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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Failing VA Medical 
Center Recovery Act’’. 
SEC. 2. ESTABLISHMENT OF AN OFFICE OF FAILING MED-
ICAL CENTER RECOVERY. 
(a) ESTABLISHMENT.— 
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(1) IN GENERAL.—Chapter 3 of title 38, United 
States Code, is amended by adding at the end the 
following new section: 
‘‘§ 323. Office of Failing Medical Center Recovery 
‘‘(a) ESTABLISHMENT.—(1) There is in the Depart-
ment an Office of Failing Medical Center Recovery (in this 
section referred to as the ‘Office’). The head of the Office 
is the Under Secretary for Failing Medical Center Recov-
ery. 
‘‘(2) The purpose of the Office is to carry out the 
managerial and day-to-day operational control of each 
medical center of the Department that the Secretary cer-
tifies as a failing medical center under subsection (b)(2). 
‘‘(b) DETERMINATION OF FAILING MEDICAL CEN-
TER.—(1) Not later than 15 days after the end of each 
fiscal quarter, the Secretary shall publish in the Federal 
Register and on a publically available, searchable Internet 
website of the Department a compilation of key health 
metrics for each medical center of the Department. 
‘‘(2) On a semiannual basis, the Secretary shall cer-
tify that each medical center of the Department that is 
ranked as ‘failing’ under the key health metrics is a failing 
medical center and is subject to the managerial and day- 
to-day operational control by the Office pursuant to this 
section. 
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‘‘(3) The Secretary shall revoke the certification of 
a medical center of the Department as a failing medical 
center under paragraph (2) if the medical center achieves 
a ranking of ‘satisfactory’ or better under the key health 
metrics for three consecutive fiscal quarters. 
‘‘(4) The Secretary shall submit to the President and 
Congress each certification made under paragraph (2). 
‘‘(5) On a quarterly basis, the Secretary shall submit 
to Congress a report on the Office, including the actions 
taken by the Under Secretary with respect to covered fail-
ing medical centers. 
‘‘(c) FUNCTIONS.—(1)(A) The Secretary shall trans-
fer each covered failing medical center from the direct con-
trol of the relevant Veterans Integrated Service Network 
to the direct control of the Under Secretary. 
‘‘(B) The Under Secretary, acting through the Office, 
shall assume responsibility for and carry out the manage-
rial and day-to-day operational control of each covered 
failing medical center. 
‘‘(C) In carrying out subparagraph (B), the Under 
Secretary shall— 
‘‘(i) have the duties, responsibilities, and au-
thority for the covered failing medical center that 
the director of the failing medical center had as of 
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the day before the date of the certification under 
subsection (b)(2); 
‘‘(ii) operate the covered failing medical center 
independently from the relevant Veterans Integrated 
Service Network; and 
‘‘(iii) retain the use of all resources and services 
that would otherwise be made available to the cov-
ered failing medical center by the Veterans Inte-
grated Service Network. 
‘‘(2)(A) Upon a certification of the Secretary under 
subsection (b)(2) with respect to a covered failing medical 
center, the Under Secretary shall deploy a rapid deploy-
ment team to the covered failing medical center to carry 
out this subsection to ensure that the covered failing med-
ical center achieves satisfactory performance as quickly as 
practicable. 
‘‘(B) Each rapid deployment team described in sub-
paragraph (A) shall report directly to the Under Secretary 
and consist of personnel with experience in the following: 
‘‘(i) Business administration. 
‘‘(ii) Human resources. 
‘‘(iii) Congressional relations. 
‘‘(iv) Acute medical care. 
‘‘(v) Non-Department health care. 
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‘‘(vi) Other professional experience the Under 
Secretary determines appropriate. 
‘‘(3)(A) The Under Secretary shall have the authority 
to carry out adverse actions, including transfers or re-
assignments, pursuant to this title or title 5 that are appli-
cable to any employee of a covered failing medical center, 
including the director and senior executives. 
‘‘(B) The Under Secretary may deem an employee 
of a covered failing medical center who is not otherwise 
covered by section 713 of this title to be an individual cov-
ered by such section for purposes of removing such indi-
vidual from the civil service (as defined in section 2101 
of title 5). 
‘‘(4)(A) The Under Secretary may hire individuals as 
employees of the Veterans Health Administration at cov-
ered failing medical centers in positions that the Under 
Secretary determines are essential to improving patient 
care. 
‘‘(B) Notwithstanding any other provision of law, in 
carrying out subparagraph (A), the Under Secretary 
may— 
‘‘(i) hire employees using the direct-hire author-
ity under section 3304(a)(3) of title 5; and 
‘‘(ii) pay such employees at a prevailing rate 
that is 125 percent of the rate for such position. 
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‘‘(d) ADMINISTRATIVE MATTERS.—(1) The Under 
Secretary shall ensure that the Office consists of the fol-
lowing personnel, including personnel of the rapid deploy-
ment teams under subsection (c)(2), in a number the 
Under Secretary determines appropriate: 
‘‘(A) Senior professional staff who have experi-
ence— 
‘‘(i) in the operational departments of 
medical centers of the Department; and 
‘‘(ii) necessary to effectively run a medical 
center. 
‘‘(B) Support staff. 
