II 

114TH CONGRESS 

1ST SESSION S. 1676 

To increase the number of graduate medical education positions treating 

veterans, to improve the compensation of health care providers, medical 

directors, and directors of Veterans Integrated Service Networks of the 

Department of Veterans Affairs, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JUNE 24, 2015 

Mr. TESTER (for himself and Mrs. MCCASKILL) introduced the following bill; 

which was read twice and referred to the Committee on Veterans’ Affairs 

A BILL 

To increase the number of graduate medical education positions treating veterans, to improve the compensation of 

health care providers, medical directors, and directors 

of Veterans Integrated Service Networks of the Department of Veterans Affairs, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Delivering Opportunities for Care and Services for Vet6 erans Act of 2015’’ or the ‘‘DOCs for Veterans Act of 

7 2015’’. 


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1 (b) TABLE OF CONTENTS.—The table of contents for 

2 this Act is as follows: 

Sec. 1. Short title; table of contents. 

TITLE I—MEDICAL EDUCATION AND TRAINING 

Sec. 101. Disregard of resident slots that include VA training against the Medicare graduate medical education limitations. 

Sec. 102. Extension of period for increase in graduate medical education residency positions at medical facilities of the Department of Veterans Affairs. 

Sec. 103. Pilot program on graduate medical education residency programs in 

behavioral medicine in underserved areas. 

Sec. 104. Inclusion of mental health professionals in education and training 

program for health personnel of the Department of Veterans 

Affairs. 

Sec. 105. Expansion of qualifications for licensed mental health counselors of 

the Department of Veterans Affairs to include doctoral degrees. 

TITLE II—HEALTH CARE PROVIDERS OF THE DEPARTMENT OF 

VETERANS AFFAIRS 

Sec. 201. Requirement that physician assistants employed by the Department 

of Veterans Affairs receive competitive pay. 

Sec. 202. Modification of education debt reduction program of Department of 

Veterans Affairs to require a certain amount to be spent in 

rural and highly rural areas. 

Sec. 203. Report on medical workforce of the Department of Veterans Affairs. 

TITLE III—LEADERSHIP OF THE VETERANS HEALTH 

ADMINISTRATION 

Sec. 301. Establishment of positions of Directors of Veterans Integrated Service Networks in Office of Under Secretary for Health of Department of Veterans Affairs and modification of qualifications 

for Medical Directors. 

Sec. 302. Pay for Medical Directors and Directors of Veterans Integrated Service Networks. 

TITLE IV—OTHER HEALTH CARE MATTERS 

Sec. 401. Pilot program on providing nurse advice line for veterans in rural and 

highly rural areas. 


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1 TITLE I—MEDICAL EDUCATION 

2 AND TRAINING 

3 SEC. 101. DISREGARD OF RESIDENT SLOTS THAT INCLUDE 

4 VA TRAINING AGAINST THE MEDICARE GRAD5 UATE MEDICAL EDUCATION LIMITATIONS. 

6 (a) DIRECT GME.—Section 1886(h)(4)(F) of the So7 cial Security Act (42 U.S.C. 1395ww(h)(4)(F)) is amend8 ed by adding at the end the following new clause: 

9 ‘‘(iii) DISREGARD OF CERTAIN RESI10 DENT SLOTS THAT INCLUDE VA TRAIN11 ING.—For portions of cost reporting peri12 ods beginning on or after July 1, 2016, in 

13 applying the limitations regarding the total 

14 number of full-time equivalent residents in 

15 the field of allopathic or osteopathic medi16 cine under clause (i) in a hospital’s ap17 proved medical residency training program, 

18 the Secretary shall not take into account 

19 any resident within such program that 

20 counts towards meeting the obligation of 

21 the Secretary of Veterans Affairs under 

22 section 301(b)(2) of the Veterans Access, 

23 Choice, and Accountability Act of 2014 

24 (Public Law 113–146; 38 U.S.C. 7302 

25 note).’’. 


