I 

114TH CONGRESS 

1ST SESSION H. R. 3234 

To amend title 38, United States Code, to establish within the Department 

of Veterans Affairs an Office of Failing Medical Center Recovery, and 

for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 28, 2015 

Mrs. ROBY introduced the following bill; which was referred to the Committee 

on Veterans’ Affairs 

A BILL 

To amend title 38, United States Code, to establish within 

the Department of Veterans Affairs an Office of Failing 

Medical Center Recovery, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Failing VA Medical 

5 Center Recovery Act’’. 

6 SEC. 2. ESTABLISHMENT OF AN OFFICE OF FAILING MED7 ICAL CENTER RECOVERY. 

8 (a) ESTABLISHMENT.— 


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1 (1) IN GENERAL.—Chapter 3 of title 38, United 

2 States Code, is amended by adding at the end the 

3 following new section: 

4 ‘‘§ 323. Office of Failing Medical Center Recovery 

5 ‘‘(a) ESTABLISHMENT.—(1) There is in the Depart6 ment an Office of Failing Medical Center Recovery (in this 

7 section referred to as the ‘Office’). The head of the Office 

8 is the Under Secretary for Failing Medical Center Recov9 ery. 

10 ‘‘(2) The purpose of the Office is to carry out the 

11 managerial and day-to-day operational control of each 

12 medical center of the Department that the Secretary cer13 tifies as a failing medical center under subsection (b)(2). 

14 ‘‘(b) DETERMINATION OF FAILING MEDICAL CEN15 TER.—(1) Not later than 15 days after the end of each 

16 fiscal quarter, the Secretary shall publish in the Federal 

17 Register and on a publically available, searchable Internet 

18 website of the Department a compilation of key health 

19 metrics for each medical center of the Department. 

20 ‘‘(2) On a semiannual basis, the Secretary shall cer21 tify that each medical center of the Department that is 

22 ranked as ‘failing’ under the key health metrics is a failing 

23 medical center and is subject to the managerial and day24 to-day operational control by the Office pursuant to this 

25 section. 


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1 ‘‘(3) The Secretary shall revoke the certification of 

2 a medical center of the Department as a failing medical 

3 center under paragraph (2) if the medical center achieves 

4 a ranking of ‘satisfactory’ or better under the key health 

5 metrics for three consecutive fiscal quarters. 

6 ‘‘(4) The Secretary shall submit to the President and 

7 Congress each certification made under paragraph (2). 

8 ‘‘(5) On a quarterly basis, the Secretary shall submit 

9 to Congress a report on the Office, including the actions 

10 taken by the Under Secretary with respect to covered fail11 ing medical centers. 

12 ‘‘(c) FUNCTIONS.—(1)(A) The Secretary shall trans13 fer each covered failing medical center from the direct con14 trol of the relevant Veterans Integrated Service Network 

15 to the direct control of the Under Secretary. 

16 ‘‘(B) The Under Secretary, acting through the Office, 

17 shall assume responsibility for and carry out the manage18 rial and day-to-day operational control of each covered 

19 failing medical center. 

20 ‘‘(C) In carrying out subparagraph (B), the Under 

21 Secretary shall— 

22 ‘‘(i) have the duties, responsibilities, and au23 thority for the covered failing medical center that 

24 the director of the failing medical center had as of 


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1 the day before the date of the certification under 

2 subsection (b)(2); 

3 ‘‘(ii) operate the covered failing medical center 

4 independently from the relevant Veterans Integrated 

5 Service Network; and 

6 ‘‘(iii) retain the use of all resources and services 

7 that would otherwise be made available to the cov8 ered failing medical center by the Veterans Inte9 grated Service Network. 

10 ‘‘(2)(A) Upon a certification of the Secretary under 

11 subsection (b)(2) with respect to a covered failing medical 

12 center, the Under Secretary shall deploy a rapid deploy13 ment team to the covered failing medical center to carry 

14 out this subsection to ensure that the covered failing med15 ical center achieves satisfactory performance as quickly as 

16 practicable. 

