US Codex
Bill
Notes

Title IV — Health Care Administrative Matters

S. 2422 · 113th Congress · Jun 3, 2014 · Lineage

IV Health Care Administrative Matters

Sec. 401 Improvement of access of veterans to mobile vet centers of the Department of Veterans Affairs

(a)
Improvement of access—
(1)
In general— The Secretary of Veterans Affairs shall improve the access of veterans to telemedicine and other health care through the use of mobile vet centers of the Department of Veterans Affairs by providing standardized requirements for the operation of such centers.
(2)
Requirements— The standardized requirements required by paragraph (1) shall include the following:
(A)
The number of days each mobile vet center of the Department is expected to travel per year.
(B)
The number of locations each center is expected to visit per year.
(C)
The number of appointments each center is expected to conduct per year.
(D)
The method and timing of notifications given by each center to individuals in the area to which such center is traveling, including notifications informing veterans of the availability to schedule appointments at the center.
(3)
Use of telemedicine— The Secretary shall ensure that each mobile vet center of the Department has the capability to provide telemedicine services.
(b)
Reports— Not later than one year after the date of the enactment of this Act, and not later than September 30 each year thereafter, 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 following:
(1)
The use of mobile vet centers to provide telemedicine services to veterans during the year preceding the submittal of the report, including the following:
(A)
The number of days each mobile vet center was open to provide such services.
(B)
The number of days each mobile vet center traveled to a location other than the headquarters of the mobile vet center to provide such services.
(C)
The number of appointments each center conducted to provide such services on average per month and in total during such year.
(2)
An analysis of the effectiveness of using mobile vet centers to provide health care services to veterans through the use of telemedicine.
(3)
Any recommendations for an increase in the number of mobile vet centers of the Department.
(4)
Any recommendations for an increase in the telemedicine capabilities of each mobile vet center.
(5)
The feasibility and advisability of using temporary health care providers, including locum tenens, to provide direct health care services to veterans at mobile vet centers.
(6)
Such other recommendations on improvement of the use of mobile vet centers by the Department as the Secretary considers appropriate.

Sec. 402 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”) to examine the access of veterans to health care from the Department of Veterans Affairs and strategically examine how best to organize the Veterans Health Administration, locate health care resources, and deliver health care to veterans during the next 10 to 20 years.
(2)
Membership—
(A)
Voting members— The Commission shall be composed of 10 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 familiar with government health care systems, including those systems of the Department of Defense, the Indian Health Service, and Federally-qualified health centers (as defined in section 1905(l)(2)(B) of the Social Security Act (42 U.S.C. 1396d(l)(2)(B))).
(iv)
At least two members from among persons who are familiar with the Veterans Health Administration.
(B)
Nonvoting members— In addition to members appointed under subparagraph (A), the Commission shall be composed of 10 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 familiar with government health care systems, including those systems of the Department of Defense, the Indian Health Service, and Federally-qualified health centers (as defined in section 1905(l)(2)(B) of the Social Security Act (42 U.S.C. 1396d(l)(2)(B))).
(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.

Sec. 403 Commission on Capital Planning for Department of Veterans Affairs Medical Facilities