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1 (b) INDIRECT GME.—Section 1886(d)(5)(B)(v) of 

2 the Social Security Act (42 U.S.C. 1395ww(d)(5)(B)(v)) 

3 is amended, in the second sentence, by striking ‘‘sub4 section (h)(4)(F)(ii)’’ and inserting ‘‘clauses (ii) and (iii) 

5 of subsection (h)(4)(F)’’. 

6 SEC. 102. EXTENSION OF PERIOD FOR INCREASE IN GRAD7 UATE MEDICAL EDUCATION RESIDENCY PO8 SITIONS AT MEDICAL FACILITIES OF THE DE9 PARTMENT OF VETERANS AFFAIRS. 

10 (a) IN GENERAL.—Paragraph (2) of section 301(b) 

11 of the Veterans Access, Choice, and Accountability Act of 

12 2014 (Public Law 113–146; 38 U.S.C. 7302 note) is 

13 amended— 

14 (1) in the paragraph heading, by striking 

15 ‘‘FIVE-YEAR’’ and inserting ‘‘TEN-YEAR’’; and 

16 (2) in subparagraph (A), by striking ‘‘5-year 

17 period’’ and inserting ‘‘10-year period’’. 

18 (b) REPORT.—Paragraph (3)(A) of such section is 

19 amended by striking ‘‘until 2019’’ and inserting ‘‘until 

20 2024’’. 

21 SEC. 103. PILOT PROGRAM ON GRADUATE MEDICAL EDU22 CATION RESIDENCY PROGRAMS IN BEHAV23 IORAL MEDICINE IN UNDERSERVED AREAS. 

24 (a) PILOT PROGRAM.—Commencing not later than 

25 one year after the date of the enactment of this Act, the 


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1 Secretary of Veterans Affairs and the Secretary of Health 

2 and Human Services shall jointly conduct a six-year pilot 

3 program to establish not less than three graduate medical 

4 education residency programs in behavioral medicine in 

5 underserved areas in the United States. 

6 (b) ELEMENTS.—Each graduate medical education 

7 residency program established under the pilot program 

8 shall— 

9 (1) provide residents participating in the grad10 uate medical education residency program with an 

11 opportunity to work with a diverse patient popu12 lation through a rotation between medical facilities 

13 of the Department of Veterans Affairs, facilities of 

14 the Indian Health Service, and facilities partici15 pating under the Medicare program under title 

16 XVIII of the Social Security Act (42 U.S.C. 1395 et 

17 seq.); 

18 (2) include graduate medical education in the 

19 field of behavioral medicine; 

20 (3) be carried out in a manner consistent with 

21 graduate medical education residency programs sup22 ported and funded by the Department of Veterans 

23 Affairs and the Department of Health and Human 

24 Services; 

25 (4) be located in a community that— 


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1 (A) is designated as a medically under2 served area under section 330(b)(3)(A) of the 

3 Public Health Service Act (42 U.S.C. 

4 254b(b)(3)(A)); 

5 (B) is in a State with a per capita popu6 lation of veterans of more than 9 percent ac7 cording to the National Center for Veterans 

8 Analysis and Statistics and the United States 

9 Census Bureau; and 

10 (C) is within 100 miles of a Reservation 

11 (as defined in Section 3(d) of the Indian Fi12 nancing Act of 1974 (25 U.S.C. 1452)). 

13 (c) REPORT.— 

14 (1) IN GENERAL.—Not later than 180 days 

15 after the date of the commencement of the pilot pro16 gram and not less frequently than once each year 

17 thereafter while the pilot program is being carried 

18 out, the Secretary of Veterans Affairs and the Sec19 retary of Health and Human Services shall, in con20 sultation with representatives from facilities partici21 pating under the Medicare program under title 

22 XVIII of the Social Security Act (42 U.S.C. 1395 et 

23 seq.) that are participating in the pilot program, 

24 jointly submit to Congress a report on the imple25 mentation of the pilot program. 


