[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[S. 1526 Introduced in Senate (IS)]

<DOC>






115th CONGRESS
  1st Session
                                S. 1526

To appropriate amounts to the Department of Veterans Affairs to improve 
   the provision of health care to veterans, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 11, 2017

   Mr. Tester (for himself, Mr. King, Mr. Sanders, Mrs. Murray, Mr. 
  Blumenthal, Mr. Brown, Ms. Baldwin, and Ms. Hirono) introduced the 
 following bill; which was read twice and referred to the Committee on 
                           Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
To appropriate amounts to the Department of Veterans Affairs to improve 
   the provision of health care to veterans, 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; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Veterans Access to 
Care Act of 2017''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
     TITLE I--APPROPRIATION OF AMOUNTS FOR HEALTH CARE FOR VETERANS

Sec. 101. Appropriation of amounts for Veterans Choice Program.
Sec. 102. Appropriation of amounts for health care from Department of 
                            Veterans Affairs.
   TITLE II--IMPROVEMENT OF HEALTH CARE FROM DEPARTMENT OF VETERANS 
                                AFFAIRS

Sec. 201. Program to increase number of graduate medical education 
                            residency positions of Department of 
                            Veterans Affairs.
Sec. 202. Expansion of eligibility for participation in and services 
                            provided under family caregiver program of 
                            Department of Veterans Affairs.
Sec. 203. Authorization of certain major medical facility leases of the 
                            Department of Veterans Affairs.
    TITLE III--ADMINISTRATION OF HEALTH CARE FROM NON-DEPARTMENT OF 
                       VETERANS AFFAIRS PROVIDERS

Sec. 301. Modification of process through which Department of Veterans 
                            Affairs records obligations for non-
                            Department care.
Sec. 302. Modification of report on amounts available under Veterans 
                            Choice Program.
                        TITLE IV--OTHER MATTERS

Sec. 401. Emergency designations.

     TITLE I--APPROPRIATION OF AMOUNTS FOR HEALTH CARE FOR VETERANS

SEC. 101. APPROPRIATION OF AMOUNTS FOR VETERANS CHOICE PROGRAM.

    (a) In General.--There is authorized to be appropriated, and is 
appropriated, to the Secretary of Veterans Affairs, out of any funds in 
the Treasury not otherwise appropriated, $4,300,000,000 to be deposited 
in the Veterans Choice Fund under section 802 of the Veterans Access, 
Choice, and Accountability Act of 2014 (Public Law 113-146; 38 U.S.C. 
1701 note).
    (b) Availability of Amounts.--The amount appropriated under 
subsection (a) shall be available for obligation or expenditure without 
fiscal year limitation.

SEC. 102. APPROPRIATION OF AMOUNTS FOR HEALTH CARE FROM DEPARTMENT OF 
              VETERANS AFFAIRS.

    (a) In General.--There is authorized to be appropriated, and is 
appropriated, to the Secretary of Veterans Affairs, out of any funds in 
the Treasury not otherwise appropriated, $4,300,000,000 to carry out 
subsection (c).
    (b) Availability of Amounts.--The amount appropriated under 
subsection (a) shall be available for obligation or expenditure without 
fiscal year limitation.
    (c) Use of Amounts.--The amount appropriated under subsection (a) 
shall be used by the Secretary as follows:
            (1) To increase the access of veterans to care as follows:
                    (A) To hire primary care and specialty care 
                physicians for employment in the Department of Veterans 
                Affairs.
                    (B) To hire other medical staff, including the 
                following:
                            (i) Physicians.
                            (ii) Gynecologists.
                            (iii) Nurses.
                            (iv) Social workers.
                            (v) Mental health professionals.
                            (vi) Physician assistants.
                            (vii) Other health care professionals as 
                        the Secretary considers appropriate.
                    (C) To carry out the following:
                            (i) Section 7412 of title 38, United States 
                        Code.
                            (ii) Section 7302(e) of such title.
                            (iii) Subchapters II and VII of chapter 76 
                        of such title.
                            (iv) Section 301(b)(2) of the Veterans 
                        Access, Choice, and Accountability Act of 2014 
                        (Public Law 113-146; 38 U.S.C. 7302 note).
                    (D) To pay for expenses, equipment, and other costs 
                associated with the hiring of primary care, specialty 
                care physicians, and other medical staff under 
                subparagraphs (A), (B), and (C).
            (2) To improve the physical infrastructure of the 
        Department as follows:
                    (A) To maintain and operate hospitals, nursing 
                homes, domiciliary facilities, and other facilities of 
                the Veterans Health Administration.
                    (B) To enter into contracts or hire temporary 
                employees to repair, alter, or improve facilities under 
                the jurisdiction of the Department that are not 
                otherwise provided for under this paragraph.
                    (C) To carry out leases for facilities of the 
                Department.
                    (D) To carry out minor construction projects of the 
                Department.
            (3) To carry out the program to increase the number of 
        graduate medical education residency positions of the 
        Department under section 201.
            (4) To carry out the major medical facility leases 
        authorized under section 203.
    (d) Report.--
            (1) In general.--Not later than one year after the date of 
        the enactment of this Act, the Secretary of Veterans Affairs 
        shall submit to the appropriate committees of Congress a report 
        on how the Secretary has obligated the amount appropriated 
        under subsection (a) as of the date of the submittal of the 
        report.
            (2) Appropriate committees of congress defined.--In this 
        subsection, 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.
    (e) Funding Plan.--The Secretary shall submit to Congress a funding 
plan describing how the Secretary intends to use the amount 
appropriated under subsection (a).

