Ensuring Veterans Access to Care Act of 2014 - Directs the Secretary of Veterans Affairs (VA) to: (1) implement an upgraded and centralized electronic system for scheduling individuals' appointments for VA health care, and (2) contract for an independent assessment of the process at each VA medical facility for scheduling such appointments.
Sets forth measures concerning the training and hiring of VA health personnel that:
Establishes measures to improve veterans' access to health care from non-VA providers by:
Sets forth VA health care administrative matters, which include:
Authorizes the Secretary to carry out certain major medical facility leases at specified locations for up to specified amounts. Sets forth requirements for the budgetary treatment of such leases.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 2422 Placed on Calendar Senate (PCS)]
Calendar No. 408
113th CONGRESS
2d Session
S. 2422
To improve the access of veterans to medical services from the
Department of Veterans Affairs, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
June 3, 2014
Mr. Sanders (for himself, Mr. Rockefeller, Mr. Begich, Mrs. Shaheen,
Mr. Kaine, Mr. Reed, Mr. Merkley, Mr. Casey, Mr. Whitehouse, Mr.
Blumenthal, Mr. Heinrich, Mr. Udall of New Mexico, Mr. Schatz, Ms.
Baldwin, Mr. Wyden, Mr. Leahy, Mr. Brown, Ms. Heitkamp, Ms. Landrieu,
Mr. Booker, Mr. Durbin, Mr. Schumer, Ms. Hirono, Mr. Harkin, Mr. Coons,
Mr. Markey, Ms. Klobuchar, Mr. Walsh, Mr. Tester, and Mr. Menendez)
introduced the following bill; which was read the first time
June 4, 2014
Read the second time and placed on the calendar
_______________________________________________________________________
A BILL
To improve the access of veterans to medical services from the
Department of Veterans Affairs, 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 ``Ensuring Veterans
Access to Care Act of 2014''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--IMPROVEMENT OF SCHEDULING SYSTEM FOR HEALTH CARE APPOINTMENTS
Sec. 101. Implementation of upgraded Department of Veterans Affairs
electronic scheduling system for
appointments for receipt of health care
from the Department.
Sec. 102. Independent assessment of the scheduling process for medical
appointments for care from Department of
Veterans Affairs.
TITLE II--TRAINING AND HIRING OF HEALTH CARE STAFF
Sec. 201. Modification of liability for breach of period of obligated
service under Health Professionals
Educational Assistance Program for primary
care physicians.
Sec. 202. Program of education at Uniformed Services University of the
Health Sciences with specialization in
primary care.
Sec. 203. Treatment of staffing shortage and biannual report on
staffing of medical facilities of the
Department of Veterans Affairs.
Sec. 204. Clinic management training program of the Department of
Veterans Affairs.
Sec. 205. Inclusion of Department of Veterans Affairs facilities in
National Health Service Corps Scholarship
and loan repayment programs.
Sec. 206. Authorization of emergency appropriations.
TITLE III--IMPROVEMENT OF ACCESS TO CARE FROM NON-DEPARTMENT OF
VETERANS AFFAIRS PROVIDERS
Sec. 301. Improvement of access by veterans to health care from non-
Department of Veterans Affairs providers.
Sec. 302. Extension of and report on joint incentives program of
Department of Veterans Affairs and
Department of Defense.
Sec. 303. Transfer of authority for payments for hospital care, medical
services, and other health care from non-
Department providers to the Chief Business
Office of the Veterans Health
Administration of the Department.
Sec. 304. Enhancement of collaboration between Department of Veterans
Affairs and Indian Health Service.
Sec. 305. Enhancement of collaboration between Department of Veterans
Affairs and Native Hawaiian health care
systems.
Sec. 306. Authorization of emergency appropriations.
TITLE IV--HEALTH CARE ADMINISTRATIVE MATTERS
Sec. 401. Improvement of access of veterans to mobile vet centers of
the Department of Veterans Affairs.
Sec. 402. Commission on Access to Care.
Sec. 403. Commission on Capital Planning for Department of Veterans
Affairs Medical Facilities.
Sec. 404. Removal of Senior Executive Service employees of the
Department of Veterans Affairs for
performance.
TITLE V--MAJOR MEDICAL FACILITY LEASES
Sec. 501. Authorization of major medical facility leases.
Sec. 502. Budgetary treatment of Department of Veterans Affairs major
medical facilities leases.
TITLE I--IMPROVEMENT OF SCHEDULING SYSTEM FOR HEALTH CARE APPOINTMENTS
SEC. 101. IMPLEMENTATION OF UPGRADED DEPARTMENT OF VETERANS AFFAIRS
ELECTRONIC SCHEDULING SYSTEM FOR APPOINTMENTS FOR RECEIPT
OF HEALTH CARE FROM THE DEPARTMENT.
(a) Implementation.--
(1) In general.--Not later than March 31, 2016, the
Secretary of Veterans Affairs shall fully implement an upgraded
and centralized electronic scheduling system described in
subsection (b) for appointments by eligible individuals for
health care from the Department of Veterans Affairs.
(2) Agile software development methodologies.--In
implementing the upgraded electronic scheduling system required
by paragraph (1), the Secretary shall use agile software
development methodologies to fully implement portions of such
system every 180 days beginning on the date on which the
Secretary begins the implementation of such system, or enters
into a contract for the implementation of such system, and
ending on the date on which such system is fully implemented.
(b) Electronic Scheduling System.--The upgraded electronic
scheduling system described in this subsection shall include mechanisms
to achieve the following:
(1) An efficient and effective graphical user interface
with a calendar view for use by employees of the Department in
scheduling appointments that enables error-free scheduling of
the health care resources of the Department.
(2) A capability to assist employees of the Department to
easily and consistently implement policies of the Department
with respect to scheduling of appointments, including with
respect to priority for appointments for certain eligible
individuals.
(3) A capability for employees of the Department to sort
and view through a unified interface the availability for each
health care provider of the Department or other health care
resource of the Department.
(4) A capability for employees of the Department to sort
and view appointments for and appointment requests made by a
particular eligible individual.
(5) A capability for seamless coordination of appointments
for primary care, specialty care, consultations, or any other
health care matter among facilities of the Department.
(6) A capability for eligible individuals to access the
system remotely and schedule appointments directly through the
system.
(7) An electronic timestamp of each activity made by an
eligible individual or on behalf of such individual with
respect to an appointment or the scheduling of an appointment
that shall be kept in the medical record of such individual.
(8) A seamless connection to the Computerized Patient
Record System of the Department so that employees of the
Department, when scheduling an appointment for an eligible
individual, have access to recommendations from the health care
provider of such individual with respect to when such
individual should receive an appointment.
(9) A capability to provide automated reminders to eligible
individuals on upcoming appointments through various electronic
and voice media.
(10) A capability to provide automated reminders to
employees of the Department when an eligible individual who is
on the wait-list for an appointment becomes eligible to
schedule an appointment.
(11) A dashboard capability to support efforts to track the
following metrics in aggregate and by medical facility with
respect to health care provided to eligible individuals under
the laws administered by the Secretary:
(A) The number of days into the future that the
schedules of health care providers are available to
schedule an appointment.
(B) The number of providers available to see
patients each day.
(C) The number of support personnel working each
day.
(D) The types of appointments available.
(E) The rate at which patients fail to appear for
appointments.
(F) The number of appointments canceled by a
patient on a daily basis.
(G) The number of appointments canceled by a health
care provider on a daily basis.
(H) The number of patients on the wait list at any
given time.
(I) The number of appointments scheduled on a daily
basis;
(J) The number of appointments available to be
scheduled on a daily basis.
(K) The number of patients seen on a daily, weekly,
and monthly basis.
(L) Wait-times for an appointment with a health
care provider of the Department.
(M) Wait-times for an appointment with a non-
Department health care provider.
(N) Wait-times for a referral to a specialist or
consult.
(12) A capability to provide data on the capacity of
medical facilities of the Department for purposes of
determining the resources needed by the Department to provide
health care to eligible individuals.
(13) Any other capabilities as specified by the Secretary
for purposes of this section.
(c) Plan.--
(1) In general.--Not later than 90 days after the date of
the enactment of this Act, the Secretary shall submit to the
Committee on Veterans' Affairs of the Senate and the Committee
on Veterans' Affairs of the House of Representatives a plan for
implementing the upgraded electronic scheduling system required
by subsection (a).
(2) Elements.--The plan required by paragraph (1) shall
include the following:
(A) A description of the priorities of the
Secretary for implementing the requirements of the
system under subsection (b).
(B) A detailed description of the manner in which
the Secretary will fully implement such system,
including deadlines for completing each such
requirement.
(3) Update.--Not later than 90 days after the submittal of
the plan required by paragraph (1), and not less frequently
than every 90 days thereafter until such system is fully
implemented, the Secretary shall submit to the Committee on
Veterans' Affairs of the Senate and the Committee on Veterans'
Affairs of the House of Representatives an update on the status
of the implementation of such plan.
(d) Use of Amounts.--The Secretary may use amounts available to the
Department of Veterans Affairs for the appropriations account under the
heading ``medical services'' in implementing and carrying out the
upgraded electronic scheduling system required by subsection (a).
(e) Eligible Individual Defined.--In this section, the term
``eligible individual'' means an individual eligible for hospital,
nursing home, domiciliary, medical care, or other health care under the
laws administered by the Secretary of Veterans Affairs.
SEC. 102. INDEPENDENT ASSESSMENT OF THE SCHEDULING PROCESS FOR MEDICAL
APPOINTMENTS FOR CARE FROM DEPARTMENT OF VETERANS
AFFAIRS.