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1 (2) ELEMENTS.—Each report required by para2 graph (1) shall include the following: 

3 (A) A description of the patient population 

4 served by the residents participating in a grad5 uate medical education residency program 

6 under the pilot program. 

7 (B) A description of the behavioral medi8 cine services provided under the pilot program, 

9 including the extent to which those services 

10 were provided using telemedicine services. 

11 (C) The academic affiliation of each resi12 dent participating in a graduate medical edu13 cation residency program under the pilot pro14 gram. 

15 (D) A description of any impediments 

16 faced in carrying out the pilot program and ac17 tions taken by the Secretary of Veterans Affairs 

18 and the Secretary of Health and Human Serv19 ices to address those impediments. 

20 SEC. 104. INCLUSION OF MENTAL HEALTH PROFESSIONALS 

21 IN EDUCATION AND TRAINING PROGRAM FOR 

22 HEALTH PERSONNEL OF THE DEPARTMENT 

23 OF VETERANS AFFAIRS. 

24 (a) IN GENERAL.—In carrying out the education and 

25 training program required under section 7302(a)(1) of 


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1 title 38, United States Code, the Secretary of Veterans 

2 Affairs shall include education and training of marriage 

3 and family therapists and licensed professional mental 

4 health counselors. 

5 (b) APPORTIONMENT OF FUNDING.—The Secretary 

6 shall apportion funding for the education and training 

7 program described in subsection (a) equally among the 

8 professions included in the program. 

9 SEC. 105. EXPANSION OF QUALIFICATIONS FOR LICENSED 

10 MENTAL HEALTH COUNSELORS OF THE DE11 PARTMENT OF VETERANS AFFAIRS TO IN12 CLUDE DOCTORAL DEGREES. 

13 Section 7402(b)(11)(A) of title 38, United States 

14 Code, is amended by inserting ‘‘or doctoral degree’’ after 

15 ‘‘master’s degree’’. 

16 TITLE II—HEALTH CARE PRO17 VIDERS OF THE DEPART18 MENT OF VETERANS AFFAIRS 

19 SEC. 201. REQUIREMENT THAT PHYSICIAN ASSISTANTS EM20 PLOYED BY THE DEPARTMENT OF VETERANS 

21 AFFAIRS RECEIVE COMPETITIVE PAY. 

22 Section 7451(a)(2) of title 38, United States Code, 

23 is amended— 

24 (1) by redesignating subparagraph (B) as sub25 paragraph (C); 


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1 (2) by inserting after subparagraph (A) the fol2 lowing new subparagraph (B): 

3 ‘‘(B) Physician assistant.’’; and 

4 (3) in subparagraph (C), as redesignated by 

5 paragraph (1), by striking ‘‘and registered nurse’’ 

6 and inserting ‘‘registered nurse, and physician as7 sistant’’. 

8 SEC. 202. MODIFICATION OF EDUCATION DEBT REDUCTION 

9 PROGRAM OF DEPARTMENT OF VETERANS 

10 AFFAIRS TO REQUIRE A CERTAIN AMOUNT 

11 TO BE SPENT IN RURAL AND HIGHLY RURAL 

12 AREAS. 

13 Section 7681 of title 38, United States Code, is 

14 amended by adding at the end the following new sub15 sections: 

16 ‘‘(c) LIMITATION ON AMOUNTS.—Not less than 30 

17 percent of the amount of debt reduction payments paid 

18 under the Education Debt Reduction Program each year 

19 shall be paid to individuals who practice medicine in a 

20 rural area or highly rural area or demonstrate a commit21 ment to practice medicine in such an area. 

22 ‘‘(d) DEFINITIONS.—In this section: 

23 ‘‘(1) The term ‘highly rural area’ means an 

24 area located in a county or similar community that 


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1 has less than seven individuals residing in that coun2 ty or community per square mile. 

