,,ii  #aaith ,,congress  #ast ,session  
,s4 #ehe  ,,in ,,the ,,senate ,,of ,,the
 ,,united ,,states  ,february #ac1      
#bjbe,mr4 ,king 7for himself1 ,mr4      
,rounds1 ,mr4 ,cramer1 and ,ms4         
,duckworth7 introduced the following    
bill2 which was read twice and referred 
to the ,committee on ,veterans' ,affairs
  ,a ,,bill  ,to amend title #ch1       
,united ,states ,code1 to establish a   
pre-transition health care registration 
process to facilitate enrollment in the 
patient enrollment system of the        
,department of ,veterans ,affairs by    
members of the ,armed ,forces who are   
separating from the ,armed ,forces1 and 
for other purposes4  #a4 ,short title   
,this ,act may be cited as the          
,servicemember to ,veteran ,health ,care
 ,connection ,act of #bjbe4  #b4        
,pre-transition health care registration
 of members of the ,armed ,forces to    
streamline receipt of health care from  
,department of ,veterans ,affairs  7a7  
,health care pre-,registration  7#a7 ,in

 general ,subchapter ,i of chapter #ag  
of title #ch1 ,united ,states ,code1 is 
amended by inserting after section      
#agje;,a the following new section3     
#agje;,b4 ,management of health care3   
registration in pre-transition system   
and facilitation of enrollment  7a7     
,pre-,transition system  7#a7 ,in       
general ,not later than #ahj days before
 the anticipated separation from the    
,armed ,forces of a member of the ,armed
 ,forces1 the ,secretary shall          
automatically register such member in   
the pre-transition health care          
registration system4  7#b7 ,registration
 ,registration of a member of the ,armed
 ,forces in the pre-transition health   
care registration system under paragraph
 7#a7 shall consist of the entry of     
relevant information of such member into
 such system so as to facilitate and    
permit1 at a future date1 a final       
determination with respect to the       
enrollment of such member in the patient
 enrollment system if such member elects

 to enroll in the patient enrollment    
system and is eligible to enroll in the 
patient enrollment system4  7b7         
,facilitation of enrollment in patient  
enrollment system  7#a7 ,in general ,not
 later than #cj days after separation of
 a covered individual from the ,armed   
,forces1 or as soon as feasibly possible
 following such separation1 the         
,secretary shall engage with such       
individual-- 7,a7 to assist and         
facilitate the completion of the process
 for enrollment of such individual in   
the patient enrollment system1 to       
include the appropriate electronic or   
paper forms2 and  7,b7 to schedule an   
initial primary care or other health    
appointment for such individual under   
the laws administered by the ,secretary 
if the individual is interested in such 
an appointment4  7#b7 ,communication    
efforts ,communication to a covered     
individual under paragraph 7#a7 shall be
 conducted through a combination of     
effective mechanisms to include by      

electronic means through email and text 
message1 paper mail1 and by phone4  7#c7
 ,covered individual defined ,in this   
subsection1 the term covered individual 
means an individual who-- 7,a7 is       
eligible for or expected to be eligible 
for enrollment in the patient enrollment
 system2 and  7,b7 is not yet enrolled  
in such system4  7c7 ,outreach  7#a7    
,pre-transition  7,a7 ,in general ,to   
the greatest extent feasible1 the       
,secretary shall conduct timely outreach
 to members of the ,armed ,forces       
registered in the pre-transition health 
care registration system1 in advance of 
their separation from the ,armed        
,forces1 to explain-- 7i7 what such     
registration means in practical terms2  
7ii7 what steps each such member will   
need to take after separation from the  
,armed ,forces to fully enroll1 if      
eligible1 in the patient enrollment     
system2  7iii7 health care services that
 may be available to such member upon   
enrollment in such system1 including the

 general rules of eligibility for such  
services2  7iv7 health care services    
that may be available to such member    
regardless of enrollment in such system1
 including counseling for military      
sexual trauma and services from ,vet    
,centers 7as defined in section #agab;,a
 of this title71 including the general  
rules of eligibility for such services2 
and  7v7 the steps required to access   
services described in clauses 7iii7 and 
7iv74  7,b7 ,outreach efforts ,outreach 
to a member of the ,armed ,forces       
required under subparagraph 7,a7 shall  
be conducted through a combination of   
effective mechanisms1 including by      
electronic means through email and text 
message1 paper mail1 and by phone4  7#b7
 ,after enrollment  7,a7 ,in general    
,not less frequently than once during   
the #ahj-;day period following the      
enrollment of an individual in the      
patient enrollment system1 the          
,secretary shall contact any such       
individual who has not scheduled a      

