(2) MEMBERSHIP.— 
(A) VOTING MEMBERS.—The Commission 
shall be composed of 10 voting members who 
are appointed by the President as follows: 
(i) At least two members who rep-
resent an organization recognized by the 
Secretary of Veterans Affairs for the rep-
resentation of veterans under section 5902 
of title 38, United States Code. 
(ii) At least one member from among 
persons who have experience as senior 
management for a private integrated 
health care system with an annual gross 
revenue of more than $50,000,000. 
(iii) At least one member from among 
persons who are familiar with government 
health care systems, including those sys-
tems of the Department of Defense, the 
Indian Health Service, and Federally-quali-
fied health centers (as defined in section 
1905(l)(2)(B) of the Social Security Act 
(42 U.S.C. 1396d(l)(2)(B))). 
(iv) At least two members from 
among persons who are familiar with the 
Veterans Health Administration but are 
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not current employees of the Veterans 
Health Administration. 
(v) At least two members from among 
persons who are veterans or eligible for 
hospital care, medical services, or other 
health care under the laws administered by 
the Secretary of Veterans Affairs. 
(B) NONVOTING MEMBERS.— 
(i) IN
GENERAL.—In addition to 
members appointed under subparagraph 
(A), the Commission shall be composed of 
10 nonvoting members who are appointed 
by the President as follows: 
(I) At least two members who 
represent an organization recognized 
by the Secretary of Veterans Affairs 
for the representation of veterans 
under section 5902 of title 38, United 
States Code. 
(II) At least one member from 
among persons who have experience 
as senior management for a private 
integrated health care system with an 
annual gross revenue of more than 
$50,000,000. 
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(III) At least one member from 
among persons who are familiar with 
government health care systems, in-
cluding those systems of the Depart-
ment of Defense, the Indian Health 
Service, and Federally-qualified health 
centers 
(as 
defined 
in 
section 
1905(l)(2)(B) of the Social Security 
Act (42 U.S.C. 1396d(l)(2)(B))). 
(IV) At least two members from 
among persons who are familiar with 
the Veterans Health Administration 
but are not current employees of the 
Veterans Health Administration. 
(V) At least two members from 
among persons who are veterans or el-
igible for hospital care, medical serv-
ices, or other health care under the 
laws administered by the Secretary of 
Veterans Affairs. 
(ii) ADDITIONAL
NONVOTING
MEM-
BERS.—In addition to members appointed 
under subparagraph (A) and clause (i), the 
Commission shall be composed of the fol-
lowing nonvoting members: 
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(I) The Comptroller General of 
the United States, or designee. 
(II) The Inspector General of the 
Department of Veterans Affairs, or 
designee. 
(C) DATE.—The appointments of members 
of the Commission shall be made not later than 
60 days after the date of the enactment of this 
Act. 
(3) PERIOD
OF
APPOINTMENT; VACANCIES.— 
Members shall be appointed for the life of the Com-
mission. Any vacancy in the Commission shall not 
affect its powers, but shall be filled in the same 
manner as the original appointment. 
(4) INITIAL MEETING.—Not later than 15 days 
after the date on which seven voting members of the 
Commission have been appointed, the Commission 
shall hold its first meeting. 
(5) MEETINGS.—The Commission shall meet at 
the call of the Chairperson. 
(6) QUORUM.—A majority of the members of 
the Commission shall constitute a quorum, but a 
lesser number of members may hold hearings. 
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(7) CHAIRPERSON AND VICE CHAIRPERSON.— 
The Commission shall select a Chairperson and Vice 
Chairperson from among its members. 
(b) DUTIES OF COMMISSION.— 
(1) EVALUATION AND ASSESSMENT.—The Com-
mission shall undertake a comprehensive evaluation 
and assessment of access to health care at the De-
partment of Veterans Affairs. 
(2) MATTERS
EVALUATED
AND
ASSESSED.— 
The matters evaluated and assessed by the Commis-
sion shall include the following: 
(A) The appropriateness of current stand-
ards of the Department of Veterans Affairs 
concerning access to health care. 
(B) The measurement of such standards. 
(C) The appropriateness of performance 
standards and incentives in relation to stand-
ards described in subparagraph (A). 
(D) Staffing levels throughout the Vet-
erans Health Administration and whether they 
are sufficient to meet current demand for 
health care from the Administration. 
(E) The results of the assessment con-
ducted by an independent third party under 
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section 101(a), including any data or rec-
ommendations included in such assessment. 
(3) REPORTS.—The Commission shall submit 
to the President, through the Secretary of Veterans 
Affairs, reports as follows: 
(A) Not later than 90 days after the date 
of the initial meeting of the Commission, an in-
terim report on— 
(i) the findings of the Commission 
with respect to the evaluation and assess-
ment required by this subsection; and 
(ii) such recommendations as the 
Commission may have for legislative or ad-
ministrative action to improve access to 
health care through the Veterans Health 
Administration. 
(B) Not later than 180 days after the date 
of the initial meeting of the Commission, a final 
report on— 
(i) the findings of the Commission 
with respect to the evaluation and assess-
ment required by this subsection; and 
(ii) such recommendations as the 
Commission may have for legislative or ad-
ministrative action to improve access to 
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health care through the Veterans Health 
Administration. 
(c) POWERS OF THE COMMISSION.— 
(1) HEARINGS.—The Commission may hold 
such hearings, sit and act at such times and places, 
take such testimony, and receive such evidence as 
the Commission considers advisable to carry out this 
section. 
(2) INFORMATION FROM FEDERAL AGENCIES.— 
The Commission may secure directly from any Fed-
eral department or agency such information as the 
Commission considers necessary to carry out this 
section. Upon request of the Chairperson of the 
Commission, the head of such department or agency 
shall furnish such information to the Commission. 
(d) COMMISSION PERSONNEL MATTERS.— 
(1) COMPENSATION OF MEMBERS.—Each mem-
ber of the Commission who is not an officer or em-
ployee of the Federal Government shall be com-
pensated at a rate equal to the daily equivalent of 
the annual rate of basic pay prescribed for level IV 
of the Executive Schedule under section 5315 of title 
5, United States Code, for each day (including travel 
time) during which such member is engaged in the 
performance of the duties of the Commission. All 
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members of the Commission who are officers or em-
ployees of the United States shall serve without com-
pensation in addition to that received for their serv-
ices as officers or employees of the United States. 
