I 
115TH CONGRESS 
1ST SESSION H. R. 3874 
To direct the Secretary of Veterans Affairs to carry out a pilot program 
on physical security at Department of Veterans Affairs medical facilities, 
to direct the Secretary to make certain improvements relating to inspec-
tions of Department of Veterans Affairs medical facilities and improving 
care for women, to direct the Secretary to evaluate the organizational 
structure of the Veterans Health Administration, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 28, 2017 
Mr. KILMER (for himself, Mr. RENACCI, Mr. AMODEI, Mrs. BROOKS of Indi-
ana, Mr. CARBAJAL, Mr. JOYCE of Ohio, Mr. KELLY of Pennsylvania, 
Mr. KRISHNAMOORTHI, Mr. MOULTON, Mr. NORCROSS, Mr. PETERS, 
Miss RICE of New York, Mr. SCHNEIDER, Mr. NEWHOUSE, Mr. WEB-
STER of Florida, Mrs. MURPHY of Florida, Mr. WELCH, Mr. BARLETTA, 
Mr. RUTHERFORD, Mr. VALADAO, and Mr. BARR) introduced the fol-
lowing bill; which was referred to the Committee on Veterans’ Affairs 
A BILL 
To direct the Secretary of Veterans Affairs to carry out 
a pilot program on physical security at Department of 
Veterans Affairs medical facilities, to direct the Secretary 
to make certain improvements relating to inspections 
of Department of Veterans Affairs medical facilities and 
improving care for women, to direct the Secretary to 
evaluate the organizational structure of the Veterans 
Health Administration, and for other purposes. 
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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 ‘‘Accountability for 
Quality VA Healthcare Act’’. 
SEC. 2. PILOT PROGRAM ON PHYSICAL SECURITY AT DE-
PARTMENT OF VETERANS AFFAIRS MEDICAL 
FACILITIES. 
(a) IN GENERAL.—Beginning not later than 90 days 
after the date of the enactment of this Act the Secretary 
of Veterans Affairs shall carry out a pilot program to en-
hance the physical security of Department of Veterans Af-
fairs medical facilities. At the medical facilities selected 
for the pilot program, the Secretary shall— 
(1) ensure that alarm systems effectively notify 
relevant staff in the police command and control 
centers and the unit nursing stations of the facility; 
and 
(2) require relevant medical center stakeholders 
to coordinate and consult on— 
(A) plans for new and renovated units; and 
(B) any changes to physical security fea-
tures, including closed-circuit television cam-
eras. 
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(b) LOCATIONS.—The Secretary shall select five med-
ical facilities of the Department to participate in the pilot 
program. 
(c) TERMINATION.—The pilot program shall termi-
nate on the date that is two years after the date on which 
the pilot program commences. 
(d) REPORT.—Not later than 30 days after the termi-
nation of the pilot program under subsection (c), the Sec-
retary shall submit to Congress a report on the pilot pro-
gram. 
SEC. 3. REPORT ON DEPARTMENT OF VETERANS AFFAIRS 
IMPROVEMENT OF FACILITY ALIGNMENT. 
(a) IN GENERAL.—Not later than 90 days after the 
date of the enactment of this Act, the Secretary of Vet-
erans Affairs shall submit to Congress a report on the 
findings and recommendations of the report of the Govern-
ment Accountability Office entitled ‘‘VA Real Property: 
VA Should Improve Its Efforts to Align Facilities with 
Veterans’ Needs’’. The report submitted by the Secretary 
shall include the plan of the Secretary, including a time 
frame for completion, to specifically address the following 
recommendations: 
(1) To address identified limitations to the stra-
tegic capital investment planning process, including 
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limitations to scoring and approval and access to in-
formation. 
(2) To assess the value of the Department of 
Veterans Affairs Integrated Planning facility master 
plans as a facility-planning tool, and based on con-
clusions contained in the Government Accountability 
Office report, either discontinue the development of 
such master plans or address the limitations of such 
master plans. 
(3) To develop and distribute guidance for Vet-
erans Integrated Service Networks and facilities 
using best practices on how to effectively commu-
nicate with stakeholders about alignment change. 
(4) To develop and implement a mechanism to 
evaluate Veterans Integrated Service Network and 
facility communication efforts with stakeholders to 
ensure that such communication efforts are working 
as intended and align with guidance and best prac-
tices. 
(b) PUBLIC AVAILABILITY.—Upon submittal of the 
report under subsection (a), the Secretary shall make the 
report publicly available on an internet website of the De-
partment. 
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SEC. 4. UPDATE OF HANDBOOK TO IMPROVE LEASING 
PROJECTS. 
Not later than 180 days after the date of the enact-
ment of this Act, and not less than once every five-year 
period thereafter, the Secretary of Veterans Affairs shall 
update the handbook of the Department of Veterans Af-
fairs titled ‘‘Planning and Activating Community Based 
Outpatient Clinics’’, or a successor handbook, to reflect 
current policies, best practices, and clarify the roles and 
responsibilities of the personnel of the Department in-
volved in the leasing projects of the Department. 