(a)
Establishment of commission—
(1)
Establishment— There is established the Commission on Capital Planning for Department of Veterans Affairs Medical Facilities (in this section referred to as the “Commission”).
(2)
Membership—
(A)
Voting members— The Commission shall, subject to subparagraph (B), be composed of 10 voting members as follows:
(i)
1 shall be appointed by the President.
(ii)
1 shall be appointed by the Administrator of General Services.
(iii)
3 shall be appointed by the Secretary of Veterans Affairs, of whom—
(I)
1 shall be an employee of the Veterans Health Administration;
(II)
1 shall be an employee of the Office of Asset Enterprise Management of the Department of Veterans Affairs; and
(III)
1 shall be an employee of the Office of Construction and Facilities Management of the Department of Veterans Affairs.
(iv)
1 shall be appointed by the Secretary of Defense from among employees of the Army Corps of Engineers.
(v)
1 shall be appointed by the majority leader of the Senate.
(vi)
1 shall be appointed by the minority leader of the Senate.
(vii)
1 shall be appointed by the Speaker of the House of Representatives.
(viii)
1 shall be appointed by the minority leader of the House of Representatives.
(B)
Requirement relating to certain appointments of voting members— Of the members appointed pursuant to clause (i), (ii), and (iv) through (viii) of subparagraph (A), all shall have expertise in capital leasing, construction, or health facility management planning.
(C)
Non-voting members— The Commission shall be assisted by 10 non-voting members, appointed by the vote of a majority of members of the Commission under subparagraph (A), of whom—
(i)
6 shall be representatives of veterans service organizations recognized by the Secretary of Veterans Affairs; and
(ii)
4 shall be individuals from outside the Department of Veterans Affairs with experience and expertise in matters relating to management, construction, and leasing of capital assets.
(D)
Date of appointment of voting members— The appointments of the members of the Commission under subparagraph (A) 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 7 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 Chair.
(6)
Quorum— A majority of the members of the Commission shall constitute a quorum, but a lesser number of members may hold hearings.
(7)
Chair and vice chair— The Commission shall select a Chair and Vice Chair from among its members.
(b)
Duties of commission—
(1)
In general— The Commission shall undertake a comprehensive evaluation and assessment of various options for capital planning for Department of Veterans Affairs medical facilities, including an evaluation and assessment of the mechanisms by which the Department currently selects means for the delivery of health care, whether by major construction, major medical facility leases, sharing agreements with the Department of Defense, the Indian Health Service, and Federally Qualified Health Clinics under section 330 of the Public Health Service Act (42 U.S.C. 254b), contract care, multisite care, telemedicine, extended hours for care, or other means.
(2)
Context of evaluation and assessment— In undertaking the evaluation and assessment, the Commission shall consider—
(A)
the importance of access to health care through the Department, including associated guidelines of the Department on access to, and drive time for, health care;
(B)
limitations and requirements applicable to the construction and leasing of medical facilities for the Department, including applicable laws, regulations, and costs as determined by both the Congressional Budget Office and the Office of Management and Budget;
(C)
the nature of capital planning for Department medical facilities in an era of fiscal uncertainty;
(D)
projected future fluctuations in the population of veterans; and
(E)
the extent to which the Department was able to meet the mandates of the Capital Asset Realignment for Enhanced Services Commission.
(3)
Particular considerations— In undertaking the evaluation and assessment, the Commission shall address, in particular, the following:
(A)
The Major Medical Facility Lease Program of the Department, including an identification of potential improvements to the lease authorization processes under that Program.
(B)
The management processes of the Department for its Major Medical Facility Construction Program, including processes relating to contract award and management, project management, and processing of change orders.
(C)
The overall capital planning program of the Department for medical facilities, including an evaluation and assessment of—
(i)
the manner in which the Department determines whether to use capital or non-capital means to expand access to health care;
(ii)
the manner in which the Department determines the disposition of under-utilized and un-utilized buildings on campuses of Department medical centers, and any barriers to disposition;
(iii)
the effectiveness of the facility master planning initiative of the Department; and
(iv)
the extent to which sustainable attributes are planned for to decrease operating costs for Department medical facilities.
(D)
The current backlog of construction projects for Department medical facilities, including an identification of the most effective means to quickly secure the most critical repairs required, including repairs relating to facility condition deficiencies, structural safety, and compliance with the Americans With Disabilities Act of 1990.
(4)
Reports— Subject to paragraph (5), the Commission shall submit to the Secretary of Veterans Affairs, and to the Committee Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives, reports as follows:
(A)
Not later than six months after its initial meeting under subsection (a)(4), a report on the Major Medical Facility Lease Program and the Congressional lease authorization process.
(B)
Not later than one year after its initial meeting, a report—
(i)
on the management processes of the Department for the construction of Department medical facilities; and
(ii)
setting forth an update of any matters covered in the report under subparagraph (A).
(C)
Not later than 18 months after its initial meeting, a report—
(i)
on the overall capital planning program of the Department for medical facilities; and
(ii)
setting forth an update of any matters covered in earlier reports under this paragraph.
(D)
Not later than two years after its initial meeting, a report—
(i)
on the current backlog of construction projects for Department medical facilities;
(ii)
setting forth an update of any matters covered in earlier reports under this paragraph; and
(iii)
including such other matters relating to the duties of the Commission that the Commission considers appropriate.
(E)
Not later than 27 months after its initial meeting, a report on the implementation by the Secretary of Veterans Affairs pursuant to subsection (g) of the recommendations included pursuant to paragraph (5) in the reports under this paragraph.
(5)
Recommendations— Each report under paragraph (4) shall include, for the aspect of the capital asset planning process of the Department covered by such report, such recommendations as the Commission considers appropriate for the improvement and enhancement of such aspect of the capital asset planning process.
(c)
Powers of 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 Chair 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 Chair 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 Chair 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 Chair 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 commission— The Commission shall terminate 60 days after the date on which the Commission submits its report under subsection (b)(4)(E).
(f)
Funding— The Secretary of Veterans Affairs shall make available to the Commission such amounts as the Secretary and the Chair of the Commission jointly consider appropriate for the Commission to perform its duties under this section.
(g)
Action on recommendations—
(1)
In general— The Secretary of Veterans Affairs shall implement each recommendation included in a report under subsection (b)(4) that the Secretary considers feasible and advisable and can be implemented without further legislative action.
(2)
Reports— Not later than 120 days after receipt of a report under subparagraphs (A) through (D) of subsection (b)(4), the Secretary shall submit to the Committee Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives a report setting forth the following:
(A)
An assessment of the feasibility and advisability of each recommendation contained in such report.
(B)
For each recommendation assessed as feasible and advisable—
(i)
if such recommendation does not require further legislative action for implementation, a description of the actions taken, and to be taken, by the Secretary to implement such recommendation; and
(ii)
if such recommendation requires further legislative action for implementation, recommendations for such legislative action.

