I 
119TH CONGRESS 
1ST SESSION H. R. 6733 
To amend title 38, United States Code, to make certain improvements to 
the administration of Veterans Integrated Service Networks under laws 
administered by the Secretary of Veterans Affairs, and for other pur-
poses. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 16, 2025 
Mr. BOST introduced the following bill; which was referred to the Committee 
on Veterans’ Affairs 
A BILL 
To amend title 38, United States Code, to make certain 
improvements to the administration of Veterans Inte-
grated Service Networks under laws administered by the 
Secretary of Veterans Affairs, 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 ‘‘VISN Reform Act of 
2025’’. 
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SEC. 2. ADMINISTRATION OF VETERANS INTEGRATED 
SERVICE NETWORKS. 
(a) VETERANS INTEGRATED SERVICE NETWORKS.— 
Subchapter I of chapter 73 of title 38, United States 
Code, is amended by inserting after section 7305 following 
new section: 
‘‘§ 7305A. Veterans Integrated Service Networks 
‘‘(a) ORGANIZATION.—The Secretary shall organize 
the Veterans Health Administration in eight geographi-
cally defined Veterans Integrated Service Networks (here-
inafter referred to as ‘VISNs’). 
‘‘(b) ALIGNMENT
WITH
MISSION
OF
DEPART-
MENT.—The Secretary shall ensure that the employees, 
services, and programs of each VISN are aligned with the 
mission of the Department and the specific health care 
requirements of each population of veterans in each Net-
work. 
‘‘(c) INTEGRATED HEALTH CARE SYSTEM.—The 
Secretary shall maintain a regional integrated health care 
system within the geographic area served by each VISN 
by— 
‘‘(1) entering into agreements with such other 
governmental, public, and private health care organi-
zations and practitioners as the Secretary considers 
appropriate to meet the needs of veterans who reside 
in the geographic area served by the VISN; 
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‘‘(2) providing oversight and management of, 
and taking responsibility for, a regional budget for 
the activities of each VISN that— 
‘‘(A) is aligned with the budget guidelines 
of the Department and the Veterans Health 
Administration; and 
‘‘(B) is balanced at the end of each fiscal 
year; and 
‘‘(3) using national metrics to develop systems 
to provide effective, efficient, and safe delivery of 
health care that is rated as highly satisfactory by 
patients and families of patients. 
‘‘(d) REDUCTION IN DUPLICATE FUNCTIONS.—The 
Secretary shall identify functions that are duplicated 
across the clinical, administrative, and operational proc-
esses and practices of the Veterans Health Administration 
and operate the system of VISNs in a manner designed 
to reduce the duplication of such functions. 
‘‘(e) COLLABORATION AND COOPERATION.—(1) The 
Secretary shall operate the VISN system by working to 
achieve maximum effectiveness with respect to the provi-
sion hospital care, medical services, and nursing home 
care, graduate medical education, and research; and 
‘‘(2) The Secretary shall assess, on an ongoing basis, 
the consolidation or realignment of institutional functions, 
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including capital asset, safety, and operational support 
functions, in collaboration and cooperation with other 
VISNs and the following offices or entities within the geo-
graphic area served by the VISN: 
‘‘(A) The offices of the Veterans Benefits Ad-
ministration and the National Cemetery Administra-
tion. 
‘‘(B) Offices of State and local agencies that 
have a mission to provide assistance to veterans. 
‘‘(C) Medical schools and other affiliates. 
‘‘(D) Federal, State, and local emergency pre-
paredness organizations. 
‘‘(E) Such other offices of the Federal Govern-
ment as the Secretary considers appropriate. 
‘‘(3) The Director of each VISN shall be responsible 
for oversight and for the enforcement of Department poli-
cies authorities applicable to medical facilities of the De-
partment with respect to such medical facilities located in 
the geographic area served by such VISN. 
‘‘(f) HEADQUARTERS.—(1) There shall be only one 
headquarters office for each VISN. The Secretary shall 
choose the location of each such office and shall ensure 
each such office is colocated with a medical center of the 
Department. 
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‘‘(2)(A) Each headquarters office established under 
paragraph (1) shall have not more than 50 full-time em-
ployees. Of such 50 full-time employees, not more than 
10 shall be contractor employees. 
‘‘(B)(i) The Secretary may waive the limitation under 
subparagraph (A) with respect to a VISN headquarters 
if the Secretary— 
‘‘(I) determines the waiver is necessary to 
maintain essential operations of the VISN head-
quarters during the implementation of the plan re-
quired under paragraph (3); and 
‘‘(II) before the date on which the waiver be-
comes effective, submits to the Committees on Vet-
erans’ Affairs of the Senate and the House of Rep-
resentatives a written certification of such deter-
mination. 
‘‘(ii) The term of any wavier issued pursuant to 
clause (i) may not exceed one year. 
‘‘(C) Not less frequently than once each fiscal year, 
the Secretary shall submit to the Committees on Veterans’ 
Affairs of the Senate and the House of Representatives 
a report on employment at the VISN headquarters offices 
during the preceding fiscal year. Each such report shall 
include the following for the year covered by the report: 
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‘‘(i) The number of individuals employed at 
each VISN headquarters office. 
‘‘(ii) The number of individuals employed by the 
Veterans Health Administration in each VISN who 
are not employed at the same location as the head-
quarters office of that VISN. 
‘‘(iii) The title for each position of employment 
at a headquarters office. 
‘‘(iv) The title for each position of employment 
with the Veterans Health Administration in each 
VISN whose duty station is not at the same location 
as the headquarters office of that VISN. 