(a) Independent Assessment.--
(1) Contract.--Not later than 30 days after the date of the
enactment of this Act, the Secretary of Veteran Affairs shall
enter into a contract with an independent third party to assess
the process at each medical facility of the Department of
Veterans Affairs for scheduling appointments for veterans to
receive hospital care, medical services, or other health care
from the Department.
(2) Elements.--In carrying out the assessment required by
paragraph (1), the independent third party shall do the
following:
(A) Review all training materials pertaining to
scheduling of appointments at each medical facility of
the Department.
(B) Assess whether all employees of the Department
conducting tasks related to scheduling are properly
trained for conducting such tasks.
(C) Assess whether changes in the technology or
system used in scheduling appointments are necessary to
limit access to the system to only those employees that
have been properly trained in conducting such tasks.
(D) Assess whether health care providers of the
Department are making changes to their schedules that
hinder the ability of employees conducting such tasks
to perform such tasks.
(E) Assess whether the establishment of a
centralized call center throughout the Department for
scheduling appointments at medical facilities of the
Department would improve the process of scheduling such
appointments.
(F) Assess whether booking templates for each
medical facility or clinic of the Department would
improve the process of scheduling such appointments.
(G) Recommend any actions to be taken by the
Department to improve the process for scheduling such
appointments, including the following:
(i) Changes in training materials provided
to employees of the Department with respect to
conducting tasks related to scheduling such
appointments.
(ii) Changes in monitoring and assessment
conducted by the Department of wait-times of
veterans for such appointments.
(iii) Changes in the system used to
schedule such appointments, including changes
to improve how the Department--
(I) measures wait-times of veterans
for such appointments;
(II) monitors the availability of
health care providers of the
Department; and
(III) provides veterans the ability
to schedule such appointments.
(iv) Such other actions as the independent
third party considers appropriate.
(3) Timing.--The independent third party carrying out the
assessment required by paragraph (1) shall complete such
assessment not later than 180 days after entering into the
contract described in such paragraph.
(b) Report.--Not later than 90 days after the date on which the
independent third party completes the assessment under this section,
the Secretary shall submit to the Committee on Veterans' Affairs of the
Senate and the Committee on Veterans' Affairs of the House of
Representatives a report on the results of such assessment.
TITLE II--TRAINING AND HIRING OF HEALTH CARE STAFF
SEC. 201. MODIFICATION OF LIABILITY FOR BREACH OF PERIOD OF OBLIGATED
SERVICE UNDER HEALTH PROFESSIONALS EDUCATIONAL ASSISTANCE
PROGRAM FOR PRIMARY CARE PHYSICIANS.
Section 7617 of title 38, United States Code, is amended--
(1) In subsection (c)(1), by striking ``If a participant''
and inserting ``Except as provided in subsection (d), if a
participant''; and
(2) by adding at the end the following new subsection:
``(d) Liability shall not arise under subsection (c) in the case of
a participant otherwise covered by that subsection who has pursued a
course of education or training in primary care if--
``(1) the participant--
``(A) does not obtain, or fails to maintain,
employment as a Department employee due to staffing
changes approved by the Under Secretary for Health; or
``(B) does not obtain, or fails to maintain,
employment in a position of primary care physician in
the Veterans Health Administration due, as determined
by the Secretary, to a number of primary care
physicians in the Administration that is excess to the
needs of the Administration; and
``(2) the participant agrees to accept and maintain
employment as a primary care physician with another department
or agency of the Federal Government (with such employment to be
under such terms and conditions as are jointly agreed upon by
the participant, the Secretary, and the head of such department
or agency, including terms and conditions relating to a period
of obligated service as a primary care physician with such
department or agency) if such employment is offered to the
participant by the Secretary and the head of such department or
agency.''.
SEC. 202. PROGRAM OF EDUCATION AT UNIFORMED SERVICES UNIVERSITY OF THE
HEALTH SCIENCES WITH SPECIALIZATION IN PRIMARY CARE.
(a) Program Required Under Health Professionals Educational
Assistance Program.--
(1) In general.--Chapter 76 of title 38, United States
Code, is amended by adding after subchapter VII the following
new subchapter:
``SUBCHAPTER VIII--PROGRAM OF EDUCATION AT UNIFORMED SERVICES
UNIVERSITY OF THE HEALTH SCIENCES WITH SPECIALIZATION IN PRIMARY CARE
``Sec. 7691. Authority for program
``As part of the Educational Assistance Program, the Secretary
shall, in collaboration with the Secretary of Defense, carry out a
program to permit individuals to enroll in the Uniformed Services
University of the Health Sciences under chapter 104 of title 10 to
pursue a medical education with a specialization in primary care. The
program shall be known as the Department of Veterans Affairs Primary
Care Educational Assistance Program (in this chapter referred to as the
`Primary Care Educational Assistance Program').
``Sec. 7692. Selection; agreement; ineligibility for certain other
educational assistance
``(a) Selection.--(1) Medical students at the Uniformed Services
University of the Health Sciences pursuant to the Primary Care
Educational Assistance Program shall be selected by the Secretary, in
consultation with the Secretary of Defense, in accordance with
procedures established by the Secretaries for purposes of the Program.
``(2) The procedures referred to in paragraph (1) shall emphasize
the basic requirement that students demonstrate a motivation and
dedication to a medical career in primary care.
``(3) The number of medical students selected each year for first-
year enrollment in the University pursuant to this subsection shall be
jointly determined by the Secretary and the Secretary of Defense.
``(b) Agreement.--An agreement between the Secretary and a
participant in the Primary Care Educational Assistance Program shall
(in addition to the requirements set forth in section 7604 of this
title) include the following:
``(1) The Secretary's agreement to cover the costs of the
participant's education and training at the Uniformed Services
University of the Health Sciences under chapter 104 of title 10
as if the participant were a medical student enrolled in the
University pursuant to section 2114 of title 10.
``(2) The participant's agreement to serve as a full-time
employee in the Veterans Health Administration in a position as
a primary care physician for a period of time (in this
subchapter referred to as the `period of obligated service') of
one calendar year for each school year or part thereof for
which the participant was a medical student at the Uniformed
Services University of the Health Sciences pursuant to the
Primary Care Educational Assistance Program, but for not less
than one year.
``(c) Ineligibility for Other Educational Assistance.--An
individual who receives education and training under the Primary Care
Educational Assistance Program shall not be eligible for other
assistance under this chapter in connection with such education and
training.
``Sec. 7693. Obligated service
``(a) In General.--Each participant in the Primary Care Educational
Assistance Program shall provide service as a full-time employee of the
Department in the Veterans Health Administration in a primary care
position for the period of obligated service provided in the agreement
of the participant entered into for purposes of this subchapter. Such
service shall be provided in a full-time primary care clinical practice
in an assignment or location determined by the Secretary.
``(b) Service Commencement Date.--(1) Not later than 60 days before
a participant's service commencement date, the Secretary shall notify
the participant of that service commencement date. That date is the
date for the beginning of the participant's period of obligated
service.
``(2) As soon as possible after a participant's service
commencement date, the Secretary shall--
``(A) in the case of a participant who is not a full-time
employee in the Veterans Health Administration, appoint the
participant as such an employee; and
``(B) in the case of a participant who is an employee in
the Veterans Health Administration but is not serving in a
position for which the participant's course of education or
training prepared the participant, assign the participant to
such a position.
``(3) A participant's service commencement for purposes of this
subsection date is the date upon which the participant becomes licensed
to practice medicine in a State.
``(c) Commencement of Obligated Service.--A participant in the
Primary Care Educational Assistance Program shall be considered to have
begun serving the participant's period of obligated service--
``(1) on the date on which the participant is appointed as
a full-time employee in the Veterans Health Administration
pursuant to subsection (b)(2)(A); or
``(2) if the participant is a full-time employee in the
Veterans Health Administration and assigned to a position
pursuant to subsection (b)(2)(B), on the date on which the
participant is so assigned to such position.
``Sec. 7694. Breach of agreement: liability
``(a) Liability During Course of Education or Training.--(1) A
participant in the Primary Care Educational Assistance Program shall be
liable to the United States for the amount which has been paid on
behalf of the participant under the agreement entered into for purposes
of this subchapter if any of the following occurs:
``(A) The participant fails to maintain an acceptable level
of academic standing in the Uniformed Services University of
the Health Sciences.
``(B) The participant is dismissed from the Uniformed
Services University of the Health Sciences for disciplinary
reasons.
``(C) The participant voluntarily terminates the course of
medical education and training in the Uniformed Services
University of the Health Sciences before the completion of such
course of education and training.
``(D) The participant fails to become licensed to practice
medicine in a State during a period of time determined under
regulations prescribed by the Secretary.
``(2) Liability under this subsection is in lieu of any service
obligation arising under a participant's agreement for purposes of this
subchapter.
``(b) Liability During Period of Obligated Service.--(1) Except as
provided in subsection (c) and subject to paragraph (2), if a
participant in the Primary Care Educational Assistance Program breaches
the agreement entered into for purposes of this subchapter by failing
for any reason to complete the participant's period of obligated
service, the United States shall be entitled to recover from the
participant an amount equal to--
``(A) the total amount paid under this subchapter on behalf
of the participant; multiplied by
``(B) a fraction--
``(i) the numerator of which is--
``(I) the total number of months in the
participant's period of obligated service;
minus
``(II) the number of months served by the
participant pursuant to the agreement; and
``(ii) the denominator of which is the total number
of months in the participant's period of obligated
service.
``(2) Any period of internship or residency training of a
participant shall not be treated as satisfying the participant's period
of obligated service for purposes of this subsection.
