Veterans Affairs Medical Scribe Pilot Act of 2017

Summary: Veterans Affairs Medical Scribe Pilot Act of 2017 (Sec. 2) This bill directs the Department of Veterans Affairs (VA) to carry out a two-year pilot program under which it shall increase the use of medical scribes at VA medical centers.  The bill defines &quot;medical scribe&quot; as an unlicensed individual hired to enter information into the electronic health record or chart at the direction of a physician or licensed independent practitioner whose responsibilities include:  assisting the physician or practitioner in navigating the electronic health record; and responding to various messages and entering information into such record, as directed by the physician or practitioner.   The VA shall carry out the program at four VA medical centers located in rural areas, four located in urban areas, and two located in areas with need for increased access or increased efficiency.  The VA shall: (1) hire 20 new VA term employees as medical scribes and seek to enter into contracts for the employment of 20 additional scribes, (2) assign four scribes to each VA medical center where the program is conducted, (3) assign two scribes to each of two physicians, (4) employ 30% of the scribes in the provision of emergency care, and (5) employ 70% of the scribes in the provision of care in specialties with the longest patient wait times or lowest efficiency ratings.  (Sec. 3) The bill replaces a provision authorizing the VA to furnish tobacco to veterans receiving hospital or domiciliary care with provisions prohibiting any person from smoking: (1) indoors in any Veterans Health Administration (VHA) facility, (2) indoors in a VHA community living center on or after December 31, 2018, and (3) outdoors at any VHA facility on or after October 1, 2021. 

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Veterans Affairs Medical Scribe 
Pilot Act of 2017''.

SEC. 2. DEPARTMENT OF VETERANS AFFAIRS MEDICAL SCRIBE PILOT PROGRAM.

    (a) In General.--The Secretary of Veterans Affairs shall carry out 
a 2-year pilot program under which the Secretary shall increase the use 
of medical scribes at Department of Veterans Affairs medical centers.
    (b) Locations.--The Secretary shall carry out the pilot program at 
the 10 medical centers of the Department as follows:
            (1) At least four such medical centers located in rural 
        areas.
            (2) At least four such medical centers located in urban 
        areas.
            (3) Two such medical centers located in areas with need for 
        increased access or increased efficiency, as determine by the 
        Secretary.
    (c) Medical Scribes.--
            (1) Hiring.--Under the pilot program the Secretary shall--
                    (A) hire 20 new Department of Veterans Affairs term 
                employees as medical scribes; and
                    (B) seek to enter into contracts with appropriate 
                entities for the employment of 20 additional medical 
                scribes.
            (2) Distribution.--The Secretary shall assign four medical 
        scribes to each of the 10 medical centers of the Department 
        where the Secretary carries out the pilot program as follows:
                    (A) Two scribes shall be assigned to each of two 
                physicians.
                    (B) Thirty percent of the scribes shall be employed 
                in the provision of emergency care.
                    (C) Seventy percent of the scribes shall be 
                employed in the provision of speciality care in 
                specialties with the longest patient wait times or 
                lowest efficiency ratings, as determined by the 
                Secretary.
    (d) Reports.--
            (1) Reports to congress.--Not later than 180 days after the 
        commencement of the pilot program required under this section, 
        and every 180 days thereafter for the duration of the pilot 
        program, the Secretary of Veterans Affairs shall submit to 
        Congress a report on the pilot program. Each such report shall 
        include each of the following:
                    (A) A separate analysis of each the following with 
                respect to medical scribes employed by the Department 
                of Veterans Affairs and medical scribes performing 
                Department of Veterans Affairs functions under a 
                contract:
                            (i) Provider efficiency.
                            (ii) Patient satisfaction.
                            (iii) Average wait time.
                            (iv) The number of patients seen per day by 
                        each physician or practitioner.
                            (v) The amount of time required to hire and 
                        train an employee to perform medical scribe 
                        functions under the pilot program.
                    (B) Metrics and data for analyzing the effects of 
                the pilot program, including an evaluation of the each 
                of the elements under clauses (i) through (iv) of 
                subparagraph (A) at medical centers who employed 
                scribes under the pilot program for an appropriate 
                period preceding the hiring of such scribes.
            (2) Comptroller general report.--Not later than 90 days 
        after the termination of the pilot program under this section, 
        the Comptroller General of the United States shall submit to 
        Congress a report on the pilot program. Such report shall 
        include a comparison of the pilot program with similar programs 
        carried out in the private sector.
    (e) Definitions.--In this section:
            (1) The term ``medical scribe'' means an unlicensed 
        individual hired to enter information into the electronic 
        health record or chart at the direction of a physician or 
        licensed independent practitioner whose responsibilities 
        include the following:
                    (A) Assisting the physician or practitioner in 
                navigating the electronic health record.
                    (B) Responding to various messages as directed by 
                the physician or practitioner.
                    (C) Entering information into the electronic health 
                record, as directed by the physician or practitioner.
            (2) The terms ``urban'' and ``rural'' have the meanings 
        given such terms under the rural-urban commuting codes 
        developed by the Secretary of Agriculture and the Secretary of 
        Health and Human Services.
    (f) Funding.--The pilot program under this section shall be carried 
out using amounts otherwise authorized to be appropriated for the 
Department of Veterans Affairs. No additional amounts are authorized to 
be appropriated to carry out such program.

SEC. 3. PROHIBITION ON SMOKING IN FACILITIES OF THE VETERANS HEALTH 
              ADMINISTRATION.

    (a) Prohibition.--Section 1715 of title 38, United States Code, is 
amended to read as follows:
``Sec. 1715. Prohibition on smoking in facilities of the Veterans 
              Health Administration
    ``(a) Prohibition.--(1)(A) Except as provided in subparagraph (B), 
no person may smoke indoors in any facility of the Veterans Health 
Administration.
    ``(B) In the case of a facility of the Veterans Health 
Administration that is a community living center, no person may smoke 
indoors in such facility on or after December 31, 2018.
    ``(2) No person may smoke outdoors in any facility of the Veterans 
Health Administration on or after October 1, 2021.
    ``(b) Definitions.--In this section:
            ``(1) The term `smoke' includes the smoking of cigarettes 
        (including e-cigarettes or electronic cigarettes), cigars, 
        pipes, and any other combustion of tobacco.
            ``(2) The term `facility of the Veterans Health 
        Administration' means any land or building (including any 
        medical center, nursing home, domiciliary facility, outpatient 
        clinic, or center that provides readjustment counseling) that 
        is--
                    ``(A) under the jurisdiction of the Department of 
                Veterans Affairs;
                    ``(B) under the control of the Veterans Health 
                Administration; and
                    ``(C) not under the control of the General Services 
                Administration.
            ``(3) The term `community living center' means a facility 
        of the Department that provides nursing home care.''.
    (b) Conforming Amendments.--
            (1) The table of sections at the beginning of chapter 17 of 
        such title is amended by striking the item relating to section 
        1715 and inserting the following:

``1715. Prohibition on smoking in facilities of the Veterans Health 
                            Administration.''.
            (2) Section 526 of the Veterans Health Care Act of 1992 
        (Public Law 102-585) is repealed.
    (c) Effective Date.--This section shall take effect 90 days after 
the date of the enactment of this Act.

            Passed the House of Representatives July 24, 2017.

            Attest:

                                                 KAREN L. HAAS,

                                                                 Clerk.