‘‘(v) An assessment of the effect of the employ-
ment of individuals at VISN headquarters offices on 
the budget of the Department. 
‘‘(3)(A) Not later than 180 days after the date of 
the enactment of this section, the Secretary shall develop 
and submit to the Committees on Veterans’ Affairs of the 
Senate and the House of Representatives a comprehensive 
plan for the reorganization and right-sizing of the work-
force of each VISN headquarters to achieve compliance 
with the limitation under paragraph (2)(A). 
‘‘(B) The plan under subparagraph (A) shall include, 
for each VISN headquarters— 
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‘‘(i) an identification of all positions currently 
assigned to the headquarters, including duty loca-
tion, occupational services, pay grade, and primary 
function; 
‘‘(ii) a determination of which positions— 
‘‘(I) are essential to execute the mission of 
the VISN; and 
‘‘(II) are duplicative or administrative in 
nature; 
‘‘(iii) a phased implementation schedule for 
such plan; 
‘‘(iv) a description of any workforce realign-
ments, reassignments, or separations required to 
comply with the limitation under paragraph (2)(A), 
including voluntary separation incentive payments or 
retraining opportunities under title 5; and 
‘‘(v) a certification that the implementation of 
such plan will not result in a reduction in access to 
care or services furnished to veterans under the laws 
administered by the Secretary. 
‘‘(C) In developing and implementing the plan re-
quired under this subsection, the Secretary shall— 
‘‘(i) ensure that each VISN headquarters is in 
compliance with the limitation under paragraph 
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(2)(A) not later than the date that is three years 
after the date of the enactment of this section; and 
‘‘(ii) to the maximum extent practicable, offer 
each employee of a VISN headquarters who is a li-
censed physician, nurse, psychologist, or other 
healthcare professional such the opportunity to 
transfer, without loss of pay or benefits, to a posi-
tion appointed under chapter 74 of this title to fur-
nish direct patient care or clinical support at a De-
partment medical facility. 
‘‘(g) PERSONNEL.—(1) The head of each VISN shall 
be the Director, who shall be appointed by the President, 
by and with the advice and consent of the Senate. The 
position of Director of a VISN shall be a noncareer ap-
pointee position. The Director of a VISN shall— 
‘‘(A) be responsible for the functions of the 
VISN; and 
‘‘(B) have the authority and responsibility to 
enforce the policies and standards of the Depart-
ment with respect to all Department personnel em-
ployed within the VISN. 
‘‘(2) Each employee employed at a facility of the Vet-
erans Health Administration located in the geographic 
area served by a VISN shall— 
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‘‘(A) report directly to the Director of the 
VISN; 
‘‘(B) in the case of an employee who is licensed 
to practice in a hospital, work at least one day each 
week in a Department medical center located in such 
geographic area; and 
‘‘(C) visit routinely with service line chiefs at 
Department medical centers, as directed by the Sec-
retary. 
‘‘(h) TRIENNIAL STRUCTURE REVIEW, REASSESS-
MENT AND REPORT.—(1) Not later than three years after 
the date of the enactment of this section, and not less fre-
quently than once every three years thereafter, the Sec-
retary shall conduct a review and assessment of the struc-
ture and operations of the VISNs. 
‘‘(2) Not later than 180 days after conducting a re-
view and assessment under paragraph (1), the Secretary 
shall submit to the Committees on Veterans’ Affairs of 
the Senate and the House of Representatives a report on 
such review and assessment, which shall include such rec-
ommendations for legislative or regulatory action as the 
Secretary considers appropriate to improve the VISNs.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of chapter 73 of such title is amended 
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by inserting after the item relating to section 7305 the 
following new item: 
‘‘7305A. Veterans Integrated Service Networks’’. 
SEC. 3. CONSOLIDATION OF VETERANS INTEGRATED SERV-
ICE NETWORKS. 
In order to comply with section 7305A of title 38, 
United States Code, as added by section 2, not later than 
one year after the date of the enactment of this Act, the 
Secretary of Veterans Affairs shall geographically realign 
and combine the Veterans Integrated Service Networks in 
effect on the day before the date of enactment of this Act 
into geographically defined Veterans Integrated Service 
Networks as follows: 
(1) Veterans Integrated Service Network 1, 
Veterans Integrated Service Network 2, and Vet-
erans Integrated Service Network 4 shall be Com-
bined into a single Veterans Integrated Service Net-
work. 
(2) Veterans Integrated Service Network 5, 
Veterans Integrated Service Network 6, and Vet-
erans Integrated Service Network 9 shall be com-
bined into a single Veterans Integrated Service Net-
work. 
(3) Veterans Integrated Service Network 10, 
Veterans Integrated Service Network 12, and Vet-
eran Integrated Service Network 23 shall be com-
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bined into a single Veterans Integrated Service Net-
work. 
(4) Veterans Integrated Service Network 7, 
Veterans Integrated Service Network 8, and Veteran 
Integrated Service Network 16 shall be combined 
into a single Veterans Integrated Service Network. 
(5) Veterans Integrated Service Network 15 
and Veteran Integrated Service Network 19 shall be 
combined into a single Veterans Integrated Service 
Network. 
(6) Veterans Integrated Service Network 17 
and Veteran Integrated Service Network 22 shall be 
combined into a single Veterans Integrated Service 
Network. 
(7) Veterans Integrated Service Network 20 
shall remain a single Veterans Integrated Service 
Network. 
(8) Veterans Integrated Service Network 21 
shall remain a single Veterans Integrated Service 
Network. 
Æ 
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