I 
116TH CONGRESS 
1ST SESSION H. R. 2916 
To require the Secretary of Veterans Affairs to carry out a pilot program 
to provide hospital care and medical services to veterans in the Freely 
Associated States of the Republic of Palau, the Republic of the Marshall 
Islands, and the Federated States of Micronesia, and to conduct a 
study on the feasibility and advisability of establishing regional offices, 
suboffices, contact units, or other subordinate offices of the Department 
of Veterans Affairs in the Freely Associated States to provide such 
care and services, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 22, 2019 
Ms. GABBARD (for herself, Mrs. RADEWAGEN, Mr. CASE, Mr. SAN NICOLAS, 
and Mr. YOUNG) introduced the following bill; which was referred to the 
Committee on Veterans’ Affairs 
A BILL 
To require the Secretary of Veterans Affairs to carry out 
a pilot program to provide hospital care and medical 
services to veterans in the Freely Associated States of 
the Republic of Palau, the Republic of the Marshall 
Islands, and the Federated States of Micronesia, and 
to conduct a study on the feasibility and advisability 
of establishing regional offices, suboffices, contact units, 
or other subordinate offices of the Department of Vet-
erans Affairs in the Freely Associated States to provide 
such care and services, and for other purposes. 
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resentation of veterans under section 5902 of title 
38, United States Code. 
SEC. 3. PILOT PROGRAM ON PROVIDING HOSPITAL CARE 
AND MEDICAL SERVICES TO VETERANS RE-
SIDING IN THE FREELY ASSOCIATED STATES. 
(a) PILOT PROGRAM REQUIRED.—Commencing not 
later than January 1, 2020, the Secretary shall carry out 
a pilot program to provide hospital care, medical services, 
and other related services to veterans residing in the Free-
ly Associated States. 
(b) DURATION.—The Secretary shall carry out the 
pilot program required by subsection (a) during the three- 
year period beginning on the date of the commencement 
of the pilot program. 
(c) SERVICES PROVIDED.—In carrying out the pilot 
program required by subsection (a), the Secretary shall 
ensure that the pilot program— 
(1) emphasizes the use of telehealth; 
(2) provides Project ECHO education and 
training to employees of the Department responsible 
for carrying out the pilot program; 
(3) includes the use of primary and specialty 
care provided by patient aligned care teams and spe-
cialty care providers; and 
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(4) includes the provision of compensation and 
pension medical examinations. 
(d) OUTREACH PROGRAM.—As part of the pilot pro-
gram required by subsection (a), the Secretary shall con-
duct a program of outreach to inform veterans in the 
Freely Associated States about the pilot program and the 
services available under the pilot program. 
(e) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to the Secretary such 
funds as may be necessary to carry out the pilot program. 
SEC. 4. STUDY ON PROVIDING HOSPITAL CARE AND MED-
ICAL SERVICES TO VETERANS RESIDING IN 
THE FREELY ASSOCIATED STATES. 
(a) STUDY REQUIRED.— 
(1) IN GENERAL.—The Secretary shall conduct 
a study on the feasibility and advisability of estab-
lishing one or more regional offices, suboffices, con-
tact units, or other subordinate offices of the De-
partment in the remote Pacific islands, including the 
Freely Associated States, to provide hospital care 
and medical services to veterans residing in the re-
mote Pacific islands, including the Freely Associated 
States. 
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(2) CONSIDERATIONS AND ANALYSIS.—In con-
ducting the study required by paragraph (1), the 
Secretary shall consider and analyze the following: 
(A) The results of the pilot program re-
quired by section 3(a). 
(B) The ability of the Department to pro-
vide hospital care and medical services to vet-
erans residing or traveling outside the United 
States, including veterans residing in the Freely 
Associated States. 
(C) The feasibility, efficacy, and advis-
ability of building clinics or leasing space on 
embassy compounds or in consulate facilities of 
the United States in the Freely Associated 
States or insular areas for the purposes of pro-
viding hospital care and medical services to vet-
erans residing or traveling outside the United 
States, including veterans residing in the Freely 
Associated States. 
(D) The feasibility and advisability of pro-
viding services, such as telehealth, Project 
ECHO education and training, primary and 
specialty care provided by patient aligned care 
teams and specialty care providers, and com-
pensation and pension medical examinations, to 
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veterans residing in the Freely Associated 
States. 
(E) Updates to census data of the Depart-
ment on the number of veterans residing in the 
Freely Associated States to determine whether 
such data supports the establishment of a per-
manent patient aligned care team of the De-
partment based in the Freely Associated States. 
(F) With respect to the United States and 
the Freely Associated States, the data stand-
ards for— 
(i) patient medical record information; 
and 
(ii) the electronic interchange of such 
information. 
(G) The feasibility and advisability of pro-
viding hospital care and medical services to vet-
erans residing in the Freely Associated States 
for non-service-connected disabilities. 
(H) The feasibility and advisability of pro-
viding continuity of care to veterans for service- 
connected disabilities that cannot be treated by 
the Department within a regional office, sub-
office, contact unit, or other subordinate office 
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of the Department in the remote Pacific is-
lands, including the Freely Associated States. 
(I) Such other matters as the Secretary 
considers appropriate. 
(3) COOPERATION
AND
CONSULTATION.—The 
Secretary shall conduct the study required by para-
graph (1)— 
(A) in cooperation with— 
(i) the Secretary of Defense; 
(ii) the Secretary of Health and 
Human Services; 
(iii) the Secretary of the Interior; 
(iv) the Secretary of State; and 
(v) such other heads of Federal agen-
cies as may be interested in the study; and 
(B) in consultation with— 
(i) such representatives of State and 
local governments as the Secretary deter-
mines may be interested in the study; 
(ii) each government of the Freely As-
sociated States; 
(iii) veterans service organizations; 
(iv) such nongovernmental organiza-
tions as the Secretary considers appro-
priate; and 
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(v) the public. 
(b) REPORT REQUIRED.— 
(1) IN
GENERAL.—Not later than 270 days 
after the date on which the pilot program required 
by section 3(a) terminates, the Secretary shall sub-
mit to the appropriate committees of Congress a re-
port on the findings of the Secretary with respect to 
the study required by subsection (a)(1). 
(2) CONTENTS.—The report submitted under 
paragraph (1) shall include the following: 
(A) A description of the processes required 
for the Secretary to establish one or more re-
gional offices, suboffices, contact units, or other 
subordinate offices in the Freely Associated 
States. 
(B) The number of veterans expected to 
receive hospital care and medical services pro-
vided under laws administered by the Secretary 
in the Freely Associated States. 
(C) A resource management plan for the 
Department to provide hospital care and med-
ical services in the Freely Associated States, in-
cluding an assessment of the effect that such 
provision would have on the Department of Vet-
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