SEC. 5. IMPROVEMENT OF INSPECTIONS OF DEPARTMENT 
OF VETERANS AFFAIRS MEDICAL FACILITIES 
AND IMPROVEMENT OF CARE FOR WOMEN 
PROVIDED BY DEPARTMENT OF VETERANS 
AFFAIRS. 
(a) FINDINGS.—Congress makes the following find-
ings: 
(1) The Department of Veterans Affairs has 
policies in place to help ensure the privacy, safety, 
and dignity of women veterans when they receive 
care at its medical facilities. 
(2) A Government Accountability Office report 
found many instances of noncompliance with such 
policies. 
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(3) Women veterans are the fastest growing co-
hort within the veteran community. 
(4) Women serve in every branch of the Armed 
Forces and represent nearly 15 percent of the mem-
bers of the Armed Forces currently serving on active 
duty and 18 percent of members of the National 
Guard and reserve components. 
(5) The number of women veterans using the 
medical care provided by the Department of Vet-
erans Affairs is expected to increase dramatically. 
(b) SENSE OF CONGRESS.—It is the sense of Con-
gress that— 
(1) female veterans are put at risk by a system 
that is currently designed for men; and 
(2) the Department of Veterans Affairs should 
follow through with commitments to ensure female 
veterans can access services tailored to their needs. 
(c) IMPROVEMENT
OF INSPECTIONS
OF DEPART-
MENT OF VETERANS AFFAIRS MEDICAL FACILITIES AND 
IMPROVEMENT OF CARE FOR WOMEN PROVIDED BY DE-
PARTMENT OF VETERANS AFFAIRS.— 
(1) IMPROVEMENT
OF
INSPECTIONS
PROC-
ESS.—The Secretary of Veterans Affairs shall 
strengthen the environment of care inspections proc-
ess and oversight of such process by— 
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(A) expanding the list of requirements that 
facility staff inspect for compliance to align 
with the policy of the Veterans Health Adminis-
tration; 
(B) ensuring that all patient care areas of 
Department medical facilities are inspected as 
required; 
(C) clarifying the roles and responsibilities 
of Department medical facility staff responsible 
for identifying and addressing compliance; and 
(D) establishing a process to verify that 
noncompliance information reported by facilities 
to the Veterans Health Administration central 
office is accurate and complete. 
(2) IMPROVEMENT OF CARE FOR WOMEN.— 
(A) MONITORING
OF
GENDER-SPECIFIC 
CARE SERVICES.—To improve care for women 
veterans, the Secretary of Veterans Affairs shall 
monitor women veterans’ access to gender-spe-
cific care services under current and future 
community care contracts or agreements. Such 
monitoring shall include an examination of ap-
pointment scheduling and completion times, 
driving times to appointments, and reasons ap-
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pointments could not be scheduled with commu-
nity providers. 
(B) DEFINITIONS.—In this subparagraph: 
(i) The term ‘‘gender-specific care 
services’’ means mammography, maternity 
care, and gynecology. 
(ii) The term ‘‘community care con-
tract or agreement’’ means an agreement 
described in section 101(d) of the Veterans 
Access, Choice, and Accountability Act of 
2014 (Public Law 113–146), or other con-
tract or agreement under which the Sec-
retary furnishes hospital care and medical 
treatment to veterans at non-Department 
of Veterans Affairs health care facilities. 
SEC. 6. IMPROVEMENT OF DELIVERY OF CARE AT DEPART-
MENT OF VETERANS AFFAIRS MEDICAL FA-
CILITIES. 
(a) WAIT TIMES.—The Secretary of Veterans Affairs 
shall clearly identify measures for wait times for medical 
appointments in Department of Veterans Affairs medical 
facilities in a manner that reduces the likelihood of an in-
dividual misinterpreting such measures. 
(b) SCHEDULING.—The Secretary shall ensure that 
the term ‘‘patient indicated date’’ is clearly defined for 
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purposes of the scheduling policy of the Veterans Health 
Administration and in related training documents. The 
Secretary shall take such steps as may be necessary to 
ensure such term is correctly implemented by employees 
who perform scheduling functions. 
(c) STAFF AVAILABILITY.— 
(1) ALLOCATION; SCHEDULING.—The Secretary 
shall develop a policy requiring Department of Vet-
erans Affairs medical facilities to routinely assess 
the scheduling needs and resources required to en-
sure that employees of such facilities are allocated in 
such a manner as to adequately respond to the de-
mand for scheduling medical appointments. 
(2) RECRUITMENT AND RETENTION.—The Sec-
retary shall develop a strategy to improve recruit-
ment and retention of Department of Veterans Af-
fairs medical providers and employees who perform 
scheduling functions for Department medical facili-
ties. Such strategy shall be designed to ensure ade-
quate staffing of Department medical facilities and 
shall emphasize recruitment and retention in facili-
ties located in rural areas. 
(d) TELEPHONE ACCESS.—The Secretary shall— 
(1) ensure that all Department medical facili-
ties provide oversight of telephone access and imple-
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ment the best practices outlined in the Department 
2015 Telephone Access and Contact Management 
Improvement Guide, or a successor guide; and 
(2) identify medical facilities that are using out-
dated telephone technology and replace such tech-
nology with new systems designed to improve tele-
phone service and access to health care. 