3 ‘‘(2) The term ‘rural area’ means an area that 

4 is not an urbanized area or a highly rural area. 

5 ‘‘(3) The term ‘urbanized area’ has the mean6 ing given that term by the Director of the Bureau 

7 of the Census.’’. 

8 SEC. 203. REPORT ON MEDICAL WORKFORCE OF THE DE9 PARTMENT OF VETERANS AFFAIRS. 

10 (a) IN GENERAL.—Not later than 120 days after the 

11 date of the enactment of this Act, the Secretary of Vet12 erans Affairs shall submit to the Committee on Veterans 

13 Affairs of the Senate and the Committee on Veterans Af14 fairs of the House of Representatives a report on the med15 ical workforce of the Department of Veterans Affairs. 

16 (b) ELEMENTS.—The report required by subsection 

17 (a) shall include the following: 

18 (1) With respect to licensed professional mental 

19 health counselors and marriage and family thera20 pists of the Department— 

21 (A) how many such counselors and thera22 pists are currently enrolled in the mental health 

23 professionals trainee program of the Depart24 ment; 


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1 (B) how many such counselors and thera2 pists are expected to enroll in the mental health 

3 professionals trainee program of the Depart4 ment during the 180-day period beginning on 

5 the date of the submittal of the report; 

6 (C) a description of the eligibility criteria 

7 for such counselors and therapists as compared 

8 to other behavioral health professions in the 

9 Department; 

10 (D) a description of the objectives, goals, 

11 and timing of the Department with respect to 

12 increasing the representation of such counselors 

13 and therapists in the behavioral health work14 force of the Department; and 

15 (E) a description of the actions taken by 

16 the Secretary, in consultation with the Director 

17 of the Office of Personnel Management, to cre18 ate an occupational series for such counselors 

19 and therapists and a timeline for the creation 

20 of such an occupational series. 

21 (2) A breakdown of spending by the Depart22 ment in connection with the education debt reduc23 tion program of the Department under subchapter 

24 VII of chapter 76 of title 38, United States Code, 

25 including— 


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1 (A) the amount spent by the Department 

2 in debt reduction payments during the three3 year period preceding the submittal of the re4 port disaggregated by the medical profession of 

5 the individual receiving the payments; 

6 (B) a description of how the Department 

7 prioritizes such spending by medical profession, 

8 including an assessment of whether such pri9 ority reflects the five occupations identified in 

10 the most recent determination by the Inspector 

11 General of the Department of Veterans Affairs 

12 as having the largest staffing shortages in the 

13 Veterans Health Administration; and 

14 (C) a description of the actions taken by 

15 the Secretary to increase the effectiveness of 

16 such spending for purposes of recruitment of 

17 health care providers to the Department, in18 cluding efforts to more consistently include eli19 gibility for the education debt reduction pro20 gram in vacancy announcements of positions for 

21 health care providers at the Department. 

22 (3) A description of any impediments to the de23 livery by the Department of telemedicine services to 

24 veterans and any actions taken by the Department 


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1 to address such impediments, including with respect 

2 to— 

3 (A) restrictions under Federal or State 

4 laws; 

5 (B) licensing or credentialing issues for 

6 health care providers, including non-Depart7 ment health care providers, practicing telemedi8 cine with a veteran located in a different State; 

9 (C) the effect of limited broadband access 

10 or limited information technology capabilities on 

11 the delivery of health care; 

12 (D) the distance a veteran is required to 

13 travel to access a facility or clinic with telemedi14 cine capabilities; 

15 (E) the effect on the provision of telemedi16 cine services to veterans of policies of and lim17 ited liability protection for certain entities; and 

18 (F) issues relating to reimbursement and 

19 travel limitations for veterans that affect the 

20 participation of non-Department health care 

21 providers in the telemedicine program. 