primary care appointment or other health
 appointment under the laws administered
 by the ,secretary and offer to schedule
 such appointment should such individual
 be interested in doing so4  7,b7       
,conduct of outreach ,the ,secretary may
 conduct outreach under subparagraph    
7,a7 as part of the ,solid ,start       
program under section #fcbj of this     
title1 other existing processes of the  
,department1 or any new process as the  
,secretary determines appropriate4  7d7 
,definitions ,in this section3 7#a7     
,patient enrollment system ,the term    
patient enrollment system means the     
system of annual patient enrollment of  
the ,department established and operated
 under section #agje7;a7 of this title4 
7#b7 ,pre-transition health care        
registration system ,the term           
pre-transition health care registration 
system means an information technology  
or other system or systems of the       
,department in which the ,department    
enters or stores the relevant           

information of a transitioning member of
 the ,armed ,forces so as to facilitate 
and permit1 at a future date1 a final   
enrollment determination with respect to
 the enrollment of such member in the   
patient enrollment system4  4  7#b7     
,clerical amendment ,the table of       
sections at the beginning of such       
chapter is amended by inserting after   
the item relating to section #agje;,a   
the following new item3  #agje;,b4      
,management of health care3 registration
 in pre-transition system and           
facilitation of enrollment4  4  7#c7    
,effective date ,this subsection and the
 amendments made by this subsection     
shall take effect on the date of the    
enactment of this ,act and apply to any 
member of the ,armed ,forces who is     
anticipated to separate from the ,armed 
,forces on and after the date that is   
one year after the date of the enactment
 of this ,act4  7b7 ,establishment of   
system  7#a7 ,in general ,not later than
 one year after the date of the         

enactment of this ,act1 the ,secretary  
of ,veterans ,affairs1 in consultation  
with the ,secretary of ,defense1 shall  
establish and implement an automated    
process to implement the pre-transition 
health care registration system required
 under section #agje;,b7a7 of title #ch1
 ,united ,states ,code1 as added by     
subsection 7a77#a74  7#b7 ,briefings on 
initial implementation ,not later than  
each of #ahj days1 one year1 and two    
years after the date of the enactment of
 this ,act1 the ,department of ,veterans
 ,affairs-,department of ,defense ,joint
 ,executive ,committee established under
 section #cbj of title #ch1 ,united     
,states ,code1 shall provide to the     
appropriate committees of ,congress a   
briefing on the implementation of the   
process required under paragraph 7#a74  
7c7 ,coordination with ,department of   
,defense  7#a7 ,in general ,in          
implementing the requirements of this   
section and the amendments made by this 
section1 the ,secretary of ,veterans    

,affairs may integrate and coordinate   
such implementation with the ,solid     
,start program of the ,department of    
,veterans ,affairs under section #fcbj  
of title #ch1 ,united ,states ,code1    
other existing processes of the         
,department1 or any new process as the  
,secretary determines appropriate to    
ensure collaboration and coordination   
with relevant programs of the           
,department of ,defense4  7#b7          
,inclusion in ,transition ,assistance   
,program ,on and after the date that is 
one year after the date of the enactment
 of this ,act1 the ,secretary of        
,defense shall include an explanation of
 the pre-transition health care         
registration system required under      
section #agje;,b of title #ch1 ,united  
,states ,code1 as added by subsection   
7a77#a71 as part of the ,transition     
,assistance ,program of the ,department 
of ,defense4  7d7 ,requirement to create
 and maintain simple and streamlined    
process for pre-,registration and       

enrollment  7#a7 ,in general ,the       
,secretary of ,veterans ,affairs shall  
make enrollment in the patient          
enrollment system1 including            
pre-transition health care registration 
under section #agje;,b of title #ch1    
,united ,states ,code1 as added by      
subsection 7a77#a71 a simple and        
streamlined process for all             
transitioning members of the ,armed     
,forces and veterans-- 7,a7 to          
facilitate access to and utilization of 
services from the ,department of        
,veterans ,affairs to which such        
individuals are entitled2  7,b7 to      
ensure such individuals have a healthy  
and smooth transition out of the ,armed 
,forces into civilian life as veterans2 
7,c7 to support the mental and physical 
health of such individuals2 and  7,d7 to
 reduce1 to the greatest extent         
possible1 veteran suicide4  7#b7        
,improvement of process ,the ,secretary 
shall continuously monitor1 improve1 and
 modernize the process described in     

