,,ii  #aai? ,,congress  #a/ ,session    
,s4 #cjcc  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,octob] #bb            
7legislative day1 ,octob] #ba71 #bjbe   
,ms4 ,duckwor? 7= h]self & ,mrs4        
,blackburn7 introduc$ ! foll[+ bill2 :i*
 0 read twice & ref]r$ to ! ,committee  
on ,vet]ans' ,affairs  ,a ,,bill  ,to   
require ! ,secret>y ( ,vet]ans ,affairs 
to e/abli% p>tn]%ips betwe5 m$ical      
facilities ( ! ,dep>tm5t ( ,vet]ans     
,affairs & m$ical facilities 9 rural    
areas1 & = o!r purposes4  #a4  ,%ort    
title  ,?is ,act may be cit$ z !        
,improv+ ,access to ,c>e = ,rural       
,vet]ans ,act4  #b4  ,p>tn]%ips betwe5  
m$ical facilities ( ,dep>tm5t ( ,vet]ans
 ,affairs & rural m$ical facilities  7a7
  ,p>tn]%ips  7#a7  ,9 g5]al  ,!        
,secret>y ( ,vet]ans ,affairs %all      
require t ea* m$ical facility ( !       
,dep>tm5t ( ,vet]ans ,affairs ent] into 
a p>tn]%ip ) a m$ical facility 9 a rural
 area4  7#b7  ,agreem5ts  ,ea* p>tn]%ip 
ent]$ into "u p>agraph 7#a7 may include 

an agreem5t = provision ( teleheal?1    
co-location or leas+ ( space or         
equipm5t1 tra9+1 c>e coord9ation1       
em]g5cy s]vices 7includ+                
transportation71 or o!r s]vices z       
det]m9$ appropriate4  7#c7  ,purpose (  
p>tn]%ip  ,! purpose ( any p>tn]%ip     
ent]$ into "u p>agraph 7#a7 %all be to  
provide great] access to c>e = vet]ans 9
 rural areas & to r$uce co/s to all     
entities )9 ! p>tn]%ip4  7b7  ,waiv]    
7#a7  ,9 g5]al  ,! ,secret>y may waive !
 requirem5t "u subsection 7a77#a7 )     
respect to a m$ical facility = a p]iod n
 to exce$ five ye>s1 subject to su*     
requirem5ts z ! ,secret>y may e/abli%1  
if ! ,secret>y notifies ,congress ( !   
waiv] n lat] ?an #dh h\rs be=e ! waiv]  
takes effect4  7#b7  ,r5ewal  ,!        
,secret>y may r5ew a waiv] "u p>agraph  
7#a7 ) respect to a m$ical facility only
 if ! ,secret>y1 9 consultation ) ! head
 ( ! m$ical facility1 evaluates ! ne$ = 
! waiv] & det]m9es t ! waiv] is         
necess>y4  7c7  ,brief+  ,n lat] ?an    

#ahj days aft] ! date ( ! enactm5t ( ?is
 ,act1 ! ,secret>y %all provide to !    
appropriate committees ( ,congress a    
brief+ on ! plans ( ! ,secret>y = !     
implem5tation ( ! requirem5t "u         
subsection 7a77#a71 includ+--  7#a7 a   
timel9e = implem5tation ( su*           
requirem5t2  7#b7 an id5tification ( an 
(ficial ( ! ,dep>tm5t responsible =     
ov]sight & implem5tation ( su*          
requirem5t2  7#c7 an update on !        
e/abli%m5t ( any (fice1 task =ce1 or    
p]sonnel assignm5ts to support !        
implem5tation ( su* requirem5t2  7#d7 a 
description ( ! plan ( ! ,dep>tm5t =    
ov]sight ( su* requirem5t2  7#e7 a      
/&>diz$ =m or =ms to be us$ = waiv]s "u 
subsection 7b7 & an explanation ( !     
crit]ia = eligibility = su* a waiv]2 &  
7#f7 su* o!r in=mation z ! ,secret>y    
consid]s to be ( int]e/ to ! appropriate
 committees ( ,congress4  7d7  ,report  
,n lat] ?an two ye>s aft] ! date ( !    
enactm5t ( ?is ,act1 & bi5nially        
!reaft]1 ! ,secret>y %all submit to !   