``(c) Exceptions.--Liability shall not arise under subsection (b)
in the case of a participant otherwise covered by that subsection if--
``(1) the participant--
``(A) does not obtain, or fails to maintain,
employment as a Department employee due to staffing
changes approved by the Under Secretary for Health; or
``(B) does not obtain, or fails to maintain,
employment in a position of primary care physician in
the Veterans Health Administration due, as determined
by the Secretary, to a number of primary care
physicians in the Administration that is excess to the
needs of the Administration; and
``(2) the participant agrees to accept and maintain
employment as a primary care physician with another department
or agency of the Federal Government (with such employment to be
under such terms and conditions as are jointly agreed upon by
the participant, the Secretary, and the head of such department
or agency, including terms and conditions relating to a period
of obligated service as a primary care physician with such
department or agency) if such employment is offered to the
participant by the Secretary and the head of such department or
agency.
``Sec. 7695. Funding
``(a) In General.--Amounts for the Primary Care Educational
Assistance Program shall be derived from amounts available to the
Secretary for the Veterans Health Administration.
``(b) Transfer.--(1) The Secretary shall transfer to the Secretary
of Defense amounts required by the Secretary of Defense to carry out
the Primary Care Educational Assistance Program.
``(2) Amounts transferred to the Secretary of Defense pursuant to
paragraph (1) shall be credited to the appropriation or account
providing funding for the Uniformed Services University of the Health
Sciences. Amounts so credited shall be merged with amounts in the
appropriation or account to which credited and shall be available,
subject to the terms and conditions applicable to such appropriation or
account, for the Uniformed Services University of the Health
Sciences.''.
(2) Clerical amendment.--The table of sections at the
beginning of chapter 76 of such title is amended by adding
after the item relating to section 7684 the following:
``subchapter viii--program of education at uniformed services
university of the health sciences with specialization in primary care
``7691. Authority for program.
``7692. Selection; agreement; ineligibility for certain other
educational assistance.
``7693. Obligated service.
``7694. Breach of agreement: liability.
``7695. Funding.''.
(b) Inclusion of Program in Health Professionals Educational
Assistance Program.--Section 7601(a) of such title is amended--
(1) in paragraph (4), by striking ``; and'' and inserting a
semicolon;
(2) in paragraph (5), by striking the period at the end and
inserting ``; and''; and
(3) by adding at the end the following new paragraph:
``(6) the enrollment of individuals in the Uniformed
Services University of the Health Sciences for specialization
in primary care provided for in subchapter VIII of this
chapter.''.
(c) Application Requirements.--
(1) In general.--Subsection (a)(1) of section 7603 of such
title is amended in the matter preceding subparagraph (A) by
striking ``, or VI'' and inserting ``, VI, or VIII''.
(2) No priority for applications.--Subsection (d) of such
section is amended--
(A) by striking ``In selecting'' and inserting
``(1) Except as provided in paragraph (2), in
selecting''; and
(B) by adding at the end the following new
paragraph:
``(2) Paragraph (1) shall not apply with respect to applicants for
participation in the Program of Education at Uniformed Services
University of the Health Sciences With Specialization in Primary Care
pursuant to subchapter VIII of this chapter.''.
(d) Agreement Requirements.--Section 7604 of such title is amended
by striking ``, or VI'' each place it appears and inserting ``, VI, or
VIII''.
SEC. 203. TREATMENT OF STAFFING SHORTAGE AND BIANNUAL REPORT ON
STAFFING OF MEDICAL FACILITIES OF THE DEPARTMENT OF
VETERANS AFFAIRS.
(a) Staffing Shortage.--
(1) In general.--Not later than 180 days after the date of
the enactment of this Act, and not later than September 30 each
year thereafter, the Secretary of Veterans Affairs shall
determine, and publish in the Federal Register, the five
occupations of health care providers of the Department of
Veterans Affairs for which there is the largest staffing
shortage throughout the Department.
(2) Recruitment and appointment.--Notwithstanding sections
3304 and 3309 through 3318 of title 5, United States Code, the
Secretary may, upon a determination by the Secretary under
paragraph (1) or a modification to such determination under
paragraph (2), that there is a staffing shortage throughout the
Department with respect to a particular occupation of health
care provider, recruit and directly appoint highly qualified
health care providers to a position to serve as a health care
provider in that particular occupation for the Department.
(3) Priority in health professionals educational assistance
program to certain providers.--Section 7612(b)(5) of title 38,
United States Code, is amended--
(A) in subparagraph (A), by striking ``and'' at the
end;
(B) by redesignating subparagraph (B) as
subparagraph (C); and
(C) by inserting after subparagraph (A) the
following new subparagraph (B):
``(B) shall give priority to applicants pursuing a course
of education or training towards a career in an occupation for
which the Secretary has, in the most current determination
published in the Federal Register pursuant to section 203(a)(1)
of the Ensuring Veterans Access to Care Act of 2014, determined
that there is one of the largest staffing shortage throughout
the Department with respect to such occupation; and''.
(b) Reports.--
(1) In general.--Not later than 180 days after the date of
the enactment of this Act, and not later than December 31 of
each even numbered year thereafter until 2024, the Secretary of
Veterans Affairs shall submit to the Committee on Veterans'
Affairs of the Senate and the Committee on Veterans' Affairs of
the House of Representatives a report assessing the staffing of
each medical facility of the Department of Veterans Affairs.
(2) Elements.--Each report submitted under paragraph (1)
shall include the following:
(A) The results of a system-wide assessment of all
medical facilities of the Department to ensure the
following:
(i) Appropriate staffing levels for health
care providers to meet the goals of the
Secretary for timely access to care for
veterans.
(ii) Appropriate staffing levels for
support personnel, including clerks.
(iii) Appropriate sizes for clinical
panels.
(iv) Appropriate numbers of full-time
staff, or full-time equivalent, dedicated to
direct care of patients.
(v) Appropriate physical plant space to
meet the capacity needs of the Department in
that area.
(vi) Such other factors as the Secretary
considers necessary.
(B) A plan for addressing any issues identified in
the assessment described in subparagraph (A), including
a timeline for addressing such issues.
(C) A list of the current wait times and workload
levels for the following clinics in each medical
facility:
(i) Mental health.
(ii) Primary care.
(iii) Gastroenterology.
(iv) Women's health.
(v) Such other clinics as the Secretary
considers appropriate.
(D) A description of the results of the
determination of the Secretary under paragraph (1) of
subsection (a) and a plan to use direct appointment
authority under paragraph (2) of such subsection to
fill staffing shortages, including recommendations for
improving the speed at which the credentialing and
privileging process can be conducted.
(E) The current staffing models of the Department
for the following clinics, including recommendations
for changes to such models:
(i) Mental health.
(ii) Primary care.
(iii) Gastroenterology.
(iv) Women's health.
(v) Such other clinics as the Secretary
considers appropriate.
(F) A detailed analysis of succession planning at
medical facilities of the Department, including the
following:
(i) The number of positions in medical
facilities throughout the Department that are
not filled by a permanent employee.
(ii) The length of time each such position
described in clause (i) remained vacant or
filled by a temporary or acting employee.
(iii) A description of any barriers to
filling the positions described in clause (i).
(iv) A plan for filling any positions that
are vacant or filled by a temporary or acting
employee for more than 180 days.
(v) A plan for handling emergency
circumstances, such administrative leave or
sudden medical leave for senior officials.
(G) The number of health care providers who have
been removed from their position or have retired, by
provider type, during the two-year period preceding the
submittal of the report.
(H) Of the health care providers specified in
subparagraph (G) that have been removed from their
position, the following:
(i) The number of such health care
providers who were reassigned to another
position in the Department.
(ii) The number of such health care
providers who left the Department.
SEC. 204. CLINIC MANAGEMENT TRAINING PROGRAM OF THE DEPARTMENT OF
VETERANS AFFAIRS.
(a) In General.--Not later than 180 days after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall
implement a clinic management training program to provide in-person,
standardized education on health care management to all managers of,
and health care providers at, medical facilities of the Department of
Veterans Affairs.
(b) Elements.--The clinic management training program required by
subsection (a) shall include the following:
(1) Training on how to manage the schedules of health care
providers of the Department, including the following:
(A) Maintaining such schedules in a manner that
allows appointments to be booked at least eight weeks
in advance.
(B) Proper planning procedures for vacation, leave,
and graduate medical education training schedules.
(2) Training on the appropriate number of appointments that
a health care provider should conduct on a daily basis, based
on specialty.
(3) Training on how to determine whether there are enough
available appointment slots to manage demand for different
appointment types and mechanisms for alerting management of
insufficient slots.
(4) Training on how to properly use the data produced by
the scheduling dashboard required by section 101(b)(11) of this
Act to meet demand for health care, including the following:
(A) Training on determining the next available
appointment for each health care provider at the
medical facility.
(B) Training on determining the number of health
care providers needed to meet demand for health care at
the medical facility.
(C) Training on determining the number of exam
rooms needed to meet demand for such health care in an
efficient manner.
(5) Training on how to properly use the appointment
scheduling system of the Department, including any new
scheduling system implemented by the Department.
(6) Training on how to optimize the use of technology,
including the following:
(A) Telemedicine.
(B) Electronic mail.
(C) Text messaging.
(D) Such other technologies as specified by the
Secretary.
(7) Training on how to properly use physical plant space at
medical facilities of the Department to ensure efficient flow
and privacy for patients and staff.
SEC. 205. INCLUSION OF DEPARTMENT OF VETERANS AFFAIRS FACILITIES IN
NATIONAL HEALTH SERVICE CORPS SCHOLARSHIP AND LOAN
REPAYMENT PROGRAMS.
