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[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 629 Reported in Senate (RS)]

<DOC>

                                                       Calendar No. 537
116th CONGRESS
  2d Session
                                 S. 629

 To require the Secretary of Veterans Affairs to review the processes 
 and requirements of the Department of Veterans Affairs for scheduling 
  appointments for health care and conducting consultations under the 
      laws administered by the Secretary, and for other purposes.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                           February 28, 2019

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

                           September 15, 2020

                Reported by Mr. Moran, with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 A BILL

 
 To require the Secretary of Veterans Affairs to review the processes 
 and requirements of the Department of Veterans Affairs for scheduling 
  appointments for health care and conducting consultations under the 
      laws administered by the Secretary, and for other purposes.

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

<DELETED>SECTION 1. SHORT TITLE.</DELETED>

<DELETED>    This Act may be cited as the ``Accountability in 
Department of Veterans Affairs Scheduling and Consult Management 
Act''.</DELETED>

<DELETED>SEC. 2. PROCESSES AND REQUIREMENTS FOR SCHEDULING APPOINTMENTS 
              FOR HEALTH CARE FROM DEPARTMENT OF VETERANS 
              AFFAIRS.</DELETED>

<DELETED>    (a) Processes and Requirements.--</DELETED>
        <DELETED>    (1) In general.--Not later than 60 days after the 
        date of the enactment of this Act, 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 description of the processes and 
        requirements of the Department of Veterans Affairs for 
        scheduling appointments for health care from the Department at 
        the medical facility level.</DELETED>
        <DELETED>    (2) Periodic revision.--</DELETED>
                <DELETED>    (A) In general.--The Secretary may revise 
                the processes and requirements required under paragraph 
                (1) as the Secretary considers necessary.</DELETED>
                <DELETED>    (B) Submittal to congress.--Not later than 
                30 days before revising the processes and requirements 
                under subparagraph (A), the Secretary shall submit to 
                the Committee on Veterans' Affairs of the Senate and 
                the Committee on Veterans' Affairs of the House of 
                Representative a description of those revised processes 
                and requirements, including a description of any 
                modifications to the certification and training under 
                subsection (b).</DELETED>
<DELETED>    (b) Training on Processes and Requirements.--</DELETED>
        <DELETED>    (1) Certification.--Not later than one year after 
        the date of the enactment of this Act, the Secretary shall 
        require individuals involved in the scheduling of appointments 
        for health care from the Department to certify to the Secretary 
        that the individual understands the processes and requirements 
        described in subsection (a), including the maximum number of 
        days allowed to complete each step of the scheduling 
        process.</DELETED>
        <DELETED>    (2) New employees.--The Secretary shall require 
        all employees hired by the Department after the date of the 
        enactment of this Act who are to be involved in the scheduling 
        of appointments for health care from the Department to undergo 
        training on the processes and requirements described in 
        subsection (a) as part of the onboarding process.</DELETED>
<DELETED>    (c) Method To Monitor Compliance.--</DELETED>
        <DELETED>    (1) In general.--Not later than 180 days after the 
        date of the enactment of this Act, the Secretary shall 
        establish or maintain a method or tool to enable real-time 
        monitoring of and ensure that each medical facility of the 
        Department complies with the scheduling processes and 
        requirements described in subsection (a), including compliance 
        with policies of the Department relating to the maximum number 
        of days allowed to complete each step of the scheduling 
        process.</DELETED>
        <DELETED>    (2) Use throughout department.--</DELETED>
                <DELETED>    (A) In general.--The Secretary shall 
                require each medical facility of the Department to use 
                the method or tool described in paragraph 
                (1).</DELETED>
                <DELETED>    (B) Certification.--Not later than one 
                year after the date of the enactment of this Act, the 
                Secretary shall require the director of each medical 
                facility of the Department to certify to the Secretary 
                that the director is using the method or tool described 
                in paragraph (1).</DELETED>
<DELETED>    (d) Comptroller General Report.--Not later than two years 
after the date of the enactment of this Act, the Comptroller General of 
the United States 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 compliance of the Secretary with the 
requirements of this section.</DELETED>

