaggregat$ by mon?1 dur+ ! p]iods ( b$ closures2 & 7,v7 a li/ ( facilities t requir$ /aff ( cov]$ treatm5t programs to p]=m duties unrelat$ to cov]$ treatm5t programs = a p]iod ( great] ?an ?ree days4 7vii7 ,an ov]view ( data collect$ pursuant to a subsequ5t cl9ical scre5+ "u subsection 7g77#c77;,f74 7viii7 ,a li/ ( heal? c>e sy/ems )\t a cov]$ treatm5t program & an assessm5t ( ! feasibility & advisability ( op5+ a cov]$ treatm5t program at su* heal? c>e sy/em t is align$ & ju/ifi$ by pati5t dem& & m>ket factors4 7ix7 ,a li/ ( heal? c>e sy/ems t (f] a cov]$ treatm5t program align$ ) pati5t dem& & m>ket factors & t h an av]age wait "t ( m ?an #bj days & an assessm5t ( ! feasibility & advisability ( exp&+ su* cov]$ treatm5t program to l[] su* av]age wait "t4 7x7 ,any recomm5dations = *anges to ! op]ation ( cov]$ treatm5t programs1 includ+ any policy *anges1 guidance *anges1 tra9+ *anges1 or o!r *anges4 7,c7 ,anonymity ,to ensure t ! data provid$ "u ?is p>agraph1 or "s portion ( t data1 w n und]m9e ! anonymity ( a vet]an1 ! ,secret>y %all provide su* data pursuant to applicable ,f$]al law & 9 a mann] t is :olly consi/5t ) applicable ,f$]al privacy & confid5tiality laws1 includ+-- 7i7 section #eeb;a ( title #e 7commonly kn[n z ! ,privacy ,act ( #aigd72 7ii7 ! ,heal? ,insurance ,portability & ,acc\ntability ,act ( #aiif 7,public ,law #ajd-aia72 7iii7 p>ts #afj & #afd ( title #de1 ,code ( ,f$]al ,regulations1 or successor regulations2 & 7iv7 sections #egja1 #egje1 & #gccb ( ?is title4 7#c7 ,notification to ,congress ( b$s n available due to lack ( /aff+ ,! ,secret>y %all notify ,congress ( any cov]$ treatm5t programs ( ! ,dep>tm5t ) m ?an five b$s or m ?an t5 p]c5t ( b$s unavailable1 clos$1 or reassign$ due to lack ( /aff+1 includ+-- 7,a7 in=mation on ! /aff ne$$ to reop5 b$s t are clos$2 7,b7 plans to recruit & reta9 /aff2 7,c7 ! total numb] ( b$s clos$ or expect$ to be clos$2 7,d7 ! e/imat$ l5g? ( "t until ^? clos$ b$s are made available2 & 7,e7 ! curr5t wait "t = access to ^? b$s4 7j7 ,?ird-p>ty assessm5t 7#a7 ,9 g5]al ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act1 ! ,secret>y %all seek to ent] into a contract ) an appropriate entity to conduct a /udy ( ! c>e provid$ "u cov]$ treatm5t programs ?r\gh facilities ( ! ,dep>tm5t & non-,dep>tm5t facilities4 7#b7 ,elem5ts ,! /udy requir$ "u p>agraph 7#a7 %all include a review (-- 7,a7 :e!r facilities are meet+ requirem5ts ( ! ,dep>tm5t pursuant to law1 regulation1 or policy2 7,b7 /aff+ models us$ by facilities & level ( adh]5ce to ^? models2 7,c7 success rates ( cov]$ treatm5t programs 9 prev5t+ readmittance to a cov]$ treatm5t program or dea? by suicide or ov]dose )9 a ye> ( dis*>ge f ! program2 7,d7 adh]5ce ( non-,dep>tm5t facilities to timel9es = claim submission & record returns to ! ,dep>tm5t2 & 7,e7 any o!r factors ! ,secret>y or ! appropriate entity det]m9es relevant or appropriate to include4 7#c7 ,completion ( /udy ,! contract s\ght "u p>agraph 7#a7 %all include a requirem5t t ! appropriate entity1 n lat] ?an f\r ye>s aft] ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act1 complete ! /udy requir$ "u su* p>agraph & submit to ! ,secret>y a report on ! /udy4 7#d7 ,action plan & comm5t>y ,n lat] ?an five ye>s aft] ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives1 & publi% on a publicly accessible website ( ! ,dep>tm5t1 a report conta9+-- 7,a7 ! results ( ! /udy requir$ "u p>agraph 7#a72 7,b7 action plans = improvem5t bas$ on ! results ( ! /udy2 & 7,c7 g5]al comm5t>y & fe$back on ! results ( ! /udy4 7#e7 ,appropriate entity def9$ ,9 ?is subsection1 ! t]m appropriate entity means-- 7,a7 a nongov]nm5tal entity ) exp]i5ce 9 assess+ programs t deliv] s]vices provid$ "u cov]$ treatm5t programs on a l>ge scale2 or 7,b7 a f$]ally fund$ rese>* & developm5t c5t]4 7k7 ,revision ( guidance ,! ,secret>y %all update ! guidance ( ! ,dep>tm5t on ! op]ation ( cov]$ treatm5t programs to reflect ea* ( ! requirem5ts "u ?is section4 7l7 ,deadl9e ,unless o!rwise specifi$1 ! ,secret>y %all c>ry out ea* requirem5t "u ?is section by n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act4 7m7 ,comptroll] ,g5]al review 7#a7 ,9 g5]al ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all review access to c>e "u a cov]$ treatm5t program = cov]$ 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 = cov]$ vet]ans "u a cov]$ treatm5t program1 disaggregat$ by-- 7i7 treatm5t track or specificity ( resid5tial rehabilitation treatm5t c>e ne$$2 7ii7 sex ( ! cov]$ vet]an2 7iii7 home ,/ate ( ! cov]$ vet]an2 7iv7 home ,vet]ans ,integrat$ ,s]vice ,network ( ! cov]$ 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 a cov]$ treatm5t program4 7,c7 ,a review ( ! rights ( cov]$ vet]ans & provid]s to appeal admission decisions "u a cov]$ treatm5t program & h[ ! ,dep>tm5t adjudicates appeals4 7,d7 ,:5 det]m9+ ! facility at :i* a cov]$ vet]an admitt$ to a cov]$ treatm5t program w be plac$ 9 su* program1 a review ( h[ ! input ( ! cov]$ vet]an is tak5 into consid]ation ) respect to-- 7i7 program specialty1 subtype1 or treatm5t track (f]$ to ! cov]$ vet]an2 & 7ii7 ! geographic placem5t ( ! cov]$ vet]an1 includ+ family- or occupation-relat$ pref]5ces or circum/ances4 7,e7 ,a review ( /aff+ & /aff+ ne$s & gaps ( cov]$ treatm5t programs1 includ+ ) respect to-- 7i7 m5tal heal? provid]s & coord9ators at ! facility level2 7ii7 /aff ( facilities ( su* programs2 7iii7 /aff ( ,vet]ans ,integrat$ ,s]vice ,networks2 & 7iv7 ov]all adm9i/ration ( su* programs at ! national level4 7,f7 ,a review ( outcomes f ,dep>tm5t & non-,dep>tm5t cov]$ treatm5t programs bas$ at lea/ 9 "p on ! subsequ5t cl9ical scre5+s requir$ "u subsection 7g77#c77;,e74 7,g7 ,recomm5dations = improvem5t ( access by cov]$ vet]ans to c>e "u a cov]$ treatm5t 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 ) cov]$ vet]ans2 & 7iv7 ov]sight ( cov]$ treatm5t programs by ! ,dep>tm5t4 #agid4 ,fee s*$ule 7a7 ,9 g5]al ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act1 ! ,secret>y %all make publicly available on an appropriate website ( ! ,dep>tm5t a fee s*$ule = ea* cov]$ treatm5t program provid$ by a non-,dep>tm5t provid] ?r\gh :i* ! ,secret>y furni%es c>e & s]vices "u section #agaj ( ?is title4 7b7 ,elem5ts ,! fee s*$ule requir$ "u subsection 7a7 = a cov]$ treatm5t program %all-- 7#a7 reflect reasonable *>ges = ! s]vices provid$2 7#b7 be bas$ on ! am\nts cu/om>ily paid = simil> s]vices "u ! ,m$icaid program "u title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 & by comm]cial heal? insurance provid]s2 7#c7 to ! greate/ ext5t practicable1 be consi/5t ) paym5t rates "u section #agjc7;i7 ( ?is title2 7#d7 be compreh5sive to include a v>iety ( possible types ( c>e1 s]vices1 & *>ges2 & 7#e7 be suffici5t to ensure a robu/ network ( qualifi$ community provid]s able to provide s]vices "u a cov]$ treatm5t program to cov]$ vet]ans4 7c7 ,coord9ation ( paym5t rates ,aft] ! date ( ! initial publication ( ! fee s*$ule "u subsection 7a71 ! rate paid by ! ,dep>tm5t = resid5tial sub/ance use disord] treatm5t %all be ! rate provid$ 9 ! fee s*$ule requir$ "u su* subsection4 7d7 ,rec\pm5t ( am\nts 7#a7 ,9 g5]al ,! ,secret>y %all rec\p f a non-,dep>tm5t entity1 includ+ a ?ird p>ty adm9i/rator1 any am\nt paid to su* entity t exce$s ! am\nt specifi$ "u ! fee s*$ule "u subsection 7a7 = ! c>e or s]vices provid$4 7#b7 ,limitation ,a non-,dep>tm5t entity %all n bill a vet]an = any *>ges rec\p$ "u p>agraph 7#a74 #agie4 ,tra9+ 7a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act1 ! ,secret>y %all-- 7#a7 develop & implem5t a plan to ensure t heal? c>e provid]s c>+ = vet]ans "u cov]$ treatm5t programs receive & complete relevant tra9+ align$ ) indu/ry /&>ds & practices2 & 7#b7 submit t plan to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives4 7b7 ,elem5ts ( tra9+ ,tra9+ requir$ "u subsection 7a7 %all-- 7#a7 be easily accessible1 no-co/1 & (f]$ 9 su* a mann] z to qualify = or fulfill cont9u+ education requirem5ts = heal? c>e pr(essionals2 7#b7 include c\rse modules relat$ to milit>y culture1 po/-traumatic /ress disord]1 ! evaluation & managem5t ( suicide1 traumatic bra9 injury1 & opioid safety1 or comp>able c\rse modules1 z det]m9$ by ! ,secret>y2 & 7#c7 be (f]$ ?r\gh ,dep>tm5t & non-,dep>tm5t entities or organizations4 7c7 ,elem5ts ( plan ,! plan requir$ "u subsection 7a7 %all-- 7#a7 all[ = ,dep>tm5t or non-,dep>tm5t provid]s to receive cr$it = non-,dep>tm5t tra9+ t is equival5t or sub/antially simil> to tra9+ requir$ "u subsection 7a72 & 7#b7 include details reg>d+ consequ5ces = non-compliance ) tra9+ requir$ "u su* plan1 :i* may include removal f a network ( provid]s "u ! ,vet]ans ,community ,c>e ,program "u section #agjc ( ?is title = a specifi$ p]iod ( "t4 7d7 ,consultation ,! ,secret>y %all consult ) relevant pr(essional organizations ) respect to ! cont5t ( relevant tra9+ requir$ "u subsection 7a74 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( su* *apt] is am5d$ by add+ at ! end ! foll[+ new items3 ,,sub*apt] ,,ix--,p>ticipation by ,vet]ans 9 ,c]ta9 ,m5tal ,heal? ,treatm5t ,programs #agia4 ,def9itions4 #agib4 ,/&>diz$ process to det]m9e eligibility ( cov]$ vet]ans = p>ticipation 9 c]ta9 m5tal heal? treatm5t programs4 #agic4 ,improvem5ts to ,dep>tm5t ( ,vet]ans ,affairs m5tal heal? resid5tial rehabilitation treatm5t program4 #agid4 ,fee s*$ule4 #agie4 ,tra9+4 4 #fbb4 ,access to m5tal heal? resid5tial rehabilitation treatm5t programs = vet]ans ) sp9al cord injury or disord] 7a7 ,plan 7#a7 ,9 g5]al ,n lat] ?an #ij days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a plan to ensure access to m5tal heal? resid5tial treatm5t programs = vet]ans ) a sp9al cord injury or disord]4 7#b7 ,elem5ts ,! plan requir$ "u p>agraph 7#a7 %all include-- 7,a7 a /aff+ plan1 :i* %all include a plan = h[ ! ,dep>tm5t w-- 7i7 incorporate /aff f o!r facilities to support ! pilot program requir$ "u subsection 7b72 & 7ii7 ensure adequate /aff+ to support ! ne$s ( vet]ans ) a sp9al cord injury or disord]2 7,b7 an assessm5t ( m$ical equipm5t ne$s2 & 7,c7 an assessm5t ( ! be/ location to deliv] treatm5t & heal? c>e "u m5tal heal? resid5tial treatm5t programs1 includ+ ?r\gh ! use ( sp9al cord injury or disord] c5t]s1 sp9al cord injury or disord] spokes1 & community c>e provid]s4 7b7 ,pilot program 7#a7 ,9 g5]al ,comm5c+ n lat] ?an #abj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all c>ry out a pilot program to provide improv$ access to m5tal heal? resid5tial treatm5t programs ( ! ,dep>tm5t ( ,vet]ans ,affairs = vet]ans ) a sp9al cord injury or disord] at n few] ?an ?ree m$ical facilities ( ! ,dep>tm5t4 7#b7 ,selection ( locations ,9 select+ sites = ! pilot program "u p>agraph 7#a71 ! ,secret>y %all prioritize sites 9 ! foll[+ areas3 7,a7 ,areas ) geographic div]sity1 includ+ areas t s]ve vet]ans resid+ 9 rural or highly rural areas4 7,b7 ,areas ) a significant numb] ( vet]ans ) sp9al cord injury or disord]4 7c7 ,report ,n lat] ?an "o ye> 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-- 7#a7 ! implem5tation ( ! plan requir$ "u subsection 7a72 7#b7 ! initial results f ! pilot program "u subsection 7b71 includ+ ! numb] ( unique vet]ans :o p>ticipat$ 9 ! pilot program1 ! co/ ( ! pilot program1 & an assessm5t ( ! effectiv5ess ( ! pilot program 9 increas+ access to1 & improv+ outcomes =1 p>ticipants 9 ! pilot program2 7#c7 plans1 if any1 to exp& or ext5d ! pilot program to address dem& = ! highly specializ$ treatm5t provid$ "u ! m5tal heal? resid5tial treatm5t programs ( ! ,dep>tm5t = vet]ans ) a sp9al cord injury or disord]2 & 7#d7 ,su* o!r matt]s z ! ,secret>y consid]s appropriate4 ,c ,/aff+ ,matt]s #fca4 ,treatm5t ( psy*ologi/s 7a7 ,treatm5t z title #ch employees ,section #gdja ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 9 p>agraph 7#a71 by ins]t+ psy*ologi/s1 aft] *iropractors12 & 7#b7 9 p>agraph 7#c71 by /rik+ psy*ologi/s14 7b7 ,inclusion 9 contracts = sc>ce m$ical speciali/ s]vices ,section #gdji7;a7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by ins]t+ psy*ologi/s1 aft] *iropractors14 #fcb4 ,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 :o has be5 9 t position = less ?an "o ye>4 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 ! regional lead]%ip 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 = m5tee p>ticipants 9 ! m5tor%ip program4 7f7 ,t]m9ation ,! au?ority "u ?is section %all t]m9ate on ,septemb] #cj1 #bjcj4 #fcc4 ,requirem5t = equival5t role po/+s = vacant positions at ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,9 g5]al ,:5ev] possible & practicable1 if ! ,secret>y ( ,vet]ans ,affairs is issu+ a po/+ = vacant positions at ! ,dep>tm5t ( ,vet]ans ,affairs t may be fill$ by m ?an "o type ( pr(essional or cl9ician1 ! ,secret>y %all issue po/+s = all possible cl9icians or pr(essionals :o c\ld fill ! position4 7b7 ,application to c]ta9 positions ,! ,secret>y %all consid] ! requirem5t "u subsection 7a7 9 p>ticul> ) respect to h>d-to-recruit1 h>d-to-reta91 prim>y c>e1 & m5tal heal? c>e positions4 #fcd4 ,improvem5ts to ,dep>tm5t ( ,vet]ans ,affairs hir+ processes 7a7 ,9 g5]al ,sub*apt] ,i ( *apt] #g ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by ins]t+ aft] section #gja ! foll[+ new section3 #gjb4 ,hir+ processes 7a7 ,/&>diz$ approval process = fill+ vacant positions 7#a7 ,process requir$ 7,a7 ,9 g5]al ,! ,secret>y %all e/abli% a /&>diz$1 nationwide approval process = fill+ vacant employm5t positions )9 ! ,dep>tm5t4 7,b7 ,v>iability ,! process requir$ by subp>agraph 7,a7 may be diff]5t = ea* type ( employm5t position 9 ! ,dep>tm5t4 7,c7 ,approval w9d[s ,! process requir$ by subp>agraph 7,a7 %all include a /&>diz$ approval w9d[ = ea* approval /ep4 7#b7 ,delegation ,if ! approval au?ority = a /ep 9 ! hir+ process e/abli%$ "u p>agraph 7#a7 is vacant1 on leave1 or o!rwise unable to respond to reque/s = approval 9 an appropriate timeframe1 su* au?ority = approval %all be delegat$ to ! ext5t practicable to ! sup]visor ( su* approval au?ority or su* o!r designee z may be specifi$ 9 ! *a9 ( comm&4 7#c7 ,"t to fill goal ,ea* w9d[ ( "t allott$ = ea* approval /ep "u p>agraph 7#a77;,c7 :5 add$ toge!r %all n exce$ ! goal ( ! ,dep>tm5t to fill w9d[ = t employm5t position4 7b7 ,process = t5tative (f]s ( employm5t ,! ,secret>y %all develop a /&>diz$ process = issu+ t5tative (f]s ( employm5t ) ! ,dep>tm5t & su* process %all require t ea* su* (f] includes a specifi$ rate ( basic pay :5 possible & practicable4 7c7 ,?ird-p>ty contracts ,! ,secret>y may conduct laboratory te/+1 backgr\nd cle>ances1 & o!r c&idate approval & vett+ proc$ures ?r\gh a contract ) a ?ird p>ty if ! ,secret>y det]m9es t ! contract w\ld ensure equal or bett] quality or timel9ess4 7d7 ,electronic signatures 7#a7 ,au?ority ,! ,secret>y %all all[ electronic signatures on any hir+1 recruitm5t1 ret5tion1 or o!r employm5t docum5ts once a /&>diz$ process = su* signatures is develop$ & implem5t$ "u p>agraph 7#b74 7#b7 ,/&>diz$ process ,! ,secret>y %all develop a /&>diz$ process = use ( electronic signatures z describ$ 9 p>agraph 7#a71 :i* %all include exceptions & limitations z ! ,secret>y consid]s appropriate & t all[s = use ( electronic signatures = employm5t docum5ts1 includ+ ,,sf #aaeb & relat$ successor =ms1 ,,sf #bhbc & relat$ successor =ms1 & ,,sf #cajb-;,,f]s & relat$ successor =ms4 7e7 ,employee community build+ program ,! ,secret>y %all1 to ! ext5t practicable1 e/abli% an employee community build+ program t connects employees 9 simil> positions1 (fices1 & programs to connect ) ea* o!r nationwide4 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( *apt] #g ( su* title is am5d$ by ins]t+ aft] ! item relat+ to section #gja ! foll[+ new item3 #gjb4 ,hir+ processes4 4 #fce4 ,dep>tm5t ( ,vet]ans ,affairs telework policy 7a7 ,policy requir$ ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all1 9 accordance ) ! requirem5ts ( ?is section & ! requirem5ts ( section #fejb ( title #e1 ,unit$ ,/ates ,code1 e/abli% a policy = ! use ( telework )9 ! ,dep>tm5t ( ,vet]ans ,affairs4 7b7 ,locations ,! policy e/abli%$ "u subsection 7a7 may be diff]5t = diff]5t locations1 specialties1 & categories ( employees1 z det]m9$ appropriate by ! ,secret>y4 7c7 ,assessm5t ,9 develop+ ! policy requir$ by subsection 7a71 ! ,secret>y %all assess ! foll[+ = ea* category ( employees at ! ,dep>tm5t-- 7#a7 /aff+ levels & tr5ds ov] ! la/ #e ye>s2 7#b7 exit survey data relat$ to telework2 7#c7 ! availability ( d$icat$ "w space at facilities ( ! ,dep>tm5t to enable onsite "w at a duty /ation2 7#d7 a comp>ison ( productivity levels :5 duties are p]=m$ on site or ?r\gh telework2 7#e7 telework flexibilities = comp>able categories ( employees 9 ! private sector & 9 o!r ,f$]al ag5cies2 & 7#f7 p>ticul> duties t necessitate on site "w4 7d7 ,notice & report+ 7#a7 ,9 g5]al ,= any *ange made to ! policy e/abli%$ pursuant to subsection 7a71 ! ,secret>y %all-- 7,a7 notify all affect$ employees ( ! ,dep>tm5t ( ! *anges2 & 7,b7 submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! *anges4 7#b7 ,report cont5ts ,= ea* report submitt$ to ,congress "u p>agraph 7#a77;,b71 ! ,secret>y %all include ! analyses = ea* category conduct$ 9 subsection 7c7 & ! role ( ^? analyses 9 ! telework policy = ea* category4 7#c7 ,deadl9e ,a report submitt$ "u p>agraph 7#a77;,b7 reg>d+ a *ange to ! policy e/abli%$ "u subsection 7a7 %all be made n few] ?an #ij days be=e ! *ange goes into effect4 7e7 ,report on budget>y impact ,n lat] ?an #a ye> aft] ! date on :i* ! policy e/abli%$ pursuant to subsection 7a7 goes into effect1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs & ! ,committee on ,appropriations ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs & ! ,committee on ,appropriations ( ! ,h\se ( ,repres5tatives a report on ! annual budget>y impact ( su* policy4 7f7 ,effective date & *anges 7#a7 ,effective date ( initial policy ,! initial policy e/abli%$ by pursuant to subsection 7a7 %all g into effect n lat] ?an #ahj days aft] ! date on :i* ! policy is e/abli%$4 7#b7 ,effective date ( subsequ5t *anges ,any *ange made to ! policy e/abli%$ pursuant to subsection 7a7 aft] ! effective date set =? 9 p>agraph 7#a7 %all take effect n less ?an #ij days aft] ! date on :i* ! *ange is made4 7#c7 ,notice ,= any *ange made to ! policy e/abli%$ pursuant to subsection 7a7 aft] ! effective date set =? 9 p>agraph 7#a71 ! ,secret>y %all-- 7,a7 notify all affect$ employees ( ! ,dep>tm5t ( ! *anges2 & 7,b7 submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! *anges4 #fcf4 ,expansion ( reimbursem5t ( cont9u+ pr(essional education exp5ses 7a7 ,9 g5]al ,section #gdaa ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ to read z foll[s3 #gdaa4 ,reimbursem5t ( cont9u+ pr(essional education exp5ses 7a7 ,requir$ reimbursem5t ,! ,secret>y %all reimburse any full-"t physician1 d5ti/1 podiatri/1 *iropractor1 optometri/1 psy*ologi/1 regi/]$ nurse 7includ+ any advanc$ practice regi/]$ nurse71 or physician assi/ant appo9t$ "u section #gdja7a7 ( ?is title n m ?an #a1jjj p] ye> = ea* su* individual = exp5ses incurr$ = cont9u+ pr(essional education directly relat$ to ! duties & responsibilities ( ! position ( ! employee or relat$ to ! duties & responsibilities ( ! position or positions ( ! employees ov]se5 by ! employee4 7b7 ,au?oriz$ reimbursem5t ,! ,secret>y may reimburse any full-"t lic5s$ practical or vocational nurse 7includ+ any nurse practition]71 m$ical te*nologi/1 ph>maci/1 ph>macy te*nician1 diagno/ic radiologic te*nologi/1 or social work] appo9t$ "u section #gdja7c7 ( ?is title1 n m ?an #a1jjj p] ye> = ea* su* individual = exp5ses incurr$ = cont9u+ pr(essional education directly relat$ to ! duties & responsibilities ( ! position ( ! employee or relat$ to ! duties & responsibilities ( ! position or positions ( ! employees ov]se5 by ! employee4 7c7 ,maximum numb] ( individuals reimburs$ ,! total numb] ( individuals :o may be reimburs$ "u ?is section may n exce$ #ej1jjj p] ye>4 7d7 ,priority reimbursem5ts ,9 provid+ reimbursem5t "u subsection 7a71 ! ,secret>y %all prioritize reimbursem5t = individuals provid+ direct pati5t c>e or individuals :o are decision-mak]s = direct pati5t c>e4 7e7 ,report requir$ 7#a7 ,9 g5]al ,n less frequ5tly ?an annually aft] ! end ( ! fir/ fiscal ye> foll[+ ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives in=mation on utilization ( reimbursem5t "u ?is section1 includ+-- 7,a7 locations at :i* reimbursem5t is claim$2 7,b7 position title & specialty ( ! individual claim+ reimbursem5t2 7,c7 av]age am\nt claim$ p] position & specialty2 & 7,d7 p]c5t utilization by ea* position & specialty ov]all4 7#b7 ,au?ority to include 9 exi/+ report ,! in=mation requir$ "u p>agraph 7#a7 may be submitt$ indep5d5tly or includ$ 9 ano!r annual report to ,congress4 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( sub*apt] ,i ( *apt] #gd ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by /rik+ ! item relat+ to section #gdaa & ins]t+ ! foll[+ new item3 #gdaa4 ,reimbursem5t ( cont9u+ pr(essional education exp5ses4 4 #fcg4 ,dep>tm5t ( ,vet]ans ,affairs p]sonnel transp>5cy 7a7 ,9 g5]al ,section #eje ( ! ,john ,s4 ,mc,cain ,,iii1 ,daniel ,k4 ,akaka1 & ,samuel ,r4 ,johnson ,,va ,ma9ta9+ ,int]nal ,sy/ems & ,/r5g!n+ ,integrat$ ,outside ,networks ,act ( #bjah 7,public ,law #aae-ahb2 #ch ,u4,s4,c4 #cja note7 is am5d$-- 7#a7 9 subsection 7a7-- 7,a7 9 p>agraph 7#a7-- 7i7 9 ! matt] be=e subp>agraph 7,a71 by /rik+ in=mation1 & all t foll[s ?r\gh facility3 & ins]t+ in=mation32 7ii7 9 subp>agraph 7,b7-- 7,i7 by ins]t+ 7i7 be=e ,! numb]2 & 7,,ii7 by add+ at ! end ! foll[+ new clause3 7ii7 ,in=mation made available "u ?is subp>agraph %all be updat$ n less frequ5tly ?an once ea* qu>t] to acc\nt = delays 9 data process+ & %all reflect ! mo/ rec5tly available data4 2 7iii7 9 subp>agraph 7,c71 by /rik+ vacancies1 by occupation4 & ins]t+ positions curr5tly und]go+ a recruitm5t action1 disaggregat$ by occupation & by /age ( recruitm5t42 7iv7 9 subp>agraph 7,e77iii71 by /rik+ pot5tial hires or2 & 7v7 by add+ at ! end ! foll[+ new subp>agraph3 7,f7 ,! numb] ( positions vacat$ dur+ ! qu>t] = :i* ! ,dep>tm5t has n initiat$ a recruitm5t action or is n plann+ to initiate a recruitm5t action4 2 7,b7 by r$esignat+ p>agraph 7#e7 z p>agraph 7#f72 7,c7 by ins]t+ aft] p>agraph 7#d7 ! foll[+ new p>agraph 7#e73 7#e7 ,display ( in=mation ,! display ( in=mation made publicly available on a website ( ! ,dep>tm5t pursuant to p>agraph 7#a7 %all be disaggregat$-- 7,a7 by dep>tm5tal compon5t2 7,b7 9 ! case ( in=mation relat+ to ,vet]ans ,heal? ,adm9i/ration positions1 by m$ical facility2 & 7,c7 9 ! case ( in=mation relat+ to ,vet]ans ,b5efits ,adm9i/ration positions1 by regional (fice4 2 & 7,d7 9 p>agraph 7#f71 z r$esignat$ by subp>agraph 7,b71 by /rik+ %all & all t foll[s & ins]t+ ! foll[+3 8%all-- 7,a7 review ! adm9i/ration ( ! website requir$ "u p>agraph 7#a72 7,b7 develop recomm5dations relat+ to ! improvem5t ( su* adm9i/ration2 & 7,c7 submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report conta9+-- 7i7 ! f9d+s ( ! ,inspector ,g5]al ) respect to ! mo/ rec5t review conduct$ "u subp>agraph 7,a72 & 7ii7 ! recomm5dations mo/ rec5tly develop$ "u subp>agraph 7,b74 2 & 7#b7 by am5d+ subsection 7b7 to read z foll[s3 7b7 ,annual report ,ea* ye>1 ! ,secret>y %all submit to ,congress an annual report t includes ! foll[+3 7#a7 ,a description ( ! /eps ! ,dep>tm5t is tak+ to a*ieve