I 
113TH CONGRESS 
2D SESSION 
H. R. 5007 
To assess staffing shortages at medical facilities of the Department of 
Veterans Affairs, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 26, 2014 
Mr. RUIZ introduced the following bill; which was referred to the Committee 
on Veterans’ Affairs 
A BILL 
To assess staffing shortages at medical facilities of the 
Department 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 ‘‘Restoring Account-
ability in Veterans Access to Health Care Act’’. 
SEC. 2. TREATMENT OF STAFFING SHORTAGE AND REPORT 
ON STAFFING OF MEDICAL FACILITIES OF 
THE DEPARTMENT OF VETERANS AFFAIRS. 
(a) STAFFING SHORTAGE.— 
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(1) IN
GENERAL.—Not later than 180 days 
after the date of the enactment of this Act, and an-
nually thereafter, the Inspector General of the De-
partment of Veterans Affairs shall determine, and 
publish in the Federal Register, the five occupations 
of health care providers of the Department of Vet-
erans Affairs for which there is the largest staffing 
shortage throughout the Department. 
(2) RECRUITMENT
AND
APPOINTMENT.—Not-
withstanding sections 3304 and 3309 through 3318 
of title 5, United States Code, the Secretary of Vet-
erans Affairs, based upon a determination by the In-
spector General under paragraph (1) that there is a 
staffing shortage throughout the Department with 
respect to a particular occupation of health care pro-
vider, may recruit and directly appoint highly quali-
fied health care providers to a position to serve as 
a health care provider in that particular occupation 
for the Department. 
(b) REPORTS.— 
(1) IN
GENERAL.—Not later than 180 days 
after the date of the enactment of this Act, and not 
later than December 31 of each even numbered year 
thereafter until 2024, the Secretary of Veterans Af-
fairs shall submit to the Committee on Veterans’ Af-
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fairs of the Senate and the Committee on Veterans’ 
Affairs of the House of Representatives a report as-
sessing the staffing of each medical facility of the 
Department of Veterans Affairs. 
(2) ELEMENTS.—Each report submitted under 
paragraph (1) shall include the following: 
(A) The results of a system-wide assess-
ment of all medical facilities of the Department 
to ensure the following: 
(i) Appropriate staffing levels for 
health care providers to meet the goals of 
the Secretary for timely access to care for 
veterans. 
(ii) Appropriate staffing levels for 
support personnel, including clerks. 
(iii) Appropriate sizes for clinical pan-
els. 
(iv) Appropriate numbers of full-time 
staff, or full-time equivalent, dedicated to 
direct care of patients. 
(v) The appropriate physician to pa-
tient ratio (including for both primary and 
specialty care), as compared to such ratio 
as it exists on the date of the report. 
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(vi) Appropriate physical plant space 
to meet the capacity needs of the Depart-
ment in that area. 
(vii) Such other factors as the Sec-
retary considers necessary. 
(B) An explanation of the measurable pro-
ductivity standards used to establish the levels 
in the assessment described in subparagraph 
(A). 
(C) A plan for addressing any issues iden-
tified in the assessment described in subpara-
graph (A), including a timeline for addressing 
such issues. 
(D) A list of the current wait times and 
workload levels for the following clinics in each 
medical facility: 
(i) Mental health. 
(ii) Primary care. 
(iii) Gastroenterology. 
(iv) Women’s health. 
(v) Specialty care. 
(vi) Ophthalmology. 
(vii) Such other clinics as the Sec-
retary considers appropriate. 
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(E) A description of the results of the de-
termination of the Secretary under paragraph 
(1) of subsection (a) and a plan to use direct 
appointment authority under paragraph (2) of 
such subsection to fill staffing shortages, in-
cluding recommendations for improving the 
speed at which the credentialing and privileging 
process can be conducted. 
(F) The current staffing models of the De-
partment for the following clinics, including rec-
ommendations for changes to such models: 
(i) Mental health. 
(ii) Primary care. 
(iii) Gastroenterology. 
(iv) Women’s health. 
(v) Specialty care. 
(vi) Ophthalmology. 
(vii) Such other clinics as the Sec-
retary considers appropriate. 
(G) A detailed analysis of succession plan-
ning at medical facilities of the Department, in-
cluding the following: 
(i) The number of positions in medical 
facilities throughout the Department that 
are not filled by a permanent employee. 
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