22 (4) An update on the efforts of the Secretary 

23 to offer training opportunities in telemedicine to 

24 medical residents in medical facilities of the Depart25 ment that use telemedicine, consistent with medical 


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1 residency program requirements established by the 

2 Accreditation Council for Graduate Medical Edu3 cation, as required in section 108(b) of the Honoring 

4 America’s Veterans and Caring for Camp Lejeune 

5 Families Act of 2012 (Public Law 112–154; 38 

6 U.S.C. 7406 note). 

7 (5) An assessment of the development and im8 plementation by the Secretary of succession planning 

9 policies to address the prevalence of vacancies in po10 sitions in the Veterans Health Administration of 

11 more than 180 days, including the development of 

12 an enterprise position management system to more 

13 effectively identify, track, and resolve such vacan14 cies. 

15 (6) A description of the actions taken by the 

16 Secretary, in consultation with the Director of the 

17 Office of Personnel Management, to address any im18 pediments to the timely appointment and determina19 tion of qualifications for Directors of Veterans Inte20 grated Service Networks and Medical Directors of 

21 the Department. 


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1 TITLE III—LEADERSHIP OF THE 

2 VETERANS HEALTH ADMINIS3 TRATION 

4 SEC. 301. ESTABLISHMENT OF POSITIONS OF DIRECTORS 

5 OF VETERANS INTEGRATED SERVICE NET6 WORKS IN OFFICE OF UNDER SECRETARY 

7 FOR HEALTH OF DEPARTMENT OF VETERANS 

8 AFFAIRS AND MODIFICATION OF QUALIFICA9 TIONS FOR MEDICAL DIRECTORS. 

10 Section 7306(a)(4) of title 38, United States Code, 

11 is amended— 

12 (1) by inserting ‘‘and Directors of Veterans In13 tegrated Service Networks’’ after ‘‘Such Medical Di14 rectors’’; and 

15 (2) by striking ‘‘, who shall be either a qualified 

16 doctor of medicine or a qualified doctor of dental 

17 surgery or dental medicine’’. 

18 SEC. 302. PAY FOR MEDICAL DIRECTORS AND DIRECTORS 

19 OF VETERANS INTEGRATED SERVICE NET20 WORKS. 

21 (a) IN GENERAL.—Chapter 74 of title 38, United 

22 States Code, is amended by adding at the end the fol23 lowing new subchapter: 


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1 ‘‘Subchapter VII—Pay for Medical Directors 

2 and Directors of Veterans Integrated 

3 Service Networks 

4 ‘‘§ 7481. Pay for Medical Directors and Directors of 

5 Veterans Integrated Service Networks 

6 ‘‘(a) ELEMENTS OF PAY.—Pay for a Medical Direc7 tor or Director of a Veterans Integrated Service Network 

8 appointed under section 7306(a)(4) of this title (in this 

9 section referred to as a ‘Director’) shall consist of basic 

10 pay set forth under section 7404(a) of this title and mar11 ket pay determined under subsection (b). 

12 ‘‘(b) MARKET PAY.—(1) Each Director is eligible for 

13 market pay determined under this subsection. 

14 ‘‘(2) The amount of market pay payable to a Director 

15 under this section shall be determined by the Secretary 

16 on a case-by-case basis and shall consist of pay intended 

17 to reflect needs of the Department with respect to the re18 cruitment and retention (as determined by the Secretary) 

19 of such Director. 

