69–006 

115TH CONGRESS REPT. 115–149 " ! HOUSE OF REPRESENTATIVES 1st Session Part 1 

VA SCHEDULING ACCOUNTABILITY ACT 

MAY 23, 2017.—Committed to the Committee of the Whole House on the State of 

the Union and ordered to be printed 

Mr. ROE of Tennessee, from the Committee on Veterans’ Affairs, 

submitted the following 

R E P O R T 

[To accompany H.R. 467] 

[Including cost estimate of the Congressional Budget Office] 

The Committee on Veterans’ Affairs, to whom was referred the 

bill (H.R. 467) to direct the Secretary of Veterans Affairs to ensure 

that each medical facility of the Department of Veterans Affairs 

complies with requirements relating to scheduling veterans for 

health care appointments, to improve the uniform application of directives of the Department, and for other purposes, having considered the same, report favorably thereon without amendment and 

recommend that the bill do pass. 

CONTENTS 

Page 

Purpose and Summary ............................................................................................ 2 

Background and Need for Legislation .................................................................... 2 

Hearings ................................................................................................................... 2 

Subcommittee Consideration .................................................................................. 3 

Committee Consideration ........................................................................................ 3 

Committee Votes ...................................................................................................... 3 

Committee Correspondence .................................................................................... 4 

Committee Oversight Findings ............................................................................... 6 

Statement of General Performance Goals and Objectives .................................... 6 

New Budget Authority, Entitlement Authority, and Tax Expenditures ............. 6 

Earmarks and Tax and Tariff Benefits .................................................................. 6 

Committee Cost Estimate ....................................................................................... 6 

Congressional Budget Office Estimate ................................................................... 6 

Federal Mandates Statement ................................................................................. 7 

Advisory Committee Statement .............................................................................. 7 

Constitutional Authority Statement ...................................................................... 7 

Applicability to Legislative Branch ........................................................................ 7 

Statement on Duplication of Federal Programs .................................................... 7 

Disclosure of Directed Rulemaking ........................................................................ 8 

Section-by-Section Analysis of the Legislation ...................................................... 8 

Changes in Existing Law Made by the Bill as Reported ...................................... 8 

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1 VHA Directive 2010–027, VHA Outpatient Scheduling Processes and Procedure 

PURPOSE AND SUMMARY

H.R. 467, the ‘‘VA Scheduling Accountability Act,’’ was introduced by Representative Jackie Walorski of Indiana on January 12, 

2017. 

H.R. 467 would require that each director of a VA medical center 

annually certify compliance with VA’s existing patient scheduling 

directive (or any successor directive that replaces it) and report to 

Congress. 

BACKGROUND AND NEED FOR LEGISLATION

Section 2. Compliance with scheduling requirements 

Veterans Health Administration (VHA) Directive 2010–027, VHA 

Outpatient Scheduling Processes and Procedures, provides national 

policy for scheduling outpatient clinic appointments and for ensuring the competency of staff directly or indirectly involved in the 

scheduling process.1 This June 2010 directive requires annual certification of full compliance with the content of the directive. In 

May 2013, the then-VA Deputy Under Secretary for Health for Operations Management waived the requirement for facility directors 

to certify compliance with VHA Directive 2010–027. Subsequently, 

in April 2014, the Committee uncovered the use of unauthorized 

waiting lists at the Phoenix VA Health Care System in Phoenix, 

Arizona. This revelation—and the investigations that resulted from 

it—found that no less than 40 veterans died while on these waiting 

lists and led to a widespread, systemic access and accountability 

scandal. Though VA has since reinstated the certification requirement for VHA Directive 2010–027, non-compliance with VA’s 

scheduling policies was a primary factor behind the 2014 access crisis, the repercussions of which continue today. 

The Committee continues to be concerned about both the integrity of VA wait time data and individual medical facilities’ compliance with VA scheduling policies. Section 2 of the bill would require VA medical center directors to certify annually that their facility is in compliance with the scheduling directive (or any successor directive that replaces it), prohibit VA from waiving certification, and require VA to report to Congress on individual medical 

facilities’ compliance. To ensure accountability for poor-performing 

facilities, section 2 of the bill would also prohibit VA medical center 

leaders from receiving awards or bonuses if their VA medical center fails to certify compliance with the scheduling directive (or any 

successor directive that replaces it). 

HEARINGS

There were no full Committee hearings held on H.R. 467. 

On March 29, 2017, the Subcommittee on Health conducted a 

legislative hearing on a number of bills including H.R. 467. 