   TITLE II--IMPROVEMENT OF HEALTH CARE FROM DEPARTMENT OF VETERANS 
                                AFFAIRS

SEC. 201. PROGRAM TO INCREASE NUMBER OF GRADUATE MEDICAL EDUCATION 
              RESIDENCY POSITIONS OF DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--The Secretary of Veterans Affairs shall conduct a 
program to increase the number of graduate medical education residency 
positions at covered facilities by not more than 1,500 positions 
through the payment of educational assistance to participants in the 
program.
    (b) Application.--To participate in the program under this section, 
an individual shall submit to the Secretary an application for such 
participation together with an agreement described in subsection (d) 
under which the individual agrees to serve a period of obligated 
service in the Veterans Health Administration as provided in the 
agreement in return for payment of educational assistance as provided 
in the agreement.
    (c) Approval by Secretary.--
            (1) In general.--An individual becomes a participant in the 
        program under this section upon the approval by the Secretary 
        of the application of the individual and the acceptance by the 
        Secretary of an agreement described in subsection (d) with 
        respect to the individual.
            (2) Notification.--Upon the approval by the Secretary under 
        paragraph (1) of the participation of an individual in the 
        program and the acceptance of an agreement described in 
        subsection (d), the Secretary shall promptly notify the 
        individual in writing of that approval and acceptance.
    (d) Agreement.--An agreement between the Secretary and a 
participant in the program under this section shall be in writing and 
shall be signed by the participant containing such terms as the 
Secretary may specify.
    (e) Conditions for Medical Residency.--The Secretary may prescribe 
the conditions of employment of individuals participating in a medical 
residency under the program under this section, including necessary 
training, and the customary amount and terms of pay for such 
individuals during the period of such employment and training as a 
medical resident.
    (f) Obligated Service.--
            (1) In general.--Each participant in the program under this 
        section shall serve as a full-time employee of the Department 
        of Veterans Affairs for a period of obligated service provided 
        in the agreement entered into by the participant under 
        subsection (d).
            (2) Practice area.--Service by a participant under 
        paragraph (1) shall be in the full-time clinical practice of 
        the profession of the participant or in another health care 
        position in an assignment or location determined by the 
        Secretary.
            (3) Notification.--Not later than 60 days before the date 
        of the beginning of the period of obligated service of a 
        participant, the Secretary shall notify the participant of that 
        date.
    (g) Breach of Agreement; Liability.--
            (1) Liquidated damages for failure to accept payment.--
                    (A) In general.--A participant in the program under 
                this section (other than a participant described in 
                paragraph (2)) who fails to accept payment, or 
                instructs the covered facility at which the participant 
                is a medical resident not to accept payment, in whole 
                or in part, of educational assistance under the 
                agreement entered into under subsection (d) shall be 
                liable to the United States for liquidated damages in 
                the amount of $1,500.
                    (B) Treatment of other obligations.--Liability for 
                liquidated damages under subparagraph (A) is in 
                addition to any period of obligated service or other 
                obligation or liability under the agreement entered 
                into under subsection (d).
            (2) Liability for certain breaches.--
                    (A) In general.--A participant in the program under 
                this section shall be liable to the United States for 
                the amount that has been paid to or on behalf of the 
                participant under the agreement if any of the following 
                occurs:
                            (i) The participant is dismissed from 
                        serving as a medical resident at a covered 
                        facility for disciplinary reasons.
                            (ii) The participant voluntarily terminates 
                        service as a medical resident at a covered 
                        facility before completion of such service.
                            (iii) The participant loses his or her 
                        license, registration, or certification to 
                        practice his or her health care profession in a 
                        State.
                    (B) Treatment of period of obligated service.--
                Liability under subparagraph (A) is in lieu of any 
                period of obligated service under the agreement entered 
                into under subsection (d).
            (3) Liability for failing to complete period of service.--
                    (A) In general.--If a participant in the program 
                under this section breaches the agreement under 
                subsection (d) by failing (for any reason) to complete 
                the period of obligated service of the participant, the 
                United States shall be entitled to recover from the 
                participant an amount determined in accordance with the 
                following formula: A = 3F(t - s/t).
                    (B) Formula variables.--In the formula specified in 
                subparagraph (A):
                            (i) ``A'' is the amount the United States 
                        is entitled to recover from the participant.
                            (ii) ``F'' is the sum of--
                                    (I) the amounts paid under this 
                                section to or on behalf of the 
                                participant; and
                                    (II) the interest on such amounts 
                                which would be payable if at the time 
                                the amounts were paid they were loans 
                                bearing interest at the maximum legal 
                                prevailing rate, as determined by the 
                                Treasurer of the United States.
                            (iii) ``t'' is the total number of months 
                        in the period of obligated service of the 
                        participant.
                            (iv) ``s'' is the number of months of such 
                        period served by the participant.
            (4) Payment deadline.--Any amount of damages that the 
        United States is entitled to recover under this subsection 
        shall be paid to the United States within the one-year period 
        beginning on the date of the breach of the agreement under 
        subsection (d).
    (h) Covered Facilities Defined.--In this section, the term 
``covered facilities'' means any of the following:
            (1) A Department facility.
            (2) A facility operated by an Indian tribe or a tribal 
        organization, as those terms are defined in section 4 of the 
        Indian Self-Determination and Education Assistance Act (25 
        U.S.C. 5304).
            (3) A facility operated by the Indian Health Service.
            (4) A Federally-qualified health center, as defined in 
        section 1905(l)(2)(B) of the Social Security Act (42 U.S.C. 
        1396d(l)(2)(B)).
            (5) A community health center.
            (6) A facility operated by the Department of Defense.
            (7) Any other health care facility designated by the 
        Secretary of Veterans Affairs.