20 ‘‘(3) In determining the amount of market pay pay21 able to a Director under this section, the Secretary shall— 

22 ‘‘(A) consult not less than two national surveys 

23 on pay for hospital directors, medical facility direc24 tors, or other similar positions, whether prepared by 

25 private, public, or quasi-public entities, to make a 


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1 general assessment of the range of potential pay for 

2 the Director; and 

3 ‘‘(B) take into account— 

4 ‘‘(i) the experience of the Director in man5 aging facilities or program offices of the De6 partment, including the complexity of such fa7 cilities or offices; 

8 ‘‘(ii) the complexity of the facility or facili9 ties to be managed by the Director; 

10 ‘‘(iii) the labor market, in such geographic 

11 area as the Secretary considers relevant, for 

12 hospital directors, medical facility directors, and 

13 other similar positions; 

14 ‘‘(iv) the experience of the Director in 

15 managing medical facilities for other Federal 

16 agencies, private entities, or non-profit entities; 

17 and 

18 ‘‘(v) such other considerations as the Sec19 retary considers appropriate. 

20 ‘‘(4)(A) The Secretary shall evaluate the amount of 

21 market pay payable to a Director under this section not 

22 less frequently than once every two years and may adjust 

23 the market pay payable to such Director as a result of 

24 such evaluation. 


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1 ‘‘(B) A Director whose market pay is evaluated under 

2 subparagraph (A) shall receive written notice of the re3 sults of such evaluation. 

4 ‘‘(c) REQUIREMENTS AND LIMITATIONS ON TOTAL

5 PAY.—(1) Not less frequently than once every two years, 

6 the Secretary shall set forth a Department-wide minimum 

7 and maximum amount for total annual pay under sub8 section (a) that may be paid to a Director and shall pub9 lish each such amount in the Federal Register. 

10 ‘‘(2) The minimum and maximum amounts set forth 

11 under paragraph (1) shall take effect not earlier than the 

12 date that is 60 days after the publication of such amounts 

13 under such paragraph. 

14 ‘‘(3) The sum of the basic pay set forth under section 

15 7404(a) of this title and market pay determined under 

16 subsection (b) for a Director for a calendar year— 

17 ‘‘(A) may not be less than the most recent min18 imum amount set forth under paragraph (1) before 

19 the beginning of such calendar year; and 

20 ‘‘(B) may not be more than the most recent 

21 maximum amount set forth under such paragraph 

22 before the beginning of such calendar year. 

23 ‘‘(4) The total amount of compensation paid to a Di24 rector under this title in any calendar year may not exceed 


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1 the amount of annual compensation (excluding expenses) 

2 of the President under section 102 of title 3. 

3 ‘‘(5) The Secretary may not delegate to an officer or 

4 employee of the Department the requirement of the Sec5 retary to set forth a Department-wide minimum and max6 imum amount under paragraph (1). 

7 ‘‘(d) TREATMENT OF PAY.—Pay under this section 

8 shall be considered pay for all purposes, including retire9 ment benefits under chapters 83 and 84 of title 5 and 

10 other benefits. 

11 ‘‘(e) ANCILLARY EFFECTS OF DECREASES IN PAY.— 

12 (1) A decrease in pay of a Director resulting from an ad13 justment in the amount of market pay of the Director 

14 under subsection (b) shall not be treated as an adverse 

15 action. 

16 ‘‘(2) A decrease in the amount of pay of a Director 

17 resulting from an involuntary reassignment in connection 

18 with a disciplinary action taken against the Director is not 

19 subject to appeal or judicial review.’’. 

20 (b) CLERICAL AMENDMENT.—The table of sections 

21 at the beginning of chapter 74 of such title is amended 

22 by adding at the end the following: 

‘‘SUBCHAPTER VII. PAY FOR MEDICAL DIRECTORS AND DIRECTORS OF

VETERANS INTEGRATED SERVICE NETWORKS

‘‘7481. Pay for Medical Directors and Directors of Veterans Integrated Service 

Networks.’’. 