The following witnesses testified: 

The Honorable David. P. Roe M.D. of Tennessee; The Honorable Jackie Walorski of Indiana; The Honorable Doug Collins 

of Georgia; The Honorable Mike Coffman of Colorado; The 

Honorable Stephen Knight of California; The Honorable Ann 

M. Kuster of New Hampshire; Jennifer S. Lee, M.D., the DepVerDate Sep 11 2014 01:03 May 27, 2017 Jkt 069006 PO 00000 Frm 00002 Fmt 6659 Sfmt 6602 E:\HR\OC\HR149P1.XXX HR149P1
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uty Under Secretary for Health for Policy and Services for the 

Veterans Health Administration of the U.S. Department of 

Veterans Affairs who was accompanied by Susan Blauert, the 

Chief Counsel for the Health Care Law Group of the Office of 

the General Counsel for the U.S. Department of Veterans Affairs; Kayda Keleher, Legislative Associate for the National 

Legislative Service of the Veterans of Foreign Wars of the 

United States; Shurhonda Y. Love, the Assistant National Legislative Director for the Disabled American Veterans; and, 

Sarah S. Dean, the Associate Legislative Director for the Paralyzed Veterans of America. 

Statements for the record were submitted by: 

The Honorable Lee Zeldin of New York; The American Legion; the National Association of State Veteran Homes; Swords 

to Plowshares; and, the Wounded Warrior Project. 

SUBCOMMITTEE CONSIDERATION

On April 6, 2017, the Subcommittee on Health met in an open 

markup session, a quorum being present, and ordered H.R. 467 to 

be reported favorably to the Full Committee by voice vote. 

COMMITTEE CONSIDERATION

On May 17, 2017, the Full Committee met in open markup session, a quorum being present, and ordered H.R. 467 to be reported 

favorably to the House of Representatives by voice vote. A motion 

by Representative Tim Walz of Minnesota, Ranking Member of the 

Committee on Veterans’ Affairs, to report H.R. 467 favorably to the 

House of Representatives was agreed to by voice vote. 

COMMITTEE VOTES

In compliance with clause 3(b) of rule XIII of the Rules of the 

House of Representatives, there were no recorded votes taken on 

amendments or in connection with ordering H.R. 467 reported to 

the House. 

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COMMITTEE OVERSIGHT FINDINGS

In compliance with clause 3(c)(1) of rule XIII and clause (2)(b)(1) 

of rule X of the Rules of the House of Representatives, the Committee’s oversight findings and recommendations are reflected in the 

descriptive portions of this report. 

STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

In accordance with clause 3(c)(4) of rule XIII of the Rules of the 

House of Representatives, the Committee’s performance goals and 

objectives are to ensure that VA medical facilities are in compliance with scheduling directives. 

NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND TAX

EXPENDITURES

In compliance with clause 3(c)(2) of rule XIII of the Rules of the 

House of Representatives, the Committee adopts as its own the estimate of new budget authority, entitlement authority, or tax expenditures or revenues contained in the cost estimate prepared by 

the Director of the Congressional Budget Office pursuant to section 

402 of the Congressional Budget Act of 1974. 

EARMARKS AND TAX AND TARIFF BENEFITS

H.R. 467 does not contain any Congressional earmarks, limited 

tax benefits, or limited tariff benefits as defined in clause 9 of rule 

XXI of the Rules of the House of Representatives. 

COMMITTEE COST ESTIMATE

The Committee adopts as its own the cost estimate on H.R. 467 

prepared by the Director of the Congressional Budget Office pursuant to section 402 of the Congressional Budget Act of 1974. 

CONGRESSIONAL BUDGET OFFICE COST ESTIMATE

Pursuant to clause 3(c)(3) of rule XIII of the Rules of the House 

of Representatives, the following is the cost estimate for H.R. 467 

provided by the Congressional Budget Office pursuant to section 

402 of the Congressional Budget Act of 1974: 

U.S. CONGRESS, 

CONGRESSIONAL BUDGET OFFICE, 

Washington, DC, May 19, 2017. 

Hon. PHIL ROE, M.D., 

Chairman, Committee on Veterans’ Affairs, 

House of Representatives, Washington, DC. 

DEAR MR. CHAIRMAN: The Congressional Budget Office has prepared the enclosed cost estimate for H.R. 467, the VA Scheduling 

Accountability Act. 

If you wish further details on this estimate, we will be pleased 

to provide them. The CBO staff contact is Ann E. Futrell. 

Sincerely, 

KEITH HALL. 

Enclosure. 

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H.R. 467—VA Scheduling Accountability Act 

H.R. 467 would require the Department of Veterans Affairs (VA) 

to ensure that the director of each medical facility of the department certify annually that the facility is in full compliance with the 

laws and regulations pertaining to scheduling medical appointments. That requirement would codify VA’s current practice, as 

specified under Directive 2010–027. The bill also would prohibit VA 

from paying bonuses to senior staff in facilities that are not able 

to certify such compliance. CBO expects that few, if any, bonuses 

would be denied under this provision. 

