I 
115TH CONGRESS 
2D SESSION 
H. R. 5047 
To direct the Secretary of Veterans Affairs to carry out a demonstration 
program to provide expanded access to medical services through partner-
ships between Department of Veterans Affairs medical centers and Fed-
erally Qualified Health Centers, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 15, 2018 
Mr. BILIRAKIS (for himself, Ms. KUSTER of New Hampshire, Mr. ARRINGTON, 
Mr. COFFMAN, and Mr. PETERS) introduced the following bill; which was 
referred to the Committee on Veterans’ Affairs 
A BILL 
To direct the Secretary of Veterans Affairs to carry out 
a demonstration program to provide expanded access to 
medical services through partnerships between Depart-
ment of Veterans Affairs medical centers and Federally 
Qualified Health Centers, 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 ‘‘VA Community Care 
Enhancement Act’’. 
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SEC. 2. DEPARTMENT OF VETERANS AFFAIRS DEMONSTRA-
TION PROGRAM ON EXPANDED AVAILABILITY 
OF 
MEDICAL 
SERVICES 
THROUGH 
CON-
TRACTS 
WITH 
FEDERALLY 
QUALIFIED 
HEALTH CENTERS. 
(a) DEMONSTRATION PROGRAM.—The Secretary of 
Veterans Affairs shall carry out a demonstration program 
under which the Secretary shall furnish certain medical 
services under chapter 17 of title 38, United States Code, 
through contracts between Department of Veterans Af-
fairs medical centers and Federally Qualified Health Cen-
ters (hereinafter referred to as ‘‘FQHCs’’). 
(b) COMMUNITY-CARE COLLABORATIVE ARRANGE-
MENTS.—Under the demonstration program, the Sec-
retary shall enter into contracts, on behalf of Department 
medical centers, with not less than five separate FQHCs 
that meet the selection criteria under subsection (c). Such 
a contract shall provide that— 
(1) a Department medical provider at the med-
ical center may refer patients directly to the FQHC, 
without any requirement to consult with other agen-
cies, offices, or units within the Department or with 
entities under contract with the Department; 
(2) all patient referrals to the FQHC are at the 
discretion of the Department medical provider, and 
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the decision whether to accept such a referral will be 
at the discretion of the patient; 
(3) if a patient accepts such a referral, the 
FQHC agrees to accept the patient; 
(4) if the FQHC accepts the patient, the 
FQHC shall provide medical services to the patient 
only to the extent that such services are available 
from the FQHC pursuant to section 330 of the Pub-
lic Health Service Act (42 U.S.C. 254b); 
(5) if a patient accepted by the FQHC is a vet-
eran, the FQHC shall accept the family members of 
the veteran and shall provide care and services to 
such family members in accordance with chapter 17 
of title 38, United States Code, if such family mem-
bers are eligible for medical services under such 
chapter; 
(6) if a patient referred under the demonstra-
tion program is not eligible for a type of care or 
service needed by the patient under chapter 17 of 
title 38, United States Code, the FQHC agrees to 
provide such care or service to the patient, and ac-
cept payment for such care or service, in accordance 
with section 330 of the Public Health Service Act 
(42 U.S.C. 254b); 
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(7) the FQHC agrees to provide to patients re-
ferred under the demonstration program— 
(A) in consultation with the Department 
medical center, appropriate education on what 
care and services may be provided to the pa-
tient under chapter 17 of title 38, United 
States Code, and what care and services may 
not be provided under such title; and 
(B) appropriate education on what care 
and services are provided under section 330 of 
the Public Health Service Act (42 U.S.C. 254b) 
and what care and services are not provided 
under such section; 
(8) the FQHC agrees to provide medical serv-
ices to the veteran in a context that sufficiently 
takes into account the culture of members of the 
uniformed services, veterans, and family members 
and caregivers of members of the uniformed services 
and veterans, including the experience of combat 
and the experience of military sexual trauma; 
(9) the medical center and the FQHC agree to 
cooperate to ensure that patients referred under the 
demonstration program are patients of both the 
medical center and the FQHC and, for such pur-
poses, to ensure interoperability, to the extent prac-
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ticable, in terms of sharing the electronic health 
records of the patients; 
(10) the FQHC agrees to begin providing care 
and services to a referred patient promptly after re-
ceiving the referral, without regard to whether the 
patient has completed the process of enrolling in the 
patient enrollment system under section 1705 of 
title 38, United States Code; 
(11) with respect to a patient who is a veteran 
who has not completed such enrollment process as of 
the time the referral is made, the FQHC agrees to— 
(A) in coordination with the medical cen-
ter, make available to the veteran assistance 
with the enrollment process; and 
(B) accept that reimbursement from the 
Secretary for providing care or services to the 
veteran will be delayed until after the enroll-
ment process is completed; 
(12) the FQHC agrees to accept the financial 
risk that a patient referred under the demonstration 
program may not qualify for care or services fur-
nished by the Secretary under title 38, United 
States Code; 
(13) the FQHC agrees to make available to re-
ferred patients, at one or more services sites of the 
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