appropriate committees ( ,congress a    
report on ! op]ation & p]=mance (       
p>tn]%ips ent]$ into "u subsection 7a71 
includ+--  7#a7 new p>tn]%ips creat$1 9 
! case ( ! initial report1 s9ce ! date (
 ! enactm5t ( ?is ,act1 &1 9 ! case (   
any subsequ5t report1 dur+ ! p]iod      
foll[+ ! previ\s report2  7#b7 exi/+    
p>tn]%ips betwe5 m$ical facilities ( !  
,dep>tm5t & m$ical facilities 9 rural   
areas2 &  7#c7 z assessm5t ( ! success (
 all p>tn]%ips describ$ 9 p>agraphs 7#a7
 & 7#b7 9 deliv]+ s]vices to vet]ans 9  
rural areas1 includ+--  7,a7 ! numb] (  
vet]ans enroll$ 9 ! sy/em ( annual      
pati5t enrollm5t ( ! ,dep>tm5t "u       
section #agje7;a7 ( title #ch1 ,unit$   
,/ates ,code1 9 ! region 9 :i* ! p>tn]$ 
m$ical facilities are locat$ comp>$ to !
 previ\s five-ye> p]iod2  7,b7 an       
evaluation ( accessibility to s]vices z 
comp>$ to ! s]vices available to ^?     
vet]ans prior to ! implem5tation ( su*  
p>tn]%ips2  7,c7 an ov]view ( new be/   
practices develop$ = su* p>tn]%ips & !  

,dep>tm5t m broadly2 &  7,d7 ! numb] (  
vet]ans receiv+ comp5sation f !         
,dep>tm5t = a s]vice-connect$ disability
 9 ! region 9 :i* ! p>tn]$ m$ical       
facilities are locat$ comp>$ to !       
previ\s five-ye> p]iod4  7e7  ,timel9e  
7#a7  ,exi/+ facilities  ,except z      
provid$ 9 p>agraph 7#b71 by n lat] ?an  
?ree ye>s aft] ! date ( ! enactm5t ( ?is
 ,act1 ! ,secret>y %all ensure t all    
m$ical facilities ( ! ,dep>tm5t t are   
see+ pati5ts are compliant ) !          
requirem5t "u subsection 7a77#a7 or h   
receiv$ a waiv] "u subsection 7b74  7#b7
  ,new facilities  ,! ,secret>y %all    
ensure t any m$ical facility ( !        
,dep>tm5t e/abli%$ aft] ! date ( !      
enactm5t ( ?is ,act is compliant ) !    
requirem5t "u subsection 7a77#a7 or has 
receiv$ a waiv] "u subsection 7b7 by n  
lat] ?an ?ree ye>s aft] ! date on :i*   
pati5ts are fir/ se5 at ! m$ical        
facility4  7f7  ,relation%ip to exi/+   
law  ,! requirem5ts & au?orities "u ?is 
section are 9 addition to1 & sep>ate f1 

! au?ority "u section #haec ( title #ch1
 ,unit$ ,/ates ,code4  7g7  ,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  ,p>tn]%ip  ,! 
t]m p>tn]%ip includes a leas+ or        
co-location agreem5t1 a memor&um (      
und]/&+1 a p>tn]%ip agreem5t1 an        
employm5t contract1 an indep5d5t        
contractor agreem5t1 a s]vice agreem5t1 
or any o!r simil> agreem5t4  7#c7       
,rural  ,! t]m rural has ! mean+ giv5 t 
t]m "u ! ,rural-,urban ,commut+ ,areas  
7,,ruca7 cod+ sy/em ( ! ,dep>tm5t (     
,agriculture4  7#d7  ,s]vice-connect$   
,! t]m s]vice-connect$ has ! mean+ giv5 
t t]m 9 section #aja7af7 ( title #ch1   
,unit$ ,/ates ,code4