II 118th CONGRESS 1st Session S. 3341 IN THE SENATE OF THE UNITED STATES November 15, 2023 Mr. Tester (for himself, Mr. Moran , and Ms. Hirono ) introduced the following bill; which was read twice and referred to the Committee on Veterans' Affairs A BILL To improve the emergency management capabilities of the Department of Veterans Affairs, and for other purposes.

1. Short title This Act may be cited as the Advancing VA’s Emergency Response to (AVERT) Crises Act of 2023 . 2. Requirement for Department of Veterans Affairs to implement a fully operational emergency communications system throughout medical facilities of Department (a) Implementation required Not later than two years after the date of the enactment of this Act, the Secretary of Veterans Affairs shall implement a fully operational high-frequency emergency communications system throughout medical facilities of the Department of Veterans Affairs. (b) Purpose of system The system required to be implemented under subsection (a) shall— (1) serve as a means of maintaining communications at medical facilities of the Department during disasters or emergencies without the need for external infrastructure; (2) enable emergency communications between medical facilities of the Department and other Government agencies with high-frequency communications capabilities; and (3) be used to reestablish the provision of health care services to veterans, maintain the situational awareness of staff of the Department, coordinate emergency response, and request resources as needed. (c) Consultation In preparing to carry out subsection (a), the Secretary of Veterans Affairs shall consult with the Secretary of Homeland Security and the heads of such other Federal agencies as the Secretary of Veterans Affairs considers relevant, on best practices in implementing high-frequency emergency communications. (d) Contracts (1) In general In carrying out subsection (a), the Secretary of Veterans Affairs shall— (A) renegotiate any contract in effect on the day before the date of the enactment of this Act that provides for the Resilient High Frequency Radio Network of the Department; or (B) solicit such new contracts as the Secretary considers appropriate to provide the high-frequency emergency communications services and equipment necessary to carry out subsection (a). (2) Maintenance In carrying out subsection (a), the Secretary shall ensure that a contract is in effect for the high-frequency emergency communications system required by such subsection, including for the provision of on-demand maintenance and routine maintenance. (e) Requirements In carrying out subsection (a), the Secretary shall— (1) designate one office in the Central Office of the Department to lead the implementation of the emergency communications system required under such subsection; (2) create a staffing model to be distributed to and used by medical facilities of the Department— (A) to identify who at the facility level will be responsible for verifying that the equipment for such system is fully functional; and (B) to ensure such system is monitored at all times; (3) create and distribute guidelines to medical facilities of the Department, in conjunction with the appropriately designated contracting officer or acquisition center, for acceptance and installation of such system, including demonstration of operability before final inspection and acceptance of such system; (4) ensure equipment functionality and operator knowledge by creating and managing a training and testing program to include— (A) ensuring relevant staff receive comprehensive training regarding such system, including training on operation and maintenance of such system; (B) conducting internal exercises at all medical facilities of the Department not less frequently than once per year to test equipment functionality and ensure staff have experience operating the equipment in a simulated emergency; and (C) collaborating with the Secretary of Homeland Security to determine the feasibility of conducting multi-agency exercises every two years; (5) create and distribute general guidance to medical facilities of the Department regarding where emergency communications equipment should be located in a medical facility, and collect and store information on the location of the equipment in each medical facility; (6) ensure medical facilities of the Department include information on such system in each facility-specific Comprehensive Emergency Management Program, or successor program; and (7) ensure medical facilities of the Department regularly monitor the staffing levels and training programs for such system to ensure enough trained staff are available to monitor such system at all times. (f) Phased implementation (1) Initial locations The Secretary of Veterans Affairs shall ensure that the system required by subsection (a) is initially installed and tested throughout three Veterans Integrated Service Networks the Secretary shall select for the purposes of this section. (2) Determination of fully operational system and notice to Congress (A) In general Once the system required by subsection (a) is installed and tested in the three Veterans Integrated Service Networks pursuant to paragraph (1) and the Secretary determines the system is fully operational in accordance with subparagraph (B) and is able to be implemented at all medical facilities of the Department, the Secretary shall submit to Congress notice of such determination. (B) Determination The Secretary may only determine that the system described in subparagraph (A) is fully operational if— (i) the Secretary validates the completion of training, certification, and system use by the applicable workforce; (ii) the system has been monitored by the applicable workforce for a period of three months; (iii) the system has been in operation for a continuous period of three months without any system outages; and (iv) the Secretary has completed two training exercises involving all test installation sites. (3) Full implementation