<DELETED>SEC. 3. AUDITS REGARDING SCHEDULING OF APPOINTMENTS AND 
              MANAGEMENT OF CONSULTATIONS FOR HEALTH CARE FROM 
              DEPARTMENT OF VETERANS AFFAIRS.</DELETED>

<DELETED>    (a) In General.--Not later than one year after the date of 
the enactment of this Act, and not less frequently than annually 
thereafter, the Secretary of Veterans Affairs shall provide for the 
conduct of facility-level audits of the scheduling of appointments and 
the management of consultations for health care under the laws 
administered by the Secretary.</DELETED>
<DELETED>    (b) Elements.--Each audit conducted under subsection (a) 
shall include the following:</DELETED>
        <DELETED>    (1) With respect to each medical center of the 
        Department of Veterans Affairs, an assessment of any scheduling 
        or consultation management issues at that medical center, 
        including the following:</DELETED>
                <DELETED>    (A) An assessment of non-compliance with 
                policies of the Veterans Health Administration relating 
                to scheduling appointments and managing 
                consultations.</DELETED>
                <DELETED>    (B) An assessment of the extent to which 
                appointments or consultations are not timely 
                processed.</DELETED>
                <DELETED>    (C) A description of any backlogs in 
                appointments or consultations that are awaiting 
                action.</DELETED>
                <DELETED>    (D) An assessment of whether consultations 
                are appropriately processed.</DELETED>
                <DELETED>    (E) Data with respect to consultations as 
                follows:</DELETED>
                        <DELETED>    (i) Consultations that were 
                        scheduled within the request window.</DELETED>
                        <DELETED>    (ii) Duplicate consultation 
                        requests.</DELETED>
                        <DELETED>    (iii) Consultations that were 
                        discontinued.</DELETED>
                        <DELETED>    (iv) Delays in 
                        consultations.</DELETED>
                        <DELETED>    (v) Consultations that were not 
                        properly closed or discontinued, including a 
                        description of remediation attempts.</DELETED>
                <DELETED>    (F) A review for accuracy with respect to 
                consultation management as follows:</DELETED>
                        <DELETED>    (i) A review of the accuracy of 
                        the type of service, either administrative or 
                        clinical, that is inputted in the electronic 
                        health record.</DELETED>
                        <DELETED>    (ii) A review of the accuracy of 
                        the type of consultation setting, either 
                        impatient or outpatient, that is inputted in 
                        the electronic health record.</DELETED>
                        <DELETED>    (iii) A review of the 
                        appropriateness of the level of urgency of the 
                        consultation that is inputted in the electronic 
                        health record.</DELETED>
                        <DELETED>    (iv) A review of any delayed or 
                        unresolved consultations.</DELETED>
        <DELETED>    (2) An identification of such recommendations for 
        corrective action as the Secretary considers necessary, 
        including additional training, increased personnel, and other 
        resources.</DELETED>
        <DELETED>    (3) A certification that the director of each 
        medical center of the Department is in compliance with the 