In addition, the bill would require VA to ensure that directives 

and policies are being implemented in a uniform manner across the 

department. To accomplish that requirement, CBO expects VA 

would distribute regular guidance through electronic correspondence. On that basis, CBO estimates that implementing H.R. 467 

would cost less than $500,000 over the 2018–2022 period; any such 

spending would be subject to the availability of appropriated funds. 

Enacting H.R. 467 would not affect direct spending or revenues; 

therefore, pay-as-you-go procedures do not apply. CBO estimates 

that enacting H.R. 467 would not increase net direct spending or 

on-budget deficits in any of the four consecutive 10-year periods beginning in 2028. 

H.R. 467 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act, and would 

not affect the budgets of state, local, or tribal governments. 

The CBO staff contact for this estimate is Ann E. Futrell. The 

estimate was approved by H. Samuel Papenfuss, Deputy Assistant 

Director for Budget Analysis. 

FEDERAL MANDATES STATEMENT

The Committee adopts as its own the estimate of Federal mandates regarding H.R. 467 prepared by the Director of the Congressional Budget Office pursuant to section 423 of the Unfunded Mandates Reform Act. 

ADVISORY COMMITTEE STATEMENT

No advisory committees within the meaning of section 5(b) of the 

Federal Advisory Committee Act would be created by H.R. 467. 

STATEMENT OF CONSTITUTIONAL AUTHORITY

Pursuant to Article I, section 8 of the United States Constitution, 

H.R. 467 is authorized by Congress’ power to ‘‘provide for the common Defense and general Welfare of the United States.’’ 

APPLICABILITY TO LEGISLATIVE BRANCH

The Committee finds that H.R. 467 does not relate to the terms 

and conditions of employment or access to public services or accommodations within the meaning of section 102(b)(3) of the Congressional Accountability Act. 

STATEMENT ON DUPLICATION OF FEDERAL PROGRAMS

Pursuant to section 3(g) of H. Res. 5, 114th Cong. (2015), the 

Committee finds that no provision of H.R. 467 establishes or reauthorizes a program of the Federal Government known to be dupliVerDate Sep 11 2014 01:03 May 27, 2017 Jkt 069006 PO 00000 Frm 00007 Fmt 6659 Sfmt 6602 E:\HR\OC\HR149P1.XXX HR149P1
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cative of another Federal program, a program that was included in 

any report from the Government Accountability Office to Congress 

pursuant to section 21 of Public Law 111–139, or a program related 

to a program identified in the most recent Catalog of Federal Domestic Assistance. 

DISCLOSURE OF DIRECTED RULEMAKING

Pursuant to section 3(i) of H. Res. 5, 114th Cong. (2015), the 

Committee estimates that H.R. 467 contains no directed rulemaking that would require the Secretary to prescribe regulations. 

SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION

Section 1. Short title 

Section 1 of the bill would provide the short title to H.R. 467 as 

the ‘‘VA Scheduling Accountability Act.’’ 

Section 2. Compliance with scheduling requirements 

Section 2(a)(1) of the bill would require that the Secretary ensure 

that the director of each center annually certifies that the medical 

facility is in full compliance with all provisions of law and regulations relating to scheduling medical appointments, including pursuant to VHA Directive 2010–027 or any successor directive. 

Section 2(a)(2) of the bill would prohibit VA from waiving any 

provision of such laws or regulations. 

Section 2(b) of the bill would require that if a director of a facility 

fails to certify compliance pursuant to section 4(a)(1) of the bill for 

any year, the director must submit to the Secretary a report containing an explanation of why the director cannot certify the facility and a description of actions taken to ensure compliance in the 

future. 

Section 2(c)(1) of the bill would prohibit ‘‘covered officials’’ from 

receiving any award or bonus the following year if the facility director cannot certify the facility. 

Section 2(c)(2) of the bill would define a ‘‘covered official’’ as an 

official who works in a VA facility that cannot be certified and 

holds one of the following positions: director; chief of staff; associate 

director; associate director for patient care; or, deputy chief of staff. 

Section 2(d) of the bill would require that the Secretary submit 

annually to the Committees on Veterans’ Affairs of the U.S. House 

of Representatives and the U.S. Senate a report that includes a list 

of each medical facility for which a certification was made during 

the preceding year and a list of each medical facility for which a 

certification was not made during the preceding year, along with 

a copy of each report submitted to the Secretary under subsection 

(4)(b) of the bill for the preceding year. 

CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED

If enacted, this bill would make no changes in existing law. 

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