full /aff+ capacity4 7#b7 ,a description ( ! actions ! ,dep>tm5t is tak+ to improve ! onbo>d timel9e = facilities ( ! ,dep>tm5t1 includ+-- 7,a7 9 ! case ( facilities ( ! ,vet]ans ,heal? ,adm9i/ration1 = facilities = :i* ! duration ( ! onbo>d+ process exce$s ! metrics laid out 9 ! ,"t to ,hire ,model ( ! ,vet]ans ,heal? ,adm9i/ration1 or successor model2 & 7,b7 9 ! case ( ! ,vet]ans ,b5efits ,adm9i/ration1 = regional (fices t exce$ ! "t-to-hire t>get ( ! ,(fice ( ,p]sonnel ,managem5t4 7#c7 ,! am\nt ( additional funds necess>y to enable ! ,dep>tm5t to rea* full /aff+ capacity4 7#d7 ,su* recomm5dations = legislative or adm9i/rative action z ! ,secret>y may h 9 ord] to a*ieve full /aff+ capacity at ! ,dep>tm5t4 4 7b7 ,effective date ,! am5dm5ts made by subsection 7a7 %all take effect on ! date ( ! enactm5t ( ?is ,act & %all apply ) respect to ! second update "u section #eje7;a77#c7 ( su* ,act beg9n+ aft] ! date ( ! enactm5t ( ?is ,act & ea* update !reaft]4 #fch4 ,modification ( au?ority ( lic5sure ( heal? c>e pr(essionals provid+ treatm5t via telem$ic9e ,section #agcj;,c ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 by am5d+ subsection 7a7 to read z foll[s3 7a7 ,9 g5]al ,not)/&+ any provision ( law reg>d+ ! lic5sure ( heal? c>e pr(essionals or ! prescrib+ ( controll$ sub/ances1 a cov]$ heal? c>e pr(essional may practice ! heal? c>e pr(ession ( ! heal? c>e pr(essional & prescribe controll$ sub/ances at any location 9 any ,/ate or any ( ! ,freely ,associat$ ,/ates 7z def9$ 9 section #agbd7;f7 ( ?is title71 reg>dless ( :]e ! cov]$ heal? c>e pr(essional or ! pati5t is locat$1 if ! cov]$ heal? c>e pr(essional is us+ telem$ic9e to provide treatm5t or prescribe controll$ sub/ances to an individual "u ?is *apt]4 2 7#b7 9 subsection 7b71 by add+ at ! end ! foll[+ new p>agraph3 7#d7 ,a heal? c>e pr(essional :o is a contractor ( ! ,dep>tm5t act+ 9 ! scope ( a contract ) ! ,dep>tm5t to furni% c>e 9 a facility or cl9ic ( ! ,dep>tm5t & :o has an active1 curr5t1 full1 & unre/rict$ lic5se1 regi/ration1 or c]tification 9 a ,/ate to practice ! heal? c>e pr(ession ( ! heal? c>e pr(essional1 exclud+ ! foll[+3 7,a7 ,a heal? c>e pr(essional locat$ outside a facility or cl9ic ( ! ,dep>tm5t provid+ c>e ?r\gh ! ,vet]ans ,community ,c>e ,program "u section #agjc ( ?is title or a simil> au?ority "u ! laws adm9i/]$ by ! ,secret>y4 7,b7 ,a heal? c>e pr(essional conduct+ disability comp5sation evaluations pursuant to a contract ) ! ,dep>tm5t4 2 7#c7 9 subsection 7d7-- 7,a7 by r$esignat+ p>agraph 7#b7 z p>agraph 7#c72 & 7,b7 by ins]t+ aft] p>agraph 7#a7 ! foll[+ new p>agraph 7#b73 7#b7 ,/ate laws t may be inconsi/5t "u p>agraph 7#a7 include-- 7,a7 ! laws (-- 7i7 ! ,/ate ( lic5sure1 c]tification1 or regi/ration ( ! cov]$ heal? c>e pr(essional2 7ii7 ! ,/ate ( practice ( ! cov]$ heal? c>e pr(essional2 7iii7 ! ,/ate 9 :i* ! pati5t is locat$2 or 7iv7 ! ,/ate ( resid5ce ( ! pati5t2 & 7,b7 su* laws specifi$ "u subp>agraph 7,a7 z incorporat$ by ! ,controll$ ,sub/ances ,act 7#ba ,u4,s4,c4 #hja et seq474 2 & 7#d7 9 subsection 7e71 /rik+ ,no?+ & ins]t+ ,except z provid$ 9 subsections 7a7 & 7d71 no?+44 #fci4 ,provision ( data on educational assi/ance programs ( ,vet]ans ,heal? ,adm9i/ration 7a7 ,9 g5]al ,beg9n+ n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all provide to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives data on graduate m$ical education programs1 heal? pr(ession s*ol>%ip programs1 & any o!r educational assi/ance programs )9 ! ,vet]ans ,heal? ,adm9i/ration4 7b7 ,elem5ts ,! data requir$ to be provid$ "u subsection 7a7 %all include1 = ea* program1 ! foll[+3 7#a7 ,! numb] ( active p>ticipants1 brok5 d[n by position or expect$ future position or lic5sure4 7#b7 ,! am\nt ( funds sp5t ea* fiscal ye>4 7#c7 ,! numb] ( p>ticipants :o h complet$ _! education & are curr5tly complet+ _! s]vice requirem5ts at ! ,dep>tm5t ( ,vet]ans ,affairs4 7#d7 ,! numb] ( p>ticipants :o 7 previ\sly active 9 ! program b left ! program be=e complet+ _! education or s]vice requirem5t dur+ ! ye> prec$+ ! date on :i* ! data is provid$4 7#e7 ,an ov]view ( outrea* by ! ,dep>tm5t to prospective p>ticipants 9 ! program4 7#f7 ,su* o!r in=mation z ! ,secret>y consid]s appropriate4 7c7 ,update & submittal ( data ,! data requir$ to be provid$ "u subsection 7a7-- 7#a7 %all be updat$ n less frequ5tly ?an annually2 & 7#b7 may be submitt$ to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives z "p ( ano!r report requir$ by law4 7d7 ,initial data ,) ! fir/ it]ation ( data provid$ "u subsection 7a71 ! ,secret>y %all provide to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! implem5tation ( ! pilot program "u section #bdf ( ! ,milit>y ,con/ruction1 ,vet]ans ,affairs1 & ,relat$ ,ag5cies ,appropriations ,act1 #bjah 7division ,j ( ,public ,law #aae-ada2 #ch ,u4,s4,c4 #gfja note71 includ+ ! curr5t /atus ( ! pilot program & a timel9e ( ! /atus ( ! pilot program s9ce its initial implem5tation4 ,d ,optimization ( ,work=ce #fda4 ,dep>tm5t ( ,vet]ans ,affairs /rategic human capital plan 7a7 ,9 g5]al ,sub*apt] ,i ( *apt] #g ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new section3 #gbi4 ,/rategic human capital plan 7a7 ,plan developm5t 7#a7 ,n lat] ?an ,septemb] #cj1 #bjbg1 ! ,secret>y %all develop & submit to ! appropriate committees ( ,congress a five-ye> /rategic human capital plan to support ! mission & responsibilities ( ! ,dep>tm5t1 disaggregat$ by ! ,vet]ans ,heal? ,adm9i/ration1 ! ,vet]ans ,b5efits ,adm9i/ration1 ! ,national ,cemet]y ,adm9i/ration1 & su* o!r adm9i/rative compon5ts ( ! ,dep>tm5t z ! ,secret>y consid]s necess>y to c>ry out ! mission ( ! ,dep>tm5t4 7#b7 ,n lat] ?an ,septemb] #cj1 #bjbh1 & ea* ,septemb] #cj !reaft]1 ! ,secret>y %all update ! plan develop$ pursuant to p>agraph 7#a7 & ext5d ! plan s t x cov]s ! next p]iod ( five fiscal ye>s comm5c+ imm$iately aft] ! date ( ! update4 7b7 ,requirem5ts 7#a7 ,9 develop+ ! plan requir$ by subsection 7a71 ! ,secret>y %all take into acc\nt & docum5t curr5t & future project$ dem& = b5efits & s]vices adm9i/]$ by ! ,dep>tm5t1 disaggregat$ = ea* compon5t by facility location1 facility type1 region1 adm9i/ration1 program (fice1 ! type ( b5efit or s]vice1 & su* o!r categories z ! ,secret>y det]m9es appropriate4 7#b7 ,! ,secret>y %all develop & update ! plan "u subsection 7a7 9 consultation ) vet]ans s]vice organizations & su* o!r /akehold]s z ! ,secret>y consid]s appropriate4 7c7 ,cont5ts ,! /rategic human capital plan requir$ by subsection 7a7 %all incorporate lead+ practices1 includ+ ! foll[+3 7#a7 ,a work=ce gap analysis1 includ+ an assessm5t (-- 7,a7 ! /aff+ levels ( ea* employee position ne$$ to deliv] high quality1 accessible1 & timely heal? c>e1 b5efits1 & o!r s]vices ! ,secret>y consid]s appropriate1 disaggregat$ by employee position1 facility location1 facility type1 region1 adm9i/ration1 program (fice1 ! type ( b5efit or s]vice1 & su* o!r categories z ! ,secret>y det]m9es appropriate2 7,b7 h[ ! /aff+ levels describ$ 9 subp>agraph 7,a7 align ) indu/ry be/ practices 9 ea* employee position = ! anticipat$ dem& = heal? c>e1 b5efits1 & o!r s]vices describ$ 9 subsection 7b72 & 7,c7 core compet5cies1 z def9$ by ! ,secret>y1 & ! /aff+ levels ne$$ 9 ea* ( ^! core compet5cies1 disaggregat$ by employee position1 facility location1 facility type1 region1 adm9i/ration1 program (fice1 ! type ( b5efit or s]vice & su* o!r categories z ! ,secret>y consid]s appropriate4 7#b7 ,an implem5tation plan t includes ! foll[+3 7,a7 ,specific recruitm5t & ret5tion goals to fulfill ! /aff+ ne$s id5tifi$ 9 ! /rategic human capital plan & ! /rategy ( ! ,dep>tm5t to a*ieve su* goals4 7,b7 ,specific /rategies-- 7i7 to improve work=ce productivity us+ te*nological1 organizational1 behavioral1 & su* o!r approa*es z ! ,secret>y det]m9es appropriate & productivity measures t are specific to employee positions & ! b5efits or s]vices !y provide2 & 7ii7 t are in=m$ by applicable indu/ry be/ practices4 7,c7 ,specific /rategies = recruit+ & reta9+ vet]ans1 sp\ses ( vet]ans & memb]s ( ! ,arm$ ,=ces1 family memb]s ( vet]ans & memb]s ( ! ,arm$ ,=ces1 c>egiv]s ( vet]ans1 & survivors ( memb]s ( ! ,arm$ ,=ces z employees ( ! ,dep>tm5t4 7,d7 ,specific goals to r$uce ! "t to hire & onbo>d employees ( ! ,dep>tm5t & a /rategy to a*ieve su* goals1 includ+ draft legislative language = any legislative action necess>y to a*ieve su* goals1 )\t degradation (-- 7i7 necess>y backgr\nd *ecks2 & 7ii7 measures to protect ,dep>tm5t cu/om] & employee safety4 7d7 ,annual updates ,n lat] ?an ,septemb] #cj1 #bjbh1 & ,septemb] #cj ( ea* ( ye> !reaft]1 ! ,secret>y %all submit to ! appropriate committees ( ,congress an update on ! implem5tation ( ! /rategic human capital plan develop$ pursuant to subsection 7a71 includ+ an assessm5t by ! ,secret>y (-- 7#a7 ! progress ( ! ,dep>tm5t 9 implem5t+ ! /rategic human capital plan2 7#b7 ! progress ( ! ,dep>tm5t 9 improv+ outcomes = vet]ans & _! sp\ses1 dep5d5ts1 & c>egiv]s ?r\gh ! deliv]y ( high quality1 accessible1 & timely heal? c>e1 b5efits1 & o!r s]vices ! ,secret>y consid]s appropriate us+ results bas$ p]=mance measures2 7#c7 *anges to project$ dem& = b5efits & s]vices bas$ on new legislative action or o!r factors1 disaggregat$ = ea* compon5t by facility location1 facility type1 region1 adm9i/ration1 program (fice & ! type ( b5efit or s]vice2 7#d7 *anges to ! /aff+ levels includ$ 9 ! /rategic human capital plan1 includ+ ju/ifications = su* *anges1 disaggregat$ by employee position1 facility location1 facility type1 region1 adm9i/ration1 program (fice1 ! type ( b5efit or s]vice & su* o!r categories z ! ,secret>y det]m9es appropriate2 7#e7 any diff]5tiation betwe5 ! /aff+ levels includ$ 9 ! /rategic human capital plan & ^? includ$ 9 ! budget ju/ification mat]ials mo/ rec5tly submitt$ to ,congress 9 support ( ! budget ( ! ,dep>tm5t 7z submitt$ ) ! budget ( ! ,presid5t "u section #aaje7;a7 ( title #ca72 & 7#f7 any diff]5tiation f ! ,quadr5nial ,vet]ans ,heal? ,adm9i/ration review requir$ by section #gccj;,c ( ?is title4 7e7 ,comptroll] ,g5]al ( ! ,unit$ ,/ates bi5nial reviews ,n lat] ?an #ahj days aft] ! date on :i* ! human capital plan is submitt$ to ! appropriate committees ( ,congress pursuant to subsection 7a71 & n less frequ5tly ?an once e #b ye>s !reaft]1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all-- 7#a7 review ! /rategic human capital plan develop$ pursuant to subsection 7a7 & updat$ pursuant to subsection 7d71 z ! case may be1 p>ticul>ly ) respect to ! adequacy ( ! plan to fulfill ! mission & responsibilities ( ! ,dep>tm5t2 & 7#b7 submit to ,congress ! f9d+s ( ! ,comptroll] ,g5]al ) respect to ! review conduct$ pursuant to p>agraph 7#a74 7f7 ,def9itions ,9 ?is section3 7#a7 ,! 