17 ‘‘(B) Each rapid deployment team described in sub18 paragraph (A) shall report directly to the Under Secretary 

19 and consist of personnel with experience in the following: 

20 ‘‘(i) Business administration. 

21 ‘‘(ii) Human resources. 

22 ‘‘(iii) Congressional relations. 

23 ‘‘(iv) Acute medical care. 

24 ‘‘(v) Non-Department health care. 


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1 ‘‘(vi) Other professional experience the Under 

2 Secretary determines appropriate. 

3 ‘‘(3)(A) The Under Secretary shall have the authority 

4 to carry out adverse actions, including transfers or re5 assignments, pursuant to this title or title 5 that are appli6 cable to any employee of a covered failing medical center, 

7 including the director and senior executives. 

8 ‘‘(B) The Under Secretary may deem an employee 

9 of a covered failing medical center who is not otherwise 

10 covered by section 713 of this title to be an individual cov11 ered by such section for purposes of removing such indi12 vidual from the civil service (as defined in section 2101 

13 of title 5). 

14 ‘‘(4)(A) The Under Secretary may hire individuals as 

15 employees of the Veterans Health Administration at cov16 ered failing medical centers in positions that the Under 

17 Secretary determines are essential to improving patient 

18 care. 

19 ‘‘(B) Notwithstanding any other provision of law, in 

20 carrying out subparagraph (A), the Under Secretary 

21 may— 

22 ‘‘(i) hire employees using the direct-hire author23 ity under section 3304(a)(3) of title 5; and 

24 ‘‘(ii) pay such employees at a prevailing rate 

25 that is 125 percent of the rate for such position. 


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1 ‘‘(d) ADMINISTRATIVE MATTERS.—(1) The Under 

2 Secretary shall ensure that the Office consists of the fol3 lowing personnel, including personnel of the rapid deploy4 ment teams under subsection (c)(2), in a number the 

5 Under Secretary determines appropriate: 

6 ‘‘(A) Senior professional staff who have experi7 ence— 

8 ‘‘(i) in the operational departments of 

9 medical centers of the Department; and 

10 ‘‘(ii) necessary to effectively run a medical 

11 center. 

12 ‘‘(B) Support staff. 

13 ‘‘(2)(A) Notwithstanding any other provision of law, 

14 in carrying out paragraph (1), the Under Secretary may— 

15 ‘‘(i) hire employees using the direct-hire 

16 authority under section 3304(a)(3) of title 5; 

17 and 

18 ‘‘(ii) pay such employees at a prevailing 

19 rate that is 125 percent of the rate for such po20 sition. 

21 ‘‘(B) The Secretary shall ensure that employees of 

22 the Department who serve two years or more in the Office 

23 receive preferential treatment for promotion and advance24 ment within the Department. 


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1 ‘‘(e) CONTRACTS.—(1) The Under Secretary may use 

2 simplified procedures to award contracts for goods and 

3 services that the Under Secretary determines essential to 

4 improving patient care in covered failing medical centers. 

5 ‘‘(2)(A) The Secretary shall include in the quarterly 

6 publications under subsection (b)(1) the amounts de7 scribed in subparagraph (B), listed by specialty area. 

8 ‘‘(B) The amounts described in this subparagraph 

9 are the amounts that the Secretary— 

10 ‘‘(i) is obligated to pay to non-Department fa11 cilities (as defined in section 1701 of this title) that 

12 provide care to veterans under a covered failing 

13 medical center pursuant to a contract entered into 

14 by the Secretary; and 

15 ‘‘(ii) has not paid by the date that is 90 days 

16 after the date required by chapter 39 of title 31. 

17 ‘‘(f) INVESTIGATIONS AND WHISTLEBLOWER PRO18 TECTIONS.—(1) The Inspector General of the Department 

19 shall prioritize investigations relating to covered failing 

20 medical centers. 

21 ‘‘(2) The Office of Accountability Review shall 

22 prioritize investigations of whistleblower retaliation relat23 ing to covered failing medical centers. 

24 ‘‘(g) DEFINITIONS.—In this section: 


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1 ‘‘(1) The term ‘covered failing medical center’ 

2 means a medical center of the Department that the 

3 Secretary certifies as a failing medical center pursu4 ant to paragraph (2) of such subsection (b) and has 

5 not revoked such certification under paragraph (3) 

6 of such subsection. 