(2) TRAVEL EXPENSES.—The members of the 
Commission shall be allowed travel expenses, includ-
ing per diem in lieu of subsistence, at rates author-
ized for employees of agencies under subchapter I of 
chapter 57 of title 5, United States Code, while 
away from their homes or regular places of business 
in the performance of services for the Commission. 
(3) STAFF.— 
(A) IN GENERAL.—The Chairperson of the 
Commission may, without regard to the civil 
service laws and regulations, appoint and termi-
nate an executive director and such other addi-
tional personnel as may be necessary to enable 
the Commission to perform its duties. The em-
ployment of an executive director shall be sub-
ject to confirmation by the Commission. 
(B) COMPENSATION.—The Chairperson of 
the Commission may fix the compensation of 
the executive director and other personnel with-
out regard to chapter 51 and subchapter III of 
chapter 53 of title 5, United States Code, relat-
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ing to classification of positions and General 
Schedule pay rates, except that the rate of pay 
for the executive director and other personnel 
may not exceed the rate payable for level V of 
the Executive Schedule under section 5316 of 
such title. 
(4) DETAIL
OF
GOVERNMENT
EMPLOYEES.— 
Any Federal Government employee may be detailed 
to the Commission without reimbursement, and such 
detail shall be without interruption or loss of civil 
service status or privilege. 
(5) PROCUREMENT OF TEMPORARY AND INTER-
MITTENT SERVICES.—The Chairperson of the Com-
mission may procure temporary and intermittent 
services under section 3109(b) of title 5, United 
States Code, at rates for individuals that do not ex-
ceed the daily equivalent of the annual rate of basic 
pay prescribed for level V of the Executive Schedule 
under section 5316 of such title. 
(e) TERMINATION OF THE COMMISSION.—The Com-
mission shall terminate 30 days after the date on which 
the Commission submits its report under subsection 
(b)(3)(B). 
(f) FUNDING.—The Secretary of Veterans Affairs 
shall make available to the Commission from amounts ap-
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propriated or otherwise made available to the Secretary 
such amounts as the Secretary and the Chairperson of the 
Commission jointly consider appropriate for the Commis-
sion to perform its duties under this section. 
(g) EXECUTIVE ACTION.— 
(1) 
ACTION
ON
RECOMMENDATIONS.—The 
President shall require the Secretary of Veterans Af-
fairs and such other heads of relevant Federal de-
partments and agencies to implement each rec-
ommendation set forth in a report submitted under 
subsection (b)(3) that the President— 
(A) considers feasible and advisable; and 
(B) determines can be implemented with-
out further legislative action. 
(2) REPORTS.—Not later than 60 days after 
the date on which the President receives a report 
under subsection (b)(3), the President shall submit 
to the Committee on Veterans’ Affairs of the Senate 
and the Committee on Veterans’ Affairs of the 
House of Representatives and such other committees 
of Congress as the President considers appropriate 
a report setting forth the following: 
(A) An assessment of the feasibility and 
advisability of each recommendation contained 
in the report received by the President. 
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(B) For each recommendation assessed as 
feasible and advisable under subparagraph (A) 
the following: 
(i) Whether such recommendation re-
quires legislative action. 
(ii) If such recommendation requires 
legislative action, a recommendation con-
cerning such legislative action. 
(iii) A description of any administra-
tive action already taken to carry out such 
recommendation. 
(iv) A description of any administra-
tive action the President intends to be 
taken to carry out such recommendation 
and by whom. 
SEC. 
404. 
IMPROVED 
PERFORMANCE 
METRICS 
FOR 
HEALTH CARE PROVIDED BY DEPARTMENT 
OF VETERANS AFFAIRS. 
(a) PROHIBITION
ON USE
OF SCHEDULING
AND 
WAIT-TIME METRICS IN DETERMINATION OF PERFORM-
ANCE AWARDS.—The Secretary of Veterans Affairs shall 
ensure that scheduling and wait-time metrics or goals are 
not used as factors in determining the performance of the 
following employees for purposes of determining whether 
to pay performance awards to such employees: 
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(1) Directors, associate directors, assistant di-
rectors, deputy directors, chiefs of staff, and clinical 
leads of medical centers of the Department of Vet-
erans Affairs. 
(2) Directors, assistant directors, and quality 
management officers of Veterans Integrated Service 
Networks of the Department of Veterans Affairs. 
(b) MODIFICATION OF PERFORMANCE PLANS.— 
(1) IN GENERAL.—Not later than 30 days after 
the date of the enactment of this Act, the Secretary 
shall modify the performance plans of the directors 
of the medical centers of the Department and the di-
rectors of the Veterans Integrated Service Networks 
to ensure that such plans are based on the quality 
of care received by veterans at the health care facili-
ties under the jurisdictions of such directors. 
(2) FACTORS.—In modifying performance plans 
under paragraph (1), the Secretary shall ensure that 
assessment of the quality of care provided at health 
care facilities under the jurisdiction of a director de-
scribed in paragraph (1) includes consideration of 
the following: 
(A) Recent reviews by the Joint Commis-
sion (formerly known as the ‘‘Joint Commission 
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on Accreditation of Healthcare Organizations’’) 
of such facilities. 
(B) The number and nature of rec-
ommendations concerning such facilities by the 
Inspector General of the Department in reviews 
conducted through the Combined Assessment 
Program (CAP), in the reviews by the Inspector 
General of community based outpatient clinics 
and primary care clinics, and in reviews con-
ducted through the Office of Healthcare Inspec-
tions during the two most recently completed 
fiscal years. 
(C) The number of recommendations de-
scribed in subparagraph (B) that the Inspector 
General of the Department determines have not 
been carried out satisfactorily with respect to 
such facilities. 
(D) Reviews of such facilities by the Com-
mission on Accreditation of Rehabilitation Fa-
cilities. 