        processes and requirements described in section 2(a) and such 
        other requirements relating to the scheduling of appointments 
        and management of consultations as the Secretary considers 
        appropriate.</DELETED>
        <DELETED>    (4) With respect to referrals for health care 
        between health care providers or facilities of the Department, 
        a measurement of, for each medical facility of the Department, 
        the time it takes from the date that a clinician of the 
        Department determines that a veteran requires care from another 
        health care provider or facility to each of the 
        following:</DELETED>
                <DELETED>    (A) The date that the referral for care is 
                sent to the other health care provider or 
                facility.</DELETED>
                <DELETED>    (B) The date that the other health care 
                provider or facility accepts the referral.</DELETED>
                <DELETED>    (C) The date that the appointment with the 
                other health care provider or at the other facility is 
                made.</DELETED>
                <DELETED>    (D) The date of the appointment with the 
                other health care provider or at the other 
                facility.</DELETED>
                <DELETED>    (E) Any other step that the Secretary 
                determines necessary to measure.</DELETED>
<DELETED>    (c) Conduct of Audit by Third Party.--Each audit conducted 
under subsection (a) with respect to a medical facility of the 
Department shall be conducted by an individual or entity that is not 
affiliated with the facility.</DELETED>
<DELETED>    (d) Transmittal to VHA.--Each audit conducted under 
subsection (a) shall be transmitted to the Under Secretary for Health 
of the Department so that the Under Secretary can--</DELETED>
        <DELETED>    (1) strengthen oversight of the scheduling of 
        appointments and management of consultations throughout the 
        Department;</DELETED>
        <DELETED>    (2) monitor national policy on such scheduling and 
        management;</DELETED>
        <DELETED>    (3) determine if a mobile deployment team 
        furnished under the pilot program established under section 402 
        of the VA MISSION Act of 2018 (Public Law 115-182) is 
        warranted; and</DELETED>
        <DELETED>    (4) develop a remediation plan to address issues 
        uncovered by those audits.</DELETED>
<DELETED>    (e) Annual Report.--</DELETED>
        <DELETED>    (1) In general.--Not later than December 31 of 
        each 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 on the audits 
        conducted under subsection (a) during the year ending on that 
        date.</DELETED>
        <DELETED>    (2) Elements.--The Secretary shall include in each 
        report required by paragraph (1)--</DELETED>
                <DELETED>    (A) a description of the audits conducted 
                under subsection (a) with respect to each facility of 
                the Department;</DELETED>
                <DELETED>    (B) an assessment of how the Department 
                strengthened oversight of the scheduling of 
                appointments and management of consultations at that 
                facility as a result of those audits;</DELETED>
                <DELETED>    (C) an assessment of how those audits 
                informed the national policy of the Department with 
                respect to the scheduling of appointments and 
                management of consultations; and</DELETED>
                <DELETED>    (D) a description of any remediation plans 
                to address issues raised by those audits that were 
                completed.</DELETED>