(a) In General.--The Secretary of Health and Human Services shall
use the funds transferred under subsection (e) to award scholarship and
loan repayment contracts under sections 338A and 338B of the Public
Health Service Act (42 U.S.C. 254l, 254l-1) to eligible individuals who
agree to a period of obligated service under section 338A(f)(1) or
338B(f)(1) of such Act, as applicable, at a health facility of the
Department of Veterans Affairs.
(b) Health Professional Shortage Areas.--For purposes of selecting
individuals eligible for the scholarships and loan repayment contracts
under subsection (a), all health facilities of the Department of
Veterans Affairs shall be deemed health professional shortage areas, as
defined in section 332 of the Public Health Service Act (42 U.S.C.
254e).
(c) Requirement.--The Secretary of Health and Human Services shall
ensure that a minimum of 5 scholarships or loan repayment contracts are
awarded to individuals who agree to a period of obligated service at
Veterans Affairs facilities in each State.
(d) Applicability of NHSC Program Requirements.--Except as
otherwise provided in this section, the terms of the National Health
Service Corps Scholarship Program and the National Health Service Corps
Loan Repayment Program shall apply to participants awarded a grant or
loan repayment contract under subsection (a) in the same manner that
such terms apply to participants awarded a grant or loan repayment
contract under section 338A or 338B of the Public Health Service Act.
(e) Inclusion of Geriatricians.--For purposes of awarding
scholarships and loan repayments contracts to eligible individuals who
agree to a period of obligated service at a health facility of the
Department of Veterans Affairs pursuant to this section, in sections
338A and 338B of the Public Health Service Act (42 U.S.C. 254l, 254l-
1), the term ``primary health services'' shall include geriatrics.
(f) Funding.--The Secretary of Veterans Affairs shall transfer
$20,000,000 for fiscal year 2014, and such sums as may be necessary for
each fiscal year thereafter, from accounts of the Veterans Health
Administration to the Secretary of Health and Human Services to award
scholarships and loan repayment contracts, as described in subsection
(a). All funds so transferred shall be used exclusively for the
purposes described in such subsection.
SEC. 206. AUTHORIZATION OF EMERGENCY APPROPRIATIONS.
There is authorized to be appropriated for the Department of
Veterans Affairs such sums as may be necessary to carry out this title.
TITLE III--IMPROVEMENT OF ACCESS TO CARE FROM NON-DEPARTMENT OF
VETERANS AFFAIRS PROVIDERS
SEC. 301. IMPROVEMENT OF ACCESS BY VETERANS TO HEALTH CARE FROM NON-
DEPARTMENT OF VETERANS AFFAIRS PROVIDERS.
(a) Improvement of Access.--
(1) In general.--The Secretary of Veterans Affairs shall
ensure timely access of all veterans to the hospital care,
medical services, and other health care for which such veterans
are eligible under the laws administered by the Secretary
through the enhanced use of authorities specified in paragraph
(2) on the provision of such care and services through non-
Department of Veterans Affairs providers (commonly referred to
as ``non-Department of Veterans Affairs medical care'').
(2) Authorities on provision of care through non-department
providers.--The authorities specified in this paragraph are the
following:
(A) Section 1703 of title 38, United States Code,
relating to contracts for the provision of hospital
care and medical services through non-Department
facilities.
(B) Section 1725 of such title, relating to
reimbursement of certain veterans for the reasonable
value of emergency treatment at non-Department
facilities.
(C) Section 1728 of such title, relating to
reimbursement of certain veterans for customary and
usual charges of emergency treatment from sources other
than the Department.
(D) Section 1786 of such title, relating to health
care services furnished to newborn children of women
veterans who are receiving maternity care furnished by
the Department at a non-Department facility.
(E) Any other authority under the laws administered
by the Secretary to provide hospital care, medical
services, or other health care from a non-Department
provider, including the following:
(i) 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))).
(ii) The Department of Defense.
(iii) The Indian Health Service.
(3) Requirements.--In ensuring timely access of all
veterans to the care and services described in paragraph (1)
through the enhanced use of authorities specified in paragraph
(2), the Secretary shall require the following:
(A) That each veteran who has not received hospital
care, medical services, or other health care from the
Department and is seeking an appointment for primary
care under the laws administered by the Secretary
receive an appointment for primary care at a time
consistent with timeliness measures established by the
Secretary for purposes of providing primary care to all
veterans.
(B) That the determination whether to refer a
veteran for specialty care through a non-Department
provider shall take into account the urgency and acuity
of such veteran's need for such care, including--
(i) the severity of the condition of such
veteran requiring specialty care; and
(ii) the wait-time for an appointment with
a specialist with respect to such condition at
the nearest medical facility of the Department
with the capacity to provide such care.
(C) That the determination whether a veteran shall
receive hospital care, medical services, or other
health care from the Department through facilities of
the Department or through non-Department providers
pursuant to the authorities specified in paragraph (2)
shall take into account, in the manner specified by the
Secretary, the following:
(i) The distance the veteran would be
required to travel to receive care or services
through a non-Department provider compared to
the distance the veteran would be required to
travel to receive care or services from a
medical facility of the Department.
(ii) Any factors that might limit the
ability of the veteran to travel, including
age, access to transportation, and infirmity.
(iii) The wait-time for the provision of
care or services through a non-Department
provider compared to the wait-time for the
provision of care or services from a medical
facility of the Department.
(iv) Where the veteran would prefer to
receive the care and services described in
paragraph (1), unless the preference of the
veteran conflicts with any of the other
requirements of this paragraph.
(D) That the Department maximize the use of
hospital care, medical services, and other health care
available to the Department through non-Department
providers, including providers available to provide
such care and services as follows:
(i) Pursuant to contracts under the
Patient-Centered Community Care Program of the
Department.
(ii) Pursuant to contracts between a
facility or facilities of the Department and a
local facility or provider.
(iii) Pursuant to contracts with Federally-
qualified health centers (as defined in section
1905(l)(2)(B) of the Social Security Act (42
U.S.C. 1396d(l)(2)(B))), the Department of
Defense, or the Indian Health Service.
(iv) On a fee-for-service basis.
(b) Medical Records.--In providing hospital care, medical services,
and other health care to veterans through non-Department providers
pursuant to the authorities specified in paragraph (2), the Secretary
shall ensure that any such provider submits to the Department any
medical record related to the care and services provided to a veteran
by that provider for inclusion in the electronic medical record of such
veteran maintained by the Department upon the completion of the
provision of such care and services to such veteran.
(c) Reports.--
(1) Initial report.--Not later than 45 days after the date
of the enactment of this Act, the Secretary shall submit to the
Committee on Veterans' Affairs of the Senate and the Committee
on Veterans' Affairs of the House of Representatives a report
on the implementation of the requirements under subsection (a)
and (b), including a plan to enforce the proper implementation
of such requirements systematically throughout the Department.
(2) Periodic reports.--Not later than 90 days after the
submittal of the report required by paragraph (1), and every 90
days thereafter for one year, the Secretary shall submit to the
Committee on Veterans' Affairs of the Senate and the Committee
on Veterans' Affairs of the House of Representatives a report
that includes the following:
(A) The progress of the Secretary in carrying out
the plan under paragraph (1) to enforce the proper
implementation of the requirements under subsection (a)
and (b) systematically throughout the Department.
(B) The impact of the implementation of such
requirements on wait-times for veterans to receive
hospital care, medical services, and other health care,
disaggregated by--
(i) new patients;
(ii) existing patients;
(iii) primary care; and
(iv) specialty care.
(C) Any recommendations for changes or improvements
to such requirements.
(D) Any requests for additional funding necessary
to carry out such requirements.
SEC. 302. EXTENSION OF AND REPORT ON JOINT INCENTIVES PROGRAM OF
DEPARTMENT OF VETERANS AFFAIRS AND DEPARTMENT OF DEFENSE.
(a) Extension.--Section 8111(d)(3) of title 38, United States Code,
is amended by striking ``September 30, 2015'' and inserting ``September
30, 2020''.
(b) Reports.--
(1) Report on implementation of recommendations.--Not later
than 60 days after the date of the enactment of this Act, the
Secretary of Veterans Affairs and the Secretary of Defense
shall jointly submit to Congress a report on the implementation
by the Department of Veterans Affairs and the Department of
Defense of the findings and recommendations of the Comptroller
General of the United States in the September 2012 report
entitled ``VA and DoD Health Care: Department-Level Actions
Needed to Assess Collaboration Performance, Address Barriers,
and Identify Opportunities'' (GAO-12-992).
(2) Comptroller general report.--
(A) In general.--Not later than one year after the
date of the enactment of this Act, the Comptroller
General of the United States shall submit to Congress a
report assessing and providing recommendations for
improvement to the program to identify, provide
incentives to, implement, fund, and evaluate creative
coordination and sharing initiatives between the
Department of Veterans Affairs and the Department of
Defense required under section 8111(d) of such title.
(B) Elements.--The report required by subparagraph
(A) shall include the following:
(i) An assessment of the extent to which
the program described in subparagraph (A) has
accomplished the goal of such program to
improve the access to, and quality and cost
effectiveness of, the health care provided by
the Veterans Health Administration and the
Military Health System to the beneficiaries of
both the Department of Veterans Affairs and the
Department of Defense.
(ii) An assessment of whether
administration of such program through the
Health Executive Committee of the Department of
Veterans Affairs-Department of Defense Joint
Executive Committee established under section
320 of such title provides sufficient
leadership attention and oversight to ensure
maximum benefits to the Department of Veterans
Affairs and the Department of Defense through
collaborative efforts.
