Title: COFA Veterans Review Act of 2019
Policy area: Armed Forces and National Security

Summary:
Compact of Free Association Veterans Review Act of 2019 or the COFA Veterans Review Act of 2019
This bill requires the Department of Veterans Affairs (VA) to carry out a three-year pilot program to provide hospital care, medical services, and other related services to veterans residing in the Republic of Palau, the Republic of the Marshall Islands, and the Federated States of Micronesia.
The bill requires the VA to conduct a study and report on the feasibility and advisability of establishing one or more VA offices in the remote Pacific islands to provide hospital care and medical services to veterans residing in the area.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 1222 Introduced in Senate (IS)]

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116th CONGRESS
  1st Session
                                S. 1222

   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 SENATE OF THE UNITED STATES

                             April 29, 2019

  Mr. Schatz introduced the following bill; which was read twice and 
             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 Veterans Affairs in the Freely Associated 
   States to provide such care and services, and for other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Compact of Free Association Veterans 
Review Act of 2019'' or the ``COFA Veterans Review Act of 2019''.

SEC. 2. DEFINITIONS.

    In this Act:
            (1) Appropriate committees of congress.--The term 
        ``appropriate committees of Congress'' means--
                    (A) the Committee on Veterans' Affairs and the 
                Committee on Appropriations of the Senate; and
                    (B) the Committee on Veterans' Affairs and the 
                Committee on Appropriations of the House of 
                Representatives.
            (2) Department.--The term ``Department'' means the 
        Department of Veterans Affairs.
            (3) Freely associated states.--The term ``Freely Associated 
        States'' means the Republic of Palau, the Republic of the 
        Marshall Islands, and the Federated States of Micronesia, which 
        have each entered into a Compact of Free Association with the 
        United States.
            (4) Hospital care; medical services.--The terms ``hospital 
        care'' and ``medical services'' have the meanings given those 
        terms in section 1701 of title 38, United States Code.
            (5) Patient aligned care team.--The term ``patient aligned 
        care team'' means a team of health care professionals of the 
        Department that provides comprehensive primary care in 
        partnership with the patient and manages and coordinates 
        comprehensive health care services consistent with agreed-upon 
        goals of care.
            (6) Project echo education and training.--The term 
        ``Project ECHO education and training'' means education and 
        training provided under the Project Extension for Community 
        Health Outcomes.
            (7) Secretary.--The term ``Secretary'' means the Secretary 
        of Veterans Affairs.
            (8) Service-connected; non-service-connected.--The terms 
        ``service-connected'' and ``non-service-connected'' have the 
        meanings given those terms in section 101 of title 38, United 
        States Code.
            (9) Veterans service organization.--The term ``veterans 
        service organization'' means any organization recognized by the 
        Secretary for the representation of veterans under section 5902 
        of title 38, United States Code.

SEC. 3. PILOT PROGRAM ON PROVIDING HOSPITAL CARE AND MEDICAL SERVICES 
              TO VETERANS RESIDING 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 Freely 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 specialty care providers; and
            (4) includes the provision of compensation and pension 
        medical examinations.
    (d) Outreach Program.--As part of the pilot program required by 
subsection (a), the Secretary shall conduct 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 MEDICAL 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 establishing one or more 
        regional offices, suboffices, contact units, or other 
        subordinate offices of the Department in the remote Pacific 
        islands, including the Freely Associated States, to provide 
        hospital care and medical services to veterans residing in the 
        remote Pacific islands, including the Freely Associated States.
            (2) Considerations and analysis.--In conducting the study 
        required by paragraph (1), the Secretary shall consider and 
        analyze the following:
                    (A) The results of the pilot program required by 
                section 3(a).
                    (B) The ability of the Department to provide 
                hospital care and medical services to veterans residing 
                or traveling outside the United States, including 
                veterans residing in the Freely Associated States.
                    (C) The feasibility, efficacy, and advisability 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 providing hospital care and medical 
                services to veterans residing or traveling outside the 
                United States, including veterans residing in the 
                Freely Associated States.
                    (D) The feasibility and advisability of providing 
                services, such as telehealth, Project ECHO education 
                and training, primary and specialty care provided by 
                patient aligned care teams and specialty care 
                providers, and compensation and pension medical 
                examinations, to veterans residing in the Freely 
                Associated States.
                    (E) Updates to census data of the Department on the 
                number of veterans residing in the Freely Associated 
                States to determine whether such data supports the 
                establishment of a permanent patient aligned care team 
                of the Department based in the Freely Associated 
                States.
                    (F) With respect to the United States and the 
                Freely Associated States, the data standards for--
                            (i) patient medical record information; and
                            (ii) the electronic interchange of such 
                        information.
                    (G) The feasibility and advisability of providing 
                hospital care and medical services to veterans residing 
                in the Freely Associated States for non-service-
                connected disabilities.
                    (H) The feasibility and advisability of providing 
                continuity of care to veterans for service-connected 
                disabilities that cannot be treated by the Department 
                within a regional office, suboffice, contact unit, or 
                other subordinate office of the Department in the 
                remote Pacific islands, 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 paragraph (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 agencies as 
                        may be interested in the study; and
                    (B) in consultation with--
                            (i) such representatives of State and local 
                        governments as the Secretary determines may be 
                        interested in the study;
                            (ii) each government of the Freely 
                        Associated States;
                            (iii) veterans service organizations;
                            (iv) such nongovernmental organizations as 
                        the Secretary considers appropriate; and
                            (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 submit to the appropriate committees of 
        Congress a report 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 regional 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 provided under laws 
                administered by the Secretary in the Freely Associated 
                States.
                    (C) A resource management plan for the Department 
                to provide hospital care and medical services in the 
                Freely Associated States, including an assessment of 
                the effect that such provision would have on the 
                Department of Veterans Affairs Pacific Islands Health 
                Care System.
                    (D) An explanation of the guidelines that the 
                Department will use to provide hospital care and 
                medical services under laws administered by the 
                Secretary in the Freely Associated States, including an 
                explanation of benefits for service-connected and non-
                service-connected disabilities.
                    (E) An explanation of how the Department expects to 
                provide continuity of care to veterans for service-
                connected disabilities that cannot be treated within a 
                regional office, suboffice, contact unit, or other 
                subordinate office in the Freely Associated States, 
                including how the Department plans to communicate with 
                such veterans regarding their continuity of care.
                    (F) An assessment of the budgetary resources 
                required to establish and provide hospital care and 
                medical services to veterans in the Freely Associated 
                States during the 10-year period beginning on the date 
                of the submittal of the report.
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