(E) The number and outcomes of adminis-
trative investigation boards, root cause analysis, 
and peer reviews conducted at such facilities 
during the fiscal year for which the assessment 
is being conducted. 
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(F) The effectiveness of any remedial ac-
tions or plans resulting from any Inspector 
General recommendations in the reviews and 
analyses 
described 
in 
subparagraphs 
(A) 
through (E). 
(3) ADDITIONAL LEADERSHIP POSITIONS.—To 
the degree practicable, the Secretary shall assess the 
performance of other employees of the Department 
in leadership positions at Department medical cen-
ters, including associate directors, assistant direc-
tors, deputy directors, chiefs of staff, and clinical 
leads, and in Veterans Integrated Service Networks, 
including assistant directors and quality manage-
ment officers, using factors and criteria similar to 
those used in the performance plans modified under 
paragraph (1). 
(c) REMOVAL OF CERTAIN PERFORMANCE GOALS.— 
For each fiscal year that begins after the date of the en-
actment of this Act, the Secretary shall not include in the 
performance goals of any employee of a Veterans Inte-
grated Service Network or medical center of the Depart-
ment any performance goal that might disincentivize the 
payment of Department amounts to provide hospital care, 
medical services, or other health care through a non-De-
partment provider. 
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SEC. 
405. 
IMPROVED 
TRANSPARENCY 
CONCERNING 
HEALTH CARE PROVIDED BY DEPARTMENT 
OF VETERANS AFFAIRS. 
(a) PUBLICATION OF WAIT TIMES.— 
(1) GOALS.— 
(A) INITIAL.—Not later than 90 days after 
the date of the enactment of this Act, the Sec-
retary of Veterans Affairs shall publish in the 
Federal Register, and on an Internet website 
accessible to the public of each medical center 
of the Department of Veterans Affairs, the 
wait-time goals of the Department for the 
scheduling of an appointment by a veteran for 
the receipt of health care from the Department. 
(B) SUBSEQUENT CHANGES.— 
(i) IN
GENERAL.—If the Secretary 
modifies the wait-time goals described in 
subparagraph (A), the Secretary shall pub-
lish the new wait-times goals— 
(I) on an Internet website acces-
sible to the public of each medical 
center of the Department not later 
than 30 days after such modification; 
and 
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(II) in the Federal Register not 
later than 90 days after such modi-
fication. 
(ii) EFFECTIVE DATE.—Any modifica-
tion under clause (i) shall take effect on 
the date of publication in the Federal Reg-
ister. 
(C) GOALS DESCRIBED.—Wait-time goals 
published under this paragraph shall include 
goals for primary care appointments, specialty 
care appointments, and appointments based on 
the general severity of the condition of the vet-
eran. 
(2) WAIT TIMES AT MEDICAL CENTERS OF THE 
DEPARTMENT.—Not later than one year after the 
date of the enactment of this Act, the Secretary of 
Veterans Affairs shall publish on an Internet website 
accessible to the public of each medical center of the 
Department the current wait time for an appoint-
ment for primary care and specialty care at the 
medical center. 
(b) PUBLICLY AVAILABLE DATABASE OF PATIENT 
SAFETY, QUALITY
OF CARE, AND OUTCOME MEAS-
URES.— 
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(1) IN
GENERAL.—Not later than 180 days 
after the date of the enactment of this Act, the Sec-
retary shall develop and make available to the public 
a comprehensive database containing all applicable 
patient safety, quality of care, and outcome meas-
ures for health care provided by the Department 
that are tracked by the Secretary. 
(2) UPDATE FREQUENCY.—The Secretary shall 
update the database required by paragraph (1) not 
less frequently than once each year. 
(3) UNAVAILABLE MEASURES.—For all meas-
ures that the Secretary would otherwise publish in 
the database required by paragraph (1) but has not 
done so because such measures are not available, the 
Secretary shall publish notice in the database of the 
reason for such unavailability and a timeline for 
making such measures available in the database. 
(4) ACCESSIBILITY.—The Secretary shall en-
sure that the database required by paragraph (1) is 
accessible to the public through the primary Internet 
website of the Department and through each pri-
mary Internet website of a Department medical cen-
ter. 
(c) HOSPITAL COMPARE WEBSITE OF DEPARTMENT 
OF HEALTH AND HUMAN SERVICES.— 
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(1) AGREEMENT
REQUIRED.—Not later than 
180 days after the date of the enactment of this Act, 
the Secretary of Veterans Affairs shall enter into an 
agreement with the Secretary of Health and Human 
Services for the provision by the Secretary of Vet-
erans Affairs of such information as the Secretary of 
Health and Human Services may require to report 
and make publicly available patient quality and out-
come information concerning Department of Vet-
erans Affairs medical centers through the Hospital 
Compare Internet website of the Department of 
Health and Human Services or any successor Inter-
net website. 
(2) INFORMATION PROVIDED.—The information 
provided by the Secretary of Veterans Affairs to the 
Secretary of Health and Human Services under 
paragraph (1) shall include the following: 
(A) Measures of timely and effective health 
care. 
(B) Measures of readmissions, complica-
tions of death, including with respect to 30-day 
mortality rates and 30-day readmission rates, 
surgical complication measures, and health care 
related infection measures. 
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(C) Survey data of patient experiences, in-
cluding the Hospital Consumer Assessment of 
Healthcare Providers and Systems or any simi-
lar successor survey developed by the Depart-
ment of Health and Human Services. 
(D) Any other measures required of or re-
ported with respect to hospitals participating in 
the Medicare program under title XVIII of the 
Social Security Act (42 U.S.C. 1395 et seq.). 
(3) UNAVAILABLE INFORMATION.—For any ap-
plicable metric collected by the Department of Vet-
erans Affairs or required to be provided under para-
graph (2) and withheld from or unavailable in the 
Hospital Compare Internet website, the Secretary of 
Veterans Affairs shall publish a notice in the Fed-
eral Register stating the reason why such metric was 
withheld from public disclosure and a timeline for 
making such metric available, if applicable. 