paragraph 7#a74  7e7 ,outreach and      
engagement ,the ,secretary of ,veterans 
,affairs shall-- 7#a7 proactively       
conduct outreach to transitioning and   
recently transitioned members of the    
,armed ,forces to assist such members in
 enrolling in the patient enrollment    
system2  7#b7 proactively and regularly 
engage with veterans already enrolled in
 the patient enrollment system to offer 
assistance in accessing health care     
services under such system2  7#c7       
proactively and regularly engage with   
veterans who may not be eligible for    
enrollment in the patient enrollment    
system but may be eligible to access    
certain specific health services of the 
,department2  7#d7 proactively engage   
with veterans from traditionally        
under-represented groups1 to include    
women veterans1 minority veterans1      
,native ,american veterans1 ,native     
,hawaiian veterans1 ,alaska ,native     
veterans1 and ,,lgbtqia veterans2 and   
7#e7 engage with veterans who are       

eligible but not enrolled in the patient
 enrollment system and offer information
 and assistance regarding the steps to  
facilitate enrollment in such system4   
7f7 ,annual report on pre-,transition   
registration ,section #haaa7;f77#b7 of  
title #ch1 ,united ,states ,code1 is    
amended-- 7#a7 by redesignating         
subparagraphs 7,e7 and 7,f7 as          
subparagraphs 7,f7 and 7,g71            
respectively2 and  7#b7 by inserting    
after subparagraph 7,d7 the following   
new subparagraph 7,e73  7,e7 ,with      
respect to the registration of members  
of the ,armed ,forces in the            
pre-transition health care registration 
system under section #agje;,b of this   
title during the preceding fiscal year1 
the following3 7i7 ,the number of       
members of the ,armed ,forces who were  
registered in such system4  7ii7 ,the   
number of such members who subsequently 
applied for enrollment in the system of 
annual patient enrollment of the        
,department established and operated    

under section #agje7;a7 of this title4  
7iii7 ,the aggregated disposition of    
each such application for enrollment1   
whether denied or approved1 and a reason
 for any denial1 if available4  7iv7    
,aggregated demographic information for 
members of the ,armed ,forces described 
in clauses 7i7 and 7ii71 including age1 
gender1 ethnicity1 length of service1   
military rank1 and branch of service4   
7v7 ,any information on health care     
utilization rates based on registration 
in the pre-transition health care       
registration system under section       
#agje;,b of this title that the         
,secretary considers relevant4  7vi7    
,any additional observations or         
information the ,secretary considers    
relevant regarding the impact of        
pre-transition health care registration 
on streamlining and improving the       
transition from the ,armed ,forces to   
civilian life4  4  7g7 ,reports  7#a7   
,report on feasibility and advisability 
of permitting members of the ,armed     

,forces to receive pre-separation health
 appointment with ,department of        
,veterans ,affairs  7,a7 ,in general    
,not later than one year after the date 
of the enactment of this ,act1 the      
,secretary of ,veterans ,affairs1 in    
consultation with the ,secretary of     
,defense1 shall submit to the           
appropriate committees of ,congress a   
report on the feasibility and           
advisability of permitting transitioning
 members of the ,armed ,forces1         
including those on separation leave1    
while still on active duty1 to receive  
at least one no-cost health care        
appointment at a facility of the        
,department of ,veterans ,affairs-- 7i7 
to familiarize the member with the      
health services of the ,department prior
 to the member leaving the ,armed       
,forces2 and  7ii7 to improve the       
transition process and health and       
wellness of the member once they have   
transitioned to civilian life4  7,b7    
,elements ,the report required under    

subparagraph 7,a7 shall include the     
following3 7i7 ,a description of the    
reasons the ,secretary of ,veterans     
,affairs has determined the policy      
described in such subparagraph is       
feasible and advisable or not4  7ii7 ,an
 identification of changes to law that  
would be required or recommended to make
 such policy feasible and advisable4    
7iii7 ,if the ,secretary determines such
 policy is feasible and advisable1 a    
proposed schedule and timeline to       
implement such policy and an estimate of
 costs to implement and sustain such    
policy4  7iv7 ,such other information as
 the ,secretary considers appropriate4  
7#b7 ,report on efforts to improve      
enrollment ,not later than one year     
after the date of the enactment of this 
,act1 the ,secretary of ,veterans       
,affairs1 in consultation with the      
,secretary of ,defense1 shall submit to 
the appropriate committees of ,congress 
a report containing the following3 7,a7 
,an assessment of the efforts of the    

