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[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 543 Introduced in Senate (IS)]

113th CONGRESS
  1st Session
                                 S. 543

To require the Secretary of Veterans Affairs to reorganize the Veterans 
Integrated Service Networks of the Veterans Health Administration, and 
                          for other purposes.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                             March 13, 2013

 Mr. Burr (for himself and Mr. Coburn) introduced the following bill; 
which was read twice and referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL

 
To require the Secretary of Veterans Affairs to reorganize the Veterans 
Integrated Service Networks of the Veterans Health Administration, 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.

    This Act may be cited as the ``VISN Reorganization Act of 2013''.

SEC. 2. ADMINISTRATION OF VETERANS INTEGRATED SERVICE NETWORKS.

    (a) Veterans Integrated Service Networks.--
            (1) In general.--Subchapter I of chapter 73 of title 38, 
        United States Code, is amended by adding at the end the 
        following new section:
``Sec. 7310. Veterans Integrated Service Networks
    ``(a) Organization.--The Secretary shall organize the Veterans 
Health Administration in 12 geographically defined Veterans Integrated 
Service Networks.
    ``(b) Alignment With Mission of Department.--The Secretary shall 
ensure that the staff, services, and programs of each Veterans 
Integrated Service Network are aligned with the mission of the 
Department and the specific health care requirements of each population 
of veterans in each Network.
    ``(c) Implementation of National Goals.--The Secretary shall ensure 
that each Veterans Integrated Service Network takes appropriate 
measures to implement the national goals of the Department within their 
networks and associated medical centers.
    ``(d) Integrated Health Care System.--The Secretary shall ensure 
that each Veterans Integrated Service Network maintains a regional 
integrated healthcare system by--
            ``(1) implementing alliances with such other governmental, 
        public, and private health care organizations and practitioners 
        as the Secretary considers appropriate to meet the needs of 
        veterans in the Network;
            ``(2) providing oversight and management of, and taking 
        responsibility for, a regional budget for the activities of the 
        Veterans Health Administration in the geographic area of the 
        Network that--
                    ``(A) is aligned with the budget guidelines of the 
                Department and the Veterans Health Administration; and
                    ``(B) is balanced at the end of each fiscal year;
            ``(3) using national metrics to develop systems to provide 
        effective, efficient, and safe delivery of health care that is 
        rated as highly satisfactory by patients and families of 
        patients; and
            ``(4) ensuring high quality clinical programs and services 
        are rendered in and through--
                    ``(A) the medical centers and outpatient clinics of 
                the Department that are located in the Network; and
                    ``(B) other non-Department clinical or health care 
                delivery settings located in the Network.
    ``(e) Reduction in Duplicate Functions.--The Secretary shall ensure 
that the Veterans Integrated Service Networks identify and reduce, 
whenever practicable, the duplication of functions in clinical, 
administrative, and operational processes and practices of the Veterans 
Health Administration.
    ``(f) Collaboration and Cooperation.--The Secretary shall ensure 
that each Veteran Integrated Service Network--
            ``(1) works to achieve maximum effectiveness in patient 
        care and safety, graduate medical education, and research; and
            ``(2) assesses the consolidation or realignment of 
        institutional functions, including capital asset, safety, and 
        operational support functions, in collaboration and cooperation 
        with other Veterans Integrated Service Networks and the 
        following offices or entities within the geographical area of 
        the Network:
                    ``(A) The offices of the Veterans Benefits 
                Administration and the National Cemetery 
                Administration.
                    ``(B) The offices, installations, and facilities of 
                the Department of Defense, including the offices, 
                installations, and facilities of each branch of the 
                Armed Forces and the reserve components of the Armed 
                Forces.
                    ``(C) The offices, installations, and facilities of 
                the Coast Guard.
                    ``(D) Offices of State and local agencies that have 
                a mission to provide assistance to veterans.
                    ``(E) Medical schools and other affiliates.
                    ``(F) Offices of Congress, offices of State and 
                local elected officials, and other government offices.
                    ``(G) Federal, State and local emergency 
                preparedness organizations.
                    ``(H) Community and faith-based organizations.
                    ``(I) Such other offices of the Federal Government 
                as the Secretary considers appropriate.
    ``(g) Development and Sharing of Innovations and Practices.--The 
Secretary shall ensure that the Veterans Integrated Service Networks 
develop and share innovations and best practices with each other at the 
local, regional, and national levels.
    ``(h) Headquarters.--(1) The Secretary shall ensure that each 
Veterans Integrated Service Network has only one headquarters office.
    ``(2) The location of a headquarters office for a Veterans 
Integrated Service Network shall be determined by the Secretary and co-
located with a Department of Veterans Affairs medical center.
    ``(3)(A) The Secretary may employ or contract for the services of 
not more than 65 full time equivalent employees and contractors at the 
headquarters of each Veterans Integrated Service Network.
    ``(B) Not less frequently than once 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 employment at the headquarters of Veterans Integrated Service 
Networks during the most recently completed fiscal year.
    ``(C) Each report submitted under subparagraph (B) shall include 
the following for the year covered by the report:
            ``(i) The number of individuals employed at each 
        headquarters of a Veterans Integrated Service Network.
            ``(ii) The number of individuals employed by the Veterans 
        Health Administration in each Veterans Integrated Service 
        Network who are not employed at the same location as the 
        headquarters of the Network.
            ``(iii) The title for each position of employment at a 
        headquarters of a Veterans Integrated Service Network.
            ``(iv) The title for each position of employment with the 
        Veterans Health Administration in each Veterans Integrated 
        Service Network that is not at the same location as the 
        headquarters of the Network.
            ``(v) An assessment of the impact on the budget of the 
        Department by the employment of individuals at the headquarters 
        of the Veterans Integrated Service Networks.
    ``(i) Triennial Structure Review, Reassessment, and Report.--(1) 
Beginning three years after the date of the enactment of this section 
and not less frequently than once every three years thereafter, the 
Secretary shall conduct a review and assessment of the structure and 
operations of the Veterans Integrated Service Networks.
    ``(2) Not later than 180 days after conducting a review and 
assessment under paragraph (1), 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 such 
review and assessment, which shall include such recommendations for 
legislative or regulatory action as the Secretary considers appropriate 
to improve the Veterans Integrated Service Networks.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of chapter 73 of such title is amended by inserting 
        after the item relating to section 7309 the following new item:

``7310. Veterans Integrated Service Networks.''.
    (b) Consolidation of Networks.--
            (1) In general.--In order to comply with section 7310(a) of 
        title 38, United States Code, as added by subsection (a), not 
        later than one year after the date of the enactment of this 
        Act, the Secretary of Veterans Affairs shall geographically 
        realign and combine the 21 Veterans Integrated Service Networks 
        in effect on the day before the date of the enactment of this 
        Act into 12 geographically defined Veterans Integrated Service 
        Networks as follows:
                    (A) Veterans Integrated Service Network 1, Veterans 
                Integrated Service Network 2, and Veterans Integrated 
                Service Network 3 shall be combined into a single 
                Veterans Integrated Service Network.
                    (B) Veterans Integrated Service Network 4 and 
                Veterans Integrated Service Network 5 shall be combined 
                into a single Veterans Integrated Service Network.
                    (C) Veterans Integrated Service Network 9 and 
                Veterans Integrated Service Network 10 shall be 
                combined into a single Veterans Integrated Service 
                Network.
                    (D) Veterans Integrated Service Network 11 and 
                Veterans Integrated Service Network 12 shall be 
                combined into a single Veterans Integrated Service 
                Network.
                    (E) Veterans Integrated Service Network 15 and 
                Veterans Integrated Service Network 23 shall be 
                combined into a single Veterans Integrated Service 
                Network.
                    (F) Veterans Integrated Service Network 17 and 
                Veterans Integrated Service Network 18 shall be 
                combined into a single Veterans Integrated Service 
                Network.
                    (G) Veterans Integrated Service Network 19 and 
                Veterans Integrated Service Network 20 shall be 
                combined into a single Veterans Integrated Service 
                Network.
                    (H) Veterans Integrated Service Network 21 and 
                Veterans Integrated Service Network 22 shall be 
                combined into a single Veterans Integrated Service 
                Network.
            (2) Consolidation of headquarters.--
                    (A) In general.--Except as provided in subsection 
                (c), for each set of Veterans Integrated Service 
                Networks consolidated under paragraph (1), the 
                Secretary shall retain one of the headquarters of such 
                set in effect on the day before the date of the 
                enactment of this Act in the same location as in effect 
                on the day before such date and eliminate any other 
                headquarters of such set to meet the requirements of 
                section 7310(h) of such title, as added by subsection 
                (a).
                    (B) Reemployment assistance.--For each individual 
                whose position of employment is eliminated as a result 
                of eliminating a headquarters under subparagraph (A), 
                the Secretary shall take such measures as the Secretary 
                considers practicable to find a new position of 
                employment for such individual within the Department of 
                Veterans Affairs.
            (3) Implementation plan.--Not later than 180 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 to carry out this subsection.
    (c) Relocation of Headquarters.--
            (1) In general.--In the case of a headquarters office of a 
        Veterans Integrated Service Network that on the day before the 
        date of the enactment of this Act was in a location that was 
        not co-located with a Department of Veterans Affairs medical 
        center and the Secretary is engaged in a lease for such 
        location, the Secretary may--
                    (A) relocate such headquarters upon the expiration 
                of such lease so that such headquarters is co-located 
                as required by section 7310(h)(2) of such title, as 
                added by subsection (a); or
                    (B) notwithstanding section 7310(h)(2) of such 
                title, as so added, renew such lease or enter into a 
                new lease to keep such headquarters in such location.
            (2) Report.--If the Secretary renews a lease or engages in 
        a new lease under paragraph (1)(B), the Secretary shall submit 
        to the Committee on Veterans' Affairs of the Senate and the 
        Committee on Veterans' Affairs of the House of Representatives, 
        before renewing such lease or engaging in such lease, a report 
        describing the reasons for such renewal or engagement. Such 
        report shall include the following:
                    (A) A list of Department of Veterans Affairs 
                medical centers in the Veterans Integrated Service 
                Network of the headquarters with underutilized 
                buildings, the number of such buildings, and the total 
                underutilized square footage for each such medical 
                center.
                    (B) The cost of the current lease (the annual 
                amount of rent, the total cost over the life of the 
                lease, and the total cost per square foot) and the 
                current square footage being leased.
                    (C) The cost of the new lease (the annual amount of 
                rent, the total cost over the life of the lease, and 
                the total cost per square foot) and the square footage 
                to be leased.