(d) COMPTROLLER GENERAL REVIEW OF PUBLICLY 
AVAILABLE SAFETY AND QUALITY METRICS.—Not later 
than three years after the date of the enactment of this 
Act, the Comptroller General of the United States shall 
conduct a review of the safety and quality metrics made 
publicly available by the Secretary of Veterans Affairs 
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under this section to assess the degree to which the Sec-
retary is complying with the provisions of this section. 
SEC. 406. INFORMATION FOR VETERANS ON THE CREDEN-
TIALS OF DEPARTMENT OF VETERANS AF-
FAIRS PHYSICIANS. 
(a) IMPROVEMENT OF ‘‘OUR PROVIDERS’’ INTERNET 
WEBSITE LINKS.— 
(1) AVAILABILITY THROUGH DEPARTMENT OF 
VETERANS AFFAIRS HOMEPAGE.—A link to the ‘‘Our 
Providers’’ health care providers database of the De-
partment of Veterans Affairs, or any successor data-
base, shall be available on and through the home-
page of the Internet website of the Department that 
is accessible to the public. 
(2) INFORMATION ON LOCATION OF RESIDENCY 
TRAINING.—The Internet website of the Department 
that is accessible to the public shall include under 
the link to the ‘‘Our Providers’’ health care pro-
viders database of the Department, or any successor 
database, the location of residency training of each 
licensed physician of the Department. 
(3) INFORMATION
ON
PHYSICIANS
AT
PAR-
TICULAR FACILITIES.—The ‘‘Our Providers’’ health 
care providers database of the Department, or any 
successor database, shall identify whether each li-
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censed physician of the Department is a physician in 
residency. 
(b) INFORMATION ON CREDENTIALS OF PHYSICIANS 
FOR VETERANS UNDERGOING SURGICAL PROCEDURES.— 
(1) IN GENERAL.—Each veteran who is under-
going a surgical procedure by or through the De-
partment shall be provided information on the cre-
dentials of the surgeon to be performing such proce-
dure at such time in advance of the procedure as is 
appropriate to permit such veteran to evaluate such 
information. 
(2) OTHER INDIVIDUALS.—If a veteran is un-
able to evaluate the information provided under 
paragraph (1) due to the health or mental com-
petence of the veteran, such information shall be 
provided to an individual acting on behalf of the vet-
eran. 
(c) COMPTROLLER GENERAL REPORT AND PLAN.— 
(1) REPORT.—Not later than two years after 
the date of the enactment of this Act, the Comp-
troller General of the United States shall submit to 
the Committee on Veterans’ Affairs of the Senate 
and the Committee on Veterans’ Affairs of the 
House of Representatives a report setting forth an 
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assessment by the Comptroller General of the fol-
lowing: 
(A) The manner in which contractors 
under the Patient-Centered Community Care 
initiative of the Department perform oversight 
of the credentials of physicians within the net-
works of such contractors under the initiative. 
(B) The oversight by the Department of 
the contracts under the Patient-Centered Com-
munity Care initiative. 
(C) The verification by the Department of 
the credentials and licenses of health care pro-
viders furnishing hospital care and medical 
services under section 301. 
(2) PLAN.— 
(A) IN GENERAL.—Not later than 30 days 
after the submittal of the report under para-
graph (1), the Secretary shall— 
(i) submit to the Comptroller General, 
the Committee on Veterans’ Affairs of the 
Senate, and the Committee on Veterans’ 
Affairs of the House of Representatives a 
plan to address any findings and rec-
ommendations of the Comptroller General 
included in such report; and 
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(ii) submit to the Committee on Vet-
erans’ Affairs of the Senate and the Com-
mittee on Veterans’ Affairs of the House 
of Representatives a request for additional 
amounts, if any, that may be necessary to 
carry out such plan. 
(B) IMPLEMENTATION.—Not later than 90 
days after the submittal of the report under 
paragraph (1), the Secretary shall carry out 
such plan. 
SEC. 407. INFORMATION IN ANNUAL BUDGET OF THE 
PRESIDENT ON HOSPITAL CARE AND MED-
ICAL SERVICES FURNISHED THROUGH EX-
PANDED USE OF CONTRACTS FOR SUCH 
CARE. 
The materials on the Department of Veterans Affairs 
in the budget of the President for a fiscal year, as sub-
mitted to Congress pursuant to section 1105(a) of title 
31, United States Code, shall set forth the following: 
(1) The number of veterans who received hos-
pital care and medical services under section 301 
during the fiscal year preceding the fiscal year in 
which such budget is submitted. 
(2) The amount expended by the Department 
on furnishing care and services under such section 
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during the fiscal year preceding the fiscal year in 
which such budget is submitted. 
(3) The amount requested in such budget for 
the costs of furnishing care and services under such 
section during the fiscal year covered by such budg-
et, set forth in aggregate and by amounts for each 
account for which amounts are so requested. 
(4) The number of veterans that the Depart-
ment estimates will receive hospital care and medical 
services under such section during the fiscal years 
covered by the budget submission. 
(5) The number of employees of the Depart-
ment on paid administrative leave at any point dur-
ing the fiscal year preceding the fiscal year in which 
such budget is submitted. 
SEC. 408. PROHIBITION ON FALSIFICATION OF DATA CON-
CERNING WAIT TIMES AND QUALITY MEAS-
URES AT DEPARTMENT OF VETERANS AF-
FAIRS. 
Not later than 60 days after the date of the enact-
ment of this Act, and in accordance with title 5, United 
States Code, the Secretary of Veterans Affairs shall estab-
lish policies whereby any employee of the Department of 
Veterans Affairs who knowingly submits false data con-
cerning wait times for health care or quality measures 
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with respect to health care to another employee of the De-
partment or knowingly requires another employee of the 
Department to submit false data concerning such wait 
times or quality measures to another employee of the De-
partment is subject to a penalty the Secretary considers 
appropriate after notice and an opportunity for a hearing, 
including civil penalties, unpaid suspensions, or termi-
nation. 
SEC. 409. REMOVAL OF SENIOR EXECUTIVE SERVICE EM-
PLOYEES OF THE DEPARTMENT OF VET-
ERANS AFFAIRS FOR PERFORMANCE. 