SEC. 202. EXPANSION OF ELIGIBILITY FOR PARTICIPATION IN AND SERVICES 
              PROVIDED UNDER FAMILY CAREGIVER PROGRAM OF DEPARTMENT OF 
              VETERANS AFFAIRS.

    (a) Family Caregiver Program.--
            (1) Expansion of eligibility.--Subsection (a)(2)(B) of 
        section 1720G of title 38, United States Code, is amended by 
        striking ``on or after September 11, 2001''.
            (2) Clarification of eligibility for illness.--Such 
        subsection is further amended by inserting ``or illness'' after 
        ``serious injury''.
            (3) Expansion of needed services in eligibility criteria.--
        Subsection (a)(2)(C) of such section is amended--
                    (A) in clause (ii), by striking ``; or'' and 
                inserting a semicolon;
                    (B) by redesignating clause (iii) as clause (iv); 
                and
                    (C) by inserting after clause (ii) the following 
                new clause (iii):
                    ``(iii) a need for regular or extensive instruction 
                or supervision without which the ability of the veteran 
                to function in daily life would be seriously impaired; 
                or''.
            (4) Expansion of services provided.--Subsection 
        (a)(3)(A)(ii) of such section is amended--
                    (A) in subclause (IV), by striking ``; and'' and 
                inserting a semicolon;
                    (B) in subclause (V), by striking the period at the 
                end and inserting a semicolon; and
                    (C) by adding at the end the following new 
                subclauses:
                    ``(VI) child care services or a monthly stipend for 
                such services if such services are not readily 
                available from the Department;
                    ``(VII) financial planning services relating to the 
                needs of injured and ill veterans and their caregivers; 
                and
                    ``(VIII) legal services, including legal advice and 
                consultation, relating to the needs of injured and ill 
                veterans and their caregivers.''.
            (5) Expansion of respite care provided.--Subsection 
        (a)(3)(B) of such section is amended by striking ``shall be'' 
        and all that follows through the period at the end and 
        inserting ``shall--
            ``(i) be medically and age-appropriate;
            ``(ii) include in-home care; and
            ``(iii) include peer-oriented group activities.''.
            (6) Modification of stipend calculation.--Subsection 
        (a)(3)(C) of such section is amended--
                    (A) by redesignating clause (iii) as clause (iv); 
                and
                    (B) by inserting after clause (ii) the following 
                new clause (iii):
    ``(iii) In determining the amount and degree of personal care 
services provided under clause (i) with respect to an eligible veteran 
whose need for personal care services is based in whole or in part on a 
need for supervision or protection under paragraph (2)(C)(ii) or 
regular or extensive instruction or supervision under paragraph 
(2)(C)(iii), the Secretary shall take into account the following:
            ``(I) The assessment by the family caregiver of the needs 
        and limitations of the veteran.
            ``(II) The extent to which the veteran can function safely 
        and independently in the absence of such supervision, 
        protection, or instruction.
            ``(III) The amount of time required for the family 
        caregiver to provide such supervision, protection, or 
        instruction to the veteran.''.
            (7) Periodic evaluation of need for certain services.--
        Subsection (a)(3) of such section is amended by adding at the 
        end the following new subparagraph:
    ``(D) In providing instruction, preparation, and training under 
subparagraph (A)(i)(I) and technical support under subparagraph 
(A)(i)(II) to each family caregiver who is approved as a provider of 
personal care services for an eligible veteran under paragraph (6), the 
Secretary shall periodically evaluate the needs of the eligible veteran 
and the skills of the family caregiver of such veteran to determine if 
additional instruction, preparation, training, or technical support 
under those subparagraphs is necessary.''.
            (8) Use of primary care teams.--Subsection (a)(5) of such 
        section is amended, in the matter preceding subparagraph (A), 
        by inserting ``(in collaboration with the primary care team for 
        the eligible veteran to the maximum extent practicable)'' after 
        ``evaluate''.
            (9) Eligibility of and assistance for family caregivers.--
        Subsection (a) of such section is amended by adding at the end 
        the following new paragraphs:
    ``(11) Notwithstanding any other provision of this subsection, a 
family caregiver of an eligible veteran who is eligible under paragraph 
(2) solely because of a serious injury or illness (including traumatic 
brain injury, psychological trauma, or other mental disorder) incurred 
or aggravated in the line of duty in the active military, naval, or air 
service before September 11, 2001, is eligible for assistance under 