SEC. 3. REGIONAL SUPPORT CENTERS FOR VETERANS INTEGRATED SERVICE 
              NETWORKS.

    (a) Regional Support Centers.--
            (1) In general.--Subchapter I of chapter 73 of title 38, 
        United States Code, as amended by section 2(a), is further 
        amended by adding at the end the following new section:
``Sec. 7310A. Regional support centers for Veterans Integrated Service 
              Networks
    ``(a) Establishment.--The Secretary shall establish not more than 
four regional support centers within the Veterans Health Administration 
to assess the effectiveness and efficiency of the Veterans Integrated 
Service Networks. The head of each regional support center shall report 
to the Under Secretary of Health.
    ``(b) Functions.--The functions of the regional support centers 
established under subsection (a) are as follows:
            ``(1) To assess the quality of work performed within 
        finance operations and other compliance related activities of 
        the Veterans Integrated Service Networks.
            ``(2) To assess how effectively and efficiently each 
        Veterans Integrated Service Network conducts outreach to 
        veterans who served in Operation Enduring Freedom, Operation 
        Iraqi Freedom, Operation New Dawn, or another contingency 
        operation (as defined in section 101 of title 10).
            ``(3) To assess how effectively and efficiently each 
        Veterans Integrated Service Network conducts programs for the 
        benefit of women veterans.
            ``(4) To assess how effectively and efficiently each 
        Veterans Integrated Service Network conducts programs that 
        address homelessness among veterans.
            ``(5) To assess how effectively and efficiently each 
        Veterans Integrated Service Network consumes energy.
            ``(6) To assess such other matters concerning the 
        operations and activities of the Veterans Integrated Service 
        Networks as the Secretary considers appropriate.
    ``(c) Staff.--The Secretary may hire such employees and contractors 
as the Secretary considers appropriate to carry out the functions of 
the regional support centers.
    ``(d) Location of Regional Support Centers.--(1) Except as provided 
in paragraph (2), the location of each regional support center 
established under subsection (a) shall be determined by the Secretary 
and co-located with a Department of Veterans Affairs medical center.
    ``(2) The Secretary may choose a location for a regional support 
center established under subsection (a) that is not co-located with a 
Department of Veterans Affairs medical center if the Secretary submits 
to the Committee on Veterans' Affairs of the Senate and the Committee 
on Veterans' Affairs of the House of Representatives, before engaging 
in a lease for such location, a report explaining the reasons for the 
choice of the Secretary of a location for the regional support center 
that is not co-located with a Department of Veterans Affairs medical 
center. Such report shall include the following:
            ``(A) A list of Department of Veterans Affairs medical 
        centers in the Veterans Integrated Service Network of the 
        regional support center with underutilized buildings, the 
        number of all Veterans Health Administration buildings in such 
        Network, and the total underutilized square footage for each 
        medical center in such Network.
            ``(B) In the case that the Secretary engages in a lease for 
        the location of the regional support center, the cost of such 
        lease (the annual amount of rent, the total cost over the life 
        of the lease, and the total cost per square foot) and the 
        square footage to be leased.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of chapter 73 of such title, as amended by section 
        2(a)(2), is further amended by inserting after the item 
        relating to section 7310 the following new item:

``7310A. Regional support centers for Veterans Integrated Service 
                            Networks.''.
    (b) Initial Staffing.--In providing for the initial staff of each 
regional support center established under section 7310A(a) of title 38, 
United States Code, as added by subsection (a), the Secretary of 
Veterans Affairs shall, to the extent practicable, transfer employees 
who were employed in positions at headquarters of Veterans Integrated 
Service Networks that covered functions similar to those described in 
section 7310A(b) of such title, as so added, from such headquarters to 
regional support centers.

SEC. 4. CONSTRUCTION.

    Nothing in this Act shall be construed to require any change in the 
location or type of medical care or service provided by a Department of 
Veterans Affairs medical center, a Department community-based 
outpatient clinic, a center for readjustment counseling and related 
mental health services for veterans under section 1712A of title 38, 
United States Code (known as a ``vet center''), or another facility 
that provides direct care or services under a law administered by the 
Secretary of Veterans Affairs.
                                 <all>
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