(a) REMOVAL OR TRANSFER.— 
(1) IN GENERAL.—Chapter 7 of title 38, United 
States Code, is amended by adding at the end the 
following new section: 
‘‘§ 713. Senior Executive Service: removal based on 
performance 
‘‘(a) IN GENERAL.—The Secretary may remove any 
individual from the Senior Executive Service if the Sec-
retary determines the performance of the individual war-
rants such removal. If the Secretary so removes such an 
individual, the Secretary may— 
‘‘(1) remove the individual from the civil service 
(as defined in section 2101 of title 5); or 
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‘‘(2) transfer the individual to a General Sched-
ule position at any grade of the General Schedule for 
which the individual is qualified and that the Sec-
retary determines is appropriate. 
‘‘(b) NOTICE TO CONGRESS.—Not later than 30 days 
after removing or transferring an individual from the Sen-
ior Executive Service under subsection (a), the Secretary 
shall submit to the Committees on Veterans’ Affairs of 
the Senate and the House of Representatives notice in 
writing of such removal or transfer and the reason for 
such removal or transfer. 
‘‘(c) PROCEDURE.—(1) The procedures under section 
7543 of title 5 shall not apply to a removal or transfer 
under this section. 
‘‘(2)(A) Subject to subparagraph (B), any removal or 
transfer under subsection (a) may be appealed to the 
Merit Systems Protection Board under section 7701 of 
title 5. 
‘‘(B) An appeal under subparagraph (A) of a removal 
or transfer may only be made if such appeal is made not 
later than 7 days after the date of such removal or trans-
fer. 
‘‘(d) EXPEDITED REVIEW BY MERIT SYSTEMS PRO-
TECTION BOARD.—(1) The Merit Systems Protection 
Board shall expedite any appeal under section 7701 of 
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title 5 of a removal or transfer under subsection (a) and, 
in any such case, shall issue a decision not later than 21 
days after the date of the appeal. 
‘‘(2) In any case in which the Merit Systems Protec-
tion Board determines that it cannot issue a decision in 
accordance with the 21-day requirement under paragraph 
(1), the Merit Systems Protection Board shall submit to 
Congress a report that explains the reason why the Merit 
Systems Protection Board is unable to issue a decision in 
accordance with such requirement in such case. 
‘‘(3) There is authorized to be appropriated such 
sums as may be necessary for the Merit Systems Protec-
tion Board to expedite appeals under paragraph (1). 
‘‘(4) The Merit Systems Protection Board may not 
stay any personnel action taken under this section. 
‘‘(5) A person who appeals under section 7701 of title 
5 a removal under subsection (a)(1) may not receive any 
pay, awards, bonuses, incentives, allowances, differentials, 
student loan repayments, special payments, or benefits 
from the Secretary until the Merit Systems Protection 
Board has made a final decision on such appeal. 
‘‘(6) A decision made by the Merit Systems Protec-
tion Board with respect to a removal or transfer under 
subsection (a) shall not be subject to any further appeal.’’. 
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(2) CLERICAL AMENDMENT.—The table of sec-
tions at the beginning of such chapter is amended 
by adding at the end the following new item: 
‘‘713. Senior Executive Service: removal based on performance.’’. 
(b) ESTABLISHMENT OF EXPEDITED REVIEW PROC-
ESS.— 
(1) IN GENERAL.—Not later than 30 days after 
the date of the enactment of this Act, the Merit Sys-
tems Protection Board shall establish and put into 
effect a process to conduct expedited reviews in ac-
cordance with section 713(d) of title 38, United 
States Code. 
(2) INAPPLICABILITY
OF
CERTAIN
REGULA-
TIONS.—Section 1201.22 of title 5, Code of Federal 
Regulations, as in effect on the day before the date 
of the enactment of this Act, shall not apply to expe-
dited reviews carried out under section 713(d) of 
title 38, United States Code. 
(3) REPORT BY MERIT SYSTEMS PROTECTION 
BOARD.—Not later than 30 days after the date of 
the enactment of this Act, the Merit Systems Pro-
tection Board shall submit to Congress a report on 
the actions the Board plans to take to conduct expe-
dited reviews under section 713(d) of title 38, 
United States Code, as added by subsection (a). 
Such report shall include a description of the re-
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sources the Board determines will be necessary to 
conduct such reviews and a description of whether 
any resources will be necessary to conduct such re-
views that were not available to the Board on the 
day before the date of the enactment of this Act. 
(c) TEMPORARY EXEMPTION FROM CERTAIN LIMI-
TATION ON INITIATION OF REMOVAL FROM SENIOR EX-
ECUTIVE SERVICE.—During the 120-day period beginning 
on the date of the enactment of this Act, an action to re-
move an individual from the Senior Executive Service at 
the Department of Veterans Affairs pursuant to section 
713 of title 38, United States Code, as added by sub-
section (a), or section 7543 of title 5, United States Code, 
may be initiated, notwithstanding section 3592(b) of title 
5, United States Code, or any other provision of law. 
(d) CONSTRUCTION.—Nothing in this section or sec-
tion 713 of title 38, United States Code, as added by sub-
section (a), shall be construed to apply to an appeal of 
a removal, transfer, or other personnel action that was 
pending before the date of the enactment of this Act. 
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TITLE V—HEALTH CARE 
RELATED TO SEXUAL TRAUMA 
SEC. 501. EXPANSION OF ELIGIBILITY FOR SEXUAL TRAU-
MA COUNSELING AND TREATMENT TO VET-
ERANS ON INACTIVE DUTY TRAINING. 
Section 1720D(a)(1) of title 38, United States Code, 
is amended by striking ‘‘or active duty for training’’ and 
inserting ‘‘, active duty for training, or inactive duty train-
ing’’. 
SEC. 502. PROVISION OF COUNSELING AND TREATMENT 
FOR SEXUAL TRAUMA BY THE DEPARTMENT 
OF VETERANS AFFAIRS TO MEMBERS OF THE 
ARMED FORCES. 