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 7#b7 ,! t]m vet]ans s]vice organization means any organization recogniz$ by ! ,secret>y "u section #eijb ( ?is title4 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( *apt] #g ( su* title is am5d$ by ins]t+ aft] ! item relat+ to section #gbh ! foll[+ new item3 #gbi4 ,/rategic human capital plan4 4 #fdb4 ,dep>tm5t ( ,vet]ans ,affairs r$uction 9 =ce notice requirem5t 7a7 ,9 g5]al ,sub*apt] ,i ( *apt] #g ( title #ch1 ,unit$ ,/ates ,code1 z am5d$ by section #b7;a71 is fur!r am5d$ by ins]t+ aft] section #gbi ! foll[+ new section3 #gbi;,a4 ,r$uctions 9 =ce 7a7 ,notice requir$ ,9 any case 9 :i* ! ,secret>y plans to c>ry out a r$uction 9 =ce1 ! ,secret>y %all1 n lat] ?an ! date t is #fj days be=e ! date on :i* ! ,secret>y comm5ces c>ry+ out su* r$uction 9 =ce1 submit to ! appropriate committees ( ,congress & ! employees ( ! ,dep>tm5t :o w be affect$ by ! r$uction 9 =ce notice ( ! int5tion ( ! ,secret>y to c>ry out su* r$uction 9 =ce4 7b7 ,limitation ,not)/&+ any o!r provision ( law1 ! ,secret>y may n c>ry out any r$uction 9 =ce ) respect to any employee :o has n receiv$ ! notice requir$ "u subsection 7a7 9 ! mann] & )9 ! "t requir$ by su* subsection4 7c7 ,cont5ts ,notice reg>d+ plans to c>ry out a r$uction 9 =ce submitt$ pursuant to subsection 7a7 %all include ! foll[+3 7#a7 ,! total numb] ( employees ( ! ,dep>tm5t :o w be affect$ by ! r$uction4 7#b7 ,! (fices ( ! ,dep>tm5t t w be affect$ by ! r$uction1 includ+1 = ea* su* (fice1 ! foll[+3 7,a7 ,! location ( ! (fice4 7,b7 ,! program ( ! ,dep>tm5t c>ri$ out by ! (fice4 7,c7 ,! total numb] ( employees ( ! (fice be=e & aft] ! r$uction 9 =ce4 7,d7 ,! s]vices provid$ by ! (fice4 7#c7 ,a ju/ification = ! r$uction 9 =ce1 includ+ h[-- 7,a7 ! new /aff+ levels result+ f ! r$uction 9 =ce align ) ! curr5t & future project$ dem& = b5efits & s]vices adm9i/]$ by ! ,dep>tm5t1 disaggregat$ = ea* compon5t by facility location1 facility type1 region1 adm9i/ration1 program (fice1 ! type ( b5efit or s]vice1 & su* o!r categories z ! ,secret>y det]m9es appropriate2 & 7,b7 ! r$uction 9 =ce aligns ) ! /rategic human capital plan requir$ by section #gbi ( ?is title4 7#d7 ,budget>y effects ( ! r$uction 9 =ce4 7#e7 ,an assessm5t ( ! anticipat$ impact ( ! r$uction 9 =ce on ! deliv]y ( b5efits & s]vices furni%$ by ! ,dep>tm5t & ! actions ! ,secret>y plans to take to mitigate any adv]se impacts4 7d7 ,equal cont5t ,a notice reg>d+ a r$uction 9 =ce s5t to an employee pursuant to subsection 7a7 %all be ! same z ! notice submitt$ "u su* subsection to ,congress = ! same r$uction 9 =ce4 7e7 ,adm9i/rative rem$y ,effect ( ,noncompliance4 ,a r$uction 9 =ce c>ri$ out ) respect to an employee 9 violation ( subsection 7b7 %all h no =ce or effect ) respect to su* employee until ! ,secret>y complies ) subsection 7a74 7f7 ,def9itions ,9 ?is section3 7#a7 ,! 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 7#b7 ,! t]m r$uction 9 =ce means any action t w\ld h requir$ notice "u "p #cea ( title #e1 ,code ( ,f$]al ,regulations1 z 9 effect on ,janu>y #a1bjbf4 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( *apt] #g ( su* title1 z am5d$ by section #b7;b71 is fur!r am5d$ by ins]t+ aft] ! item relat+ to section #gbi ! foll[+ new item3 #gbi;,a4 ,r$uctions 9 =ce4 4 #fdc4 ,detail$ plans & ju/ifications = reorganization ( (fices ,section #eaj ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 9 subsection 7f77#b7-- 7,a7 9 subp>agraph 7,d71 by ins]t+ 9 improv+ outcomes = vet]ans & _! sp\ses1 dep5d5ts1 & c>egiv]s ?r\gh ! deliv]y ( high quality1 accessible1 & timely heal? c>e1 b5efits1 & o!r s]vices ! ,secret>y consid]s appropriate be=e ! p]iod at ! end2 & 7,b7 by add+ at ! end ! foll[+ new subp>agraphs3 7,g7 ,a description ( h[ ! ,secret>y w analyze success ( ! reorganization us+ results bas$ p]=mance metrics t are d]iv$ f ! ju/ification = ! reorganization4 7,h7 ,a risk mitigation plan id5tify+ significant op]ational1 work=ce1 f9ancial1 in=mation te*nology1 pati5t c>e1 & s]vice-deliv]y risks reasonably anticipat$ by ! ,secret>y & ! actions plann$ to mitigate su* risks4 2 7#b7 by r$esignat+ subsections 7e7 & 7f7 z subsections 7f7 & 7g71 respectively2 & 7#c7 by ins]t+ aft] subsection 7d7 ! foll[+ new subsection 7e73 7e7 ,n lat] ?an #ahj days aft] ! date on :i* ! ,secret>y completes an adm9i/rative reorganization = :i* ! ,secret>y submitt$ "u subsection 7b7 a report conta9+ a detail$ plan & ju/ification = ! adm9i/rative reorganization1 & n less frequ5tly ?an once e #ahj days !reaft] until ! date t is two ye>s aft] ! date ( ! completion ( su* adm9i/rative reorganization1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report assess+ ! adm9i/rative reorganization us+ ! p]=mance metrics describ$ 9 ! detail$ plan & ju/ification pursuant to subsection 7g77#b77;,g74 4 #fdd4 ,rule ( con/ruction ,no?+ 9 ?is subtitle or an am5dm5t made by ?is subtitle %all be con/ru$ to h any effect on any provision ( law 9 effect be=e ! date ( ! enactm5t ( ?is ,act4 ,e ,vet]ans ,infra/ructure & ,trans=mation #fea4 ,%ort title ,?is subtitle may be cit$ z ! ,vet]ans ,infra/ructure & ,trans=mation ,act ( #bjbf or ! ,,vital ,act ( #bjbf4 #feb4 ,modification ( au?ority = %>+ ( heal?-c>e res\rces ( ,dep>tm5t ( ,vet]ans ,affairs to include flexible space utilization & /reaml9$ s]vice agreem5ts ,section #haec ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 9 subsection 7a77#c7-- 7,a7 9 subp>agraph 7,a71 by ins]t+ physical be=e space2 7,b7 9 subp>agraph 7,b77i71 by ins]t+ physical be=e space2 7,c7 by /rik+ subp>agraph 7,e72 7,d7 by r$esignat+ subp>agraphs 7,c7 & 7,d7 z subp>agraphs 7,d7 & 7,e71 respectively2 7,e7 by ins]t+ aft] subp>agraph 7,b7 ! foll[+ new subp>agraph 7,c73 7,c7 ,if ! heal?-c>e res\rce requir$ is physical space or common s]vices ) respect to exi/+ build+s & is to be acquir$ f an in/itution affiliat$ ) ! ,dep>tm5t 9 accordance ) section #gcjb ( ?is title or ano!r entity1 ! ,secret>y may ent] into contracts or agreem5ts = ! acquisition ( ! space or s]vice-- 7i7 )\t reg>d to any law or regulation 7includ+ any ,executive ord]1 circul>1 or o!r adm9i/rative policy7 t w\ld o!rwise require ! use ( competitive proc$ures = acquir+ ! res\rce2 & 7ii7 if all obligations are fund$ ?r\gh available appropriations or borne by ! in/itution or entity1 )\t reg>d to any limitations applicable to leases ( ! ,dep>tm5t1 if1 9 ! case ( a multi-ye> space-%>+ agreem5t1 ! agreem5t-- 7,i7 requires t paym5ts = ea* fiscal ye> be made only f appropriat$ funds & available t ye>2 & 7,,ii7 includes a provision t ! ,gov]nm5t's obligations = future ye>s is cont+5t ^u availability ( appropriations4 2 7,f7 9 subp>agraph 7,d71 z r$esignat$ by subp>agraph 7,d7 ( ?is p>agraph1 by /rik+ subp>agraph 7,a7 or 7,b7 & ins]t+ subp>agraph 7,a71 7,b71 or 7,c72 7#b7 by add+ at ! end ! foll[+3 7h7 ,9 ?is section3 7#a7 ,! t]m comm]cial s]vice means a s]vice t is (f]$ & sold competitively 9 ! comm]cial m>ketplace1 is p]=m$ "u /&>d comm]cial t]ms & conditions1 & is procur$ us+ firm-fix$ price contracts4 7#b7 ,! t]m common s]vice means a comm]cial s]vice necess>y to ma9ta9 or op]ate exi/+ physical space1 includ+ ma9t5ance1 heat+1 v5tilation1 air condition+1 electricity1 en]gy1 wat]1 wa/ewat]1 l&scap+1 security1 laundry1 or any o!r s]vice z det]m9$ by ! ,secret>y4 7#c7 ,! t]m physical space means a portion ( a build+ or p>k+ facilities4 4 #fec4 ,use ( comm]cial con/ruction & facilities code & /&>ds 7a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs may use comm]cial codes & /&>ds in/ead ( or 9 addition to ,f$]al codes & /&>ds 9 ! con/ruction or alt]ation ( facilities ( ! ,dep>tm5t ( ,vet]ans ,affairs1 :]e su* comm]cial codes & /&>ds d n conflict ) /atutory & regulatory requirem5ts4 7b7 ,pilot projects ,! ,secret>y %all "u take n few] ?an ?ree pilot projects dur+ ea* ( fiscal ye>s #bjbg1 #bjbh1 #bjbi1 #bjcj1 & #bjca utiliz+ comm]cial codes & /&>ds in/ead ( ,f$]al codes & /&>ds to lease or con/ruct facilities ( ! ,dep>tm5t = major con/ruction1 m9or con/ruction1 or major lease projects4 7c7 ,reports ,! ,secret>y %all submit a report to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives n lat] ?an #ij days aft] ! end ( ea* ( fiscal ye>s #bjbg1 #bjbh1 #bjbi1 #bjcj1 & #bjca detail+ ! use by ! ,secret>y ( ! au?ority provid$ by subsection 7a7 & conduct ( ea* pilot project requir$ by subsection 7b7 t 0 initiat$1 ongo+1 or complet$ dur+ ! fiscal ye>4 7d7 ,def9itions ,9 ?is section3 7#a7 ,comm]cial codes & /&>ds ,! t]m comm]cial codes & /&>ds means build+ codes or /&>ds ( ! foll[+3 7,a7 ,! ,national ,fire ,protection ,association4 7,b7 ,! ,int]national ,code ,c\ncil4 7,c7 ,! ,am]ican ,society = ,te/+ & ,mat]ials4 7,d7 ,! ,am]ican ,society ( ,civil ,eng9e]s4 7,e7 ,any o!r build+ code or /&>d1 o!r ?an ^? describ$ 9 7#b71 det]m9$ by ! ,secret>y4 7#b7 ,f$]al codes & /&>ds ,! t]m ,f$]al codes & /&>ds means ! foll[+3 7,a7 ,build+ codes or /&>ds specific to "o or m ,f$]al ag5cies4 7,b7 ,build+ codes or /&>ds specific to ! ,dep>tm5t1 includ+ ! ,te*nical ,in=mation ,libr>y4 7,c7 ,/&>ds ( ! ,f$]al ,guidel9es ,in/itute4 #fed4 ,feasibility /udy = full-s]vice hospital ( ,dep>tm5t ( ,vet]ans ,affairs 9 c]ta9 ,/ates 7a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all conduct a /udy on ! feasibility ( e/abli%+ a full-s]vice hospital ( ! ,dep>tm5t ( ,vet]ans ,affairs 9 ,alaska & ,hawaii4 7b7 ,publication ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is title1 ! ,secret>y %all publi% on a publicly available website ( ! ,dep>tm5t ! f9d+s ( ! ,secret>y ) respect to ! /udy conduct$ "u subsection 7a74 #fee4 ,report on /rategic plan = infra/ructure & capital assets ( ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,report ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is title1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! /rategic plan = infra/ructure & capital assets ( ! ,dep>tm5t ( ,vet]ans ,affairs1 :i* summ>izes a facility lifecycle /rategy t>get+ mod]nization ( own$ & leas$ facilities & infra/ructure requir$ to mitigate increas+ sy/emic failures1 vet]an & /aff safety1 b5efits deliv]y int]ruptions1 & fund+ associat$ to address em]g5cy repairs4 7b7 ,elem5ts ,! report requir$ by subsection 7a7 %all cov] kn[n & project$ requirem5ts ov] a p]iod ( n less ?an #aj ye>s = ! foll[+3 7#a7 ,l& acquisition4 7#b7 ,op]ations & ma9t5ance ( facilities ( ! exi/+ capital asset portfolio ( ! ,dep>tm5t4 7#c7 ,op]ations & ma9t5ance ( ! plann$ future capital asset portfolio ( ! ,dep>tm5t4 7#d7 ,new con/ruction1 disaggregat$ by type ( new con/ruction1 includ+ ! foll[+ types ( con/ruction3 7,a7 ,major con/ruction4 7,b7 ,m9or con/ruction4 7,c7 ,nonrecurr+ ma9t5ance4 7#e7 ,leas+4 7#f7 ,alt]native acquisition me?ods1 su* z p>tn]%ips & donations4 7#g7 ,activation ( space4 7#h7 ,disposal1 reuse1 & rem$iation4 7#i7 ,facility lifecycle /rategy process support+ ! plann+1 programm+ deliv]y1 managem5t1 & ma9t5ance ( ! curr5t & future capital asset portfolio ( ! ,dep>tm5t4 7#aj7 ,a discussion ( ! negative effect ( ! lack ( /able & pr$ictable capital asset fund+ on ! ability ( ! ,dep>tm5t to plan1 /aff1 & execute effective capital asset managem5t4 7#aa7 ,ov]view ( ! /rategy be+ utiliz$ 9 ! approa* ( ! ,secret>y to capital inve/m5t1 across all ! capital & leas+ programs1 includ+ ! approa* ( repair v]sus recapitalization1 use ( leas+1 & o!r relevant /rategies z deem$ appropriate by ! ,secret>y4 7#ab7 ,su* o!r matt]s z ! ,secret>y consid]s appropriate1 includ+ ) respect to legislative or adm9i/rative action1 if su* actions are subject to ! availability ( appropriat$ funds4 7c7 ,rule ( con/ruction ,no?