‘‘(2)(A) Notwithstanding any other provision of law, 
in carrying out paragraph (1), the Under Secretary may— 
‘‘(i) hire employees using the direct-hire 
authority under section 3304(a)(3) of title 5; 
and 
‘‘(ii) pay such employees at a prevailing 
rate that is 125 percent of the rate for such po-
sition. 
‘‘(B) The Secretary shall ensure that employees of 
the Department who serve two years or more in the Office 
receive preferential treatment for promotion and advance-
ment within the Department. 
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‘‘(e) CONTRACTS.—(1) The Under Secretary may use 
simplified procedures to award contracts for goods and 
services that the Under Secretary determines essential to 
improving patient care in covered failing medical centers. 
‘‘(2)(A) The Secretary shall include in the quarterly 
publications under subsection (b)(1) the amounts de-
scribed in subparagraph (B), listed by specialty area. 
‘‘(B) The amounts described in this subparagraph 
are the amounts that the Secretary— 
‘‘(i) is obligated to pay to non-Department fa-
cilities (as defined in section 1701 of this title) that 
provide care to veterans under a covered failing 
medical center pursuant to a contract entered into 
by the Secretary; and 
‘‘(ii) has not paid by the date that is 90 days 
after the date required by chapter 39 of title 31. 
‘‘(f) INVESTIGATIONS AND WHISTLEBLOWER PRO-
TECTIONS.—(1) The Inspector General of the Department 
shall prioritize investigations relating to covered failing 
medical centers. 
‘‘(2) The Office of Accountability Review shall 
prioritize investigations of whistleblower retaliation relat-
ing to covered failing medical centers. 
‘‘(g) DEFINITIONS.—In this section: 
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‘‘(1) The term ‘covered failing medical center’ 
means a medical center of the Department that the 
Secretary certifies as a failing medical center pursu-
ant to paragraph (2) of such subsection (b) and has 
not revoked such certification under paragraph (3) 
of such subsection. 
‘‘(2) The term ‘key health metrics’ means the 
following: 
‘‘(A) The Strategic Analytics Improvement 
and Learning (commonly referred to as ‘SAIL’) 
data used by the Department (or such suc-
cessor data metric). 
‘‘(B) A ranking for each medical center of 
the Department based on the total data de-
scribed in subparagraph (A) for the specific 
medical center whereby— 
‘‘(i) medical centers in the 90th per-
centile are rated as ‘excellent’; 
‘‘(ii) medical centers in the 30th to 
89th percentiles are rated as ‘satisfactory’; 
‘‘(iii) medical centers in the 4th to 
29th percentiles are rated as ‘poor’; and 
‘‘(iv) medical centers in the 3rd per-
centile and below are rated as ‘failing’.’’. 
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(2) CLERICAL AMENDMENT.—The table of sec-
tions at the beginning of chapter 3 of such title is 
amended by adding after the item relating to section 
322 the following new item: 
‘‘323. Office of Failing Medical Center Recovery.’’. 
(3) INITIAL KEY HEALTH METRICS PUBLICA-
TION.—The Secretary shall publish the initial key 
health metrics under section 323(b)(1) of title 38, 
United States Code, as added by paragraph (1), by 
not later than 90 days after the date of the enact-
ment of this Act. 
(4) INITIAL
CERTIFICATIONS
OF
A
FAILING 
MEDICAL CENTER.—The Secretary shall make the 
initial certifications under section 323(b)(2) of title 
38, United States Code, as added by paragraph (1), 
by not later than 90 days after the date of the en-
actment of this Act. Such certifications shall cover 
not fewer than two and not more than seven medical 
centers of the Department of Veterans Affairs. 
(b) UNDER SECRETARY.— 
(1) IN GENERAL.—Chapter 3 of title 38, United 
States Code, is further amended by inserting after 
section 305 the following new section: 
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‘‘§ 305A. Under Secretary for Failing Medical Center 
Recovery 
‘‘(a)(1) There is in the Department an Under Sec-
retary for Failing Medical Center Recovery (in this section 
referred to as the ‘Under Secretary’), who is appointed 
by the President, by and with the advice and consent of 
the Senate. 
‘‘(2) The Under Secretary shall be appointed without 
regard to political affiliation or activity and solely— 
‘‘(A) on the basis of demonstrated ability in the 
medical profession, in health-care administration and 
policy formulation, in health-care fiscal management, 
or in health-care operations; and 
‘‘(B) on the basis of substantial operational ex-
perience in connection with the programs of the Vet-
erans Health Administration or programs of similar 
content and scope. 
‘‘(b) The Under Secretary is the head of, and is di-
rectly responsible to the Secretary for the operation of, 
the Office of Failing Medical Center Recovery.’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions at the beginning of chapter 3 of such title is 
further amended by inserting after the item relating 
to section 305 the following new item: 
‘‘305A. Under Secretary for Failing Medical Center Recovery.’’. 
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(c) INCLUSION OF OFFICE IN EDUCATIONAL ASSIST-
ANCE PROGRAM.—Chapter 76 of title 38, United States 
Code, is amended— 
(1) by striking ‘‘Veterans Health Administra-
tion’’ each place it appears (other than section 
7622(b)(1)) and inserting ‘‘Veterans Health Admin-
istration or the Office of Failing Medical Center Re-
covery’’; and 
(2) by striking ‘‘section 7401 of this title’’ each 
place it appears and inserting ‘‘section 7401 or sec-
tion 323(d) of this title’’. 
Æ 
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