(a) EXPANSION OF COVERAGE TO MEMBERS OF THE 
ARMED FORCES.—Subsection (a) of section 1720D of title 
38, United States Code, is amended— 
(1) by redesignating paragraph (2) as para-
graph (3); 
(2) by inserting after paragraph (1) the fol-
lowing new paragraph (2): 
‘‘(2)(A) In operating the program required by para-
graph (1), the Secretary may, in consultation with the 
Secretary of Defense, provide counseling and care and 
services to members of the Armed Forces (including mem-
bers of the National Guard and Reserves) on active duty 
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to overcome psychological trauma described in that para-
graph. 
‘‘(B) A member described in subparagraph (A) shall 
not be required to obtain a referral before receiving coun-
seling and care and services under this paragraph.’’; and 
(3) in paragraph (3), as redesignated by para-
graph (1)— 
(A) by striking ‘‘a veteran’’ and inserting 
‘‘an individual’’; and 
(B) by striking ‘‘that veteran’’ each place 
it appears and inserting ‘‘that individual’’. 
(b) INFORMATION TO MEMBERS ON AVAILABILITY OF 
COUNSELING AND SERVICES.—Subsection (c) of such sec-
tion is amended— 
(1) by striking ‘‘to veterans’’ each place it ap-
pears; and 
(2) in paragraph (3), by inserting ‘‘members of 
the Armed Forces and’’ before ‘‘individuals’’. 
(c) INCLUSION OF MEMBERS IN REPORTS ON COUN-
SELING AND SERVICES.—Subsection (e) of such section 
is amended— 
(1) in the matter preceding paragraph (1), by 
striking ‘‘to veterans’’; 
(2) in paragraph (2)— 
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SEC. 503. REPORTS ON MILITARY SEXUAL TRAUMA. 
(a) REPORT ON SERVICES AVAILABLE FOR MILITARY 
SEXUAL TRAUMA IN THE DEPARTMENT OF VETERANS 
AFFAIRS.—Not later than 630 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs 
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 the treatment and 
services available from the Department of Veterans Af-
fairs for male veterans who experience military sexual 
trauma compared to such treatment and services available 
to female veterans who experience military sexual trauma. 
(b) REPORTS ON TRANSITION OF MILITARY SEXUAL 
TRAUMA TREATMENT FROM DEPARTMENT OF DEFENSE 
TO DEPARTMENT
OF VETERANS AFFAIRS.—Not later 
than 630 days after the date of the enactment of this Act, 
and annually thereafter for five years, the Department of 
Veterans Affairs-Department of Defense Joint Executive 
Committee established by section 320(a) of title 38, 
United States Code, shall submit to the appropriate com-
mittees of Congress a report on military sexual trauma 
that includes the following: 
(1) The processes and procedures utilized by 
the Department of Veterans Affairs and the Depart-
ment of Defense to facilitate transition of treatment 
of individuals who have experienced military sexual 
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trauma from treatment provided by the Department 
of Defense to treatment provided by the Department 
of Veterans Affairs. 
(2) A description and assessment of the collabo-
ration between the Department of Veterans Affairs 
and the Department of Defense in assisting veterans 
in filing claims for disabilities related to military 
sexual trauma, including permitting veterans access 
to information and evidence necessary to develop or 
support such claims. 
(c) DEFINITIONS.—In this section: 
(1) 
APPROPRIATE
COMMITTEES
OF
CON-
GRESS.—The term ‘‘appropriate committees of Con-
gress’’ means— 
(A) the Committee on Veterans’ Affairs 
and the Committee on Armed Services of the 
Senate; and 
(B) the Committee on Veterans’ Affairs 
and the Committee on Armed Services of the 
House of Representatives. 
(2) MILITARY
SEXUAL
TRAUMA.—The term 
‘‘military sexual trauma’’ means psychological trau-
ma, which in the judgment of a mental health pro-
fessional employed by the Department, resulted from 
a physical assault of a sexual nature, battery of a 
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sexual nature, or sexual harassment which occurred 
while the veteran was serving on active duty or ac-
tive duty for training. 
(3) SEXUAL HARASSMENT.—The term ‘‘sexual 
harassment’’ means repeated, unsolicited verbal or 
physical contact of a sexual nature which is threat-
ening in character. 
(4) SEXUAL TRAUMA.—The term ‘‘sexual trau-
ma’’ shall have the meaning given that term by the 
Secretary of Veterans Affairs for purposes of this 
section. 
(d) EFFECTIVE DATE.—This section shall take effect 
on the date that is 270 days after the date of the enact-
ment of this Act. 
TITLE VI—MAJOR MEDICAL 
FACILITY LEASES 
SEC. 601. AUTHORIZATION OF MAJOR MEDICAL FACILITY 
LEASES. 
The Secretary of Veterans Affairs may carry out the 
following major medical facility leases at the locations 
specified, and in an amount for each lease not to exceed 
the amount shown for such location (not including any es-
timated cancellation costs): 
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(1) For a clinical research and pharmacy co-
ordinating center, Albuquerque, New Mexico, an 
amount not to exceed $9,560,000. 
(2) For a community-based outpatient clinic, 
Brick, New Jersey, an amount not to exceed 
$7,280,000. 
(3) For a new primary care and dental clinic 
annex, Charleston, South Carolina, an amount not 
to exceed $7,070,250. 
(4) For the Cobb County community-based 
Outpatient Clinic, Cobb County, Georgia, an amount 
not to exceed $6,409,000. 
(5) For the Leeward Outpatient Healthcare Ac-
cess Center, Honolulu, Hawaii, including a co-lo-
cated clinic with the Department of Defense and the 
co-location of the Honolulu Regional Office of the 
Veterans Benefits Administration and the Kapolei 
Vet Center of the Department of Veterans Affairs, 
an amount not to exceed $15,887,370. 
(6) For a community-based outpatient clinic, 
Johnson County, Kansas, an amount not to exceed 
$2,263,000. 
(7) For a replacement community-based out-
patient clinic, Lafayette, Louisiana, an amount not 
to exceed $2,996,000. 
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(8) For a community-based outpatient clinic, 
Lake Charles, Louisiana, an amount not to exceed 
$2,626,000. 
(9) For outpatient clinic consolidation, New 
Port Richey, Florida, an amount not to exceed 
$11,927,000. 
(10) For an outpatient clinic, Ponce, Puerto 
Rico, an amount not to exceed $11,535,000. 