+ 9 ?is section or a report submitt$ "u ?is section %all be con/ru$ to create or imply any f9ancial or op]ational obligation beyond ! availability ( appropriat$ funds4 #fef4 ,p]man5t ext5sion ( pilot program on acceptance by ! ,dep>tm5t ( ,vet]ans affairs ( donat$ facilities & relat$ improvem5ts 7a7 ,9 g5]al ,section #b ( ! ,communities ,help+ ,inve/ ?r\gh ,prop]ty & ,improvem5ts ,ne$$ = ,vet]ans ,act ( #bjaf 7,public ,law #aad-bid2 #ch ,u4,s4,c4 #hajc note7 is am5d$-- 7#a7 9 ! section head+1 by /rik+ ,pilot2 7#b7 9 subsection 7a71 9 ! subsection head+1 by /rik+ ,pilot2 7#c7 by /rik+ pilot ea* place x appe>s2 7#d7 by /rik+ subsection 7i72 & 7#e7 by r$esignat+ subsection 7j7 z subsection 7i74 7b7 ,modification ( acceptance ( prop]ty ,p>agraph 7#a7 ( subsection 7b7 ( su* section is am5d$ to read z foll[s3 7#a7 ! donation aligns )-- 7,a7 a ne$ id5tifi$ 9 a ,/rategic ,capital ,inve/m5t ,plann+ process priority li/1 a five-ye> developm5t plan1 a facility ma/] plan1 or an annual capital ne$s inv5tory ( ! ,dep>tm5t2 or 7,b7 any compon5t or phase ( a ne$ describ$ 9 p>agraph 7#a72 & 4 #feg4 ,au?ority to accept donations ( con/ruction s]vices1 m9or con/ruction or nonrecurr+ ma9t5ance projects1 & t>get$ contributions 7a7 ,au?ority ,not)/&+ any o!r provision ( law1 ! ,secret>y ( ,vet]ans ,affairs may accept donations compris+ ! total co/ or a portion ( ! co/ (-- 7#a7 m9or con/ruction projects2 7#b7 nonrecurr+ ma9t5ance projects2 or 7#c7 con/ruction s]vices relat+-- 7,a7 to m9or con/ruction projects2 7,b7 to nonrecurr+ ma9t5ance projects2 7,c7 to an exi/+ facility ( ! ,dep>tm5t2 or 7,d7 to a new facility or portion !re( ( ! ,dep>tm5t4 7b7 ,alignm5t to ne$s ,! ,secret>y may accept a donation "u ?is section only if-- 7#a7 ! donation aligns )-- 7,a7 a ne$ id5tifi$ 9 a ,/rategic ,capital ,inve/m5t ,plann+ process priority li/1 a five-ye> developm5t plan1 a facility ma/] plan1 or an annual capital ne$s inv5tory ( ! ,dep>tm5t2 or 7,b7 any compon5t or phase ( a ne$ describ$ 9 subp>agraph 7,a72 7#b7 ! donation is f an entity describ$ 9 section #b7;a77#b7 ( ! ,communities ,help+ ,inve/ ?r\gh ,prop]ty & ,improvem5ts ,ne$$ = ,vet]ans ,act ( #bjaf 7,public ,law #aad-bid2 #ch ,u4,s4,c4 #hajc note72 7#c7 ! ,secret>y det]m9es su* donation w\ld-- 7,a7 accel]ate project completion2 7,b7 r$uce ! exp5se to ! ,dep>tm5t2 7,c7 improve facility condition2 or 7,d7 o!rwise b5efit vet]ans2 7#d7 ! donor ent]s into a =mal agreem5t ) ! ,secret>y t includes-- 7,a7 provisions = ! ,dep>tm5t's ov]sight dur+ p]=mance2 7,b7 compliance ) applicable con/ruction codes & /&>ds1 & applicable laws & regulations2 7,c7 donor-provid$ insurance1 w>ranties1 & liability protections2 7,d7 ! am\nt ( ! donation & ! am\nt ( ! ,dep>tm5t's fund+ contribution1 if any2 7,e7 t ! donation %all n increase ! co/ to ! ,f$]al ,gov]nm5t ( complet+ su* project describ$ 9 subsection 7a7 7exclud+ activation & su/a9m5t ( su* facility72 & 7,f7 su* o!r t]ms z ! ,secret>y det]m9es necess>y4 7c7 ,/reaml9$ requirem5ts ,= donations "u ?is section t d n involve transf] ( real prop]ty title-- 7#a7 ! donor %all ent] into an agreem5t ) ! ,dep>tm5t t det]m9es :o is responsible to ensure environm5tal or hi/oric pres]vation due dilig5ce is complet$2 7#b7 ! donor %all obta9 all f$]ally requir$ con/ruction & facility relat$ p]mits2 & 7#c7 agreem5ts may be simplifi$ relative to ^? "u section #b ( ! ,communities ,help+ ,inve/ ?r\gh ,prop]ty & ,improvem5ts ,ne$$ = ,vet]ans ,act ( #bjaf 7,public ,law #aad-bid2 #ch ,u4,s4,c4 #hajc note7 to reflect ! nature ( s]vices or t>get$ contributions4 7d7 ,report+ ,! ,secret>y %all include in=mation on donations accept$ "u ?is section 9 ! reports requir$ "u section #b7;g7 ( ! ,communities ,help+ ,inve/ ?r\gh ,prop]ty & ,improvem5ts ,ne$$ = ,vet]ans ,act ( #bjaf 7,public ,law #aad-bid2 #ch ,u4,s4,c4 #hajc note71 ) sep>ate track+ = donations "u ?is section4 #feh4 ,report on use ( additional au?orities relat+ to recruitm5t & ret5tion ( p]sonnel 7a7 ,report requir$ ,n lat] ?an #ij days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! appropriate committees ( ,congress a report detail+ h[ ! ,secret>y w use ! au?orities ( section #gjf ( title #ch1 ,unit$ ,/ates ,code1 to increase ! size & p]=mance ( ! acquisition work=ce ( ! ,dep>tm5t ( ,vet]ans ,affairs4 7b7 ,def9itions ,9 ?is section3 7#a7 ,acquisition work=ce ( ! ,dep>tm5t ,! t]m acquisition work=ce ( ! ,dep>tm5t ( ,vet]ans ,affairs means p]sonnel ( ! ,dep>tm5t ( ,vet]ans ,affairs occupy+ positions )9 occupational s]ies1 z def9$ by ! ,director ( ! ,(fice ( ,p]sonnel ,managem5t1 responsible = acquisition functions1 z det]m9$ by ! ,secret>y4 7#b7 ,appropriate committees ( ,congress ,! t]m appropriate committees ( ,congress means ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives4 #fei4 ,reports on key capital asset inve/m5ts1 activities1 & p]=mance ( ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,9 g5]al ,section #habj ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ to read z foll[s3 #habj4 ,reports on key capital asset inve/m5ts1 activities1 & p]=mance 7a7 ,capital asset inve/m5t1 activities1 & p]=mance 7#a7 ,9 g5]al ,n lat] ?an #cj days aft] ! end ( ea* fiscal ye>1 & e #fj days !reaft] until ! end ( ! subsequ5t fiscal ye>1 ! ,secret>y %all submit to ! appropriate committees ( ,congress a report on key capital asset inve/m5ts1 activities1 & p]=mance ( ! ,dep>tm5t4 7#b7 ,elem5ts 7,a7 ,fir/ report 9 ea* fiscal ye> ,! fir/ report "u p>agraph 7#a7 9 ea* fiscal ye> %all include ! foll[+3 7i7 ,a brief summ>y ( "w t 0 complet$ on ea* capital asset project t 0 complet$ 9 ! previ\s fiscal ye>4 7ii7 ,a brief summ>y ( ! accompli%m5ts1 imp$im5ts1 & *all5ges exp]i5c$ by ! ,dep>tm5t ) respect to capital asset projects 9 ! previ\s fiscal ye> & a description ( ef=ts made to address any su* imp$im5ts & *all5ges4 7iii7 ,) respect to ea* capital asset project complet$ 9 su* ye>1 ! foll[+3 7,i7 ,! type ( project 7major con/ruction1 m9or con/ruction1 nonrecurr+ ma9t5ance1 leases1 or o!r category1 includ+ disposals74 7,,ii7 ,! e/imat$ total co/ & ! actual total co/ ( ! project4 7,,iii7 ,a description ( ! project4 7,,iv7 ,! location & facility ) respect to :i* ! project 0 c>ri$ out4 7,v7 ,! fiscal qu>t] ! project 0 expect$ to beg91 ! fiscal qu>t] ! project began1 ! mon? & ye> ! project 0 complet$1 & ! fiscal qu>t] ! facility 9 connection to su* project 0 9 use by vet]ans1 employees ( ! ,dep>tm5t1 or o!r relevant us]s1 z ! case may be4 7iv7 ,9 ! case ( any capital asset project complet$ dur+ ! previ\s fiscal ye> ) respect to :i* ! f9al co/ ( ! project 7or any increm5t ( ! project7 0 m ?an #aj p]c5t great] ?an ! e/imat$ co/ ( ! project 7or increm5t7 or ! completion ( su* project 7or increm5t7 0 m ?an #ahj days lat] ?an ! plann$ s*$ule = su* project 7or increm5t7-- 7,i7 ! reason = any su* ov]age or delay2 & 7,,ii7 actions be+ tak5 to prev5t any su* ov]age or delay 9 future projects4 7v7 ,a li/ ( any capital asset projects cancell$ dur+ ! previ\s fiscal ye>1 includ+ any projects 9 ! design phase & includ+ ! reason = ! cancellation4 7vi7 ,a summ>y ( total actual obligations = capital asset projects = ! previ\s fiscal ye>1 brok5 out by major con/ruction1 m9or con/ruction1 nonrecurr+ ma9t5ance1 & leases f ! m$ical facilities appropriation acc\nt ( ! ,dep>tm5t4 7vii7 ,a project$ li/ ( capital asset projects1 brok5 out by type ( project "u subclause 7,i71 t are expect$ to be initiat$ dur+ ! curr5t fiscal ye> & ^? t are expect$ to be complet$ dur+ ! curr5t fiscal ye>1 :i* %all include ! foll[+3 7,i7 ,! type ( project 7major con/ruction1 m9or con/ruction1 nonrecurr+ ma9t5ance1 leases1 or o!r category1 includ+ disposals74 7,,ii7 ,! e/imat$ total co/ ( ! project4 7,,iii7 ,a description ( ! project4 7,,iv7 ,! location & facility ) respect to :i* ! project 0 c>ri$ out or is expect$ to be c>ri$ out4 7,v7 ,! fiscal qu>t] ! project is expect$ to beg91 ! fiscal qu>t] ! project is expect$ to be complet$1 & ! fiscal qu>t] ! facility 9 connection to su* project is expect$ to be 9 use by vet]ans1 employees ( ! ,dep>tm5t1 or o!r relevant us]s1 z ! case may be4 7viii7 ,project$ total obligations = capital asset projects = ! curr5t fiscal ye>1 brok5 out by major con/ruction1 m9or con/ruction1 nonrecurr+ ma9t5ance1 & leases1 f ! m$ical facilities appropriation acc\nt ( ! ,dep>tm5t4 7ix7 ,su* obs]vations ( be/ practices1 imp$im5ts1 & accompli%m5ts relat$ to ! capital asset managem5t & p]=mance ( ! ,dep>tm5t1 includ+ any legislative or adm9i/rative action1 z ! ,secret>y consid]s appropriate ) respect to su* practices1 imp$im5ts1 & accompli%m5ts4 7x7 ,mean+ful metrics t %[ ! progress ( ! ,dep>tm5t t[>d meet+ relevant goals ( ! ,dep>tm5t relat+ to capital asset managem5t4 7xi7 ,su* o!r matt]s z ! ,secret>y consid]s appropriate4 7,b7 ,subsequ5t reports ,ea* report 9 a fiscal ye> aft] ! fir/ report %all include1 at a m9imum1 relevant updates on any capital asset projects t are ongo+ dur+ t fiscal ye>1 includ+ any updates to in=mation provid$ ) respect to su* projects "u subp>agraph 7,a74 7#c7 ,matt]s relat+ to report+ co/s ,9 ea* report "u p>agraph 7#a71 :5 report+ on co/s = capital asset projects1 ! ,secret>y may include in=mation reg>d+ ,f$]al requirem5ts1 includ+ ^? specific to ! ,dep>tm5t1 t may n exi/ 9 ! non-,f$]al con/ruction sector t may increase co/s = capital asset projects4 7b7 ,sup] con/ruction projects 7#a7 ,9 g5]al ,n lat] ?an #cj days aft] ! end ( ea* fiscal ye>1 & e #fj days !reaft] until ! end ( t fiscal ye>1 ! ,secret>y %all submit to ! appropriate committees ( ,congress a report on ! sup] con/ruction projects c>ri$ out by ! appropriate non-,dep>tm5t ,f$]al entity describ$ 9 section #hajc7;e77#a7 ( ?is title dur+ su* ye>4 7#b7 ,elem5ts ,ea* report requir$ "u p>agraph 7#a7 %all include1 = ea* project describ$ 9 su* p>agraph-- 7,a7 ! budget>y & s*$ul+ /atus ( ! project1 z ( ! la/ day ( ! mo/ rec5t fiscal qu>t] end+ be=e ! date on :i* ! report is requir$ to be submitt$2 & 7,b7 ! actual co/ & s*$ule v>iances ( ! project1 z ( su* day1 comp>$ to ! plann$ co/ & s*$ules = ! project4 7c7 ,def9itions ,9 ?is section3 7#a7 ,appropriate committees ( ,congress ,! t]m appropriate committees ( ,congress means-- 7,a7 ! ,committee on ,appropriations & ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate2 & 7,b7 ! ,committee on ,appropriations & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives4 7#b7 ,capital asset project ,! t]m capital asset project means a capital asset inve/m5t or activity ( ! ,dep>tm5t4 7#c7 ,sup] con/ruction project ,! t]m sup] con/ruction project has ! mean+ giv5 su* t]m 9 section #hajc7;e77#c7 ( ?is title4 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( *apt] #ha ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by /rik+ ! item relat+ to section #habj & ins]t+ ! foll[+ new item3 #habj4 ,reports on key capital asset inve/m5ts1 activities1 & p]=mance4 4 #ffj4 ,developm5t ( /reaml9$ procurem5t model2 report ,n lat] ?an #ahj days aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs1 9 consultation ) ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates1 ! ,director ( ! ,(fice ( ,managem5t & ,budget1 & private sector /akehold]s1 %all develop a revis$ process = ! procurem5t ( major m$ical facility leases "u *apt] #ha ( title #ch1 ,unit$ ,/ates ,code1 & submit to ! ,committees on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives & ! ,s5ate a report t includes a description ( su* revis$ process4 #ffa4 ,submission & notification ( co/ e/imates = m$ical facility leases 7a7 ,submission ( co/ e/imates = major m$ical facility leases ) presid5tial budget reque/ ,sub*apt] ,i ( *apt] #ha ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by ins]t+ aft] section #hajd ! foll[+ new section3 #hajd;,a4 ,submission ( co/ e/imates = major m$ical facility leases ) presid5t's budget reque/ 7a7 ,9 g5]al ,= ea* major m$ical facility lease or prospectus-level lease = :i* ! ,secret>y seeks au?orization1 appropriations1 or prospectus approval1 ! ,secret>y %all include 9 ! budget ju/ification mat]ials submitt$ to ,congress 9 connection ) ! budget ( ! ,dep>tm5t = ! applicable fiscal ye> 7z submitt$ ) ! budget ( ! ,presid5t "u section #aaje7;a7 ( title #ca7 a m>ket-bas$ co/ e/imate & full life-cycle co/ e/imate = su* lease4 7b7 ,m>ket-bas$ co/ e/imate ,ea* m>ket-bas$ co/ e/imate requir$ "u subsection 7a7 %all include an evaluation (-- 7#a7 local l& values2 7#b7 applicable con/ruction co/s2 & 7#c7 o!r co/ factors ! ,secret>y det]m9es relevant to build-to-suit facilities4 7c7 ,/&>diz$ me?odology 7#a7 ,9 g5]al ,! ,secret>y %all adopt & apply a /&>diz$ me?odology = e/imat+ "u subsection 7a7 ! full life-cycle co/ ( major m$ical facility leases & prospectus-level leases4 7#b7 ,requir$ elem5ts ,! me?odology requir$ "u p>agraph 7#a7 %all include1 at a m9imum-- 7,a7 base r5t projections ov] ! full lease t]m2 7,b7 t5ant improvem5t & build\t co/s bas$ on curr5t m$ical facility /&>ds2 7,c7 e/imat$ op]at+ exp5ses1 includ+ utilities1 ma9t5ance1 & security2 7,d7 annual escalation factors ti$ to con/ruction co/ indices1 labor rates1 & m>ket tr5ds2 7,e7 co/ assumptions = option p]iods or pot5tial r5ewal t]ms2 & 7,f7 geographic adju/m5ts us+ curr5t regional m>ket data to reflect location-specific con/ruction & leas+ conditions4 7d7 ,annual adju/m5t 7#a7 ,9 g5]al ,to reflect inflation & m>ket escalation1 ! ,secret>y %all annually adju/ ea* co/ e/imate = a lease submitt$ to ,congress = au?orization1 appropriations1 or prospectus approval dur+ ! p]iod beg9n+ on ! date on :i* ! ,secret>y fir/ includes su* co/ e/imate 9 ! budget ju/ification mat]ials describ$ 9 subsection 7a7 & end+ on ! project$ aw>d date = ! lease4 7#b7 ,indices ,9 adju/+ a co/ e/imate "u p>agraph 7#a71 ! ,secret>y %all use su* m$ical con/ruction or real e/ate indices z ! ,secret>y det]m9es appropriate4 7e7 ,rules ( con/ruction 7#a7 ,budget>y treatm5t ,no?