<DELETED>SEC. 4. ADMINISTRATION OF NON-DEPARTMENT OF VETERANS AFFAIRS 
              HEALTH CARE.</DELETED>

<DELETED>    (a) Certification of Proper Administration.--</DELETED>
        <DELETED>    (1) Review.--</DELETED>
                <DELETED>    (A) In general.--The Secretary of Veterans 
                Affairs shall conduct a review of the staffing, 
                training, and other requirements necessary to 
                administer section 101 of the Veterans Access, Choice, 
                and Accountability Act of 2014 (Public Law 113-146; 38 
                U.S.C. 1701 note), section 1703 of title 38, United 
                States Code (as in effect on the date specified in 
                section 101(b) of the Caring for Our Veterans Act of 
                2018 (title I of Public Law 115-182)), and any other 
                community care program of the Department of Veterans 
                Affairs.</DELETED>
                <DELETED>    (B) Elements.--The review conducted under 
                paragraph (1) shall include, with respect to each 
                medical facility of the Department--</DELETED>
                        <DELETED>    (i) an assessment of the type of 
                        positions required to be staffed at the medical 
                        facility;</DELETED>
                        <DELETED>    (ii) the number of such positions 
                        authorized;</DELETED>
                        <DELETED>    (iii) the number of such positions 
                        filled; and</DELETED>
                        <DELETED>    (iv) the number of additional such 
                        positions required to be authorized.</DELETED>
        <DELETED>    (2) Certification.--Not later than 180 days after 
        the date of the enactment of this Act, and every 180 days 
        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 
        the results of the review conducted under paragraph (1), 
        including a certification that all staffing, training, and 
        other requirements described in paragraph (1)(A) are 
        fulfilled.</DELETED>
<DELETED>    (b) Scheduling of Appointments.--</DELETED>
        <DELETED>    (1) In general.--The Secretary shall be 
        responsible for ensuring that appointments for health care from 
        non-Department health care providers under the laws 
        administered by the Secretary are scheduled.</DELETED>
        <DELETED>    (2) Timeliness goals.--Not later than 30 days 
        after the date of the enactment of this Act, the Secretary 
        shall establish timeliness goals for each step in scheduling an 
        appointment for health care from a non-Department health care 
        provider set forth under subparagraphs (A) through (F) of 
        paragraph (3).</DELETED>
        <DELETED>    (3) Measurement of timeliness for each facility.--
        Not later than 120 days after the date of the enactment of this 
        Act, the Secretary shall measure, for each medical facility of 
        the Department, the time it takes from the date that a 
        clinician of the Department determines that a veteran requires 
        care from a non-Department health care provider to each of the 
        following:</DELETED>
                <DELETED>    (A) The date that the referral for care is 
                sent to the non-Department health care 
                provider.</DELETED>
                <DELETED>    (B) The date that the non-Department 