SEC. 7. EVALUATIONS OF ORGANIZATIONAL STRUCTURE 
OF 
VETERANS 
HEALTH 
ADMINISTRATION 
AND 
REALIGNMENT 
OF 
VETERANS 
INTE-
GRATED SERVICE NETWORKS. 
(a) ORGANIZATIONAL STRUCTURE.— 
(1) PROCESS.—The Secretary of Veterans Af-
fairs, acting through the Under Secretary for 
Health, shall implement a process to consistently 
evaluate reviews described in paragraph (3). 
(2) MATTERS INCLUDED.—The process under 
paragraph (1) shall include the following: 
(A) Identification of the officials and the 
offices of the Department of Veterans Affairs 
responsible for evaluating and approving, and 
ensuring the implementation of, recommenda-
tions made by reviews described in paragraph 
(3), including— 
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(i) the roles of each such official and 
office; and 
(ii) a description of how decisions are 
made and documented to approve such im-
plementation. 
(B) A description of how recommendations 
made by reviews described in paragraph (3) 
should be evaluated. 
(C) A description of how timelines should 
be established to ensure recommendations are 
evaluated and implemented in a timely manner 
and metrics to assess the progress made with 
respect to such implementation. 
(3) REVIEWS
DESCRIBED.—The reviews de-
scribed in this paragraph are reviews of the organi-
zational structure of the Veterans Health Adminis-
tration conducted by the Secretary, the Inspector 
General of the Department of Veterans Affairs, the 
Comptroller General of the United States, the Com-
mission on Care established by section 202 of the 
Veterans Access, Choice, and Accountability Act of 
2014 (Public Law 113–146; 128 Stat. 1773), or by 
an independent entity, as determined appropriate by 
the Secretary. 
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(4) FIRST USE.—The Under Secretary shall use 
the process under paragraph (1) to evaluate the re-
sults of the evaluation conducted under subsection 
(b)(1). The Under Secretary shall make any re-
quired improvements to such process based on the 
lessons learned by the Under Secretary resulting 
from such use. 
(b) VETERANS INTEGRATED SERVICE NETWORKS.— 
(1) EVALUATION.—Consistent with the report 
of the Comptroller General of the United States ti-
tled ‘‘VA Health Care: Processes to Evaluate, Imple-
ment, 
and 
Monitor 
Organizational 
Structure 
Changes Needed’’ (GAO–16–803), the Secretary, 
acting through the Under Secretary for Health, shall 
conduct an evaluation of all the Veterans Integrated 
Service Networks, including with respect to— 
(A) the implementation by the Secretary of 
realignments to such Networks; and 
(B) identifying deficiencies to such Net-
works that require corrective action. 
(2) ASSESSMENT
AND
IMPLEMENTATION.—In 
accordance with subsection (a)(4), the Under Sec-
retary shall use the process implemented under sub-
section (a) to assess the results of the evaluation 
conducted under paragraph (1) and to implement 
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changes and other actions to improve the Veterans 
Integrated Service Networks. 
(c) REPORT.—Not later than 90 days after the date 
of the enactment of this Act, the Under Secretary shall 
submit to Congress a report that includes a description 
of— 
(1) the process implemented under subsection 
(a)(1); 
(2) the deficiencies identified under paragraph 
(1) of subsection (b); and 
(3) how the Under Secretary will carry out 
paragraph (2) of such subsection. 
(d) PROHIBITION ON NEW APPROPRIATIONS.—No 
additional funds are authorized to be appropriated to 
carry out this section, and this section shall be carried 
out using amounts otherwise made available for such pur-
poses. 
SEC. 8. ANNUAL REPORT REGARDING THE RECRUITMENT, 
HIRING, AND RETENTION OF NURSES FOR 
THE VETERANS HEALTH ADMINISTRATION. 
(a) REPORT REQUIRED.—Not later than one year 
after the date of the enactment of this Act and annually 
thereafter, the Secretary of Veterans Affairs shall publish 
and submit to the Committees on Veterans’ Affairs of the 
Senate and the House of Representatives a report regard-
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ing efforts to recruit, hire, and retain nurses for the Vet-
erans Health Administration. 
(b) ELEMENTS.—The report under subsection (a) 
shall include details relating to— 
(1) efforts to recruit, hire, and retain nurses at 
each medical facility of the Department; 
(2) resources provided by the Secretary to re-
cruit, hire, and retain nurses for the Veterans 
Health Administration; and 
(3) recommendations for legislation the Sec-
retary considers appropriate. 
SEC. 9. REINSTATEMENT OF REPORTING REQUIREMENT 
REGARDING 
THE 
DEPARTMENT 
OF 
VET-
ERANS AFFAIRS HEALTH PROFESSIONALS 
EDUCATIONAL ASSISTANCE PROGRAM. 
Section 3003(a)(1) of the Federal Reports Elimi-
nation and Sunset Act of 1995 (Public Law 104–66; 31 
U.S.C. 1113 note) shall not apply to the report required 
under section 7632 of title 38, United States Code. 
Æ 
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