+ 9 ?is section %all be con/ru$ to alt]1 sup]s$e1 waive1 or o!rwise affect ! application ( ! scorekeep+ guidel9es1 includ+ ! budget>y treatm5t ( leases "u ,(fice ( ,managem5t & ,budget ,circul> ,a-#aa or any successor guidance4 7#b7 ,pres]vation ( exi/+ budget au?ority requirem5ts ,no?+ 9 ?is section %all be con/ru$ to au?orize ! ,secret>y to ent] into a lease1 incur an obligation1 or make an exp5diture except to ! ext5t & 9 ! am\nt provid$ 9 advance 9 appropriations ,acts4 7f7 ,def9itions ,9 ?is section1 ! t]m major m$ical facility lease has ! mean+ giv5 t t]m 9 section #hajd7;a77#c77;,b7 ( ?is title4 4 7b7 ,congressional notification & plan requir$ = co/ e/imates exce$+ approv$ prospectus am\nts ,sub*apt] ,i ( su* *apt] is fur!r am5d$ by ins]t+ aft] section #hajd;,a ! foll[+ new section3 #hajd;,b4 ,congressional notification & plan requir$ = co/ e/imates exce$+ approv$ prospectus am\nts 7a7 ,price e/imates requir$ dur+ solicitation phase ,z "p ( ! reque/ = lease proposals 7or equival5t =mal solicitation7 = a major m$ical facility lease1 ! ,secret>y %all require (f]ors to provide detail$ price proposals1 includ+ ! co/ ( l& 7if applicable71 to enable evaluation aga9/ ! au?oriz$ prospectus am\nt4 7b7 ,notification requir$ ,if ! l[e/ responsive (f] = a major m$ical facility lease exce$s ! uns]vic$ %ell r5t au?oriz$ 9 ! approv$ prospectus by m ?an #aj p]c5t1 ! ,secret>y %all notify ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives n lat] ?an #de days aft] ! date on :i* ! ,secret>y det]m9es t su* (f] exce$s su* au?oriz$ am\nt4 7c7 ,plan requir$ 7#a7 ,9 g5]al ,n lat] ?an #fj days aft] notification "u subsection 7b7 ) respect to a major m$ical facility lease1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a plan to address ! co/ discrepancy = su* lease1 :i* may include scope adju/m5t1 value eng9e]+1 reque/+ additional au?ority1 or o!r appropriate measures4 7#b7 ,limitation on aw>d ,! ,secret>y %all n aw>d a major m$ical facility lease until ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives h receiv$ ! plan requir$ "u p>agraph 7#a7 ) respect to su* lease4 7d7 ,limitation on fur!r action ,if ! ,secret>y is requir$ to submit a notification "u subsection 7b71 ! ,secret>y may n issue a reque/ = lease proposals = ! applicable major m$ical facility lease until ! date on :i* ! ,secret>y submits ! plan requir$ "u subsection 7c74 7e7 ,rule ( con/ruction ,no?+ 9 ?is section %all be con/ru$ to au?orize ! ,secret>y to exce$ any am\nt au?oriz$ 9 an approv$ prospectus or any am\nt provid$ 9 advance 9 an appropriations ,act4 4 7c7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( su* *apt] is am5d$ by ins]t+ aft] ! item relat+ to section #hajd ! foll[+ new items3 #hajd;,a4 ,submission ( co/ e/imates = major m$ical facility leases ) ,presid5t's budget reque/ #hajd;,b4 ,congressional notification & plan requir$ = co/ e/imates exce$+ approv$ prospectus am\nts 4 #ffb4 ,report on capital asset & in=mation te*nology ne$s ( ! rese>* & developm5t program ( ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,report requir$ ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ,congress a report on ! capital asset & in=mation te*nology ne$s ( ! rese>* & developm5t program ( ! ,dep>tm5t ( ,vet]ans ,affairs4 7b7 ,cont5ts 7#a7 ,9 g5]al ,! report requir$ by subsection 7a7 %all include ! foll[+3 7,a7 ,a compreh5sive summ>y ( new facilities1 r5ovations ( exi/+ facilities1 leas+ ( facilities1 & any o!r su* facilities or physical infra/ructure ! ,dep>tm5t requires to effectively p]=m its rese>* & developm5t functions1 includ+ project$ functions4 7,b7 ,detail$ in=mation on ! in=mation te*nology res\rces1 projects1 equipm5t1 & relat$ in=mation te*nology ne$s1 disaggregat$ by type ( in=mation te*nology fund+ categories1 su* z developm5t or op]ations & ma9t5ance1 ! ,dep>tm5t requires 9 ord] to make ! rese>* & developm5t program & activities ( ! ,dep>tm5t functional & high-p]=m+ 9 ! %ort-1 m$ium-1 & long-t]m1 & ^? ne$$ to enable employees ( ! ,dep>tm5t to p]=m _! rese>* & developm5t activities 9 an effective & effici5t mann]4 7,c7 ,su* matt]s z ! ,secret>y det]m9es relevant to ma9ta9 & fur!r improve & advance ! rese>* & developm5t functions ( ! ,dep>tm5t ?r\gh improv$ capital asset & in=mation te*nology support4 7#b7 ,requirem5ts 7,a7 ,facilities 7i7 ,summ>ies by project ,9 provid+ in=mation "u p>agraph 7#a77;,a71 ! ,secret>y %all provide e/imat$ summ>ies = ea* project ) co/ data z well z a reali/ic multi-ye> plan to design & deliv] ! capital asset projects1 assum+ requir$ fund+ is provid$4 7ii7 ,id5tification ( projects ,! ,secret>y %all id5tify ea* project "u p>agraph 7#a77;,a7 by its project type1 su* z major con/ruction1 m9or con/ruction1 nonrecurr+ ma9t5ance1 major lease1 m9or lease1 or su* o!r category z ! ,secret>y det]m9es may be appropriate4 7,b7 ,in=mation te*nology ,9 provid+ in=mation "u p>agraph 7#a77;,b71 ! ,secret>y %all provide e/imat$ summ>ies = ea* project or inve/m5t ) individual & total co/ data z well z a reali/ic multi-ye> plan to develop relevant requirem5ts & acquire & deploy ! relevant in=mation te*nology s]vices1 projects1 equipm5t1 & relat$ matt]s4 7,c7 ,scope ,! scope ( ! report submitt$ "u subsection 7a7 is on ! capital asset1 in=mation te*nology1 & o!r relat$ critical support functions1 exclud+ human capital relat$ ne$s1 ne$$ = ! ,dep>tm5t to p]=m rese>* & developm5t 9 an effective & effici5t mann]4 7c7 ,consid]ations ,9 prep>+ ! report requir$ by subsection 7a71 ! ,secret>y may consid] ! foll[+3 7#a7 ,! f9d+s ( ! #bjab f9al report ( ! ,rese>* ,infra/ructure ,program ( ! ,dep>tm5t4 7#b7 ,curr5t & updat$ data provid+ ! mo/ accurate & holi/ic pres5tation ( ! physical infra/ructure1 in=mation te*nology1 & o!r relevant support function ne$s ( ! rese>* & developm5t program ( ! ,dep>tm5t4 7#c7 ,su* o!r matt]s z ! ,secret>y consid]s appropriate4 #ffc4 ,improv+ prev5tion1 detection1 & report+ ( wa/e1 fraud1 & abuse 9 ,dep>tm5t ( ,vet]ans ,affairs capital asset projects & activities 7a7 ,report requir$ ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! appropriate committees ( ,congress a report on actions ! ,dep>tm5t ( ,vet]ans ,affairs is tak+ or plans to take to enhance ! ability ( ! ,dep>tm5t to prev5t1 detect1 & report wa/e1 fraud1 & abuse occurr+ 9 capital asset projects ( ! ,dep>tm5t1 :e!r by employees1 contractors1 or o!r relevant p]sons or entities involv$ ) ! ,dep>tm5t4 7b7 ,elem5ts ,! report requir$ by subsection 7a7 %all include ! foll[+3 7#a7 ,an assessm5t ( :e!r new tra9+ or enhancem5ts to exi/+ tra9+ %\ld be und]tak5 to improve ! prev5tion1 detection1 & report+ ( wa/e1 fraud1 & abuse4 7#b7 ,recomm5dations = su* legislative & adm9i/rative action z ! ,secret>y det]m9es appropriate to improve ! prev5tion1 detection1 & report+ ( wa/e1 fraud1 & abuse4 7#c7 ,su* o!r matt]s z ! ,secret>y consid]s appropriate4 7c7 ,consultation ,9 c>ry+ out subsection 7a71 ! ,secret>y-- 7#a7 %all consult ) ! ,inspector ,g5]al ( ! ,dep>tm5t ( ,vet]ans ,affairs & ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates on matt]s relat+ to be/ practices & /rategies to improve detection & prev5tion by ! ,dep>tm5t ( wa/e1 fraud1 & abuse 9 capital asset projects & managem5t2 & 7#b7 may consult ) su* o!r p]sons & entities on su* matt]s z ! ,secret>y consid]s appropriate4 #ffd4 ,report on long-t]m c>e physical infra/ructure ne$s ( ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! appropriate committees ( ,congress a report1 disaggregat$ by m$ical c5t] or o!r relevant heal? c>e facility ( ! ,dep>tm5t ( ,vet]ans ,affairs1 id5tify+ ! physical infra/ructure ne$s ( ! ,dep>tm5t to support curr5t & future anticipat$ long-t]m c>e ne$s & models ( c>e = vet]ans1 includ+-- 7#a7 infra/ructure ne$$ to support ! deliv]y ( long-t]m c>e = wom5 vet]ans1 vet]ans ) sp9al cord injuries & diseases1 vet]ans ) traumatic bra9 injury1 vet]ans ) unique behavioral heal? ne$s1 vet]ans ) memory loss1 & o!r population gr\ps ) unique ne$s or project$ future ne$s2 7#b7 in=mation reg>d+ ! plans ( ! ,dep>tm5t to provide su* c>e z ! ,dep>tm5t builds int]nal capacity b space is n yet available to meet ! dem& = su* c>e2 & 7#c7 ) respect to any projects ne$$ to provide ! infra/ructure specifi$ "u p>agraph 7#a7-- 7,a7 ! e/imat$ individual project co/ & total co/ to accompli% ^? projects2 & 7,b7 ! e/imat$ individual project timel9e to accompli% ea* su* project ^u receipt ( appropriate fund+4 7b7 ,inclusion ( in=mation reg>d+ prioritization ( c]ta9 projects ,! ,secret>y %all include 9 ! report requir$ "u subsection 7a7 in=mation reg>d+ h[ ! infra/ructure prioritization processes ( ! ,dep>tm5t1 su* z ! ,/rategic ,capital ,inve/m5t ,plann+ process1 or successor process1 c\ld be modifi$ to include high] prioritization ( projects t support ! provision ( a heal? c>e s]vice t is n widely available1 or is n available 9 compliance ) appropriate quality or access /&>ds1 f non-,dep>tm5t provid]s4 7c7 ,developm5t ( report ,9 develop+ ! report requir$ "u subsection 7a71 ! ,secret>y %all consult ) relevant regional & national program (fices ( ! ,vet]ans ,heal? ,adm9i/ration ) responsibility = manag+ ! v>i\s heal? c>e s]vices cov]$ by ! report1 includ+ long-t]m c>e & c>e relat+ to sp9al cord injuries & diseases1 to ensure t ! report conta9s a holi/ic1 compreh5sive1 & integrat$ plan to address ! capital asset & o!r space ne$s = ! population ( vet]ans :o require ^? s]vices4 7d7 ,indication ( types ( projects ,9 ! report requir$ "u subsection 7a71 ! ,secret>y %all indicate ! projects t c be mo/ effici5tly & effectively accompli%$ ?r\gh small] individual infra/ructure projects or ?r\gh a l>g] m$ical facility replacem5t or new site ( c>e1 z det]m9$ by ! ,secret>y4 ,f ,o!r ,heal? ,c>e ,matt]s #fga4 ,prescription1 deliv]y1 di/ribution1 & disp5sation ( controll$ sub/ance m$ications by cov]$ heal? c>e pr(essionals ( ,dep>tm5t ( ,vet]ans ,affairs via telem$ic9e 7a7 ,9 g5]al ,sub*apt] ,,iii ( *apt] #ag ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new section3 #agcj;,d4 ,prescription1 deliv]y1 di/ribution1 & disp5sation ( controll$ sub/ance m$ications via telem$ic9e 7a7 ,9 g5]al ,not)/&+ sections #ajb7ed7 & #cji7;e7 ( ! ,controll$ ,sub/ances ,act 7#ba ,u4,s4,c4 #hjb7ed7 & #hbi7;e771 a cov]$ heal? c>e pr(essional may prescribe1 deliv]1 di/ribute1 & disp5se a controll$ sub/ance if ! cov]$ heal? c>e pr(essional is us+ telem$ic9e ?r\gh ! use ( an int]active telecommunications sy/em1 includ+ an audio-only telecommunications sy/em :5 necess>y1 to prescribe1 deliv]1 di/ribute1 or