(iii) An assessment of whether additional
authorities to jointly construct, lease, or
acquire facilities would facilitate additional
collaborative efforts under such program.
(iv) An assessment of whether the funding
for such program is sufficient to ensure
consistent identification of potential
opportunities for collaboration and oversight
of existing collaborations to ensure a
meaningful partnership between the Department
of Veterans Affairs and the Department of
Defense and remove any barriers to integration
or collaboration.
(v) An assessment of whether existing
processes for identifying opportunities for
collaboration are sufficient to ensure maximum
collaboration between the Veterans Health
Administration and the Military Health System.
(vi) Such legislative or administrative
recommendations for improvement to such program
as the Comptroller General considers
appropriate to enhance the use of such program
to increase access to health care.
SEC. 303. TRANSFER OF AUTHORITY FOR PAYMENTS FOR HOSPITAL CARE, MEDICAL
SERVICES, AND OTHER HEALTH CARE FROM NON-DEPARTMENT
PROVIDERS TO THE CHIEF BUSINESS OFFICE OF THE VETERANS
HEALTH ADMINISTRATION OF THE DEPARTMENT.
(a) Transfer of Authority.--
(1) In general.--Effective on October 1, 2014, the
Secretary of Veterans Affairs shall transfer the authority to
pay for hospital care, medical services, and other health care
through non-Department providers to the Chief Business Office
of the Veterans Health Administration of the Department of
Veterans Affairs from the Veterans Integrated Service Networks
and medical centers of the Department of Veterans Affairs.
(2) Manner of care.--The Chief Business Office shall work
in consultation with the Office of Clinical Operations and
Management of the Department of Veterans Affairs to ensure that
care and services described in paragraph (1) is provided in a
manner that is clinically appropriate and effective.
(3) No delay in payment.--The transfer of authority under
paragraph (1) shall be carried out in a manner that does not
delay or impede any payment by the Department for hospital
care, medical services, or other health care provided through a
non-Department provider under the laws administered by the
Secretary.
(b) Budgetary Effect.--The Secretary shall, for each fiscal year
that begins after the date of the enactment of this Act--
(1) include in the budget for the Chief Business Office of
the Veterans Health Administration amounts to pay for hospital
care, medical services, and other health care provided through
non-Department providers, including any amounts necessary to
carry out the transfer of authority to pay for such care and
services under subsection (a), including any increase in staff;
and
(2) not include in the budget of each Veterans Integrated
Service Network and medical center of the Department amounts to
pay for such care and services.
(c) Removal From Performance Goals.--For each fiscal year that
begins after the date of the enactment of this Act, the Secretary shall
not include in the performance goals of any employee of a Veterans
Integrated Service Network or medical center of the Department any
performance goal that might disincentivize the payment of Department
amounts to provide hospital care, medical services, or other health
care through a non-Department provider.
SEC. 304. ENHANCEMENT OF COLLABORATION BETWEEN DEPARTMENT OF VETERANS
AFFAIRS AND INDIAN HEALTH SERVICE.
(a) Outreach to Tribal-run Medical Facilities.--The Secretary of
Veterans Affairs shall, in consultation with the Director of the Indian
Health Service, conduct outreach to each medical facility operated by
an Indian tribe or tribal organization through a contract or compact
with the Indian Health Service under the Indian Self-Determination and
Education Assistance Act (25 U.S.C. 450 et seq.) to raise awareness of
the ability of such facilities, Indian tribes, and tribal organizations
to enter into agreements with the Department of Veterans Affairs under
which the Secretary reimburses such facilities, Indian tribes, or
tribal organizations, as the case may be, for health care provided to
veterans eligible for health care at such facilities.
(b) Metrics for Memorandum of Understanding Performance.--The
Secretary of Veterans Affairs shall implement performance metrics for
assessing the performance by the Department of Veterans Affairs and the
Indian Health Service under the memorandum of understanding entitled
``Memorandum of Understanding between the Department of Veterans
Affairs (VA) and the Indian Health Service (IHS)'' in increasing access
to health care, improving quality and coordination of health care,
promoting effective patient-centered collaboration and partnerships
between the Department and the Service, and ensuring health-promotion
and disease-prevention services are appropriately funded and available
for beneficiaries under both health care systems.
(c) Report.--Not later than 180 days after the date of the
enactment of this Act, the Secretary of Veterans Affairs and the
Director of the Indian Health Service shall jointly submit to Congress
a report on the feasibility and advisability of the following:
(1) Entering into agreements for the reimbursement by the
Secretary of the costs of direct care services provided through
organizations receiving amounts pursuant to grants made or
contracts entered into under section 503 of the Indian Health
Care Improvement Act (25 U.S.C. 1653) to veterans who are
otherwise eligible to receive health care from such
organizations.
(2) Including the reimbursement of the costs of direct care
services provided to veterans who are not Indians in agreements
between the Department and the following:
(A) The Indian Health Service.
(B) An Indian tribe or tribal organization
operating a medical facility through a contract or
compact with the Indian Health Service under the Indian
Self-Determination and Education Assistance Act (25
U.S.C. 450 et seq.).
(C) A medical facility of the Indian Health
Service.
(d) Definitions.--In this section:
(1) Indian.--The terms ``Indian'' and ``Indian tribe'' have
the meanings given those terms in section 4 of the Indian
Health Care Improvement Act (25 U.S.C. 1603).
(2) Medical facility of the indian health service.--The
term ``medical facility of the Indian Health Service'' includes
a facility operated by an Indian tribe or tribal organization
through a contract or compact with the Indian Health Service
under the Indian Self-Determination and Education Assistance
Act (25 U.S.C. 450 et seq.).
(3) Tribal organization.--The term ``tribal organization''
has the meaning given the term in section 4 of the Indian Self-
Determination and Education Assistance Act (25 U.S.C. 450b).
SEC. 305. ENHANCEMENT OF COLLABORATION BETWEEN DEPARTMENT OF VETERANS
AFFAIRS AND NATIVE HAWAIIAN HEALTH CARE SYSTEMS.
(a) In General.--The Secretary of Veterans Affairs shall, in
consultation with Papa Ola Lokahi and such other organizations involved
in the delivery of health care to Native Hawaiians as the Secretary
considers appropriate, enter into contracts or agreements with Native
Hawaiian health care systems that are in receipt of funds from the
Secretary of Health and Human Services pursuant to grants awarded or
contracts entered into under section 6(a) of the Native Hawaiian Health
Care Improvement Act (42 U.S.C. 11705(a)) for the reimbursement of
direct care services provided to eligible veterans as specified in such
contracts or agreements.
(b) Definitions.--In this section, the terms ``Native Hawaiian'',
``Native Hawaiian health care system'', and ``Papa Ola Lokahi'' have
the meanings given those terms in section 12 of the Native Hawaiian
Health Care Improvement Act (42 U.S.C. 11711).
SEC. 306. AUTHORIZATION OF EMERGENCY APPROPRIATIONS.
There is authorized to be appropriated for the Department of
Veterans Affairs such sums as may be necessary to carry out this title.
TITLE IV--HEALTH CARE ADMINISTRATIVE MATTERS
SEC. 401. IMPROVEMENT OF ACCESS OF VETERANS TO MOBILE VET CENTERS OF
THE DEPARTMENT OF VETERANS AFFAIRS.
(a) Improvement of Access.--
(1) In general.--The Secretary of Veterans Affairs shall
improve the access of veterans to telemedicine and other health
care through the use of mobile vet centers of the Department of
Veterans Affairs by providing standardized requirements for the
operation of such centers.
(2) Requirements.--The standardized requirements required
by paragraph (1) shall include the following:
(A) The number of days each mobile vet center of
the Department is expected to travel per year.
(B) The number of locations each center is expected
to visit per year.
(C) The number of appointments each center is
expected to conduct per year.
(D) The method and timing of notifications given by
each center to individuals in the area to which such
center is traveling, including notifications informing
veterans of the availability to schedule appointments
at the center.
(3) Use of telemedicine.--The Secretary shall ensure that
each mobile vet center of the Department has the capability to
provide telemedicine services.
(b) Reports.--Not later than one year after the date of the
enactment of this Act, and not later than September 30 each year
thereafter, the Secretary of Veterans Affairs shall submit to the
Committee on Veterans' Affairs of the Senate and the Committee on
Veterans' Affairs of the House of Representatives a report on the
following:
(1) The use of mobile vet centers to provide telemedicine
services to veterans during the year preceding the submittal of
the report, including the following:
(A) The number of days each mobile vet center was
open to provide such services.
(B) The number of days each mobile vet center
traveled to a location other than the headquarters of
the mobile vet center to provide such services.
(C) The number of appointments each center
conducted to provide such services on average per month
and in total during such year.
(2) An analysis of the effectiveness of using mobile vet
centers to provide health care services to veterans through the
use of telemedicine.
(3) Any recommendations for an increase in the number of
mobile vet centers of the Department.
(4) Any recommendations for an increase in the telemedicine
capabilities of each mobile vet center.
(5) The feasibility and advisability of using temporary
health care providers, including locum tenens, to provide
direct health care services to veterans at mobile vet centers.
(6) Such other recommendations on improvement of the use of
mobile vet centers by the Department as the Secretary considers
appropriate.
SEC. 402. COMMISSION ON ACCESS TO CARE.
(a) Establishment of Commission.--
(1) In general.--There is established the Commission on
Access to Care (in this section referred to as the
``Commission'') to examine the access of veterans to health
care from the Department of Veterans Affairs and strategically
examine how best to organize the Veterans Health
Administration, locate health care resources, and deliver
health care to veterans during the next 10 to 20 years.