this subsection as follows:
            ``(A) Not earlier than October 1, 2018, if the family 
        caregiver would merit a monthly personal caregiver stipend 
        under paragraph (3)(A)(ii)(V) in an amount that is in the 
        highest tier specified in the schedule established by the 
        Secretary under paragraph (3)(C)(i).
            ``(B) Not earlier than October 1, 2020, if the family 
        caregiver would merit such a stipend in an amount that is in 
        the middle tier specified in such schedule.
            ``(C) Not earlier than October 1, 2022, if the family 
        caregiver would merit such a stipend in an amount that is in 
        the lowest tier specified in such schedule.
    ``(12)(A) In providing assistance under this subsection to family 
caregivers of eligible veterans, the Secretary may enter into 
contracts, provider agreements, and memoranda of understanding with 
Federal agencies, States, and private, nonprofit, and other entities to 
provide such assistance to such family caregivers.
    ``(B) The Secretary may provide assistance under this paragraph 
only if such assistance is reasonably accessible to the family 
caregiver and is substantially equivalent or better in quality to 
similar services provided by the Department.
    ``(C) The Secretary may provide fair compensation to Federal 
agencies, States, and other entities that provide assistance under this 
paragraph.''.
    (b) Termination of General Caregiver Support Program.--
            (1) In general.--Subsection (b) of such section is amended 
        by adding at the end the following new paragraph:
    ``(6) The authority of the Secretary to provide support services 
for caregivers of covered veterans under this subsection shall 
terminate on October 1, 2022.''.
            (2) Continuation of certain assistance.--The Secretary of 
        Veterans Affairs shall ensure that any activities carried out 
        under subsection (b) of such section on September 30, 2022, are 
        continued under subsection (a) of such section on and after 
        October 1, 2022.
    (c) Modification of Definition of Family Member.--Subparagraph (B) 
of subsection (d)(3) of such section is amended to read as follows:
                    ``(B) is not a member of the family of the veteran 
                and does not provide care to the veteran on a 
                professional basis.''.
    (d) Modification of Definition of Personal Care Services.--
Subsection (d)(4) of such section is amended--
            (1) in subparagraph (A), by striking ``independent'';
            (2) by redesignating subparagraph (B) as subparagraph (D); 
        and
            (3) by inserting after subparagraph (A) the following new 
        subparagraphs:
                    ``(B) Supervision or protection based on symptoms 
                or residuals of neurological or other impairment or 
                injury.
                    ``(C) Regular or extensive instruction or 
                supervision without which the ability of the veteran to 
                function in daily life would be seriously impaired.''.
    (e) Annual Evaluation Report.--Paragraph (2) of section 101(c) of 
the Caregivers and Veterans Omnibus Health Services Act of 2010 (Public 
Law 111-163; 38 U.S.C. 1720G note) is amended to read as follows:
            ``(2) Contents.--Each report required by paragraph (1) 
        after the date of the enactment of the Veterans Choice Act of 
        2017 shall include the following with respect to the program of 
        comprehensive assistance for family caregivers required by 
        subsection (a)(1) of such section 1720G:
                    ``(A) The number of family caregivers that received 
                assistance under such program.
                    ``(B) The cost to the Department of providing 
                assistance under such program.
                    ``(C) A description of the outcomes achieved by, 
                and any measurable benefits of, carrying out such 
                program.
                    ``(D) An assessment of the effectiveness and the 
                efficiency of the implementation of such program, 
                including a description of any barriers to accessing 
                and receiving care and services under such program.
                    ``(E) A description of the outreach activities 
                carried out by the Secretary under such program.
                    ``(F) An assessment of the manner in which 
                resources are expended by the Secretary under such 
                program, particularly with respect to the provision of 
                monthly personal caregiver stipends under subsection 
                (a)(3)(A)(ii)(V) of such section 1720G.
                    ``(G) An evaluation of the sufficiency and 
                consistency of the training provided to family 
                caregivers under such program in preparing family 
                caregivers to provide care to veterans under such 
                program.
                    ``(H) Such recommendations, including 
                recommendations for legislative or administrative 
                action, as the Secretary considers appropriate in light 
                of carrying out such program.''.