(11) For lease consolidation, San Antonio, 
Texas, an amount not to exceed $19,426,000. 
(12) For a community-based outpatient clinic, 
San Diego, California, an amount not to exceed 
$11,946,100. 
(13) For an outpatient clinic, Tyler, Texas, an 
amount not to exceed $4,327,000. 
(14) For the Errera Community Care Center, 
West Haven, Connecticut, an amount not to exceed 
$4,883,000. 
(15) For the Worcester community-based Out-
patient Clinic, Worcester, Massachusetts, an amount 
not to exceed $4,855,000. 
(16) For the expansion of a community-based 
outpatient clinic, Cape Girardeau, Missouri, an 
amount not to exceed $4,232,060. 
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(17) For a multispecialty clinic, Chattanooga, 
Tennessee, an amount not to exceed $7,069,000. 
(18) For the expansion of a community-based 
outpatient clinic, Chico, California, an amount not to 
exceed $4,534,000. 
(19) For a community-based outpatient clinic, 
Chula Vista, California, an amount not to exceed 
$3,714,000. 
(20) For a new research lease, Hines, Illinois, 
an amount not to exceed $22,032,000. 
(21) For a replacement research lease, Hous-
ton, Texas, an amount not to exceed $6,142,000. 
(22) For a community-based outpatient clinic, 
Lincoln, Nebraska, an amount not to exceed 
$7,178,400. 
(23) For a community-based outpatient clinic, 
Lubbock, 
Texas, 
an 
amount 
not 
to 
exceed 
$8,554,000. 
(24) For a community-based outpatient clinic 
consolidation, Myrtle Beach, South Carolina, an 
amount not to exceed $8,022,000. 
(25) For a community-based outpatient clinic, 
Phoenix, Arizona, an amount not to exceed 
$20,757,000. 
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(26) For the expansion of a community-based 
outpatient clinic, Redding, California, an amount not 
to exceed $8,154,000. 
SEC. 602. BUDGETARY TREATMENT OF DEPARTMENT OF 
VETERANS AFFAIRS MAJOR MEDICAL FACILI-
TIES LEASES. 
(a) FINDINGS.—Congress finds the following: 
(1) Title 31, United States Code, requires the 
Department of Veterans Affairs to record the full 
cost of its contractual obligation against funds avail-
able at the time a contract is executed. 
(2) Office of Management and Budget Circular 
A–11 provides guidance to agencies in meeting the 
statutory requirements under title 31, United States 
Code, with respect to leases. 
(3) For operating leases, Office of Management 
and Budget Circular A–11 requires the Department 
of Veterans Affairs to record up-front budget au-
thority in an ‘‘amount equal to total payments under 
the full term of the lease or [an] amount sufficient 
to cover first year lease payments plus cancellation 
costs’’. 
(b) REQUIREMENT
FOR
OBLIGATION
OF
FULL 
COST.— 
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(1) IN GENERAL.—Subject to the availability of 
appropriations provided in advance, in exercising the 
authority of the Secretary of Veterans Affairs to 
enter into leases provided in this Act, the Secretary 
shall record, pursuant to section 1501 of title 31, 
United States Code, as the full cost of the contrac-
tual obligation at the time a contract is executed ei-
ther— 
(A) an amount equal to total payments 
under the full term of the lease; or 
(B) if the lease specifies payments to be 
made in the event the lease is terminated before 
its full term, an amount sufficient to cover the 
first year lease payments plus the specified can-
cellation costs. 
(2) SELF-INSURING AUTHORITY.—The require-
ments of paragraph (1) may be satisfied through the 
use of a self-insuring authority consistent with Of-
fice of Management and Budget Circular A–11. 
(c) TRANSPARENCY.— 
(1) COMPLIANCE.—Subsection (b) of section 
8104 of title 38, United States Code, is amended by 
adding at the end the following new paragraph: 
‘‘(7) In the case of a prospectus proposing 
funding for a major medical facility lease, a detailed 
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analysis of how the lease is expected to comply with 
Office of Management and Budget Circular A–11 
and section 1341 of title 31 (commonly referred to 
as the ‘Anti-Deficiency Act’). Any such analysis shall 
include— 
‘‘(A) an analysis of the classification of the 
lease as a ‘lease-purchase’, ‘capital lease’, or 
‘operating lease’ as those terms are defined in 
Office of Management and Budget Circular A– 
11; 
‘‘(B) an analysis of the obligation of budg-
etary resources associated with the lease; and 
‘‘(C) an analysis of the methodology used 
in determining the asset cost, fair market value, 
and cancellation costs of the lease.’’. 
(2) SUBMITTAL
TO
CONGRESS.—Such section 
8104 is further amended by adding at the end the 
following new subsection: 
‘‘(h)(1) Not less than 30 days before entering into 
a major medical facility lease, the Secretary shall submit 
to the Committees on Veterans’ Affairs of the Senate and 
the House of Representatives— 
‘‘(A) notice of the Secretary’s intention to enter 
into the lease; 
‘‘(B) a detailed summary of the proposed lease; 
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‘‘(C) a description and analysis of any dif-
ferences between the prospectus submitted pursuant 
to subsection (b) and the proposed lease; and 
‘‘(D) a scoring analysis demonstrating that the 
proposed lease fully complies with Office of Manage-
ment and Budget Circular A–11. 
‘‘(2) Each committee described in paragraph (1) shall 
ensure that any information submitted to the committee 
under such paragraph is treated by the committee with 
the same level of confidentiality as is required by law of 
the Secretary and subject to the same statutory penalties 
for unauthorized disclosure or use as the Secretary. 
‘‘(3) Not more than 30 days after entering into a 
major medical facility lease, the Secretary shall submit to 
each committee described in paragraph (1) a report on 
any material differences between the lease that was en-
tered into and the proposed lease described under such 
paragraph, including how the lease that was entered into 
changes the previously submitted scoring analysis de-
scribed in subparagraph (D) of such paragraph.’’. 
(d) RULE OF CONSTRUCTION.—Nothing in this sec-
tion, or the amendments made by this section, shall be 
construed to in any way relieve the Department of Vet-
erans Affairs from any statutory or regulatory obligations 
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or requirements existing prior to the enactment of this 
section and such amendments. 