(2) Membership.--
(A) Voting members.--The Commission shall be
composed of 10 voting members who are appointed by the
President as follows:
(i) At least two members who represent an
organization recognized by the Secretary of
Veterans Affairs for the representation of
veterans under section 5902 of title 38, United
States Code.
(ii) At least one member from among persons
who are experts concerning a public or private
hospital system.
(iii) At least one member from among
persons who are familiar with government health
care systems, including those systems of the
Department of Defense, the Indian Health
Service, and Federally-qualified health centers
(as defined in section 1905(l)(2)(B) of the
Social Security Act (42 U.S.C.
1396d(l)(2)(B))).
(iv) At least two members from among
persons who are familiar with the Veterans
Health Administration.
(B) Nonvoting members.--In addition to members
appointed under subparagraph (A), the Commission shall
be composed of 10 nonvoting members who are appointed
by the President as follows:
(i) At least two members who represent an
organization recognized by the Secretary of
Veterans Affairs for the representation of
veterans under section 5902 of title 38, United
States Code.
(ii) At least one member from among persons
who are experts in a public or private hospital
system.
(iii) At least one member from among
persons who are familiar with government health
care systems, including those systems of the
Department of Defense, the Indian Health
Service, and Federally-qualified health centers
(as defined in section 1905(l)(2)(B) of the
Social Security Act (42 U.S.C.
1396d(l)(2)(B))).
(iv) At least two members from among
persons who are familiar with the Veterans
Health Administration.
(C) Date.--The appointments of members of the
Commission shall be made not later than 60 days after
the date of the enactment of this Act.
(3) Period of appointment; vacancies.--Members shall be
appointed for the life of the Commission. Any vacancy in the
Commission shall not affect its powers, but shall be filled in
the same manner as the original appointment.
(4) Initial meeting.--Not later than 15 days after the date
on which seven voting members of the Commission have been
appointed, the Commission shall hold its first meeting.
(5) Meetings.--The Commission shall meet at the call of the
Chairperson.
(6) Quorum.--A majority of the members of the Commission
shall constitute a quorum, but a lesser number of members may
hold hearings.
(7) Chairperson and vice chairperson.--The Commission shall
select a Chairperson and Vice Chairperson from among its
members.
(b) Duties of Commission.--
(1) Evaluation and assessment.--The Commission shall
undertake a comprehensive evaluation and assessment of access
to health care at the Department of Veterans Affairs.
(2) Matters evaluated and assessed.--The matters evaluated
and assessed by the Commission shall include the following:
(A) The appropriateness of current standards of the
Department of Veterans Affairs concerning access to
health care.
(B) The measurement of such standards.
(C) The appropriateness of performance standards
and incentives in relation to standards described in
subparagraph (A).
(D) Staffing levels throughout the Veterans Health
Administration and whether they are sufficient to meet
current demand for health care from the Administration.
(3) Reports.--The Commission shall submit to the President,
through the Secretary of Veterans Affairs, reports as follows:
(A) Not later than 90 days after the date of the
initial meeting of the Commission, an interim report
on--
(i) the findings of the Commission with
respect to the evaluation and assessment
required by this subsection; and
(ii) such recommendations as the Commission
may have for legislative or administrative
action to improve access to health care through
the Veterans Health Administration.
(B) Not later than 180 days after the date of the
initial meeting of the Commission, a final report on--
(i) the findings of the Commission with
respect to the evaluation and assessment
required by this subsection; and
(ii) such recommendations as the Commission
may have for legislative or administrative
action to improve access to health care through
the Veterans Health Administration.
(c) Powers of the Commission.--
(1) Hearings.--The Commission may hold such hearings, sit
and act at such times and places, take such testimony, and
receive such evidence as the Commission considers advisable to
carry out this section.
(2) Information from federal agencies.--The Commission may
secure directly from any Federal department or agency such
information as the Commission considers necessary to carry out
this section. Upon request of the Chairperson of the
Commission, the head of such department or agency shall furnish
such information to the Commission.
(d) Commission Personnel Matters.--
(1) Compensation of members.--Each member of the Commission
who is not an officer or employee of the Federal Government
shall be compensated at a rate equal to the daily equivalent of
the annual rate of basic pay prescribed for level IV of the
Executive Schedule under section 5315 of title 5, United States
Code, for each day (including travel time) during which such
member is engaged in the performance of the duties of the
Commission. All members of the Commission who are officers or
employees of the United States shall serve without compensation
in addition to that received for their services as officers or
employees of the United States.
(2) Travel expenses.--The members of the Commission shall
be allowed travel expenses, including per diem in lieu of
subsistence, at rates authorized for employees of agencies
under subchapter I of chapter 57 of title 5, United States
Code, while away from their homes or regular places of business
in the performance of services for the Commission.
(3) Staff.--
(A) In general.--The Chairperson of the Commission
may, without regard to the civil service laws and
regulations, appoint and terminate an executive
director and such other additional personnel as may be
necessary to enable the Commission to perform its
duties. The employment of an executive director shall
be subject to confirmation by the Commission.
(B) Compensation.--The Chairperson of the
Commission may fix the compensation of the executive
director and other personnel without regard to chapter
51 and subchapter III of chapter 53 of title 5, United
States Code, relating to classification of positions
and General Schedule pay rates, except that the rate of
pay for the executive director and other personnel may
not exceed the rate payable for level V of the
Executive Schedule under section 5316 of such title.
(4) Detail of government employees.--Any Federal Government
employee may be detailed to the Commission without
reimbursement, and such detail shall be without interruption or
loss of civil service status or privilege.
(5) Procurement of temporary and intermittent services.--
The Chairperson of the Commission may procure temporary and
intermittent services under section 3109(b) of title 5, United
States Code, at rates for individuals which do not exceed the
daily equivalent of the annual rate of basic pay prescribed for
level V of the Executive Schedule under section 5316 of such
title.
(e) Termination of the Commission.--The Commission shall terminate
30 days after the date on which the Commission submits its report under
subsection (b)(3)(B).
(f) Funding.--The Secretary of Veterans Affairs shall make
available to the Commission from amounts appropriated or otherwise made
available to the Secretary such amounts as the Secretary and the
Chairperson of the Commission jointly consider appropriate for the
Commission to perform its duties under this section.
(g) Executive Action.--
(1) Action on recommendations.--The President shall require
the Secretary of Veterans Affairs and such other heads of
relevant Federal departments and agencies to implement each
recommendation set forth in a report submitted under subsection
(b)(3) that the President--
(A) considers feasible and advisable; and
(B) determines can be implemented without further
legislative action.
(2) Reports.--Not later than 60 days after the date on
which the President receives a report under subsection (b)(3),
the President shall submit to the Committee on Veterans'
Affairs of the Senate and the Committee on Veterans' Affairs of
the House of Representatives and such other committees of
Congress as the President considers appropriate a report
setting forth the following:
(A) An assessment of the feasibility and
advisability of each recommendation contained in the
report received by the President.
(B) For each recommendation assessed as feasible
and advisable under subparagraph (A) the following:
(i) Whether such recommendation requires
legislative action.
(ii) If such recommendation requires
legislative action, a recommendation concerning
such legislative action.
(iii) A description of any administrative
action already taken to carry out such
recommendation.
(iv) A description of any administrative
action the President intends to be taken to
carry out such recommendation and by whom.
SEC. 403. COMMISSION ON CAPITAL PLANNING FOR DEPARTMENT OF VETERANS
AFFAIRS MEDICAL FACILITIES.
(a) Establishment of Commission.--
(1) Establishment.--There is established the Commission on
Capital Planning for Department of Veterans Affairs Medical
Facilities (in this section referred to as the ``Commission'').
(2) Membership.--
(A) Voting members.--The Commission shall, subject
to subparagraph (B), be composed of 10 voting members
as follows:
(i) 1 shall be appointed by the President.
(ii) 1 shall be appointed by the
Administrator of General Services.
(iii) 3 shall be appointed by the Secretary
of Veterans Affairs, of whom--
(I) 1 shall be an employee of the
Veterans Health Administration;
(II) 1 shall be an employee of the
Office of Asset Enterprise Management
of the Department of Veterans Affairs;
and
(III) 1 shall be an employee of the
Office of Construction and Facilities
Management of the Department of
Veterans Affairs.
(iv) 1 shall be appointed by the Secretary
of Defense from among employees of the Army
Corps of Engineers.
(v) 1 shall be appointed by the majority
leader of the Senate.
(vi) 1 shall be appointed by the minority
leader of the Senate.
(vii) 1 shall be appointed by the Speaker
of the House of Representatives.
(viii) 1 shall be appointed by the minority
leader of the House of Representatives.
(B) Requirement relating to certain appointments of
voting members.--Of the members appointed pursuant to
clause (i), (ii), and (iv) through (viii) of
subparagraph (A), all shall have expertise in capital
leasing, construction, or health facility management
planning.
(C) Non-voting members.--The Commission shall be
assisted by 10 non-voting members, appointed by the
vote of a majority of members of the Commission under
subparagraph (A), of whom--
(i) 6 shall be representatives of veterans
service organizations recognized by the
Secretary of Veterans Affairs; and
(ii) 4 shall be individuals from outside
the Department of Veterans Affairs with
experience and expertise in matters relating to
management, construction, and leasing of
capital assets.
(D) Date of appointment of voting members.--The
appointments of the members of the Commission under
subparagraph (A) shall be made not later than 60 days
after the date of the enactment of this Act.
(3) Period of appointment; vacancies.--Members shall be
appointed for the life of the Commission. Any vacancy in the
Commission shall not affect its powers, but shall be filled in
the same manner as the original appointment.
