I 
114TH CONGRESS 
1ST SESSION 
H. R. 444 
To expand the research and education on and delivery of complementary 
and alternative medicine to veterans, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 21, 2015 
Ms. BROWNLEY of California introduced the following bill; which was referred 
to the Committee on Veterans’ Affairs 
A BILL 
To expand the research and education on and delivery of 
complementary and alternative medicine to veterans, and 
for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Expanding Care for 
Veterans Act’’. 
SEC. 2. EXPANSION OF RESEARCH AND EDUCATION ON 
AND DELIVERY OF COMPLEMENTARY AND 
ALTERNATIVE MEDICINE TO VETERANS. 
(a) DEVELOPMENT
OF
PLAN
TO
EXPAND
RE-
SEARCH, EDUCATION, AND DELIVERY.—Not later than 
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six months after the effective date specified in subsection 
(f), the Secretary of Veterans Affairs shall develop a plan 
to expand materially and substantially the scope of re-
search and education on, and delivery and integration of, 
complementary and alternative medicine services into the 
health care services provided to veterans. 
(b) ELEMENTS.—The plan required by subsection (a) 
shall provide for the following: 
(1) Research on the following: 
(A) The comparative effectiveness of var-
ious complementary and alternative medicine 
therapies. 
(B) Approaches to integrating complemen-
tary and alternative medicine services into other 
health care services provided by the Depart-
ment. 
(2) Education and training for health care pro-
fessionals of the Department on the following: 
(A) Complementary and alternative medi-
cine services selected by the Secretary for pur-
poses of the plan. 
(B) Appropriate uses of such services. 
(C) Integration of such services into the 
delivery of health care to veterans. 
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(3) Research, education, and clinical activities 
on complementary and alternative medicine at cen-
ters of innovation at Department medical centers. 
(4) Identification or development of metrics and 
outcome measures to evaluate the provision and inte-
gration of complementary and alternative medicine 
services into the delivery of health care to veterans. 
(5) Integration and delivery of complementary 
and alternative medicine services with other health 
care services provided by the Department. 
(c) CONSULTATION.— 
(1) IN GENERAL.—In carrying out subsection 
(a), the Secretary shall consult with the following: 
(A) The Director of the National Center 
on Complementary and Alternative Medicine of 
the National Institutes of Health. 
(B) The Commissioner of Food and Drugs. 
(C) Institutions of higher education, pri-
vate research institutes, and individual re-
searchers with extensive experience in com-
plementary and alternative medicine and the in-
tegration of complementary and alternative 
medicine practices into the delivery of health 
care. 
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(D) Nationally recognized providers of 
complementary and alternative medicine. 
(E) Such other officials, entities, and indi-
viduals with expertise on complementary and al-
ternative medicine as the Secretary considers 
appropriate. 
(2) SCOPE OF CONSULTATION.—The Secretary 
shall undertake consultation under paragraph (1) in 
carrying out subsection (a) with respect to the fol-
lowing: 
(A) To develop the plan. 
(B) To identify specific complementary and 
alternative medicine practices that, on the basis 
of research findings or promising clinical inter-
ventions, are appropriate to include as services 
to veterans. 
(C) To identify barriers to the effective 
provision and integration of complementary and 
alternative medicine services into the delivery of 
health care to veterans, and to identify mecha-
nisms for overcoming such barriers. 
(d) FUNDING.—There is authorized to be appro-
priated to the Secretary such sums as may be necessary 
to carry out this section. 
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(e) COMPLEMENTARY AND ALTERNATIVE MEDICINE 
DEFINED.—In this section, the term ‘‘complementary and 
alternative medicine’’ shall have the meaning given that 
term in regulations the Secretary shall prescribe for pur-
poses of this section, which shall, to the degree practicable, 
be consistent with the meaning given such term by the 
Secretary of Health and Human Services. 
(f) EFFECTIVE DATE.—This section shall take effect 
on the date that is one year after the date of the enact-
ment of this Act. 
SEC. 3. PROGRAM ON INTEGRATION OF COMPLEMENTARY 
AND ALTERNATIVE MEDICINE WITHIN DE-
PARTMENT OF VETERANS AFFAIRS MEDICAL 
CENTERS. 
(a) PROGRAM REQUIRED.—The Secretary of Vet-
erans Affairs shall— 
(1) carry out, through the Office of Patient 
Centered Care and Cultural Transformation of the 
Department of Veterans Affairs, a program to as-
sess the feasibility and advisability of integrating the 
delivery of complementary and alternative medicine 
services selected by the Secretary with other health 
care services provided by the Department for vet-
erans with mental health conditions, chronic pain 
conditions, other chronic conditions, and such other 
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conditions as the Secretary determines appropriate; 
and 
(2) in developing the program, identify and re-
solve barriers to the provision of complementary and 
alternative medicine services selected by the Sec-
retary and the integration of those services with 
other health care services provided by the Depart-
ment. 