TITLE VII—VETERANS BENEFITS 
MATTERS 
SEC. 701. EXPANSION OF MARINE GUNNERY SERGEANT 
JOHN DAVID FRY SCHOLARSHIP. 
(a) EXPANSION
OF
ENTITLEMENT.—Subsection 
(b)(9) of section 3311 of title 38, United States Code, is 
amended by inserting ‘‘or spouse’’ after ‘‘child’’. 
(b) LIMITATION AND ELECTION ON CERTAIN BENE-
FITS.—Subsection (f) of such section is amended— 
(1) by redesignating paragraph (2) as para-
graph (4); and 
(2) by inserting after paragraph (1) the fol-
lowing new paragraphs: 
‘‘(2) LIMITATION.—The entitlement of an indi-
vidual to assistance under subsection (a) pursuant to 
paragraph (9) of subsection (b) because the indi-
vidual was a spouse of a person described in such 
paragraph shall expire on the earlier of— 
‘‘(A) the date that is 15 years after the 
date on which the person died; and 
‘‘(B) the date on which the individual re-
marries. 
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‘‘(3) ELECTION ON RECEIPT OF CERTAIN BENE-
FITS.—A surviving spouse entitled to assistance 
under subsection (a) pursuant to paragraph (9) of 
subsection (b) who is also entitled to educational as-
sistance under chapter 35 of this title may not re-
ceive assistance under both this section and such 
chapter, but shall make an irrevocable election (in 
such form and manner as the Secretary may pre-
scribe) under which section or chapter to receive 
educational assistance.’’. 
(c) CONFORMING AMENDMENT.—Section 3321(b)(4) 
of such title is amended— 
(1) by striking ‘‘an individual’’ and inserting ‘‘a 
child’’; and 
(2) by striking ‘‘such individual’s’’ each time it 
appears and inserting ‘‘such child’s’’. 
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SEC. 702. APPROVAL OF COURSES OF EDUCATION PRO-
VIDED BY PUBLIC INSTITUTIONS OF HIGHER 
LEARNING FOR PURPOSES OF ALL-VOLUN-
TEER 
FORCE 
EDUCATIONAL 
ASSISTANCE 
PROGRAM AND POST-9/11 EDUCATIONAL AS-
SISTANCE CONDITIONAL ON IN-STATE TUI-
TION RATE FOR VETERANS. 
(a) IN GENERAL.—Section 3679 of title 38, United 
States Code, is amended by adding at the end the fol-
lowing new subsection: 
‘‘(c)(1) Notwithstanding any other provision of this 
chapter and subject to paragraphs (3) through (6), the 
Secretary shall disapprove a course of education provided 
by a public institution of higher learning to a covered indi-
vidual pursuing a course of education with educational as-
sistance under chapter 30 or 33 of this title while living 
in the State in which the public institution of higher learn-
ing is located if the institution charges tuition and fees 
for that course for the covered individual at a rate that 
is higher than the rate the institution charges for tuition 
and fees for that course for residents of the State in which 
the institution is located, regardless of the covered individ-
ual’s State of residence. 
‘‘(2) For purposes of this subsection, a covered indi-
vidual is any individual as follows: 
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‘‘(A) A veteran who was discharged or released 
from a period of not fewer than 90 days of service 
in the active military, naval, or air service less than 
three years before the date of enrollment in the 
course concerned. 
‘‘(B) An individual who is entitled to assistance 
under section 3311(b)(9) or 3319 of this title by vir-
tue of such individual’s relationship to a veteran de-
scribed in subparagraph (A). 
‘‘(3) If after enrollment in a course of education that 
is subject to disapproval under paragraph (1) by reason 
of paragraph (2)(A) or (2)(B) a covered individual pur-
sues one or more courses of education at the same public 
institution of higher learning while remaining continuously 
enrolled (other than during regularly scheduled breaks be-
tween courses, semesters or terms) at that institution of 
higher learning, any course so pursued by the covered indi-
vidual at that institution of higher learning while so con-
tinuously enrolled shall also be subject to disapproval 
under paragraph (1). 
‘‘(4) It shall not be grounds to disapprove a course 
of education under paragraph (1) if a public institution 
of higher learning requires a covered individual pursuing 
a course of education at the institution to demonstrate an 
intent, by means other than satisfying a physical presence 
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100 
requirement, to establish residency in the State in which 
the institution is located, or to satisfy other requirements 
not relating to the establishment of residency, in order to 
be charged tuition and fees for that course at a rate that 
is equal to or less than the rate the institution charges 
for tuition and fees for that course for residents of the 
State. 
‘‘(5) The Secretary may waive such requirements of 
paragraph (1) as the Secretary considers appropriate. 
‘‘(6) Disapproval under paragraph (1) shall apply 
only with respect to educational assistance under chapters 
30 and 33 of this title.’’. 
(b) EFFECTIVE DATE.—Subsection (c) of section 
3679 of title 38, United States Code (as added by sub-
section (a) of this section), shall apply with respect to edu-
cational assistance provided for pursuit of programs of 
education during academic terms that begin after July 1, 
2015, through courses of education that commence on or 
after that date. 
TITLE 
VIII—APPROPRIATION 
AND EMERGENCY DESIGNA-
TIONS 
SEC. 801. APPROPRIATION OF EMERGENCY AMOUNTS. 
There is authorized to be appropriated, and is appro-
priated, to the Secretary of Veterans Affairs, out of any 
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funds in the Treasury not otherwise appropriated, for fis-
cal years 2014, 2015, and 2016, such sums as may be 
necessary to carry out this Act. 
SEC. 802. EMERGENCY DESIGNATIONS. 
(a) IN GENERAL.—This Act is designated as an 
emergency requirement pursuant to section 4(g) of the 
Statutory Pay-As-You-Go Act of 2010 (2 U.S.C. 933(g)). 
(b) DESIGNATION IN SENATE.—In the Senate, this 
Act is designated as an emergency requirement pursuant 
to section 403(a) of S. Con. Res. 13 (111th Congress), 
the concurrent resolution on the budget for fiscal year 
2010. 
Æ 
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