Sec. 404 Removal of Senior Executive Service employees of the Department of Veterans Affairs for performance

(a)
Removal or transfer—
(1)
In general— Chapter 7 of title 38, United States Code, is amended by adding at the end the following new section:

“713. Senior Executive Service: removal based on performance

“(a) In general—The Secretary may remove any individual from the Senior Executive Service if the Secretary determines the performance of the individual warrants such removal. If the Secretary so removes such an individual, the Secretary may—

“(1) remove the individual from the civil service (as defined in section 2101 of title 5); or

“(2) transfer the individual to a General Schedule position at any grade of the General Schedule for which the individual is qualified and that the Secretary determines is appropriate.

“(b) Notice to Congress—Not later than 30 days after removing or transferring an individual from the Senior Executive Service under paragraph (1), the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives notice in writing of such removal or transfer and the reason for such removal or transfer.

“(c) Appeal of removal or transfer—Any removal or transfer under subsection (a) may be appealed to the Merit Systems Protection Board under section 7701 of title 5 not later than 7 days after such removal or transfer.

“(d) Expedited review by Merit Systems Protection Board

“(1) The Merit Systems Protection Board shall expedite any appeal under section 7701 of title 5 of a removal or transfer under subsection (a) and, in any such case, shall issue a decision not later than 21 days after the date of the appeal.

“(2) In any case in which the Merit Systems Protection Board determines that it cannot issue a decision in accordance with the 21-day requirement under paragraph (1), the Merit Systems Protection Board shall submit to Congress a report that explains the reason why the Merit Systems Protection Board is unable to issue a decision in accordance with such requirement in such case.

“(3) There is authorized to be appropriated such sums as may be necessary for the Merit Systems Protection Board to expedite appeals under paragraph (1).

“(4) The Merit Systems Protection Board may not stay any personnel action taken under this section.”

(2)
Clerical amendment— The table of sections at the beginning of such chapter is amended by adding at the end the following new item:
(b)
Establishment of expedited review process—
(1)
In general— Not later than 30 days after the date of the enactment of this Act, the Merit Systems Protection Board shall establish and put into effect a process to conduct expedited reviews in accordance with section 713(d) of title 38, United States Code.
(2)
Inapplicability of certain regulations— Section 1201.22 of title 5, Code of Federal Regulations, as in effect on the day before the date of the enactment of this Act, shall not apply to expedited reviews carried out under section 713(d) of title 38, United States Code.
(3)
Report by Merit Systems Protection Board— Not later than 30 days after the date of the enactment of this Act, the Merit Systems Protection Board shall submit to Congress a report on the actions the Board plans to take to conduct expedited reviews under section 713(d) of title 38, United States Code, as added by subsection (a). Such report shall include a description of the resources the Board determines will be necessary to conduct such reviews and a description of whether any resources will be necessary to conduct such reviews that were not available to the Board on the day before the date of the enactment of this Act.
(c)
Temporary exemption from certain limitation on initiation of removal from Senior Executive Service— During the 120-day period beginning on the date of the enactment of this Act, an action to remove an individual from the Senior Executive Service at the Department of Veterans Affairs pursuant to section 713 of title 38, United States Code, as added by subsection (a), or section 7543 of title 5, United States Code, may be initiated, notwithstanding section 3592(b) of title 5, United States Code, or any other provision of law.
(d)
Construction— Nothing in this section or section 713 of title 38, United States Code, as added by subsection (a), shall be construed to apply to an appeal of a removal, transfer, or other personnel action that was pending before the date of the enactment of this Act.