(4) Initial meeting.--Not later than 15 days after the date
on which 7 members of the Commission have been appointed, the
Commission shall hold its first meeting.
(5) Meetings.--The Commission shall meet at the call of the
Chair.
(6) Quorum.--A majority of the members of the Commission
shall constitute a quorum, but a lesser number of members may
hold hearings.
(7) Chair and vice chair.--The Commission shall select a
Chair and Vice Chair from among its members.
(b) Duties of Commission.--
(1) In general.--The Commission shall undertake a
comprehensive evaluation and assessment of various options for
capital planning for Department of Veterans Affairs medical
facilities, including an evaluation and assessment of the
mechanisms by which the Department currently selects means for
the delivery of health care, whether by major construction,
major medical facility leases, sharing agreements with the
Department of Defense, the Indian Health Service, and Federally
Qualified Health Clinics under section 330 of the Public Health
Service Act (42 U.S.C. 254b), contract care, multisite care,
telemedicine, extended hours for care, or other means.
(2) Context of evaluation and assessment.--In undertaking
the evaluation and assessment, the Commission shall consider--
(A) the importance of access to health care through
the Department, including associated guidelines of the
Department on access to, and drive time for, health
care;
(B) limitations and requirements applicable to the
construction and leasing of medical facilities for the
Department, including applicable laws, regulations, and
costs as determined by both the Congressional Budget
Office and the Office of Management and Budget;
(C) the nature of capital planning for Department
medical facilities in an era of fiscal uncertainty;
(D) projected future fluctuations in the population
of veterans; and
(E) the extent to which the Department was able to
meet the mandates of the Capital Asset Realignment for
Enhanced Services Commission.
(3) Particular considerations.--In undertaking the
evaluation and assessment, the Commission shall address, in
particular, the following:
(A) The Major Medical Facility Lease Program of the
Department, including an identification of potential
improvements to the lease authorization processes under
that Program.
(B) The management processes of the Department for
its Major Medical Facility Construction Program,
including processes relating to contract award and
management, project management, and processing of
change orders.
(C) The overall capital planning program of the
Department for medical facilities, including an
evaluation and assessment of--
(i) the manner in which the Department
determines whether to use capital or non-
capital means to expand access to health care;
(ii) the manner in which the Department
determines the disposition of under-utilized
and un-utilized buildings on campuses of
Department medical centers, and any barriers to
disposition;
(iii) the effectiveness of the facility
master planning initiative of the Department;
and
(iv) the extent to which sustainable
attributes are planned for to decrease
operating costs for Department medical
facilities.
(D) The current backlog of construction projects
for Department medical facilities, including an
identification of the most effective means to quickly
secure the most critical repairs required, including
repairs relating to facility condition deficiencies,
structural safety, and compliance with the Americans
With Disabilities Act of 1990.
(4) Reports.--Subject to paragraph (5), the Commission
shall submit to the Secretary of Veterans Affairs, and to the
Committee Veterans' Affairs of the Senate and the Committee on
Veterans' Affairs of the House of Representatives, reports as
follows:
(A) Not later than six months after its initial
meeting under subsection (a)(4), a report on the Major
Medical Facility Lease Program and the Congressional
lease authorization process.
(B) Not later than one year after its initial
meeting, a report--
(i) on the management processes of the
Department for the construction of Department
medical facilities; and
(ii) setting forth an update of any matters
covered in the report under subparagraph (A).
(C) Not later than 18 months after its initial
meeting, a report--
(i) on the overall capital planning program
of the Department for medical facilities; and
(ii) setting forth an update of any matters
covered in earlier reports under this
paragraph.
(D) Not later than two years after its initial
meeting, a report--
(i) on the current backlog of construction
projects for Department medical facilities;
(ii) setting forth an update of any matters
covered in earlier reports under this
paragraph; and
(iii) including such other matters relating
to the duties of the Commission that the
Commission considers appropriate.
(E) Not later than 27 months after its initial
meeting, a report on the implementation by the
Secretary of Veterans Affairs pursuant to subsection
(g) of the recommendations included pursuant to
paragraph (5) in the reports under this paragraph.
(5) Recommendations.--Each report under paragraph (4) shall
include, for the aspect of the capital asset planning process
of the Department covered by such report, such recommendations
as the Commission considers appropriate for the improvement and
enhancement of such aspect of the capital asset planning
process.
(c) Powers of Commission.--
(1) Hearings.--The Commission may hold such hearings, sit
and act at such times and places, take such testimony, and
receive such evidence as the Commission considers advisable to
carry out this section.
(2) Information from federal agencies.--The Commission may
secure directly from any Federal department or agency such
information as the Commission considers necessary to carry out
this section. Upon request of the Chair of the Commission, the
head of such department or agency shall furnish such
information to the Commission.
(d) Commission Personnel Matters.--
(1) Compensation of members.--Each member of the Commission
who is not an officer or employee of the Federal Government
shall be compensated at a rate equal to the daily equivalent of
the annual rate of basic pay prescribed for level IV of the
Executive Schedule under section 5315 of title 5, United States
Code, for each day (including travel time) during which such
member is engaged in the performance of the duties of the
Commission. All members of the Commission who are officers or
employees of the United States shall serve without compensation
in addition to that received for their services as officers or
employees of the United States.
(2) Travel expenses.--The members of the Commission shall
be allowed travel expenses, including per diem in lieu of
subsistence, at rates authorized for employees of agencies
under subchapter I of chapter 57 of title 5, United States
Code, while away from their homes or regular places of business
in the performance of services for the Commission.
(3) Staff.--
(A) In general.--The Chair of the Commission may,
without regard to the civil service laws and
regulations, appoint and terminate an executive
director and such other additional personnel as may be
necessary to enable the Commission to perform its
duties. The employment of an executive director shall
be subject to confirmation by the Commission.
(B) Compensation.--The Chair of the Commission may
fix the compensation of the executive director and
other personnel without regard to chapter 51 and
subchapter III of chapter 53 of title 5, United States
Code, relating to classification of positions and
General Schedule pay rates, except that the rate of pay
for the executive director and other personnel may not
exceed the rate payable for level V of the Executive
Schedule under section 5316 of such title.
(4) Detail of government employees.--Any Federal Government
employee may be detailed to the Commission without
reimbursement, and such detail shall be without interruption or
loss of civil service status or privilege.
(5) Procurement of temporary and intermittent services.--
The Chair of the Commission may procure temporary and
intermittent services under section 3109(b) of title 5, United
States Code, at rates for individuals which do not exceed the
daily equivalent of the annual rate of basic pay prescribed for
level V of the Executive Schedule under section 5316 of such
title.
(e) Termination of Commission.--The Commission shall terminate 60
days after the date on which the Commission submits its report under
subsection (b)(4)(E).
(f) Funding.--The Secretary of Veterans Affairs shall make
available to the Commission such amounts as the Secretary and the Chair
of the Commission jointly consider appropriate for the Commission to
perform its duties under this section.
(g) Action on Recommendations.--
(1) In general.--The Secretary of Veterans Affairs shall
implement each recommendation included in a report under
subsection (b)(4) that the Secretary considers feasible and
advisable and can be implemented without further legislative
action.
(2) Reports.--Not later than 120 days after receipt of a
report under subparagraphs (A) through (D) of subsection
(b)(4), the Secretary shall submit to the Committee Veterans'
Affairs of the Senate and the Committee on Veterans' Affairs of
the House of Representatives a report setting forth the
following:
(A) An assessment of the feasibility and
advisability of each recommendation contained in such
report.
(B) For each recommendation assessed as feasible
and advisable--
(i) if such recommendation does not require
further legislative action for implementation,
a description of the actions taken, and to be
taken, by the Secretary to implement such
recommendation; and
(ii) if such recommendation requires
further legislative action for implementation,
recommendations for such legislative action.
SEC. 404. REMOVAL OF SENIOR EXECUTIVE SERVICE EMPLOYEES OF THE
DEPARTMENT OF VETERANS AFFAIRS FOR PERFORMANCE.
(a) Removal or Transfer.--
(1) In general.--Chapter 7 of title 38, United States Code,
is amended by adding at the end the following new section:
``Sec. 713. Senior Executive Service: removal based on performance
``(a) In General.--The Secretary may remove any individual from the
Senior Executive Service if the Secretary determines the performance of
the individual warrants such removal. If the Secretary so removes such
an individual, the Secretary may--
``(1) remove the individual from the civil service (as
defined in section 2101 of title 5); or
``(2) transfer the individual to a General Schedule
position at any grade of the General Schedule for which the
individual is qualified and that the Secretary determines is
appropriate.
``(b) Notice to Congress.--Not later than 30 days after removing or
transferring an individual from the Senior Executive Service under
paragraph (1), the Secretary shall submit to the Committees on
Veterans' Affairs of the Senate and House of Representatives notice in
writing of such removal or transfer and the reason for such removal or
transfer.
``(c) Appeal of Removal or Transfer.--Any removal or transfer under
subsection (a) may be appealed to the Merit Systems Protection Board
under section 7701 of title 5 not later than 7 days after such removal
or transfer.
``(d) Expedited Review by Merit Systems Protection Board.--(1) The
Merit Systems Protection Board shall expedite any appeal under section
7701 of title 5 of a removal or transfer under subsection (a) and, in
any such case, shall issue a decision not later than 21 days after the
date of the appeal.
``(2) In any case in which the Merit Systems Protection Board
determines that it cannot issue a decision in accordance with the 21-
day requirement under paragraph (1), the Merit Systems Protection Board
shall submit to Congress a report that explains the reason why the
Merit Systems Protection Board is unable to issue a decision in
accordance with such requirement in such case.