Once the Secretary has determined pursuant to paragraph (2) that the system required by subsection (a) is fully operational and submitted notice to Congress of such determination in accordance with such paragraph, the Secretary shall implement the system at all medical facilities of the Department. (g) Initial report (1) In general Not later than 180 days after the date of the enactment of this Act, the Secretary 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 plans of the Secretary to implement the system required by subsection (a). (2) Elements The report submitted pursuant to paragraph (1) shall include the following: (A) A detailed timeline of the planned implementation of the system required by subsection (a). (B) An identification of the three Veterans Integrated Service Networks selected under subsection (f)(1). (C) A description of the specific metrics and benchmarks the Secretary plans to use to make the determination under subsection (f)(2). (D) A description of the plans of the Secretary for contracting under subsection (d)(1). (E) A description of the plans of the Secretary for contracting under subsection (d)(2). (F) A spending plan for implementation of the system. (G) An identification of which office the Department has designated under subsection (e)(1). (H) An identification of the staffing structure of the office identified in subparagraph (G), including any plans to change the structure of such office to more effectively implement the system. (I) Details on the roles and responsibilities of each of the following entities in implementing the system: (i) The office identified pursuant to subparagraph (G). (ii) Any other offices of the Department involved at the Central Office of the Department. (iii) Veterans Integrated Service Networks. (iv) Medical facilities of the Department. (J) A description of the staffing model required under subsection (e)(2). (K) Details on the training required under subsection (e)(4)(A), including— (i) the components of the training; (ii) the duration of the training; (iii) the frequency of the training; (iv) which employees will be required to take such training; (v) whether the training will be conducted by the Department or a contractor; and (vi) how the Secretary plans to oversee and track completion of the training. (L) A description of the guidelines created and distributed under subsection (e)(5). (M) A description of how the Secretary plans to ensure medical facilities of the Department include information on the system in each facility-specific Comprehensive Emergency Management Program, or successor program. (N) A description of how the Secretary plans to ensure medical facilities of the Department regularly monitor the staffing levels for the system to ensure enough trained staff are available to monitor the system at all times. (O) A description of any updates the Secretary plans to make to the directives of the Department on the topic of emergency communications. (P) An assessment of whether other facilities of the Department, including facilities of the Veterans Benefits Administration and facilities of the National Cemetery Administration, require the implementation of a high-frequency emergency communications system, and if so— (i) the plan of the Secretary to implement a high-frequency emergency communications system throughout such facilities; and (ii) whether the Secretary requires action by Congress to carry out such plan. (h) Annual reports (1) In general Not later than 90 days after the date on which the Secretary completes implementation of the system under subsection (a), and not less frequently than once each year thereafter, the Secretary 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 operations of such system. (2) Contents Each report submitted pursuant to paragraph (1) shall include, for the period covered by the report, the following: (A) Information on whether each site hosting the system required by subsection (a) is adequately staffed to monitor the system 24 hours per day for seven days per week. (B) Information on whether any outages have occurred with respect to such system since the previous report, or, for the first report, whether any outages have occurred since the full implementation of such system under subsection (f)(3). (C) The results of internal and external exercises conducted to demonstrate functionality of such system. (D) Whether any contract renegotiations or modifications or new contracts have occurred for either the procurement of high-frequency emergency communications equipment, maintenance, or training. (E) Any updated guidance or trainings provided to employees tasked with overseeing such system. (i) OIG report Not later than three years after the date of the enactment of this Act, the Inspector General of the Department 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 implementation by the Department of the system required by subsection (a), which shall include an analysis of the following: (1) The effectiveness and functionality of the system. (2) The staffing model required under subsection (e)(2). (3) The level of coordination by the Central Office of the Department with medical facilities of the Department in helping those facilities implement and maintain the system. (4) The effectiveness of the training and testing program required under subsection (e)(4). (5) Any difficulties with ensuring trained staff are available to monitor the system at all times. 