SEC. 203. AUTHORIZATION OF CERTAIN MAJOR MEDICAL FACILITY LEASES OF THE 
              DEPARTMENT OF VETERANS AFFAIRS.

    The Secretary of Veterans Affairs may carry out the following major 
medical facility leases at the locations specified and in an amount for 
each lease not to exceed the amount specified for such location (not 
including any estimated cancellation costs):
            (1) For an outpatient clinic, Ann Arbor, Michigan, an 
        amount not to exceed $4,247,000.
            (2) For an outpatient mental health clinic, Birmingham, 
        Alabama, an amount not to exceed $6,649,000.
            (3) For research space, Boston, Massachusetts, an amount 
        not to exceed $6,224,000.
            (4) For research space, Charleston, South Carolina, an 
        amount not to exceed $7,274,000.
            (5) For an outpatient clinic, Corpus Christi, Texas, an 
        amount not to exceed $6,556,000.
            (6) For an outpatient clinic, Daytona Beach, Florida, an 
        amount not to exceed $12,198,000.
            (7) For Chief Business Office Purchased Care office space, 
        Denver, Colorado, an amount not to exceed $14,784,000.
            (8) For an outpatient clinic, Fredericksburg, Virginia, an 
        amount not to exceed $45,015,000.
            (9) For an outpatient clinic, Gainesville, Florida, an 
        amount not to exceed $7,891,000.
            (10) For an outpatient mental health clinic, Gainesville, 
        Florida, an amount not to exceed $4,320,000.
            (11) For an outpatient clinic, Hampton Roads, Virginia, an 
        amount not to exceed $18,141,000.
            (12) For a replacement outpatient clinic, Indianapolis, 
        Indiana, an amount not to exceed $7,876,000.
            (13) For a replacement outpatient clinic, Jacksonville, 
        Florida, an amount not to exceed $18,623,000.
            (14) For an outpatient clinic, Missoula, Montana, an amount 
        not to exceed $6,942,000.
            (15) For an outpatient mental health clinic, Northern 
        Colorado, Colorado, an amount not to exceed $8,904,000.
            (16) For an outpatient clinic, Ocala, Florida, an amount 
        not to exceed $5,026,000.
            (17) For an outpatient clinic, Oxnard, California, an 
        amount not to exceed $5,274,000.
            (18) For an outpatient clinic, Pike County, Georgia, an 
        amount not to exceed $5,565,000.
            (19) For a replacement outpatient clinic, Pittsburgh, 
        Pennsylvania, an amount not to exceed $6,247,000.
            (20) For an outpatient clinic, Portland, Maine, an amount 
        not to exceed $6,808,000.
            (21) For an outpatient clinic, Raleigh, North Carolina, an 
        amount not to exceed $21,870,000.
            (22) For a replacement outpatient clinic, phase II, 
        Rochester, New York, an amount not to exceed $3,645,000.
            (23) For research space, San Diego, California, an amount 
        not to exceed $4,852,000.
            (24) For an outpatient clinic, Santa Rosa, California, an 
        amount not to exceed $6,922,000.
