I 113th CONGRESS 2d Session H. R. 4861 IN THE HOUSE OF REPRESENTATIVES June 12, 2014 Mr. Heck of Washington (for himself, Ms. DelBene , and Mr. Kilmer ) introduced the following bill; which was referred to the Committee on Veterans’ Affairs A BILL To establish the Commission on Access to Care to undertake a comprehensive evaluation and assessment of access to health care at the Department of Veterans Affairs.

1. Short title This Act may be cited as the Commission for Our Veterans’ Care Act . 2. Commission on Access to Care (a) Establishment of commission (1) In general There is established the Commission on Access to Care (in this section referred to as the Commission ). (2) Membership (A) Voting members The Commission shall be composed of voting 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 are experts concerning a public or private hospital system. (iii) At least one member from among persons who are leading experts in the private insurance industry. (iv) At least two members from among persons who are familiar with the Veterans Health Administration of the Department of Veterans Affairs. (B) Nonvoting members In addition to members appointed under subparagraph (A), the Commission shall be composed of 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 are experts in a public or private hospital system. (iii) At least one member from among persons who are leading experts in the private insurance industry. (iv) At least two members from among persons who are familiar with the Veterans Health Administration. (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 Commission. 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. (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 Commission shall undertake a comprehensive evaluation and assessment of access to health care at the Department of Veterans Affairs. (2) Matters evaluated and assessed The matters evaluated and assessed by the Commission shall include the following: (A) The appropriateness of current standards 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 standards described in subparagraph (A). (D) Staffing levels throughout the Veterans Health Administration and whether they are sufficient to meet current demand for health care from the Administration. (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 interim report on— (i) the findings of the Commission with respect to the evaluation and assessment required by this subsection; and (ii) such recommendations as the Commission may have for legislative or administrative 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 assessment required by this subsection; and (ii) such recommendations as the Commission may have for legislative or administrative action to improve access to 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 Federal 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 member of the Commission who is not an officer or employee of the Federal Government shall be compensated 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 members of the Commission who are officers or employees of the United States shall serve without compensation in addition to that received for their services as officers or employees of the United States. (2) Travel expenses The members of the Commission shall be allowed travel expenses, including per diem in lieu of subsistence, at rates authorized 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 terminate an executive director and such other additional personnel as may be necessary to enable the Commission to perform its duties. The employment of an executive director shall be subject to confirmation by the Commission. (B) Compensation The Chairperson of the Commission may fix the compensation of the executive director and other personnel without regard to chapter 51 and subchapter III of chapter 53 of title 5, United States Code, relating 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 intermittent services The Chairperson of the Commission may procure temporary and intermittent services under section 3109(b) of title 5, United States Code, at rates for individuals which do not exceed 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 Commission 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 appropriated or otherwise made available to the Secretary such amounts as the Secretary and the Chairperson of the Commission jointly consider appropriate for the Commission to perform its duties under this section. (g) Executive action (1) Action on recommendations The President shall require the Secretary of Veterans Affairs and such other heads of relevant Federal departments and agencies to implement each recommendation set forth in a report submitted under subsection (b)(3) that the President— (A) considers feasible and advisable; and (B) determines can be implemented without 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. (B) For each recommendation assessed as feasible and advisable under subparagraph (A) the following: (i) Whether such recommendation requires legislative action. (ii) If such recommendation requires legislative action, a recommendation concerning such legislative action. (iii) A description of any administrative action already taken to carry out such recommendation. (iv) A description of any administrative action the President intends to be taken to carry out such recommendation and by whom.