7 ‘‘(2) The term ‘key health metrics’ means the 

8 following: 

9 ‘‘(A) The Strategic Analytics Improvement 

10 and Learning (commonly referred to as ‘SAIL’) 

11 data used by the Department (or such suc12 cessor data metric). 

13 ‘‘(B) A ranking for each medical center of 

14 the Department based on the total data de15 scribed in subparagraph (A) for the specific 

16 medical center whereby— 

17 ‘‘(i) medical centers in the 90th per18 centile are rated as ‘excellent’; 

19 ‘‘(ii) medical centers in the 30th to 

20 89th percentiles are rated as ‘satisfactory’; 

21 ‘‘(iii) medical centers in the 4th to 

22 29th percentiles are rated as ‘poor’; and 

23 ‘‘(iv) medical centers in the 3rd per24 centile and below are rated as ‘failing’.’’. 


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1 (2) CLERICAL AMENDMENT.—The table of sec2 tions at the beginning of chapter 3 of such title is 

3 amended by adding after the item relating to section 

4 322 the following new item: 

‘‘323. Office of Failing Medical Center Recovery.’’. 

5 (3) INITIAL KEY HEALTH METRICS PUBLICA6 TION.—The Secretary shall publish the initial key 

7 health metrics under section 323(b)(1) of title 38, 

8 United States Code, as added by paragraph (1), by 

9 not later than 90 days after the date of the enact10 ment of this Act. 

11 (4) INITIAL CERTIFICATIONS OF A FAILING

12 MEDICAL CENTER.—The Secretary shall make the 

13 initial certifications under section 323(b)(2) of title 

14 38, United States Code, as added by paragraph (1), 

15 by not later than 90 days after the date of the en16 actment of this Act. Such certifications shall cover 

17 not fewer than two and not more than seven medical 

18 centers of the Department of Veterans Affairs. 

19 (b) UNDER SECRETARY.— 

20 (1) IN GENERAL.—Chapter 3 of title 38, United 

21 States Code, is further amended by inserting after 

22 section 305 the following new section: 


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1 ‘‘§ 305A. Under Secretary for Failing Medical Center 

2 Recovery 

3 ‘‘(a)(1) There is in the Department an Under Sec4 retary for Failing Medical Center Recovery (in this section 

5 referred to as the ‘Under Secretary’), who is appointed 

6 by the President, by and with the advice and consent of 

7 the Senate. 

8 ‘‘(2) The Under Secretary shall be appointed without 

9 regard to political affiliation or activity and solely— 

10 ‘‘(A) on the basis of demonstrated ability in the 

11 medical profession, in health-care administration and 

12 policy formulation, in health-care fiscal management, 

13 or in health-care operations; and 

14 ‘‘(B) on the basis of substantial operational ex15 perience in connection with the programs of the Vet16 erans Health Administration or programs of similar 

17 content and scope. 

18 ‘‘(b) The Under Secretary is the head of, and is di19 rectly responsible to the Secretary for the operation of, 

20 the Office of Failing Medical Center Recovery.’’. 

21 (2) CLERICAL AMENDMENT.—The table of sec22 tions at the beginning of chapter 3 of such title is 

23 further amended by inserting after the item relating 

24 to section 305 the following new item: 

‘‘305A. Under Secretary for Failing Medical Center Recovery.’’. 


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1 (c) INCLUSION OF OFFICE IN EDUCATIONAL ASSIST2 ANCE PROGRAM.—Chapter 76 of title 38, United States 

3 Code, is amended— 

4 (1) by striking ‘‘Veterans Health Administra5 tion’’ each place it appears (other than section 

6 7622(b)(1)) and inserting ‘‘Veterans Health Admin7 istration or the Office of Failing Medical Center Re8 covery’’; and 

9 (2) by striking ‘‘section 7401 of this title’’ each 

10 place it appears and inserting ‘‘section 7401 or sec11 tion 323(d) of this title’’. 

Æ 


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