disp5se to a pati5t eligible to receive hospital c>e or m$ical s]vices "u ?is *apt] a controll$ sub/ance t is a prescription drug z det]m9$ "u ! ,f$]al ,food1 ,drug1 & ,cosmetic ,act 7#ba ,u4,s4,c4 #cja et seq471 reg>dless ( :e!r su* cov]$ heal? c>e pr(essional has conduct$ an 9-p]son m$ical exam9ation ( su* pati5t1 if-- 7#a7 su* cov]$ heal? c>e pr(essional-- 7,a7 is act+ 9 ! usual c\rse ( pr(essional practice2 7,b7 is regi/]$ pursuant to section #cjc7;g7 ( ! ,controll$ ,sub/ances ,act 7#ba ,u4,s4,c4 #hbc7;g77 9 any ,/ate or is utiliz+ ! regi/ration ( a facility ( ! ,dep>tm5t regi/]$ pursuant to section #cjc7;f7 ( su* ,act 7#ba ,u4,s4,c4 #hbc7;f772 7,c7 has access to m$ical docum5tation f an 9-p]son m$ical evaluation ( su* pati5t 9 ! pa/ two ye>s by-- 7i7 a cov]$ heal? c>e pr(essional2 7ii7 a heal? c>e pr(essional :o furni%$ c>e & s]vices "u ! ,vet]ans ,community ,c>e ,program "u section #agjc ( ?is title2 or 7iii7 a heal? c>e pr(essional ( ! ,dep>tm5t ( ,def5se2 & 7,d7 at ! "t ( ! telem$ic9e visit ( ! pati5t-- 7i7 has review$ ! prescription data ( ! individual f ! electronic heal? record database ( ! ,dep>tm5t & data f ! prescription drug monitor+ program = ! ,/ate 9 :i* ! pati5t is locat$ at ! "t ( ! telem$ic9e enc\nt] 7if su* a program exi/s7 = at lea/ ! "o-ye> p]iod prec$+ ! date ( ! visit or1 if less ?an "o ye> ( data is available1 = ! entire p]iod available2 & 7ii7 provides docum5tation (-- 7,i7 su* review2 7,,ii7 all successful attempts to access su* databases & program2 & 7,,iii7 all unsuccessful attempts to access su* databases & program t result$ 9 ! prescription ( a limit$ supply "u subsection 7b72 & 7#b7 su* sub/ance is deliv]$1 di/ribut$1 or disp5s$ = a legitimate m$ical purpose4 7b7 ,au?ority = limit$ supply 7#a7 ,9 g5]al ,if ! databases & program describ$ 9 subsection 7a77#a77;,d7 are unavailable or inaccessible at ! "t ( a telem$ic9e enc\nt] conduct$ by a cov]$ heal? c>e pr(essional1 ! cov]$ heal? c>e pr(essional may n prescribe1 deliv]1 di/ribute1 or disp5se m ?an a sev5-day supply ( a controll$ sub/ance until ! cov]$ heal? c>e pr(essional is able to review su* databases & program4 7#b7 ,databases unavailable or inaccessible ,if a database or program requir$ to be review$ "u subsection 7a77#a77;,d7 is unavailable or inaccessible = an ext5d$ p]iod1 z det]m9$ by ! ,secret>y1 a cov]$ heal? c>e pr(essional may provide additional sev5-day supplies ( a controll$ sub/ance until su* database or program is accessible4 7c7 ,maximum supply ,! au?ority "u ?is section may be us$ to supply a controll$ sub/ance = n m ?an a six-mon? p]iod4 7d7 ,use ( au?ority ,! ,secret>y %all ensure t ! au?ority "u ?is section is us$ to prev5t int]ruptions to pati5t c>e & n z a replacem5t = r\t9e 9-p]son pati5t c>e4 7e7 ,regulations 7#a7 ,9 g5]al ,! ,secret>y %all e/abli% 9 regulations guidel9es & a process = ! prescription1 deliv]y1 di/ribution1 & disp5sation ( a controll$ sub/ance pursuant to subsection 7a74 7#b7 ,elem5ts ,! ,secret>y %all ensure ! guidel9es & process describ$ 9 p>agraph 7#a7-- 7,a7 d n re/rict access ( a pati5t to 9-p]son c>e2 & 7,b7 provide = ! collection & analysis ( data to det]m9e if an individual has evid5ce ( a prior 9-p]son m$ical evaluation by a heal? c>e pr(essional describ$ 9 subsection 7a77#a77;,c7 :o w\ld reasonably be expect$ to h prescrib+ au?ority bas$ on _! cr$5tial or organizational role4 7#c7 ,initiat+ treatm5t 7,a7 ,9 g5]al ,! guidel9es e/abli%$ by p>agraph 7#a7 %all prohibit a cov]$ heal? c>e pr(essional f initiat+ treatm5t ) an opioid m$ication li/$ 9 s*$ule ,,ii or ,,iii "u section #bjb ( ! ,controll$ ,sub/ances ,act 7#ba ,u4,s4,c4 #hab7 unless ! cov]$ heal? c>e pr(essional is provid+ treatm5t-- 7i7 = opioid use disord]2 7ii7 = a pati5t receiv+ palliative c>e or enroll$ 9 hospice c>e2 or 7iii7 = a pati5t :o is physically locat$ 9 a m$ical facility :]e ! pati5t is receiv+ 9-p]son c>e4 7,b7 ,exception ,! prohibition "u subp>agraph 7,a7 %all n apply to r5ewal or ma9t5ance ( a previ\sly prescrib$ m$ication describ$ 9 su* subp>agraph4 7f7 ,report+ 7#a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ! ,take ,c>e ( ,am]ica's ,vet]ans ,act1 & n less frequ5tly ?an annually !reaft] until ! t]m9ation date "u subsection 7g71 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report t addresses ! use ( ! au?ority "u ?is section dur+ ! fiscal ye> prec$+ ! date ( submission ( ! report 9 ea* ,vet]ans ,integrat$ ,s]vice ,network4 7#b7 ,elem5ts ,ea* report "u p>agraph 7#a7 %all indicate1 at a m9imum-- 7,a7 h[ _m pati5ts receiv$ prescriptions = controll$ sub/ance m$ications ?r\gh telem$ic9e "u ?is section2 7,b7 :i* controll$ sub/ances are be+ prescrib$ "u ?is section & h[ _m prescriptions 7 writt5 = ea* su* sub/ance2 7,c7 ! numb] ( individuals :o receiv$ a controll$ sub/ance m$ication t 0 prescrib$1 deliv]$1 di/ribut$1 or disp5s$ "u ?is section )\t evid5ce ( an 9-p]son m$ical evaluation )9 ! previ\s two ye>s by a heal? c>e pr(essional describ$ 9 subsection 7a77#a77;,c72 & 7,d7 ! b>ri]s t exi/ to review+ prescription drug monitor+ programs ( ,/ates & h[ (t5 ^? b>ri]s occur4 7g7 ,duration ,! au?ority "u ?is section %all t]m9ate on ,septemb] #cj1 #bjca4 7h7 ,def9itions ,9 ?is section3 7#a7 ,! t]ms controll$ sub/ance1 deliv]1 disp5se1 & di/ribute h ! mean+s giv5 ^? t]ms 9 section #ajb ( ! ,controll$ ,sub/ances ,act 7#ba ,u4,s4,c4 #hjb74 7#b7 ,! t]m cov]$ heal? c>e pr(essional means-- 7,a7 a heal? c>e pr(essional :o-- 7i7 is-- 7,i7 an employee ( ! ,dep>tm5t appo9t$ "u section #gcjf1 #gdja1 #gdje1 #gdjf1 or #gdjh ( ?is title or "u title #e2 or 7,,ii7 op]at+ f a facility ( ! ,dep>tm5t1 includ+ a cl9ic ( ! ,dep>tm5t2 7ii7 is au?oriz$ by ! ,secret>y to provide heal? c>e "u ?is *apt]2 7iii7 is requir$ to adh]e to all /&>ds = quality relat+ to ! provision ( heal? c>e 9 accordance ) applicable policies ( ! ,dep>tm5t2 7iv7 has an active1 curr5t1 full1 & unre/rict$ lic5se1 regi/ration1 or c]tification or meets qualification /&>ds set =? by ! ,secret>y )9 a specifi$ "t frame2 & 7v7 ) respect to a heal? c>e pr(ession li/$ "u section #gdjb7;b7 ( ?is title1 has ! qualifications = su* pr(ession z set =? by ! ,secret>y2 & 7,b7 a heal? pr(essions tra9ee :o-- 7i7 is appo9t$ "u section #gdje ( ?is title2 & 7ii7 is "u ! cl9ical sup]vision ( a heal? c>e pr(essional describ$ 9 subp>agraph 7,a74 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( su* *apt] is am5d$ by ins]t+ aft] ! item relat+ to section #agcj;,c ! foll[+ new item3 #agcj;,d4 ,prescription1 deliv]y1 di/ribution1 & disp5sation ( controll$ sub/ance m$ications via telem$ic9e4 4 #fgb4 ,copaym5ts = limit$ supplies ( m$ications ,p>agraph 7#d7 ( section #agbb;,a7a7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ to read z foll[s3 7#d7 ,p>agraph 7#a7 does n apply-- 7,a7 to opioid antagoni/s furni%$ "u ?is *apt] to a vet]an :o is at high risk = ov]dose ( a specific m$ication or sub/ance 9 ord] to rev]se ! effect ( su* an ov]dose2 & 7,b7 to any limit$ supply prescription = m$ication1 up to a #cj-;day supply ( su* m$ication1 "u section #agcj;,d7b7 ( ?is title if ! cov]$ heal? c>e pr(essional w\ld h prescrib$1 deliv]$1 di/ribut$1 or disp5s$ a supply = m ?an sev5 days if n = ! re/rictions "u su* section4 4 #fgc4 ,plan on e/abli%m5t ( int]active1 onl9e self-s]vice module = c>e 7a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all develop & implem5t a plan to e/abli%1 to ! greate/ ext5t practicable1 an int]active1 onl9e self-s]vice module-- 7#a7 to all[ vet]ans enroll$ 9 ! sy/em ( annual pati5t enrollm5t ( ! ,dep>tm5t ( ,vet]ans ,affairs e/abli%$ & op]at$ "u section #agje7;a7 ( title #ch1 ,unit$ ,/ates ,code-- 7,a7 to reque/ appo9tm5ts1 track ref]rals = heal? c>e "u ! laws adm9i/]$ by ! ,secret>y1 :e!r at a facility ( ! ,dep>tm5t ( ,vet]ans ,affairs or ?r\gh a non-,dep>tm5t provid]1 & receive appo9tm5t rem9d]s2 7,b7 to appeal & track decisions relat+ to-- 7i7 d5ials ( reque/s = au?orization = c>e or s]vices "u section #agjc ( title #ch1 ,unit$ ,/ates ,code2 or 7ii7 d5ials ( reque/s = c>e or s]vices at facilities ( ! ,dep>tm5t1 includ+ "u section #agaj ( su* title2 7,c7 to comp>e ! av]age wait times = appo9tm5ts = ! type ( c>e s\ght by ! vet]an at facilities ( ! ,dep>tm5t & ) non-,dep>tm5t facilities & provid]s ?r\gh :i* ! ,secret>y furni%es c>e & s]vices "u section #agjc ( su* title2 7,d7 to comp>e av]age driv+ times betwe5 _! resid5ce & ! ne>e/ facility ( ! ,dep>tm5t t provides ! c>e !y are seek+ & betwe5 _! resid5ce & ! close/ non-,dep>tm5t provid] t provides ! c>e !y are seek+ & ?r\gh :i* ! ,secret>y furni%es c>e & s]vices "u section #agjc ( su* title2 & 7,e7 to view a provid] directory1 in=mation reg>d+ p5d+ m$ical claims1 & explanations ( b5efits2 & 7#b7 to implem5t su* o!r matt]s z det]m9$ appropriate by ! ,secret>y4 7b7 ,submittal ( plan 7#a7 ,initial plan ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives ! plan develop$ "u subsection 7a74 7#b7 ,biannual update ,n less frequ5tly ?an once e #ahj days dur+ ! two-ye> p]iod beg9n+ on ! submittal ( ! plan "u p>agraph 7#a71 ! ,secret>y %all brief ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives on any updates on ! implem5tation ( su* plan4 #fgd4 ,modification ( requirem5ts = ,c5t] = ,innovation = ,c>e & ,paym5t ( ! ,dep>tm5t ( ,vet]ans ,affairs & transf] ( au?ority 7a7 ,9 g5]al ,*apt] #c ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new section3 #cbf4 ,c5t] = ,innovation 7a7 ,e/abli%m5t ,!re is e/abli%$ )9 ! ,dep>tm5t a ,c5t] = ,innovation 79 ?is section ref]r$ to z ! ,c5t]74 7b7 ,purpose ,! purpose ( ! ,c5t] is to te/ innovative paym5t & s]vice deliv]y models to r$uce program exp5ditures ( ! ,dep>tm5t "u *apt] #ag ( ?is title :ile pres]v+ or enhanc+ ! quality ( c>e furni%$ to vet]ans & o!r eligible individuals4 7c7 ,id5tification & te/+ ( models 7#a7 ,9 g5]al ,! ,c5t] %all-- 7,a7 id5tify & te/ heal? c>e paym5t & s]vice deliv]y models "u ?is title1 includ+ c>e f non-,dep>tm5t provid]s "u sub*apt] ,i ( *apt] #ag ( ?is title1 t h ! pot5tial to-- 7i7 r$uce program exp5ditures2 & 7ii7 pres]ve or enhance ! quality ( c>e furni%$ to vet]ans2 7,b7 give pref]5ce to models t improve ! coord9ation1 quality1 & effici5cy ( heal? c>e s]vices furni%$ "u ?is title2 & 7,c7 evaluate ! effect ( apply+ su* models on program exp5ditures & quality outcomes "u ?is title4 7#b7 ,includ$ models ,! models id5tifi$ & te/$ "u p>agraph 7#a7 may include ! foll[+3 7,a7 ,bundl$ paym5t arrangem5ts4 7,b7 ,prev5tive c>e initiatives4 7,c7 ,*ronic c>e coord9ation models4 7d7 ,selection ( models 7#a7 ,9 g5]al ,! ,secret>y1 act+ ?r\gh ! ,c5t]1 %all select models to be te/$ "u subsection 7b7 f among ^? t-- 7,a7 address a def9$ population = :i* !re are demon/rat$ deficits 9 c>e lead+ to poor cl9ical outcomes or pot5tially avoidable exp5ditures2 & 7,b7 are expect$ to r$uce program co/s :ile pres]v+ or enhanc+ ! quality ( c>e furni%$ to vet]ans4 7#b7 ,crit]ia ,9 select+ models "u p>agraph 7#a71 ! ,secret>y %all apply crit]ia consi/5t ) ! model selection framework us$ 9 evid5ce-bas$ crit]ia t ! ,secret>y det]m9es appropriate4 7e7 ,te/+ & evaluation 7#a7 ,9 g5]al ,! ,secret>y %all design & te/ ea* model "u ?is section 9 a mann] t all[s = ! evaluation (-- 7,a7 *anges 9 program exp5ditures2 7,b7 *anges 9 quality & outcomes ( c>e = vet]ans2 & 7,c7 o!r factors ! ,secret>y det]m9es relevant to c>e coord9ation1 access1 & equity4 7#b7 ,evaluation ,! ,secret>y %all evaluate ea* model "u ?is section us+ sci5tifically valid me?odologies1 includ+ control or comp>ison gr\ps if practicable4 7f7 ,report+ 7#a7 ,annual report ,n less frequ5tly ?an annually1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on models be+ te/$ "u ?is section & _! prelim9>y results1 includ+-- 