IIB 

114TH CONGRESS 

2D SESSION H. R. 3234 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 10, 2016 

Received; read twice and referred to the Committee on Veterans’ Affairs 

AN ACT 

To amend title 38, United States Code, to direct the Secretary of Veterans Affairs to evaluate the ability of each 

medical center of the Department to provide quality 

health care to veterans, to ensure that the Secretary 

improves such medical centers that are underperforming, 

and for other purposes. 


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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 ‘‘VA Medical Center 

5 Recovery Act’’. 

6 SEC. 2. EVALUATION AND IMPROVEMENT OF MEDICAL 

7 CENTERS. 

8 (a) UNDERPERFORMING MEDICAL CENTERS.— 

9 (1) IN GENERAL.—Chapter 73 of title 38, 

10 United States Code, is amended by inserting after 

11 section 7311A the following new section: 

12 ‘‘§ 7311B. Evaluation and improvement of medical 

13 centers 

14 ‘‘(a) IDENTIFICATION OF UNDERPERFORMING MED15 ICAL CENTERS.—(1) Not later than 15 days after the end 

16 of each fiscal quarter, the Secretary shall publish in the 

17 Federal Register and on a publically available, searchable 

18 Internet website of the Department a compilation of key 

19 health metrics for each medical center of the Department. 

20 ‘‘(2) On a semiannual basis, the Secretary shall de21 termine, under the key health metrics, whether each med22 ical center of the Department is satisfactory or underper23 forming. 

24 ‘‘(b) RAPID DEPLOYMENT TEAMS.—(1) Not later 

25 than 30 days after the date on which the Secretary identiVerDate Sep 11 2014 22:53 Feb 10, 2016 Jkt 059200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3234.RFS H3234

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1 fies a medical center as an underperforming medical cen2 ter under subsection (a)(2), the Secretary shall deploy a 

3 rapid deployment team to the medical center to ensure 

4 that the medical center achieves satisfactory performance 

5 as quickly as practicable. 

6 ‘‘(2) Each rapid deployment team deployed to an 

7 underperforming medical center under paragraph (1) 

8 shall— 

9 ‘‘(A) identify the areas of the medical center 

10 that require improvement, including with respect to 

11 the procedures of the medical center, inefficiencies of 

12 the medical center, and whether the medical center 

13 follows directives and best practices; 

14 ‘‘(B) establish a remediation plan to improve 

15 the performance of the medical center; 

16 ‘‘(C) review and assesses the status of any— 

17 ‘‘(i) disciplinary actions taken at the med18 ical center; 

19 ‘‘(ii) recommendations made by the Inspec20 tor General of the Department applicable to the 

21 medical center; and 

22 ‘‘(iii) findings made by the Comptroller 

23 General of the United States applicable to the 

24 medical center; and 


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1 ‘‘(D) provide training to the director and staff 

2 of the medical center with respect to carrying out 

3 such improvements. 

4 ‘‘(3) The Secretary shall ensure that— 

5 ‘‘(A) the director of each underperforming med6 ical center carries out the remediation plan under 

7 paragraph (2)(B); and 

8 ‘‘(B) the rapid deployment team has access to 

9 all facilities and all electronic systems, records, re10 ports, audits, reviews, documents, papers, or other 

11 materials the rapid deployment team determines 

12 necessary to carry out this subsection. 

13 ‘‘(4) Each rapid deployment team deployed to an 

14 underperforming medical center under paragraph (1) shall 

15 consist of— 

16 ‘‘(A) subject matter experts with experience 

17 in— 

18 ‘‘(i) customer service training; 

19 ‘‘(ii) increasing the efficiency of organiza20 tions; 

21 ‘‘(iii) clinical care specific to the areas in 

22 which the underperforming medical center re23 quires improvement; and 


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1 ‘‘(iv) any other areas that the Secretary 

2 determines appropriate to improve the under3 performing medical center; and 

4 ‘‘(B) an employee of the Office of the Inspector 

5 General of the Department. 

6 ‘‘(5) To the extent practicable, each rapid deployment 

7 team shall include process improvement subject matter ex8 perts from the Veterans Experience Office of the Depart9 ment. 