                health care provider accepts the referral.</DELETED>
                <DELETED>    (C) The date that the appointment with the 
                non-Department health care provider is made.</DELETED>
                <DELETED>    (D) The date that the appointment with the 
                non-Department health care provider occurs.</DELETED>
                <DELETED>    (E) The date that the referral to the non-
                Department health care provider is completed.</DELETED>
                <DELETED>    (F) Any other step that the Secretary 
                determines necessary to measure.</DELETED>
        <DELETED>    (4) Publication of data.--</DELETED>
                <DELETED>    (A) In general.--Not later than one year 
                after the date of the enactment of this Act, the 
                Secretary shall publish the data measured under 
                paragraph (3), disaggregated by medical facility, on a 
                publicly available Internet website of the 
                Department.</DELETED>
                <DELETED>    (B) Update.--Not less frequently than 
                biweekly, the Secretary shall update the data published 
                under subparagraph (A).</DELETED>
<DELETED>    (c) Comptroller General Report.--</DELETED>
        <DELETED>    (1) Review.--Beginning not later than one year 
        after the date of the enactment of this Act, the Comptroller 
        General of the United States shall review compliance by the 
        Secretary with the requirements of this section, including a 
        review of the validity and reliability of data published by the 
        Secretary under subsection (b)(4).</DELETED>
        <DELETED>    (2) Completion.--Not later than three years after 
        the date of the enactment of this Act, the Comptroller General 
        shall submit to the Committee on Veterans' Affairs of the 
        Senate and the Committee on Veterans' Affairs of the House of 
        Representatives the results of the review conducted under 
        paragraph (1).</DELETED>

<DELETED>SEC. 5. REQUESTS FOR MOBILE DEPLOYMENT TEAMS BY DIRECTORS OF 
              MEDICAL CENTERS OF DEPARTMENT OF VETERANS 
              AFFAIRS.</DELETED>

<DELETED>    (a) In General.--A director of a medical center of the 
Department of Veterans Affairs shall request from the Secretary of 
Veterans Affairs a mobile deployment team under the pilot program 
established under section 402 of the VA MISSION Act of 2018 (Public Law 
115-182) if requirements of the Department under sections 2 and 4 have 
not been met with respect to a facility under the jurisdiction of the 
director.</DELETED>
<DELETED>    (b) Report.--Not less frequently than once every 180 days, 
the Secretary shall submit to the appropriate committees of Congress a 
report setting forth each request under subsection (a) during the 
period covered by the report, including an explanation of why a mobile 
deployment team was or was not provided, as the case may be.</DELETED>
<DELETED>    (c) Appropriate Committees of Congress Defined.--In this 
section, the term ``appropriate committees of Congress'' means--
</DELETED>
        <DELETED>    (1) the Committee on Veterans' Affairs and the 
        Committee on Appropriations of the Senate; and</DELETED>
        <DELETED>    (2) the Committee on Veterans' Affairs and the 
        Committee on Appropriations of the House of 
        Representatives.</DELETED>