(b) DURATION OF PROGRAM.—The program shall be 
carried out during the three-year period beginning on the 
effective date specified in subsection (j). 
(c) LOCATIONS.— 
(1) IN
GENERAL.—The Secretary shall carry 
out the program at not fewer than 15 separate De-
partment medical centers. 
(2) POLYTRAUMA CENTERS.—Not less than two 
of the medical centers designated under paragraph 
(1) shall be located at polytrauma rehabilitation cen-
ters of the Department. 
(3) SELECTION
OF
LOCATIONS.—In carrying 
out the program, the Secretary shall select locations 
that include the following areas: 
(A) Rural areas. 
(B) Areas that are not in close proximity 
to an active duty military installation. 
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(C) Areas representing different geo-
graphic locations, such as census tracts estab-
lished by the Bureau of the Census. 
(d) PROVISION OF SERVICES.—Under the program, 
the Secretary shall provide covered services to covered vet-
erans by integrating complementary and alternative medi-
cine services with other services provided by the Depart-
ment at the medical centers designated under subsection 
(c)(1). 
(e) COVERED VETERANS.—For purposes of the pro-
gram, a covered veteran is any veteran who— 
(1) has a mental health condition diagnosed by 
a clinician of the Department; 
(2) experiences chronic pain; or 
(3) has a chronic condition being treated by a 
clinician of the Department. 
(f) COVERED SERVICES.— 
(1) IN
GENERAL.—For purposes of the pro-
gram, covered services are services consisting of 
complementary and alternative medicine as selected 
by the Secretary. 
(2) ADMINISTRATION
OF
SERVICES.—Covered 
services shall be administered under the program as 
follows: 
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(A) Covered services shall be administered 
by clinicians employed by the Secretary for pur-
poses of this section who, to the extent prac-
ticable, shall provide services consisting of com-
plementary and alternative medicine, including 
those clinicians who solely provide such services. 
(B) Covered services shall be included as 
part of the Patient Aligned Care Teams initia-
tive of the Office of Patient Care Services, Pri-
mary Care Program Office, in coordination with 
the Office of Patient Centered Care and Cul-
tural Transformation. 
(C) Covered services shall be made avail-
able to both— 
(i) covered veterans with mental 
health conditions, pain conditions, or 
chronic conditions described in subsection 
(e) who have received conventional treat-
ments from the Department for such con-
ditions; and 
(ii) covered veterans with mental 
health conditions, pain conditions, or 
chronic conditions described in subsection 
(e) who have not received conventional 
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treatments from the Department for such 
conditions. 
(g) VOLUNTARY PARTICIPATION.—The participation 
of a veteran in the program shall be at the election of 
the veteran and in consultation with a clinician of the De-
partment. 
(h) REPORTS TO CONGRESS.— 
(1) QUARTERLY REPORTS.—Not later than 90 
days after the date of the commencement of the pro-
gram and not less frequently than once every 90 
days thereafter for the duration of the program, the 
Secretary shall submit to the Committee on Vet-
erans’ Affairs of the Senate and the Committee on 
Veterans’ Affairs of the House of Representatives a 
report on the efforts of the Secretary to carry out 
the program, including a description of the outreach 
conducted by the Secretary to veterans and commu-
nity organizations to inform such organizations 
about the program. 
(2) FINAL REPORT.— 
(A) IN
GENERAL.—Not later than 180 
days after the completion of the program, the 
Secretary shall submit to the Committee on 
Veterans’ Affairs of the Senate and the Com-
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mittee on Veterans’ Affairs of the House of 
Representatives a report on the program. 
(B) CONTENTS.—The report submitted 
under subparagraph (A) shall include the fol-
lowing: 
(i) The findings and conclusions of 
the Secretary with respect to the program, 
including with respect to— 
(I) the utilization and efficacy of 
the complementary and alternative 
medicine services established under 
the program; 
(II) an assessment of the benefit 
of the program to covered veterans in 
mental health diagnoses, pain man-
agement, and treatment of chronic ill-
ness; and 
(III) the comparative effective-
ness of various complementary and al-
ternative medicine therapies. 
(ii) Barriers identified under sub-
section (a)(2) that were not resolved. 
(iii) Such recommendations for the 
continuation or expansion of the program 
as the Secretary considers appropriate. 
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(i) COMPLEMENTARY AND ALTERNATIVE MEDICINE 
DEFINED.—In this section, the term ‘‘complementary and 
alternative medicine’’ shall have the meaning given that 
term in section 2(e) of this Act. 
(j) EFFECTIVE DATE.—This section shall take effect 
on the date that is one year after the date of the enact-
ment of this Act. 
SEC. 4. STUDIES OF BARRIERS ENCOUNTERED BY VET-
ERANS IN RECEIVING, AND ADMINISTRATORS 
AND 
CLINICIANS 
IN 
PROVIDING, 
COM-
PLEMENTARY AND ALTERNATIVE MEDICINE 
SERVICES FURNISHED BY THE DEPARTMENT 
OF VETERANS AFFAIRS. 