``(3) There is authorized to be appropriated such sums as may be
necessary for the Merit Systems Protection Board to expedite appeals
under paragraph (1).
``(4) The Merit Systems Protection Board may not stay any personnel
action taken under this section.''.
(2) Clerical amendment.--The table of sections at the
beginning of such chapter is amended by adding at the end the
following new item:
``713. Senior Executive Service: removal based on performance.''.
(b) Establishment of Expedited Review Process.--
(1) In general.--Not later than 30 days after the date of
the enactment of this Act, the Merit Systems Protection Board
shall establish and put into effect a process to conduct
expedited reviews in accordance with section 713(d) of title
38, United States Code.
(2) Inapplicability of certain regulations.--Section
1201.22 of title 5, Code of Federal Regulations, as in effect
on the day before the date of the enactment of this Act, shall
not apply to expedited reviews carried out under section 713(d)
of title 38, United States Code.
(3) Report by merit systems protection board.--Not later
than 30 days after the date of the enactment of this Act, the
Merit Systems Protection Board shall submit to Congress a
report on the actions the Board plans to take to conduct
expedited reviews under section 713(d) of title 38, United
States Code, as added by subsection (a). Such report shall
include a description of the resources the Board determines
will be necessary to conduct such reviews and a description of
whether any resources will be necessary to conduct such reviews
that were not available to the Board on the day before the date
of the enactment of this Act.
(c) Temporary Exemption From Certain Limitation on Initiation of
Removal From Senior Executive Service.--During the 120-day period
beginning on the date of the enactment of this Act, an action to remove
an individual from the Senior Executive Service at the Department of
Veterans Affairs pursuant to section 713 of title 38, United States
Code, as added by subsection (a), or section 7543 of title 5, United
States Code, may be initiated, notwithstanding section 3592(b) of title
5, United States Code, or any other provision of law.
(d) Construction.--Nothing in this section or section 713 of title
38, United States Code, as added by subsection (a), shall be construed
to apply to an appeal of a removal, transfer, or other personnel action
that was pending before the date of the enactment of this Act.
TITLE V--MAJOR MEDICAL FACILITY LEASES
SEC. 501. AUTHORIZATION OF MAJOR MEDICAL FACILITY LEASES.
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 shown for such location (not
including any estimated cancellation costs):
(1) For a clinical research and pharmacy coordinating
center, Albuquerque, New Mexico, an amount not to exceed
$9,560,000.
(2) For a community-based outpatient clinic, Brick, New
Jersey, an amount not to exceed $7,280,000.
(3) For a new primary care and dental clinic annex,
Charleston, South Carolina, an amount not to exceed $7,070,250.
(4) For the Cobb County community-based Outpatient Clinic,
Cobb County, Georgia, an amount not to exceed $6,409,000.
(5) For the Leeward Outpatient Healthcare Access Center,
Honolulu, Hawaii, including a co-located clinic with the
Department of Defense and the co-location of the Honolulu
Regional Office of the Veterans Benefits Administration and the
Kapolei Vet Center of the Department of Veterans Affairs, an
amount not to exceed $15,887,370.
(6) For a community-based outpatient clinic, Johnson
County, Kansas, an amount not to exceed $2,263,000.
(7) For a replacement community-based outpatient clinic,
Lafayette, Louisiana, an amount not to exceed $2,996,000.
(8) For a community-based outpatient clinic, Lake Charles,
Louisiana, an amount not to exceed $2,626,000.
(9) For outpatient clinic consolidation, New Port Richey,
Florida, an amount not to exceed $11,927,000.
(10) For an outpatient clinic, Ponce, Puerto Rico, an
amount not to exceed $11,535,000.
(11) For lease consolidation, San Antonio, Texas, an amount
not to exceed $19,426,000.
(12) For a community-based outpatient clinic, San Diego,
California, an amount not to exceed $11,946,100.
(13) For an outpatient clinic, Tyler, Texas, an amount not
to exceed $4,327,000.
(14) For the Errera Community Care Center, West Haven,
Connecticut, an amount not to exceed $4,883,000.
(15) For the Worcester community-based Outpatient Clinic,
Worcester, Massachusetts, an amount not to exceed $4,855,000.
(16) For the expansion of a community-based outpatient
clinic, Cape Girardeau, Missouri, an amount not to exceed
$4,232,060.
(17) For a multispecialty clinic, Chattanooga, Tennessee,
an amount not to exceed $7,069,000.
(18) For the expansion of a community-based outpatient
clinic, Chico, California, an amount not to exceed $4,534,000.
(19) For a community-based outpatient clinic, Chula Vista,
California, an amount not to exceed $3,714,000.
(20) For a new research lease, Hines, Illinois, an amount
not to exceed $22,032,000.
(21) For a replacement research lease, Houston, Texas, an
amount not to exceed $6,142,000.
(22) For a community-based outpatient clinic, Lincoln,
Nebraska, an amount not to exceed $7,178,400.
(23) For a community-based outpatient clinic, Lubbock,
Texas, an amount not to exceed $8,554,000.
(24) For a community-based outpatient clinic consolidation,
Myrtle Beach, South Carolina, an amount not to exceed
$8,022,000.
(25) For a community-based outpatient clinic, Phoenix,
Arizona, an amount not to exceed $20,757,000.
(26) For the expansion of a community-based outpatient
clinic, Redding, California, an amount not to exceed
$8,154,000.
(27) For the expansion of a community-based outpatient
clinic, Tulsa, Oklahoma, an amount not to exceed $13,269,200.
SEC. 502. BUDGETARY TREATMENT OF DEPARTMENT OF VETERANS AFFAIRS MAJOR
MEDICAL FACILITIES LEASES.
(a) Findings.--Congress finds the following:
(1) Title 31, United States Code, requires the Department
of Veterans Affairs to record the full cost of its contractual
obligation against funds available at the time a contract is
executed.
(2) Office of Management and Budget Circular A-11 provides
guidance to agencies in meeting the statutory requirements
under title 31, United States Code, with respect to leases.
(3) For operating leases, Office of Management and Budget
Circular A-11 requires the Department of Veterans Affairs to
record up-front budget authority in an ``amount equal to total
payments under the full term of the lease or [an] amount
sufficient to cover first year lease payments plus cancellation
costs''.
(b) Requirement for Obligation of Full Cost.--
(1) In general.--Subject to the availability of
appropriations provided in advance, in exercising the authority
of the Secretary of Veterans Affairs to enter into leases
provided in this Act, the Secretary shall record, pursuant to
section 1501 of title 31, United States Code, as the full cost
of the contractual obligation at the time a contract is
executed either--
(A) an amount equal to total payments under the
full term of the lease; or
(B) if the lease specifies payments to be made in
the event the lease is terminated before its full term,
an amount sufficient to cover the first year lease
payments plus the specified cancellation costs.
(2) Self-insuring authority.--The requirements of paragraph
(1) may be satisfied through the use of a self-insuring
authority consistent with Office of Management and Budget
Circular A-11.
(c) Transparency.--
(1) Compliance.--Subsection (b) of section 8104 of title
38, United States Code, is amended by adding at the end the
following new paragraph:
``(7) In the case of a prospectus proposing funding for a
major medical facility lease, a detailed analysis of how the
lease is expected to comply with Office of Management and
Budget Circular A-11 and section 1341 of title 31 (commonly
referred to as the `Anti-Deficiency Act'). Any such analysis
shall include--
``(A) an analysis of the classification of the
lease as a `lease-purchase', `capital lease', or
`operating lease' as those terms are defined in Office
of Management and Budget Circular A-11;
``(B) an analysis of the obligation of budgetary
resources associated with the lease; and
``(C) an analysis of the methodology used in
determining the asset cost, fair market value, and
cancellation costs of the lease.''.
(2) Submittal to congress.--Such section 8104 is further
amended by adding at the end the following new subsection:
``(h)(1) Not less than 30 days before entering into a major medical
facility lease, the Secretary shall submit to the Committees on
Veterans' Affairs of the Senate and the House of Representatives--
``(A) notice of the Secretary's intention to enter into the
lease;
``(B) a detailed summary of the proposed lease;
``(C) a description and analysis of any differences between
the prospectus submitted pursuant to subsection (b) and the
proposed lease; and
``(D) a scoring analysis demonstrating that the proposed
lease fully complies with Office of Management and Budget
Circular A-11.
``(2) Each committee described in paragraph (1) shall ensure that
any information submitted to the committee under such paragraph is
treated by the committee with the same level of confidentiality as is
required by law of the Secretary and subject to the same statutory
penalties for unauthorized disclosure or use as the Secretary.
``(3) Not more than 30 days after entering into a major medical
facility lease, the Secretary shall submit to each committee described
in paragraph (1) a report on any material differences between the lease
that was entered into and the proposed lease described under such
paragraph, including how the lease that was entered into changes the
previously submitted scoring analysis described in subparagraph (D) of
such paragraph.''.
(d) Rule of Construction.--Nothing in this section, or the
amendments made by this section, shall be construed to in any way
relieve the Department of Veterans Affairs from any statutory or
regulatory obligations or requirements existing prior to the enactment
of this section and such amendments.
Calendar No. 408
113th CONGRESS
2d Session
S. 2422
_______________________________________________________________________
A BILL
To improve the access of veterans to medical services from the
Department of Veterans Affairs, and for other purposes.
_______________________________________________________________________
June 4, 2014
Read the second time and placed on the calendar
Introduced in Senate
Sponsor introductory remarks on measure. (CR S3369-3370)
Introduced in the Senate. Read the first time. Placed on Senate Legislative Calendar under Read the First Time. (text of measure as introduced: CR S3370-3379)
Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 408.
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