<DELETED>SEC. 6. EXAMINATION OF HEALTH CARE CONSULTATION AND SCHEDULING 
              POSITIONS OF DEPARTMENT OF VETERANS AFFAIRS.</DELETED>

<DELETED>    (a) Proper Grading of Consultation and Scheduling 
Positions.--</DELETED>
        <DELETED>    (1) In general.--The Secretary of Veterans Affairs 
        shall conduct an examination of health care positions of the 
        Department of Veterans Affairs to determine whether health care 
        positions involved in the consultation and scheduling processes 
        are appropriately graded.</DELETED>
        <DELETED>    (2) Consultation.--In conducting the examination 
        under paragraph (1), the Secretary shall consult with health 
        care staffing experts in the Federal Government and the private 
        sector.</DELETED>
        <DELETED>    (3) Submittal to congress.--Not later than 120 
        days after the date of the enactment of this Act, the Secretary 
        shall submit to the appropriate committees of Congress the 
        results of the examination conducted under paragraph 
        (1).</DELETED>
<DELETED>    (b) Review of Onboarding Process.--Not later than 180 days 
after the date of the enactment of this Act, the Secretary shall submit 
to the appropriate committees of Congress--</DELETED>
        <DELETED>    (1) a review of the onboarding process of 
        individuals in health care positions described in subsection 
        (a), including how long it takes to hire those individuals; 
        and</DELETED>
        <DELETED>    (2) a description of any changes that the 
        Secretary has made or plans to make to improve that 
        process.</DELETED>
<DELETED>    (c) Appropriate Committees of Congress Defined.--In this 
section, the term ``appropriate committees of Congress'' means--
</DELETED>
        <DELETED>    (1) the Committee on Veterans' Affairs and the 
        Committee on Appropriations of the Senate; and</DELETED>
        <DELETED>    (2) the Committee on Veterans' Affairs and the 
        Committee on Appropriations of the House of 
        Representatives.</DELETED>

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Accountability in Department of 
Veterans Affairs Scheduling and Consult Management Act''.

SEC. 2. PROCESS AND REQUIREMENTS FOR SCHEDULING APPOINTMENTS FOR HEALTH 
              CARE FROM DEPARTMENT OF VETERANS AFFAIRS.

    (a) Process and Requirements.--
            (1) In general.--Not later than 60 days after the date of 
        the enactment of this Act, the Secretary of Veterans Affairs 
        shall--
                    (A) establish a process and requirements for 
                scheduling appointments for health care from the 
                Department of Veterans Affairs; and
                    (B) submit to the Committee on Veterans' Affairs of 
                the Senate and the Committee on Veterans' Affairs of 
                the House of Representatives a description of such 
                process and requirements.
            (2) Elements of description.--The description of the 
        process and requirements for scheduling appointments for health 
        care from the Department required to be submitted under 
        paragraph (1)(B) shall include--
                    (A) information on how such process and 
                requirements take into account the access standards 
                established under section 1703B of title 38, United 
                States Code; and
                    (B) the maximum number of days allowed to complete 
                each step of such process.
            (3) Periodic revision.--
                    (A) In general.--The Secretary may revise the 
                process and requirements required under paragraph (1) 
                as the Secretary considers necessary.
                    (B) Submittal to congress.--Not later than 30 days 
                before revising the process and requirements under 
                subparagraph (A), 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 description of such revised process 
                and requirements, including a description of any 
                modifications to the certification and training under 
                subsection (b).
    (b) Certification and Training on Process and Requirements.--
            (1) Certification.--Not later than one year after the date 
        of the enactment of this Act, the Secretary shall require 
        individuals involved in the scheduling of appointments for 
        health care from the Department, including schedulers, clinical 
        coordinators, and supervisors, to certify to the Secretary that 
        the individual understands the process and requirements 
        established under subsection (a), including the maximum number 
        of days allowed to complete each step of such process.
            (2) New employees.--The Secretary shall require all 
        employees hired by the Department on or after the date of the 
        enactment of this Act who are to be involved in the scheduling 
        of appointments for health care from the Department--
                    (A) to undergo training on the process and 
                requirements established under subsection (a) as part 
                of training for the position for which they have been 
                hired; and
                    (B) to make the certification to the Secretary 
                required under paragraph (1).
    (c) Method to Monitor Compliance.--
            (1) In general.--Not later than 180 days after the date of 
        the enactment of this Act, the Secretary shall establish or 
        maintain a method or tool--
                    (A) to enable monitoring of the compliance of the 
                Department with the process and requirements 
                established under subsection (a), including compliance 
                with policies of the Department relating to the maximum 
                number of days allowed to complete each step of such 
                process; and
                    (B) to ensure that each medical facility of the 
                Department complies with such process and requirements.
            (2) Use throughout department.--
                    (A) In general.--The Secretary shall require each 
                medical facility of the Department to use the method or 
                tool described in paragraph (1).
                    (B) Report.--Not later than one year 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 indicating whether 
                each medical facility of the Department is using the 
                method or tool described in paragraph (1).
    (d) Comptroller General Report.--Not later than two years after the 
date of the enactment of this Act, the Comptroller General of the 
United States 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 compliance of the Secretary with the 
requirements of this section.