7,a7 a brief n>rative description ( ! model expla9+ its int5t & ! propos$ mann] 9 :i* x is suppos$ to r$uce exp5ditures & increase quality ( or access to c>e = vet]ans2 7,b7 ! numb] ( vet]ans & provid]s p>ticipat+ 9 ! model1 brok5 d[n by demographics su* z age1 race or e?nicity1 geographic location1 & o!r *>act]i/ics z *os5 by ! ,secret>y2 7,c7 gross & net sav+s or increases to ! m$ical s]vices acc\nt ( ! ,dep>tm5t1 includ+ 9 comp>ison to basel9e budget>y assumptions 9 ! abs5ce ( ! model2 7,d7 an assessm5t ( ! utilization ( ! model1 includ+ ! proportion ( provid]s *oos+ to p>ticipate 9 ! model & ! proportion ( vet]ans *oos+ to p>ticipate 9 ! model1 z ! case may be2 7,e7 an assessm5t ( quality ( c>e & pati5t outcome z measur$ by discrete objective metrics1 includ+ *anges to morbidity & mortality1 *anges to admission rates1 *anges to readmission rates1 *anges to population heal? metrics su* z av]age blood pressure1 ,a#a;,c levels1 body mass index1 or o!r relevant heal? metrics1 or o!r relevant cl9ical outcome metrics2 7,f7 a description ( provid]1 /akehold]1 & vet]an exp]i5ces2 & 7,g7 su* o!r matt]s z ! ,secret>y may consid] relevant4 7#b7 ,f9al report on models ,n lat] ?an #ahj days aft] complet+ ea* model "u ?is section1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a f9al report on su* model1 includ+-- 7,a7 f9d+s f ! evaluation ( su* model2 7,b7 updat$ f9d+s "u p>agraph 7#a7 ) respect to su* model2 7,c7 an assessm5t ( ! fiscal impact ( su* model2 & 7,d7 recomm5dations = expansion or t]m9ation ( ! use ( su* model4 7g7 ,expansion ( successful models 7#a7 ,9 g5]al ,except z provid$ 9 p>agraph 7#b71 ! ,secret>y may1 ?r\gh rulemak+1 exp& ! duration & scope ( a model te/$ "u ?is section to ! ext5t t-- 7,a7 ! ,secret>y det]m9es su* expansion is expect$ to-- 7i7 r$uce program exp5ditures )\t r$uc+ quality ( c>e2 or 7ii7 improve quality ( c>e )\t increas+ program exp5ditures2 & 7,b7 ! ,*ief ,f9ancial ,(fic] ( ! ,dep>tm5t c]tifies t su* expansion w ma9ta9 budget neutrality4 7#b7 ,limitation ,! ,secret>y %all n exp& a model unless ! results ( ! evaluation ( ! model "u subsection 7e7 demon/rate t ! requirem5ts ( p>agraph 7#a7 are satisfi$4 7h7 ,co/ neutrality & fund+ 7#a7 ,9 g5]al ,implem5tation or expansion ( any model "u ?is section %all be conduct$ 9 a mann] t is co/-neutral to ! ,dep>tm5t ov] ! duration ( ! use ( ! model1 includ+ adm9i/rative co/s4 7#b7 ,use ( available am\nts ,! ,secret>y %all ensure t exp5ditures "u ?is section are made f am\nts o!rwise available to ! ,dep>tm5t = m$ical s]vices1 community c>e1 or m$ical support & compliance4 7i7 ,rule ( con/ruction ,no?+ 9 ?is section %all be con/ru$ to au?orize ! ,secret>y to r$uce ! scope or am\nt ( b5efits "u ?is title1 or to impose additional eligibility requirem5ts1 except z may be necess>y to c>ry out an approv$ model "u ?is section4 4 7b7 ,con=m+ & cl]ical am5dm5ts 7#a7 ,con=m+ repeal ,section #agjc;,e ( title #ch1 ,unit$ ,/ates ,code1 is repeal$4 7#b7 ,con=m+ am5dm5ts 7,a7 ,pilot program to improve adm9i/ration ( c>e "u ,vet]ans ,community ,c>e ,program ,section #aje7;a7 ( ! ,s5ator ,elizabe? ,dole #ba/ ,c5tury ,vet]ans ,heal?c>e & ,b5efits ,improvem5t ,act 7,public ,law #aah-baj2 #ch ,u4,s4,c4 #agjc note7 is am5d$1 9 ! matt] prec$+ p>agraph 7#a71 by /rik+ ,pursuant to section #agjc;,e ( title #ch1 ,unit$ ,/ates ,code1 ! ,secret>y ( ,vet]ans ,affairs1 act+ ?r\gh ! ,c5t] = ,innovation = ,c>e & ,paym5t & ins]t+ ,pursuant to section #cbf ( title #ch1 ,unit$ ,/ates ,code1 ! ,secret>y ( ,vet]ans ,affairs1 act+ ?r\gh ! ,c5t] = ,innovation4 7,b7 ,pilot program on consolidat+ approval process ( ,dep>tm5t ( ,vet]ans ,affairs = cov]$ d5tal c>e ,section #ajf7;a7 ( ! ,s5ator ,elizabe? ,dole #ba/ ,c5tury ,vet]ans ,heal?c>e & ,b5efits ,improvem5t ,act 7,public ,law #aah-baj2 #ch ,u4,s4,c4 #agjc note7 is am5d$1 9 ! matt] prec$+ p>agraph 7#a71 by /rik+ ! ,c5t] = ,innovation = ,c>e & ,paym5t e/abli%$ "u section #agjc;,e ( title #ch1 ,unit$ ,/ates ,code & ins]t+ ! ,c5t] = ,innovation e/abli%$ "u section #cbf ( title #ch1 ,unit$ ,/ates ,code4 7,c7 ,/rategic plan on value-bas$ heal? c>e sy/em = ,vet]ans ,heal? ,adm9i/ration2 pilot program ,section #ajg ( ! ,s5ator ,elizabe? ,dole #ba/ ,c5tury ,vet]ans ,heal?c>e & ,b5efits ,improvem5t ,act 7,public ,law #aah-baj2 #ch ,u4,s4,c4 #agja note7 is am5d$-- 7i7 9 subsection 7a77#b77;,a77viii71 by /rik+ ! ,c5t] = ,innovation = ,c>e & ,paym5t ( ! ,dep>tm5t "u section #agjc;,e ( title #ch1 ,unit$ ,/ates ,code & ins]t+ ! ,c5t] = ,innovation "u section #cbf ( title #ch1 ,unit$ ,/ates ,code2 & 7ii7 9 subsection 7c77#a71 by /rik+ ! ,c5t] = ,innovation = ,c>e & ,paym5t e/abli%$ "u section #agjc;,e ( title #ch1 ,unit$ ,/ates ,code & ins]t+ 8! ,c5t] = ,innovation "u section #cbf ( title #ch1 ,unit$ ,/ates ,code4 7#c7 ,cl]ical am5dm5ts 7,a7 ,*apt] #ag ,! table ( sections at ! beg9n+ ( *apt] #ag ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by /rik+ ! item relat+ to section #agjc;,e4 7,b7 ,*apt] #c ,! table ( sections at ! beg9n+ ( *apt] #c ( su* title is am5d$ by add+ at ! end ! foll[+ new item3 #cbf4 ,c5t] = ,innovation4 4 7c7 ,comptroll] ,g5]al report ,n lat] ?an #ah mon?s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all submit to ,congress a report-- 7#a7 on ! ef=ts ( ! ,c5t] = ,innovation ( ! ,dep>tm5t ( ,vet]ans ,affairs 9 fulfill+ ! objectives & requirem5ts "u section #cbf ( title #ch1 ,unit$ ,/ates ,code1 z add$ by subsection 7a72 & 7#b7 conta9+ su* recomm5dations z ! ,comptroll] ,g5]al consid]s appropriate4 7d7 ,review ( ,vet]ans ,community ,c>e ,program 7#a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs1 act+ ?r\gh ! ,(fice ( ,managem5t ( ! ,dep>tm5t ( ,vet]ans ,affairs1 %all conduct a review ( all aspects ( ! ,vet]ans ,community ,c>e ,program4 7#b7 ,elem5ts ,! review requir$ by p>agraph 7#a7 %all-- 7,a7 id5tify prov5 managem5t & paym5t be/ practices ( ! ,f$]al ,gov]nm5t us$ "u ! ,m$ic>e program "u title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq471 ! ,m$icaid program "u title ,,xix ( su* ,act 7#db ,u4,s4,c4 #acif et seq471 & ! ,,tric>e program 7z def9$ 9 section #ajgb ( title #aj1 ,unit$ ,/ates ,code72 7,b7 det]m9e :at be/ practices1 if any1 id5tifi$ "u subp>agraph 7,a7 %\ld be adopt$ & implem5t$ by ! ,secret>y1 includ+ ^? practices t w\ld require legislative action be=e adoption & implem5tation2 7,c7 det]m9e h[ ! ,secret>y c improve access to c>e ?r\gh ! ,vet]ans ,community ,c>e ,program = vet]ans eligible = su* c>e2 7,d7 id5tify solutions to ease adm9i/rative1 legislative1 & regulatory burd5s & improve effici5cy 9 ! ,vet]ans ,community ,c>e ,program2 7,e7 id5tify improvem5ts to ! ,vet]ans ,community ,c>e ,program t c enhance ! exp]i5ce ( vet]ans & p>ticipat+ entities & provid]s furni%+ hospital c>e1 m$ical s]vices1 & ext5d$ c>e s]vices "u ! ,vet]ans ,community ,c>e ,program2 7,f7 review h[ ! ,secret>y-- 7i7 id5tifies eligibility = & reviews1 processes1 & approves ref]rals = c>e "u ! ,vet]ans ,community ,c>e ,program2 7ii7 au?orizes ! furni%+ ( s]vices "u ! ,vet]ans ,community ,c>e ,program2 & 7iii7 receives1 reviews1 processes1 & approves reque/s = paym5t f p>ticipat+ entities & provid]s furni%+ s]vices "u ! ,vet]ans ,community ,c>e ,program4 7,g7 assess su* o!r factors z det]m9$ appropriate by ! ,secret>y 9 consultation ) ,congress4 7#c7 ,brief+ & report 7,a7 ,brief+ ,p]iodically ?r\gh\t ! duration ( ! review requir$ "u p>agraph 7#a71 b n less frequ5tly ?an qu>t]ly1 ! ,secret>y %all brief ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives on ! /atus & prelim9>y f9d+s ( su* review4 7,b7 ,report ,n lat] ?an #cj days aft] ! conclusion ( ! review requir$ "u p>agraph 7#a71 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a writt5 report conta9+-- 7i7 a complete & unr$act$ li/ ( all f9d+s & recomm5dations f ! review2 & 7ii7 any legislative1 adm9i/rative1 regulatory1 policy1 or o!r *anges s\ght by ! ,secret>y z a result ( su* f9d+s4 7#d7 ,vet]ans ,community ,c>e ,program def9$ ,9 ?is subsection1 ! t]m ,vet]ans ,community ,c>e ,program means ! ,vet]ans ,community ,c>e ,program "u section #agjc ( title #ch1 ,unit$ ,/ates ,code4 7e7 ,pilot programs 7#a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all comm5ce c>ry+ out ! pilot programs describ$ 9 p>agraph 7#b7 ?r\gh ! ,c5t] = ,innovation e/abli%$ by section #cbf ( title #ch1 ,unit$ ,/ates ,code1 z add$ by subsection 7a71 & ! ,(fice ( ,managem5t ( ! ,dep>tm5t ( ,vet]ans ,affairs4 7#b7 ,pilot programs describ$ ,! ,secret>y %all c>ry out ! foll[+ pilot programs3 7,a7 ,a pilot program to te/ innovative paym5t models = ! furni%+ ( prev5tive heal? s]vices1 z su* t]m is def9$ 9 section #agja ( title #ch1 ,unit$ ,/ates ,code4 7,b7 ,a pilot program to te/ innovative paym5t models involv+ paym5t bundl+ = integrat$ c>e dur+ an episode ( c>e au?oriz$ "u ! ,vet]ans ,community ,c>e ,program "u section #agjc ( title #ch1 ,unit$ ,/ates ,code1 to improve ! coord9ation1 quality1 & effici5cy ( heal? c>e deliv]y "u su* program4 7f7 ,modification ( indep5d5t assessm5ts ( heal? c>e deliv]y sy/ems & managem5t processes ,subsection #agjd;,a ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 9 subsection 7a77#b77;,i71 by add+ at ! end ! foll[+ new clause3 7vi7 ,to id5tify prov5 managem5t & paym5t be/ practices ( ! ,f$]al ,gov]nm5t us$ "u ! ,m$ic>e program "u title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq471 ! ,m$icaid program "u title ,,xix ( su* ,act 7#db ,u4,s4,c4 #acif et seq471 & ! ,,tric>e program 7z def9$ 9 section #ajgb ( title #aj74 2 & 7#b7 9 subsection 7d71 by ins]t+ or f$]ally fund$ rese>* & developm5t c5t] aft] private entity4 #fge4 ,report on improvem5ts to cl9ical appeals process 7a7 ,9 g5]al ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs1 9 consultation ) vet]ans s]vice organizations1 vet]ans1 c>egiv]s ( vet]ans1 employees ( ! ,dep>tm5t ( ,vet]ans ,affairs1 & o!r /akehold]s z det]m9$ by ! ,secret>y1 %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report conta9+ recomm5dations = legislative or adm9i/rative action to improve ! cl9ical appeals process ( ! ,dep>tm5t ) respect to timel9ess1 transp>5cy1 objectivity1 consi/5cy1 & fairness4 7b7 ,inapplicability ( requirem5ts relat+ to ,f$]al advisory committees ,*apt] #aj ( title #e1 ,unit$ ,/ates ,code1 %all n apply to ! consultation requir$ by subsection 7a74 7c7 ,vet]ans s]vice organization def9$ ,9 ?is section1 ! t]m vet]ans s]vice organization means any organization recogniz$ by ! ,secret>y "u section #eijb ( title #ch1 ,unit$ ,/ates ,code4 #fgf4 ,plan on increas+ accessibility ( c>e = vet]ans ) sp9al cord injury or disord] 7a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a plan on improv+ disability-relat$ access to c>e f facilities ( ! ,dep>tm5t & f non-,dep>tm5t facilities & provid]s ?r\gh :i* ! ,secret>y furni%es c>e & s]vices "u section #agjc ( title #ch1 ,unit$ ,/ates ,code1 = vet]ans ) sp9al cord injury or disord]4 7b7 ,consultation ,9 develop+ ! plan requir$ "u subsection 7a71 ! ,secret>y %all consult ) relevant /akehold]s1 includ+ vet]ans s]vice organizations :o s]ve vet]ans ) sp9al cord injury or disord]4 7c7 ,elem5ts ,! plan requir$ "u subsection 7a7 %all include an assessm5t ( disability-relat$ b>ri]s to c>e at m$ical facilities ( ! ,dep>tm5t ( ,vet]ans ,affairs & ?r\gh community c>e networks ( non-,dep>tm5t provid]s = vet]ans ) sp9al cord injury or disord] & a description ( ! actions ne$$ to ov]come su* b>ri]s1 includ+ co/ e/imates1 timel9es = corrective action1 & reque/s = legislative action1 if any4 7d7 ,vet]ans s]vice organization def9$ ,9 ?is section1 ! t]m vet]ans s]vice organization means any organization recogniz$ by ! ,secret>y "u section #eijb ( title #ch1 ,unit$ ,/ates ,code4