,secretary of ,veterans ,affairs as     
follows3 7i7 ,to develop and implement a
 system or systems1 and processes to    
implement such a system or systems1 to  
notify veterans who receive a positive  
adjudication for a service-connected    
disability and are not already enrolled 
in the patient enrollment system        
regarding how to enroll in the patient  
enrollment system1 should they be       
inclined to enroll4  7ii7 ,to           
pre-populate information in the         
pre-transition health care registration 
system required under section #agje;,b  
of title #ch1 ,united ,states ,code1 as 
added by subsection 7a77#a71 using data 
available within the ,department of     
,veterans ,affairs1 other ,federal      
agencies1 or ,state agencies or other   
appropriate commercial or publicly      
available information so as to assist   
transitioning members of the ,armed     
,forces with completing the process of  
enrollment in the patient enrollment    
system1 and to simplify and streamline  

enrollment in such system1 including--  
7,i7 a description of any roadblocks to 
pre-populating such information2  7,,ii7
 a description of any challenges in     
receiving relevant information from any 
,federal agency or ,state agency2 and   
7,,iii7 an identification of any        
legislative action that may be required 
to improve the collection of data       
necessary to carry out this clause4     
7,b7 ,an assessment of any challenges   
experienced by the ,secretary of        
,veterans ,affairs in receiving timely  
and reliable electronic information1    
data feeds1 and notifications from the  
,department of ,defense1 other ,federal 
agencies1 or non-,federal entities      
regarding the separation from the ,armed
 ,forces of members of the ,armed       
,forces1 including-- 7i7 specific       
requests for legislative action to      
improve data transmission from the      
,department of ,defense or other        
,federal agencies to the ,department of 
,veterans ,affairs2 and  7ii7 a         

description of policy reforms to require
 the military departments to report to  
the ,secretary of ,defense known or     
anticipated separations in a more timely
 manner4  7,c7 ,the identification of an
 individual in a ,senior ,executive     
,service position 7as defined in section
 #cacb7;a7 of title #e1 ,united ,states 
,code71 or equivalent1 and office within
 the ,department of ,veterans ,affairs  
that is coordinating or will coordinate 
all programs of the ,department relating
 to improving the registration and      
enrollment of transitioning or          
transitioned members of the ,armed      
,forces in health care services of the  
,department 7including pursuant to this 
section and the amendments made by this 
section7 and the usage by such members  
of those services1 to include the       
following programs and offices3 7i7 ,the
 ,solid ,start program of the           
,department under section #fcbj of title
 #ch1 ,united ,states ,code4  7ii7 ,the 
,federal ,recovery ,consultant ,office  

of the ,department4  7iii7 ,the         
,post-#i_/aa ,military#b,,va ,case      
,management ,program of the ,department4
  7iv7 ,the ,liaison ,program of the    
,department4  7v7 ,the ,concierge for   
,care ,program of the ,department4  7vi7
 ,the office of the ,department         
responsible for carrying out the        
pre-transition health care registration 
system under section #agje;,b of title  
#ch1 ,united ,states ,code1 as added by 
subsection 7a77#a74  7vii7 ,other       
similar or successor programs or offices
 of the ,department4  7,d7 ,a           
description of how the individual and   
office identified under subparagraph    
7,c7 manages or will manage various     
programs across the ,department1 to     
include-- 7i7 programs under the        
,veterans ,health ,administration1      
,veterans ,benefits ,administration1 and
 other entities of the ,department that 
have different reporting chains2  7ii7  
an identification of metrics that are   
used or will be used to monitor program 

goals2  7iii7 an identification of steps
 that can be taken to improve management
 and outcomes of such programs1 to      
include collaboration and coordination  
with relevant programs of the           
,department of ,defense2 and  7iv7 an   
organizational chart to show how efforts
 described under this subparagraph are  
managed across the ,department of       
,veterans ,affairs4  7h7 ,rule of       
construction ,nothing in this section or
 the amendments made by this section    
shall be construed to require any member
 of the ,armed ,forces1 former member of
 the ,armed ,forces1 or veteran to use  
any service of the ,department of       
,veterans ,affairs or to enroll in the  
patient enrollment system4  7i7         
,definitions ,in this section3 7#a7     
,appropriate committees of ,congress    
,the term appropriate committees of     
,congress means-- 7,a7 the ,committee on
 ,armed ,services and the ,committee on 
,veterans ,affairs' of the ,senate2 and 
7,b7 the ,committee on ,armed ,services 

and the ,committee on ,veterans         
,affairs' of the ,house of              
,representatives4  7#b7 ,patient        
enrollment system ,the term patient     
enrollment system means the system of   
annual patient enrollment of the        
,department established and operated    
under section #agje7;a7 of title #ch1   
,united ,states ,code4