SEC. 3. AUDITS REGARDING SCHEDULING OF APPOINTMENTS AND MANAGEMENT OF 
              CONSULTATIONS FOR HEALTH CARE FROM DEPARTMENT OF VETERANS 
              AFFAIRS.

    (a) In General.--Not later than each of one year and two years 
after the date of the enactment of this Act, the Secretary of Veterans 
Affairs shall provide for the conduct of a facility-level audit of the 
scheduling of appointments and the management of consultations for 
health care under the laws administered by the Secretary.
    (b) Application.--
            (1) First audit.--The first audit required under subsection 
        (a) shall apply to each medical facility of the Department of 
        Veterans Affairs.
            (2) Second audit.--The second audit required under 
        subsection (a) shall apply to only those medical facilities of 
        the Department that did not fare well in the first audit and 
        are in need of corrective action, as determined by the 
        Secretary.
    (c) Elements.--Each audit conducted under subsection (a) shall 
include the following:
            (1) With respect to each medical center of the Department 
        covered by the audit, an assessment of any scheduling or 
        consultation management issues at that medical center, 
        including the following:
                    (A) An assessment of noncompliance with policies of 
                the Veterans Health Administration relating to 
                scheduling appointments and managing consultations.
                    (B) An assessment of the extent to which 
                appointments or consultations are not timely processed.
                    (C) A description of any backlogs in appointments 
                or consultations that are awaiting action.
                    (D) An assessment of whether consultations are 
                appropriately processed.
                    (E) Data with respect to consultations as follows:
                            (i) Consultations that were scheduled 
                        within the request window.
                            (ii) Duplicate consultation requests.
                            (iii) Consultations that were discontinued.
                            (iv) Delays in consultations.
                            (v) Consultations that were not properly 
                        closed or discontinued, including a description 
                        of remediation attempts.
                    (F) A review for accuracy with respect to 
                consultation management as follows:
                            (i) A review of the accuracy of the type of 
                        service, either administrative or clinical, 
                        that is inputted in the electronic health 
                        record.
                            (ii) A review of the accuracy of the type 
                        of consultation setting, either impatient or 
                        outpatient, that is inputted in the electronic 
                        health record.
                            (iii) A review of the appropriateness of 
                        the level of urgency of the consultation that 
                        is inputted in the electronic health record.
                            (iv) A review of any delayed or unresolved 
                        consultations.
            (2) An identification of such recommendations for 
        corrective action as the Secretary considers necessary, 
        including additional training, increased personnel, and other 
        resources.
            (3) A certification that the director of each medical 
        center of the Department covered by the audit is in compliance 
        with the process and requirements established under section 
        2(a) and such other requirements relating to the scheduling of 
        appointments and management of consultations as the Secretary 
        considers appropriate.
            (4) With respect to referrals for health care between 
        health care providers or facilities of the Department, a 
        measurement of, for each medical facility of the Department 
        covered by the audit, the time it takes from the date that a 
        clinician of the Department determines that a veteran requires 
        care from another health care provider or facility to each of 
        the following:
                    (A) The date that the referral for care is sent to 
                the other health care provider or facility.
                    (B) The date that the other health care provider or 
                facility accepts the referral.
                    (C) The date that the appointment with the other 
                health care provider or at the other facility is made.
                    (D) The date of the appointment with the other 
                health care provider or at the other facility.
                    (E) Any other step that the Secretary determines 
                necessary to measure.
    (d) Conduct of Audit by Third Party.--Each audit conducted under 
subsection (a) with respect to a medical facility of the Department 
shall be conducted by an individual or entity that is not affiliated 
with the facility.
    (e) Transmittal to VHA.--Each audit conducted under subsection (a) 
shall be transmitted to the Under Secretary for Health of the 
Department so that the Under Secretary can--
            (1) strengthen oversight of the scheduling of appointments 
        and management of consultations throughout the Department;
            (2) monitor national policy on such scheduling and 
        management; and
            (3) develop a remediation plan to address issues uncovered 
        by those audits.
    (f) Annual Report.--
            (1) In general.--Not later than December 31 of each year in 
        which an audit is conducted under subsection (a), 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 audit conducted during that 
        year.
            (2) Elements.--The Secretary shall include in each report 
        required by paragraph (1)--
                    (A) a description of the audits conducted under 
                subsection (a) with respect to each facility of the 
                Department covered by such audits;
                    (B) an assessment of how the Department 
                strengthened oversight of the scheduling of 
                appointments and management of consultations at that 
                facility as a result of those audits;
                    (C) an assessment of how those audits informed the 
                national policy of the Department with respect to the 
                scheduling of appointments and management of 
                consultations; and
                    (D) a description of any remediation plans to 
                address issues raised by those audits that were 
                completed.