10 ‘‘(6) The Secretary shall determine the duration of 

11 the deployment of a rapid deployment team under para12 graph (1). 

13 ‘‘(c) INVESTIGATIONS AND WHISTLEBLOWER PRO14 TECTIONS.—(1) The Inspector General of the Department 

15 shall prioritize investigations relating to underperforming 

16 medical centers. 

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

18 prioritize investigations of whistleblower retaliation relat19 ing to underperforming medical centers. 

20 ‘‘(d) QUARTERLY REPORTS.—On a quarterly basis, 

21 the Secretary shall submit to Congress a report that in22 cludes, with respect to the quarter covered by the report— 

23 ‘‘(1) each identification of an underperforming 

24 medical center made by the Secretary; 


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1 ‘‘(2) the actions taken by the Secretary and 

2 rapid deployment teams with respect to improving 

3 underperforming medical centers; and 

4 ‘‘(3) an update on any progress made by each 

5 underperforming medical center, including whether 

6 the underperforming medical center is carrying out 

7 the remediation plan pursuant to subsection 

8 (b)(3)(A). 

9 ‘‘(e) RELATIONSHIP TO QUALITY ASSURANCE AND

10 NATIONAL QUALITY MANAGEMENT OFFICER.—The re11 quirements of this section are in addition to any require12 ments under sections 7311 and 7311A of this title. 

13 ‘‘(f) DEFINITIONS.—In this section: 

14 ‘‘(1) The term ‘underperforming medical center’ 

15 means a medical center of the Department that the 

16 Secretary determines is underperforming under sub17 section (a)(2). 

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

19 following: 

20 ‘‘(A) The Strategic Analytics Improvement 

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

22 data used by the Department (or such suc23 cessor data metric). 

24 ‘‘(B) An evaluation system established by 

25 the Secretary based on the total data described 


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1 in subparagraph (A) to determine whether the 

2 performance of a medical center is satisfactory 

3 or underperforming and requires remediation 

4 pursuant to this section.’’. 

5 (2) CLERICAL AMENDMENT.—The table of sec6 tions at the beginning of chapter 73 of such title is 

7 amended by adding after the item relating to section 

8 7311A the following new item: 

‘‘7311B. Evaluation and improvement of medical centers’’. 

9 (b) INITIAL KEY HEALTH METRICS PUBLICATION.— 

10 The Secretary shall publish the initial key health metrics 

11 under section 7311B(a)(1) of title 38, United States Code, 

12 as added by subsection (a)(1), by not later than 90 days 

13 after the date of the enactment of this Act. 

14 (c) INITIAL IDENTIFICATION OF AN UNDERPER15 FORMING MEDICAL CENTER.—The Secretary shall make 

16 the initial identifications under section 7311B(a)(2) of 

17 title 38, United States Code, as added by subsection 

18 (a)(1), by not later than 180 days after the date of the 

19 enactment of this Act. 

20 SEC. 3. STANDARDIZED TRAINING FOR NURSES. 

21 (a) TRAINING.—The Secretary of Veterans Affairs 

22 shall seek to enter into partnerships with recognized 

23 schools of nursing to provide undergraduate nursing stu24 dents enrolled in such schools with standardized training 

25 with respect to the following: 


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1 (1) The culture of the military and veterans. 

2 (2) Post-traumatic stress disorder. 

3 (3) Traumatic brain injury. 

4 (4) Amputation and assistive devices. 

5 (5) Environmental, chemical, and toxic expo6 sure. 

7 (6) Substance use disorders. 

8 (7) Military sexual trauma. 

9 (8) Suicide. 

10 (9) Homelessness. 

11 (10) Serious illness at the end of life. 

12 (11) Benefits, services, and resources for vet13 erans that are administered by the Federal Govern14 ment. 

15 (b) DEVELOPMENT.—In developing the training 

16 under subsection (a), the Secretary shall consult with ap17 propriate accrediting bodies, schools of nursing, and in18 dustry leaders. 

Passed the House of Representatives February 9, 

2016. 

Attest: KAREN L. HAAS, 

Clerk. 


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