(a) STUDIES REQUIRED.— 
(1) IN GENERAL.—The Secretary of Veterans 
Affairs shall conduct comprehensive studies of the 
barriers encountered by veterans in receiving, and 
administrators and clinicians in providing, com-
plementary and alternative medicine services fur-
nished by the Department of Veterans Affairs. 
(2) STUDIES CONDUCTED.— 
(A) VETERANS.—In conducting the study 
of veterans, the Secretary shall— 
(i) survey veterans who seek or receive 
hospital care or medical services furnished 
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by the Department, as well as veterans 
who do not seek or receive such care or 
services; 
(ii) administer the survey to a rep-
resentative sample of veterans from each 
Veterans Integrated Service Network; and 
(iii) ensure that the sample of vet-
erans surveyed is of sufficient size for the 
study results to be statistically significant. 
(B) ADMINISTRATORS AND CLINICIANS.— 
In conducting the study of clinicians and ad-
ministrators, the Secretary shall— 
(i) survey administrators of the De-
partment who are involved in the provision 
of health care services; 
(ii) survey clinicians that have pro-
vided complementary and alternative medi-
cine services through the program estab-
lished under section 3 of this Act, after 
those clinicians have provided those serv-
ices through such program for at least 90 
days; and 
(iii) administer the survey to adminis-
trators under clause (i)— 
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(I) before the introduction of 
complementary and alternative medi-
cine services through such program; 
and 
(II) not earlier than 90 days 
after the introduction of complemen-
tary and alternative medicine services 
through such program. 
(b) ELEMENTS OF STUDIES.— 
(1) VETERANS.—In conducting the study of 
veterans required by subsection (a), the Secretary 
shall study the following: 
(A) The perceived barriers associated with 
obtaining complementary and alternative medi-
cine services from the Department. 
(B) The satisfaction of veterans with com-
plementary and alternative medicine services in 
primary care. 
(C) The degree to which veterans are 
aware of eligibility requirements for, and the 
scope of services available under, complemen-
tary and alternative medicine services furnished 
by the Department. 
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(D) The effectiveness of outreach to vet-
erans on the availability of complementary and 
alternative medicine for veterans. 
(E) Such other barriers as the Secretary 
considers appropriate. 
(2) ADMINISTRATORS
AND
CLINICIANS.—In 
conducting the study of administrators and clini-
cians required by subsection (a), the Secretary shall 
study the following: 
(A) The extent of the integration of com-
plementary and alternative medicine services 
within the services provided by the Department. 
(B) The perception by administrators and 
clinicians of the structural and attitudinal bar-
riers to the delivery of high quality complemen-
tary and alternative medicine services by the 
Department. 
(C) Strategies that have been used to re-
duce or eliminate such barriers and the results 
of such strategies. 
(D) The satisfaction of administrators and 
clinicians regarding the integration of com-
plementary and alternative medicine services 
within the services provided by the Department. 
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(E) The perception by administrators and 
clinicians of the value of specific complementary 
and alternative medicine services for inpatient 
and outpatient veteran populations. 
(c) DISCHARGE BY CONTRACT.—The Secretary shall 
enter into a contract with a qualified independent entity 
or organization to carry out the studies required by this 
section. 
(d) MANDATORY REVIEW
OF DATA
BY
THE NA-
TIONAL RESEARCH ADVISORY COUNCIL.— 
(1) IN GENERAL.—The Secretary shall ensure 
that the head of the National Research Advisory 
Council reviews the results of the studies conducted 
under this section. 
(2) SUBMITTAL OF FINDINGS.—The head of the 
National Research Advisory Council shall submit 
findings with respect to the studies to the Under 
Secretary for Health and to other pertinent program 
offices within the Department with responsibilities 
relating to health care services for veterans. 
(e) REPORTS.— 
(1) REPORT ON IMPLEMENTATION.—Not later 
than one year after the date of the enactment of this 
Act, the Secretary shall submit to Congress a report 
on the status of the implementation of this section. 
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(2) REPORT ON STUDY.— 
(A) IN GENERAL.—Not later than 45 days 
after the date of the completion of the study, 
the Secretary shall submit to Congress a report 
on the study required by subsection (a). 
(B) CONTENTS.—The report required by 
subparagraph (A) shall include the following: 
(i) Recommendations for such admin-
istrative and legislative proposals and ac-
tions as the Secretary considers appro-
priate. 
(ii) The findings of the head of the 
National Research Advisory Council and of 
the Under Secretary for Health. 
(f) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated for fiscal year 2016 for the 
Department of Veterans Affairs, $2,000,000 to carry out 
this section. 
(g) COMPLEMENTARY AND ALTERNATIVE MEDICINE 
DEFINED.—In this section, the term ‘‘complementary and 
alternative medicine’’ shall have the meaning given that 
term in section 2(e) of this Act. 
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