Title: Accountability for Quality VA Healthcare Act
Policy area: Armed Forces and National Security

Summary:
Accountability for Quality VA Healthcare Act
This bill directs the Department of Veterans Affairs (VA) to carry out a two-year pilot program to enhance the physical security of VA medical facilities.
The VA shall periodically update its Planning and Activating Community Based Outpatient Clinics handbook to reflect current policies and clarify the responsibilities of VA leasing project personnel.
The VA shall: (1) strengthen its medical facility inspection process; and (2) monitor women veterans' access to gender-specific care services under community care contracts, including appointment scheduling and completion times.
The VA shall: (1) clarify measures for medical appointment wait times in a manner that reduces the likelihood of misinterpretation, (2) ensure that "patient indicated date" (the earliest date the patient needs to be seen) is clearly defined for purposes of Veterans Health Administration (VHA) scheduling and related training documents, (3) improve recruitment and retention of scheduling staff and require facilities to routinely assess scheduling and resource needs, and (4) improve telephone access at its medical facilities.

The VA shall conduct evaluations of the VHA's organizational structure and the Veterans Integrated Service Networks (regional VA health care administrative areas).

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3874 Introduced in House (IH)]

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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 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.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 28, 2017

   Mr. Kilmer (for himself, Mr. Renacci, Mr. Amodei, Mrs. Brooks of 
 Indiana, 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. Webster of Florida, Mrs. 
    Murphy of Florida, Mr. Welch, Mr. Barletta, Mr. Rutherford, Mr. 
    Valadao, and Mr. Barr) introduced the following 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.

    Be it enacted by the Senate and House of Representatives 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 DEPARTMENT 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 enhance the physical security of Department of 
Veterans Affairs 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 features, 
                including closed-circuit television cameras.
    (b) Locations.--The Secretary shall select five medical facilities 
of the Department to participate in the pilot program.
    (c) Termination.--The pilot program shall terminate 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 termination of the 
pilot program under subsection (c), the Secretary shall submit to 
Congress a report on the pilot program.

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 Veterans Affairs shall submit 
to Congress a report on the findings and recommendations of the report 
of the Government 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 strategic 
        capital investment planning process, including limitations to 
        scoring and approval and access to information.
            (2) To assess the value of the Department of Veterans 
        Affairs Integrated Planning facility master plans as a 
        facility-planning tool, and based on conclusions 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 Veterans 
        Integrated Service Networks and facilities using best practices 
        on how to effectively communicate 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 practices.
    (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 Department.

SEC. 4. UPDATE OF HANDBOOK TO IMPROVE LEASING PROJECTS.

    Not later than 180 days after the date of the enactment 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 Affairs 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 involved 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 findings:
            (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.
            (3) Women veterans are the fastest growing cohort within 
        the veteran community.
            (4) Women serve in every branch of the Armed Forces and 
        represent nearly 15 percent of the members 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 Veterans Affairs is expected to 
        increase dramatically.
    (b) Sense of Congress.--It is the sense of Congress 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 Department of Veterans Affairs 
Medical Facilities and Improvement of Care for Women Provided by 
Department of Veterans Affairs.--
            (1) Improvement of inspections process.--The Secretary of 
        Veterans Affairs shall strengthen the environment of care 
        inspections process and oversight of such process by--
                    (A) expanding the list of requirements that 
                facility staff inspect for compliance to align with the 
                policy of the Veterans Health Administration;
                    (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-specific care services under current and 
                future community care contracts or agreements. Such 
                monitoring shall include an examination of appointment 
                scheduling and completion times, driving times to 
                appointments, and reasons appointments could not be 
                scheduled with community providers.
                    (B) Definitions.--In this subparagraph:
                            (i) The term ``gender-specific care 
                        services'' means mammography, maternity care, 
                        and gynecology.
                            (ii) The term ``community care contract 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 contract or agreement under 
                        which the Secretary 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 DEPARTMENT OF VETERANS 
              AFFAIRS MEDICAL FACILITIES.

    (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 individual misinterpreting such measures.
    (b) Scheduling.--The Secretary shall ensure that the term ``patient 
indicated date'' is clearly defined for 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 Veterans Affairs medical 
        facilities to routinely assess the scheduling needs and 
        resources required to ensure that employees of such facilities 
        are allocated in such a manner as to adequately respond to the 
        demand for scheduling medical appointments.
            (2) Recruitment and retention.--The Secretary shall develop 
        a strategy to improve recruitment and retention of Department 
        of Veterans Affairs medical providers and employees who perform 
        scheduling functions for Department medical facilities. Such 
        strategy shall be designed to ensure adequate staffing of 
        Department medical facilities and shall emphasize recruitment 
        and retention in facilities located in rural areas.
    (d) Telephone Access.--The Secretary shall--
            (1) ensure that all Department medical facilities provide 
        oversight of telephone access and implement 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 outdated 
        telephone technology and replace such technology with new 
        systems designed to improve telephone service and access to 
        health care.

SEC. 7. EVALUATIONS OF ORGANIZATIONAL STRUCTURE OF VETERANS HEALTH 
              ADMINISTRATION AND REALIGNMENT OF VETERANS INTEGRATED 
              SERVICE NETWORKS.

    (a) Organizational Structure.--
            (1) Process.--The Secretary of Veterans Affairs, 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, recommendations made by reviews 
                described in paragraph (3), including--
                            (i) the roles of each such official and 
                        office; and
                            (ii) a description of how decisions are 
                        made and documented to approve such 
                        implementation.
                    (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 described in this 
        paragraph are reviews of the organizational structure of the 
        Veterans Health Administration conducted by the Secretary, the 
        Inspector General of the Department of Veterans Affairs, the 
        Comptroller General of the United States, the Commission 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.
            (4) First use.--The Under Secretary shall use the process 
        under paragraph (1) to evaluate the results of the evaluation 
        conducted under subsection (b)(1). The Under Secretary shall 
        make any required 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 titled ``VA Health 
        Care: Processes to Evaluate, Implement, 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 Networks that 
                require corrective action.
            (2) Assessment and implementation.--In accordance with 
        subsection (a)(4), the Under Secretary shall use the process 
        implemented under subsection (a) to assess the results of the 
        evaluation conducted under paragraph (1) and to implement 
        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 purposes.

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 regarding efforts to recruit, hire, and retain nurses for the 
Veterans 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 recruit, hire, 
        and retain nurses for the Veterans Health Administration; and
            (3) recommendations for legislation the Secretary considers 
        appropriate.

SEC. 9. REINSTATEMENT OF REPORTING REQUIREMENT REGARDING THE DEPARTMENT 
              OF VETERANS AFFAIRS HEALTH PROFESSIONALS EDUCATIONAL 
              ASSISTANCE PROGRAM.

    Section 3003(a)(1) of the Federal Reports Elimination 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.
                                 <all>