SEC. 4. ADMINISTRATION OF NON-DEPARTMENT OF VETERANS AFFAIRS HEALTH 
              CARE.

    (a) Certification of Proper Administration of Non-Department 
Care.--
            (1) Review.--
                    (A) In general.--The Secretary of Veterans Affairs 
                shall conduct a review of the staffing, training, and 
                other requirements necessary to administer section 1703 
                of title 38, United States Code.
                    (B) Elements.--The review conducted under 
                subparagraph (A) shall include, with respect to each 
                medical facility of the Department--
                            (i) an assessment of the type of positions 
                        required to be staffed at the medical facility;
                            (ii) the number of such positions 
                        authorized;
                            (iii) the number of such positions filled; 
                        and
                            (iv) the number of additional such 
                        positions required to be authorized.
            (2) Submittal to congress.--Not later than 180 days after 
        the date of the enactment of this Act, and every 180 days 
        thereafter, 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) the results of the review conducted under 
                paragraph (1); and
                    (B) a certification that the Secretary has 
                established all staffing, training, and other 
                requirements required to be reviewed under such 
                paragraph.
    (b) Scheduling of Appointments.--
            (1) In general.--The Secretary shall be responsible for 
        ensuring that appointments for health care from non-Department 
        of Veterans Affairs health care providers under section 1703 of 
        title 38, United States Code, are scheduled.
            (2) Timeliness goals.--Not later than 30 days after the 
        date of the enactment of this Act, the Secretary shall 
        establish timeliness goals for each step in scheduling an 
        appointment for health care from a non-Department health care 
        provider set forth under subparagraphs (A) through (F) of 
        paragraph (3).
            (3) Measurement of timeliness for each facility.--Not later 
        than 120 days after the date of the enactment of this Act, the 
        Secretary shall measure, for each medical facility of the 
        Department, the time it takes from the date that a clinician of 
        the Department determines that a veteran requires care, or a 
        veteran presents to the Department requesting care, from a non-
        Department health care provider to each of the following:
                    (A) The date that the referral for care is sent to 
                a non-Department health care provider.
                    (B) The date that a non-Department health care 
                provider accepts the referral.
                    (C) The date that the referral to a non-Department 
                health care provider is completed.
                    (D) The date that an appointment with a non-
                Department health care provider is made.
                    (E) The date that an appointment with a non-
                Department health care provider occurs.
                    (F) Any other step that the Secretary determines 
                necessary to measure.
            (4) Publication of data.--
                    (A) In general.--Not later than one year after the 
                date of the enactment of this Act, the Secretary shall 
                publish the data measured under paragraph (3), 
                disaggregated by medical facility, on a publicly 
                available website of the Department.
                    (B) Update.--Not less frequently than biweekly, the 
                Secretary shall update the data published under 
                subparagraph (A).
            (5) Method to monitor compliance.--Not later than 180 days 
        after the date of the enactment of this Act, the Secretary 
        shall establish or maintain a method or tool--
                    (A) to enable monitoring of compliance by each 
                medical facility of the Department with the timeliness 
                goals established under paragraph (2); and
                    (B) to ensure that each medical facility of the 
                Department complies such timeliness goals.
    (c) Comptroller General Report.--
            (1) Review.--Beginning not later than one year after the 
        date of the enactment of this Act, the Comptroller General of 
        the United States shall review compliance by the Secretary with 
        the requirements of this section, including a review of the 
        validity and reliability of data published by the Secretary 
        under subsection (b)(4).
            (2) Report.--Not later than three years after the date of 
        the enactment of this Act, the Comptroller General shall submit 
        to the Committee on Veterans' Affairs of the Senate and the 
        Committee on Veterans' Affairs of the House of Representatives 
        the results of the review conducted under paragraph (1).

SEC. 5. EXAMINATION OF HEALTH CARE CONSULTATION AND SCHEDULING 
              POSITIONS OF DEPARTMENT OF VETERANS AFFAIRS.

    (a) Proper Grading of Consultation and Scheduling Positions.--
            (1) In general.--The Secretary of Veterans Affairs shall 
        conduct an examination of health care positions of the 
        Department of Veterans Affairs to determine whether health care 
        positions involved in the consultation and scheduling processes 
        are appropriately graded.
            (2) Consultation.--In conducting the examination under 
        paragraph (1), the Secretary shall consult with health care 
        staffing experts in the Federal Government and the private 
        sector.
            (3) Submittal to congress.--Not later than 120 days after 
        the date of the enactment of this Act, the Secretary shall 
        submit to the appropriate committees of Congress the results of 
        the examination conducted under paragraph (1).
    (b) Review of Onboarding Process.--Not later than 180 days after 
the date of the enactment of this Act, the Secretary shall submit to 
the appropriate committees of Congress--
            (1) a review of the onboarding process of individuals in 
        health care positions described in subsection (a), including 
        how long it takes to hire those individuals; and
            (2) a description of any changes that the Secretary has 
        made or plans to make to improve that process.
    (c) Appropriate Committees of Congress Defined.--In this section, 
the term ``appropriate committees of Congress'' means--
            (1) the Committee on Veterans' Affairs and the Committee on 
        Appropriations of the Senate; and
            (2) the Committee on Veterans' Affairs and the Committee on 
        Appropriations of the House of Representatives.
                                                       Calendar No. 537

116th CONGRESS

  2d Session

                                 S. 629

_______________________________________________________________________

                                 A BILL

 To require the Secretary of Veterans Affairs to review the processes 
 and requirements of the Department of Veterans Affairs for scheduling 
  appointments for health care and conducting consultations under the 
      laws administered by the Secretary, and for other purposes.

_______________________________________________________________________

                           September 15, 2020

                       Reported with an amendment
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