3. Report on emergency management roles for Department of Veterans Affairs (a) In general Not later than 180 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 outlining the roles and responsibilities of all offices of the Department of Veterans Affairs involved with emergency management. (b) Consultation In preparing the report required by subsection (a), the Secretary of Veterans Affairs shall consult with the Comptroller General of the United States, the Inspector General of the Department of Veterans Affairs, the Secretary of Homeland Security, and such other Federal agencies as the Secretary of Veterans Affairs considers relevant, to obtain insights from their experience and trends that they have found, and such recommendations as they may have with respect to the management by the Department of Veterans Affairs of emergency management functions. (c) Contents The report submitted pursuant to subsection (a) shall include the following: (1) A description of the organizational structure of each office, both during normal operations and during emergency or disaster operations. (2) The roles and responsibilities of each office. (3) A detailed description of roles and responsibilities that are shared by both the Office of Emergency Management of the Department and the Office of Operations, Security, and Preparedness of the Department, including an analysis of how each office plays a part in emergency management functions. (4) Recommendations for improving the structure and alignment of relevant offices to better prepare the Department for emergencies, remove redundancies, and improve accountability. (5) An analysis of the feasibility and advisability of consolidating relevant offices into one centralized emergency management office to improve communication and streamline emergency preparedness and response efforts of the Department. 4. Report on Regional Readiness Centers of Department of Veterans Affairs (a) In general Not later than 180 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 Regional Readiness Centers of the Department of Veterans Affairs. (b) Contents The report submitted pursuant to subsection (a) shall include the following: (1) The number of requests made by facilities of the Department to obtain supplies from a Regional Readiness Center since the inception of the Regional Readiness Center program, disaggregated by Regional Readiness Center. (2) Information on types and amounts of material distributed since the inception of the Regional Readiness Center program, disaggregated by Regional Readiness Center. (3) Current inventory, disaggregated by Regional Readiness Center. (4) An overview of the change in inventory in each Regional Readiness Center during the two-year period ending on the date of the enactment of this Act. (5) The percentage of inventory that is expired or that will expire in the next month, disaggregated by Regional Readiness Center. (6) Operational costs since the inception of the Regional Readiness Center program, disaggregated by Regional Readiness Center. (7) An analysis of the types and sizes of emergencies, including natural disasters, public health emergencies, or Fourth Mission activations of the Department, with respect to which each Regional Readiness Center would be able to provide sufficient resources to respond to, based on the current capacity of the Regional Readiness Center. (8) Any plans of the Secretary to realign or change the number of Regional Readiness Centers. 5. Improvements to the emergency cache program of Department of Veterans Affairs Not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall carry out the following: (1) Tracking system and minimum time frames Establish a tracking system and minimum time frames by which the Emergency Pharmacy Service initiates resupply orders to make sure emergency caches and emergency pharmacy vehicles are fully stocked with unexpired inventory. Such time frames shall account for— (A) any extension of the shelf life of inventory under the Shelf Life Extension Program; and (B) historical data of the Department of Veterans Affairs on the time it typically takes the Department to reorder, receive, and restock emergency caches or emergency pharmacy vehicles, as the case may be. (2) Accountability mechanism Create an accountability mechanism to ensure the Emergency Pharmacy Service and the Watch Office are maintaining accurate and complete records of emergency cache activations. (3) Guidelines on authorized access Provide guidelines for facilities of the Department regarding which individuals are authorized to access the emergency caches. (4) Guidelines on responsibility for distribution Provide guidelines for facilities of the Department regarding which individuals are responsible for distributing the contents of the emergency cache if activated. (5) Training Provide all Department employees identified by the Secretary under paragraphs (3) and (4) with a training that includes information on— (A) the contents of the emergency cache; (B) circumstances for use of the emergency cache; (C) the actions the employee should take if they believe activation of the cache is warranted; and (D) procedures for distributing the contents of the cache. (6) Oversight of Veterans Health Administration emergency caches Designate one program office of the Department to have primary responsibility for oversight of emergency caches of the Veterans Health Administration. 6. Plan to allow fuel sharing and increased coordination between the Federal Emergency Management Agency and the Department of Veterans Affairs Not later than 90 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall, after consulting with the Administrator of the Federal Emergency Management Agency, submit to the Committee on Veterans’ Affairs of the Senate, the Committee on Veterans’ Affairs of the House of Representatives, the Committee on Homeland Security and Government Affairs of the Senate, and the Committee on Homeland Security of the House of Representatives a report regarding— (1) the current limitations preventing the Federal Emergency Management Agency from providing fuel or other resources to the Department of Veterans Affairs during emergencies; (2) whether the Department requires action by Congress to allow such resource provision to occur; (3) whether the Secretary has been unable to coordinate with the Administrator during prior emergencies or Fourth Mission activations due to a lack of authority for such coordination; and (4) whether the Secretary requires action by Congress to address any of the issues mentioned under paragraph (3).