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1 TITLE IV—OTHER HEALTH CARE 

2 MATTERS 

3 SEC. 401. PILOT PROGRAM ON PROVIDING NURSE ADVICE 

4 LINE FOR VETERANS IN RURAL AND HIGHLY 

5 RURAL AREAS. 

6 (a) IN GENERAL.—Commencing not later than one 

7 year after the date of the enactment of this Act, the Sec8 retary of Veterans Affairs shall conduct a two-year pilot 

9 program to assess the feasibility and advisability of imple10 menting in rural areas and highly rural areas with a large 

11 percentage of veterans a nurse advice line to furnish to 

12 veterans medical advice, appointment and cancellation 

13 services, and information on the availability of benefits 

14 from the Department of Veterans Affairs. 

15 (b) NURSE ADVICE LINE.—In carrying out the pilot 

16 program under subsection (a) the Secretary shall establish 

17 a nurse advice line that— 

18 (1) operates free of charge; 

19 (2) is based on, and improves upon, the nurse 

20 advice line implemented by the Department of De21 fense for beneficiaries under the TRICARE program 

22 (as defined in section 1072(5) of title 10, United 

23 States Code); 

24 (3) complies with call center requirements set 

25 forth by URAC; 


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1 (4) operates in close consultation with the Sec2 retary to— 

3 (A) establish a process through which the 

4 eligibility of a caller for the nurse advice line 

5 can be validated; 

6 (B) allow eligibility and benefit information 

7 in possession of the Department of Veterans 

8 Affairs to be shared with the nurse advice line; 

9 and 

10 (C) allow the nurse advice line to connect 

11 with appropriate technology and personnel of 

12 the Department for purposes of scheduling ap13 pointments for the receipt of health care from 

14 the Department; and 

15 (5) maintains quality controls to ensure that 

16 calls are answered by a customer service representa17 tive within 30 seconds and with an abandonment 

18 rate of less than 5 percent. 

19 (c) SERVICES PROVIDED.—The nurse advice line es20 tablished under the pilot program shall provide an array 

21 of services to veterans, including the following: 

22 (1) Medical advice from licensed registered 

23 nurses who assess the symptoms of the caller using 

24 a proprietary clinical algorithm that— 


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1 (A) has been shown in peer-reviewed med2 ical journals to most closely emulate the clinical 

3 decisionmaking processes of physicians; and 

4 (B) triages the caller to the appropriate 

5 venue at which the caller may receive the health 

6 care that they need. 

7 (2) Information to address basic questions re8 garding the eligibility of the caller for benefits from 

9 the Department of Veterans Affairs and the avail10 ability of those benefits. 

11 (3) Use of an appointment clerk to facilitate the 

12 scheduling, rescheduling, and cancellation of ap13 pointments for health care from the Department. 

14 (d) REPORT.— 

15 (1) IN GENERAL.—Not later than 120 days 

16 after the date of the completion of the pilot pro17 gram, the Secretary of Veterans Affairs shall submit 

18 to Congress a report on the findings of the Secretary 

19 with respect to the pilot program. 

20 (2) ELEMENTS.—The report required by para21 graph (1) shall include the following: 

22 (A) A description of the veterans who have 

23 benefitted from advice through the nurse advice 

24 line under the pilot program, including the loca25 tions of the veterans served. 


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1 (B) A description of any impediments to 

2 the Secretary in carrying out the pilot program. 

3 (C) A description of any impediments en4 countered by individuals in seeking advice or 

5 services through the nurse advice line under the 

6 pilot program. 

7 (D) An assessment of the feasibility and 

8 advisability of expanding the pilot program to 

9 include more veterans. 

10 (e) DEFINITIONS.—In this section: 

11 (1) HIGHLY RURAL AREA.—The term ‘‘highly 

12 rural area’’ means an area located in a county or 

13 similar community that has less than seven individ14 uals residing in that county or community per 

15 square mile. 

16 (2) RURAL AREA.—The term ‘‘rural area’’ 

17 means an area that is not an urbanized area or a 

18 highly rural area. 

19 (3) URBANIZED AREA.—The term ‘‘urbanized 

20 area’’ has the meaning given that term by the Direc21 tor of the Bureau of the Census. 

Æ 


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