            (25) For a replacement mental health clinic, Tampa, 
        Florida, an amount not to exceed $13,387,000.
            (26) For a replacement outpatient clinic, Lakeland, Tampa, 
        Florida, an amount not to exceed $10,760,000.
            (27) For a replacement outpatient clinic, Terre Haute, 
        Indiana, an amount not to exceed $4,102,000.

    TITLE III--ADMINISTRATION OF HEALTH CARE FROM NON-DEPARTMENT OF 
                       VETERANS AFFAIRS PROVIDERS

SEC. 301. MODIFICATION OF PROCESS THROUGH WHICH DEPARTMENT OF VETERANS 
              AFFAIRS RECORDS OBLIGATIONS FOR NON-DEPARTMENT CARE.

    (a) In General.--Subchapter III of chapter 17 of title 38, United 
States Code, is amended by adding at the end the following new section:
``Sec. 1730B. Recording obligations for care at non-Department 
              facilities
    ``Notwithstanding sections 1341(a)(1) and 1501 of title 31, the 
Secretary may record as an obligation of the United States Government 
amounts owed for hospital care or medical services furnished under this 
chapter at non-Department facilities on the date on which a claim by a 
health care provider for payment is approved rather than on the date 
that the hospital care or medical services are authorized by the 
Secretary.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 17 of such title is amended by inserting after the item 
relating to section 1730A the following new item:

``1730B. Recording obligations for care at non-Department 
                            facilities.''.

SEC. 302. MODIFICATION OF REPORT ON AMOUNTS AVAILABLE UNDER VETERANS 
              CHOICE PROGRAM.

    Section 101(q)(2) of the Veterans Access, Choice, and 
Accountability Act of 2014 (Public Law 113-146; 38 U.S.C. 1701 note) is 
amended--
            (1) in the matter preceding subparagraph (A), by striking 
        ``30 days'' and inserting ``14 days'';
            (2) by redesignating subparagraph (F) as subparagraph (H); 
        and
            (3) by inserting after subparagraph (E) the following new 
        subparagraphs:
                    ``(F) An assessment of the rate at which amounts 
                deposited in the Veterans Choice Fund have been 
                exhausted during the 90-day period preceding the 
                submittal of the report, including an identification of 
                any major factors that are causing amounts to be 
                exhausted quickly or slowly.
                    ``(G) An estimate of when amounts in the Veterans 
                Choice Fund will be completely exhausted.''.

                        TITLE IV--OTHER MATTERS

SEC. 401. EMERGENCY DESIGNATIONS.

    (a) In General.--This Act is designated as an emergency requirement 
pursuant to section 4(g) of the Statutory Pay-As-You-Go Act of 2010 (2 
U.S.C. 933(g)).
    (b) Designation in Senate.--In the Senate, this Act is designated 
as an emergency requirement pursuant to section 403(a) of S. Con. Res. 
13 (111th Congress), the concurrent resolution on the budget for fiscal 
year 2010.
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